US20100234961A1 - High Performance Knee Prostheses - Google Patents
High Performance Knee Prostheses Download PDFInfo
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- US20100234961A1 US20100234961A1 US12/781,526 US78152610A US2010234961A1 US 20100234961 A1 US20100234961 A1 US 20100234961A1 US 78152610 A US78152610 A US 78152610A US 2010234961 A1 US2010234961 A1 US 2010234961A1
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- knee
- lateral
- femoral component
- medial
- flexion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3886—Joints for elbows or knees for stabilising knees against anterior or lateral dislocations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3836—Special connection between upper and lower leg, e.g. constrained
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3859—Femoral components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/389—Tibial components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3868—Joints for elbows or knees with sliding tibial bearing
Definitions
- the invention relates generally to knee prostheses and, more specifically, to knee prostheses which more closely emulate the anatomy and function of the knee and thereby feature range of flexion, rotation of the tibia relative to the femur, the screw home mechanism, and other structural and functional characteristics of the actual knee joint.
- TKS total knee replacement
- a surgeon typically affixes two prosthetic components to the patient's bone structure; a first to the patient's femur and a second to the patient's tibia. These components are typically known as the femoral component and the tibial component respectively.
- the femoral component is placed on a patient's distal femur after appropriate resection of the femur.
- the femoral component is usually metallic, having a highly polished outer condylar articulating surface, which is commonly J-shaped.
- a common type of tibial component uses a tray or plateau that generally conforms to the patient's resected proximal tibia.
- the tibial component also usually includes a stern that extends at an angle to the plateau in order to extend into a surgically formed opening in the patient's intramedullary canal.
- the tibial component and tibial stem are both usually metallic.
- a plastic or polymeric (often ultra high molecular weight polyethylene) insert or bearing fits between the tray of the tibial component and the femoral component. This insert provides a surface against which the femoral component condylar portion articulates, i.e., moves in gross motion corresponding generally to the motion of the femur relative to the tibia.
- TKR's are tricompartmental designs; they replace three separate articulating surfaces within the knee joint: the patello-femoral compartment and the lateral and medial inferior tibio-femoral compartments.
- Most currently available TKR's are designed to articulate from a position of slight hyperextension to approximately 115 to 130° flexion.
- a tricompartmental design can meet the needs of most TKR patients even though the healthy human knee is capable of a range of motion (ROM) approaching 170°.
- ROM range of motion
- TKR patients who have a particular need to obtain high flexion in the knee joint.
- a TKR that permits patients to achieve a ROM in excess of 130° is desirable to allow deep kneeling, squatting and sitting on the floor with the legs tucked underneath.
- TKR patients a common complaint of TKR patients is that the replaced knee does not does function like a normal knee or “feel normal”. The replaced knee does not achieve normal knee kinematics or motion and generally has a more limited ROM than a normal knee.
- Currently available designs produce kinematics different than the normal knee during gait, due to the complex nature of the knee joint and the motion of the femur and tibia relative to one another during flexion and extension. For example, it is known that, in addition to rotating about a generally horizontal axis during flexion and extension, the tibia also rotates about its longitudinal axis. Such longitudinal rotation is typically referred to as either external or internal rotation, depending on whether reference is being made to the femur or tibia respectively.
- Devices according to aspects of the invention achieve more faithful replication of the structure and function of the actual knee joint by, among other things, adoption and use of structure and shaping of at least the polymeric insert and the femoral component to cause these components to cooperate with each other in new and unconventional ways (at least in the art of prosthetics) at various stages throughout the range of knee motion.
- a knee prosthesis in which the insert features a lateral posterior surface which slopes in a distal direction (as compared to the corresponding medial posterior surface) as it continues toward the posterior aspect of the insert, in order to cooperate with the lateral condyle of the femoral component to impart internal rotation to the tibia as the knee flexes between substantially 0 and substantially 130 degrees of flexion, to allow the prosthesis to induce or allow tibial internal rotation in a controllable manner as a function of flexion, to reduce the forces of any femoral component cam acting upon a post or other raised portion of the insert, or any combinations of these.
- a knee prosthesis in which the insert features a greater thickness in certain lateral portions to increase durability, accommodate a more anatomic femoral component which features a lateral condyle smaller in some dimensions than its medial condyle, to impart a joint line more accurately replicating natural physiology, or any combinations of these.
- a knee prosthesis in which the insert features more anatomic sulcus placement in order improve operation of the prosthesis by more anatomically applying forces imposed on the prosthesis by quadriceps and the patellar tendon, allow the prosthesis to replicate natural anatomy more effectively, or any combinations of these.
- a knee prosthesis in which the insert features a lateral surface that is curved or “swept” in plan, in order to allow the lateral condyle to track in arcuate fashion on the bearing surface at certain ranges of knee flexion and rotation, to assist in facilitating the screw home mechanism, or combinations of these.
- a knee prosthesis in which the insert features a post or other raised portion whose anterior surface is shaped to serve effectively as an anterior cruciate ligament when engaged with a cam during ranges of flexion such as after heel strike upon actuation of the quadriceps combinations of these.
- a knee prosthesis in which the insert features a post or other raised portion whose posterior surface is shaped to assist internal rotation of the tibia relative to the femur as the knee flexes, such as starting at angles such as in a range of substantially 50 or more degrees, to help ensure that post/cam forces are directed net anteriorly, or a combination of these.
- a knee prosthesis in which the insert features rounded or chamfered peripheral edges to help reduce wear on surrounding tissue and/or for other purposes.
- knee prosthesis with any desired combination or permutation of any of the foregoing features, properties or results.
- a knee prosthesis including a femoral component that includes a lateral condyle that is in some distal and posterior aspect small than corresponding dimensions of the medial condyle, in order to simulate more closely natural physiology, allow adequate insert thickness under the lateral condyle so that, for instance, the posteriolateral surface of the insert can feature convexity or slope, assist internal rotation of the tibia relative to the femur as the knee flexes from substantially 0 degrees to substantially 130 degrees, or any combinations of these.
- a knee prosthesis including a femoral component that includes a lateral condyle with anterior surfaces more pronounced than corresponding anterior surfaces on the medial condyle, in order to replicate more closely natural anatomic structures in retaining the patella in lower ranges of flexion, cause the patella or substitute to track more physiologically at such ranges of motion, cause the quadriceps more physiologically to apply force to the prosthetic components and tibia in lower ranges of flexion, or any combinations of these.
- a knee prosthesis including a femoral component that includes a cam that cooperates with a post or other raised portion on the insert to assist internal rotation on the tibia, ensure that cam/post forces are directed net anteriorly or a combination of these.
- a knee prosthesis including a femoral component that includes an anterior cam which cooperates with a post or other raised portion on the insert to simulate action of the anterior cruciate ligament at lower ranges of flexion.
- a knee prosthesis including a femoral component and an insert in which during operation in situ, the femoral component is situated more anteriorly on the insert at low angles of flexion than in conventional knee prostheses, in order to reduce the forces on the post of the insert, to resemble more closely actual operation and kinematics of the knee, or a combination of these.
- a knee prosthesis including a femoral component and an insert which during operation in situ reduces paradoxical motion and actual cam to post contact, and when there is contact, reduces impact of contact and force of contact, between the femoral component cam and the insert post or other raised portion during desired ranges of motion.
- a knee prosthesis including a femoral component which features a backdrafted anterior slope of the interior surfaces of the posterior condylar portions, in order to allow the distal portion of the femur to be resected so that the anterior cut and the posterior cut are not parallel, such that the distal extremity of the femur is physically greater in anterior-posterior dimension than portions more proximal, whereby the distal extremity of the femur can be physically captured by the interior surfaces of the femoral component.
- a knee prosthesis which helps impart internal rotation to the tibia as the knee flexes from substantially 0 degrees of flexion to substantially 130 degrees of flexion, such that the tibia is substantially fully internally rotated to an angle of at least approximately 8 degrees in order to allow such flexion to occur in more physiological fashion, to reduce the possibility that the quadriceps will pull the patella undesirably relative to the knee in a lateral direction (lateral subluxation), to allow the patella or its replacement to track the trochlear groove, or any combinations of these.
- a knee prosthesis which helps impart internal rotation of the tibia as the knee flexes between substantially zero degrees and substantially 130 degrees, to at least substantially 8 degrees of internal rotation of the tibia relative to the femur at flexion angles greater than 130 degrees
- a knee prosthesis which imparts internal rotation of the tibia relative to the femur as the knee flexes from substantially 0 degrees to substantially 130 degrees of flexion, so that the tibia is substantially fully internally rotated relative to the femur to an angle of at least substantially 8 degrees at a flexion angle of substantially 130 degrees, such flexion and internal rotation of the tibia being facilitated at least in part by a twisting moment created by contact of the condyles of the femoral component on the insert.
- a knee prosthesis which imparts internal rotation of the tibia relative to the femur as the knee flexes from substantially 0 degrees to substantially 130 degrees of flexion, so that the tibia is substantially fully internally rotated relative to the femur to an angle of at least substantially 8 degrees at a flexion angle of substantially 130 degrees, such flexion and internal rotation of the tibia being facilitated at least in part by a twisting moment created by contact between the post or other raised portion of the insert and at least one cam of the femoral component.
- a knee prosthesis whose structure facilitates the screw home mechanism.
- a knee prosthesis which allows flexion at flexion angles greater than 130 degrees while allowing internal rotation of the tibia relative to the femur as the knee flexes from substantially 0 degrees to substantially 130 degrees, without the need for a mobile bearing design or to allow the insert to swivel or rotate relative to the tibial component.
- a femoral, patella and insert structure comprising: a femoral, patella and insert structure, physiological data regarding structure and function of natural knees, and applying at least six force vectors to the structure throughout a desired range of motion to effectively and efficiently simulate forces applied to the tibia in the body: force applied by the patella ligament, ground reaction force, relative force applied by the lateral condyle on the insert, relative force applied by the medial condyle on the insert, force applied by the hamstring muscles, and relative force applied by the cam surfaces of the femoral component on the post or other raised portion of the insert.
- a knee prosthesis comprising:
- a knee prosthesis comprising a femoral component adapted to fit on a distal end of a femur, the femoral component including:
- FIG. 1A shows a perspective view of a left knee prosthesis according to an embodiment of the invention.
- FIGS. 1B-1C show an exploded front perspective view of a femoral component and an insert of a left knee prosthesis according to an embodiment of the invention.
- FIG. 2 shows an exploded back perspective view of a femoral component and an insert of a left knee prosthesis according to an embodiment of the invention.
- FIG. 3 shows an exploded front perspective view of a femoral component and an insert of a left knee prosthesis according to an embodiment of the invention.
- FIG. 4 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the left knee at full extension.
- FIG. 5 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 30° flexion.
- FIG. 6 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 60° flexion.
- FIG. 7 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 90° flexion.
- FIG. 8 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 120° flexion.
- FIG. 9 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 130° flexion.
- FIG. 10 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 140° flexion.
- FIG. 11 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 150° flexion.
- FIG. 12 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at full extension.
- FIG. 13 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 30° flexion.
- FIG. 14 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 60° flexion.
- FIG. 15 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 90° flexion.
- FIG. 16 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 120° flexion.
- FIG. 17 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 130° flexion.
- FIG. 18 is a top plan view of portions of a left knee prosthesis according to, an embodiment of the invention showing the kinematics of the knee at 140° flexion.
- FIG. 19 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 150° flexion.
- FIG. 20 shows a front plan view of a left knee prosthesis according to an embodiment of the invention.
- FIG. 21 shows certain aspects of a femoral component of a knee prosthesis according to an embodiment of the invention.
- FIG. 22 shows certain aspects of a cam of a femoral component of a knee prosthesis according to an embodiment of the invention.
- FIG. 23 shows certain aspects of a proximal surface of an insert of a knee prosthesis according to an embodiment of the invention.
- FIG. 24 is a cross sectional view showing certain aspects of a lateral bearing surface of a knee prosthesis according to an embodiment of the invention.
- Various embodiments of the invention provide improved knee prostheses for replacing at least a portion of a knee joint between the distal end of a femur and the proximal end of a tibia.
- knee prostheses which more faithfully and closely replicated the function, anatomy and physiology of the normal human knee would yield a number of advantages.
- such prostheses would provide an increased range of motion and would function more normally particularly in extension, deep flexion and during normal gait. They would take into account the forces imposed on the knee by quadriceps and hamstrings actuation, forces which great in magnitude but not fully considered in conventional knee prosthesis design.
- Knee prostheses according to various aspects of the invention recognize that during movement of the knee, particularly during flexion, the position and orientation (kinematics) of the bones of the knee are a result of achieving equilibrium of the forces that cause motion of the knee (kinetics).
- aspects of the invention take into account that anatomy influences kinetics and kinetics determine kinematics.
- Knee prostheses provide various surfaces on at least the femoral component and the insert which promote such greater flexion, the screw home mechanism, internal rotation of the tibia relative to the femur as the knee flexes, and other characteristics of the natural knee.
- the design of knee prosthesis components is conducted using a process which (1) tests various performance aspects of a proposed design using computer simulation of the design and various forces imposed upon it, (2) allows analysis of the test results for development of improvements to the proposed design; (3) uses test results to change the proposed design (either manually or automatically), (4) tests various performance aspects of the modified design using computer simulation of the design and various forces imposed upon it, and (5) repeats these tasks in an iterative fashion until the performance testing shows an iteratively modified design to feature acceptable performance characteristics.
- FIGS. 1A-1C and 2 - 4 A preferred embodiment of a knee prosthesis according to the invention is shown in FIGS. 1A-1C and 2 - 4 , and identified by the numeral 100 .
- the knee prosthesis 100 shown in these figures is designed to replace at least a portion of a left knee joint between the distal end of a femur and the proximal end of a tibia.
- a mirror image (not shown) of knee prosthesis 100 will replace at least a portion of a right knee between the distal end of a femur and the proximal end of a tibia.
- the knee prosthesis 100 includes a femoral component 200 for mounting to a distal end of a femur, a tibial component 300 for mounting to a proximal end of a tibia, and an insert 400 .
- Embodiments of the femoral component 200 preferably include a medial condylar section 202 , a lateral condylar section 204 and a trochlear groove 206 joining the anterior portions 214 , 216 of the medial and lateral condylar sections 202 , 204 together.
- the medial and lateral condylar sections 202 , 204 are disposed apart from one another to form an intercondylar recess or notch 208 .
- Each condylar section 202 , 204 has an outer surface 210 , 212 for engaging a tibial component 300 or insert 400 as will become apparent.
- each condylar section 202 , 204 preferably have distal portion 218 , 220 for engaging a portion of the tibial component 300 or insert 400 when the knee joint is extended and partially flexed, and posterior portions 222 , 224 for engaging a portion of the tibial component 300 or insert 400 when the knee joint is flexed at angles of substantially 90° or greater.
- Embodiments of a femoral component 200 also replicate the physiological joint line 227 of a normal knee as shown in FIG. 20 .
- the physiological joint line 227 may be considered to be a line extending between the distal most portions of each condyle at a knee flexion angle of zero degrees.
- This physiological joint line is oriented at an angle of approximately 93 degrees from the mechanical axis of the leg (which could also be considered to be 87 degrees from the mechanical axis of the leg depending on perspective), or approximately 3 degrees from horizontal as shown in FIG. 20 .
- the joint line established by prostheses according to certain embodiments and aspects of the invention preferably replicate this physiological joint line 227 as shown in that drawing.
- Embodiments of the femoral component 200 preferably have a thickness approximately matching the bone resection necessary for the total knee replacement.
- Embodiments of the femoral component 200 also preferably have a lateral condylar section 204 that is different in geometry than the geometry of the medial condylar section 202 .
- the size of lateral condylar section 204 is smaller than the size of medial condylar section 202 so that its outer surface distal portion 220 does not extend as far distally as does the outer surface distal portion 218 of medial condylar section 202 .
- the femoral component 200 may include a rounded medial profile. According to certain embodiments, for example, it may feature a medial profile which includes a single radius from 15-160°, and may also include a lateral profile that is less round or curved distally, with a single radius from 10-160°.
- the patella glides caudally on the femoral condyles from full extension to full flexion.
- the patella first begins to articulate with the trochlear groove.
- the patella lies in the intercondylar recess.
- Patellofemoral contact force is substantially body weight when walking, and increases to substantially 5 times body weight when stair climbing.
- Knee prostheses incorporate features that allow the patellar implant of the knee prostheses to move in a way similar to the normal human knee and to withstand the normal patellofemoral contact force without unnecessary ligament release. These features include various aspects of the shape of portions of the medial condylar section 202 and the lateral condylar section 204 , to be more consistent with natural anatomical geometry.
- anterior portion 216 of lateral condylar section 204 can be configured to extend further anteriorly than anterior portion 214 of medial condylar section 202 , or to be more abruptly shaped on its surface that cooperates with the patella, so that it acts as a buttress to guide the patella at low flexion angles and in extension.
- Femoral components according to certain embodiments and aspects of the invention can also include a patella-friendly trochlear groove 206 .
- the trochlear groove 206 in such embodiments is substantially S-shaped and lateralizes the patella 500 .
- the trochlear groove 206 further allows for a smooth transition between the anterior portions 214 , 216 of the condylar sections and intercondylar notch 208 . This further reduces the contact forces on the patella 500 .
- Femoral components 200 can include flexed or backdrafted substantially planar interior or bone interface surfaces 223 and 225 (collectively, backdrafted surface 229 ), on the anterior surfaces of posterior portions of medial condyle section 222 and lateral condyle section 224 .
- the interior surfaces 223 , 225 are coplanar and are oriented so that their planes converge with a plane formed by the interior surface 215 on the posterior side of anterior portions 214 and 216 of the femoral component 200 as shown more clearly in FIG. 21 .
- proximal portions of these posterior condylar interior surfaces 223 and 225 are located closer to the plane of the interior surface 215 of the anterior portion of the femoral component 200 than are distal portions of surfaces 223 and 225 .
- the convergence angle is in a range of between 1 and 30 degrees, and more preferably, the convergence angle is approximately 15 degrees.
- the backdrafted surface 229 extends the articular surface of the femoral component 200 with minimal bone resection. Removing less bone decreases the likelihood of later femoral fracture. It also minimizes the likelihood that the femoral component 200 will be forced off the end of the femur in deep flexion, since it serves to lock onto or capture the distal end of the femur in the femoral component 200 .
- the femoral component 200 with the backdrafted surface 229 can be installed by hinging and rotating the femoral component 200 onto the resected femur about the posterior portions of the condyles of the femur.
- the inventors have discovered that it is possible, by configuring all anterior surfaces of the femoral component 200 correctly, as shown in FIGS. 4-11 and 21 , for example, to allow those surfaces to physically clear the resected bone as the femoral component is rotated onto the femur during installation.
- Interior surfaces of the component 200 need not be planar or substantially planar to accomplish the objective of capturing or locking onto the femur.
- one or more of them may be curved or partially curved and accomplish this objective by orienting one or both of the interior surfaces of the condylar sections 202 , 204 relative to the interior surface of the anterior portion of the femoral component at other than parallel.
- Certain embodiments of the femoral component 200 may include an anterior cam 230 , as shown in FIGS. 4-11 .
- the anterior cam 230 works with the post or other raised portion 422 of the insert 400 to provide anterior stabilization during early gait.
- the anterior cam 230 preferably includes a large radius to increase the contact area between the anterior cam 230 and the post 422 .
- the anterior cam surface 230 preferably does not engage the anterior surface of the post 422 for approximately 1-2 mm.
- the femoral component 200 may include a posterior cam 232 as shown in FIGS. 4-11 , among other places as well as in a closer view in FIG. 22 .
- the posterior cam 232 is asymmetrical.
- the lateral side 238 may be larger than the medial side 240 , for example, as shown in FIG. 22 .
- the larger lateral side 238 provides optimal contact between the posterior cam 232 and the post 422 during axial rotation, to assist in imparting internal rotation to the tibia relative to the femur as the knee flexes.
- the posterior cam 232 engages the post 422 between 50-60° flexion.
- the post 422 may be thickened distally for additional strength.
- Prostheses according to certain embodiments of the invention which do not need to serve a posterior stabilization function, such as those which can be characterized as cruciate retaining, need not have a post or other raised surface 422 on insert 400 , or cams, such as cams 232 or 230 .
- other surfaces such as portions of the medial and lateral condylar sections 202 , 204 acting without a post or raised surface 422 , for example, achieve or help achieve objectives of aspects of the invention, including allowing or imparting internal rotation to the tibia relative to the femur as the knee flexes, such as from substantially 0 degrees to substantially 130 degrees.
- Certain embodiments of the femoral component 200 may include conventional attachment aids for helping to secure the femoral component 200 to a distal end of a femur.
- Such attachment aids may include one or more pegs, fins, surface treatments including bone ingrowth surfaces, surfaces for accommodating spacers, shims or other structures, or as otherwise desired.
- Tibial components 300 include a tray or base member for being secured to a proximal end of a tibia.
- the base member can include a stabilizing post, which is insertable into the tibial medullary canal and provides for the stabilization of the tibial component 300 on the tibia.
- Tibial components feature a tray member which includes a proximal or upper surface, a distal or lower surface, a medial surface, a lateral surface, an anterior or front surface, and a posterior or rear surface.
- the proximal surface may be substantially flat and planar.
- the tray member preferably includes attachment aids for helping to secure the tray member to a proximal end of a tibia.
- attachment aids may include one or more pegs, fins, screws, surface treatments, etc.
- Femoral components 200 and tibial components 300 may be constructed in various manners and out of various materials.
- the femoral component 200 and tibial component 300 may be machined, cast, forged or otherwise constructed as a one-piece integral unit out of a medical grade, physiologically acceptable metal such as a cobalt chromium alloy or the like, in various sizes to fit a range of typical patients, or may be custom-designed for a specific patient based on data provided by a surgeon after physical and radiography examination of the specific patient.
- Inserts 400 include a proximal or upper surface 402 , a distal or lower surface 404 , a medial surface 406 , a lateral surface 408 , an anterior or front surface 410 , and a posterior or rear surface 412 .
- such an insert 400 may be considered to feature a medial side 414 and a lateral side 416 , corresponding to medial and lateral sides of the limb in which the insert is to be installed.
