CN1179709A

CN1179709A - Tibial prosthesis

Info

Publication number: CN1179709A
Application number: CN 96192852
Authority: CN
Inventors: C·E·约翰森; T·A·卡尔斯; D·L·埃范斯; L·A·维特思德
Original assignee: Smith and Nephew Richards Inc
Current assignee: Smith and Nephew Inc
Priority date: 1995-01-31
Filing date: 1996-01-30
Publication date: 1998-04-22

Abstract

A tibial prosthesis (10) includes a tibial tray (11) and a stem (25). The stem (25) has a cylindrical section (39) and a tapering section (40). Fins (41) extend longitudinally from the proximal end to the distal end of the stem, tracking both the cylindrical and tapering portions (39, 40) thereof so that each of the fins (41) tracks a uniform diameter section of the stem (25) for a majority of its length. The tapering section (40) of the stem (25) is equal to about one third of its overall length, and defines the distal end of the stem. The fins (41) are longitudinally placed about the stem exterior surface, and are generally parallel. Between the fins are U-shaped channels (42) that are similarly longitudinally extending and generally parallel. The stem (25) provides a central longitudinal axis. The fins (41) and channels (42) are parallel to the central longitudinal axis of the stem (25).

Description

Tibial prosthesis

The present invention relates to orthopedics's prosthetic appliance, specifically, relate to a kind of improved kneed prosthese of patient's part that is used to replace.More particularly, the present invention relates to a kind of improved combination type tibial prosthesis, this prosthese has a metaphysis cadre that can remove who comprises cylindrical section and tapered segment, the near-end that wherein parallel fin is done from metaphysis extends to far-end continuously, and at first conduct cylindrical section, the tapered segment of then passing through.

Many tibial components are applied for a patent, and they relate to the tibial component with a dish and a cadre, and when prosthese was implanted, this cadre provided initial fixing.

In the U.S. Pat-5,246 of being entitled as of Elias " a kind of combination type tibia supporting nail that is used for the tibial component of prosthese knee joint alternative system ", can see the example of a combination type tibial bearing in 459.The patent disclosure of Elias a kind of combination type tibia supporting nail so that exercisable tibial component with a knee-joint prosthesis is fixed on the slotted tibia.This combination type tibia supporting nail comprises the cylinder main body of a with ribbing outer surface, but so that operable engagement in the groove of tibia.This combination type tibia supporting nail also comprises a plurality of nails that stretch out from cylindrical-shaped main body downwards.These follow closely exercisable lower end engages tibia at groove.

The U.S. Pat of Tomihisa Koshino-5,137,536 have described a kind of tibial component that is used for artificial knee joint.This tibial component comprises a plate portion, and the latter has a upper surface and a pair of area supported parts that are suitable for the tibial component sliding-contact.A cadre stretches out downwards from the plate portion lower surface.A pair of flat member stretches out from this dried receding.The plate portion lower surface has a plurality of elongated grooves, is used to improve the affinity with respect to the surrounding bone tissue, and these grooves comprise first group of groove and the second group of groove that extends perpendicular to first group of groove.

British patent GB-2,192,543A discloses a kind of nail that is used for prosthetic appliance.This nail is made holder and/or the bone booster that is suitable for as being connected with prosthetic appliance by metal or pottery.This is followed closely some and is essentially taper, and its cross section increases gradually from insertion end.The surface of this tapering point part has alternative ridge, extend along its length direction around this end, when a ridge moves away the insertion end, each ridge in succession has one by smaller amount outer surface at interval, and this outer surface is than the outer surface of the previous ridge bigger distance of axis from nail.This nail can be independent, or forms the part of prosthetic appliance.

The U.S. Pat of James Shaw-4,938,769 disclose the end bone fastening assembly that a kind of tibial prosthesis is used, and this assembly comprises dried and a plurality of and dried elongated staple that separates in the center of an elongation vertically.Do and follow closely and all have near-end and far-end.These near-ends that should do form one and connect platform.A plurality of structure connecting rods make these nails and dried interconnecting.The device that is provided is used for tibial tray is connected this assembly removably, and wherein each nail is connected with the structure connecting rod and does.

People's such as Bolesky the U.S. Pat-4 that is entitled as " being suitable for promoting the inwardly prosthetic appliance of growth of bone/tissue ", 479,271 disclose a kind of tibial component, these parts comprise that a platform and at least one porous metals are dried, this is done from the following basal surface of this bottom bottom and stretches out, wherein this stretches out dried outer surface and is suitable for directly contact promoting the inside growth of bone and/or tissue with the bone surface of preparation, and the dried through hole that comprises the upper surface extension of a bottom bottom that passes through this from the far-end of doing of each porous metals that stretch out wherein.

