WO2001013825A1 - Linked condylar total knee replacement - Google Patents
Linked condylar total knee replacement Download PDFInfo
- Publication number
- WO2001013825A1 WO2001013825A1 PCT/GB2000/003259 GB0003259W WO0113825A1 WO 2001013825 A1 WO2001013825 A1 WO 2001013825A1 GB 0003259 W GB0003259 W GB 0003259W WO 0113825 A1 WO0113825 A1 WO 0113825A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- post
- component
- prosthesis
- opposite end
- tibial
- Prior art date
Links
Classifications
-
- 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
- A61F2/3854—Special connection between upper and lower leg, e.g. constrained with ball and socket joint
Definitions
- This invention relates to a linked condylar knee prosthesis.
- the most commonly used design is the total condylar replacement.
- the prosthesis replaces the femoral-tibial and the patello-femoral bearing surfaces of the natural knee.
- the tibial component consists of two parts, a metal tray to cover the upper tibia, with a plastic bearing surface, articulating with the Femoral Component, fixed to the metal tray.
- a plastic component is frequently used to resurface the patella.
- the anterior cruciate is not retained, its function being replaced by dishing of the plastic bearing surface.
- the posterior cruciate is retained.
- the posterior cruciate is resected and its function replaced by increased dishing or by an intercondylar cam.
- the latter design is usually referred to as a posterior stabilised, or posterior cruciate substituting.
- Most cases of arthritis of the knee can be treated with one of these types of condylar replacement, and the results have a high success rate at up to 10 years and even beyond.
- a compartmental knee replacement generally called a "uni".
- the fiinctional results closely resemble normal.
- Such knees are often used in the younger and more active patients because of the very limited amount of bone and tissue removal, and the incisions can be much smaller than for conventional total condylar replacement.
- Another consideration for the younger active patients is the wear of the bearing surfaces. In order to reduce the wear of the bearing surfaces, the femoral-tibial bearing can be made to be conforming which minimises the contact stresses.
- the plastic bearing needs to be mobile, such that it slides and rotates on a polished upper surface of the tibial tray.
- Such designs are called mobile bearing knees. These can be made in either the compartmental form, or as a total condylar type.
- knee replacements involving one or more of the following conditions: severe bone loss of deformity, severe instability, gross deformity with non-viable soft tissues, bone tumour where the distal femur or proximal tibia requires resection, failed knee replacements of various types.
- this category includes those knees for which a total condylar replacement would be inadequate, particularly in terms of providing the required stability.
- a knee replacement which provides the appropriate amount of constraint is required.
- One type of knee which has been used for such cases is a variant of a total condylar called the constrained condylar.
- the design incorporates all of the design characteristics of a total condylar, but the Femoral Component includes a housing located in the intercondylar region, into which a post projecting from the centre of the tibial bearing component is located.
- This combination provides varus-valgus stability, partial anterior-posterior stability, and partial rotational stability.
- An advantage of the design is that the bone resection required for insertion is little greater than that for a total condylar, while the intercondylar region only requires squaring off.
- the limitations are that there is no limit to hyperextension, there can be inadequate anterior-posterior stability in some cases, and the varus-valgus stability is limited in some designs by the strength and stiffness of the tibial plastic post. When greater stability and strength is required,
- an intercondylar knee prosthesis which comprises a Femoral Component having condylar bearing surfaces and a tibial component having bearing surfaces for receiving the condylar bearing surfaces, the femoral and tibial components being linked together by a post which is secured at a first end to the tibial component and at the opposite end is received in an intercondylar housing of the femoral component, said opposite end of the post having surfeces which permit relative rotational movement of the post within the housing, but prevents the femoral component separating from the tibial component.
- the opposite end of the post may be a sphere or a cylinder or other shaped surface which permits the femoral component to undergo at least a limited degree of lateral-medial rotation, e.g. up to about ⁇ 10 ⁇ 15°, e.g. about 12° to each side of the anterior-posterior center-line.
- the post comprises a cylindrical post fixed to the tibial component mounted on the post.
- the plastic pivot component is fixed against rotation on the cylindrical post and is formed with spherical or cylindrical surfaces for engaging in and rotating within recesses in the intercondylar housing.
- Figure 2 is a perspective view of the embodiment shown in Figure 1 after assembly
- Figure 3A, B & C show the stages of assembly of the prosthesis
- Figures 4A & B show posterior and lateral views of a modified prosthesis in
- the components of the prosthesis are shown individually in Figure 1.