- the proximal surface 402 of the particular insert 400 has a medial portion 418 for engaging the outer surface 210 of the medial condylar section 202 of the femoral component 200 , and a lateral portion 420 for engaging the outer surface 212 of the lateral condylar section 204 of the femoral component 200 .
- Inserts 400 can include a central post or raised portion 422 as shown in the drawings.
- the post 422 includes a proximal surface 424 , an anterior surface 426 , a posterior surface 428 and medial and lateral side surfaces 430 , 432 .
- the anterior surface 426 of post 422 in an embodiment of the insert is tapered or curved at a desired angle with respect to the distal surface 404 of the insert 400 to minimize impingement of the patella or a patellar implant 500 in deep flexion.
- the base can be tapered as desired in a posterior direction from the anterior surface 426 to minimize impingement of the intercondylar notch 208 of femoral component 200 in hyperextension.
- Inserts 400 of certain embodiments and aspects of the invention as shown in the drawings include an anterior curved surface.
- the anterior curved surface allows room for the patellar tendon (not shown).
- the insert may also include a posterior curved surface.
- the result of the posterior curved surface is the removal of material that may impinge on the posterior cortex of the femur in deep flexion.
- the radius of curvature may vary as desired to provide sufficient room for maximal flexion.
- the distal surface of the insert 400 may be substantially flat or planar for contacting the proximal surface of the tray member of the tibial component 300 .
- the distal surface preferably includes a dovetail or other appropriate locking mechanism that consists of an anterior portion and a posterior portion.
- any conventional method for positioning and/or retaining the insert relative to the tray member, whether constrained or unconstrained, may be used.
- the insert 400 may be allowed to articulate relative to the tray of the tibial component 300 .
- parts of the medial portion 418 of the proximal surface and parts of the lateral portion 420 are shaped to cooperate with outer surfaces 210 of the medial condylar section of femoral component 200 and outer surfaces 212 of the lateral condylar section of the femoral component, as the knee flexes and extends. These parts are referred to as medial insert bearing surface 440 and lateral insert bearing surface 442 .
- posterior parts of the lateral bearing surface 442 of the particular insert shown in the drawings features a reverse slope; that is, the lateral bearing surface slopes toward the bottom or distal surface of the insert 400 as the lateral bearing surface progresses toward the posterior or back periphery of the insert 400 , preferably either through a convex arc or a straight slope.
- the purpose of the slope is to change the direction of the contact force between the lateral bearing surface 442 and the lateral condylar section 204 , in order to add an anterior force on the lateral bearing surface 442 greater than a corresponding anterior force on the medial bearing surface 440 at some angles of knee flexion, to produce or help produce a twisting moment about the longitudinal axis of the tibia or impart or assist in imparting internal rotation of the tibia as the knee flexes.
- this rotation-imparting surface 444 is configured to impart or assist inward tibial rotation relative to the femur as the knee flexes between substantially 0 degrees of flexion to substantially 130 degrees of flexion, the internal rotation angle achieving a magnitude of at least substantially 8 degrees at substantially 130 degrees of knee flexion. Since the contact force vector is perpendicular to the lateral bearing surface 442 , during rollback in the lateral compartment, a component of the contact force vector is generally parallel to the generally anteriorly oriented contact vector acting on the post 422 .
- this contact force not only can help delay engagement of the post 422 with the posterior cam 232 , but it can also beneficially reduce the force required by the post 422 to produce lateral rollback, resist anterior motion of the femoral component 200 relative to the insert 400 , and resist total force which is absorbed by the post 422 in accomplishing posterior stabilization of the knee.
- tibial inward rotation inducing couple on the insert 400 by the femoral component 200 not only by using the posterior cam 232 as discussed below, but also by altering the shape of parts of the medial insert bearing surface 440 or using other structures, surface shaping or other techniques, or any combination of them, as desired.
- the lateral insert bearing surface 442 of the insert features a curved generally concave portion which sweeps laterally from its anterior extremity to approximately its middle, and then back medially from its middle to its posterior extremity, as shown in FIG. 23 , for example.
- a swept surface helps guide the lateral condylar section 202 as the locus of its contact points with the insert 400 move in a posterior direction as the knee flexes.
- Inserts 400 may be constructed in various manners and from various materials. For example, they may be machined, molded or otherwise constructed as a one-piece, integral unit out of medical grade, physiologically acceptable plastic such as ultra high molecular weight polyethylene or the like, in various sizes to fit a range of typical patients, or may be custom-designed for a specific patient based on data provided by a surgeon after physical and radiographic examination of the specific patient.
- the material can be treated, for example, by radiation, chemistry, or other technology to alter its wear properties and/or strength or hardness. Portions of various surfaces of inserts 400 can be treated with radiation, chemicals or other substances or techniques to enhance wear resistance properties; they can also be subjected to suitable surface treatments for such purposes and others.
- the insert 400 shown in the drawings would be thinner between its lateral insert bearing surface 442 and its distal surface 404 than between its medial insert bearing surface 440 and that distal surface 404 . Such thinness may become unacceptable in regions between the rotation inducing surface 444 and the distal surface 404 in the posteriolateral region of the insert 400 .
- lateral parts of the insert 400 may be created thicker than medial parts, as shown for example in FIG. 20 , so that the lateral insert bearing surface 442 is “higher” or more proximal than the medial insert bearing surface 440 .
- a line drawn between the most distal part of the medial insert bearing surface 440 and the most distal part of the lateral insert bearing surface 442 and denominated physiological joint line 227 forms an approximately 3 degree angle from a line perpendicular to the mechanical axis of the leg or in many insert 400 structures, substantially 3 degrees from the plane of the distal surface of the insert 400 .
- This 3 degree angle is similar to the structure of the human knee, where the physiological joint line is usually substantially 3 degrees from the mechanical axis of the joint.
- the lateral contact point 436 of the femoral component 200 and the insert 400 is initially higher than the medial contact point 434 .
- the lateral femoral condyle 204 moves down the arc or slope of tibial rotation inducing surface 444 of insert 400 .
- the epicondylar axis 242 (the line connecting the lateral epicondylar prominence and the medial sulcus of the medial epicondyle) could have a tendency to decline, which could cause rotation about the long axis of the femur and might cause laxity of the LCL. According to certain embodiments of the invention, it would be possible to keep the epicondylar axis 242 at the same height, by causing the sagittal curve of the posterior portion 224 of the lateral condyle 204 to be extended outwardly as could be visualized with reference to, for instance, FIGS. 4-11 .
- the lateral contact point 434 could decline approximately 2.6 mm, so that 2.6 mm would be added to the lateral condyle 204 thickness at a point corresponding to 155 degrees flexion on the condyle to accomplish such a result, although other structures could be created to achieve the same end.
- the femoral component 200 shown in the drawings When assembled, the femoral component 200 shown in the drawings is positioned on the insert 400 so that there is a slight posterior overhang. This optimizes the anterior-posterior patella ligament force components.
- the overhang may be much less than in conventional knee prostheses.
- the posterior overhang of the femoral component 200 may be as much as 6 mm.
- the posterior overhang of the femoral component 200 is approximately 2 mm.
- axial rotation is normal in knee joint motion.
- the “screw-home” mechanism is example of this motion.
- the femur In the normal knee, during knee extension, the femur is positioned anteriorly on the tibial plateau. During the last 20° of knee extension, the femur glides anteriorly on the tibia and produces external tibial rotation.
- This screw-home mechanism in terminal extension results in tightening of both cruciate ligaments and locks the knee such that the tibia is in the position of maximal stability with respect to the femur.
- posterior glide of the femur begins first on the lateral tibial surface. Between approximately 0° and 130° of flexion, posterior glide on the lateral side produces relative tibial internal rotation, a reversal of the screw-home mechanism.
- Knee prostheses 100 incorporate an allowance that mimics the screw-home mechanism.
- the screw-home allowance may be achieved by incorporating a swept surface on the lateral surface 416 of the insert 400 .
- the screw-home allowance is illustrated most clearly in FIG. 12 .
- FIGS. 12-19 demonstrate that as the knee flexes from approximately zero degrees to approximately 130 degrees, the femoral component 200 and the insert 400 rotate relative to each other generally about a closely grouped set of medial contact points 436 .
- the femoral component 200 rotates externally relative to the insert 400 , which would be fixed on a tibial component 300 in a fully assembled knee prosthesis 100 ; or considered from the other perspective, the insert 400 and the tibia rotate internally relative to the femoral component 200 and the femur.
- the asymmetrical shape of the posterior cam 232 reduces force on the central post 422 that would oppose this rotation.
- the rotation continues as the knee flexes to 130 degrees, as shown in FIG. 9 , reaching at least approximately 8 degrees of internal rotation of the tibia relative to the femur. As the knee continues to flex beyond approximately 130 degrees, as shown in FIGS. 10-11 , the internal rotation stays substantially the same, as the relative motion is primarily posterior translation of the femoral component on the insert.
- the central post or raised portion of the insert 400 fits within the intercondylar recess. Because the femoral component 200 and the insert 400 are not fastened to each other, the femoral component 200 is able to easily articulate on the insert 400 .
- FIGS. 4-11 thus sequentially show, from a side cross sectional aspect, kinematics of components of a knee prosthesis according to a preferred embodiment of the invention.
- FIGS. 12-19 show the same kinematics from a plan aspect, looking “down” on the prosthesis.
- These figures show kinematics of the prosthesis components at flexion angles of 0, 30, 60, 90, 120, 130, 140, and 150 degrees, respectively.
- the cam 232 begins contacting the post 422 for posterior stabilization, as shown in FIG. 6 .
- the patella implant 500 moves down the trochlear groove 206 , which is structured according to aspects of the invention to simulate natural anatomy in order to allow the patella implant 500 to track properly, and generally from a lateral to medial position relative to the femoral component 200 as flexion continues.
- the shape of the femoral component accommodates the natural action of the kneecap as a fulcrum on the knee joint for the considerable forces applied by the quadriceps and the patellar ligament.
- 6 major forces on the tibia can be used to simulate what a natural knee experiences during certain activities such as walking: (1) ground reaction force which can range from some part up to multiples of body weight in a normal knee kinetic environment; (2) tension imposed by the quadriceps acting through the patella tendon in a generally proximal direction tending to proximal-posterior in flexion and to proximal-anterior in extension; (3) tension applied by the hamstrings in a generally posterior direction; (4, 5) contact force of each condyle on its corresponding bearing surface of the tibial plateau; and (6) posterior stabilization force imposed by the posterior cruciate ligament or insert on the femur.
- the inventors have recognized that reducing the myriad of forces acting on the knee (such as from various more minor tendons and ligaments) to a manageable number, which may increase as time and processing power continue to evolve, allows for reliable and effective testing of proposed knee prosthesis designs, by accurately simulating what real knees experience.
- This manageable set of conditions may be combined with information that is known about the structure and the kinematics of natural knees to impose an essentially realistic test regime for computer testing and development of acceptable knee prosthetic designs.
- Applying a testing regime using a manageable but essentially realistic set of conditions allows iterative proposal of a design, testing it for performance in virtual, automated fashion in a computer, modification of the proposed design to reduce negative performance characteristics and to enhance positive ones, and repeated iteration of these tasks until an acceptable design is reached.
- the developers may therefore accordingly proceed at least partially iteratively, using test conditions that simulate what a real knee joint experiences and how it performs in such an environment, rather than attempting to design the complicated knee prosthetic components in a deterministic fashion based on anecdotal information, observation of knee components being articulated in the operating room, or based on assumptions that can be static and not reflect the complexity of nature.
Abstract
Description
- This is a divisional application of and claims priority to U.S. application Ser. No. 12/023,112, filed Jan. 31, 2008, which is a continuation application of U.S. patent application Ser. No. 10/743,885, filed Dec. 22, 2003, now U.S. Pat. No. 7,326,252, issued Feb. 5, 2008, which claims priority to U.S. Provisional Ser. No. 60/435,426, filed Dec. 20, 2002, the contents of all of which are incorporated herein in their entities by this reference.
- 1. Field of the Invention
- The invention relates generally to knee prostheses and, more specifically, to knee prostheses which more closely emulate the anatomy and function of the knee and thereby feature range of flexion, rotation of the tibia relative to the femur, the screw home mechanism, and other structural and functional characteristics of the actual knee joint.
- 2. General Background of the Invention
- Disease and trauma affecting the articular surfaces of the knee joint are commonly treated by surgically replacing the ends of the femur and tibia with prosthetic femoral and tibial implants, and, in some cases, replacing the patella with a patella component. Such surgeries are sometimes referred to as total knee replacement (TKR). In TKS surgery, a surgeon typically affixes two prosthetic components to the patient's bone structure; a first to the patient's femur and a second to the patient's tibia. These components are typically known as the femoral component and the tibial component respectively.
- The femoral component is placed on a patient's distal femur after appropriate resection of the femur. The femoral component is usually metallic, having a highly polished outer condylar articulating surface, which is commonly J-shaped.
- A common type of tibial component uses a tray or plateau that generally conforms to the patient's resected proximal tibia. The tibial component also usually includes a stern that extends at an angle to the plateau in order to extend into a surgically formed opening in the patient's intramedullary canal. The tibial component and tibial stem are both usually metallic.
- A plastic or polymeric (often ultra high molecular weight polyethylene) insert or bearing fits between the tray of the tibial component and the femoral component. This insert provides a surface against which the femoral component condylar portion articulates, i.e., moves in gross motion corresponding generally to the motion of the femur relative to the tibia.
- Modern TKR's are tricompartmental designs; they replace three separate articulating surfaces within the knee joint: the patello-femoral compartment and the lateral and medial inferior tibio-femoral compartments. Most currently available TKR's are designed to articulate from a position of slight hyperextension to approximately 115 to 130° flexion. A tricompartmental design can meet the needs of most TKR patients even though the healthy human knee is capable of a range of motion (ROM) approaching 170°. However, there are some TKR patients who have a particular need to obtain high flexion in the knee joint. For many, a TKR that permits patients to achieve a ROM in excess of 130° is desirable to allow deep kneeling, squatting and sitting on the floor with the legs tucked underneath.
- Additionally, a common complaint of TKR patients is that the replaced knee does not does function like a normal knee or “feel normal”. The replaced knee does not achieve normal knee kinematics or motion and generally has a more limited ROM than a normal knee. Currently available designs produce kinematics different than the normal knee during gait, due to the complex nature of the knee joint and the motion of the femur and tibia relative to one another during flexion and extension. For example, it is known that, in addition to rotating about a generally horizontal axis during flexion and extension, the tibia also rotates about its longitudinal axis. Such longitudinal rotation is typically referred to as either external or internal rotation, depending on whether reference is being made to the femur or tibia respectively.
- Very few currently available designs allow this longitudinal rotation. One known method to allow rotation is a mobile-bearing knee prosthesis. In mobile-bearing knee prostheses, the insert has increased contact with the condyles of the femoral component and rotates on top of the tibial component. However, mobile-bearing knee prostheses are less forgiving of soft tissue imbalance, increasing the incidence of bearing spin-out and dislocation. Another concern is that the mobile-bearing prostheses create an additional interface and underside wear may occur.
- Constructing a total knee prosthesis which replicates the kinematics of a natural knee has been an on-going challenge in the orthopaedic field. Several attempts have been made and are well known in the prior art, including those shown in U.S. Pat. Nos. 6,246,697 and 6,325,828. Conventional designs such as these, however, leave room for improvement in simulating the structure and operation of actual knee joints, in at least the aspects of range of motion, internal rotation of the tibia relative to the femur as the knee flexes, and rotation of the tibia relative to the femur in overextension in order to allow the knee to be stabilized more efficiently.
- Devices according to aspects of the invention achieve more faithful replication of the structure and function of the actual knee joint by, among other things, adoption and use of structure and shaping of at least the polymeric insert and the femoral component to cause these components to cooperate with each other in new and unconventional ways (at least in the art of prosthetics) at various stages throughout the range of knee motion.
- According to certain aspects and embodiments of the invention, there is provided a knee prosthesis in which the insert features a lateral posterior surface which slopes in a distal direction (as compared to the corresponding medial posterior surface) as it continues toward the posterior aspect of the insert, in order to cooperate with the lateral condyle of the femoral component to impart internal rotation to the tibia as the knee flexes between substantially 0 and substantially 130 degrees of flexion, to allow the prosthesis to induce or allow tibial internal rotation in a controllable manner as a function of flexion, to reduce the forces of any femoral component cam acting upon a post or other raised portion of the insert, or any combinations of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis in which the insert features a greater thickness in certain lateral portions to increase durability, accommodate a more anatomic femoral component which features a lateral condyle smaller in some dimensions than its medial condyle, to impart a joint line more accurately replicating natural physiology, or any combinations of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis in which the insert features more anatomic sulcus placement in order improve operation of the prosthesis by more anatomically applying forces imposed on the prosthesis by quadriceps and the patellar tendon, allow the prosthesis to replicate natural anatomy more effectively, or any combinations of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis in which the insert features a lateral surface that is curved or “swept” in plan, in order to allow the lateral condyle to track in arcuate fashion on the bearing surface at certain ranges of knee flexion and rotation, to assist in facilitating the screw home mechanism, or combinations of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis in which the insert features a post or other raised portion whose anterior surface is shaped to serve effectively as an anterior cruciate ligament when engaged with a cam during ranges of flexion such as after heel strike upon actuation of the quadriceps combinations of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis in which the insert features a post or other raised portion whose posterior surface is shaped to assist internal rotation of the tibia relative to the femur as the knee flexes, such as starting at angles such as in a range of substantially 50 or more degrees, to help ensure that post/cam forces are directed net anteriorly, or a combination of these.
- Accordingly to certain aspects and embodiments of the invention, there is further provided a knee prosthesis in which the insert features rounded or chamfered peripheral edges to help reduce wear on surrounding tissue and/or for other purposes.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis with any desired combination or permutation of any of the foregoing features, properties or results.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis including a femoral component that includes a lateral condyle that is in some distal and posterior aspect small than corresponding dimensions of the medial condyle, in order to simulate more closely natural physiology, allow adequate insert thickness under the lateral condyle so that, for instance, the posteriolateral surface of the insert can feature convexity or slope, assist internal rotation of the tibia relative to the femur as the knee flexes from substantially 0 degrees to substantially 130 degrees, or any combinations of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis including a femoral component that includes a lateral condyle with anterior surfaces more pronounced than corresponding anterior surfaces on the medial condyle, in order to replicate more closely natural anatomic structures in retaining the patella in lower ranges of flexion, cause the patella or substitute to track more physiologically at such ranges of motion, cause the quadriceps more physiologically to apply force to the prosthetic components and tibia in lower ranges of flexion, or any combinations of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis including a femoral component that includes a cam that cooperates with a post or other raised portion on the insert to assist internal rotation on the tibia, ensure that cam/post forces are directed net anteriorly or a combination of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis including a femoral component that includes an anterior cam which cooperates with a post or other raised portion on the insert to simulate action of the anterior cruciate ligament at lower ranges of flexion.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis including a femoral component and an insert in which during operation in situ, the femoral component is situated more anteriorly on the insert at low angles of flexion than in conventional knee prostheses, in order to reduce the forces on the post of the insert, to resemble more closely actual operation and kinematics of the knee, or a combination of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis including a femoral component and an insert which during operation in situ reduces paradoxical motion and actual cam to post contact, and when there is contact, reduces impact of contact and force of contact, between the femoral component cam and the insert post or other raised portion during desired ranges of motion.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis including a femoral component which features a backdrafted anterior slope of the interior surfaces of the posterior condylar portions, in order to allow the distal portion of the femur to be resected so that the anterior cut and the posterior cut are not parallel, such that the distal extremity of the femur is physically greater in anterior-posterior dimension than portions more proximal, whereby the distal extremity of the femur can be physically captured by the interior surfaces of the femoral component.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis which helps impart internal rotation to the tibia as the knee flexes from substantially 0 degrees of flexion to substantially 130 degrees of flexion, such that the tibia is substantially fully internally rotated to an angle of at least approximately 8 degrees in order to allow such flexion to occur in more physiological fashion, to reduce the possibility that the quadriceps will pull the patella undesirably relative to the knee in a lateral direction (lateral subluxation), to allow the patella or its replacement to track the trochlear groove, or any combinations of these.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis which helps impart internal rotation of the tibia as the knee flexes between substantially zero degrees and substantially 130 degrees, to at least substantially 8 degrees of internal rotation of the tibia relative to the femur at flexion angles greater than 130 degrees
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis which imparts internal rotation of the tibia relative to the femur as the knee flexes from substantially 0 degrees to substantially 130 degrees of flexion, so that the tibia is substantially fully internally rotated relative to the femur to an angle of at least substantially 8 degrees at a flexion angle of substantially 130 degrees, such flexion and internal rotation of the tibia being facilitated at least in part by a twisting moment created by contact of the condyles of the femoral component on the insert.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis which imparts internal rotation of the tibia relative to the femur as the knee flexes from substantially 0 degrees to substantially 130 degrees of flexion, so that the tibia is substantially fully internally rotated relative to the femur to an angle of at least substantially 8 degrees at a flexion angle of substantially 130 degrees, such flexion and internal rotation of the tibia being facilitated at least in part by a twisting moment created by contact between the post or other raised portion of the insert and at least one cam of the femoral component.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis whose structure facilitates the screw home mechanism.
- According to certain aspects and embodiments of the invention, there is further provided a knee prosthesis which allows flexion at flexion angles greater than 130 degrees while allowing internal rotation of the tibia relative to the femur as the knee flexes from substantially 0 degrees to substantially 130 degrees, without the need for a mobile bearing design or to allow the insert to swivel or rotate relative to the tibial component.
- According to certain aspects and embodiments of the invention, there are provided methods of designing knee prosthetic components using simulation of a femoral, patella and insert structure, physiological data regarding structure and function of natural knees, and applying at least six force vectors to the structure throughout a desired range of motion to effectively and efficiently simulate forces applied to the tibia in the body: force applied by the patella ligament, ground reaction force, relative force applied by the lateral condyle on the insert, relative force applied by the medial condyle on the insert, force applied by the hamstring muscles, and relative force applied by the cam surfaces of the femoral component on the post or other raised portion of the insert.