The U.S. Pat of Murray-4,016,606 disclose a kind of knee prostheses, this prosthese comprises a tibial component that has dish and do, this is dried to be suitable for being encased in vertical hole of patient's femur, this is dried have one with a sagging integrally formed end, spheric basically surface, this surperficial radius is identical with the radius of bulb-shaped recess in the jack.

When implanting tibial tray (for example porous or agglutinating), it is extremely important obtaining good initial fixation.Implant must be able to be resisted the power that makes parts rotate, shear or tilt.The invention provides a kind of improvedly for doing that tibial component uses, this is done can resist rotatory force, shearing force and tilting force.

According to the present invention, tibial prosthesis knee spare comprises: a tibial tray that is used for substituting patient's segment proximal tibia; Cadre with near-end and distal portions, this form becomes a protuberance that stretches out from dish, and with it at an angle, is used for tibial tray is fixed on proximal tibia; Driedly comprise that becomes a columnar proximal part basically; The fin that the length direction that do on the distal portions of a taper and a plurality of substantially parallel edge substantially along periphery separates extends.

Therefore, the invention provides a kind of improved tibial prosthesis with good initial fixation.The dried tibial component for implantation of metaphysis tibia of the present invention provides the resistance to rotating, shearing and tilt.

The inventive system comprises a tibial tray that is used for substituting patient's segment proximal tibia.Dried have near-end and distal portions and a protuberance that stretches out at the lower surface of dish arranged, and with it at an angle.This dried being used for is fixed on proximal tibia with tibial tray.

Do and to comprise connector, be used for being connected to dish with combining form doing.This just makes the dried of a plurality of different sizes can form set of parts, makes the surgeon can select doing of a specific dimensions, is used to be connected to adaptive patient's tibial tray.

Driedly comprise that one becomes columnar proximal part and a tapered basically distal portions basically.A plurality of fins substantially parallel and that the edge periphery separates that extend longitudinally extend along the whole length of doing substantially.Like this, each fin this cylindrical shape proximal part of passing through is then with the angle tapering part of passing through.In a preferred embodiment, the distal portions of the taper of Ganing is conical.Do a cylindrical shape part that is substantially the hollow of tubulose endoporus can be arranged.

Near-end of doing in the preferred embodiment and distal portions fuse in this transition part office of doing, so each fin has an outward flange, and this outward flange comprises first and second straightways, and forms an obtuse angle between them.In the preferred embodiment, this angle is greater than 90 degree but less than 180 degree.

Doing preferably has a flat basically distal tip, this head to define the dried lower end and the end of tapering part.

Fin is equally spaced around the periphery of doing preferably.

Fin can be separated by the cannelure that becomes U-shaped basically.

Each fin preferably include a pair of between near-end and far-end the surface of longitudinal extension.Fin preferably is essentially triangle on cross section.When each fin when tapering part extends, a pair of surface of each fin preferably narrows down, and forms a sharpened edge before reaching dried flat distal tip, the sharp keen degree at this edge in the proximal end comparable far-end difference a little.At least one peripheral part of doing can not have fin.

Tibial prosthesis preferably provides with combining form, so that can assemble a suitable prosthese to be fit to single patient.Like this, in this way, tibia and cadre can separately provide, and do a device can be arranged, so that removably involvement is received on the tibial tray.This device can comprise a cone locking device.

In order further to understand essence of the present invention and purpose, reference is only as the following detailed description of an example of the present invention in conjunction with the accompanying drawings, and wherein identical parts represent that with same numeral accompanying drawing has:

Fig. 1 is the perspective exploded view of a preferred embodiment of device of the present invention;

Fig. 2 is cadre's the partial end view of the preferred embodiment of apparatus of the present invention;

Fig. 2 A is the sectional view along the tapering part that passes through the cadre of the 2A-2A hatching intercepting of Fig. 1;

Fig. 2 B is that this figure comprises the overlapping of Fig. 2 A along the sectional view of the 2B-2B hatching intercepting of Fig. 1, and the dried tapering part and the varied in thickness of fin are described thus;

Fig. 3 is the sectional view of the preferred embodiment of device of the present invention, and its cadre is described;

Fig. 4 is the perspective view of the preferred embodiment of device of the present invention;

Fig. 5 is the perspective view of the preferred embodiment of device of the present invention;

Fig. 6 is the sectional view along 6-6 hatching intercepting among Fig. 5;

Fig. 7 is the partial perspective cutaway view of the preferred embodiment of device of the present invention, and its cadre is described;

Fig. 8 is another partial perspective cutaway view of the preferred embodiment of device of the present invention; Its cadre is described;

Fig. 9 is the partial elevation view of the preferred embodiment of device of the present invention, and the cadre of its various sizes and shape is described; And

Figure 10-the 12nd, the front view of signal illustrate the surgical method of preferred embodiment of implantation device of the present invention.

