CN101744675B - There is the knee prosthesis kit of winged sleeve pipe and milling guide - Google Patents
There is the knee prosthesis kit of winged sleeve pipe and milling guide Download PDFInfo
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- CN101744675B CN101744675B CN200910208200.5A CN200910208200A CN101744675B CN 101744675 B CN101744675 B CN 101744675B CN 200910208200 A CN200910208200 A CN 200910208200A CN 101744675 B CN101744675 B CN 101744675B
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- sleeve pipe
- main body
- ladder
- lateral dimension
- summit
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- 238000003801 milling Methods 0.000 title claims abstract description 144
- 210000003127 Knee Anatomy 0.000 title claims abstract description 63
- 210000001519 tissues Anatomy 0.000 claims abstract description 38
- 230000002093 peripheral Effects 0.000 claims description 52
- 239000007943 implant Substances 0.000 claims description 51
- 210000000689 upper leg Anatomy 0.000 claims description 36
- 210000000629 knee joint Anatomy 0.000 claims description 27
- 238000005452 bending Methods 0.000 claims description 25
- 238000009416 shuttering Methods 0.000 claims description 22
- 210000002303 Tibia Anatomy 0.000 claims description 19
- 239000011159 matrix material Substances 0.000 claims description 9
- 230000001154 acute Effects 0.000 claims description 6
- 230000000295 complement Effects 0.000 claims description 5
- 230000000670 limiting Effects 0.000 claims description 5
- 238000011049 filling Methods 0.000 claims description 4
- 238000009434 installation Methods 0.000 claims description 3
- 230000000451 tissue damage Effects 0.000 claims 2
- 231100000827 tissue damage Toxicity 0.000 claims 2
- 238000005553 drilling Methods 0.000 claims 1
- 238000005520 cutting process Methods 0.000 description 20
- 210000000988 Bone and Bones Anatomy 0.000 description 19
- 230000000875 corresponding Effects 0.000 description 11
- 210000001699 lower leg Anatomy 0.000 description 9
- 230000000712 assembly Effects 0.000 description 7
- 238000000034 method Methods 0.000 description 7
- 210000002745 Epiphyses Anatomy 0.000 description 4
- NOQGZXFMHARMLW-UHFFFAOYSA-N Succinic acid 2,2-dimethylhydrazide Chemical group CN(C)NC(=O)CCC(O)=O NOQGZXFMHARMLW-UHFFFAOYSA-N 0.000 description 4
- 239000011248 coating agent Substances 0.000 description 4
- 238000000576 coating method Methods 0.000 description 4
- 210000001624 Hip Anatomy 0.000 description 3
- 241000283220 Odobenus rosmarus Species 0.000 description 3
- 210000003786 Sclera Anatomy 0.000 description 3
- 230000015572 biosynthetic process Effects 0.000 description 3
- 201000010099 disease Diseases 0.000 description 3
- 238000005755 formation reaction Methods 0.000 description 3
- 230000036961 partial Effects 0.000 description 3
- 210000003414 Extremities Anatomy 0.000 description 2
- 210000004417 Patella Anatomy 0.000 description 2
- 241001074085 Scophthalmus aquosus Species 0.000 description 2
- 210000002435 Tendons Anatomy 0.000 description 2
- 230000003247 decreasing Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 238000005304 joining Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000006011 modification reaction Methods 0.000 description 2
- 238000002360 preparation method Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 210000000845 Cartilage Anatomy 0.000 description 1
- 241000196324 Embryophyta Species 0.000 description 1
- 206010016654 Fibrosis Diseases 0.000 description 1
- 210000001503 Joints Anatomy 0.000 description 1
- 210000003041 Ligaments Anatomy 0.000 description 1
- 208000003076 Osteolysis Diseases 0.000 description 1
- 210000000824 Sesamoid Bones Anatomy 0.000 description 1
- 238000007792 addition Methods 0.000 description 1
- 238000005253 cladding Methods 0.000 description 1
- 239000012141 concentrate Substances 0.000 description 1
- 238000002316 cosmetic surgery Methods 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000005611 electricity Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000002708 enhancing Effects 0.000 description 1
- 230000002349 favourable Effects 0.000 description 1
- 230000004761 fibrosis Effects 0.000 description 1
- 210000004394 hip joint Anatomy 0.000 description 1
- 238000011065 in-situ storage Methods 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 238000011068 load Methods 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 239000011148 porous material Substances 0.000 description 1
- 238000004321 preservation Methods 0.000 description 1
- 230000002829 reduced Effects 0.000 description 1
- 230000000717 retained Effects 0.000 description 1
- 108010048734 sclerotin Proteins 0.000 description 1
- 238000007493 shaping process Methods 0.000 description 1
- 238000011105 stabilization Methods 0.000 description 1
- 230000003313 weakening Effects 0.000 description 1
- 238000005303 weighing Methods 0.000 description 1
Abstract
The present invention relates to the knee prosthesis kit with winged sleeve pipe and milling guide.A kind of knee prosthesis kit includes single-blade and double-vane metaphysis thimble assembly.Milling guide in described external member and reamer allow to form cavity, to receive described metaphysis thimble assembly by one of them pivoting described reamer in a part for described milling guide.Described instrument can make described cavity be directed at described medullary cavity, regardless of the described osseous tissue near described cavity relative hardness how.
Description
The cross reference of related application
Require the priority of following patent application: on October 31st, 2008 by Stephanie M.
DeRuntz, Timothy G.Vendrely, Brian Haas and Jeffery L.Koenemann submits to
, entitled " KNEE PROSTHESIS KIT WITH WINGED SLEEVES AND MILLING
GUIDE " U.S. of (having the knee prosthesis kit of winged sleeve pipe and milling guide) is the most special
Profit patent application serial numbers No.61/110174 (attorney DEP6004USPSP).
Technical field
Present invention relates generally to prosthetic joint, more particularly, relate to modular knee articular prosthesis system
System, this system includes metaphysis assembly and for processing osseous tissue to make it to receive the work of metaphysis assembly
Tool.
Background technology
Knee joint is substantially made up of the bone interface of distal femur and proximal tibia.In appearance, cladding or
Protect this interface at least in part is Patella, and it is within longue (musculus quadriceps) tendon of thigh front
Sesamoid bone.This tendon inserts tibial tubercle bone, and the Patella back side smooths, and can slide on femur.
Femur is configured to have two spherical protuberances (interior condyle and ectocondyle), and the two projection is substantially
Smooth, and engage with medial tibial plateau bone and outside platform bone respectively.Tibial plateau bone is the most flat
Sliding, and slightly cupping, thus the small acceptor receiving condyle of femur is provided.
When knee joint is because of accident or disease damages, for pain relief with recover normally the making of joint
With, it may be necessary to use prosthetic joint to replace the joint of damage.Generally replaced whole by surgical operation
Knee joint, this operation relates to the surface removing the damaged bony tissues of correspondence, and replaces with prothesis implant body
These surfaces.It is referred to as initial total knee arthroplasty by the method for prosthetic joint displacement native joint.
Sometimes, first knee-joint prosthesis can lose efficacy.Inefficacy may be caused by a lot of reasons, including mill
Damage, aseptic loosening, osteolysis, ligament instability, joint fibrosis and patellofemoral complications.
When the mobility of weakening people of losing efficacy, it is necessary to carry out Knee Joint Surgery revision procedure.Carry out overhauling hands
During art, remove first knee-joint prosthesis, and put with the assembly overhauling knee joint prosthesis system
Change.
Knee joint implant system that is first and that overhaul application is available from including DePuy Orthopaedics,
Inc. (Warsaw, Ind.) is in interior multiple manufacturers.DePuy and other manufacturer provide for first
With the some different systems overhauling application.Such as, DePuy Orthopaedics provides P.F.C.Knee joint system (P.F.C.
Knee System)、
Total knee system
(
Total Knee System) and S-ROM modular total knee articular system (S-ROM Modular
Total Knee System).Each of these plastic surgery's knee joint systems all include some assemblies,
Some is applicable to first knee replacements, and some is applicable to surgery revision procedure.
DePuy Orthopaedics also provides for other orthopaedic implants system for other purposes
System.The such system of one of which is LPS system (LPS System).LPS system is used in serious wound
Use under wound and disease event.In this case, wound or disease can cause a large amount of damages of osseous tissue
Lose.LPS system provides the group wholly or largely that can replace some osseous tissue, such as femur
Part.DePuy LPS system is that on April 30th, 2002 is submitted to by Hazebrouck et al., entitled
The U.S. of " Modular Limb Preservation System " (modularity extremity protection system) is special
Profit patent application serial numbers No.10/135, is more fully described below in 791, this patent application with its in full with
Way of reference is expressly incorporated herein.
In some patients, there is cavity Cranial defect, described sky in the metaphysis of juxtra-articular osseous tissue
Property Cranial defect in chamber can not be filled up completely with standard knee implant.The existence of this metaphysis defect can be led
Cause prothesis implant body to elapse in time and loosen, thus reduce the stability of prothesis implant body, and very
Jointing repair prosthesis implant is needed in the case of Duo.