- According to certain aspects and embodiments of the invention, there are provided methods of designing knee prosthetic components using simulation of a femoral and insert structure and applying to the structure throughout a desired range of motion, force vectors that represent relatively greater forces applied by some ligaments, tendons and muscles than others, such as the relatively great forces applied by the quadriceps when they actuate and by the hamstrings when they actuate.
- According to certain aspects and embodiments of the invention, there are provided methods of designing knee prosthetic components using simulation of a femoral and insert structure and applying to the structure a desired set of forces, evaluating the performance of the structure, modifying the structure as simulated in the computer, and repeating the process until a desired design is reached.
- According to additional aspects and embodiments of the invention, there is provided a knee prosthesis comprising:
-
- a femoral component adapted to fit on a distal end of a femur, the femoral component including a lateral condylar structure and a medial condylar structure, the geometry of the lateral condylar structure being different from the geometry of the medial condylar structure; and
- an accommodation structure including a lateral proximal surface adapted to cooperate with the lateral condylar structure of the femoral component, and a medial proximal surface adapted to cooperate with the medial condylar structure of the femoral component, the geometry of the lateral proximal surface and the medial proximal surface being different from each other, to assist in imparting internal rotation on the tibia relative to the femoral component as the knee flexes from substantially zero degrees of flexion to substantially 130 degrees of flexion.
- According to additional aspects and embodiments of the invention, there is provided a knee prosthesis comprising a femoral component adapted to fit on a distal end of a femur, the femoral component including:
-
- an anterior portion which includes an interior surface adapted to interface with the femur;
- a lateral condylar structure which includes a posterior section which in turn includes an interior surface adapted to interface with the femur; and
- a medial condylar structure which includes a posterior section which in turn includes an interior surface adapted to interface with the femur;
- wherein the interior surfaces are adapted to physically capture at least a portion of the femur in the femoral component relative to a distal translation substantially parallel to the anatomic axis of the femur; and
- wherein all interior surfaces of the femoral component are adapted to allow the femoral component to clear resected portions of the femur physically as the femoral component is rotated onto the femur about its posterior portions during installation.
- wherein the interior surfaces are adapted to physically capture at least a portion of the femur in the femoral component relative to a distal translation substantially parallel to the anatomic axis of the femur; and
- Certain embodiments and aspects of the invention also provide other characteristics and benefits, and other objects, features and advantages of various embodiments and aspects of the invention will be apparent in the other parts of this document.
-
FIG. 1A shows a perspective view of a left knee prosthesis according to an embodiment of the invention. -
FIGS. 1B-1C show an exploded front perspective view of a femoral component and an insert of a left knee prosthesis according to an embodiment of the invention. -
FIG. 2 shows an exploded back perspective view of a femoral component and an insert of a left knee prosthesis according to an embodiment of the invention. -
FIG. 3 shows an exploded front perspective view of a femoral component and an insert of a left knee prosthesis according to an embodiment of the invention. -
FIG. 4 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the left knee at full extension. -
FIG. 5 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 30° flexion. -
FIG. 6 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 60° flexion. -
FIG. 7 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 90° flexion. -
FIG. 8 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 120° flexion. -
FIG. 9 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 130° flexion. -
FIG. 10 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 140° flexion. -
FIG. 11 is a side view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 150° flexion. -
FIG. 12 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at full extension. -
FIG. 13 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 30° flexion. -
FIG. 14 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 60° flexion. -
FIG. 15 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 90° flexion. -
FIG. 16 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 120° flexion. -
FIG. 17 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 130° flexion. -
FIG. 18 is a top plan view of portions of a left knee prosthesis according to, an embodiment of the invention showing the kinematics of the knee at 140° flexion. -
FIG. 19 is a top plan view of portions of a left knee prosthesis according to an embodiment of the invention showing the kinematics of the knee at 150° flexion. -
FIG. 20 shows a front plan view of a left knee prosthesis according to an embodiment of the invention. -
FIG. 21 shows certain aspects of a femoral component of a knee prosthesis according to an embodiment of the invention. -
FIG. 22 shows certain aspects of a cam of a femoral component of a knee prosthesis according to an embodiment of the invention. -
FIG. 23 shows certain aspects of a proximal surface of an insert of a knee prosthesis according to an embodiment of the invention. -
FIG. 24 is a cross sectional view showing certain aspects of a lateral bearing surface of a knee prosthesis according to an embodiment of the invention. - Various embodiments of the invention provide improved knee prostheses for replacing at least a portion of a knee joint between the distal end of a femur and the proximal end of a tibia.
- While not wishing to be bound by any particular theory, the inventors have discovered that knee prostheses which more faithfully and closely replicated the function, anatomy and physiology of the normal human knee would yield a number of advantages. Among other things, such prostheses would provide an increased range of motion and would function more normally particularly in extension, deep flexion and during normal gait. They would take into account the forces imposed on the knee by quadriceps and hamstrings actuation, forces which great in magnitude but not fully considered in conventional knee prosthesis design. Knee prostheses according to various aspects of the invention recognize that during movement of the knee, particularly during flexion, the position and orientation (kinematics) of the bones of the knee are a result of achieving equilibrium of the forces that cause motion of the knee (kinetics). Additionally, the shape of the articular surfaces (anatomy) acting in combination with forces imposed by various muscles, ligaments and tendons, determines the direction of the large contact forces. Therefore, aspects of the invention take into account that anatomy influences kinetics and kinetics determine kinematics.
- Conventional knee prostheses have been developed without recognition of the full range of kinetics of active knee movement. Many are primarily concerned with achieving greater flexion. However, in addition to flexion and extension, motion of the knee is both rotational and translational. The femoral condyles both roll and glide as they articulate with respect to the tibial plateaus. As the knee moves from full extension into flexion the axis of rotation between the femur and the tibia moves posteriorly relative to both the femur and the tibia. Additionally, in the normal human knee, internal rotation of the tibia relative to the femur occurs as the knee flexes between full extension and approximately 130° of flexion. Knee prostheses according to various aspects of the invention provide various surfaces on at least the femoral component and the insert which promote such greater flexion, the screw home mechanism, internal rotation of the tibia relative to the femur as the knee flexes, and other characteristics of the natural knee.
- According to some aspects of the invention; the design of knee prosthesis components is conducted using a process which (1) tests various performance aspects of a proposed design using computer simulation of the design and various forces imposed upon it, (2) allows analysis of the test results for development of improvements to the proposed design; (3) uses test results to change the proposed design (either manually or automatically), (4) tests various performance aspects of the modified design using computer simulation of the design and various forces imposed upon it, and (5) repeats these tasks in an iterative fashion until the performance testing shows an iteratively modified design to feature acceptable performance characteristics. It is also significant that in such performance testing, the performance of the proposed design is tested using forces that occur at various points in various activities, so that the performance testing is dynamic across extended ranges of motion and takes into account considerable forces placed on the design by actuation of the quadriceps and hamstring muscles, for example, and the consequent kinetic and kinematic effects of such forces.
- A preferred embodiment of a knee prosthesis according to the invention is shown in
FIGS. 1A-1C and 2-4, and identified by the numeral 100. Theknee prosthesis 100 shown in these figures is designed to replace at least a portion of a left knee joint between the distal end of a femur and the proximal end of a tibia. A mirror image (not shown) ofknee prosthesis 100 will replace at least a portion of a right knee between the distal end of a femur and the proximal end of a tibia. - The
knee prosthesis 100 includes afemoral component 200 for mounting to a distal end of a femur, atibial component 300 for mounting to a proximal end of a tibia, and aninsert 400. - Embodiments of the
femoral component 200 preferably include amedial condylar section 202, alateral condylar section 204 and atrochlear groove 206 joining theanterior portions condylar sections condylar sections condylar section outer surface tibial component 300 or insert 400 as will become apparent. Theouter surfaces condylar section distal portion tibial component 300 or insert 400 when the knee joint is extended and partially flexed, andposterior portions tibial component 300 or insert 400 when the knee joint is flexed at angles of substantially 90° or greater. - Embodiments of a
femoral component 200 according certain aspects of this particular nonlimiting embodiment of the invention also replicate the physiologicaljoint line 227 of a normal knee as shown inFIG. 20 . The physiologicaljoint line 227 may be considered to be a line extending between the distal most portions of each condyle at a knee flexion angle of zero degrees. This physiological joint line is oriented at an angle of approximately 93 degrees from the mechanical axis of the leg (which could also be considered to be 87 degrees from the mechanical axis of the leg depending on perspective), or approximately 3 degrees from horizontal as shown inFIG. 20 . The joint line established by prostheses according to certain embodiments and aspects of the invention preferably replicate this physiologicaljoint line 227 as shown in that drawing. - Embodiments of the
femoral component 200 preferably have a thickness approximately matching the bone resection necessary for the total knee replacement. - Embodiments of the
femoral component 200 also preferably have alateral condylar section 204 that is different in geometry than the geometry of themedial condylar section 202. In the embodiment shown inFIG. 1 , the size of lateralcondylar section 204 is smaller than the size of medialcondylar section 202 so that its outer surfacedistal portion 220 does not extend as far distally as does the outer surfacedistal portion 218 of medialcondylar section 202. - The
femoral component 200 may include a rounded medial profile. According to certain embodiments, for example, it may feature a medial profile which includes a single radius from 15-160°, and may also include a lateral profile that is less round or curved distally, with a single radius from 10-160°. - In the normal human knee, the patella glides caudally on the femoral condyles from full extension to full flexion. By 20 to 30 degrees of flexion, the patella first begins to articulate with the trochlear groove. At extreme flexion, the patella lies in the intercondylar recess. Initially the patella contact occurs distally and with increased flexion the contact areas shift proximally on the patella. Patellofemoral contact force is substantially body weight when walking, and increases to substantially 5 times body weight when stair climbing. These contact forces therefore impose a substantial toad on the knee joint, which prostheses according to certain embodiments and aspects specifically take into account.
- Knee prostheses according to certain embodiments and aspects of the invention incorporate features that allow the patellar implant of the knee prostheses to move in a way similar to the normal human knee and to withstand the normal patellofemoral contact force without unnecessary ligament release. These features include various aspects of the shape of portions of the
medial condylar section 202 and thelateral condylar section 204, to be more consistent with natural anatomical geometry. For instance,anterior portion 216 of lateralcondylar section 204 can be configured to extend further anteriorly thananterior portion 214 of medialcondylar section 202, or to be more abruptly shaped on its surface that cooperates with the patella, so that it acts as a buttress to guide the patella at low flexion angles and in extension. - Femoral components according to certain embodiments and aspects of the invention can also include a patella-friendly
trochlear groove 206. Thetrochlear groove 206 in such embodiments is substantially S-shaped and lateralizes thepatella 500. Thetrochlear groove 206 further allows for a smooth transition between theanterior portions intercondylar notch 208. This further reduces the contact forces on thepatella 500. -
Femoral components 200 according to certain embodiments and aspects of the invention can include flexed or backdrafted substantially planar interior or bone interface surfaces 223 and 225 (collectively, backdrafted surface 229), on the anterior surfaces of posterior portions ofmedial condyle section 222 andlateral condyle section 224. Preferably, theinterior surfaces interior surface 215 on the posterior side ofanterior portions femoral component 200 as shown more clearly inFIG. 21 . In this way, proximal portions of these posterior condylarinterior surfaces interior surface 215 of the anterior portion of thefemoral component 200 than are distal portions ofsurfaces backdrafted surface 229 extends the articular surface of thefemoral component 200 with minimal bone resection. Removing less bone decreases the likelihood of later femoral fracture. It also minimizes the likelihood that thefemoral component 200 will be forced off the end of the femur in deep flexion, since it serves to lock onto or capture the distal end of the femur in thefemoral component 200. - The
femoral component 200 with thebackdrafted surface 229 can be installed by hinging and rotating thefemoral component 200 onto the resected femur about the posterior portions of the condyles of the femur. The inventors have discovered that it is possible, by configuring all anterior surfaces of thefemoral component 200 correctly, as shown inFIGS. 4-11 and 21, for example, to allow those surfaces to physically clear the resected bone as the femoral component is rotated onto the femur during installation. Among other ways to accomplish this configuration are: (1) to cause the interior surfaces to create a shallow interior space; and/or (2) to adjust angles and/or dimensions of the chamfered surfaces that connect theinterior surfaces condylar sections interior surface 215 of the anterior portion of thecomponent 200 to the bottom interior surface of thecomponent 200. - Interior surfaces of the
component 200, includingsurfaces condylar sections - Certain embodiments of the
femoral component 200 may include ananterior cam 230, as shown inFIGS. 4-11 . As explained further below, theanterior cam 230 works with the post or other raisedportion 422 of theinsert 400 to provide anterior stabilization during early gait. Theanterior cam 230 preferably includes a large radius to increase the contact area between theanterior cam 230 and thepost 422. Theanterior cam surface 230 preferably does not engage the anterior surface of thepost 422 for approximately 1-2 mm. - Certain embodiments of the
femoral component 200 may include aposterior cam 232 as shown inFIGS. 4-11 , among other places as well as in a closer view inFIG. 22 . Preferably, theposterior cam 232 is asymmetrical. Thelateral side 238 may be larger than themedial side 240, for example, as shown inFIG. 22 . As explained further below, the largerlateral side 238 provides optimal contact between theposterior cam 232 and thepost 422 during axial rotation, to assist in imparting internal rotation to the tibia relative to the femur as the knee flexes. In general, theposterior cam 232 engages thepost 422 between 50-60° flexion. Thepost 422 may be thickened distally for additional strength. - Prostheses according to certain embodiments of the invention, which do not need to serve a posterior stabilization function, such as those which can be characterized as cruciate retaining, need not have a post or other raised
surface 422 oninsert 400, or cams, such ascams condylar sections surface 422, for example, achieve or help achieve objectives of aspects of the invention, including allowing or imparting internal rotation to the tibia relative to the femur as the knee flexes, such as from substantially 0 degrees to substantially 130 degrees. - Certain embodiments of the
femoral component 200 may include conventional attachment aids for helping to secure thefemoral component 200 to a distal end of a femur. Such attachment aids may include one or more pegs, fins, surface treatments including bone ingrowth surfaces, surfaces for accommodating spacers, shims or other structures, or as otherwise desired. -
Tibial components 300 according to certain embodiments and aspects of the invention include a tray or base member for being secured to a proximal end of a tibia. The base member can include a stabilizing post, which is insertable into the tibial medullary canal and provides for the stabilization of thetibial component 300 on the tibia. - Tibial components according to embodiments and aspects of the invention feature a tray member which includes a proximal or upper surface, a distal or lower surface, a medial surface, a lateral surface, an anterior or front surface, and a posterior or rear surface. The proximal surface may be substantially flat and planar. The tray member preferably includes attachment aids for helping to secure the tray member to a proximal end of a tibia. Such attachment aids may include one or more pegs, fins, screws, surface treatments, etc.
-
Femoral components 200 andtibial components 300 according to certain embodiments and aspects of the invention may be constructed in various manners and out of various materials. For example, thefemoral component 200 andtibial component 300 may be machined, cast, forged or otherwise constructed as a one-piece integral unit out of a medical grade, physiologically acceptable metal such as a cobalt chromium alloy or the like, in various sizes to fit a range of typical patients, or may be custom-designed for a specific patient based on data provided by a surgeon after physical and radiography examination of the specific patient. -
Inserts 400 according to certain embodiments and aspects of the invention include a proximal orupper surface 402, a distal orlower surface 404, amedial surface 406, alateral surface 408, an anterior orfront surface 410, and a posterior orrear surface 412. For convenience, such aninsert 400 may be considered to feature amedial side 414 and alateral side 416, corresponding to medial and lateral sides of the limb in which the insert is to be installed. - The
proximal surface 402 of theparticular insert 400 according to one embodiment of the invention shown in the drawings has amedial portion 418 for engaging theouter surface 210 of themedial condylar section 202 of thefemoral component 200, and alateral portion 420 for engaging theouter surface 212 of thelateral condylar section 204 of thefemoral component 200. -
Inserts 400 according to certain embodiments and aspects of the invention can include a central post or raisedportion 422 as shown in the drawings. Thepost 422 includes aproximal surface 424, ananterior surface 426, aposterior surface 428 and medial and lateral side surfaces 430, 432. Theanterior surface 426 ofpost 422 in an embodiment of the insert, is tapered or curved at a desired angle with respect to thedistal surface 404 of theinsert 400 to minimize impingement of the patella or apatellar implant 500 in deep flexion. The base can be tapered as desired in a posterior direction from theanterior surface 426 to minimize impingement of theintercondylar notch 208 offemoral component 200 in hyperextension. -
Inserts 400 of certain embodiments and aspects of the invention as shown in the drawings include an anterior curved surface. The anterior curved surface allows room for the patellar tendon (not shown). The insert may also include a posterior curved surface. The result of the posterior curved surface is the removal of material that may impinge on the posterior cortex of the femur in deep flexion. The radius of curvature may vary as desired to provide sufficient room for maximal flexion. - The distal surface of the
insert 400 according to certain embodiments and aspects of the invention may be substantially flat or planar for contacting the proximal surface of the tray member of thetibial component 300. The distal surface preferably includes a dovetail or other appropriate locking mechanism that consists of an anterior portion and a posterior portion. However, any conventional method for positioning and/or retaining the insert relative to the tray member, whether constrained or unconstrained, may be used. In other embodiments, theinsert 400 may be allowed to articulate relative to the tray of thetibial component 300. - On the
proximal surface 402 ofinserts 400 according to certain embodiments and aspects of the invention, parts of themedial portion 418 of the proximal surface and parts of thelateral portion 420 are shaped to cooperate withouter surfaces 210 of the medial condylar section offemoral component 200 andouter surfaces 212 of the lateral condylar section of the femoral component, as the knee flexes and extends. These parts are referred to as medialinsert bearing surface 440 and lateralinsert bearing surface 442. - From a sagittal aspect, as shown in
FIGS. 4-11 and also inFIGS. 23 and 24 , posterior parts of thelateral bearing surface 442 of the particular insert shown in the drawings features a reverse slope; that is, the lateral bearing surface slopes toward the bottom or distal surface of theinsert 400 as the lateral bearing surface progresses toward the posterior or back periphery of theinsert 400, preferably either through a convex arc or a straight slope. The purpose of the slope is to change the direction of the contact force between thelateral bearing surface 442 and thelateral condylar section 204, in order to add an anterior force on thelateral bearing surface 442 greater than a corresponding anterior force on themedial bearing surface 440 at some angles of knee flexion, to produce or help produce a twisting moment about the longitudinal axis of the tibia or impart or assist in imparting internal rotation of the tibia as the knee flexes. Preferably, this rotation-impartingsurface 444 is configured to impart or assist inward tibial rotation relative to the femur as the knee flexes between substantially 0 degrees of flexion to substantially 130 degrees of flexion, the internal rotation angle achieving a magnitude of at least substantially 8 degrees at substantially 130 degrees of knee flexion. Since the contact force vector is perpendicular to thelateral bearing surface 442, during rollback in the lateral compartment, a component of the contact force vector is generally parallel to the generally anteriorly oriented contact vector acting on thepost 422. Accordingly, this contact force not only can help delay engagement of thepost 422 with theposterior cam 232, but it can also beneficially reduce the force required by thepost 422 to produce lateral rollback, resist anterior motion of thefemoral component 200 relative to theinsert 400, and resist total force which is absorbed by thepost 422 in accomplishing posterior stabilization of the knee. - It is also possible to generate the tibial inward rotation inducing couple on the
insert 400 by thefemoral component 200 not only by using theposterior cam 232 as discussed below, but also by altering the shape of parts of the medialinsert bearing surface 440 or using other structures, surface shaping or other techniques, or any combination of them, as desired. - Preferably, the lateral
insert bearing surface 442 of the insert as shown in the drawings features a curved generally concave portion which sweeps laterally from its anterior extremity to approximately its middle, and then back medially from its middle to its posterior extremity, as shown inFIG. 23 , for example. Such a swept surface helps guide thelateral condylar section 202 as the locus of its contact points with theinsert 400 move in a posterior direction as the knee flexes. -
Inserts 400 according to certain embodiments and aspects of the invention may be constructed in various manners and from various materials. For example, they may be machined, molded or otherwise constructed as a one-piece, integral unit out of medical grade, physiologically acceptable plastic such as ultra high molecular weight polyethylene or the like, in various sizes to fit a range of typical patients, or may be custom-designed for a specific patient based on data provided by a surgeon after physical and radiographic examination of the specific patient. The material can be treated, for example, by radiation, chemistry, or other technology to alter its wear properties and/or strength or hardness. Portions of various surfaces ofinserts 400 can be treated with radiation, chemicals or other substances or techniques to enhance wear resistance properties; they can also be subjected to suitable surface treatments for such purposes and others. - If the
medial condylar section 202 and thelateral condylar section 204 of thefemoral component 200 were the same size, theinsert 400 shown in the drawings would be thinner between its lateralinsert bearing surface 442 and itsdistal surface 404 than between its medialinsert bearing surface 440 and thatdistal surface 404. Such thinness may become unacceptable in regions between therotation inducing surface 444 and thedistal surface 404 in the posteriolateral region of theinsert 400. To compensate, lateral parts of theinsert 400 may be created thicker than medial parts, as shown for example inFIG. 20 , so that the lateralinsert bearing surface 442 is “higher” or more proximal than the medialinsert bearing surface 440. In certain embodiments of theinsert 400 as shown for example inFIG. 20 , a line drawn between the most distal part of the medialinsert bearing surface 440 and the most distal part of the lateralinsert bearing surface 442 and denominated physiologicaljoint line 227, forms an approximately 3 degree angle from a line perpendicular to the mechanical axis of the leg or in many insert 400 structures, substantially 3 degrees from the plane of the distal surface of theinsert 400. This 3 degree angle is similar to the structure of the human knee, where the physiological joint line is usually substantially 3 degrees from the mechanical axis of the joint. Thelateral contact point 436 of thefemoral component 200 and theinsert 400 is initially higher than themedial contact point 434. During flexion, as thelateral condyle 204 rolls posteriorly, the lateralfemoral condyle 204 moves down the arc or slope of tibialrotation inducing surface 444 ofinsert 400. - In some cases, the epicondylar axis 242 (the line connecting the lateral epicondylar prominence and the medial sulcus of the medial epicondyle) could have a tendency to decline, which could cause rotation about the long axis of the femur and might cause laxity of the LCL. According to certain embodiments of the invention, it would be possible to keep the epicondylar axis 242 at the same height, by causing the sagittal curve of the
posterior portion 224 of thelateral condyle 204 to be extended outwardly as could be visualized with reference to, for instance,FIGS. 4-11 . For example, at 155° flexion, thelateral contact point 434 could decline approximately 2.6 mm, so that 2.6 mm would be added to thelateral condyle 204 thickness at a point corresponding to 155 degrees flexion on the condyle to accomplish such a result, although other structures could be created to achieve the same end. - When assembled, the
femoral component 200 shown in the drawings is positioned on theinsert 400 so that there is a slight posterior overhang. This optimizes the anterior-posterior patella ligament force components. The overhang may be much less than in conventional knee prostheses. For example, in conventional knee prostheses, the posterior overhang of thefemoral component 200 may be as much as 6 mm. However, in knee prosthesis according to certain embodiments and aspects of the invention, the posterior overhang of thefemoral component 200 is approximately 2 mm. - As explained above, axial rotation is normal in knee joint motion. The “screw-home” mechanism is example of this motion. In the normal knee, during knee extension, the femur is positioned anteriorly on the tibial plateau. During the last 20° of knee extension, the femur glides anteriorly on the tibia and produces external tibial rotation. This screw-home mechanism in terminal extension results in tightening of both cruciate ligaments and locks the knee such that the tibia is in the position of maximal stability with respect to the femur.
