CN101683289A - 后稳定的矫形假体 - Google Patents
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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
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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
- A61F2/3836—Special connection between upper and lower leg, e.g. constrained
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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
- A61F2/3868—Joints for elbows or knees with sliding tibial bearing
Abstract
一种后稳定的膝关节矫形假体,包括胫骨支承和构造成与胫骨支承铰接的股骨组件。胫骨支承包括具有凹入式凸轮表面和凸出式凸轮表面的隆凸。股骨组件包括具有凹入式凸轮表面和凸出式凸轮表面的后凸轮。在弯曲期间,后凸轮的凹入式凸轮表面与隆凸的凸出式凸轮表面接触,以及后凸轮的凸出式凸轮表面和隆凸的凹入式凸轮表面接触。
Description
相关美国专利申请的交叉引用
【0001】交叉援引了由John L.Williams等在2008年6月30日提交的题为“Orthopaedic Femoral Component Having Controlled Condylar Curvature”的美国实用新型专利申请序列号12/165,579;由Christel M.Wagner在2008年6月30日提交的题为“Posterior Cruciate-Retaining Orthopaedic Knee Prosthesis HavingControlled Condylar Curvature”的美国实用新型专利申请序列号12/165,574,以及由Joseph G.Wyss在2008年6月30日提交的题为“Posterior StabilizedOrthopaedic Knee Prosthesis Having Controlled Condylar Curvature”的美国实用专利申请序列号12/165,575,上述申请中的每一个通过参考而被整体合并入本文。
技术领域
【0002】本公开总体涉及矫形假体,并且更具体地涉及用于膝关节置换手术的后稳定矫形假体。
背景技术
【0003】关节成形术是公知的用假体关节置换病变的和/或受损害的天然关节的外科手术过程。典型的膝关节假体包括胫骨托、股骨组件以及定位在胫骨托与股骨组件之间的聚合体嵌入件或支承。膝关节假体通常设计成复原患者关节的自然运动。然而,取决于患者关节损伤的严重程度,可采用具有变动灵活性的矫形假体。例如,对于某些患者,在矫形外科手术过程期间,后十字韧带可能受到损伤、有缺损或被移除。在这些情况下,可采用通常对于胫骨相对股骨而进行的后移动有制约或限制作用的后稳定的膝关节矫形假体。
发明内容
【0004】根据一个方面,后稳定的膝关节矫形假体包括胫骨支承和股骨组件。胫骨支承可构造成与胫骨托连接并可包括平台和从该平台向上延伸的隆凸(spine)。隆凸可具有包括上凸轮表面和下凸轮表面的后侧。上凸轮表面可具体化为凸出式凸轮表面并且下凸轮表面可具体化为凹入式凸轮表面。胫骨支承的隆凸的凹入式凸轮表面的曲率半径可以大致等于或不同于隆凸的凸出式凸轮表面的曲率半径。
【0005】在一些实施例中,胫骨支承的隆凸的上凸轮表面可在矢状面(sagittalplane)上外凸地弯曲。另外,隆凸的下凸轮表面可在矢状面上内凹地弯曲。再者,在一些实施例中,隆凸的上凸轮表面和下凸轮表面可在横剖面上外凸地弯曲。在这些实施例中,隆凸的在下的凹入式凸轮表面在横剖面上的曲率半径大致等于或不同于隆凸的在上的凸出式凸轮表面在横剖面上的曲率半径。