In order to fill metaphysis cavity Cranial defect, it is provided that the knee joint with modularity metaphysis sleeve pipe closes
Joint system.This kind of sleeve pipe is such as shown in following documents: entitled " Modular Orthopaedic
Implant System With Multi-Use Stems " (have outside the modularity shaping of utility rod
Surgical implant system) U.S. Patent Publication No. No.2006/0030945A1；Entitled " Modular
Implant System With Fully Porous Coated Sleeve " (there is full micro porous coating set
The modular implant systems of pipe) U.S. Patent Publication No. No.2005/0107883A1；Entitled
" Prosthetic Tibial Component With Modular Sleeve " (has modularity set
The tibial prosthesis assembly of pipe) United States Patent (USP) No.7,291,174；Entitled " Medical
Fastening System " United States Patent (USP) No.6,171,342 of (medical treatment fixed system)；Entitled
United States Patent (USP) No. of " Medical Fastening System " (medical treatment fixed system)
5,824,097；Entitled " Modular Knee Prosthesis " (modular knee articular prosthesis)
United States Patent (USP) No.5,782,921；And entitled " Semi-Constrained Artificial
Joint " United States Patent (USP) No.4,634,444 of (half restricted type artificial joint).These sleeve pipes exist
Commercially available knee-joint prosthesis implant system uses, such as P.F.C.
Knee joint system,Total knee system, S-ROM modular total knee articular system and LPS system, all systems all may be used
Derive from DePuy Orthopaedics, Inc. (Warsaw, Indiana).
Modularity sleeve pipe also has been used in hip implant system, as shown in such as following documents
As going out: entitled " Modular Stem and Sleeve Prosthesis " (modularity is socketed
Formula prosthese) United States Patent (USP) No.6,264,699 and entitled " Sleeves for Affixing
Artificial Joints to Bone " (for artificial joint being fixed to the sleeve pipe of osseous tissue)
United States Patent (USP) No.4,790,852.This kind of hip joint sleeve pipe has been used for commercially available hip prosthesis implant
System, the S-ROM hip such as deriving from DePuy Orthopaedics, Inc. (Warsaw, Indiana) closes
Joint system.
Content disclosed in above-mentioned all patent applications and patent is all incorporated by herein.
In the knee joint system with modularity metaphysis sleeve pipe, the most polysleeve conventional shape is substantially
For elliptical cone, there is at joint line bigger elliptical profile, towards the assembly end away from joint line
At end, section gradually becomes less ellipse or circular section.In general, sleeve pipe has ladder or step
Shape outer surface and for being fixed to the internal channel on another assembly by friction mode.This geometry
The cavity Cranial defect in metaphysis can be filled so that form region, broader surface and transmitted by joint
Load, and connect assembly offer rotational stabilization to the joint of prosthese.The geometry of sleeve pipe of the present invention
Be conducive to by boring, osseous tissue being processed.
In general, borer is by drill bit is clamp-oned in the metaphysis of osseous tissue shape in osseous tissue
Become or the taper-type dropper of enlarged cavities.Knee joint implants the typical borehole utensil in external member usual and dry epiphysis
The profile that the shape of end thimble assembly is coincide.In general, the cavity prepared with borer preferably with bone group
The medullary cavity alignment knitted, thus it is properly positioned the implant being arranged on intracavity.
In some patients, osseous tissue has the hard sclera bone region adjacent with metaphysis cartilage.For
For these patients, the hard sclera influential point of bone forces borer to remove more sclerotin in soft region, relatively
Territory, hard area removes less osseous tissue, thus causes implant to be arranged on less desirable position.This
The distal femur that situation is generally stiffer than prebone at rear bone becomes apparent from.Conventional boring method frequently can lead to
The cavity of preparation and therefore implant location are the most forward, thus form flexing gap, make joint more be difficult to ensure
Maintain an equal level weighing apparatus.Additionally, implant positions incorrect meeting, and the long-term behaviour of prosthese and existence are produced unfavorable shadow
Ring.
Additionally, in some patients, metaphysis defect is probably one side: there may be and needs to use
The inner side of metaphysis sleeve pipe or outside defect, but opposite side is then likely to be of more healthy osseous tissue.Will be
In this case use conventional symmetric sleeve pipe, then need to sacrifice some and originally can be retained in support vacation in situ
The healthy osseous tissue of body.Have tried to by using enhancing thing to solve unilateral deletion problem, however this
System only solves periphery deletion problem, and does not considers the surrounding bony tissue feelings that there is gap intact, middle
Shape.
Accordingly, it would be desirable to a kind of knee joint implant system, it can provide prediction more accurate, more reliable doing
Epiphysis end bone preparation method so that implant is properly positioned, and is not affected by hard sclera bone.Additionally,
Also need to solve the knee joint implant system of metaphysis one side deletion problem.
Summary of the invention
The present invention is by providing new design, new knee implant external member, the new work of metaphysis sleeve pipe
Tool and the new surgical technique of process metaphysis bone, thus solve for above-mentioned such knee implant
The demand of system.
According to an aspect of the invention, it is provided for the prosthese sleeve pipe implant of artificial knee joint.
This joint has joint motions surface.This sleeve pipe include main body, described main body have restriction the first end and
The central longitudinal axis of the second end, middle part, the first shoulder portion, the second shoulder portion and be used for limiting
Inwall along the passage of central longitudinal axis.Passage is tapered between the first end and the second end.
Main body has the outer surface including multiple adjacent steps.Each ladder has the outward flange around its periphery.
The outward flange of each ladder is positioned at the plane being substantially perpendicular to main center's longitudinal axis.In main body
At portion, the outward flange of each ladder includes the bending section that a pair diametrically opposite, radius of curvature is identical
Point.The center of curvature of each diametrically opposite sweep is distributed along the central longitudinal axis of main body.
Diametrically opposite sweep defines the outer peripheral summit of main body center.The first flank in main body
Part, the outward flange of each ladder includes a pair relative and spaced apart straight line, and straight line is connected to directly by this
Sweep opposed on footpath, and by spaced apart with the diametrically opposite sweep at middle part curved
Bent end segments is connected.At Part I on outward flange relative to and spaced apart straight line between distance be less than
Distance between the outer peripheral diametrically opposite sweep of main body center.Bent back ends section limits
The outer peripheral summit of body first side alar part office.At the second shoulder portion of main body, each ladder
Outward flange include a pair relative and spaced apart straight line, straight line is connected in the middle part of main body diametrically by this
Opposed sweep, and by the bent back ends section spaced apart with diametrically opposite sweep
It is connected.Distance between the second outer peripheral relative straight line in flank section office is less than outside main body center
Distance between the diametrically opposite sweep of edge.Bent back ends section defines the body second side wing
Outer peripheral summit at Bu Fen.Each ladder be respectively provided be positioned at outer peripheral summit at Part I and
The first lateral dimension between outer peripheral summit at Part II, and it is outer peripheral to be positioned at center
The second lateral dimension between the summit of diametrically opposite sweep.Ladder near the first end
The first lateral dimension more than the first lateral dimension of adjacent steps, near the of the ladder of the first end
Two lateral dimensions are more than the second lateral dimension of adjacent steps.
In one exemplary embodiment, sleeve pipe is symmetrical, and the outward flange its outer edges of each ladder
Diametrically opposite sweep recessed with the intersection of outer peripheral relative and spaced apart straight line.
According to another aspect of the present invention, it is provided that modular knee prosthesis kit.This external member
Including there is the distal femoral component on bending convex condyle surface, having for receiving distal femoral component to bend convex condyle table
The bending tibial component on matrix condyle surface, femur adapter and the sleeve pipe in face.The bending matrix of tibial component
The bending convex condyle surface of condyle surface and distal femoral component defines joint motions surface.Femur adapter can be pacified
It is contained on distal femoral component.Sleeve pipe includes that main body, described main body have and limits the first end and the second end
Central longitudinal axis, middle part, shoulder portion and restriction are along the inwall of the passage of central longitudinal axis.Passage
It is tapered between the first end and the second end.Main body has the appearance including multiple adjacent steps
Face, each ladder has the outward flange around its periphery.The outward flange of each ladder is positioned at perpendicular
In the plane of main center's longitudinal axis.In main body center, the outward flange of each ladder includes a pair
Diametrically opposite sweep, sweep defines the outer peripheral summit of main body center.In main body
Shoulder portion, the outward flange of each ladder is connected to diametrically opposite sweep, and have with
The spaced apart bent back ends section of diametrically opposite sweep at middle part.Bent back ends section defines
The outward flange summit of main body side alar part office.The outward flange of each ladder intersecting at middle part and shoulder portion
Locate recessed.Each ladder is respectively provided with the horizontal chi of first between outer peripheral summit, flank section office
Very little, and second between the summit of the outer peripheral diametrically opposite sweep of center is horizontal
Size.The first lateral dimension near the ladder of the first end is more than the first horizontal chi of adjacent steps
Very little, near second lateral dimension of ladder of the first end more than the second lateral dimension of adjacent steps.
The outer surface of casing main body is configured to fill the non-pooled defect in one of knee joint osseous tissue.
In one exemplary embodiment, sleeve pipe is asymmetric, has single flank and middle part.
In another exemplary embodiment, external member includes two sleeve pipes, and one of them sleeve pipe is the most right
Claiming, another sleeve pipe is symmetrical.Asymmetric sleeve pipe has single flank, is used for adapting to have non-pooled dry epiphysis
The patient of end defect.Symmetrical sleeve pipe has two flanks, is used for adapting to have the trouble concentrating metaphysis defect
Person.