- the femoral component (1) is made from a metal such as cast cobalt-chrome or titanium alloy. In use, this component is affixed to the distal end of the femur which is shaped during surgery with rectangular and angular cuts so that the Femoral Component is a close fit.
- Component (1) replaces the normal bearing surfaces of the distal femur.
- the main bearing surf ⁇ ces of component (1) are the lateral and medial condyles (2 & 3), which extend distally to posteriorly. These bearing surfaces transmit the forces between the femur and the tibia.
- a patella bearing surf ⁇ ce (4) consisting of a groove along which the patella slides as the knee is flexed and extended.
- an intercondylar housing (5) which fits within the intercondylar region of the femur, requiring only squaring off of this area in the femur in order to locate and provide space for the housing (5).
- the posterior region of the housing is hollowed with parallel sides.
- spherical surfaces are machined into the housing so that each side of the sphere creates spherical saucer- like recesses (6) on either side of the anterior-posterior (A-P) centre-line of the housing, with a spherical surface also being formed at the top of the housing.
- the anterior part of the housing is solid, but has a hole (7) bored into it from the top for the fitting of a femoral stem, to facilitate fixation of the femoral component into the femur.
- the hole is tapered to allow for modular stems of different lengths and diameters to be fitted to the femoral component (1).
- the tibial base plate (10) is made from a metal such as cast cobalt-chrome or titanium alloy. This component is affixed during surgery to the upper end of the tibia, which has been resected horizontally to accommodate the component.
- a spigot (11) is attached to the lower surf ⁇ ce of the baseplate in line with the intramedullary canal of the tibia, for the purpose of attaching a stem, along similar lines to that on the femoral side.
- a metal post (12), preferably cylindrical, projects from the upper surf ⁇ ce of the baseplate. This may be formed integrally with the baseplate or rigidly fixed thereto.
- the lower part (13) of the post is preferably conical and radiused at (14), in order to maximise its strength for horizontally directed forces applied at the top of the post.
- a cylindrical hole (15) passes through the top of the post in an anterior-posterior direction, the purpose being described below.
- the bearing component is intended to lock tightly to the base plate, e.g. using cooperating rims and undercuts on the tibial base plate and meniscal component.
- Post (12) projects through a hole (26) in the bearing
- a plastics pivot component (17) made from UHMWPE. It comprises a cylindrical part (18) integral with a spherical top (19).
- the spherical top has flats (20) on opposite sides, such that the width across the flats is substantially the same as the diameter of the cylindrical part (18).
- Pivot component (17) has a second hole (22) for receiving and locking pin (23) extending in an anterior-posterior direction through the component, in line with the centre of
- Locking pin (23) is made from forged cobalt-chrome or titanium alloy. The material needs to be such that the two ends of the pin can be compressed, closing the slot, without permanent deformation or fracturing of the pin.
- Pin (23) is formed with a slot (24) and tangs (25) to snap outwardly after insertion. The diameters of the tangs and pin head of the locking pin are such that they are a clearance fit in the hole in the pivot component (17).
- the main cylindrical part of the pin is a sliding fit in the hole in the post (12) of the tibial base plate (10). Assembly of components into the knee
- FIG. 2 Assembled condition of the components shown in Figure 1 is shown in Figure 2.
- the ends of the bones are shaped to receive the femoral component (1) and the tibial base plate (10).
- the plastics tibial bearing component (17) is fixed to the top of the tibial base plate.
- the plastic pivot component (17) is located onto the post (12) projecting from the tibial base plate.
- the orientation of the pivot component (17) in the frilly assembled position is as in Figure 1.
- the pivot component (17) is held in place on the post by the locking pin (23).
- the spherical sides of the plastic pivot component are located within the spherical saucer-like recesses (6) in the housing of the femoral component.
- the spherical top of the pivot component (17) engages against the spherical top of the housing.
- the lateral and medial metal femoral condylar bearing surf ⁇ ces (2,3) locate on to the corresponding plastic tibial dished lateral and medial bearing surfaces (31,32).
- the plastic pivot component (17) is slid on top of the post, in an orientation such that the plane of the flats (20) is parallel to the sagittal plane of the knee. In this orientation, when the tibia is moved posteriorly towards the femoral component, the plastic pivot component (20) slides into the slot (33) of the housing (5). It is noted that the width of the plastic pivot component across the flats is substantially the same as the width of the housing ( Figure 3B) so that the pivot component (17) is a sliding fit into the slot (33). When the spherical part of the pivot component is in line with the spherical saucerlike recesses (6) in the housing, the pivot component is rotated by 90 degrees about its vertical axis.