【0006】矫形假体的股骨组件可构造成与胫骨支承铰接。股骨组件可包括一对间隔开的髁突和后凸轮,所述的该对髁突在其间限定出髁间窝,所述后凸轮定位在该髁间窝中。后凸轮可包括凹入式凸轮表面和凸出式凸轮表面。胫骨支承和股骨组件构造成使得在第一弯曲范围期间后凸轮的凹入式凸轮表面可接触隆凸的凸出式凸轮表面,而在第二弯曲范围期间后凸轮的凸出式凸轮表面可接触隆凸的凹入式凸轮表面。在一些实施例中,第一弯曲范围可小于第二弯曲范围。例如,在一个具体实施例中,第一弯曲范围在大约50度弯曲到大约80度弯曲,而第二弯曲范围在大约80度弯曲到大约150度弯曲。
【0007】在一些实施例中,胫骨支承的隆凸和股骨组件的后凸轮各自可具有大致“S”形横截面轮廓。此外,在一些实施例中,隆凸的凸出式凸轮表面的曲率半径可大于隆凸的凹入式凸轮表面的曲率半径。再者,在这些实施例中,股骨组件的后凸轮的凹入式凸轮表面的曲率半径可大致大于后凸轮的凸出式凸轮表面的曲率半径。
【0008】根据另一方面,后稳定膝关节矫形假体可包括构造成与胫骨托连接的胫骨支承和构造成与股骨远端的已作好手术准备的表面相连接的股骨组件。胫骨支承可包括平台和从平台向上延伸的隆凸。隆凸可包括后上方的凸轮表面和后下方的凸轮表面。后上方的凸轮表面可为凹入式的而后下方的凸轮表面可为凸出式的。
【0009】在一些实施例中,胫骨支承隆凸的上凸轮表面的曲率半径可大致等于隆凸的下凸轮表面的曲率半径。上凸轮表面可在矢状面中内凹地弯曲。相似地,下凸轮表面可在矢状面上外凸地弯曲。此外,在一些实施例中,胫骨支承的隆凸的上凸轮表面可在矢状面上外凸地弯曲,而隆凸的下凸轮表面可在矢状面上内凹地弯曲。隆凸的后下方的凸轮表面和后上方的凸轮表面还可在横剖面上外凸地弯曲。在这些实施例中,隆凸的下凸轮表面在横剖面上的曲率半径大致等于或不同于隆凸的凸出式凸轮表面在横剖面上的曲率半径。
【0010】股骨组件可包括构造成与胫骨支承的隆凸铰接的后凸轮。后凸轮可包括凹入式凸轮表面和凸出式凸轮表面。在一些实施例中,胫骨支承的隆凸和股骨组件的后凸轮各自可具有大致“S”形的横截面轮廓。此外,在一些实施例中,隆凸的后凸出式凸轮表面的曲率半径可大致大于隆凸的后凹入式凸轮表面的曲率半径,并且股骨组件的后凸轮的凸出式凸轮表面的曲率半径大致大于后凸轮的凹入式凸轮表面的曲率半径。胫骨支承和股骨组件构造成使得在第一弯曲范围期间后凸轮的凹入式凸轮表面铰接在隆凸的后凸出式凸轮表面,并且在大于第一弯曲范围的第二弯曲范围期间后凸轮的凸出式凸轮表面铰接在隆凸的后凹入式凸轮表面。
【0011】根据又一个方面,后稳定的膝关节矫形假体可包括构造成与胫骨托连接的胫骨支承和构造成与股骨远端的已作好手术准备的表面连接的股骨组件。胫骨支承可包括平台,平台包括内侧支承表面和外侧支承表面。胫骨支承还可包括在内侧支承表面与外侧支承表面之间从平台向上延伸的隆凸。隆凸可包括凹入式凸轮表面和凸出式凸轮表面。
【0012】股骨组件可包括构造成与胫骨支承的外侧支承表面铰接的外侧髁突,构造成与内侧支承表面铰接的内侧髁突,和定位在限定于外侧髁突与内侧髁突之间的髁间窝中的后凸轮。后凸轮可包括凹入式凸轮表面和凸出式凸轮表面。在第一弯曲角度时后凸轮的凹入式凸轮表面可与隆凸的凸出式凸轮表面初始接触,以及在大于第一弯曲角度的第二弯曲角度时后凸轮的凸出式凸轮表面可与隆凸的凹入式凸轮表面初始接触。
附图说明
【0013】详细描述具体参考下面的附图,其中:
【0014】图1是矫形假体的一个实施例的分解透视图;
【0015】图2是图1的矫形假体的股骨组件的一个实施例的横截面视图;
【0016】图3是图1的矫形假体的胫骨支承的一个实施例的横截面视图;
【0017】图4是图2的股骨组件的另一个横截面视图;
【0018】图5是图3的胫骨支承的另一个横截面视图;
【0019】图6至15是图1的矫形假体在不同弯曲角度下的侧视图;
【0020】图16是图1的矫形假体的胫骨支承的另一个实施例的顶平面视图;
【0021】图17是图16的胫骨支承去掉了隆凸的一部分的横截面视图;