Fig. 1-6 totally represents the preferred embodiment of device of the present invention with label 10.Tibial prosthesis 10 comprises a tibial tray 11 along horizontal expansion, and this tibial tray has a proximal end face 12 and a distal surface 13.As known in this technology, after the near-end of patient's tibia had carried out Surgery Treatment with transverse cuts, distal surface 13 was just towards the near-end of patient's tibia.Tibial tray 11 has a periphery surface 14, and its shape meets the treatment surface of proximal tibia.

By coiling 11 a plurality of holes 15 that all are communicated with proximal end face 12 and distal surface 13 are set.One or more bone screw are accepted in hole 15, so that prosthese 10 is connected on patient's the proximal tibia.A plurality of nails 16 stretch out from distal surface 13, and with this surface shape at an angle, preferably about 90 the degree.

Distal surface 13 can provide a bone to connect surface 17, for example a pearl surface.Post 18 at the central part of distal surface 13 approximately to become 90 degree (90 °) to stretch out with the surface.Post 18 comprises a section 19 and the section 20 that the diameter with taper is less that diameter is bigger.Ring-type type conical bench 21 has defined the changeover portion between the less tapered segment 20 of the bigger section 19 of diameter and diameter.

Post 18 has flat surface 22 parts on the outer surface of the bigger section 19 of diameter, this part extends on the circular step 21, as shown in fig. 1.As below illustrating more fully, flat surface 22 matches with the similar flat surface of combination type metaphysis dried 25, does the 25 mistake assemblings with respect to post 18 to prevent metaphysis.

Post 18 has a flat toroidal head portion 23, and this head 23 forms the far-end of post 18.Post 18 is connected on the tibial tray 11 at 24 places, joint portion, and joint portion 24 can for example be welded, and perhaps post 18 and dish 11 can machining be one.Bone connects surface 17 and can extend on the joint portion 24, and partly arrives the bigger section of diameter 19.

Metaphysis does 25, and (Fig. 1,2,2A-2B, 3,4 and 7-9) has a near-end 26 and a far-end 27.Do 25 a hole 28 of being with blind end is arranged.There are a closed end portion 29 and an opening portion 30 in hole 28.The size and dimension in hole 28 is identical with post 18, is used for the post 18 of packing into when being assembled to metaphysis dried 25 on the post 18.Like this, hole 28 provides circular step that the bigger section of diameter 31, one define transition zone 35, tapered section that diameter is less 32, a circular step 32A who defines transition zone, and a tapered end 33.Can on closed ends 29, female thread be arranged.

Corresponding

flat surface

22,34 guarantees to do 25 and correctly assembles with respect to post 18.The corresponding

less section

20 and 22 of diameter is ring-type plug section, they the time intermesh in assembling, make when do 25 be placed on the post 18 and doing when for example being loaded on the post 18 with jump bit 25 and post 18 between realize wedge-like locking or Ying Shi cone locking cooperation.During use, this jump bit will be used for transferring loads to metaphysis at flat distal surface 36 places and do 25.

In a preferred embodiment, can there be the multiple metaphysis of different size as shown in Figure 9 to do 25A-25C.The diameter of the flat distal surface 36 of the dried 25A-25B of the metaphysis shown in Fig. 9 is bigger than the diameter of the flat distal surface 36A of the dried 25C of the metaphysis shown in Fig. 9.

Each flat metaphysis does 25 a flat surface that extends longitudinally 37, and the latter starts from metaphysis and does 25 near-end 26 and extend to dried 25 ring-type transition portion 38, as shown in Fig. 5-6.Ring-type transition portion 38 is located substantially on metaphysis and does 25 cylindrical section 39 and metaphysis and do between 25 the tapered segment 40.This tapered segment 40 can be made Frusto-conical shape as shown in Fig. 1,3-9.

By the cylindrical section 39 that a diameter substantial constant is provided, the surgeon can bore a cylinder-shaped hole in patient's reticulated bone tissue, with pack into diameter than the external diameter of cylindrical section 39 little do 25.Tapered segment 40 at first enters the hole that surgical operation forms, and aims at metaphysis and do 25 in correct position., continue drive prosthese 10 enter patient's tibia, make in a plurality of fin 41 incision reticulated bone tissues thereafter.

A plurality of passages 42 (Fig. 2,2A, 2B, 5,7 and 8) between a plurality of fins 41, have been defined.Fin 41 separates and parallel to each other basically along periphery.In a preferred embodiment, passage is essentially U-shaped, extend longitudinally, and parallel to each other basically.Fin 41 and passage 42 done 25 central longitudinal axis 43 around metaphysis and separated along periphery.Can see that in Fig. 2 A-2B fin 41 has sharp keen edge 44 and has blunt edge 45 at cylindrical section 39 places at frusto-conical section 40 places.