- Alternate configurations can be specified for engaging a spherical surf ⁇ ce into a spherical recess in the housing, such that assembly is possible but disengagement is prevented.
- the top of the plastic pivot component (20) does not have the flats but has a complete spherical surface on top of the cylindrical part (12).
- the inside of the housing (5) in the femoral component (1) rather than having spherical recesses, has a cylindrical hole which is substantially the same diameter as the spherical top (19) drilled in from the distal end of the component to enter the spherical recesses. With the femoral component at 90 degrees of flexion, this cylindrical hole lies horizontally.
- plastic pivot component (17) can now enter from the anterior uutil it reaches its proper location. In order to prevent it from escaping, an arcuate-shaped component
- the component to snap into and be held in place.
- the component essentially restores the
- This component has a boss (36) at the lower end.
- the component is first assembled on the post (12).
- varus-valgus and hyperextension movements could be with a locking pin through the anterior of the bearing component and into the boss.
- the joint acts as a hinge point, pivoting about a
- the femoral bearing surfaces have the same radius in the sagittal plane from the distalmost point to the posterior upper limit.
- Another aspect of the design is the capability for internal-external rotation
- Internal-external rotation may be restricted by providing
- the posterior part of the femoral housing is designed to allow for a high
- range of flexion such as 130 degrees. It is unlikely that a knee will reach this angle
- the femoral condylars are designed to locate on the anterior of the plastic tibial bearing component. Anterior to the distalmost point, the radius is larger, such that a restraint is provided to further extension. This provides that motion beyond full extension is prevented by the interaction between the femoral-tibial contact points and the action of the sphere in the housing. A few degrees of hyperextension is provided by allowing clearance at the anterior surface of the housing. In this way, the knee is brought to a stop without a sudden impact. In cases where the condylar surf ⁇ ces and the corresponding dished recesses in the plastic bearing component are closely conforming (which is the preferred arrangement), the condylar surfaces may be relieved to provide recesses. This allows for maximum extension as described in WO 94/26212, the disclosure of which is specifically incorporated herein by reference.
- the sphere is allowed a small amount of upward-downward movement on the post, for example, by making the hole in the pivot component slightly larger than the diameter of the diameter of the tangs and the pin head.
- Other methods may be adopted for providing such tolerance, e.g., the recess (6) in the intercondylar housing can be made slightly larger
Abstract
Description
Claims
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU67120/00A AU6712000A (en) | 1999-08-23 | 2000-08-23 | Linked condylar total knee replacement |
JP2001517967A JP2003507123A (en) | 1999-08-23 | 2000-08-23 | Linked condylar knee replacement |
CA002382778A CA2382778A1 (en) | 1999-08-23 | 2000-08-23 | Linked condylar total knee replacement |
EP00954765A EP1214024A1 (en) | 1999-08-23 | 2000-08-23 | Linked condylar total knee replacement |
GB0207005A GB2370782A (en) | 1999-08-23 | 2000-08-23 | Linked condylar total knee replacement |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB9919954.9 | 1999-08-23 | ||
GBGB9919954.9A GB9919954D0 (en) | 1999-08-23 | 1999-08-23 | Linked condylar total knee replacement |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2001013825A1 true WO2001013825A1 (en) | 2001-03-01 |
Family
ID=10859667
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/GB2000/003259 WO2001013825A1 (en) | 1999-08-23 | 2000-08-23 | Linked condylar total knee replacement |
Country Status (6)
Country | Link |
---|---|
EP (1) | EP1214024A1 (en) |
JP (1) | JP2003507123A (en) |