According to another aspect of the present invention, it is provided that knee prosthesis kit.This external member includes set
Pipe, milling template and reamer.Sleeve pipe includes that main body, described main body have restriction the first end and second
The central longitudinal axis of end, middle part, shoulder portion and restriction are along the passage of central longitudinal axis
Wall.Passage is tapered between the first end and the second end.Main body has and includes multiple adjacent steps
Outer surface, each ladder has the outward flange around its periphery.The outward flange of each ladder is positioned at substantially
On be perpendicular in the plane of main center's longitudinal axis.At main body center, the outward flange bag of each ladder
Including a pair diametrically opposite sweep, sweep defines the outer peripheral summit of main body center.
At the first shoulder portion of main body, the outward flange of each ladder is connected to diametrically opposite sweep,
And there is the bent back ends section spaced apart with the diametrically opposite sweep at middle part.Bent back ends
Section defines the outer peripheral summit of body first side alar part office.Each ladder is respectively provided with and is positioned at flank
First lateral dimension of the apex of partial outer edge, and it is positioned at the outer peripheral diametrically opposite of center
Sweep summit between the second lateral dimension.Ladder first horizontal near the first end
Size is more than the first lateral dimension of adjacent steps, near the second lateral dimension of the ladder of the first end
The second lateral dimension more than adjacent steps.Milling guide receives the cavity of sleeve pipe for being formed, and
And include the sidewall of modular shuttering element, base component and connection mode board member and base component.Modular shuttering element has
There is the inner surface limiting elongated milling pilot hole.Elongated milling pilot hole has the first lateral dimension and second
Lateral dimension.First lateral dimension of elongated milling pilot hole at least with the set near first sleeve end
First lateral dimension of pipe ladder is the biggest.Second lateral dimension is less than the first lateral dimension.Pedestal and mould
Board member is spaced apart, and includes the bulb-shaped recess being directed at milling pilot hole.Reamer has the first end
End, the second end and central longitudinal axis.First end of reamer includes the spherical surface protruded, ball
Shape surface has right dimensions and shapes so that it is can be received into the spherical of milling guide pedestal
In depression.Reamer has right dimensions and shapes, can stretch out from the pedestal of milling guide,
And through elongated milling pilot hole.
In one exemplary embodiment, this external member also includes adjustable stem.Adjustable stem and milling guide dress
Put and there is complementary characteristic, such that it is able to adjustable stem to be connected to the base component of milling guide.Therefore
Can arrange and fix milling guide, making pedestal be directed at medullary cavity.
In another exemplary embodiment, this external member includes second that diameter is bigger than the first reamer
Reamer.Second reamer is for forming the cavity portion received in the middle part of sleeve pipe.Second reamer can connect
Extension rod to be received in receiving medullary cavity, so that the second reamer is directed at medullary cavity in use.
According to another aspect of the present invention, it is provided that be used for being formed in osseous tissue and receive knee joint false
The milling guide of the cavity of body assembly.Milling guide includes modular shuttering element, pedestal and connection mode
Board member and the sidewall of base component.Modular shuttering element has the inner surface limiting elongated milling pilot hole, carefully
Long milling pilot hole has the first lateral dimension and the second lateral dimension.Second lateral dimension is horizontal less than first
To size.Pedestal separates with modular shuttering element, and includes the bulb-shaped recess being directed at milling pilot hole.Carefully
Long milling pilot hole has and includes two parallel straight portion and the edge of two crooked ends.Two bendings
End straight portion parallel with two is connected.Each crooked end has summit.Elongated milling pilot hole
Maximum the first lateral dimension be positioned at the apex of crooked end.The horizontal chi of the second of elongated milling pilot hole
Very little is the distance between two parallel straight portion.Central longitudinal axis is from the center of elongated milling pilot hole
Stretch out, and through the bulb-shaped recess center of pedestal.The summit of the crooked end of elongated milling pilot hole and
The central longitudinal axis of milling guide is coplanar.The bulb-shaped recess of the pedestal of milling guide has week
Limit and relative summit, relative summit and the summit of elongated milling pilot hole crooked end and milling are led
Coplanar to the longitudinal axis of device.Spherical to pedestal from each summit of elongated milling pilot hole crooked end
Acute angle is defined between the most subapical straight line and the milling guide longitudinal axis of depression periphery.
In one exemplary embodiment, adjustable stem is from pedestal along the center of milling guide longitudinally
Axis stretches out.
According to another aspect of the present invention, it is provided that process the length for receiving prothesis implant body assembly
The method of bone.The method includes that formation is directed at medullary cavity and penetrates elongated pilot hole therein.There is provided
Reamer, this reamer has taper cutting tip and the axle stretched out from taper cutting tip to far-end.Will
The axle of reamer inserts in pilot hole, and rotates reamer, recessed to form the taper being directed at pilot hole
Portion.Then reamer is removed.Milling guide is provided.Milling guide have modular shuttering element and
Pedestal that modular shuttering element is spaced apart and the axle stretched out to far-end from pedestal.Modular shuttering element has milling and guides
Hole.The axle of milling guide is inserted in pilot hole, and the pedestal of milling guide is inserted bone
In the tapered recess of tissue.Second reamer is provided.Second reamer has cutting tip and far-end.Will
Second reaming is drilled through milling pilot hole and inserts recess, until the far-end of the second reamer and milling guide
Till base into contact.Rotate the second reamer around the far-end on pedestal, and rotate reamer to change bone
The shape of tissue center dant.
Accompanying drawing explanation
It is described in detail referring specifically to the following drawings, wherein:
Fig. 1 is the view of the distal femoral component of modularity knee prosthesis kit；
Fig. 2 is the view of the tibial component of modularity knee prosthesis kit；
Fig. 3 is the side view of the single-blade metaphysis thimble assembly of the external member of Fig. 1-2；
Fig. 4 is the end-view of the single-blade metaphysis thimble assembly of Fig. 3；
Fig. 5 is the top plan view of the single-blade metaphysis thimble assembly of Fig. 3-4；
Fig. 6 is the single-blade metaphysis thimble assembly sectional view along the line 6-6 of Fig. 3 of Fig. 3-5；
Fig. 7 is the single-blade metaphysis thimble assembly sectional view along the line 7-7 of Fig. 3 of Fig. 3-5；
Fig. 8 is the single-blade metaphysis thimble assembly sectional view along the line 8-8 of Fig. 5 of Fig. 3-5；
Fig. 9 is the side view of the double-vane metaphysis thimble assembly of the external member of Fig. 1-2；
Figure 10 is the end-view of the double-vane metaphysis thimble assembly of Fig. 9；
Figure 11 is the top plan view of the double-vane metaphysis thimble assembly of Fig. 9-10；
Figure 12 is the double-vane metaphysis thimble assembly sectional view along the line 12-12 of Fig. 9 of Fig. 9-11；
Figure 13 is the double-vane metaphysis thimble assembly sectional view along the line 13-13 of Fig. 9 of Fig. 9-11；
Figure 14 is the double-vane metaphysis thimble assembly sectional view along the line 14-14 of Figure 11 of Fig. 9-11；
Figure 15 is front view, it is shown that some assembly of the modularity knee prosthesis kit of Fig. 1 and 2
Assembling parts, it is shown that use the situation of single-blade metaphysis sleeve pipe；
Figure 16 is side view, it is shown that some assembly of the modularity knee prosthesis kit of Fig. 1 and 2
Assembling parts, it is shown that use the situation of double-vane metaphysis sleeve pipe；
Figure 17 is the front view of the assembling parts of Figure 16；
Figure 18 is the top plan view of the alternate embodiments of double-vane metaphysis sleeve pipe；
Figure 19 is the top plan view of another alternate embodiments of double-vane metaphysis sleeve pipe；
Figure 20 is the forward sight can bored as the countersinking that instrument is included in knee prosthesis kit
Figure；
Figure 21 be the countersinking can being included in knee prosthesis kit as instrument bore another
The front view of embodiment；
Figure 22 is milling guide, the DS can being included in knee prosthesis kit as instrument
The exploded perspective view of hole drill, shank and adjustable stem；
Figure 23 is another exploded perspective view of the instrument of Figure 22；
Figure 24 is the amagnified partial perspective view of the milling guide of Figure 22-23；
Figure 25 is milling guide and the amagnified partial perspective view of DS hole drill of Figure 22-23；
Figure 26 is the three-dimensional view of the assembling parts of milling guide, shank and adjustable stem, it is shown that
DS hole drill is received in milling guide, and rotates to a position in the hole of milling guide
Put；
Figure 27 is another three-dimensional view of the assembling parts of Figure 26, it is shown that DS hole drill is led in milling
Another position is rotated in hole；
Figure 28 is another three-dimensional view of the assembling parts of Figure 26-27, it is shown that DS hole drill is in milling
Another position is rotated in pilot hole；And
Figure 29 is the vertical of the assembling parts of the milling guide and shank that are arranged on femur cutter block
Stereogram, wherein DS hole drill turns to a position in milling guide hole.