【0022】图18是包括胫骨支承的矫形假体位于前期弯曲角度的一个实施例的侧视图;
【0023】图19是图18的矫形假体大致沿剖面线19-19的横截面视图;
【0024】图20是图18的矫形假体位于后期弯曲角度的侧视图;
【0025】图21是图20的矫形假体大致沿剖面线21-21的横截面视图;
【0026】图22是矫形假体的另一个实施例的分解透视图;
【0027】图23是图22中的矫形假体的股骨组件的一个实施例的横截面视图;
【0028】图24是图22中的矫形假体的胫骨支承的一个实施例的横截面视图;
【0029】图25至28是图22的矫形假体在不同弯曲角度下的侧视图。
具体实施方式
【0030】虽然本公开的构思允许多种修改和可替代形式,但是其特定实施例已经在附图中以示例的形式示出并将在此详细描述。然而应当理解,这并不是将本发明的概念限定为所披露的具体形式,相反的,其目的在于覆盖属于由所附权利要求限定的本发明的宗旨和范围内的所有修改、等价物、和替换物。
【0031】在本公开全文中,通过参考本文中所描述的矫形植入物和患者的自然骨骼二者,可采用诸如前、后、内侧、外侧、上、下等等表示解剖参照的术语。这些术语在解剖学研究和矫形学领域中具有公知的含义。除非有另外的注释,认为在说明书和权利要求书中这些解剖参照术语的使用与其公知含义一致。
【0032】现在参考图1,在一个实施例中,后稳定的膝关节矫形假体10包括胫骨嵌入件或支承12、股骨组件14和胫骨托15。股骨组件14构造成以在应用期间与胫骨支承12铰接。胫骨支承12示例性地由诸如超高分子量的聚乙烯(UHMWPE)这样的聚合物材料形成,但在其它实施例中也可由其它材料形成,诸如:陶瓷材料、金属材料、生物工程材料或其它类似物。股骨组件12和胫骨托15示例性地由诸如钴铬(cobalt-chromium)或钛这样的金属材料形成,但在其它实施例中也可由其它材料形成,诸如:陶瓷材料、聚合物材料、生物工程材料或其它类似物。
【0033】如下面将更详细讨论的,股骨组件14构造成以与胫骨支承12铰接,胫骨支承12构造成以与胫骨托15连接。示例性的胫骨支承12具体化为旋转的或活动的胫骨支承并构造成以在应用期间相对于胫骨托15旋转。然而,在其它实施例中,胫骨支承12可具体化为固定的胫骨支承,其相对于胫骨托15的旋转被限制或约束。
【0034】胫骨托15构造成固定到已作好手术准备的患者胫骨的近端(未示出)。胫骨托15可通过涂覆骨胶或应用其它附接工具而固定到患者的胫骨。胫骨托15包括具有顶面82和底面84的平台80。示意性地,顶面82大体是平的,在一些实施例中,可经过高度抛光。胫骨托15还包括从平台80的底面84向下延伸的柄86。腔或孔88限定在平台80的顶面82中并向下延伸到进柄86内。如下文较详细讨论的,孔88形成以接收胫骨嵌入件12的配合柄。
【0035】如上所述,胫骨支承12构造成以与胫骨托15连接。胫骨支承12包括具有上支承表面18和底面20的平台16。在胫骨支承12具体化为旋转的或移动的胫骨支承的示例性实施例中,支承12包括从平台16的底面20向下延伸的柄22。当胫骨支承12连接到胫骨托15时,柄22被接收在胫骨托15的孔88中。使用中,胫骨支承12构造成围绕着由柄22限定的轴线相对胫骨托15旋转。在胫骨支承15具体化为固定的胫骨支承的实施例中,支承12可包括或不包括柄22和/或可包括以非旋转方式将胫骨支承12固定到胫骨托15的其它设备或特征。
【0036】胫骨支承12的上支承表面18包括内侧支承表面24,外侧支承表面26,以及从平台16向上延伸的隆凸30。内侧支承表面24和外侧支承表面26构造成以接收或以其它形式接触将在下文详细介绍的股骨组件14的相应的内侧髁突44和外侧髁突46。这样,在一些实施例中支承表面24、26可具有凹入式的轮廓。隆凸30定位于支承表面24、26之间并且包括前侧32和后侧34。
【0037】股骨组件14构造成连接到患者股骨远端的已作好手术准备的表面(未示出)。股骨组件14可通过使用骨胶或其它附接工具而固定到患者股骨。股骨组件14包括铰接表面40,铰接表面40具有一对间隔开的内侧髁突44和外侧髁突46。在使用时,髁突44、46替代患者股骨的天然髁突并且构造成铰接在胫骨支承12的平台16的相应支承表面24、26上。