- When the normal knee begins to flex, posterior glide of the femur begins first on the lateral tibial surface. Between approximately 0° and 130° of flexion, posterior glide on the lateral side produces relative tibial internal rotation, a reversal of the screw-home mechanism.
-
Knee prostheses 100 according to certain embodiments of the invention incorporate an allowance that mimics the screw-home mechanism. The screw-home allowance may be achieved by incorporating a swept surface on thelateral surface 416 of theinsert 400. The screw-home allowance is illustrated most clearly inFIG. 12 .FIGS. 12-19 demonstrate that as the knee flexes from approximately zero degrees to approximately 130 degrees, thefemoral component 200 and theinsert 400 rotate relative to each other generally about a closely grouped set of medial contact points 436. As the knee flexes, thefemoral component 200 rotates externally relative to theinsert 400, which would be fixed on atibial component 300 in a fully assembledknee prosthesis 100; or considered from the other perspective, theinsert 400 and the tibia rotate internally relative to thefemoral component 200 and the femur. The asymmetrical shape of theposterior cam 232 reduces force on thecentral post 422 that would oppose this rotation. - This rotation, along with the increased flexion of the
knee prostheses 100 of the invention, is evident in the series of side views of portions of aknee prosthesis 100 shown inFIGS. 4-11 . To demonstrate the rotation between thefemoral component 200 and theinsert 400, which would be fixed on atibial component 300 in a fully assembledknee prosthesis 100, theinsert 400 shown remains stationary, as thefemoral component 200 rotates substantially about the medial contact point. Thus, as shown inFIG. 4 , the knee is fully extended. As the knee flexes to 90 degrees (shown inFIG. 7 ), thelateral condylar section 204 of thefemoral component 200 rotates posteriorly on thelateral side 416 of theinsert 400. The rotation continues as the knee flexes to 130 degrees, as shown inFIG. 9 , reaching at least approximately 8 degrees of internal rotation of the tibia relative to the femur. As the knee continues to flex beyond approximately 130 degrees, as shown inFIGS. 10-11 , the internal rotation stays substantially the same, as the relative motion is primarily posterior translation of the femoral component on the insert. - As the drawings show, when the
knee prosthesis 100 is assembled, the central post or raised portion of theinsert 400 fits within the intercondylar recess. Because thefemoral component 200 and theinsert 400 are not fastened to each other, thefemoral component 200 is able to easily articulate on theinsert 400. -
FIGS. 4-11 thus sequentially show, from a side cross sectional aspect, kinematics of components of a knee prosthesis according to a preferred embodiment of the invention.FIGS. 12-19 show the same kinematics from a plan aspect, looking “down” on the prosthesis. These figures show kinematics of the prosthesis components at flexion angles of 0, 30, 60, 90, 120, 130, 140, and 150 degrees, respectively. At flexion angles of approximately 50 to 60 degrees, thecam 232 begins contacting thepost 422 for posterior stabilization, as shown inFIG. 6 . As the rotation of thefemoral component 200 continues, thepatella implant 500 moves down thetrochlear groove 206, which is structured according to aspects of the invention to simulate natural anatomy in order to allow thepatella implant 500 to track properly, and generally from a lateral to medial position relative to thefemoral component 200 as flexion continues. In this fashion, the shape of the femoral component accommodates the natural action of the kneecap as a fulcrum on the knee joint for the considerable forces applied by the quadriceps and the patellar ligament. As the knee flexes from substantially zero degrees of flexion to substantially 130 degrees of flexion, the tibialrotation inducing surface 444 of the particular (nonlimiting) structure shown in the drawings acting in combination with thelateral condylar section 204, plus the action of theasymmetrical posterior cam 232 of thefemoral component 200 on thepost 422 of the insert, impart inward rotation to theinsert 400 relative to the femur. This inward rotation corresponds to such inward rotation in the normal knee, and allows, among other things, the lower leg to be “folded” inward relative to the upper leg so that the patellar ligament and tendons from the quadriceps are not forced to be extended over the lateral part of the knee as is the case in some conventional designs. Yet the structure of the components shown in these drawings allows such natural internal rotation and other natural articulation of the tibia and femur relative to each other without freeing rotation of the insert relative to the tibial implant, or freeing other components in the prosthesis to move relative to each other, thereby taxing the other, weaker ligaments and tendons forming part of the knee, which are required to assume the new task of restraining the freed prosthetic components. - Designs more closely approximating the structure and/or operation of the natural knee may be carried out according to the present invention by considering forces acting on the knee that are of more considerable magnitude than other forces. For instance, 6 major forces on the tibia can be used to simulate what a natural knee experiences during certain activities such as walking: (1) ground reaction force which can range from some part up to multiples of body weight in a normal knee kinetic environment; (2) tension imposed by the quadriceps acting through the patella tendon in a generally proximal direction tending to proximal-posterior in flexion and to proximal-anterior in extension; (3) tension applied by the hamstrings in a generally posterior direction; (4, 5) contact force of each condyle on its corresponding bearing surface of the tibial plateau; and (6) posterior stabilization force imposed by the posterior cruciate ligament or insert on the femur. The inventors have recognized that reducing the myriad of forces acting on the knee (such as from various more minor tendons and ligaments) to a manageable number, which may increase as time and processing power continue to evolve, allows for reliable and effective testing of proposed knee prosthesis designs, by accurately simulating what real knees experience. This manageable set of conditions may be combined with information that is known about the structure and the kinematics of natural knees to impose an essentially realistic test regime for computer testing and development of acceptable knee prosthetic designs.
- Applying a testing regime using a manageable but essentially realistic set of conditions allows iterative proposal of a design, testing it for performance in virtual, automated fashion in a computer, modification of the proposed design to reduce negative performance characteristics and to enhance positive ones, and repeated iteration of these tasks until an acceptable design is reached. The developers may therefore accordingly proceed at least partially iteratively, using test conditions that simulate what a real knee joint experiences and how it performs in such an environment, rather than attempting to design the complicated knee prosthetic components in a deterministic fashion based on anecdotal information, observation of knee components being articulated in the operating room, or based on assumptions that can be static and not reflect the complexity of nature.
- The foregoing is provided for disclosure of various embodiments, aspects and structures relating to the invention. Various modifications, additions and deletions may be made to these embodiments and/or structures without departing from the scope and spirit of the invention.
Claims (8)
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Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2012058540A1 (en) * | 2010-10-28 | 2012-05-03 | Jerry Gerald J | Knee system |
WO2012058560A1 (en) * | 2010-10-28 | 2012-05-03 | Jerry Gerald J | Tibial tray system and method of implantation |
US8808387B2 (en) | 2012-01-26 | 2014-08-19 | Epic Ortho, LLC | Prosthetic joint |
US20150134067A1 (en) * | 2011-11-28 | 2015-05-14 | Beijing Naton Technology Group Co., Ltd. | Artificial knee joint |
US9364332B2 (en) | 2011-09-27 | 2016-06-14 | Kyocera Medical Corporation | Artificial knee joint implant |
Families Citing this family (208)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8603095B2 (en) | 1994-09-02 | 2013-12-10 | Puget Bio Ventures LLC | Apparatuses for femoral and tibial resection |
US6695848B2 (en) * | 1994-09-02 | 2004-02-24 | Hudson Surgical Design, Inc. | Methods for femoral and tibial resection |
US8480754B2 (en) * | 2001-05-25 | 2013-07-09 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
US20090222103A1 (en) * | 2001-05-25 | 2009-09-03 | Conformis, Inc. | Articular Implants Providing Lower Adjacent Cartilage Wear |
US9603711B2 (en) * | 2001-05-25 | 2017-03-28 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
US8556983B2 (en) | 2001-05-25 | 2013-10-15 | Conformis, Inc. | Patient-adapted and improved orthopedic implants, designs and related tools |
US8617242B2 (en) * | 2001-05-25 | 2013-12-31 | Conformis, Inc. | Implant device and method for manufacture |
US20110071645A1 (en) * | 2009-02-25 | 2011-03-24 | Ray Bojarski | Patient-adapted and improved articular implants, designs and related guide tools |
US8771365B2 (en) * | 2009-02-25 | 2014-07-08 | Conformis, Inc. | Patient-adapted and improved orthopedic implants, designs, and related tools |
US8545569B2 (en) | 2001-05-25 | 2013-10-01 | Conformis, Inc. | Patient selectable knee arthroplasty devices |
US8735773B2 (en) | 2007-02-14 | 2014-05-27 | Conformis, Inc. | Implant device and method for manufacture |
US8882847B2 (en) * | 2001-05-25 | 2014-11-11 | Conformis, Inc. | Patient selectable knee joint arthroplasty devices |
US20110071802A1 (en) * | 2009-02-25 | 2011-03-24 | Ray Bojarski | Patient-adapted and improved articular implants, designs and related guide tools |
US9289153B2 (en) * | 1998-09-14 | 2016-03-22 | The Board Of Trustees Of The Leland Stanford Junior University | Joint and cartilage diagnosis, assessment and modeling |
ATE414310T1 (en) | 2000-09-14 | 2008-11-15 | Univ Leland Stanford Junior | METHOD FOR MANIPULATION OF MEDICAL IMAGES |
US6558426B1 (en) | 2000-11-28 | 2003-05-06 | Medidea, Llc | Multiple-cam, posterior-stabilized knee prosthesis |
US6719800B2 (en) | 2001-01-29 | 2004-04-13 | Zimmer Technology, Inc. | Constrained prosthetic knee with rotating bearing |
US6485519B2 (en) | 2001-01-29 | 2002-11-26 | Bristol-Myers Squibb Company | Constrained prosthetic knee with rotating bearing |
US8062377B2 (en) | 2001-03-05 | 2011-11-22 | Hudson Surgical Design, Inc. | Methods and apparatus for knee arthroplasty |
DE60239674D1 (en) * | 2001-05-25 | 2011-05-19 | Conformis Inc | METHOD AND COMPOSITIONS FOR REPAIRING THE SURFACE OF JOINTS |
US9308091B2 (en) * | 2001-05-25 | 2016-04-12 | Conformis, Inc. | Devices and methods for treatment of facet and other joints |
EP1460977B1 (en) | 2001-12-21 | 2006-08-30 | Smith & Nephew, Inc. | Hinged joint system |
US7615081B2 (en) * | 2002-05-24 | 2009-11-10 | Zimmer, Inc. | Femoral components for knee arthroplasty |
JP2006501977A (en) | 2002-10-07 | 2006-01-19 | コンフォーミス・インコーポレイテッド | Minimally invasive joint implant with a three-dimensional profile that conforms to the joint surface |
US7796791B2 (en) | 2002-11-07 | 2010-09-14 | Conformis, Inc. | Methods for determining meniscal size and shape and for devising treatment |
WO2004058108A1 (en) | 2002-12-20 | 2004-07-15 | Smith & Nephew, Inc. | High performance knee prostheses |
JP4045194B2 (en) * | 2003-02-25 | 2008-02-13 | 京セラ株式会社 | Artificial knee joint |
US20050143832A1 (en) * | 2003-10-17 | 2005-06-30 | Carson Christopher P. | High flexion articular insert |
US8236060B2 (en) | 2003-12-30 | 2012-08-07 | Zimmer, Inc. | Tethered joint bearing implants and systems |
US7815645B2 (en) * | 2004-01-14 | 2010-10-19 | Hudson Surgical Design, Inc. | Methods and apparatus for pinplasty bone resection |
US8114083B2 (en) * | 2004-01-14 | 2012-02-14 | Hudson Surgical Design, Inc. | Methods and apparatus for improved drilling and milling tools for resection |
US20060030854A1 (en) * | 2004-02-02 | 2006-02-09 | Haines Timothy G | Methods and apparatus for wireplasty bone resection |
US8021368B2 (en) * | 2004-01-14 | 2011-09-20 | Hudson Surgical Design, Inc. | Methods and apparatus for improved cutting tools for resection |
US7857814B2 (en) * | 2004-01-14 | 2010-12-28 | Hudson Surgical Design, Inc. | Methods and apparatus for minimally invasive arthroplasty |
US20060015115A1 (en) * | 2004-03-08 | 2006-01-19 | Haines Timothy G | Methods and apparatus for pivotable guide surfaces for arthroplasty |
JP3915989B2 (en) * | 2004-03-17 | 2007-05-16 | 徹 勝呂 | Artificial knee joint |
US20090036993A1 (en) * | 2004-04-22 | 2009-02-05 | Robert Metzger | Patellar implant |
US7465320B1 (en) * | 2004-05-06 | 2008-12-16 | Biomet Manufacturing Corp. | Knee joint prosthesis |
US8157867B2 (en) | 2004-07-09 | 2012-04-17 | Zimmer, Inc. | Trochlear groove implants and related methods and instruments |
US7806898B2 (en) | 2004-07-09 | 2010-10-05 | Zimmer, Inc. | Modular guide systems and related rasps and methods for resecting a joint articulation surface |
EP1838224B1 (en) * | 2005-01-21 | 2013-04-03 | Medicinelodge, Inc. | Trochlear groove implants and related instruments |
GB0510194D0 (en) * | 2005-05-19 | 2005-06-22 | Mcminn Derek J W | Knee prosthesis |
GB0510193D0 (en) * | 2005-05-19 | 2005-06-22 | Mcminn Derek J W | Knee prosthesis |
US9301845B2 (en) | 2005-06-15 | 2016-04-05 | P Tech, Llc | Implant for knee replacement |
US7413577B1 (en) * | 2005-09-22 | 2008-08-19 | Howmedica Osteonics Corp. | Total stabilized knee prosthesis with constraint |
JP2009516545A (en) * | 2005-11-21 | 2009-04-23 | フィリップ ラング, | Apparatus and method for treating facet joints, pyramidal saddle joints, vertebral joints, and other joints |
US20070179626A1 (en) * | 2005-11-30 | 2007-08-02 | De La Barrera Jose L M | Functional joint arthroplasty method |
US8211181B2 (en) | 2005-12-14 | 2012-07-03 | New York University | Surface guided knee replacement |
US8292964B2 (en) * | 2005-12-14 | 2012-10-23 | New York University | Surface guided knee replacement |
US9592127B2 (en) * | 2005-12-15 | 2017-03-14 | Zimmer, Inc. | Distal femoral knee prostheses |
US7625407B2 (en) * | 2006-02-07 | 2009-12-01 | Howmedica Osteonics Corp. | Tibial prosthesis with asymmetric articular surfaces |
AU2006339993A1 (en) * | 2006-03-14 | 2007-09-20 | Mako Surgical Corp. | Prosthetic device and system and method for implanting prosthetic device |
CN101431967A (en) | 2006-03-21 | 2009-05-13 | 理查德·D·科米斯泰克 | Torque-introducing full joint replacement prosthesis |
GR1005477B (en) * | 2006-04-07 | 2007-03-26 | Total knee arthroplasty consisting in the use of an internal prosthesis composed of a third condylus and a pivoting polyethylene insert | |
ES2568932T3 (en) | 2006-06-30 | 2016-05-05 | Smith & Nephew, Inc. | Articulated prosthesis for anatomical movement |
CA2662785A1 (en) * | 2006-09-06 | 2008-03-13 | Smith & Nephew, Inc. | Implants with transition surfaces and related processes |
DE102006042829A1 (en) * | 2006-09-08 | 2008-03-27 | Siebel, Thomas, Dr. | knee prosthesis |
US7875081B2 (en) * | 2006-09-25 | 2011-01-25 | New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Posterior stabilized knee prosthesis |
ES2595494T3 (en) * | 2006-10-31 | 2016-12-30 | Smith & Nephew, Inc. | Femoral trial prosthesis and its use |
US20110166671A1 (en) | 2006-11-07 | 2011-07-07 | Kellar Franz W | Prosthetic joint |
US8308812B2 (en) | 2006-11-07 | 2012-11-13 | Biomedflex, Llc | Prosthetic joint assembly and joint member therefor |
US9005307B2 (en) | 2006-11-07 | 2015-04-14 | Biomedflex, Llc | Prosthetic ball-and-socket joint |
EP2081520B1 (en) | 2006-11-07 | 2017-07-12 | Biomedflex, LLC | Medical implants |
US8029574B2 (en) | 2006-11-07 | 2011-10-04 | Biomedflex Llc | Prosthetic knee joint |
US8512413B2 (en) | 2006-11-07 | 2013-08-20 | Biomedflex, Llc | Prosthetic knee joint |
US8070823B2 (en) | 2006-11-07 | 2011-12-06 | Biomedflex Llc | Prosthetic ball-and-socket joint |
US8177849B2 (en) * | 2007-05-07 | 2012-05-15 | Zimmer, Inc. | Methods and apparatuses for attaching tissue to orthopaedic implants |
US9107769B2 (en) | 2007-08-27 | 2015-08-18 | Kent M. Samuelson | Systems and methods for providing a femoral component |
US9872774B2 (en) | 2007-08-27 | 2018-01-23 | Connor E. Samuelson | Systems and methods for providing a femoral component having a modular stem |
US10213826B2 (en) | 2007-08-27 | 2019-02-26 | Connor E Samuelson | Systems and methods for providing prosthetic components |
US8382846B2 (en) | 2007-08-27 | 2013-02-26 | Kent M. Samuelson | Systems and methods for providing deeper knee flexion capabilities for knee prosthesis patients |
US8273133B2 (en) * | 2007-08-27 | 2012-09-25 | Samuelson Kent M | Systems and methods for providing deeper knee flexion capabilities for knee prosthesis patients |
US8366783B2 (en) | 2007-08-27 | 2013-02-05 | Samuelson Kent M | Systems and methods for providing deeper knee flexion capabilities for knee prosthesis patients |
US8128703B2 (en) | 2007-09-28 | 2012-03-06 | Depuy Products, Inc. | Fixed-bearing knee prosthesis having interchangeable components |
US8632600B2 (en) | 2007-09-25 | 2014-01-21 | Depuy (Ireland) | Prosthesis with modular extensions |
US9204967B2 (en) | 2007-09-28 | 2015-12-08 | Depuy (Ireland) | Fixed-bearing knee prosthesis having interchangeable components |
US7918893B2 (en) * | 2007-09-30 | 2011-04-05 | Depuy Products, Inc. | Hinged orthopaedic prosthesis |
CA2719033C (en) * | 2007-12-07 | 2014-07-08 | Zimmer Orthopaedic Surgical Products, Inc. | Spacer mold and methods therefor |
US8292965B2 (en) * | 2008-02-11 | 2012-10-23 | New York University | Knee joint with a ramp |
WO2009105496A1 (en) | 2008-02-18 | 2009-08-27 | Maxx Orthopedics, Inc. | Total knee replacement prosthesis |
WO2009105495A1 (en) * | 2008-02-18 | 2009-08-27 | Maxx Orthopedics, Inc. | Total knee replacement prosthesis with high order nurbs surfaces |
AU2009221773B2 (en) * | 2008-03-05 | 2015-03-05 | Conformis, Inc. | Edge-matched articular implant |
WO2009111626A2 (en) | 2008-03-05 | 2009-09-11 | Conformis, Inc. | Implants for altering wear patterns of articular surfaces |