Detailed description of the invention
Although idea of the invention is prone to have various modification and alternative form, but its concrete example
Property embodiment illustrates the most by way of example, and will herein be described in detail.But should
Work as understanding, be not intended to limit the invention to disclosed concrete form herein, but on the contrary, it is therefore intended that
Contain all modifications form in the spirit and scope of the present invention defined in the appended claims, equivalents
And alternative form.
Fig. 1 and 2 shows an example of the assembly of modularity knee prosthesis kit.Such as institute in Fig. 1
Showing, external member includes the distal femoral assembly 10 with bending convex condyle surface 12 and 14 in femur side.Shown in
Distal femoral assembly is rear to stablize assembly.Additionally provide femur adapter 16, and be used for being placed on switching
Hoop 18 between device 16 and distal femoral assembly 10.Bolt 20 is provided for adapter 16, hoop 18 and remote
End distal femoral component 10 links together.Adapter 16 has smooth conical outer surface.Provide extension rod
22.Above-mentioned all component can be derived from DePuy Orthopaedics, Inc. (Warsaw,
Indiana) P.F.C.
The building block of knee joint system.Adapter can have such as
Entitled " Modular Orthopaedic Implant System with Multi-Use Stems "
U.S. Patent Publication No. No. of (there is the modular orthopaedic implant system of utility rod)
Those features shown in 2006/0030945, or those features shown in following patent: title
United States Patent (USP) No. for " Medical Fastening System " (medical treatment fixed system)
6,171,342；The U.S. of entitled " Medical Fastening System " (medical treatment fixed system)
State's patent No.5,824,097；Entitled " Modular Knee Prosthesis " (modular knee is closed
Joint prosthese) United States Patent (USP) No.5,782,921.It addition, such as U.S. Patent Publication No. No.
Described in 2006/0030945, extension rod can have the feature in addition to shown in Fig. 1.Should manage
Solve, describe these assemblies and be only used to illustrate；Unless claim explicitly points out, the present invention
It is not limited to the distal femoral assembly of any particular type or bar or other concrete assembly any.
As it is shown in figure 1, the distal femoral component of external member also includes two kinds of metaphysis sleeve pipe 24 and 26.As
As described in detailed below, one of them metaphysis sleeve pipe 24 is provided for the metaphysis at osseous tissue
Using in interior unilateral defect, another metaphysis sleeve pipe 26 is provided for will filling in metaphysis both sides
In the case of use.
As shown in Figure 2, external member pads 32 and extension rod within tibial side includes tibia support assembly 30, tibia
34.Shown in tibia support assembly 30 for derive from DePuy Orthopaedics, Inc. (Warsaw,
Indiana) commercial MBT overhauls (MBT Revision) tibia support.Tibia support assembly 30 has with holes
The integral type bar part 36 of (not shown), its mesopore has the female thread that can connect extension rod 34.Bar
The outer surface of part 36 is smooth finish, and is tapered away from joint motions surface.Joint is transported
Dynamic surface is corresponding to the bending convex condyle surface 12 and 14 of distal femoral assembly 10 and the bending of pad 32 in tibia
The joint on matrix condyle surface (in Figure 16 37 at show exemplary bending matrix condyle surface).
As in figure 2 it is shown, the tibial component of external member also includes two kinds of metaphysis sleeve pipe 38 and 40.As
As being described in detail below, one of them metaphysis sleeve pipe 38 is provided in the metaphysis of osseous tissue
Unilateral defect in use, another metaphysis sleeve pipe 40 is provided for will filling in metaphysis both sides
In the case of use.
Fig. 3-8 shows the first example of metaphysis sleeve pipe prothesis implant body.Shown first sleeve 24 designs
In the osseous tissue having following defect: the situation of this osseous tissue need in the metaphyseal inner side of osseous tissue or
Outside provides extra support or fixing, but is not to provide in both sides simultaneously；Defect in this osseous tissue can
To be characterized as non-pooled defect.Shown sleeve pipe 24 includes having middle part 44 and the main body of shoulder portion 46.In
Portion 44 has restriction the first end 50 and central longitudinal axis 48 of the second end 52.As viewed in figures 5-8,
Inwall 54 in middle part 44 defines the passage 56 of the central longitudinal axis 48 along middle part 44.Passage 56 is
It is tapered between one end and the second end.Tapered channel 56 can have any suitable cone angle, with
Locked with another assembly by friction mode；Such as, tapered channel 56 can limit Morse's taper
(Morse taper).Passage 56 is designed for receiving conical surface or the tibia of the adapter 16 of femur side
The conical surface of the bar part 36 of torr 30, and by friction mode and a locking in these assemblies.Though
So it may be desirable to provide a set of to can be not only used for tibial side, can be used for again the sleeve pipe 24 of femur side, but it should reason
Solve, present invention also contemplates that following situations: provide and be designed for the sleeve pipe 24 of femur side and be designed for
The a set of single sleeve pipe of tibial side；The shape of this assembly internal channel 56 can have difference, in order at sleeve pipe
For joining transit device 16 to frictionally during Distal femoral metaphysis sleeve pipe, or engage tibia support to frictionally
The bar part 36 of 30.
The main body of sleeve pipe 24 has the outer surface 58 including multiple adjacent steps or step.Shown in Fig. 3-8
In embodiment, sleeve pipe has eight ladders or step, represents with 60a-60h in figures 3 and 4.In Fig. 3
Shown in, each ladder 60a-60h is respectively provided with the outward flange 62a-62h around its periphery.First ladder 60a
Having two outward flanges being shaped like, an edge 62a is positioned at the end 50 of sleeve pipe 24, and also exists
The edge represented with 60a in Fig. 3 is then positioned at the first ladder 60a and the joint of the second ladder 60b.As Fig. 3-
Shown in 4, the outward flange 62a-62h of ladder 60a-60h is positioned at the center of 44 in the middle part of main body that is substantially perpendicular to
In the plane of longitudinal axis 48.
The outer peripheral shape of representational ladder 60a, 60c and 60d such as 62a, the 62c in Fig. 5-7 and
Shown in 62d.In the middle part of main body at 44, outward flange 62a, 62c of each ladder 60a, 60c and 60d and
62d all include a pair having same curvature radius, diametrically opposite sweep 64a, 64c,
64d, 65a, 65c and 65d.Each diametrically opposite sweep 64a, 64c, 64d, 65a,
The center of curvature of 65c and 65d is distributed each along the central longitudinal axis 48 of main body.Diametrically opposite bending
Part 64a, 64c, 64d, 65a, 65c and 65d define in the middle part of main body 44 outward flange 62a, 62c and
Summit 66a, 66c, 66d, 67a, 67c and 67d of 62d.Outward flange 62a, 62c of 44 in the middle part of main body
Illustrate with at the tangent line of summit 66a, 66c, 66d, 67a, 67c and 67d of 62d in the diagram 68 and 70.
In the embodiment shown, each of which of these tangent lines 68 and 70 defines the angle of about 2-4 degree.This angle
Degree can be to change for femur side or tibial side according to sleeve pipe: for Distal femoral metaphysis sleeve pipe, example
As, this angle can be about 2 degree；For tibial metaphysis sleeve pipe, such as, this angle can be about 4
Degree.Alternatively, tibial side can be set or Universal casing that femur side all can use.Cause
This, the lateral dimension between the diameter of each ladder, i.e. opposed apexes, at the first end 50 and the second end
Successively decrease between end 52；Exemplarily, the diameter d in the middle part of the first ladder 60a shown in Fig. 5aMore than institute in Fig. 6
Show the diameter d in the middle part of the ladder 60c of the second end 52c, and the diameter d in the middle part of ladder 60ccThe biggest
In shown in Fig. 7 closer to the diameter d in the middle part of the ladder 60d of the second end 52 of sleeve piped。
At main body side alar part 46, the outward flange 62 of each ladder 60 all includes sweep 72, should
Sweep 72 is connected with the diametrically opposite sweep 64 of the outward flange 62 at middle part 44.Fig. 5-7
Show the example of ladder 60a, 60c and 60d.As shown in Figures 5 and 6, the ladder of shoulder portion 46
Outward flange can include a pair relative and spaced apart straight line 74a, 74c, 76a and 76c, and this is to straight line even
Receive diametrically opposite sweep 64a, 64c, 65a and 65c, and be connected to bent back ends section
72a、72c.Therefore, bent back ends section 72a, 72c can outer peripheral the most right with middle part 44
Sweep 64a, 64c, 65a and 65c of putting are spaced apart.As shown in Figure 7, the curve of outward flange 62d
Section 72d can be directly connected to section 64d and 65d of the outward flange 62d at middle part 44, and in not occuping
Between straight section.The curved section 72 of the outward flange 62 of each ladder 60 is respectively provided with summit, in Fig. 5-7
78a, 78c and 78d shown in.