【0038】髁突44、46间隔开以在其间限定出髁间窝或凹槽42。后凸轮50和前凸轮52(见图2)定位于髁间窝42中。后凸轮50定位成朝向股骨组件14的后侧并构造成在如图4至13中图示并且如在下文关于图4至13较为详细描述般在弯曲期间啮合或以其它方式接触胫骨支承12的隆凸30。
【0039】现在参考附图2至5,股骨组件14的后凸轮50和胫骨支承12的隆凸30各自在矢状面中具有大致“S”形的横截面轮廓。特别地,如图2所示,股骨组件14的后凸轮50包括凸轮表面54,其构造成在使用期间接触隆凸30的凸轮表面60。这样,后凸轮50的凸轮表面54包括凹入式凸轮表面56和凸出式凸轮表面58。在示例性实施例中,凸出式凸轮表面58在凹入式凸轮表面56的后部定位。凸轮表面56、58可具有类似或不同的曲率半径。例如,在一些实施例中,凸出式凸轮表面58可具有比凹入式凸轮表面56的曲率半径大致更大的曲率半径。然而,在其他实施例中,凸出式凸轮半径58可具有大致等于或小于凹入式凸轮表面56的曲率半径的曲率半径。
【0040】在一些实施例中,凸轮表面56、58的曲率可由单一的曲率半径限定。凸轮表面56、58的特定曲率半径(即:凸轮表面的“尺寸”)可取决于一定数目的标准,诸如:植入物的尺寸、胫骨植入物12的隆凸30的铰接表面的形状或几何结构和/或类似标准等等。然而,在其他实施例中,股骨组件14的凹入式凸轮表面56和凸出式凸轮表面58可由多个曲率半径形成。例如,在图4所示的实施例中,凹入式凸轮表面56由曲率半径200和曲率半径202限定,这两个曲率半径彼此相切。在一个特定实施例中,曲率半径200大约为10.42毫米以及曲率半径202大约为8.13毫米。此外,凸出式凸轮表面58由多个曲率半径204、206、208、210限定。这些曲率半径204、206、208、210各自与每个相邻的曲率半径相切。在一个特定实施例中,曲率半径204大约为7.14毫米,曲率半径206大约为7.01毫米,曲率半径208大约为7.30毫米,且曲率半径210大约为2.30毫米。在其它实施例中,可采用更多或更少数量的曲率半径来限定凸轮表面56、58。再者,曲率半径200、202、204、206、208、210在其它实施例中可具有其它值。
【0041】现在参考图3,胫骨支承12的凸轮表面60限定在隆凸30的后侧34上。与股骨组件14的后凸轮50的凸轮表面54类似,隆凸30的凸轮表面60包括凸出式凸轮表面62和凹入式凸轮表面64。在示例性实施例中,凸出式凸轮表面62定位成高于凹入式凸轮表面64。与后凸轮50的凸轮表面56、58类似,隆凸30的凸轮表面62、64可具有类似或不同的曲率半径。例如,在一些实施例中,凹入式凸轮表面64具有比凸出式凸轮表面62的曲率半径大致更大的曲率半径。然而,在其它实施例中,凹入式凸轮表面64具有大致等于或小于凸出式凸轮表面62的曲率半径的曲率半径。
【0042】在一些实施例中,凸轮表面62、64的曲率可由单一的曲率半径限定。凸轮表面62、64的特定曲率半径(即,凸轮表面的“尺寸”)可能取决于一定数目的标准,诸如:植入物的尺寸、股骨组件14的后凸轮50的铰接表面的形状或几何结构和/或类似标准等等。然而,在其它实施例中,胫骨支承12的凸出式凸轮表面62和凹入式凸轮表面64可由多个曲率半径形成。例如,在图5所示的实施例中,凹入式凸轮表面64由曲率半径220和曲率半径222限定,曲率半径220、222各自是彼此相切的。在一个特定实施例中,曲率半径220大约为9.00毫米以及曲率半径222大约为13.00毫米。凸出式凸轮表面62由曲率半径224限定。在一个特定实施例中,曲率半径224大约为8.00毫米。当然,在其它实施例中,可由更多或更少数量的曲率半径限定凸轮表面62、64。再者,在其它实施例中曲率半径220、222、224可具有其它值。
