WO2017194614A1 - Composant fémoral pour prothèse du genou et prothèse du genou associée - Google Patents

Composant fémoral pour prothèse du genou et prothèse du genou associée Download PDF

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Publication number
WO2017194614A1
WO2017194614A1 PCT/EP2017/061203 EP2017061203W WO2017194614A1 WO 2017194614 A1 WO2017194614 A1 WO 2017194614A1 EP 2017061203 W EP2017061203 W EP 2017061203W WO 2017194614 A1 WO2017194614 A1 WO 2017194614A1
Authority
WO
WIPO (PCT)
Prior art keywords
femoral
femoral condyle
thickness
component
posterior
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2017/061203
Other languages
English (en)
Inventor
Marco Schiraldi
Charles Alvernhe
Xavier Nicolay
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Adler Ortho SpA
Original Assignee
Adler Ortho SpA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Adler Ortho SpA filed Critical Adler Ortho SpA
Priority to EP17722767.5A priority Critical patent/EP3454791A1/fr
Publication of WO2017194614A1 publication Critical patent/WO2017194614A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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
    • 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

Definitions

  • the present invention relates to a femoral component for a knee prosthesis and the related knee prosthesis.
  • the knee is the biggest joint in the human body and it is necessary for carrying out normal everyday activities.
  • the knee joint is constituted by the lower end of the femur (distal epiphysis), by the upper end of the tibia (proximal epiphysis), and by the patella.
  • the distal epiphysis of the femur has two convex surfaces called femoral condyles (one medial and the other lateral).
  • intercondylar cavity Between the two condyles is a groove called the intercondylar cavity.
  • the proximal epiphysis of the tibia has two concave surfaces called tibial hemiplateaus.
  • the femoral condyles rotate and slide on the tibial hemiplateaus with the menisci interposed, while the patella slides in the intercondylar cavity.
  • the ligaments are further present, which give stability to the joint.
  • An artificial knee prostheses is constituted by a femoral component, a tibial component and a tibial insert.
  • the femoral component usually made of cobalt/chrome/molybdenum alloy, substitutes the distal epiphysis of the femur and, like the latter, has two convex surfaces.
  • the tibial component which is usually made of metal, substitutes the proximal epiphysis of the tibia, and the tibial insert is mounted on it.
  • the latter which is usually made of polyethylene, has a lower, flat surface in contact with the tibial component and an upper, concave surface that articulates with the femoral component.
  • a variation of fixed plateau prostheses which, although little used, is worthy of mention is the single-piece "All-Polythene" prosthesis where the tibial component and the tibial insert are combined in a single component, made of polyethylene.
  • anterior cruciate ligament except in very few cases, is usually damaged and, as a consequence, artificial knee prostheses usually do not allow for its presence.
  • the posterior cruciate ligament is often present and even, in a certain number of cases, efficient.
  • the posterior cruciate ligament is removed and its function is performed by a prostheses with a pin-and-cam mechanism.
  • the pin is present on the tibial insert and extends from the insert toward the femoral component, where the cam is present between the two condyles.
  • the pin and cam interact, limiting the translation of the femur on the tibia, and preventing the dislocation of the joint.
  • the posterior cruciate ligament in fact, is tensioned in flexion and, in this manner, pulls the femur toward the tibia.
  • the aim of the present invention consists in providing a femoral component for a knee prosthesis, as well as a knee prosthesis, that overcomes the drawbacks of the known art by making it possible to stabilize the joint.
  • an object of the present invention is to provide a femoral component that can offer a degree of movement in flexion that is such as to allow the prosthesized individual to carry out the physical activities that are usually required.
  • Another object of the present invention consists in providing a femoral component that ensures a long survival of the knee prosthesis.
  • Another object of the present invention consists in providing a knee prosthesis that is capable of offering the widest guarantees of reliability and safety in use.
  • Another object of the present invention consists in providing a knee prosthesis that is easy to implement and economically competitive when compared to the known art.
  • a femoral component for a knee prosthesis comprising at least one convex articular surface that defines at least one femoral condyle, characterized in that the posterior portion of said femoral condyle is thicker than the distal portion of said femoral condyle.
  • Figure 1 is a first side view of an embodiment of a femoral component, according to the invention.
  • Figure 2 is a second side view of the femoral component of Figure 1 , according to the invention.
  • Figure 3 is a plan view from above of the femoral component of Figure 1 , according to the invention.
  • Figure 4 is a cross-sectional view of the femoral component shown in Figure 3, taken along the line IV-IV;
  • Figure 5 is a cross-sectional view of the femoral component shown in
  • Figure 6 is a cross-sectional view of the femoral component shown in Figure 3, taken along the line VI- VI;
  • Figure 7 is a perspective view of a tibial insert that can be associated with the femoral component of Figure 1 , according to the invention.
  • Figure 8 is a plan view from above of the tibial insert of Figure 7;
  • Figure 9 is a cross-sectional view of the tibial insert shown in Figure 8, taken along the line IX-IX;
  • Figure 10 is a cross-sectional view of the tibial insert shown in Figure 8, taken along the line X-X.
  • distal distal
  • proximal anterior
  • proximal anterior
  • proximal proximal
  • proximal relate to the direction of the longitudinal axis
  • anterior relate to the direction of the sagittal axis
  • lateral relate to the direction of the transverse axis.
  • the femoral component for a knee prosthesis comprises at least one convex articular surface 2, 22 which defines at least one femoral condyle 3, 23.
  • the posterior portion 4, 24 of the femoral condyle 3, 23 is thicker than the distal portion 5, 25.
  • the femoral component 1 comprises two convex articular surfaces 2, 22 which define respectively a lateral femoral condyle 3 and a medial femoral condyle 23.
  • the posterior portion 4 of the lateral femoral condyle 3 is thicker than the distal portion 5.
  • the posterior portion 24 of the medial femoral condyle 23 is thicker than the distal portion 25.
  • the maximum difference between the thickness of the posterior portion 4, 24 of the femoral condyle 3, 23 and the thickness of the distal portion 5, 25 is comprised in the interval between 1.5 and 3.5 millimeters, and is preferably substantially equal to 2.5 millimeters.