The tangent line of the shoulder portion 46 of the main body of sleeve pipe 24 and the joint at middle part 44 is in the diagram at 80 and 82
Illustrate.In the embodiment shown, each of which of these tangent lines 80 and 82 defines and central longitudinal axis
The angle of the about 2-4 degree between the plane of 48.Angle can be intended for use femur side or tibial side according to sleeve pipe
And change: for Distal femoral metaphysis sleeve pipe, such as, this angle can be about 2 degree；For tibial metaphysis
Sleeve pipe, such as, this angle can be about 4 degree.Alternatively, it is possible to provide tibial side or femur
The Universal casing that side all can use.Therefore, the width of the sidepiece of each ladder, the sidepiece of the most each ladder
Maximum transverse size, successively decreases between the first end 50 and the second end 52；Exemplarily, institute in Fig. 5
The width w in the middle part of the first ladder 60a shownaMore than shown in Fig. 6 closer to the ladder 60c of the second end 52
The width w at middle partc, and the width w in the middle part of ladder 60ccThen it is more than shown in Fig. 7 closer to the second of sleeve pipe
Width w in the middle part of the ladder 60d of end 52d.Additionally can as seen from Figure 4, the sidepiece 46 of each ladder
Width is respectively less than the width at the middle part 44 of each ladder 60.Therefore, each ladder 60, including its outward flange
62, the diametrically opposite sweep 64a of the outward flange 62 at middle part 44,64c, 64d, 65a,
65c and 65d is recessed with the joint of the outward flange section of shoulder portion 46.
The overall length of each ladder 60 is also successively decreased between the first end 50 and the second end 52.Such as institute in Fig. 3
Show, the tangent line on the summit 78 of sidepiece 46, in Fig. 3 shown in 84, can flat with central longitudinal axis 48
Face limits multiple angles；This angle will depend upon which the size of such as implant.In the embodiment shown, with
The tangent line of the point on each outward flange of each ladder that tangent line 84 is relative, in Fig. 3 shown in 86, with in
The angle of the planes bound of heart longitudinal axis 48 about 2-4 degree.This angle can be intended for use femur according to sleeve pipe
Side or tibial side and change: for Distal femoral metaphysis sleeve pipe, such as, this angle can be about 2 degree；For
Tibial metaphysis sleeve pipe, such as, this angle can be about 4 degree.Alternatively, it is possible to provide
Universal casing all available in tibial side or femur side.Therefore, length, the maximum transversal of the most each ladder
Size, successively decreases between the first end 50 and the second end 52；Exemplarily, the first rank shown in Fig. 5
Length l in the middle part of ladder 60aaMore than shown in Fig. 6 closer to the length in the middle part of the ladder 60c of the second end 52
lc, and the width w in the middle part of ladder 60ccThen it is more than the ladder of shown the second end 52 closer to sleeve pipe of Fig. 7
Width w in the middle part of 60dd。
Sleeve pipe 24 shown in Fig. 3-8 is the most right about a transverse plane through central longitudinal axis 48
Claim, symmetrical about the vertical plane through central longitudinal axis 48.Should be appreciated that the feature of sleeve pipe 24
Above description is also applied for the single-blade sleeve pipe 38 of Fig. 2.
By contrast, shown second sleeve pipe 26 of Fig. 9-13 is about through two of central longitudinal axis 148
Vertical plane is symmetrical.Shown second sleeve pipe 26 is designed in such osseous tissue: the situation in osseous tissue
Need to support or fix osseous tissue metaphysis inner side and outer side extraly.
Shown second sleeve pipe 24 includes having middle part the 144, first shoulder portion 145 and the second shoulder portion
The main body of 146.Middle part 144 has restriction the first end 150 and central longitudinal axis of the second end 152
148.As viewed in figures 5-8, the inwall 154 at middle part 144 defines the central longitudinal axis 148 along middle part 144
Passage 156.Passage 156 is tapered between the first end and the second end.Tapered channel 156 can
To have any suitable cone angle, to be locked with another assembly by friction mode；Such as, taper is led to
Road 156 can limit Morse's taper.Passage 156 is designed for receiving the cone of the adapter 16 being positioned at femur side
The conical surface of the bar part 36 of shape surface or tibia support 30, and by friction mode and these assemblies
A locking.Both can tibial side on joint motions surface use while it is desirable to provide a set of, again can be
The sleeve pipe 26 that the femur side on joint motions surface uses, it is to be understood that, present invention also contemplates that following feelings
Condition: the set that the design sleeve pipe 26 in the use of femur side and a set of single design use in tibial side is provided
Pipe；The shape of the passage 156 in this class component can have difference, in order to when sleeve pipe is Distal femoral metaphysis
Joining transit device 16 to frictionally during sleeve pipe, or engage the bar part of tibia support 30 to frictionally
36。
The main body of sleeve pipe 26 has the outer surface 158 including multiple adjacent steps or step.In Fig. 9-14
In the embodiment illustrated, sleeve pipe 26 has eight ladders or step, uses 160a-160h table in figures 9 and 10
Show.As shown in Figure 9, each ladder 160a-160h is respectively provided with the outward flange 162a-around its periphery
162h.First ladder 160a has two outward flanges being shaped like, and an edge 162a is positioned at sleeve pipe 26
End 150 at, the edge represented with 60a the most in figure 3 is then positioned at the first ladder 160a and second-order
The joint of ladder 160b.As depicted in figs. 9-10, the outward flange 162a-162h of ladder 160a-160h is positioned at
It is substantially perpendicular in the plane of central longitudinal axis 148 of in the middle part of main body 144.
The 162a of outer peripheral shape such as Figure 11-13 of representational ladder 160a, 160c and 160d,
Shown in 162c and 162d.In the middle part of main body at 144, the outside of each ladder 160a, 160c and 160d
Edge 162a, 162c and 162d all include having same curvature radius, diametrically opposite bending section a pair
Divide 164a, 164c, 164d, 165a, 165c and 165d.Each diametrically opposite sweep
The center of curvature of 164a, 164c, 164d, 165a, 165c and 165d is each along the center longitudinal axis of main body
Line 148 is distributed.Diametrically opposite sweep 164a, 164c, 164d, 165a, 165c and 165d
Define in the middle part of main body the summit 166a of outward flange 162a, 162c and 162d at 144,166c,
166d, 167a, 167c and 167d.The summit of outward flange 162a, 162c and 162d of 144 in the middle part of main body
The tangent line of 166a, 166c, 166d, 167a, 167c and 167d illustrates at 168 and 170 in Fig. 10.?
In illustrated embodiment, each of which of these tangent lines 168 and 170 defines the angle of about 2-4 degree.This angle
Degree can be intended for use femur side or tibial side according to sleeve pipe and change: for Distal femoral metaphysis sleeve pipe, example
As, this angle can be about 2 degree；For tibial metaphysis sleeve pipe, such as, this angle can be about 4 degree.Make
Select for another, it is possible to provide at the Universal casing that tibial side or femur side all can use.Therefore, each
Lateral dimension between the diameter of ladder, i.e. opposed apexes, the first end 150 and the second end 152 it
Between successively decrease；Exemplarily, the diameter d in the middle part of the first ladder 160a shown in Figure 11aShown in Figure 12
The ladder 160c closer to the second end 152 in the middle part of diameter dc, and the diameter d in the middle part of ladder 160cc
Then it is more than the shown diameter d in the middle part of the ladder 160d of the second end 152 of sleeve pipe 26 of Figure 13d。
It is also seen that the maximum that the total length of each ladder 60 " l " is each ladder 60 from Fig. 5-7
Size.The length " l " of each ladder is more than its diameter " d ": la＞ da；lc＞ dc；ld＞ dd。
The outward flange 162 of each ladder 160 at each shoulder portion of main body 145 and 146 all includes bending
Part 172, this sweep is attached to the diametrically opposite bending section of the outward flange 162 at middle part 144
Divide 164,165.Figure 11-13 shows the example of ladder 160a, 160c and 160d.Such as Figure 11 and 12
Shown in, the outward flange of the ladder of shoulder portion 145,146 each can include a pair relatively and interval
Straight line 174a, 174c, 176a and the 176c opened, this is connected to diametrically opposite sweep to straight line
164a, 164c, 165a and 165c, and it is connected to bent back ends section 172a, 172c.Therefore, curved
Bent end segments 172a and 172c can be with the outer peripheral diametrically opposite sweeps at middle part 144
164a, 164c, 165a and 165c are spaced apart.As shown in Figure 7, the curved section 172d of outward flange 162d
Can be directly connected to section 164d and 165d of outward flange 162d at middle part 144, and do not occupy middle
Straight section.The curved section 172 of the outward flange 162 of each ladder 160 is respectively provided with summit, such as Figure 11-12
In 178a, 178c and 178d shown in.
First shoulder portion 145 of casing main body and the tangent line of the joint at middle part 144 in Fig. 10 180 and
Illustrate at 182.In the embodiment shown, each of which of these tangent lines 180 and 182 defines and center
The angle of the about 2-4 degree of the plane of longitudinal axis 148.Second shoulder portion 146 has similar shape.
This angle can be intended for use femur side or tibial side according to sleeve pipe and change: for Distal femoral metaphysis set
Pipe, such as, this angle can be about 2 degree；For tibial metaphysis sleeve pipe, such as, this angle can be about 4
Degree.Alternatively, it is possible to provide Universal casing all available in tibial side or femur side.Cause
This, the width of the sidepiece 145 and 146 of each ladder, the maximum transversal chi of the shoulder portion of the most each ladder
Very little, successively decrease between the first end 150 and the second end 152；Exemplarily, the first rank shown in Figure 11
Width w in the middle part of ladder 160aaMore than shown in Figure 12 closer in the middle part of the ladder 160c of the second end 152
Width wc, and the width w in the middle part of ladder 160ccThen it is more than the second end closer to sleeve pipe shown in Figure 13
Width w in the middle part of the ladder 160d of 152d.Additionally can find out from Figure 11-13, the sidepiece of each ladder
145, the width of 146 is respectively less than the width at middle part 144 of each ladder 160.Therefore, each ladder
160, including its outward flange 162, the diametrically opposite sweep of the outward flange 162 at middle part 144
Outer peripheral section at 164a, 164c, 164d, 165a, 165c and 165d and shoulder portion 146
Joint is recessed.