【0043】现在参考图6至15,股骨组件14和胫骨支承12构造成使得在弯曲期间股骨组件14的后凸轮50与胫骨支承12的隆凸30接触。特别地,在前期弯曲期间,后凸轮50的凹入式凸轮表面56与隆凸30的凸出式凸轮表面62接触。随着矫形假体10的弯曲加剧,后凸轮50与隆凸30之间的接触从后凸轮50的凹入式凸轮表面56与隆凸30的凸出式凸轮表面62之间的接触转变为在后期弯曲期间后凸轮50的凸出式凸轮表面58与隆凸30的凹入式凸轮表面64之间的接触。
【0044】如图6所示,当矫形假体10处于伸展状态或其它非弯曲状态(例如:大约0度弯曲),后凸轮50不与隆凸30接触。然而,在如图7和8所示的前期弯曲期间,股骨组件14的后凸轮50与胫骨支承12的隆凸30接触。例如,在图7所示的一个实施例中,当矫形假体10移动到弯曲状态时,后凸轮50的凹入式凸轮表面56与隆凸的凸出式凸轮表面62以预定弯曲角度成初始接触。在示例性实施例中,股骨组件14和胫骨支承12构造成使得凸轮表面56、62以大约60度弯曲成初始接触。然而,在其它实施例中,后凸轮50与隆凸30之间初始接触的弯曲角度的设定可基于诸如矫形假体10的尺寸、股骨组件14的铰接表面和/或胫骨支承12的外形或几何结构和/或类似物等特定标准来确定。
【0045】在矫形假体10的前期弯曲期间,保持了在凹入式凸轮表面56与凸出式凸轮表面62之间的接触。例如,在图8示出的一个实施例中,在大约60度弯曲时隆凸30的凸出式凸轮表面62可完全“种入(seeded)”后凸轮50的凹入式凸轮表面56。在前期弯曲之后,后凸轮50与隆凸30之间的接触从凸轮表面56、62的接触转变为凸轮表面58、64的接触。例如,在图9示出的实施例中,在大约80度弯曲时后凸轮50与隆凸30之间的接触开始转变为凸轮表面58、64的接触。在这个弯曲角度,可以形成后凸轮50的凸出式凸轮表面58与隆凸30的凹入式凸轮表面64之间的初始接触。
【0046】在矫形假体10的后期弯曲期间,凸出式凸轮表面58与凹入式凸轮表面64保持接触。例如,图10至15示出了一个在后期弯曲的不同角度下的实施例。特别地,所示的矫形假体10在图10中弯曲约100度,在图11中弯曲约110度,在图12中弯曲约120度,在图13中弯曲约130度,在图14中弯曲约140度,以及在图15中弯曲约150度。
【0047】应当理解,在前期以及后期弯曲的整个范围内保持后凸轮50与隆凸30之间的接触。矫形假体10特定的前期弯曲范围(即:在后凸轮50的凹入式凸轮表面56与隆凸30的凸出式凸轮表面62接触时的范围)和后期弯曲的范围(即:在后凸轮50的凸出式凸轮表面58与隆凸30的凹入式凸轮表面64接触时的范围)可取决于一个或更多个标准,诸如矫形假体10的尺寸、胫骨支承12和股骨组件14的铰接凸轮表面的外形或几何结构或类似物等。在示例性实施例中,矫形假体10构造成具有大约50度至大约80度的前期弯曲范围和大约80度至大约150度的后期弯曲范围,但在其它实施例中也可以采用其它弯曲范围。矫形假体10的前期和后期弯曲的范围部分地是基于凸轮表面56、58、62、64的曲率半径而确定的。照此,矫形假体10的前期和后期弯曲的范围可通过调节凸轮表面56、58、62、64的曲率半径而设置。
【0048】还应当理解,由于后凸轮50的凸轮表面54包括凹入式凸轮表面56和凸出式凸轮表面58并且隆凸30的凸轮表面34包括凸出式凸轮表面62和凹入式凸轮表面64,所以介于后凸轮50与隆凸30之间的接触表面面积通过相对矫形假体的弯曲范围而增加,其中后凸轮和/或隆凸包括平坦的凸轮表面或仅具有一个凹或凸表面的凸轮表面。例如,在前期弯曲时,由于后凸轮50的凹入式凸轮表面56与隆凸30的凸出式凸轮表面62的交界,所以后凸轮50和隆凸30之间的接触面积增加。此外,在后期弯曲时,由于后凸轮50的凸出式凸轮表面58与隆凸30的凹入式凸轮表面64的交界,所以在较为后期的弯曲角度下,后凸轮50与隆凸30之间的接触面积增加。由于后凸轮50与隆凸30之间的接触遍布了较大的接触区域,因此也可以降低隆凸30的前部磨损。