AU (1) | AU6712000A (en) |
CA (1) | CA2382778A1 (en) |
GB (2) | GB9919954D0 (en) |
WO (1) | WO2001013825A1 (en) |
Cited By (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7232465B2 (en) * | 2002-07-26 | 2007-06-19 | Waldemar Link Gmbh & Co. Kg | Knee prosthesis |
US7918893B2 (en) | 2007-09-30 | 2011-04-05 | Depuy Products, Inc. | Hinged orthopaedic prosthesis |
US8382848B2 (en) | 2009-08-11 | 2013-02-26 | Imds Corporation | Position adjustable trial systems for prosthetic implants |
US8425617B2 (en) | 2002-12-20 | 2013-04-23 | Smith & Nephew, Inc. | Knee prostheses with convex slope on portion of tibial articular surface |
US8496666B2 (en) | 2009-08-11 | 2013-07-30 | Imds Corporation | Instrumentation for mobile bearing prosthetics |
US8523950B2 (en) | 2006-06-30 | 2013-09-03 | Smith & Nephew, Inc. | Anatomical motion hinged prosthesis |
US8545570B2 (en) | 2001-12-21 | 2013-10-01 | Smith & Nephew, Inc. | Hinged joint system |
US8568485B2 (en) | 2009-08-11 | 2013-10-29 | Imds Corporation | Articulating trials for prosthetic implants |
US8926709B2 (en) | 2010-08-12 | 2015-01-06 | Smith & Nephew, Inc. | Structures for use in orthopaedic implant fixation and methods of installation onto a bone |
US8998997B2 (en) | 2009-08-11 | 2015-04-07 | Michael D. Ries | Implantable mobile bearing prosthetics |
US9066804B2 (en) | 1994-09-02 | 2015-06-30 | Puget Bioventures Llc | Method and apparatus for femoral and tibial resection |
US9095453B2 (en) | 2009-08-11 | 2015-08-04 | Michael D. Ries | Position adjustable trial systems for prosthetic implants |
US9192391B2 (en) | 2001-03-05 | 2015-11-24 | Puget Bioventures Llc | Method for minimally invasive total knee arthroplasty |
US9642711B2 (en) | 2003-10-17 | 2017-05-09 | Smith & Nephew, Inc. | High flexion articular insert |
US9814539B2 (en) | 2004-01-14 | 2017-11-14 | Puget Bioventures Llc | Methods and apparatus for conformable prosthetic implants |
US10736748B2 (en) | 2018-05-02 | 2020-08-11 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a hinged-knee prosthesis |
US11033396B2 (en) | 2019-02-05 | 2021-06-15 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a rotating hinged-knee prosthesis |
US11116641B2 (en) | 2019-02-05 | 2021-09-14 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a rotating hinged-knee prosthesis |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE102014106012B9 (en) * | 2014-04-29 | 2015-09-17 | Aesculap Ag | Knee endoprosthesis |
Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3824630A (en) * | 1972-06-23 | 1974-07-23 | Zimmer Mfg Co | Prosthetic joint for total knee replacement |
US3868730A (en) * | 1973-09-24 | 1975-03-04 | Howmedica | Knee or elbow prosthesis |
US3869729A (en) * | 1972-01-05 | 1975-03-11 | Nat Res Dev | Bone joint prosthesis |
US4224697A (en) * | 1978-09-08 | 1980-09-30 | Hexcel Corporation | Constrained prosthetic knee |
EP0493629A1 (en) * | 1989-12-09 | 1992-07-08 | GMT Gesellschaft für medizinische Technik mbH | Elbow endoprosthesis |
DE9414970U1 (en) * | 1994-09-15 | 1994-12-22 | Diehl Klaus Prof Dr | Partially coupled knee prosthesis |
EP0639358A1 (en) * | 1993-08-20 | 1995-02-22 | Societe Civile Essor | Knee prosthesis with ball joint |
-
1999
- 1999-08-23 GB GBGB9919954.9A patent/GB9919954D0/en not_active Ceased
-
2000
- 2000-08-23 EP EP00954765A patent/EP1214024A1/en not_active Withdrawn
- 2000-08-23 JP JP2001517967A patent/JP2003507123A/en not_active Withdrawn
- 2000-08-23 GB GB0207005A patent/GB2370782A/en not_active Withdrawn
- 2000-08-23 CA CA002382778A patent/CA2382778A1/en not_active Abandoned
- 2000-08-23 AU AU67120/00A patent/AU6712000A/en not_active Abandoned
- 2000-08-23 WO PCT/GB2000/003259 patent/WO2001013825A1/en not_active Application Discontinuation
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3869729A (en) * | 1972-01-05 | 1975-03-11 | Nat Res Dev | Bone joint prosthesis |
US3824630A (en) * | 1972-06-23 | 1974-07-23 | Zimmer Mfg Co | Prosthetic joint for total knee replacement |
US3868730A (en) * | 1973-09-24 | 1975-03-04 | Howmedica | Knee or elbow prosthesis |