The overall length of each ladder 160 is also successively decreased between the first end 150 and the second end 152.Such as Fig. 9
Shown in, the tangent line on the summit 178,179 (as figs 11-13) of sidepiece 145,146, in Fig. 9 184
Shown in 185, can with the planes bound of central longitudinal axis 148 multiple angles；This angle will depend on
Size in such as implant.Therefore, length, the maximum transverse size of the most each ladder 160,
Successively decrease between one end 150 and the second end 152；Exemplarily, the first ladder 160a shown in Figure 11
Length l at middle partaMore than the length in the middle part of the ladder 160c closer to the second end 152 shown in Figure 12
lc, and length l in the middle part of ladder 160ccThen more than the second end closer to sleeve pipe shown in Figure 13
Length l in the middle part of the ladder 160d of 152d.Additionally can be seen that from Figure 11-13, the overall length of each ladder 160
Degree is the full-size of each ladder 160.
Should be appreciated that the description above with respect to sleeve pipe 26 is also applied for the double-vane metaphysis sleeve pipe 40 of Fig. 2.
Should be appreciated that typical modularity knee prosthesis kit will include the metaphysis set of multiple size
Pipe, and the multiple dimensions of each in shown sleeve pipe 24,26,38 and 40 can be included.All
This kind of sleeve pipe all can have and those similar features described above.Additionally, the sleeve pipe of external member can have
Other features, such as micro porous coating, to strengthen fastness.Such as, such as entitled " Modular
Implant System With Fully Porous Coated Sleeve " (there is full micro porous coating set
The modular implant systems of pipe) U.S. Patent Publication No. No.2005/0107883A1 disclosed in
's.Should be appreciated that sleeve pipe can also use the micro porous coating more less than described in described patent disclosure.
In the embodiment shown, the ladder 60,160 of sleeve pipe 24,26 provides and is perpendicular to axis 48,148
Parallel flat surface.Distance between these parallel flat surfaces define each ladder 60,160 or
The height of step.In the embodiment shown, the height of ladder is all substantially identical, it is to be understood that, appoint
What given sleeve pipe all can have the ladder of differing heights, and various sizes of sleeve pipe can have height
Identical or different ladder.
As it has been described above, the passage 56,156 of shown sleeve pipe 24,26 is taper, to allow by friction side
Formula is connected to the assembly of femur side and tibial side.Figure 15-17 showing, the modular knee joint of Fig. 1-2 is false
The example of the assembling parts of body assembly.Although not shown, but the assembling parts of combination can also be included in pass
Single-blade metaphysis sleeve pipe 24 on joint moving surface side, and be positioned on the opposite side of joint motions surface
Double-vane metaphysis sleeve pipe 26, or the metaphysis sleeve pipe 24 that can only use on side, joint motions surface
With the type in 26.The situation of patient bone tissue is depended in the use of these variations.Favourable
Be, utilize the present invention modular system can substantially customized implants in surgical operation, to meet
The demand of each patient.
Be to be understood that, although the curved section of metaphysis sleeve pipe shown in Fig. 5-7 and 11-13 64,65,
72,164,165 and 172 are made up of circular arc, but described curved section can also have other shapes.Example
As, diametrically opposite curved section can be oval, such as shown in Figure 18.Embodiment at Figure 18
In, for those assemblies similar with in the embodiment of Figure 11-13, employ identical reference,
And add apostrophe later.Therefore, metaphysis sleeve pipe is expressed as 26 '.It is also understood that and not all
Outer peripheral all sections of ladder all must be of similar shape.Such as, near end 150 '
The outward flange of ladder can have diametrically opposite elliptic curve section 164 ' and 165 ', but near end
The outward flange of the ladder of end 152 ' can have diametrically opposite curved section 164 He being defined to circular arc
165.The curved edge 172 of shoulder portion 145,146 is likely to be of similar variations.
If tibial side sleeve pipe is by being used together with the tibia support with Os Draconis, the most maybe advantageously exist
Ladder near the end on joint motions surface includes embossment, to adapt to Os Draconis.Allow sleeve pipe phase
The suitable embossment of regulation is rotated at entitled " Prosthetic Tibial for tibia support
Component with Modular Sleeve " (there is the tibial prosthesis assembly of modularity sleeve pipe)
United States Patent (USP) No.7, has disclosed in 291,174, and can be similarly together with the sleeve pipe of the present invention
Use.Figure 19 shows the example of the double-vane metaphysis sleeve pipe with this embossment.Enforcement at Figure 19
In example, for those the similar assemblies in the embodiment of Figure 11 to 13, employ identical accompanying drawing mark
Note, and later plus double apostrophes.Therefore, metaphysis sleeve pipe is expressed as 26 ".In Figure 19, embossment represents
It is 190 and 192.Embossment 190 and 192 will be passed down through near end 150 " first some ladders prolong
Stretch, to adapt to the Os Draconis on tibia support.Os Draconis illustrate in fig. 2 at 194 and 196.
The complete external member of knee joint prosthesis system also will include making when processing osseous tissue to receive implant
Instrument.The complete external member of the present invention will preferably include for processing osseous tissue to receive the above-mentioned type
The reamer of metaphysis sleeve pipe and milling guide.
One of them reamer (not shown) can include for forming straight pilot hole in medullary cavity
Standard straight reamer.It is public that such reamer can be analogous in United States Patent (USP) No.4,790,852 institute
As opening.Typical tool group will include some various sizes of this DS hole drills.
Figure 20 to 21 shows the example of Equations of The Second Kind reamer.The reamer 300 of Figure 20 is used in bone group
Knit the cone-shaped cavity that interior formation is directed at medullary cavity, to receive metaphysis sleeve pipe 24,26,26 ' and 26
" the middle part 44 and 144 of one of them.Countersinking bores 300 and includes being positioned at the guiding at its far-end 304
Axle 302, is used for countersinking bores 300 alignment medullary cavity or the pilot hole formed with DS hole drill.Described
Reamer also includes boring the band groove cutting between the axis of guide 302 and the near-end 308 of 300 between countersinking
Part 306.The taper cutting enveloping surface with length L is limited with groove cutting tip 306.With groove
Cutting tip 306 from proximally facing 308 maximum gauge be gradually reduced to the joint of the axis of guide 302
Minimum diameter.The length of cutting tip 306 with groove, as shown in Figure 20 310, corresponding to institute
Select the length of metaphysis sleeve pipe, as shown in Fig. 8 and 14 312 and 314.Cutting tip with groove
Maximum gauge illustrates at 316 in fig. 20, and minimum diameter illustrates at 318 in fig. 20.Cutting with groove
The maximum gauge 316 of part is corresponding to selected metaphysis sleeve pipe 24,26,26 ' and 26 " middle part 44,
144, maximum gauge 144 ' and 144 ", diameter d as seen in figures 5 and 11a.Cutting with groove
The minimum diameter 318 of part is corresponding to selected metaphysis sleeve pipe 24,26,26 ' and 26 " middle part 44,
144, minimum diameter 144 ' and 144 ".Cone angle with groove cutting tip 306 corresponding to by Fig. 4 and
The cone angle that tangent line 68,70,168 and 170 shown in 10 limits.Countersinking bores the near-end 308 of 300 and sets
Put accessory, be used for boring countersinking being connected to shank or power supply, to be come by rotary conic reamer
Form cone-shaped cavity.
Figure 21 shows second of the countersinking brill with the axis of guide more longer than in the embodiment of Figure 20
Individual example.In the embodiment of Figure 21, for those the similar assemblies with the embodiment of Figure 20, use
Identical reference, and add apostrophe later.Therefore, countersinking bores and is expressed as 300 '.
Figure 22 to 28 shows the example of other instruments can being included in external member.These other works
Tool includes DS hole drill 350.DS hole drill 350 can be similar to standard reamer, have near-end 352,
Far-end 354 and the cutting tip with groove 356 between two ends.Reamer has central longitudinal axis
358。
The near-end 352 of DS hole drill 350 is provided with accessory, is used for reamer 350 is connected to shank or electricity
Source, to form osseous tissue cavity by rotation reamer.Cutting tip 356 with groove defines base
It it is columned cutting enveloping surface in basis.The far-end 354 of DS hole drill 350 includes convex spherical surface
In 360, Figure 23 it will be clear that.
Other instruments can being included in external member also include milling guide.Shown in Figure 22 to 28
The example of milling guide, this device may be used for processing osseous tissue, receiving metaphysis sleeve pipe,
Such as double-vane metaphysis sleeve pipe 26.Shown milling guide 400 includes modular shuttering element 402, pedestal 404
Pair of sidewalls 406 and 408 with connection mode board member 402 with pedestal 404.Modular shuttering element 402 has restriction
The inner surface 410 of elongated milling pilot hole 412.Elongated milling pilot hole 412 is shaped as corresponding to by double
Wing metaphysis sleeve pipe 26,26 ' and 26 " two shoulder portion 145,145 ', 145 ", 146,
146 ' and 146 " shape limited.