US8790411B2 (en) * | 2008-04-17 | 2014-07-29 | Steven L. Mandell | Femoral component of an artificial knee joint |
CA2728888C (en) * | 2008-06-24 | 2014-09-09 | New York University | Recess-ramp knee joint prosthesis |
US8828086B2 (en) | 2008-06-30 | 2014-09-09 | Depuy (Ireland) | Orthopaedic femoral component having controlled condylar curvature |
US9119723B2 (en) | 2008-06-30 | 2015-09-01 | Depuy (Ireland) | Posterior stabilized orthopaedic prosthesis assembly |
US9168145B2 (en) | 2008-06-30 | 2015-10-27 | Depuy (Ireland) | Posterior stabilized orthopaedic knee prosthesis having controlled condylar curvature |
US8192498B2 (en) | 2008-06-30 | 2012-06-05 | Depuy Products, Inc. | Posterior cructiate-retaining orthopaedic knee prosthesis having controlled condylar curvature |
US8480752B2 (en) | 2008-06-30 | 2013-07-09 | DePuy Synthes Products, LLC | Tibial bearing having increased axial-rotation |
US8075626B2 (en) | 2008-06-30 | 2011-12-13 | Depuy Products, Inc. | Orthopaedic knee prosthesis having increased axial-rotation |
US8236061B2 (en) | 2008-06-30 | 2012-08-07 | Depuy Products, Inc. | Orthopaedic knee prosthesis having controlled condylar curvature |
US8206451B2 (en) | 2008-06-30 | 2012-06-26 | Depuy Products, Inc. | Posterior stabilized orthopaedic prosthesis |
US8187335B2 (en) * | 2008-06-30 | 2012-05-29 | Depuy Products, Inc. | Posterior stabilized orthopaedic knee prosthesis having controlled condylar curvature |
US7981159B2 (en) * | 2008-07-16 | 2011-07-19 | Depuy Products, Inc. | Antero-posterior placement of axis of rotation for a rotating platform |
US8202323B2 (en) * | 2008-07-16 | 2012-06-19 | Depuy Products, Inc. | Knee prostheses with enhanced kinematics |
US8529631B2 (en) * | 2008-07-18 | 2013-09-10 | Zimmer, Gmbh | Base component for a tibial implant |
US8715358B2 (en) | 2008-07-18 | 2014-05-06 | Michael A. Masini | PCL retaining ACL substituting TKA apparatus and method |
US8506640B2 (en) * | 2008-09-12 | 2013-08-13 | Exactech, Inc. | Systems and methods relating to a knee prosthesis capable of conversion from a cruciate retaining type prosthesis to a posterior stabilizng type prosthesis |
US20100100193A1 (en) * | 2008-10-22 | 2010-04-22 | Biomet Manufacturing Corp. | Patient matched hip system |
JP5400891B2 (en) | 2008-10-29 | 2014-01-29 | ジンマー オーソピーディック サージカル プロダクツ,インコーポレーテッド | Spacer mold with releasable fixing structure |
US8491662B2 (en) | 2008-12-23 | 2013-07-23 | Aesculap Ag | Knee prosthesis |
US9220600B2 (en) | 2008-12-23 | 2015-12-29 | Aesculap Implant Systems, Llc | Knee prosthesis |
US20100161067A1 (en) * | 2008-12-23 | 2010-06-24 | Aesculap Ag | Knee prosthesis |
JP5404342B2 (en) * | 2009-01-06 | 2014-01-29 | キヤノン株式会社 | Optical scanning device and image forming apparatus using the same |
WO2010085656A1 (en) * | 2009-01-23 | 2010-07-29 | Zimmer, Inc. | Posterior stabilized total knee prosthesis |
CA2749909A1 (en) * | 2009-01-28 | 2010-08-05 | Christopher M. Byrd | Lateral condyle with posteriorly located inflection point for total knee implant |
WO2010099231A2 (en) | 2009-02-24 | 2010-09-02 | Conformis, Inc. | Automated systems for manufacturing patient-specific orthopedic implants and instrumentation |
US8945222B2 (en) * | 2009-03-20 | 2015-02-03 | Linares Medical Devices, Llc | Wear compensating joint assembly incorporating a pressurized fluid injectable reservoir upwardly biasing a hardened plastic with a wear surface |
CN105380733B (en) * | 2009-03-27 | 2021-09-14 | 史密夫和内修整形外科股份公司 | Artificial knee joint |
US8915965B2 (en) * | 2009-05-07 | 2014-12-23 | Depuy (Ireland) | Anterior stabilized knee implant |
AU2015249142B2 (en) * | 2009-06-10 | 2017-02-16 | Kent M. Samuelson | Systems and methods for providing deeper knee flexion capabilities for knee prosthesis patients |
DE202009008370U1 (en) * | 2009-06-17 | 2010-10-28 | Lawton Gmbh & Co. Kg | Surgical instrument |
AU2015202416B2 (en) * | 2009-06-24 | 2017-03-02 | Conformis, Inc. | Patient-adapted and improved orthopedic implants, designs and related tools |
WO2011016905A1 (en) * | 2009-07-27 | 2011-02-10 | Thomas P Andriacchi | Knee replacement system and method for enabling natural knee movement |
US9095453B2 (en) * | 2009-08-11 | 2015-08-04 | Michael D. Ries | Position adjustable trial systems for prosthetic implants |
US8496666B2 (en) | 2009-08-11 | 2013-07-30 | Imds Corporation | Instrumentation for mobile bearing prosthetics |
US8998997B2 (en) | 2009-08-11 | 2015-04-07 | Michael D. Ries | Implantable mobile bearing prosthetics |
US8906105B2 (en) | 2009-08-11 | 2014-12-09 | Michael D. Ries | Systems and methods for mobile bearing prosthetic knee |
US8382848B2 (en) * | 2009-08-11 | 2013-02-26 | Imds Corporation | Position adjustable trial systems for prosthetic implants |
US8568485B2 (en) * | 2009-08-11 | 2013-10-29 | Imds Corporation | Articulating trials for prosthetic implants |
DE102009029360A1 (en) * | 2009-09-10 | 2011-03-24 | Aesculap Ag | Knee endoprosthesis |
GB2521953A (en) * | 2009-10-07 | 2015-07-08 | Otis Biotech Co Ltd | Artificial knee joint |
US8870964B2 (en) * | 2009-11-16 | 2014-10-28 | New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Prosthetic condylar joints with articulating bearing surfaces having a translating contact point during rotation thereof |
US8900315B2 (en) * | 2009-11-16 | 2014-12-02 | New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Constrained condylar knee device |
CN102917670B (en) | 2009-12-09 | 2016-08-03 | 马萨诸塞总医院运营总医院公司 | For recovering normal bending range and the implant of motion of knee joint performance |
EP2509539B1 (en) * | 2009-12-11 | 2020-07-01 | ConforMIS, Inc. | Patient-specific and patient-engineered orthopedic implants |
US9011547B2 (en) | 2010-01-21 | 2015-04-21 | Depuy (Ireland) | Knee prosthesis system |
KR101902350B1 (en) * | 2010-01-29 | 2018-10-01 | 스미스 앤드 네퓨, 인크. | Cruciate-retaining knee prosthesis |
US9132014B2 (en) | 2010-04-13 | 2015-09-15 | Zimmer, Inc. | Anterior cruciate ligament substituting knee implants |
WO2012012726A1 (en) | 2010-07-23 | 2012-01-26 | Medicinelodge, Inc Dba Imds Co-Innovation | Systems and methods for prosthetic knee |
EP2595574B1 (en) | 2010-07-24 | 2017-05-03 | Zimmer, Inc. | Asymmetric tibial components for a knee prosthesis |
US8764840B2 (en) | 2010-07-24 | 2014-07-01 | Zimmer, Inc. | Tibial prosthesis |
US8545571B2 (en) | 2010-07-30 | 2013-10-01 | Howmedica Osteonics Corp. | Stabilized knee prosthesis |
BR112013003254A2 (en) | 2010-08-12 | 2016-05-17 | Smith & Nephew Inc | structures for use in orthopedic implant fixation and methods for bone installation |
US8591594B2 (en) | 2010-09-10 | 2013-11-26 | Zimmer, Inc. | Motion facilitating tibial components for a knee prosthesis |
CA2810729C (en) | 2010-09-10 | 2018-04-10 | Zimmer Gmbh | Femoral prosthesis with medialized patellar groove |
US8287601B2 (en) | 2010-09-30 | 2012-10-16 | Depuy Products, Inc. | Femoral component of a knee prosthesis having an angled cement pocket |
US8317870B2 (en) | 2010-09-30 | 2012-11-27 | Depuy Products, Inc. | Tibial component of a knee prosthesis having an angled cement pocket |
ES2443827T3 (en) * | 2010-10-05 | 2014-02-20 | Aesculap Ag | Knee Joint Endoprosthesis |
WO2012051178A2 (en) * | 2010-10-12 | 2012-04-19 | Walker Peter S | Total knee replacement implant based on normal anatomy and kinematics |
CN103200903B (en) * | 2010-11-12 | 2016-01-20 | 捷迈有限责任公司 | There is the knee prostheses guiding and stretch curvature movement |
US8603101B2 (en) | 2010-12-17 | 2013-12-10 | Zimmer, Inc. | Provisional tibial prosthesis system |
US20120185054A1 (en) * | 2011-01-19 | 2012-07-19 | Wright Medical Technology, Inc. | Medial pivot posterior stabilized knee implant system |
US8403994B2 (en) | 2011-01-19 | 2013-03-26 | Wright Medical Technology, Inc. | Knee implant system |
CN103327937B (en) * | 2011-01-27 | 2017-08-08 | 史密夫和内修有限公司 | Constrained knee-joint prosthesis |
SG193484A1 (en) | 2011-02-15 | 2013-10-30 | Conformis Inc | Patent-adapted and improved articular implants, designs, surgical procedures and related guide tools |
US9308095B2 (en) | 2011-06-16 | 2016-04-12 | Zimmer, Inc. | Femoral component for a knee prosthesis with improved articular characteristics |
US8932365B2 (en) | 2011-06-16 | 2015-01-13 | Zimmer, Inc. | Femoral component for a knee prosthesis with improved articular characteristics |
US8551179B2 (en) * | 2011-06-16 | 2013-10-08 | Zimmer, Inc. | Femoral prosthesis system having provisional component with visual indicators |
US9060868B2 (en) | 2011-06-16 | 2015-06-23 | Zimmer, Inc. | Femoral component for a knee prosthesis with bone compacting ridge |
CN103648442B (en) | 2011-07-13 | 2016-03-23 | 捷迈有限责任公司 | There is the femoral knee prostheses of expansion lateral condyle |
CN103997978A (en) * | 2011-07-13 | 2014-08-20 | 通用医疗公司 | Methods and devices for knee joint replacement with anterior cruciate ligament substitution |
US8409293B1 (en) * | 2011-10-26 | 2013-04-02 | Sevika Holding AG | Knee prosthesis |
EP3848005A3 (en) | 2011-11-18 | 2021-09-15 | Zimmer, Inc. | Tibial bearing component for a knee prosthesis with improved articular characteristics |
AU2012341026B2 (en) | 2011-11-21 | 2015-01-29 | Zimmer, Inc. | Tibial baseplate with asymmetric placement of fixation structures |
US9913690B2 (en) * | 2011-12-21 | 2018-03-13 | Zimmer, Inc. | System and method for pre-operatively determining desired alignment of a knee joint |
JP5826025B2 (en) * | 2011-12-28 | 2015-12-02 | 京セラメディカル株式会社 | Total knee implant |
IN2014DN07145A (en) | 2012-01-30 | 2015-04-24 | Zimmer Inc | |
AU2013225659A1 (en) * | 2012-03-02 | 2014-10-02 | Conformis, Inc. | Patient-adapted posterior stabilized knee implants, designs and related methods and tools |
AU2013300021B2 (en) * | 2012-08-09 | 2018-08-23 | Peter Stanley Walker | Total knee replacement substituting function of anterior cruciate ligament |
FR2994644B1 (en) * | 2012-08-24 | 2014-08-29 | Anatomic | PROTHETIC TIBIAL PLUG AND TIBIAL PROTHETIC INSERT FOR IMMOBILIZATION ON SUCH PROTHETIC TIBIAL PLUG |
WO2014080416A1 (en) | 2012-11-21 | 2014-05-30 | Mehta Krishnachandra Chandrashanker | Knee replacement prosthetic |
US8740985B1 (en) | 2012-11-30 | 2014-06-03 | Smith & Nephew, Inc. | Knee prosthesis |
US9387083B2 (en) | 2013-01-30 | 2016-07-12 | Conformis, Inc. | Acquiring and utilizing kinematic information for patient-adapted implants, tools and surgical procedures |
EP2953559B1 (en) * | 2013-02-08 | 2018-01-31 | Orthopaedic International, Inc. | Total knee arthroplasty systems |
BR112015023432A2 (en) * | 2013-03-15 | 2017-07-18 | Conformis Inc | posteriorly stabilized knee implant components and instruments |
RS61560B1 (en) | 2013-06-23 | 2021-04-29 | Canary Medical Inc | Devices, systems and methods for monitoring knee replacements |
US9925052B2 (en) | 2013-08-30 | 2018-03-27 | Zimmer, Inc. | Method for optimizing implant designs |
TR201905582T4 (en) * | 2013-09-27 | 2019-05-21 | Joint Innovation Tech Llc | Reverse knee replacement. |
CA2927291C (en) * | 2013-11-08 | 2019-09-10 | Bank Of Canada | Optically variable devices, their production and use |
US10219908B2 (en) * | 2013-12-30 | 2019-03-05 | Mako Surgical Corp. | Femoral component for bone conservation |
CA2990814A1 (en) | 2014-06-25 | 2015-12-30 | William L. Hunter | Devices, systems and methods for using and monitoring implants |
US11596347B2 (en) | 2014-06-25 | 2023-03-07 | Canary Medical Switzerland Ag | Devices, systems and methods for using and monitoring orthopedic hardware |
US10130375B2 (en) | 2014-07-31 | 2018-11-20 | Zimmer, Inc. | Instruments and methods in performing kinematically-aligned total knee arthroplasty |
BR102015021321A2 (en) | 2014-09-04 | 2016-09-20 | Dow Agrosciences Llc | methods and compositions for the recombination of agrobacterium tumefaciens gene deficient strains |
CA2998709A1 (en) | 2014-09-17 | 2016-03-24 | Canary Medical Inc. | Devices, systems and methods for using and monitoring medical devices |
AU2015320707B2 (en) | 2014-09-24 | 2020-07-02 | Depuy Ireland Unlimited Company | Surgical planning and method |
CN114848240A (en) | 2015-08-27 | 2022-08-05 | 捷迈有限公司 | Direction-locking reverse shoulder prosthesis and system |
EP3352708B1 (en) | 2015-09-21 | 2020-07-22 | Zimmer, Inc. | Prosthesis system including tibial bearing component |
US10136997B2 (en) | 2015-09-29 | 2018-11-27 | Zimmer, Inc. | Tibial prosthesis for tibia with varus resection |
US9833324B2 (en) | 2015-12-30 | 2017-12-05 | Eva15 Llc | Knee prosthetic implant |
JP6801675B2 (en) * | 2016-01-12 | 2020-12-16 | Agc株式会社 | Method for producing transformant and transferrin |
US11191479B2 (en) | 2016-03-23 | 2021-12-07 | Canary Medical Inc. | Implantable reporting processor for an alert implant |
KR102594123B1 (en) | 2016-03-23 | 2023-10-26 | 카나리 메디칼 아이엔씨. | Implantable reporting processor for an alert implant |
US10245148B2 (en) | 2016-04-25 | 2019-04-02 | Howmedica Osteonics Corp. | Flexible snap-fit prosthetic component |
US10179052B2 (en) | 2016-07-28 | 2019-01-15 | Depuy Ireland Unlimited Company | Total knee implant prosthesis assembly and method |
US11406502B2 (en) | 2017-03-02 | 2022-08-09 | Optimotion Implants LLC | Orthopedic implants and methods |
ES2878003T3 (en) | 2017-03-10 | 2021-11-18 | Zimmer Inc | Tibial prosthesis with locking feature for a tibial bearing component |
AU2018266322B2 (en) | 2017-05-12 | 2020-03-19 | Zimmer, Inc. | Femoral prostheses with upsizing and downsizing capabilities |
AU2018203343B2 (en) * | 2017-05-15 | 2023-04-27 | Howmedica Osteonics Corp. | Patellofemoral implant |
US10940666B2 (en) | 2017-05-26 | 2021-03-09 | Howmedica Osteonics Corp. | Packaging structures and additive manufacturing thereof |
WO2019023476A1 (en) | 2017-07-26 | 2019-01-31 | Optimotion Implants LLC | Modular knee prosthesis, instruments, and methods |
US11426282B2 (en) | 2017-11-16 | 2022-08-30 | Zimmer, Inc. | Implants for adding joint inclination to a knee arthroplasty |
US10307255B1 (en) | 2017-11-29 | 2019-06-04 | b-ONE Ortho, Corp. | Acetabular cup assembly |
US10835380B2 (en) | 2018-04-30 | 2020-11-17 | Zimmer, Inc. | Posterior stabilized prosthesis system |
US10736748B2 (en) | 2018-05-02 | 2020-08-11 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a hinged-knee prosthesis |
US10864082B2 (en) * | 2018-10-19 | 2020-12-15 | Roy D. Bloebaum | Osteolysis-resistant cementless joint implant with improved stability and seating function |
KR102171582B1 (en) * | 2018-11-27 | 2020-10-29 | 심영복 | Artificial Knee Joint Having A Plural Of Curved Contact Surface |
US11116641B2 (en) | 2019-02-05 | 2021-09-14 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a rotating hinged-knee prosthesis |
US11033396B2 (en) | 2019-02-05 | 2021-06-15 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a rotating hinged-knee prosthesis |
EP3698761B1 (en) | 2019-02-22 | 2021-11-17 | Stryker European Operations Limited | Total ankle prosthesis |
US11129720B2 (en) | 2019-03-05 | 2021-09-28 | Jonathan P. GARINO | Cruciate replacing artificial knee |
EP3979909A4 (en) * | 2019-06-06 | 2023-11-08 | Canary Medical Inc. | Intelligent joint prosthesis |
US11357634B1 (en) * | 2020-01-15 | 2022-06-14 | Lento Medical, Inc. | Posterior-stabilized symmetric knee prosthesis |
US11382757B1 (en) * | 2020-01-15 | 2022-07-12 | Lento Medical, Inc. | Condylar asymmetry knee prosthesis |
CN111437077A (en) * | 2020-04-23 | 2020-07-24 | 北京市春立正达医疗器械股份有限公司 | Anatomical knee prosthesis |
US20230310163A1 (en) * | 2020-08-29 | 2023-10-05 | Rajesh MANIAR | Femoral orthopedic implant of a knee prosthesis |
Citations (95)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3748662A (en) * | 1971-04-21 | 1973-07-31 | A Helfet | Replacements for bicondylar joints in human limbs |
US3798679A (en) * | 1971-07-09 | 1974-03-26 | Ewald Frederick | Joint prostheses |
US3816855A (en) * | 1971-06-01 | 1974-06-18 | Nat Res Dev | Knee joint prosthesis |
US3869781A (en) * | 1974-02-25 | 1975-03-11 | Eubanks Eng Co | Apparatus for attaching terminals to electric conductors |
US3958278A (en) * | 1974-04-22 | 1976-05-25 | National Research Development Corporation | Endoprosthetic knee joint |
US4016606A (en) * | 1975-07-14 | 1977-04-12 | Research Corporation | Knee joint prosthesis |
US4207627A (en) * | 1979-01-18 | 1980-06-17 | Cloutier Jean Marie | Knee prosthesis |
US4209861A (en) * | 1978-02-22 | 1980-07-01 | Howmedica, Inc. | Joint prosthesis |
US4213209A (en) * | 1978-05-22 | 1980-07-22 | New York Society For The Relief Of The Ruptured And Crippled | Knee joint prosthesis |
US4249270A (en) * | 1978-10-06 | 1981-02-10 | Sulzer Brothers Limited | Endoprosthesis for a knee joint |
US4340978A (en) * | 1979-07-02 | 1982-07-27 | Biomedical Engineering Corp. | New Jersey meniscal bearing knee replacement |
US4524766A (en) * | 1982-01-07 | 1985-06-25 | Petersen Thomas D | Surgical knee alignment method and system |
US4568348A (en) * | 1982-03-13 | 1986-02-04 | Chas. F. Thackray Limited | Knee prosthesis |
US4586933A (en) * | 1983-09-30 | 1986-05-06 | Hiromu Shoji | Dual articulating total knee prosthesis |
US4653488A (en) * | 1982-02-18 | 1987-03-31 | Howmedica, Inc. | Prosthetic knee implantation |
US4659331A (en) * | 1983-11-28 | 1987-04-21 | Regents Of University Of Michigan | Prosthesis interface surface and method of implanting |
US4662889A (en) * | 1983-04-28 | 1987-05-05 | Feldmuhle Aktiengesellschaft | Knee joint prosthesis |
US4721104A (en) * | 1985-12-02 | 1988-01-26 | Dow Corning Wright Corporation | Femoral surface shaping apparatus for posterior-stabilized knee implants |
US4722330A (en) * | 1986-04-22 | 1988-02-02 | Dow Corning Wright Corporation | Femoral surface shaping guide for knee implants |
US4731086A (en) * | 1987-04-20 | 1988-03-15 | Dow Corning Wright | Shim for femoral knee joint prosthesis and method of using |
US4822365A (en) * | 1986-05-30 | 1989-04-18 | Walker Peter S | Method of design of human joint prosthesis |
US4834758A (en) * | 1988-05-26 | 1989-05-30 | New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery | Bone prosthesis for the leg and thigh |
US4926847A (en) * | 1988-12-27 | 1990-05-22 | Johnson & Johnson Orthopaedics, Inc. | Surgical cutting block |
US4936853A (en) * | 1989-01-11 | 1990-06-26 | Kirschner Medical Corporation | Modular knee prosthesis |
US4938769A (en) * | 1989-05-31 | 1990-07-03 | Shaw James A | Modular tibial prosthesis |
US5002547A (en) * | 1987-02-07 | 1991-03-26 | Pfizer Hospital Products Group, Inc. | Apparatus for knee prosthesis |