US4224697A (en) * | 1978-09-08 | 1980-09-30 | Hexcel Corporation | Constrained prosthetic knee |
EP0493629A1 (en) * | 1989-12-09 | 1992-07-08 | GMT Gesellschaft für medizinische Technik mbH | Elbow endoprosthesis |
EP0639358A1 (en) * | 1993-08-20 | 1995-02-22 | Societe Civile Essor | Knee prosthesis with ball joint |
DE9414970U1 (en) * | 1994-09-15 | 1994-12-22 | Diehl Klaus Prof Dr | Partially coupled knee prosthesis |
Cited By (30)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9066804B2 (en) | 1994-09-02 | 2015-06-30 | Puget Bioventures Llc | Method and apparatus for femoral and tibial resection |
US9421022B2 (en) | 2001-03-05 | 2016-08-23 | Puget Bioventures Llc | Method and apparatus for total knee arthroplasty |
US9192391B2 (en) | 2001-03-05 | 2015-11-24 | Puget Bioventures Llc | Method for minimally invasive total knee arthroplasty |
US8545570B2 (en) | 2001-12-21 | 2013-10-01 | Smith & Nephew, Inc. | Hinged joint system |
US9381087B2 (en) | 2001-12-21 | 2016-07-05 | Smith & Nephew, Inc. | Hinged joint system |
US9693868B2 (en) | 2001-12-21 | 2017-07-04 | Smith & Nephew, Inc. | Hinged joint system |
US9056012B2 (en) | 2001-12-21 | 2015-06-16 | Smith & Nephew, Inc. | Hinged joint system |
US7232465B2 (en) * | 2002-07-26 | 2007-06-19 | Waldemar Link Gmbh & Co. Kg | Knee prosthesis |
US9707087B2 (en) | 2002-12-20 | 2017-07-18 | Smith & Nephew, Inc. | High performance knee prosthesis |
US8425617B2 (en) | 2002-12-20 | 2013-04-23 | Smith & Nephew, Inc. | Knee prostheses with convex slope on portion of tibial articular surface |
US9402729B2 (en) | 2002-12-20 | 2016-08-02 | Smith & Nephew, Inc. | High performance knee prostheses |
US10149768B2 (en) | 2002-12-20 | 2018-12-11 | Smith & Nephew, Inc. | High performance knee prostheses |
US9320605B2 (en) | 2002-12-20 | 2016-04-26 | Smith & Nephew, Inc. | High performance knee prostheses |
US9642711B2 (en) | 2003-10-17 | 2017-05-09 | Smith & Nephew, Inc. | High flexion articular insert |
US9814539B2 (en) | 2004-01-14 | 2017-11-14 | Puget Bioventures Llc | Methods and apparatus for conformable prosthetic implants |
US9730799B2 (en) | 2006-06-30 | 2017-08-15 | Smith & Nephew, Inc. | Anatomical motion hinged prosthesis |
US8523950B2 (en) | 2006-06-30 | 2013-09-03 | Smith & Nephew, Inc. | Anatomical motion hinged prosthesis |
US10779949B2 (en) | 2006-06-30 | 2020-09-22 | Smith & Nephew, Inc. | Anatomical motion hinged prosthesis |
US7918893B2 (en) | 2007-09-30 | 2011-04-05 | Depuy Products, Inc. | Hinged orthopaedic prosthesis |
US8568485B2 (en) | 2009-08-11 | 2013-10-29 | Imds Corporation | Articulating trials for prosthetic implants |
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 |
US8382848B2 (en) | 2009-08-11 | 2013-02-26 | Imds Corporation | Position adjustable trial systems for prosthetic implants |
US8998997B2 (en) | 2009-08-11 | 2015-04-07 | Michael D. Ries | Implantable mobile bearing prosthetics |
US8926709B2 (en) | 2010-08-12 | 2015-01-06 | Smith & Nephew, Inc. | Structures for use in orthopaedic implant fixation and methods of installation onto a bone |
US10736748B2 (en) | 2018-05-02 | 2020-08-11 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a hinged-knee prosthesis |
US11833053B2 (en) | 2018-05-02 | 2023-12-05 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a hinged-knee prosthesis |
US11033396B2 (en) | 2019-02-05 | 2021-06-15 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a rotating hinged-knee prosthesis |
US11116641B2 (en) | 2019-02-05 | 2021-09-14 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a rotating hinged-knee prosthesis |
US11696834B2 (en) | 2019-02-05 | 2023-07-11 | Depuy Ireland Unlimited Company | Orthopaedic prosthetic system for a rotating hinged-knee prosthesis |
Also Published As
Publication number | Publication date |
---|---|
JP2003507123A (en) | 2003-02-25 |
CA2382778A1 (en) | 2001-03-01 |
GB0207005D0 (en) | 2002-05-08 |
AU6712000A (en) | 2001-03-19 |
EP1214024A1 (en) | 2002-06-19 |
GB2370782A (en) | 2002-07-10 |
GB9919954D0 (en) | 1999-10-27 |
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