As shown in Figure 24, elongated milling pilot hole 412 has edge 418, and this edge includes that two are put down
Row straight portion 420 and 422 and two crooked ends 424 and 426.Two crooked ends 424 and 426 with
Two parallel straight portion 420 are connected with 422.Each of crooked end 424 and 426 has summit 428
With 430.Maximum first lateral dimension 432 of elongated milling pilot hole 412 is at crooked end 424 and 426
At summit 428 and 430.Second lateral dimension 434 of elongated milling pilot hole 412 is two parallel flat parts
Divide the distance between 420 and 422, and less than the first lateral dimension 432.Central longitudinal axis 436 is from carefully
The center 437 of long milling pilot hole 412 is stretched out, and the center of the bulb-shaped recess through pedestal.Elongated milling
The summit 428 and 430 of crooked end 424 and 426 cutting pilot hole 412 is indulged with the center of milling guide
Coplanar to axis 436.
Pedestal 404 is spaced apart with modular shuttering element 402, and includes along central longitudinal axis 436 and milling
The recessed bulb-shaped recess 438 of pilot hole 412 alignment.As shown in Figure 25, the base of milling guide 400
The recessed bulb-shaped recess 438 of seat 404 has periphery 440 and relative summit 442 and 444, the two top
The summit 428 of point and the crooked end 424 and 426 of elongated milling pilot hole 412 and 430 and milling guiding
The longitudinal axis 436 of device is coplanar.Each from the crooked end 424 and 426 of elongated milling pilot hole 412
Individual summit 428 and 430 is to nearest summit 442 He of the periphery 440 of the recessed bulb-shaped recess 438 of pedestal 404
The straight line of 444 defines acute angle with the longitudinal axis 436 of milling guide 400.
Recessed bulb-shaped recess 438 has right dimensions and shapes, can receive the convex of DS hole drill 350
Spherical surface 360, and allow DS hole drill 350 around Figure 26 to 28 shown in convex spherical surface
360 rotate.When DS hole drill 350 so rotates around convex spherical surface 360 in depression 438, expand
The cutting tip with groove 356 of hole drill 350 cuts depression in osseous tissue, and this depression is corresponding to by doing
Epiphysis end sleeve pipe 26,26 ' and 26 " shoulder portion 145,145 ', 145 ", 146,146 ' and
146 " shape that enveloping surface limits.
Figure 22 is to as shown in 23, and the pedestal 404 of milling guide 400 includes along central longitudinal axis
The 436 threaded male members 446 extended away from pedestal 404.Threaded male member 446 is received into school
In the female spiral hole 448 of positive bar (stem trial) 450.If Figure 26 is to as shown in 28, during assembling, school
Positive bar 450 extends along the central longitudinal axis 436 of milling guide 400 away from pedestal 404.Adjustable stem
450 have right dimensions and shapes, can be received into by, the first DS hole drill in the district of medullary cavity
In the bore hole formed in territory.Therefore, reamer 350 recess formed will centered by medullary cavity and with
Alignment.
The sidewall 406 and 408 of milling guide 400 is from the maximum width with the joint of modular shuttering element 402
Degree tapers into the minimum widith with the joint of pedestal 404.In figure 27, Breadth Maximum shows
At 461, minimum widith shows at 463.In figure 27, between modular shuttering element 402 far-end and recessed ball
The total length of the milling guide between shape depression 438 shows at 465.These sizes 461,463 and
465 substantially with countersinking bore 300 and 300 ' band groove cutting tip 306 and 306 ' size 310,
310 ', 316,316 ', 318 and 318 ' (seeing Figure 20 to 21) are corresponding.Therefore, milling is led
The tapered recess formed by countersinking brill should be assemblied in the sidewall 406 and 408 of device 400 and pedestal 404
In.
Tool group can also include the shank 470 shown in Figure 22-23 and 26-28.Shank 470 and template
Component 402 can include installation component and the hole of complementation, substantially as shown in Figure 22-23 472 and 474.
In the embodiment shown, modular shuttering element 402 is provided with two groups of holes 474, to allow shank to be connected to template
Inside component or outside.Complementary installation component and hole can include entitled " Quick-Release
Tibial Alignment Handle " United States Patent (USP) No. of (Quick release tibia location shank)
Feature described in 5,733,290, the disclosure of which is incorporated by reference in its entirety herein.
Should be appreciated that similar with the implant assembly of knee prosthesis kit, including reamer and milling
Guider would generally be with corresponding many with the size of metaphysis sleeve pipe implant assembly at interior above-mentioned instrument
Plant size to provide.
During use, surgeon would generally carry out initial osseous tissue cutting to tibia and femur, and determines
The situation of patient bone tissue is if appropriate for using metaphysis thimble assembly.If be suitable for, surgeon will really
The situation determining osseous tissue is to be suitable for single-blade metaphysis sleeve pipe or double-vane metaphysis sleeve pipe, and determines sleeve pipe
Just size.
In tibial side, surgeon will be formed first by DS hole drill and be directed at medullary cavity and extend into
Enter the pilot hole in the medullary cavity of described osseous tissue.It follows that according to selected metaphysis sleeve pipe 24,26,
The diameter at middle part 44 and 144 26 ' and 26 ", surgeon selects the countersinking of appropriate size to bore
300.Countersinking is bored in the pilot hole that the axis of guide 302 insertion of 300 is formed with DS hole drill, rotation
Countersinking bores 300, and it is moved to far-end, in order to cutting tip with groove 306 at osseous tissue
Interior formation tapered recess.This tapered recess will be with metaphysis sleeve pipe 24,26,26 ' on size and dimension
With 26 " middle part 44 corresponding with the size and dimension of 144, and will be directed at medullary cavity.Remove taper
Reamer.
Surgeon is then by having the milling guide 400 of appropriate size and having appropriate size
Adjustable stem 450 fits together.Adjustable stem part 450 is inserted in the recess formed in pore widening step, and
And moved to far-end by milling guide 400, so that pedestal 404 is received into sidewall 406 and 408
In recess.In DS hole drill 350 is inserted milling pilot hole 412 and move to far-end, until the ball protruded
In the matrix bulb-shaped recess 438 of the pedestal 404 that shape surface 360 is received into milling guide 400.Then
DS hole drill 350 is rotated around its central longitudinal axis 358, simultaneously around the protrusion in depression 438
Spherical surface 360 rotates.Figure 27 and 28 shows the situation that DS hole drill 350 pivots in a manner described.As
Really defect is nonconcentrated, and surgeon have selected single-blade metaphysis sleeve pipe, then surgeon is permissible
DS hole drill 350 is pivoted to inner side or outside.If defect is concentrate, and surgeon selects
Double-vane metaphysis sleeve pipe, then not only can pivot DS hole drill 350 to inner side but also pivot laterally.Will
DS hole drill 350 rotates in a manner described, pivot and move it along the edge 418 of milling pilot hole 412
After, it should can be formed size and dimension allow its receive metaphysis implant assembly 24,26,26 ',
26 ", the recess of one of them in 38 and 40.
Similar procedure can be carried out in femur side.As shown in Figure 29, at single femoral cut block 500
In the case of being placed to distal femur, it is possible to use milling guide 400.
Should be appreciated that when metaphysis implant is single-blade sleeve pipe, such as during sleeve pipe 24, it is possible to use phase
Same instrument and similar process.In this case, DS hole drill 350 is not along milling pilot hole
The whole length of 412 pivots, but only along the part pivot of milling pilot hole length.As additionally
A kind of selection, it is possible to use there is size and dimension corresponding with the proximate dimensional of single-blade sleeve pipe 24 and shape
One group of single milling guide of milling pilot hole.
Multiple features of system described herein make idea of the invention have multiple advantage.Such as, due to
Countersinking bores and milling guide is configured to be directed at medullary cavity, no matter therefore metaphysis osseous tissue
The hardest in some position, the recess formed should be at correct position.Therefore, metaphysis is planted
Enter thing and should be at correct position rather than position is the most forward or too rearward, it is to avoid flexing gap and
Joint is unbalance.
It should be noted that, the alternate embodiment of each system of the present invention can not include all described
Feature, but still can have the beneficial effect of at least some of advantage of these features.This area common
Technical staff can easily design the system embodiment of their own, and this system can integrate feature of present invention
In one or more, and fall in the spirit and scope of the present invention being defined by the following claims.