US5007933A (en) * | 1989-01-31 | 1991-04-16 | Osteonics Corp. | Modular knee prosthesis system |
US5021061A (en) * | 1990-09-26 | 1991-06-04 | Queen's University At Kingston | Prosthetic patello-femoral joint |
US5080675A (en) * | 1990-03-12 | 1992-01-14 | Howmedica | Tibial component for a replacement knee prosthesis |
US5092869A (en) * | 1991-03-01 | 1992-03-03 | Biomet, Inc. | Oscillating surgical saw guide pins and instrumentation system |
US5098436A (en) * | 1991-03-07 | 1992-03-24 | Dow Corning Wright Corporation | Modular guide for shaping of femur to accommodate intercondylar stabilizing housing and patellar track of implant |
US5100409A (en) * | 1991-03-07 | 1992-03-31 | Dow Corning Wright Corporation | Shaping and trial reduction guide for implantation of femoral prosthesis and method of using same |
US5116375A (en) * | 1990-08-27 | 1992-05-26 | Hofmann Aaron A | Knee prosthesis |
US5122144A (en) * | 1989-09-26 | 1992-06-16 | Kirschner Medical Corporation | Method and instrumentation for unicompartmental total knee arthroplasty |
US5181925A (en) * | 1991-04-22 | 1993-01-26 | Zimmer, Inc. | Femoral component for a knee joint prosthesis having a modular cam and stem |
US5201881A (en) * | 1991-08-13 | 1993-04-13 | Smith & Nephew Richards Inc. | Joint prosthesis with improved shock absorption |
US5203807A (en) * | 1991-07-10 | 1993-04-20 | Smith & Nephew Richards Inc. | Knee joint prosthesis articular surface |
US5219362A (en) * | 1991-02-07 | 1993-06-15 | Finsbury (Instruments) Limited | Knee prosthesis |
US5282867A (en) * | 1992-05-29 | 1994-02-01 | Mikhail Michael W E | Prosthetic knee joint |
US5282803A (en) * | 1991-03-07 | 1994-02-01 | Smith & Nephew Richards Inc. | Instrumentation for long stem surgery |
US5304181A (en) * | 1990-01-08 | 1994-04-19 | Caspari Richard B | Methods and apparatus for arthroscopic prosthetic knee replacement |
US5314482A (en) * | 1988-02-05 | 1994-05-24 | British Technology Group Ltd. | Femoral component, tool and method |
US5405398A (en) * | 1993-08-30 | 1995-04-11 | Intermedics Orthopedics, Inc. | Prosthetic knee with posterior stabilized femoral component |
US5413604A (en) * | 1992-12-24 | 1995-05-09 | Osteonics Corp. | Prosthetic knee implant for an anterior cruciate ligament deficient total knee replacement |
US5417694A (en) * | 1993-11-08 | 1995-05-23 | Smith & Nephew Richards Inc. | Distal femoral cutting guide apparatus with anterior or posterior referencing for use in knee joint replacement surgery |
US5480446A (en) * | 1990-06-12 | 1996-01-02 | British Technology Group Ltd. | Prosthetic knee joint devices |
US5507820A (en) * | 1992-12-14 | 1996-04-16 | Biomedical Engineering Trust I | Fixed bearing joint endoprosthesis |
US5514143A (en) * | 1991-11-27 | 1996-05-07 | Apogee Medical Products, Inc. | Apparatus and method for use during surgery |
US5520695A (en) * | 1992-02-14 | 1996-05-28 | Johnson & Johnson Professional, Inc. | Instruments for use in knee replacement surgery |
US5609645A (en) * | 1994-10-28 | 1997-03-11 | Intermedics, Inc. | Knee revision prosthesis with shims |
US5611802A (en) * | 1995-02-14 | 1997-03-18 | Samuelson; Kent M. | Method and apparatus for resecting bone |
US5639279A (en) * | 1995-02-09 | 1997-06-17 | Intermedics Orthopedics, Inc. | Posteriorly-stabilized prosthetic knee |
US5723016A (en) * | 1993-04-01 | 1998-03-03 | British Technology Group Ltd. | Implantable prosthetic patellar components |
US5728162A (en) * | 1993-01-28 | 1998-03-17 | Board Of Regents Of University Of Colorado | Asymmetric condylar and trochlear femoral knee component |
US5755804A (en) * | 1996-02-21 | 1998-05-26 | Plus Endoprothetik Ag | Endoprosthetic knee joint |
US5755801A (en) * | 1993-07-16 | 1998-05-26 | Walker; Peter Stanley | Prostheses for knee replacement |
US5755803A (en) * | 1994-09-02 | 1998-05-26 | Hudson Surgical Design | Prosthetic implant |
US5766200A (en) * | 1993-05-06 | 1998-06-16 | Linvatec Corporation | Rotatable endoscopic shaver with polymeric blades |
US5766257A (en) * | 1997-01-28 | 1998-06-16 | Implant Manufacturing And Testing Corporation | Artificial joint having natural load transfer |
US5871546A (en) * | 1995-09-29 | 1999-02-16 | Johnson & Johnson Professional, Inc. | Femoral component condyle design for knee prosthesis |
US5871545A (en) * | 1994-09-14 | 1999-02-16 | Btg International Limited | Prosthetic knee joint device |
US5879392A (en) * | 1996-05-08 | 1999-03-09 | Mcminn; Derek James Wallace | Knee prosthesis |
US5906643A (en) * | 1994-07-28 | 1999-05-25 | Walker; Peter Stanley | Stabilised mobile bearing knee |
US6039764A (en) * | 1997-08-18 | 2000-03-21 | Arch Development Corporation | Prosthetic knee with adjusted center of internal/external rotation |
US6059788A (en) * | 1995-05-31 | 2000-05-09 | Katz; Lawrence | Method and apparatus for locating bone cuts at the distal condylar femur region to receive a femoral prosthesis and properly articulated with patellar and tibial prosthesis |
US6068658A (en) * | 1997-03-13 | 2000-05-30 | Zimmer Ltd. | Prosthesis for knee replacement |
US6080195A (en) * | 1998-07-08 | 2000-06-27 | Johnson & Johnson Professional, Inc. | Rotatable and translatable joint prosthesis with posterior stabilization |
US6171340B1 (en) * | 1998-02-27 | 2001-01-09 | Mcdowell Charles L. | Method and device for regenerating cartilage in articulating joints |
US6203576B1 (en) * | 1996-12-09 | 2001-03-20 | Groupe Controle Dedienne Gcd Societe De Droit Francais | Complete knee joint prosthesis |
US6206926B1 (en) * | 1997-10-06 | 2001-03-27 | Biomedical Engineering Trust I | Prosthetic knee joint with enhanced posterior stabilization and dislocation prevention features |
US6210443B1 (en) * | 1998-04-15 | 2001-04-03 | Aesculap | Knee prosthetics |
US6235060B1 (en) * | 1996-11-13 | 2001-05-22 | Hjs Gelenk System Gmbh | Artificial joint, in particular endoprosthesis for replacing natural joints |
US6361564B1 (en) * | 1999-02-02 | 2002-03-26 | Aesculap | Total knee joint comprising an insert movable relative to a tenon |
US6379388B1 (en) * | 1999-12-08 | 2002-04-30 | Ortho Development Corporation | Tibial prosthesis locking system and method of repairing knee joint |
US6406497B2 (en) * | 2000-07-19 | 2002-06-18 | Tsunenori Takei | Artificial knee joint |
US6506215B1 (en) * | 1998-05-12 | 2003-01-14 | Patrick Letot | Synthetic knee system |
US20030028196A1 (en) * | 2000-01-14 | 2003-02-06 | Bonutti Peter M. | Method of performing surgery |
US6554838B2 (en) * | 2001-05-31 | 2003-04-29 | Howmedica Osteonics Corp. | Method and apparatus for implanting a prosthetic device |
US6569202B2 (en) * | 2001-04-02 | 2003-05-27 | Whiteside Biomechanics, Inc. | Tray and liner for joint replacement system |
US6575980B1 (en) * | 1997-01-28 | 2003-06-10 | New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Method and apparatus for femoral resection |
US6695848B2 (en) * | 1994-09-02 | 2004-02-24 | Hudson Surgical Design, Inc. | Methods for femoral and tibial resection |
US6702821B2 (en) * | 2000-01-14 | 2004-03-09 | The Bonutti 2003 Trust A | Instrumentation for minimally invasive joint replacement and methods for using same |
US6730128B2 (en) * | 2001-04-17 | 2004-05-04 | Exactech, Inc. | Prosthetic knee joint |
US6755864B1 (en) * | 1999-09-24 | 2004-06-29 | Sulzer Orthopedics Ltd. | Tibia part for a knee joint prosthesis and a kit with a tibia part of this kind |
US6846329B2 (en) * | 2002-02-26 | 2005-01-25 | Mcminn Derek James Wallace | Knee prosthesis |
US6866684B2 (en) * | 1999-05-10 | 2005-03-15 | Barry M. Fell | Surgically implantable knee prosthesis having different tibial and femoral surface profiles |
US6866683B2 (en) * | 2002-12-13 | 2005-03-15 | Medicine Lodge, Inc. | Modular implant for joint reconstruction and method of use |
US6887276B2 (en) * | 2002-12-13 | 2005-05-03 | Medicine Lodge, Inc | Modular implant for joint reconstruction and method of use |
US6911044B2 (en) * | 1999-05-10 | 2005-06-28 | Barry M. Fell | Surgically implantable knee prosthesis having medially shifted tibial surface |
US7018418B2 (en) * | 2001-01-25 | 2006-03-28 | Tecomet, Inc. | Textured surface having undercut micro recesses in a surface |
US7048741B2 (en) * | 2002-05-10 | 2006-05-23 | Swanson Todd V | Method and apparatus for minimally invasive knee arthroplasty |
US7160330B2 (en) * | 2003-01-21 | 2007-01-09 | Howmedica Osteonics Corp. | Emulating natural knee kinematics in a knee prosthesis |
US7326252B2 (en) * | 2002-12-20 | 2008-02-05 | Smith & Nephew, Inc. | High performance knee prostheses |
US7371240B2 (en) * | 2000-03-10 | 2008-05-13 | Smith & Nephew, Inc. | Method of arthroplasty on a knee joint and apparatus for use in same |
US20100100192A1 (en) * | 2001-03-05 | 2010-04-22 | Haines Timothy G | Femoral prosthetic implant |
Family Cites Families (263)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US792271A (en) * | 1904-08-02 | 1905-06-13 | John A Knight | Machine for sawing, matching, and jointing staves. |
US3924277A (en) | 1971-05-04 | 1975-12-09 | Nat Res Dev | Knee joint prosthesis |
US3774244A (en) | 1972-02-08 | 1973-11-27 | Relief Ruptured And Crippled S | Knee-joint prosthesis |
US3824630A (en) | 1972-06-23 | 1974-07-23 | Zimmer Mfg Co | Prosthetic joint for total knee replacement |
CH555671A (en) | 1972-09-01 | 1974-11-15 | Sulzer Ag | ENDO-PROSTHESIS FOR A KNEE JOINT. |
JPS541510B2 (en) | 1973-02-19 | 1979-01-25 | ||
US4199296A (en) * | 1974-09-03 | 1980-04-22 | Chair Rory S De | Gas turbine engines |
US4012166A (en) * | 1974-12-04 | 1977-03-15 | Deere & Company | Supersonic shock wave compressor diffuser with circular arc channels |
DE2703059C3 (en) | 1977-01-26 | 1981-09-03 | Sanitätshaus Schütt & Grundei, Werkstätten für Orthopädie-Technik, 2400 Lübeck | Knee joint endoprosthesis |
DE2845231A1 (en) | 1977-10-21 | 1979-05-03 | Indong Oh | JOINT PROSTHESIS AND PROCEDURE FOR IMPLANTING THEREOF |
US4470158A (en) | 1978-03-10 | 1984-09-11 | Biomedical Engineering Corp. | Joint endoprosthesis |
US4309778A (en) | 1979-07-02 | 1982-01-12 | Biomedical Engineering Corp. | New Jersey meniscal bearing knee replacement |
JPS5623829A (en) | 1979-08-06 | 1981-03-06 | Nichimo Kk | Operation of purse seine |
US4358859A (en) | 1979-10-04 | 1982-11-16 | Schurman David J | Articulated prosthetic knee and method for implanting same |
US4353135A (en) | 1980-05-09 | 1982-10-12 | Minnesota Mining And Manufacturing Company | Patellar flange and femoral knee-joint prosthesis |
DE3314038A1 (en) * | 1982-04-20 | 1983-10-27 | Mecron Medizinische Produkte Gmbh, 1000 Berlin | Knee prosthesis |
US4474177A (en) | 1983-03-09 | 1984-10-02 | Wright Manufacturing Company | Method and apparatus for shaping a distal femoral surface |
DE3314036A1 (en) | 1983-04-19 | 1984-10-25 | Kehrberg, Lutz, 1000 Berlin | Fully automatic parking disc |
NL8304339A (en) | 1983-12-16 | 1985-07-16 | Jonas Lindwer | WEIGHT PROSTHESIS AND A TOOL TO BE USED THEREOF. |
DE3433264C2 (en) | 1984-09-11 | 1986-10-02 | S + G Implants GmbH, 2400 Lübeck | Tibial part for a knee joint endoprosthesis |
DE3444001C2 (en) | 1984-11-29 | 1986-12-18 | L. Prof. Dr.med. 1000 Berlin Hanslik | Knee joint prosthesis |
GB8432267D0 (en) | 1984-12-20 | 1985-01-30 | Thackray C F Ltd | Knee prosthesis |
EP0189253A2 (en) | 1985-01-18 | 1986-07-30 | Pfizer Hospital Products Group, Inc. | Press fit knee prosthesis and instrumentation |
JPS61170453U (en) | 1985-04-09 | 1986-10-22 | ||
US4714473A (en) | 1985-07-25 | 1987-12-22 | Harrington Arthritis Research Center | Knee prosthesis |
US4787383A (en) | 1985-12-19 | 1988-11-29 | Howmedica, Inc. | Prosthetic knee implantation |
JPS62133948U (en) | 1986-02-17 | 1987-08-24 | ||
US4703751A (en) | 1986-03-27 | 1987-11-03 | Pohl Kenneth P | Method and apparatus for resecting a distal femoral surface |
US4714474A (en) | 1986-05-12 | 1987-12-22 | Dow Corning Wright Corporation | Tibial knee joint prosthesis with removable articulating surface insert |
US4963152A (en) | 1986-10-27 | 1990-10-16 | Intermedics Orthopedics, Inc. | Asymmetric prosthetic tibial component |
US4714472A (en) | 1987-01-20 | 1987-12-22 | Osteonics Corp. | Knee prosthesis with accommodation for angular misalignment |
US5250050A (en) | 1987-02-07 | 1993-10-05 | Pfizer Hospital Products Group, Inc. | Apparatus for knee prosthesis |
US4822385A (en) * | 1987-07-14 | 1989-04-18 | Maysteel Corporation | Exhaust cleansing apparatus |
US5011496A (en) | 1988-02-02 | 1991-04-30 | Joint Medical Products Corporation | Prosthetic joint |
US4959071A (en) | 1988-02-03 | 1990-09-25 | Biomet, Inc. | Partially stabilized knee prosthesis |
US4950298A (en) | 1988-04-08 | 1990-08-21 | Gustilo Ramon B | Modular knee joint prosthesis |
US4979949A (en) | 1988-04-26 | 1990-12-25 | The Board Of Regents Of The University Of Washington | Robot-aided system for surgery |
GB8817908D0 (en) | 1988-07-27 | 1988-09-01 | Howmedica | Tibial component for replacement knee prosthesis |
FR2635675B1 (en) | 1988-08-23 | 1990-11-30 | Laboureau Jacques Philippe | ANCILLARY INSTRUMENTATION FOR THE IMPLANTATION OF A TOTAL KNEE PROSTHESIS AND SECONDARY FOR AXIAL CORRECTION OSTEOTOMIES |
US4944757A (en) * | 1988-11-07 | 1990-07-31 | Martinez David M | Modulator knee prosthesis system |
IT1227847B (en) | 1989-01-11 | 1991-05-10 | Cremascoli Spa G | EQUIPMENT FOR THE CORRECT FEMORAL RESECTION AND FOR THE APPLICATION OF REPLACEMENT PROSTHESES OF THE KNEE ARTICULATION. |
DE3908958C2 (en) | 1989-03-18 | 1996-09-12 | Kubein Meesenburg Dietmar | Artificial joint |
JPH0541510Y2 (en) | 1989-08-25 | 1993-10-20 | ||
US5234433A (en) | 1989-09-26 | 1993-08-10 | Kirschner Medical Corporation | Method and instrumentation for unicompartmental total knee arthroplasty |
GB2237200B (en) | 1989-09-27 | 1994-02-23 | Univ London | Knee prosthesis |
US5059216A (en) | 1989-09-29 | 1991-10-22 | Winters Thomas F | Knee joint replacement apparatus |
FR2656217B1 (en) * | 1989-12-26 | 1997-04-25 | Kyocera Corp | ARTIFICIAL KNEE JOINT. |
US5035699A (en) | 1990-01-09 | 1991-07-30 | Dow Corning Wright | Patella track cutter and guide |
US5147405A (en) | 1990-02-07 | 1992-09-15 | Boehringer Mannheim Corporation | Knee prosthesis |
US5062852A (en) | 1990-02-09 | 1991-11-05 | Intermedics Orthopedics, Inc. | Tibial prosthesis with independent medial and lateral baseplates |
IT1248971B (en) | 1990-06-22 | 1995-02-11 | Cremascoli G Srl | EQUIPMENT SUITABLE TO ALLOW THE PERFORMANCE OF A CORRECT FEMORAL AND TIBIAL RESECTION FOR THE APPLICATION OF REPLACEMENT PROSTHESES OF THE KNEE JOINT |
FR2664157B1 (en) | 1990-07-06 | 1992-10-30 | Jbs Sa | FEMORAL CUTTING GUIDE. |
GB9018782D0 (en) | 1990-08-28 | 1990-10-10 | Goodfellow John W | Phosthetic femoral components |
US5370701A (en) | 1990-09-28 | 1994-12-06 | Arch Development Corporation | Rotating/sliding contrained prosthetic knee |
US5071438A (en) | 1990-11-07 | 1991-12-10 | Intermedics Orthopedics, Inc. | Tibial prothesis with pivoting articulating surface |
US5330532A (en) | 1990-11-09 | 1994-07-19 | Chitranjan Ranawat | Knee joint prosthesis |
DE69128961T2 (en) | 1990-11-14 | 1998-10-08 | Arch Dev Corp | IMPROVED KNEE PROSTHESIS WITH MOVABLE BEARING |
US5176710A (en) | 1991-01-23 | 1993-01-05 | Orthopaedic Research Institute | Prosthesis with low stiffness factor |
GB9102348D0 (en) * | 1991-02-04 | 1991-03-20 | Inst Of Orthopaedics The | Prosthesis for knee replacement |
US5053037A (en) | 1991-03-07 | 1991-10-01 | Smith & Nephew Richards Inc. | Femoral instrumentation for long stem surgery |
US5129909A (en) | 1991-03-13 | 1992-07-14 | Sutherland Charles J | Apparatus and method for making precise bone cuts in total knee replacement |
US5358527A (en) | 1991-03-22 | 1994-10-25 | Forte Mark R | Total knee prosthesis with resurfacing and posterior stabilization capability |
US5236461A (en) * | 1991-03-22 | 1993-08-17 | Forte Mark R | Totally posterior stabilized knee prosthesis |
US5147406A (en) | 1991-04-22 | 1992-09-15 | Zimmer, Inc. | Femoral component for a knee joint prosthesis having a modular cam and stem |
US5133759A (en) * | 1991-05-24 | 1992-07-28 | Turner Richard H | Asymmetrical femoral condye total knee arthroplasty prosthesis |
JPH0541510A (en) | 1991-08-06 | 1993-02-19 | Fujitsu Ltd | Manufacture of solid-state image sensing device |
US5190545A (en) | 1991-08-27 | 1993-03-02 | Pfizer Hospital Products Group, Inc. | Cerclage wire positioning insert |
CH685669A5 (en) * | 1991-08-28 | 1995-09-15 | Sulzer Aktiengesellschaftprote | Knee joint prosthesis. |
US5133758A (en) | 1991-09-16 | 1992-07-28 | Research And Education Institute, Inc. Harbor-Ucla Medical Center | Total knee endoprosthesis with fixed flexion-extension axis of rotation |
FR2681778B1 (en) | 1991-10-01 | 1997-11-28 | Impact | MODULAR ANCILLARY FOR THE PLACEMENT OF A KNEE PROSTHESIS. |
US5470354A (en) | 1991-11-12 | 1995-11-28 | Biomet Inc. | Force sensing apparatus and method for orthopaedic joint reconstruction |
DE4202717C1 (en) | 1991-12-11 | 1993-06-17 | Dietmar Prof. Dr. 3350 Kreiensen De Kubein-Meesenburg | |
CH686611A5 (en) * | 1992-01-14 | 1996-05-15 | Sulzer Medizinaltechnik Ag | Art Royal knee. |
US5480443A (en) | 1992-01-31 | 1996-01-02 | Elias; Sarmed G. | Artifical implant component and method for securing same |
GB9202561D0 (en) | 1992-02-07 | 1992-03-25 | Howmedica | Orthopaedic instrument |
US5330534A (en) | 1992-02-10 | 1994-07-19 | Biomet, Inc. | Knee joint prosthesis with interchangeable components |
SE9201557D0 (en) | 1992-05-18 | 1992-05-18 | Astra Ab | JOINT PROSTHESIS AND APPARATUS FOR PREPARING THE BONE PRIOR TO FITTING OF THE PROSTHESIS |
DE4219939C2 (en) | 1992-06-18 | 1995-10-19 | Klaus Dipl Ing Radermacher | Device for aligning, positioning and guiding machining tools, machining or measuring devices for machining a bony structure and method for producing this device |
US5824102A (en) | 1992-06-19 | 1998-10-20 | Buscayret; Christian | Total knee prosthesis |
CA2144337A1 (en) | 1992-09-10 | 1994-03-17 | Donald E. Mcnulty | Method and apparatus for installing a femoral component |
US5312411A (en) | 1992-10-27 | 1994-05-17 | Smith & Nephew Richards, Inc. | Uni-compartmental femoral knee instruments and prosthesis |
US5344460A (en) | 1992-10-30 | 1994-09-06 | Encore Orthopedics, Inc. | Prosthesis system |
US5658342A (en) | 1992-11-16 | 1997-08-19 | Arch Development | Stabilized prosthetic knee |
US5370699A (en) | 1993-01-21 | 1994-12-06 | Orthomet, Inc. | Modular knee joint prosthesis |
FR2701387B1 (en) | 1993-02-10 | 1995-06-23 | Reach | POSTERO-STABILIZED KNEE PROSTHESIS. |
US5358529A (en) | 1993-03-05 | 1994-10-25 | Smith & Nephew Richards Inc. | Plastic knee femoral implants |