In bone, pour an inserted link (perpendicular to cutting planes) and produce one for example diameter be 12-14mm and be the hole 46 of 40-50mm deeply, prepare bone like this and this metaphysis of packing into dried.Then this device is driven in this hole, as shown in Figure 10-12.Attention is at the diameter of Figure 11 mesopore 46 diameter less than the cylindrical section of doing 39.This just makes the fin 41 can embedded hole in the osseous tissue around 46.

Following table is enumerated parts label and the component names described in this paper and the accompanying drawing.

Component list

Parts label component names

10 tibial prosthesis

11 tibial trays

12 proximal end face

13 distal surfaces

14 periphery surfaces

15 holes

16 nails

17 bone connecting surfaces

18 posts

The section that 19 diameters are bigger

The tapered segment that 20 diameters are less

21 circular steps

22 flat surfaces

23 rounded ends

24 joint portions

25 metaphysis are done

The 25A metaphysis is done

The 25B metaphysis is done

The 25C metaphysis is done

26 near-ends

27 far-ends

28 holes

The blind end in 29 holes

The opening in 30 holes

The section that 31 diameters are bigger

The tapered segment that 32 diameters are less

The annular surface that 32A is flat

33 tapered segment

34 flat surfaces

35 flat annular surfaces

36 flat distal surfaces

The distal surface that 36A is flat

37 flat vertical surfaces

38 annular transition portions

39 cylindrical section

40 tapered segment

41 fins

42 passages

43 central longitudinal axis

44 sharp edges

45 root faces

The hole that 46 surgical operations form

The T tibia

Claims

1. tibial prosthesis knee spare comprises:

A) tibial tray is used for substituting patient's segment proximal tibia;

B) cadre has near-end and distal portions, and this is dried has determined a protuberance that stretches out from dish, and shape is used for tibial tray is fixed on proximal tibia at an angle with it;

C) this a dried columnar basically proximal part and tapered distal end part of comprising;

It is characterized in that, a plurality ofly extend along the length direction that should do substantially along the fin of peripheral intervals substantially parallelly.

2. the tibial prosthesis knee spare described in claim 1 is characterized in that, these fins have sharp keen tip with cutting bone in the distal portion office of doing.

3. the tibial prosthesis knee spare described in claim 2 is characterized in that, it is more not sharp-pointed that these fin tips become in the proximal end.

4. as any one described prosthese in the above-mentioned claim, it is characterized in that these fins are equally spaced.

5. any one described prosthese as in the above-mentioned claim is characterized in that, these fins have basically the hollow cylindrical of tubulose endoporus from of doing and partly extend.

6. as any one described prosthese in the above-mentioned claim, it is characterized in that the cross section of these fins is essentially triangle.

7. as any one described prosthese in the above-mentioned claim, it is characterized in that this is done and removably is connected on the dish.

8. the prosthese described in claim 7 also comprises cone locking mechanism, is used for removably being connected dish with doing.

9. the prosthese described in claim 7 or claim 8 is characterized in that, described tibial tray and described cadre are that the member as combination type tibial prosthesis knee spare provides.

10. the prosthese described in claim 9 is characterized in that, a plurality of described dishes and described dried be the set of parts of using as combination type tibial prosthesis knee spare of assembling and providing together.

11., it is characterized in that doing and coiling is one as any one described prosthese among the claim 1-6.

12., it is characterized in that having three fins at least as any one described prosthese in the above-mentioned claim.

13., it is characterized in that this proximal section and distal section are that integral body is combined on the transition portion as any one described prosthese in the above-mentioned claim.

14. as any one described prosthese in the above-mentioned claim, it is characterized in that each fin has an outward flange that comprises near-end and far-end linear segments, form an obtuse angle between two sections.

15. the prosthese described in claim 14 is characterized in that, this angle is spent less than 180 greater than 90 degree.

16., it is characterized in that each fin is separated by a vertical passage as any one described prosthese in the above-mentioned claim.

17. the prosthese described in claim 16 is characterized in that these passages are equally spaced.

18., it is characterized in that this is done and also comprises a flat surface as any one described prosthese in the above-mentioned claim, its extends along at least a portion length of doing in the vertical.

19. the prosthese described in claim 18 is characterized in that, the width of this vertical flat surface about 0 and 40mm between.

20. the prosthese described in claim 18 or 19 is characterized in that this flat surface is arranged essentially parallel to these fins.

21. as any one described prosthese in the above-mentioned claim, it is characterized in that dried have a flat distal tip.

22., it is characterized in that about 3 ° to 180 ° of fins along peripheral intervals as any one described prosthese in the above-mentioned claim.

23. as any one described prosthese in the above-mentioned claim, it is characterized in that the fin height that the outer edge part from the core diameters of cylindrical section to fin records is 2mm to 40mm.