【0049】现在参考图16和17,在一些实施例中,隆凸30的后侧34在横剖面上也可以是弯曲的。也就是说,在上方的凸出式凸轮表面62和在下的凹入式凸轮表面64中的每个都可以在横剖面的方向上是凸的。例如,如图16所示,隆凸30的凸出式凸轮表面62可在横剖面上外凸地弯曲。此外,如在图17中所示,隆凸30的凹入式凸轮表面64可在横剖面上外凸地弯曲。凸出式凸轮表面62和凹入式凸轮表面64在横剖面上的曲率半径可大致相等或不等。例如,在一些实施例中,凹入式凸轮表面64在横剖面上的曲率半径可大于凸出式凸轮表面62在横剖面上的曲率半径。可选择地,在其它实施例中,凸出式凸轮表面62在横剖面上的曲率半径可大于凹入式凸轮表面64在横剖面上的曲率半径。
【0050】在隆凸30的凸轮表面62、64在横剖面上是弯曲的实施例中,股骨组件12的后凸轮50在横剖面上铰接于凸轮表面62、64上,从而使得股骨组件14围绕着隆凸30旋转一定量。例如,如图18和19所示,当后凸轮50的凹入式凸轮表面56与隆凸30的凸出式凸轮表面62在前期弯曲期间接触时,股骨组件14可在横剖面上如箭头70所示以大体上为“内侧-外侧”的方向围绕着隆凸30旋转。在这些实施例中,后凸轮50的凹入式凸轮表面56在一些实施例中在“内侧-外侧”的方向上大致为平的。可替代地,与隆凸30的凸出式凸轮表面62类似,股骨组件12的后凸轮50的凹入式凸轮表面56在“内侧-外侧”的方向上也可以是弯曲的。例如,如图19所示,凹入式凸轮表面56可在“内侧-外侧”的方向上内凹地弯曲。在一些实施例中,凹入式凸轮表面56在“内侧-外侧”方向上的曲率半径可大致等于隆凸30的凸出式凸轮表面62在横剖面上的曲率半径。可替代地,凹入式凸轮表面56在“内侧-外侧”方向上的曲率半径可大于或小于凸出式凸轮表面62在横剖面上的曲率半径。在前期弯曲期间股骨组件14与胫骨支承12之间的旋转量可基于凸轮表面56、62在横剖面上的曲率半径而进行调节。例如,在矫形假体的前期弯曲期间增加的旋转量可通过降低凸出式凸轮表面62在横剖面上的曲率半径来获得。
【0051】参考图20和21,在后期弯曲期间,当后凸轮50的凸出式凸轮表面58与隆凸30的凹入式凸轮表面64接触时,在一些实施例中,股骨组件14可以如箭头72所示在横剖面上在大体“内侧-外侧”的方向上围绕着隆凸30而旋转。在这些实施例中,后凸轮50的凸出式凸轮表面58在“内侧-外侧”方向上大致为平的。可替代地,与隆凸30的凹入式凸轮表面64类似,股骨组件12的后凸轮50的凸出式凸轮表面58在“内侧-外侧”方向上可以是弯曲的。例如,如图21所示,凸出式凸轮表面58可在“内侧-外侧”方向上可以是内凹地弯曲的。在一些实施例中,凸出式凸轮表面58在“内侧-外侧”方向上的曲率半径可大致等于隆凸30的凹入式凸轮表面64在“内侧-外侧”方向上的曲率半径。可替代地,凸出式凸轮表面58在“内侧-外侧”方向上的曲率半径可大于或稍小于凹入式凸轮表面64在“内侧-外侧”方向上的曲率半径。如上关于前期弯曲所述,在后期弯曲期间股骨组件14与胫骨支承12之间的旋转量可基于凸轮表面58、64在“内侧-外侧”方向上的曲率半径而进行调节。
【0052】如上所述,示意性矫形假体10的后期弯曲的范围大于前期弯曲的范围。然而,在其它实施例中,矫形假体10可具有大于后期弯曲范围的前期弯曲范围。也就是说,因为部分基于凸轮表面56、58、62、64的曲率半径确定了矫形假体的前期和后期弯曲的范围,所以可通过改变凸轮表面56、58、62、64的曲率半径(即,凸轮表面的“尺寸”)来调节前期和后期弯曲的范围。例如,如图22至28所示,在另一个实施例中,矫形假体10可包括大于后期弯曲范围(即,后凸轮50的凹入式凸轮表面接触隆凸30的凸出式凸轮表面时的范围)的前期弯曲范围(即,后凸轮50的凸出式凸轮表面接触隆凸30的凹入式凸轮表面时的范围)。
【0053】如图22至24中所示,在这些实施例中,股骨组件14的后凸轮50包括构造为成在使用期间与隆凸30的凸轮表面102接触的凸轮表面100。这样,后凸轮50的凸轮表面100包括凹入式凸轮表面104和凸出式凸轮表面106。在示例性实施例中,凸出式凸轮表面106定位于凹入式凸轮表面104的后部。凹入式凸轮表面104具有比凸出式凸轮表面106的曲率半径大致更大的曲率半径。如上关于凸轮表面56、58所讨论的,凸轮表面104、106的特定曲率半径(即,凸轮表面的“尺寸”)可取决于一定数目的标准,诸如植入物的尺寸、股骨组件14和/或胫骨支承12的铰接表面的形状或几何结构和/或其它类似的标准等等。在一个特定的实施例中,凹入式凸轮表面104具有约12.7毫米的曲率半径而凸出式凸轮表面106具有大约6.4毫米的曲率半径。