DE4310968C2 (en) | 1993-04-03 | 1995-08-10 | Kubein Meesenburg Dietmar | Artificial joint as an endoprosthesis for the human patella joint |
US6156223A (en) | 1993-04-26 | 2000-12-05 | Armstrong World Industries, Inc. | Xerogels and their preparation |
WO1994028812A1 (en) | 1993-06-15 | 1994-12-22 | Kevin Hardinge | Bone fracture fixation apparatus |
DE4417629B4 (en) | 1993-06-24 | 2006-03-16 | SDGI Holdings, Inc., Wilmington | Implant for the replacement of vertebral bodies |
GB9315428D0 (en) | 1993-07-26 | 1993-09-08 | Dall Desmond Meiring | Bone fixation system |
FR2710258B1 (en) | 1993-09-20 | 1995-12-15 | Medinov Sa | Knee prosthesis. |
US5549686A (en) * | 1994-06-06 | 1996-08-27 | Zimmer, Inc. | Knee prosthesis having a tapered cam |
GB9413607D0 (en) | 1994-07-06 | 1994-08-24 | Goodfellow John W | Endoprosthetic knee joint device |
FR2722392A1 (en) | 1994-07-12 | 1996-01-19 | Biomicron | APPARATUS FOR RESECTING KNEE CONDYLES FOR PLACING A PROSTHESIS AND METHOD FOR PLACING SUCH AN APPARATUS |
US5549688A (en) * | 1994-08-04 | 1996-08-27 | Smith & Nephew Richards Inc. | Asymmetric femoral prosthesis |
US6676704B1 (en) | 1994-08-12 | 2004-01-13 | Diamicron, Inc. | Prosthetic joint component having at least one sintered polycrystalline diamond compact articulation surface and substrate surface topographical features in said polycrystalline diamond compact |
US5810827A (en) | 1994-09-02 | 1998-09-22 | Hudson Surgical Design, Inc. | Method and apparatus for bony material removal |
US5702458A (en) | 1994-12-09 | 1997-12-30 | New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Joint prosthesis |
IT1277091B1 (en) | 1994-12-30 | 1997-11-04 | Jbs Sa | STABILIZED RECOVERY PROSTHESIS FROM BEHIND BY KNEE ARTICULATION |
CA2166450C (en) | 1995-01-20 | 2008-03-25 | Ronald Salovey | Chemically crosslinked ultrahigh molecular weight polyethylene for artificial human joints |
AUPN089495A0 (en) * | 1995-02-03 | 1995-03-02 | Denupo Pty. Ltd. | Knee prosthesis |
US5609642A (en) * | 1995-02-15 | 1997-03-11 | Smith & Nephew Richards Inc. | Tibial trial prosthesis and bone preparation system |
US5578039A (en) | 1995-02-15 | 1996-11-26 | Smith & Nephew Richards Inc. | Tibial resection instrumentation and surgical method |
US5683468A (en) | 1995-03-13 | 1997-11-04 | Pappas; Michael J. | Mobile bearing total joint replacement |
FR2732886B1 (en) | 1995-04-13 | 1997-10-31 | France Bloc Sa | PATELLAR CUTTING GUIDE FOR PLACEMENT OF THE PROSTHETIC KNEE PROSTHESIS PATELLA |
US6099502A (en) | 1995-04-20 | 2000-08-08 | Acist Medical Systems, Inc. | Dual port syringe |
DE19521597A1 (en) | 1995-06-14 | 1996-12-19 | Kubein Meesenburg Dietmar | Artificial joint, especially an endoprosthesis to replace natural joints |
DE19529824A1 (en) * | 1995-08-14 | 1997-02-20 | Bodo Gnutzmann | Bi-condylar endoprosthesis for knee |
US5682886A (en) | 1995-12-26 | 1997-11-04 | Musculographics Inc | Computer-assisted surgical system |
US5658344A (en) | 1995-12-29 | 1997-08-19 | Johnson & Johnson Professional, Inc. | Tibial insert reinforcement pin |
US5681354A (en) | 1996-02-20 | 1997-10-28 | Board Of Regents, University Of Colorado | Asymmetrical femoral component for knee prosthesis |
DE19606462C1 (en) | 1996-02-21 | 1997-10-16 | Plus Endoprothetik Ag | Knee joint endoprosthesis |
US5741259A (en) | 1996-02-22 | 1998-04-21 | Chan; Kwan-Ho | Surgical fastener device for use in bone fracture fixation |
US5964808A (en) * | 1996-07-11 | 1999-10-12 | Wright Medical Technology, Inc. | Knee prosthesis |
US5782921A (en) * | 1996-07-23 | 1998-07-21 | Johnson & Johnson Professional, Inc. | Modular knee prosthesis |
CA2264722A1 (en) | 1996-09-02 | 1998-03-12 | Sanyo Trading Co., Ltd. | Silane-treated clay production method, silane-treated clay and composition containing same |
WO1998016258A1 (en) * | 1996-10-15 | 1998-04-23 | The Orthopaedic Hospital | Wear resistant surface-gradient cross-linked polyethylene |
US5824100A (en) | 1996-10-30 | 1998-10-20 | Osteonics Corp. | Knee prosthesis with increased balance and reduced bearing stress |
DE19647155C2 (en) | 1996-11-14 | 1998-11-19 | Plus Endoprothetik Ag | Implant |
US8771365B2 (en) | 2009-02-25 | 2014-07-08 | Conformis, Inc. | Patient-adapted and improved orthopedic implants, designs, and related tools |
US5810824A (en) | 1997-02-13 | 1998-09-22 | Chan; Kwan-Ho | Surgical fastener assembly and method for bone fracture fixation |
US6205411B1 (en) | 1997-02-21 | 2001-03-20 | Carnegie Mellon University | Computer-assisted surgery planner and intra-operative guidance system |
FR2760352B3 (en) | 1997-03-10 | 1999-04-16 | Philippe Berret | TOTAL KNEE PROSTHESIS |
CA2233265C (en) * | 1997-04-04 | 2004-09-14 | Bryan Cornwall | Deep flexion knee prosthesis |
GB9707717D0 (en) | 1997-04-16 | 1997-06-04 | Walker Peter S | Knee prosthesis having guide surfaces for control of anterior-posterior translation |
US6139581A (en) | 1997-06-06 | 2000-10-31 | Depuy Orthopaedics, Inc. | Posterior compensation tibial tray |
EP0890347B1 (en) * | 1997-07-10 | 2003-10-01 | Société Ortho-Id | Knee joint prosthesis |
RU2121319C1 (en) | 1997-08-14 | 1998-11-10 | Акционерное общество открытого типа "Санкт-Петербургский институт огнеупоров" | Knee joint endoprosthesis |
FR2769495B1 (en) | 1997-10-14 | 1999-12-31 | Michel Timoteo | KNEE PROSTHESIS |
DE59711302D1 (en) * | 1997-10-28 | 2004-03-18 | Ct Pulse Orthopedics Ltd | knee prosthesis |
US5782925A (en) * | 1997-11-06 | 1998-07-21 | Howmedica Inc. | Knee implant rotational alignment apparatus |
CA2254218C (en) | 1997-11-18 | 2003-11-25 | Michael J. Pappas | Prosthetic knee joint with enhanced posterior stabilization and dislocation prevention features |
US6325828B1 (en) | 1997-12-02 | 2001-12-04 | Rose Biomedical Research | Apparatus for knee prosthesis |
BE1011626A3 (en) | 1997-12-17 | 1999-11-09 | Memento S A | A total knee prosthesis tibial plateau mobile rotating. |
EP0923916A1 (en) | 1997-12-19 | 1999-06-23 | Sulzer Orthopädie AG | Knee joint prosthesis |
US6246697B1 (en) | 1998-01-24 | 2001-06-12 | Motorola, Inc. | Method and system for generating a complex pseudonoise sequence for processing a code division multiple access signal |
US6123729A (en) * | 1998-03-10 | 2000-09-26 | Bristol-Myers Squibb Company | Four compartment knee |
DE19812624A1 (en) * | 1998-03-23 | 1999-09-30 | Bmw Rolls Royce Gmbh | Rotor blade of an axial flow machine |
US6258095B1 (en) | 1998-03-28 | 2001-07-10 | Stryker Technologies Corporation | Methods and tools for femoral intermedullary revision surgery |
EP0956836B1 (en) * | 1998-05-13 | 2004-07-28 | DePuy Products, Inc. | Tibial tray with adjustable keel |
US6428577B1 (en) * | 1998-05-20 | 2002-08-06 | Smith & Nephew, Inc. | Mobile bearing knee prosthesis |
US6126692A (en) * | 1998-06-25 | 2000-10-03 | New York Society For The Relief Of The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Retaining mechanism for a modular tibial component of a knee prosthesis |
US6132468A (en) | 1998-09-10 | 2000-10-17 | Mansmann; Kevin A. | Arthroscopic replacement of cartilage using flexible inflatable envelopes |
US6443991B1 (en) * | 1998-09-21 | 2002-09-03 | Depuy Orthopaedics, Inc. | Posterior stabilized mobile bearing knee |
US6152960A (en) | 1998-10-13 | 2000-11-28 | Biomedical Engineering Trust I | Femoral component for knee endoprosthesis |
US6500208B1 (en) | 1998-10-16 | 2002-12-31 | Biomet, Inc. | Nonmodular joint prosthesis convertible in vivo to a modular prosthesis |
JP2000201955A (en) | 1999-01-07 | 2000-07-25 | Soc Orto Ed | Prosthesis for knee joint |
US6623526B1 (en) | 1999-01-08 | 2003-09-23 | Corin Limited | Knee prosthesis |
US6306172B1 (en) | 1999-01-28 | 2001-10-23 | Johnson & Johnson Professional, Inc. | Modular tibial insert for prosthesis system |
US6086590A (en) | 1999-02-02 | 2000-07-11 | Pioneer Laboratories, Inc. | Cable connector for orthopaedic rod |
US6165223A (en) | 1999-03-01 | 2000-12-26 | Biomet, Inc. | Floating bearing knee joint prosthesis with a fixed tibial post |
US6413279B1 (en) * | 1999-03-01 | 2002-07-02 | Biomet, Inc. | Floating bearing knee joint prosthesis with a fixed tibial post |
US6972039B2 (en) | 1999-03-01 | 2005-12-06 | Biomet, Inc. | Floating bearing knee joint prosthesis with a fixed tibial post |
US8019421B2 (en) * | 1999-03-05 | 2011-09-13 | Metacure Limited | Blood glucose level control |
US6923831B2 (en) * | 1999-05-10 | 2005-08-02 | Barry M. Fell | Surgically implantable knee prosthesis having attachment apertures |
US6966928B2 (en) * | 1999-05-10 | 2005-11-22 | Fell Barry M | Surgically implantable knee prosthesis having keels |
US7338524B2 (en) | 1999-05-10 | 2008-03-04 | Fell Barry M | Surgically implantable knee prosthesis |
US20050033424A1 (en) * | 1999-05-10 | 2005-02-10 | Fell Barry M. | Surgically implantable knee prosthesis |
US6855165B2 (en) * | 1999-05-10 | 2005-02-15 | Barry M. Fell | Surgically implantable knee prosthesis having enlarged femoral surface |
US7491235B2 (en) | 1999-05-10 | 2009-02-17 | Fell Barry M | Surgically implantable knee prosthesis |
US7297161B2 (en) | 1999-05-10 | 2007-11-20 | Fell Barry M | Surgically implantable knee prosthesis |
GB9914074D0 (en) | 1999-06-16 | 1999-08-18 | Btg Int Ltd | Tibial component |
US8066776B2 (en) | 2001-12-14 | 2011-11-29 | Btg International Limited | Tibial component |
FR2796836B1 (en) * | 1999-07-26 | 2002-03-22 | Michel Bercovy | NEW KNEE PROSTHESIS |
GB9919954D0 (en) | 1999-08-23 | 1999-10-27 | Walker Peter S | Linked condylar total knee replacement |
US6620198B2 (en) * | 1999-10-07 | 2003-09-16 | Exactech, Inc. | Composite bearing inserts for total knee joints |
US6378289B1 (en) | 1999-11-19 | 2002-04-30 | Pioneer Surgical Technology | Methods and apparatus for clamping surgical wires or cables |
DE50015731D1 (en) | 1999-12-13 | 2009-10-08 | Zimmer Gmbh | Kit for a knee joint prosthesis |
FR2805454B1 (en) * | 2000-02-24 | 2003-01-10 | Aesculap Sa | KNEE PROSTHESIS WITH CAVITY IN THE TROCHLE |
US6491726B2 (en) | 2000-03-08 | 2002-12-10 | Biomedical Engineering Trust I | Posterior stabilized prosthetic knee replacement with bearing translation and dislocation prevention features |
US6475241B2 (en) * | 2000-03-13 | 2002-11-05 | Biomedical Engineering Trust I | Posterior stabilized knee replacement with bearing translation for knees with retained collateral ligaments |
US7585323B2 (en) | 2000-05-05 | 2009-09-08 | Medlden, Llc | In vitro mechanical loading of musculoskeletal tissues |
JP4409784B2 (en) | 2000-05-29 | 2010-02-03 | ツィマー ゲーエムベーハー | Artificial knee joint |
US6436145B1 (en) | 2000-06-02 | 2002-08-20 | Zimmer, Inc. | Plug for a modular orthopaedic implant and method for assembly |
US6707452B1 (en) | 2000-07-19 | 2004-03-16 | Pixar | Method and apparatus for surface approximation without cracks |
US6524315B1 (en) | 2000-08-08 | 2003-02-25 | Depuy Acromed, Inc. | Orthopaedic rod/plate locking mechanism |
JP2004521666A (en) | 2000-08-28 | 2004-07-22 | アドバンスト バイオ サーフェイシズ,インコーポレイティド | Methods and systems for enhancing mammalian joints |
DE10057675C2 (en) * | 2000-11-21 | 2003-02-13 | Andrej Nowakowski | Knee endoprosthesis |
US6558426B1 (en) * | 2000-11-28 | 2003-05-06 | Medidea, Llc | Multiple-cam, posterior-stabilized knee prosthesis |
DE20100962U1 (en) | 2001-01-19 | 2001-05-03 | Keramed Medizintechnik Gmbh | Inlay for a knee endoprosthesis |
US6645251B2 (en) | 2001-01-22 | 2003-11-11 | Smith & Nephew, Inc. | Surfaces and processes for wear reducing in orthopaedic implants |
US6485519B2 (en) * | 2001-01-29 | 2002-11-26 | Bristol-Myers Squibb Company | Constrained prosthetic knee with rotating bearing |
US6773461B2 (en) * | 2001-01-29 | 2004-08-10 | Zimmer Technology, Inc. | Constrained prosthetic knee with rotating bearing |
US6719800B2 (en) | 2001-01-29 | 2004-04-13 | Zimmer Technology, Inc. | Constrained prosthetic knee with rotating bearing |
US20020120340A1 (en) * | 2001-02-23 | 2002-08-29 | Metzger Robert G. | Knee joint prosthesis |
US7547307B2 (en) * | 2001-02-27 | 2009-06-16 | Smith & Nephew, Inc. | Computer assisted knee arthroplasty instrumentation, systems, and processes |
WO2002067800A2 (en) | 2001-02-27 | 2002-09-06 | Smith & Nephew, Inc. | Surgical navigation systems and processes for high tibial osteotomy |
US7776085B2 (en) * | 2001-05-01 | 2010-08-17 | Amedica Corporation | Knee prosthesis with ceramic tibial component |
US6589283B1 (en) * | 2001-05-15 | 2003-07-08 | Biomet, Inc. | Elongated femoral component |
US6960213B2 (en) | 2001-05-23 | 2005-11-01 | Medicinelodge, Inc. | Apparatus and method for orthopedic fixation |
US6520965B2 (en) | 2001-05-23 | 2003-02-18 | Alan Chervitz | Apparatus and method for orthopedic fixation |
US6482209B1 (en) * | 2001-06-14 | 2002-11-19 | Gerard A. Engh | Apparatus and method for sculpting the surface of a joint |
US20030009230A1 (en) * | 2001-06-30 | 2003-01-09 | Gundlapalli Rama Rao V. | Surface sterilizable joint replacement prosthesis component with insert |
EP1414369A2 (en) | 2001-07-27 | 2004-05-06 | Medtronic, Inc. | Adventitial fabric reinforced porous prosthetic graft |
JP3614802B2 (en) | 2001-08-27 | 2005-01-26 | 有限会社エイド−ル | Artificial joint |
JP3740638B2 (en) * | 2001-11-28 | 2006-02-01 | 準平 山崎 | Knee brace |
US7141053B2 (en) | 2001-11-28 | 2006-11-28 | Wright Medical Technology, Inc. | Methods of minimally invasive unicompartmental knee replacement |
US20030100953A1 (en) * | 2001-11-28 | 2003-05-29 | Rosa Richard A. | Knee joint prostheses |
JP3781355B2 (en) | 2001-12-10 | 2006-05-31 | 徹 勝呂 | Femoral component in knee prosthesis |
EP1460977B1 (en) * | 2001-12-21 | 2006-08-30 | Smith & Nephew, Inc. | Hinged joint system |
US7334990B2 (en) * | 2002-01-29 | 2008-02-26 | Ramgen Power Systems, Inc. | Supersonic compressor |
US20030153978A1 (en) | 2002-02-08 | 2003-08-14 | Whiteside Biomechanics, Inc. | Apparatus and method of ligament balancing and component fit check in total knee arthroplasty |
US20040034432A1 (en) * | 2002-02-11 | 2004-02-19 | Dean Hughes | Mobile bearing tibial base prosthetic devices employing oxidized zirconium surfaces |
US20030153979A1 (en) | 2002-02-11 | 2003-08-14 | Dean Hughes | Posterior stabilized knee system prosthetic devices employing diffusion-hardened surfaces |
JP3781186B2 (en) | 2002-02-13 | 2006-05-31 | 徹 勝呂 | Knee prosthesis |
EP1482877B1 (en) * | 2002-03-11 | 2007-05-30 | Spinal Concepts Inc. | Instrumentation for implanting spinal implant devices |
US7615082B2 (en) | 2002-03-22 | 2009-11-10 | Hjs Gelenk System Gmbh | Artificial joint |
US7275218B2 (en) | 2002-03-29 | 2007-09-25 | Depuy Products, Inc. | Method, apparatus, and program for analyzing a prosthetic device |
US6946001B2 (en) | 2003-02-03 | 2005-09-20 | Zimmer Technology, Inc. | Mobile bearing unicompartmental knee |
US7150761B2 (en) * | 2002-05-24 | 2006-12-19 | Medicinelodge, Inc. | Modular femoral components for knee arthroplasty |
US7615081B2 (en) * | 2002-05-24 | 2009-11-10 | Zimmer, Inc. | Femoral components for knee arthroplasty |
US20030225458A1 (en) * | 2002-06-04 | 2003-12-04 | Ron Donkers | Universal femoral component for endoprosthetic knee |
US20040002767A1 (en) | 2002-06-28 | 2004-01-01 | Joseph Wyss | Modular knee joint prosthesis |
US20040006393A1 (en) * | 2002-07-03 | 2004-01-08 | Brian Burkinshaw | Implantable prosthetic knee for lateral compartment |
DE10231538C1 (en) * | 2002-07-11 | 2003-10-09 | Hjs Gelenk System Gmbh | Artificial joint, used as endoprosthesis for human knee joint, comprises a first joint compartment and a second joint compartment having contact surfaces arranged at an angle so that their surface normals have a common intersection |
US20040054416A1 (en) | 2002-09-12 | 2004-03-18 | Joe Wyss | Posterior stabilized knee with varus-valgus constraint |
US6770099B2 (en) | 2002-11-19 | 2004-08-03 | Zimmer Technology, Inc. | Femoral prosthesis |
US20040102852A1 (en) * | 2002-11-22 | 2004-05-27 | Johnson Erin M. | Modular knee prosthesis |
US7033397B2 (en) | 2003-02-03 | 2006-04-25 | Zimmer Technology, Inc. | Mobile bearing unicondylar tibial knee prosthesis |
US20040153066A1 (en) | 2003-02-03 | 2004-08-05 | Coon Thomas M. | Apparatus for knee surgery and method of use |
US6916324B2 (en) | 2003-02-04 | 2005-07-12 | Zimmer Technology, Inc. | Provisional orthopedic prosthesis for partially resected bone |
JP4045194B2 (en) | 2003-02-25 | 2008-02-13 | 京セラ株式会社 | Artificial knee joint |
US7364590B2 (en) | 2003-04-08 | 2008-04-29 | Thomas Siebel | Anatomical knee prosthesis |
FR2854792B1 (en) * | 2003-05-12 | 2005-09-09 | Tornier Sa | GAME OF PROTHETIC ELEMENTS FOR A TIBIAL PROTHETIC SET |
AU2003902467A0 (en) | 2003-05-19 | 2003-06-05 | Boris Rjazancev | A prosthetic component, a method of attaching a prosthetic component to a bone, a method of performing knee replacement surgery and a frame for application to a knee joint during knee replacement surgery |
JP4297254B2 (en) | 2003-06-03 | 2009-07-15 | 日本碍子株式会社 | Joint, luminous container, high pressure discharge lamp assembly and high pressure discharge lamp |
US7513867B2 (en) * | 2003-07-16 | 2009-04-07 | Kardium, Inc. | Methods and devices for altering blood flow through the left ventricle |
US7094259B2 (en) * | 2003-07-24 | 2006-08-22 | Samih Tarabichi | Physiological total knee implant |
US20050143832A1 (en) * | 2003-10-17 | 2005-06-30 | Carson Christopher P. | High flexion articular insert |
US7139887B2 (en) * | 2003-12-31 | 2006-11-21 | Veritas Operating Corporation | Coordinated storage management operations in replication environment |
US20060030854A1 (en) * | 2004-02-02 | 2006-02-09 | Haines Timothy G | Methods and apparatus for wireplasty bone resection |
US7815645B2 (en) * | 2004-01-14 | 2010-10-19 | Hudson Surgical Design, Inc. | Methods and apparatus for pinplasty bone resection |
US7857814B2 (en) * | 2004-01-14 | 2010-12-28 | Hudson Surgical Design, Inc. | Methods and apparatus for minimally invasive arthroplasty |
US20060015115A1 (en) | 2004-03-08 | 2006-01-19 | Haines Timothy G | Methods and apparatus for pivotable guide surfaces for arthroplasty |
US8114083B2 (en) * | 2004-01-14 | 2012-02-14 | Hudson Surgical Design, Inc. | Methods and apparatus for improved drilling and milling tools for resection |
US8021368B2 (en) | 2004-01-14 | 2011-09-20 | Hudson Surgical Design, Inc. | Methods and apparatus for improved cutting tools for resection |
US20050171604A1 (en) | 2004-01-20 | 2005-08-04 | Alexander Michalow | Unicondylar knee implant |
US20090210066A1 (en) | 2004-01-23 | 2009-08-20 | The General Hospital Corporation Dba Massachusetts General Hospital | Anterior cruciate ligament substituting knee replacement prosthesis |