  • the thickness of the femoral condyle 3, 23 increases progressively starting from the distal portion 5, 25 up to the posterior portion 4, 24, reaching the aforementioned maximum difference in thickness at the posterior portion 4, 24.
  • the thickness of the femoral condyle 3, 23 further increases progressively between 20° of flexion and 90° of flexion of the knee.
  • Figures 1 and 2 show, in dotted lines, the ideal tibial planes 60 and 70 for contact with the femoral component 1 respectively when the knee is flexed at 20° (configuration designated with the reference numeral 6) and when the knee is flexed at 90° (configuration designated with the reference numeral 7).
  • the posterior portion 4, 24 of the femoral condyles 3, 23 has, with respect to the thickness of the distal portion 5, 25 of the femoral condyles 3, 23, a gradual increase in thickness that, between 20° and 90° of flexion of the knee, reaches 2.5 millimeters.
  • the anterior portion 8, 28 and the distal portion 5, 25 of the femoral condyle 3, 23 advantageously have a substantially constant thickness.
  • the posterior and proximal portion 9, 29 of the femoral condyle 3, 23 advantageously has a thickness that decreases progressively starting from 90° of flexion (configuration designated with the reference numeral 7) of the knee up to the rear and proximal end 11, 31 of the femoral condyle 3, 23.
  • the convex surface 2, 22 has:
  • a second radius of curvature adapted to define, between 20° of flexion (configuration designated with the reference numeral 6) and 90° of flexion (configuration designated with the reference numeral 7) of the knee, a progressively increasing thickness of the femoral condyle 3, 23;
  • a third radius of curvature adapted to define, starting from 90° of flexion (configuration designated with the reference numeral 7) of the knee up to the posterior and proximal end 11 , 31, a progressively decreasing thickness of the femoral condyle 3, 23.
  • the femoral component 1 has three radii of curvature, and is in fact defined as a multi-radius femoral component.
  • the value of a radius and the position of the center of rotation are chosen such that the thickness of the femoral condyles 3, 23 remains constant up to 20°, toward the posterior part, i.e. up to the configuration designated with the reference numeral 6.
  • the centers of rotation and the radii are chosen so that the femoral condyles 3, 23 increase in thickness from 8 millimeters to 10.5 millimeters, where the thickness of 8 millimeters can be found at 20° of flexion of the knee, while the thickness of 10.5 millimeters can be found at 90° of flexion.
  • the femoral component 1 comprises, centrally and at the distal portion 5, 25, a cam 26 adapted to engage a corresponding pin 51 of a tibial insert 50.
  • the femoral component 1 is advantageously made of chrome-cobalt alloy, and advantageously exists both in a cemented version and in a version without cement.
  • the surface of the femoral component 1 in contact with the bone has a shape that enables a good coupling on the conveniently- prepared distal end of the femur.
  • the present invention also relates to a knee prosthesis that comprises a femoral component 1 as described above and which further comprises a tibial component which in turn comprises a tibial insert 50 which comprises a pin 51 that engages the cam 26 of the femoral component 1.
  • the tibial component substitutes the removed part of the tibia and has a lower, distal part in contact with the bone.
  • the upper, proximal part has a flat surface that accommodates the tibial insert 50.
  • the tibial component can exist both in a cemented version and in a non-cemented version.
  • the tibial component can be made of a material of the type of titanium alloy and be coupled to a tibial insert that is fixed by way of an adapted locking mechanism.
  • the tibial component can be made of a material of the type of cobalt-chrome alloy, or of the type of cobalt-chrome-molybdenum alloy, and be coupled to a moveable tibial insert.
  • the tibial component is provided with an adapted opening for the movement of the insert.
  • the tibial insert 50 is advantageously made of a material of the type of polyethylene, and preferably of a material of the type of ultra-high molecular weight polyethylene (UHMWPE).
  • UHMWPE ultra-high molecular weight polyethylene
  • the tibial insert 50 advantageously has a lower, flat surface 52 in contact with the tibial component and an upper, concave surface 53 that articulates with the femoral component 1.
  • the tibial insert 50 advantageously comprises a pin 51 , also made of ultra-high molecular weight polyethylene, which extends toward the femoral component 1 where, with the cam 26, it provides a "Posterior Stability (PS)" joint.
  • a pin 51 also made of ultra-high molecular weight polyethylene, which extends toward the femoral component 1 where, with the cam 26, it provides a "Posterior Stability (PS)" joint.
  • PS Posterior Stability
  • the shape and the size of the pin 51 and of the corresponding cam 26 are configured so as to minimize the wear of the polyethylene.
  • the tibial insert 50 is advantageously available in two versions: fixed and moveable.
  • the fixed tibial insert is fully coupled, by way of an adapted mechanism, to the tibial component which is usually made of a material of the type of titanium alloy.
  • the moveable tibial insert is provided in the lower part with a pin, also made of polyethylene, which rotates in the adapted opening of the tibial component made of cobalt-chrome-molybdenum alloy.
  • Another advantage of the femoral component according to the invention consists in that the increased thickness of the posterior condyles makes it possible to fill the articular space (gap) that is created in flexion, owing to the absence of the posterior cruciate ligament, in this way succeeding in stabilizing the joint even in flexion and therefore reducing the risk of dislocation.
  • Another advantage of the femoral component according to the invention consists in that the increased thickness of the posterior condyles makes it possible to also increase the offset of the posterior condyles, thus making it possible to reach degrees of flexion greater than those obtainable with normal knee prostheses, and adequate for carrying out a normal physical activity.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un composant fémoral (1) pour prothèse du genou, comprenant au moins une surface articulaire convexe (2, 22) qui délimite au moins un condyle fémoral (3, 23). La partie postérieure (4, 24) du condyle fémoral (3, 23) est plus épaisse que la partie distale (5, 25).
PCT/EP2017/061203 2016-05-12 2017-05-10 Composant fémoral pour prothèse du genou et prothèse du genou associée Ceased WO2017194614A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP17722767.5A EP3454791A1 (fr) 2016-05-12 2017-05-10 Composant fémoral pour prothèse du genou et prothèse du genou associée