【0054】与股骨组件14的后凸轮50的凸轮表面100类似,隆凸30的凸轮表面102包括凸出式凸轮表面108和凹入式凸轮表面110。在示例性实施例中,凸出式凸轮表面108相对于凹入式凸轮表面110定位在上方。凸出式凸轮表面108具有比凹入式凸轮表面110的曲率半径大致更大的曲率半径。再者,凸轮表面108、110的特定曲率半径(即,凸轮表面的“尺寸”)可取决于一定数目的标准,诸如植入物的尺寸、患者的骨骼、和/或其它类似的标准等等。在一个特定实施例中,凸出式凸轮表面108具有大约10.3毫米的曲率半径而凹入式凸轮表面110具有大约1.00毫米的曲率半径。
【0055】由于凸轮表面104、108的曲率半径大于凸轮表面106、110的曲率半径,所以图22至28所示的矫形假体10的实施例的前期弯曲范围大于后期弯曲范围。例如,如图25所示,当矫形假体10处于伸展状态或其它非弯曲状态(例如,约0度弯曲),后凸轮50不与隆凸30接触。然而,在如图26所示的前期弯曲期间,股骨组件14的后凸轮50与胫骨支承12的隆凸30接触。也就是说,在前期弯曲期间,后凸轮50的凹入式凸轮表面104与隆凸30的凸出式凸轮表面108接触。由于凸轮表面104、108的曲率半径增加,所以凸轮表面104、108在较大的弯曲范围保持彼此接触。这样,矫形假体的前期弯曲范围相对于凸轮表面104、108的曲率半径缩小的实施例有所增加。前期弯曲之后,后凸轮50与隆凸30之间的接触从凸轮表面104、108的接触转变为凸轮表面106、110的接触。例如,在如图27所示的一个实施例中,后凸轮50和隆凸30之间的接触开始转变为凸轮表面106、110。在这个弯曲角度,可以形成后凸轮50的凸出式凸轮表面106与隆凸30的凹入式凸轮表面110之间的初始接触。随后,如图28所示,在矫形假体10的后期弯曲期间,凸出式凸轮表面106与凹入式凸轮表面110保持接触。
【0056】再者,应当理解,在前期弯曲和后期弯曲的整个范围保持后凸轮50与隆凸30之间的接触。矫形假体10特定的前期弯曲的范围(即,后凸轮50的凹入式凸轮表面104和隆凸30的凸出式凸轮表面108接触时的范围)和后期弯曲的范围(即,后凸轮50的凸出式凸轮表面106和隆凸30的凹入式凸轮表面110接触时的范围)可取决于一个或更多个标准,诸如矫形假体10的尺寸、患者的骨骼或其它标准等等。在图22至28所示的示范性实施例中,矫形假体构造成具有大约50度到约100度的前期弯曲范围和大约100度到约150度的后期弯曲范围,但是在其它实施例中也可采用其它弯曲范围。
【0057】还应当理解,由于后凸轮50的凸轮表面100包括凹入式凸轮表面104和凸出式凸轮表面106并且隆凸30的凸轮表面102包括凸出式凸轮表面108和凹入式凸轮表面110,所以相对于后凸轮和/或隆凸包括平的凸轮表面或仅具有凹或凸表面的凸轮表面的矫形假体而言,后凸轮50与隆凸30之间的接触表面积增加。特别地,由于后凸轮50的凹入式凸轮表面104和隆凸30的凸出式凸轮表面108各自具有大的曲率半径,因此在前期弯曲期间后凸轮50与隆凸30之间的接触面积增加。此外,如上所述,由于后凸轮50与隆凸30之间的接触遍布着较大的接触面积,所以隆凸30的前部磨损也可降低。
【0058】虽然在附图和前面的描述中对本发明做了详细的图示和描述,但这些图示和描述在性质上应理解为是示范性的并且非限制性的,应当理解仅示出和描述了示例性实施例,并且进入本发明精神内的全部改变和修改都应当被保护。
【0059】本发明的多个优势缘于在此描述的设备和组件的各种特征。需要说明的是本发明的设备和组件的替换实施例可以不包括所描述的全部特征,但仍然得益于至少这些特征的部分优势。本领域技术人员可设计出结合了本发明的一个或多个特征但属于附加权利要求所限定的本发明的精神和范围内的设备或组件的实施方式。