DE202004003133U1 (en) | 2004-02-26 | 2004-07-29 | Aap Implantate Ag | Joint replacement tibial plateau |
JP3915989B2 (en) | 2004-03-17 | 2007-05-16 | 徹 勝呂 | Artificial knee joint |
US7413577B1 (en) | 2005-09-22 | 2008-08-19 | Howmedica Osteonics Corp. | Total stabilized knee prosthesis with constraint |
US8211181B2 (en) | 2005-12-14 | 2012-07-03 | New York University | Surface guided knee replacement |
GB0607544D0 (en) | 2006-04-13 | 2006-05-24 | Pinskerova Vera | Knee prothesis |
JP5041510B2 (en) | 2006-06-13 | 2012-10-03 | テイ・エス テック株式会社 | Vehicle seat |
US7686812B2 (en) | 2006-06-30 | 2010-03-30 | Howmedica Osteonics Corp. | Method for setting the rotational position of a femoral component |
US7875081B2 (en) | 2006-09-25 | 2011-01-25 | New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Posterior stabilized knee prosthesis |
US8382846B2 (en) | 2007-08-27 | 2013-02-26 | Kent M. Samuelson | Systems and methods for providing deeper knee flexion capabilities for knee prosthesis patients |
WO2009105496A1 (en) | 2008-02-18 | 2009-08-27 | Maxx Orthopedics, Inc. | Total knee replacement prosthesis |
CA2728888C (en) | 2008-06-24 | 2014-09-09 | New York University | Recess-ramp knee joint prosthesis |
US20100161067A1 (en) | 2008-12-23 | 2010-06-24 | Aesculap Ag | Knee prosthesis |
US9220600B2 (en) | 2008-12-23 | 2015-12-29 | Aesculap Implant Systems, Llc | Knee prosthesis |
CN101609678B (en) * | 2008-12-30 | 2011-07-27 | 华为技术有限公司 | Signal compression method and compression device thereof |
DE102009033471B3 (en) | 2009-07-10 | 2011-04-07 | Brose Fahrzeugteile Gmbh & Co. Kommanditgesellschaft, Coburg | Locking device for releasably locking an adjustment part |
US8906105B2 (en) | 2009-08-11 | 2014-12-09 | Michael D. Ries | Systems and methods for mobile bearing prosthetic knee |
US8382848B2 (en) | 2009-08-11 | 2013-02-26 | Imds Corporation | Position adjustable trial systems for prosthetic implants |
US8740984B2 (en) | 2009-10-06 | 2014-06-03 | Microport Orthopedics Holdings Inc. | Tibial implant base |
CN102917670B (en) | 2009-12-09 | 2016-08-03 | 马萨诸塞总医院运营总医院公司 | For recovering normal bending range and the implant of motion of knee joint performance |
US20110137691A1 (en) | 2010-04-01 | 2011-06-09 | The Crawford Group, Inc. | Method and System for Reducing Carbon Emissions Arising from Vehicle Travel |
US20120185054A1 (en) | 2011-01-19 | 2012-07-19 | Wright Medical Technology, Inc. | Medial pivot posterior stabilized knee implant system |
CN103327937B (en) | 2011-01-27 | 2017-08-08 | 史密夫和内修有限公司 | Constrained knee-joint prosthesis |
US20130123931A1 (en) | 2011-11-14 | 2013-05-16 | Maxx Orthopedics, Inc. | Knee Revision Prosthesis With Progressive Restraint |
JP6079858B2 (en) | 2012-07-10 | 2017-02-15 | 株式会社リコー | System and storage medium |
-
2003
- 2003-12-22 WO PCT/US2003/041088 patent/WO2004058108A1/en active Application Filing
- 2003-12-22 ES ES10012160.7T patent/ES2465090T3/en not_active Expired - Lifetime
- 2003-12-22 AT AT03800125T patent/ATE497741T1/en not_active IP Right Cessation
- 2003-12-22 JP JP2004563999A patent/JP4943655B2/en not_active Expired - Lifetime
- 2003-12-22 AU AU2003299851A patent/AU2003299851B2/en not_active Expired
- 2003-12-22 EP EP10012160.7A patent/EP2316385B1/en not_active Expired - Lifetime
- 2003-12-22 DE DE60336013T patent/DE60336013D1/en not_active Expired - Lifetime
- 2003-12-22 EP EP03800125A patent/EP1575456B1/en not_active Expired - Lifetime
- 2003-12-22 ES ES03800125T patent/ES2363767T3/en not_active Expired - Lifetime
- 2003-12-22 CA CA2511216A patent/CA2511216C/en not_active Expired - Lifetime
- 2003-12-22 US US10/743,885 patent/US7326252B2/en active Active
-
2008
- 2008-01-31 US US12/023,112 patent/US7922771B2/en not_active Expired - Lifetime
-
2009
- 2009-10-20 US US12/582,300 patent/US8398715B2/en not_active Expired - Lifetime
-
2010
- 2010-03-10 AU AU2010200901A patent/AU2010200901B2/en not_active Expired
- 2010-05-17 US US12/781,526 patent/US20100234961A1/en not_active Abandoned
- 2010-07-02 JP JP2010152060A patent/JP5399989B2/en not_active Expired - Lifetime
- 2010-11-23 US US12/952,584 patent/US8398716B2/en not_active Expired - Lifetime
- 2010-11-23 US US12/952,859 patent/US8603178B2/en not_active Expired - Lifetime
- 2010-11-23 US US12/952,779 patent/US8449618B2/en not_active Expired - Lifetime
- 2010-11-23 US US12/952,611 patent/US8425617B2/en not_active Expired - Lifetime
- 2010-11-23 US US12/952,667 patent/US8394147B2/en not_active Expired - Lifetime
- 2010-11-23 US US12/952,625 patent/US8652210B2/en not_active Expired - Lifetime
- 2010-11-23 US US12/952,648 patent/US8394148B2/en not_active Expired - Lifetime
- 2010-11-23 US US12/952,704 patent/US8403992B2/en not_active Expired - Lifetime
- 2010-12-17 US US12/971,623 patent/US20110137619A1/en not_active Abandoned
- 2010-12-17 US US12/971,507 patent/US8647389B2/en not_active Expired - Lifetime
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2012
- 2012-10-24 US US13/659,309 patent/US9320605B2/en not_active Expired - Lifetime
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2015
- 2015-03-09 US US14/642,242 patent/US9402729B2/en not_active Expired - Lifetime
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2016
- 2016-05-26 US US15/165,031 patent/US9707087B2/en not_active Expired - Lifetime
- 2016-07-06 US US15/203,038 patent/US10149768B2/en not_active Expired - Lifetime
-
2018
- 2018-10-11 US US16/157,463 patent/US11369477B2/en active Active
Patent Citations (99)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3748662A (en) * | 1971-04-21 | 1973-07-31 | A Helfet | Replacements for bicondylar joints in human limbs |
US3816855A (en) * | 1971-06-01 | 1974-06-18 | Nat Res Dev | Knee joint prosthesis |
US3798679A (en) * | 1971-07-09 | 1974-03-26 | Ewald Frederick | Joint prostheses |
US3869781A (en) * | 1974-02-25 | 1975-03-11 | Eubanks Eng Co | Apparatus for attaching terminals to electric conductors |
US3958278A (en) * | 1974-04-22 | 1976-05-25 | National Research Development Corporation | Endoprosthetic knee joint |
US4016606A (en) * | 1975-07-14 | 1977-04-12 | Research Corporation | Knee joint prosthesis |
US4209861A (en) * | 1978-02-22 | 1980-07-01 | Howmedica, Inc. | Joint prosthesis |
US4213209A (en) * | 1978-05-22 | 1980-07-22 | New York Society For The Relief Of The Ruptured And Crippled | Knee joint prosthesis |
US4249270A (en) * | 1978-10-06 | 1981-02-10 | Sulzer Brothers Limited | Endoprosthesis for a knee joint |
US4207627A (en) * | 1979-01-18 | 1980-06-17 | Cloutier Jean Marie | Knee prosthesis |
US4340978A (en) * | 1979-07-02 | 1982-07-27 | Biomedical Engineering Corp. | New Jersey meniscal bearing knee replacement |
US4524766A (en) * | 1982-01-07 | 1985-06-25 | Petersen Thomas D | Surgical knee alignment method and system |
US4653488A (en) * | 1982-02-18 | 1987-03-31 | Howmedica, Inc. | Prosthetic knee implantation |
US4568348A (en) * | 1982-03-13 | 1986-02-04 | Chas. F. Thackray Limited | Knee prosthesis |
US4662889A (en) * | 1983-04-28 | 1987-05-05 | Feldmuhle Aktiengesellschaft | Knee joint prosthesis |
US4586933A (en) * | 1983-09-30 | 1986-05-06 | Hiromu Shoji | Dual articulating total knee prosthesis |
US4659331A (en) * | 1983-11-28 | 1987-04-21 | Regents Of University Of Michigan | Prosthesis interface surface and method of implanting |
US4721104A (en) * | 1985-12-02 | 1988-01-26 | Dow Corning Wright Corporation | Femoral surface shaping apparatus for posterior-stabilized knee implants |
US4722330A (en) * | 1986-04-22 | 1988-02-02 | Dow Corning Wright Corporation | Femoral surface shaping guide for knee implants |
US4822365A (en) * | 1986-05-30 | 1989-04-18 | Walker Peter S | Method of design of human joint prosthesis |
US5002547A (en) * | 1987-02-07 | 1991-03-26 | Pfizer Hospital Products Group, Inc. | Apparatus for knee prosthesis |
US4731086A (en) * | 1987-04-20 | 1988-03-15 | Dow Corning Wright | Shim for femoral knee joint prosthesis and method of using |
US5314482A (en) * | 1988-02-05 | 1994-05-24 | British Technology Group Ltd. | Femoral component, tool and method |
US4834758A (en) * | 1988-05-26 | 1989-05-30 | New York Society For The Relief Of The Ruptured And Crippled, Maintaining The Hospital For Special Surgery | Bone prosthesis for the leg and thigh |
US4926847A (en) * | 1988-12-27 | 1990-05-22 | Johnson & Johnson Orthopaedics, Inc. | Surgical cutting block |
US4936853A (en) * | 1989-01-11 | 1990-06-26 | Kirschner Medical Corporation | Modular knee prosthesis |
US5007933A (en) * | 1989-01-31 | 1991-04-16 | Osteonics Corp. | Modular knee prosthesis system |
US4938769A (en) * | 1989-05-31 | 1990-07-03 | Shaw James A | Modular tibial prosthesis |
US5122144A (en) * | 1989-09-26 | 1992-06-16 | Kirschner Medical Corporation | Method and instrumentation for unicompartmental total knee arthroplasty |
US5304181A (en) * | 1990-01-08 | 1994-04-19 | Caspari Richard B | Methods and apparatus for arthroscopic prosthetic knee replacement |
US5080675A (en) * | 1990-03-12 | 1992-01-14 | Howmedica | Tibial component for a replacement knee prosthesis |
US5480446A (en) * | 1990-06-12 | 1996-01-02 | British Technology Group Ltd. | Prosthetic knee joint devices |
US5116375A (en) * | 1990-08-27 | 1992-05-26 | Hofmann Aaron A | Knee prosthesis |
US5021061A (en) * | 1990-09-26 | 1991-06-04 | Queen's University At Kingston | Prosthetic patello-femoral joint |
US5219362A (en) * | 1991-02-07 | 1993-06-15 | Finsbury (Instruments) Limited | Knee prosthesis |
US5092869A (en) * | 1991-03-01 | 1992-03-03 | Biomet, Inc. | Oscillating surgical saw guide pins and instrumentation system |
US5098436A (en) * | 1991-03-07 | 1992-03-24 | Dow Corning Wright Corporation | Modular guide for shaping of femur to accommodate intercondylar stabilizing housing and patellar track of implant |
US5282803A (en) * | 1991-03-07 | 1994-02-01 | Smith & Nephew Richards Inc. | Instrumentation for long stem surgery |
US5100409A (en) * | 1991-03-07 | 1992-03-31 | Dow Corning Wright Corporation | Shaping and trial reduction guide for implantation of femoral prosthesis and method of using same |
US5181925A (en) * | 1991-04-22 | 1993-01-26 | Zimmer, Inc. | Femoral component for a knee joint prosthesis having a modular cam and stem |
US5203807A (en) * | 1991-07-10 | 1993-04-20 | Smith & Nephew Richards Inc. | Knee joint prosthesis articular surface |
US5201881A (en) * | 1991-08-13 | 1993-04-13 | Smith & Nephew Richards Inc. | Joint prosthesis with improved shock absorption |
US5514143A (en) * | 1991-11-27 | 1996-05-07 | Apogee Medical Products, Inc. | Apparatus and method for use during surgery |
US5520695A (en) * | 1992-02-14 | 1996-05-28 | Johnson & Johnson Professional, Inc. | Instruments for use in knee replacement surgery |
US5282867A (en) * | 1992-05-29 | 1994-02-01 | Mikhail Michael W E | Prosthetic knee joint |
US5507820A (en) * | 1992-12-14 | 1996-04-16 | Biomedical Engineering Trust I | Fixed bearing joint endoprosthesis |
US5413604A (en) * | 1992-12-24 | 1995-05-09 | Osteonics Corp. | Prosthetic knee implant for an anterior cruciate ligament deficient total knee replacement |
US5728162A (en) * | 1993-01-28 | 1998-03-17 | Board Of Regents Of University Of Colorado | Asymmetric condylar and trochlear femoral knee component |
US5723016A (en) * | 1993-04-01 | 1998-03-03 | British Technology Group Ltd. | Implantable prosthetic patellar components |
US5766200A (en) * | 1993-05-06 | 1998-06-16 | Linvatec Corporation | Rotatable endoscopic shaver with polymeric blades |
US5755801A (en) * | 1993-07-16 | 1998-05-26 | Walker; Peter Stanley | Prostheses for knee replacement |
US5405398A (en) * | 1993-08-30 | 1995-04-11 | Intermedics Orthopedics, Inc. | Prosthetic knee with posterior stabilized femoral component |
US5417694A (en) * | 1993-11-08 | 1995-05-23 | Smith & Nephew Richards Inc. | Distal femoral cutting guide apparatus with anterior or posterior referencing for use in knee joint replacement surgery |
US5906643A (en) * | 1994-07-28 | 1999-05-25 | Walker; Peter Stanley | Stabilised mobile bearing knee |
US5755803A (en) * | 1994-09-02 | 1998-05-26 | Hudson Surgical Design | Prosthetic implant |
US6197064B1 (en) * | 1994-09-02 | 2001-03-06 | Hudson Surgical Design, Inc. | Prosthetic implant |
US6695848B2 (en) * | 1994-09-02 | 2004-02-24 | Hudson Surgical Design, Inc. | Methods for femoral and tibial resection |
US5871545A (en) * | 1994-09-14 | 1999-02-16 | Btg International Limited | Prosthetic knee joint device |
US5609645A (en) * | 1994-10-28 | 1997-03-11 | Intermedics, Inc. | Knee revision prosthesis with shims |
US5639279A (en) * | 1995-02-09 | 1997-06-17 | Intermedics Orthopedics, Inc. | Posteriorly-stabilized prosthetic knee |
US5611802A (en) * | 1995-02-14 | 1997-03-18 | Samuelson; Kent M. | Method and apparatus for resecting bone |
US6059788A (en) * | 1995-05-31 | 2000-05-09 | Katz; Lawrence | Method and apparatus for locating bone cuts at the distal condylar femur region to receive a femoral prosthesis and properly articulated with patellar and tibial prosthesis |
US5871546A (en) * | 1995-09-29 | 1999-02-16 | Johnson & Johnson Professional, Inc. | Femoral component condyle design for knee prosthesis |
US5755804A (en) * | 1996-02-21 | 1998-05-26 | Plus Endoprothetik Ag | Endoprosthetic knee joint |
US5879392A (en) * | 1996-05-08 | 1999-03-09 | Mcminn; Derek James Wallace | Knee prosthesis |
US6235060B1 (en) * | 1996-11-13 | 2001-05-22 | Hjs Gelenk System Gmbh | Artificial joint, in particular endoprosthesis for replacing natural joints |
US6203576B1 (en) * | 1996-12-09 | 2001-03-20 | Groupe Controle Dedienne Gcd Societe De Droit Francais | Complete knee joint prosthesis |
US6575980B1 (en) * | 1997-01-28 | 2003-06-10 | New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Method and apparatus for femoral resection |
US5766257A (en) * | 1997-01-28 | 1998-06-16 | Implant Manufacturing And Testing Corporation | Artificial joint having natural load transfer |
US6068658A (en) * | 1997-03-13 | 2000-05-30 | Zimmer Ltd. | Prosthesis for knee replacement |
US6039764A (en) * | 1997-08-18 | 2000-03-21 | Arch Development Corporation | Prosthetic knee with adjusted center of internal/external rotation |
US6206926B1 (en) * | 1997-10-06 | 2001-03-27 | Biomedical Engineering Trust I | Prosthetic knee joint with enhanced posterior stabilization and dislocation prevention features |
US6171340B1 (en) * | 1998-02-27 | 2001-01-09 | Mcdowell Charles L. | Method and device for regenerating cartilage in articulating joints |
US6210443B1 (en) * | 1998-04-15 | 2001-04-03 | Aesculap | Knee prosthetics |
US6506215B1 (en) * | 1998-05-12 | 2003-01-14 | Patrick Letot | Synthetic knee system |
US6080195A (en) * | 1998-07-08 | 2000-06-27 | Johnson & Johnson Professional, Inc. | Rotatable and translatable joint prosthesis with posterior stabilization |
US6361564B1 (en) * | 1999-02-02 | 2002-03-26 | Aesculap | Total knee joint comprising an insert movable relative to a tenon |
US6911044B2 (en) * | 1999-05-10 | 2005-06-28 | Barry M. Fell | Surgically implantable knee prosthesis having medially shifted tibial surface |
US6866684B2 (en) * | 1999-05-10 | 2005-03-15 | Barry M. Fell | Surgically implantable knee prosthesis having different tibial and femoral surface profiles |
US6755864B1 (en) * | 1999-09-24 | 2004-06-29 | Sulzer Orthopedics Ltd. | Tibia part for a knee joint prosthesis and a kit with a tibia part of this kind |
US6379388B1 (en) * | 1999-12-08 | 2002-04-30 | Ortho Development Corporation | Tibial prosthesis locking system and method of repairing knee joint |
US20030028196A1 (en) * | 2000-01-14 | 2003-02-06 | Bonutti Peter M. | Method of performing surgery |
US6702821B2 (en) * | 2000-01-14 | 2004-03-09 | The Bonutti 2003 Trust A | Instrumentation for minimally invasive joint replacement and methods for using same |
US7371240B2 (en) * | 2000-03-10 | 2008-05-13 | Smith & Nephew, Inc. | Method of arthroplasty on a knee joint and apparatus for use in same |
US6406497B2 (en) * | 2000-07-19 | 2002-06-18 | Tsunenori Takei | Artificial knee joint |
US7018418B2 (en) * | 2001-01-25 | 2006-03-28 | Tecomet, Inc. | Textured surface having undercut micro recesses in a surface |
US20100100192A1 (en) * | 2001-03-05 | 2010-04-22 | Haines Timothy G | Femoral prosthetic implant |
US6569202B2 (en) * | 2001-04-02 | 2003-05-27 | Whiteside Biomechanics, Inc. | Tray and liner for joint replacement system |
US6730128B2 (en) * | 2001-04-17 | 2004-05-04 | Exactech, Inc. | Prosthetic knee joint |
US6554838B2 (en) * | 2001-05-31 | 2003-04-29 | Howmedica Osteonics Corp. | Method and apparatus for implanting a prosthetic device |
US6846329B2 (en) * | 2002-02-26 | 2005-01-25 | Mcminn Derek James Wallace | Knee prosthesis |
US7048741B2 (en) * | 2002-05-10 | 2006-05-23 | Swanson Todd V | Method and apparatus for minimally invasive knee arthroplasty |
US6866683B2 (en) * | 2002-12-13 | 2005-03-15 | Medicine Lodge, Inc. | Modular implant for joint reconstruction and method of use |
US6887276B2 (en) * | 2002-12-13 | 2005-05-03 | Medicine Lodge, Inc | Modular implant for joint reconstruction and method of use |
US20100042224A1 (en) * | 2002-12-20 | 2010-02-18 | Smith & Nephew, Inc. | High performance knee prostheses |
US7326252B2 (en) * | 2002-12-20 | 2008-02-05 | Smith & Nephew, Inc. | High performance knee prostheses |
US20110125280A1 (en) * | 2002-12-20 | 2011-05-26 | Otto Jason K | High Performance Knee Prostheses |
US20110137619A1 (en) * | 2002-12-20 | 2011-06-09 | Otto Jason K | High Performance Knee Prostheses |
US7160330B2 (en) * | 2003-01-21 | 2007-01-09 | Howmedica Osteonics Corp. | Emulating natural knee kinematics in a knee prosthesis |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2012058540A1 (en) * | 2010-10-28 | 2012-05-03 | Jerry Gerald J | Knee system |
WO2012058560A1 (en) * | 2010-10-28 | 2012-05-03 | Jerry Gerald J | Tibial tray system and method of implantation |
US9675464B2 (en) | 2010-10-28 | 2017-06-13 | Gerald J. Jerry | Tibial tray system and method of implantation |
US9364332B2 (en) | 2011-09-27 | 2016-06-14 | Kyocera Medical Corporation | Artificial knee joint implant |
US20150134067A1 (en) * | 2011-11-28 | 2015-05-14 | Beijing Naton Technology Group Co., Ltd. | Artificial knee joint |
US9554911B2 (en) * | 2011-11-28 | 2017-01-31 | Beijing Naton Technology Group Co., Ltd | Artificial knee joint |
US8808387B2 (en) | 2012-01-26 | 2014-08-19 | Epic Ortho, LLC | Prosthetic joint |
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