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT102016000048667 2016-05-12
ITUA2016A003373A ITUA20163373A1 (it) 2016-05-12 2016-05-12 Componente femorale per protesi di ginocchio e relativa protesi di ginocchio.

Publications (1)

Publication Number Publication Date
WO2017194614A1 true WO2017194614A1 (fr) 2017-11-16

Family

ID=56990717

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2017/061203 Ceased WO2017194614A1 (fr) 2016-05-12 2017-05-10 Composant fémoral pour prothèse du genou et prothèse du genou associée

Country Status (3)

Country Link
EP (1) EP3454791A1 (fr)
IT (1) ITUA20163373A1 (fr)
WO (1) WO2017194614A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0600806A1 (fr) * 1992-12-01 1994-06-08 Medinov Sa Prothèse tricompartimentale du genou
EP0707839A1 (fr) * 1994-10-17 1996-04-24 France-Bloc Prothèse fémorale d'articulation du genou
FR2844704A1 (fr) * 2002-09-24 2004-03-26 Biomet Merck France Prothese de genou a plateau mobile
EP2762106A1 (fr) * 2011-09-27 2014-08-06 Kyocera Medical Corporation Implant de genou artificiel

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0600806A1 (fr) * 1992-12-01 1994-06-08 Medinov Sa Prothèse tricompartimentale du genou
EP0707839A1 (fr) * 1994-10-17 1996-04-24 France-Bloc Prothèse fémorale d'articulation du genou
FR2844704A1 (fr) * 2002-09-24 2004-03-26 Biomet Merck France Prothese de genou a plateau mobile
EP2762106A1 (fr) * 2011-09-27 2014-08-06 Kyocera Medical Corporation Implant de genou artificiel

Also Published As

Publication number Publication date
ITUA20163373A1 (it) 2017-11-12
EP3454791A1 (fr) 2019-03-20

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