Claims (10)
1、一种矫形假体,包括:
胫骨支承,其构造成与胫骨托连接,该胫骨支承具有平台和从平台向上延伸的隆凸,该隆凸具有包括凹入式凸轮表面和凸出式凸轮表面的后侧;以及
股骨组件,其构造成与胫骨支承铰接,股骨组件包括(i)一对间隔开的髁突,所述髁突限定它们之间的髁间窝和(ii)定位于髁间窝中的后凸轮,后凸轮包括凹入式凸轮表面和凸出式凸轮表面,
其中在第一弯曲范围期间,后凸轮的凹入式凸轮表面与隆凸的凸出式凸轮表面接触,以及在第二弯曲范围期间,后凸轮的凸出式凸轮表面和隆凸的凹入式凸轮表面接触。
2、根据权利要求1的矫形假体,其中胫骨支承的隆凸的凸出式凸轮表面在矢状面上外凸地弯曲,并且隆凸的凹入式凸轮表面在矢状面上内凹地弯曲。
3、根据权利要求2的矫形假体,其中隆凸的凹入式凸轮表面和凸出式凸轮表面在横剖面上外凸地弯曲。
4、根据权利要求3的矫形假体,其中隆凸的凹入式凸轮表面在横剖面上的曲率半径大致等于隆凸的凸出式凸轮表面在横剖面上的曲率半径。
5、根据权利要求1的矫形假体,其中股骨组件的后凸轮的凹入式凸轮表面在矢状面上内凹地弯曲,而股骨组件的后凸轮的凸出式凸轮表面在矢状面上外凸地弯曲。
6、根据权利要求5的矫形假体,其中股骨组件的后凸轮的凹入式凸轮表面和凸出式凸轮表面在内侧-外侧方向上内凹地弯曲。
7、根据权利要求1的矫形假体,其中第一弯曲范围的弯曲角度小于第二弯曲范围的弯曲角度。
8、根据权利要求1的矫形假体,其中第一弯曲范围为约50度弯曲至约80度弯曲,而第二弯曲范围为约80度弯曲至约150度弯曲。
9、根据权利要求1的矫形假体,其中胫骨支承的隆凸的凹入式凸轮表面由第一曲率半径限定,而隆凸的凸出式凸轮表面由第二曲率半径限定,第一曲率半径与第二曲率半径不同。
10、根据权利要求9的矫形假体,其中股骨组件的后凸轮的凹入式凸轮表面由第一曲率半径限定,以及股骨组件的后凸轮的凸出式凸轮表面由第二曲率半径限定,第一曲率半径与第二曲率半径不同。
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US11911279B2 (en) | 2018-04-30 | 2024-02-27 | Zimmer, Inc. | Posterior stabilized prosthesis system |
Also Published As
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AU2009202627B2 (en) | 2015-07-02 |
EP2878283A1 (en) | 2015-06-03 |
US20120259417A1 (en) | 2012-10-11 |
US8734522B2 (en) | 2014-05-27 |
EP2149354A1 (en) | 2010-02-03 |
EP2149354B1 (en) | 2015-01-14 |
CN101683289B (zh) | 2014-08-13 |
US8206451B2 (en) | 2012-06-26 |
US20140228965A1 (en) | 2014-08-14 |
JP5535533B2 (ja) | 2014-07-02 |
US9204968B2 (en) | 2015-12-08 |
DK2149354T3 (en) | 2015-03-09 |
AU2009202627A1 (en) | 2010-01-14 |
EP2878283B8 (en) | 2016-12-28 |
EP2878283B1 (en) | 2016-11-09 |
JP2010012256A (ja) | 2010-01-21 |
ES2534653T3 (es) | 2015-04-27 |
ES2614051T3 (es) | 2017-05-29 |
US20090326666A1 (en) | 2009-12-31 |
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