Claims (39)
1. an artificial knee joint prosthesis sleeve pipe implant, described joint has joint motions surface, institute
State prosthese sleeve pipe implant to include:
Main body, described main body have restriction the first end and the central longitudinal axis of the second end, in
Portion, shoulder portion and restriction are along the inwall of the passage of described central longitudinal axis, and described passage exists
It is tapered between described first end and described second end；
Described main body has the outer surface including multiple adjacent steps, and each ladder is respectively provided with around it
The outward flange of periphery, the described outward flange of each ladder is positioned at and is substantially perpendicular to the described of described main body
In the plane of central longitudinal axis；
At the described middle part of described main body, the described outward flange of each ladder includes a pair having identical
Sweep radius of curvature, diametrically opposite, each described diametrically opposite sweep
The center of curvature is distributed along the described central longitudinal axis of described main body, described diametrically opposite bending
The described outer peripheral summit of the described center of partially defined described main body；
At the described shoulder portion of described main body, the described outward flange of each ladder include a pair relative
And spaced apart straight line, described straight line is connected to described diametrically opposite sweep, and passes through
The bent back ends section spaced apart with the described diametrically opposite sweep at described middle part is connected, institute
State the distance between the described outer peripheral described relative and spaced apart straight line of flank section office less than institute
Between the described outer peripheral described diametrically opposite sweep of the described center stating main body away from
From, described bent back ends section defines the described outer peripheral of the described flank section office of described main body
Summit；
Each ladder has between the described outer peripheral described summit of described shoulder portion
One lateral dimension, and the described outer peripheral described diametrically opposite bending section between described middle part
The second lateral dimension between the described summit divided；And
Wherein, described first lateral dimension near the described ladder of described first end is more than adjacent
Described first lateral dimension of ladder, near described second horizontal stroke of the described ladder of described first end
Described second lateral dimension of adjacent steps it is more than to size,
It is non-pooled scarce that the outer surface of wherein said main body is configured in one of filling knee joint osseous tissue
Damage.
Prosthese sleeve pipe implant the most according to claim 1, wherein near described first end
The maximum transverse size of the described ladder of end is described first lateral dimension.
Prosthese sleeve pipe implant the most according to claim 1, wherein said main body described outside
Surface is taper so that:
The tangent line on the described outer peripheral described summit of the described ladder of described shoulder portion and described master
The described central longitudinal axis of body intersects；And
In the tangent line on the described summit of described diametrically opposite sweep and the described of described main body
Heart longitudinal axis intersects.
Prosthese sleeve pipe implant the most according to claim 1, the institute of wherein said shoulder portion
State outer peripheral described relative and spaced apart straight line parallel to each other.
Prosthese sleeve pipe implant the most according to claim 1, the most each ladder include along
Described outer peripheral flat surfaces, described flat surfaces is substantially perpendicular to the described center of described main body
Longitudinal axis.
Prosthese sleeve pipe implant the most according to claim 5, the most each ladder includes and is somebody's turn to do
The described flat surfaces of ladder is adjacent and extends to the table of described flat surfaces of described adjacent steps
Face.
Prosthese sleeve pipe implant the most according to claim 1, the most each ladder described outside
Edge is outer peripheral described relative with described at described outer peripheral described diametrically opposite sweep
And the joint of spaced apart straight line is recessed.
Prosthese sleeve pipe implant the most according to claim 1, wherein said prosthese sleeve pipe is implanted
Thing is the parts of external member, and described external member also includes:
There is the distal femoral component on bending convex condyle surface；And
There is bending matrix condyle surface to receive the described bending convex condyle surface of described distal femoral component
Tibial component, the described bending matrix condyle surface of described tibial component and described distal femoral component described curved
Bent convex condyle surface defines described joint motions surface.
Prosthese sleeve pipe implant the most according to claim 8, wherein:
Described tibial component includes torr, and described torr includes bar；And
Described sleeve pipe defines that tibial sleeves, described tibial sleeves and described bar have suitably sized
And shape so that described tibial sleeves may be mounted on described bar, and makes described bar by described
The described passage of sleeve pipe stretches out, and is locked to frictionally on described sleeve pipe.
Prosthese sleeve pipe implant the most according to claim 8, wherein:
Described external member also includes the femur adapter that may be installed on described distal femoral component；And
Described sleeve pipe defines that femoral sleeves, described femoral sleeves and described femur adapter have conjunction
Suitable size and dimension so that described femoral sleeves may be mounted on described adapter, and makes institute
State adapter to be stretched out by the described passage of described sleeve pipe, and be locked to described adapter to frictionally
On.
11. prosthese sleeve pipe implants according to claim 10, wherein said femoral sleeves closes
In two vertical plane symmetries.
12. 1 kinds of modularity knee prosthesis kits, including:
There is the distal femoral component on bending convex condyle surface；
There is bending matrix condyle surface to receive the described bending convex condyle surface of described distal femoral component
Tibial component, the described bending matrix condyle surface of described tibial component and described distal femoral component described curved
Bent convex condyle surface defines joint motions surface；
Sleeve pipe, described sleeve pipe includes having restriction the first end and the central longitudinal axis of the second end
Main body, middle part, shoulder portion and limit the inwall of passage along described central longitudinal axis, institute
State passage to be tapered between described first end and described second end；
Described main body has the outer surface including multiple adjacent steps, and each ladder is respectively provided with around it
The outward flange of periphery, the described outward flange of each ladder is positioned at and is substantially perpendicular to the described of described main body
In the plane of central longitudinal axis；
At the described middle part of described main body, the described outward flange of each ladder include a pair the most right
The sweep put, described diametrically opposite sweep defines the described center of described main body
Described outer peripheral summit；
At the described shoulder portion of described main body, the described outward flange of each ladder be connected to described directly
Sweep opposed on footpath, and there is the described diametrically opposite sweep with described middle part
The bent back ends section separated, described bent back ends section defines the described shoulder portion of described main body
Described outer peripheral summit；
Each ladder has between the described outer peripheral described summit of described flank section office
First lateral dimension, and described outer peripheral described diametrically opposite curved between described center
The second lateral dimension between the described summit of bent portions；
Wherein, described first lateral dimension near the described ladder of described first end is more than institute
State described first lateral dimension of adjacent steps, near described in the described ladder of described first end
Second lateral dimension is more than described second lateral dimension of described adjacent steps；And
The described outer surface of wherein said main body is configured to fill in described knee joint osseous tissue
The non-pooled defect of one of them.
13. modularity knee prosthesis kits according to claim 12, wherein said sleeve pipe
Maximum transverse size at described first lateral dimension.
14. modularity knee prosthesis kits according to claim 12, the most each ladder
The described outward flange joint at described middle part and described shoulder portion recessed.
15. modularity knee prosthesis kits according to claim 12, wherein said sleeve pipe
Two vertical planes about the described central longitudinal axis of the described main body through described sleeve pipe are the most right
Claim.
16. modularity knee prosthesis kits according to claim 15, also include the second set
Pipe, described second sleeve pipe includes:
Main body, described main body have restriction the first end and the central longitudinal axis of the second end, in
Portion, the first shoulder portion, the second shoulder portion and restriction are along the passage of described central longitudinal axis
Inwall, described passage is tapered between described first end and described second end；
Described main body has the outer surface including multiple adjacent steps, and each ladder is respectively provided with around it
The outward flange of periphery, the described outward flange of each ladder is positioned at and is substantially perpendicular to the described of described main body
In the plane of central longitudinal axis；
At the described middle part of described main body, the described outward flange of each ladder includes a pair having identical
Sweep radius of curvature, diametrically opposite, each described diametrically opposite sweep
The center of curvature is distributed along the described central longitudinal axis of described main body, described diametrically opposite bending
The described outer peripheral summit at the described middle part of partially defined described main body；
At described first shoulder portion of described main body, the described outward flange of each ladder includes a pair
Relative and spaced apart straight line, described straight line is connected to described diametrically opposite sweep, and
There is the bent back ends section that the described diametrically opposite sweep with described middle part separates, described
Distance between the described outer peripheral described relative and spaced apart straight line of the first flank section office is less than
Between the described outer peripheral described diametrically opposite sweep of the described center of described main body
Distance, described bent back ends section define the described first flank section office of described main body described outside
The summit at edge；
At described second shoulder portion of described main body, the described outward flange of each ladder includes a pair
Straight line that is relative and that separate, described straight line is connected to the described the most right of the described middle part of described main body
The sweep put, and by the bent back ends district separated with described diametrically opposite sweep
Duan Xianglian, the distance between the described outer peripheral described relative rectilinear of described second flank section office is little
Between the described outer peripheral described diametrically opposite sweep of the described center of described main body
Distance, described bent back ends section defines the described of the described second flank section office of described main body
Outer peripheral summit；
Each ladder have between described first flank section office described outer peripheral described summit with
The first lateral dimension between the described outer peripheral described summit of described second flank section office, and
Between described center described outer peripheral described diametrically opposite sweep described summit it
Between the second lateral dimension；
Wherein, described first lateral dimension near the described ladder of described first end is more than institute
State described first lateral dimension of adjacent steps, near described in the described ladder of described first end
Second lateral dimension is more than described second lateral dimension of described adjacent steps；And
Wherein said sleeve pipe is about the described central longitudinal axis of described main body through described sleeve pipe
Two vertical plane symmetries.
17. modularity knee prosthesis kits according to claim 12, wherein:
Described tibial component includes that the tibia support with bar and the tibia carried by described tibia support are inserted
Part；And
Described sleeve pipe defines that tibial sleeves, described tibial sleeves and described bar have suitably sized
And shape so that described tibial sleeves may be mounted on described bar, and makes described bar by described
The described passage of sleeve pipe stretches out, and is locked to frictionally on described sleeve pipe.
18. modularity knee prosthesis kits according to claim 12, wherein:
Described external member also includes the femur adapter that may be installed on described distal femoral component；And
Described sleeve pipe defines that femoral sleeves, described femoral sleeves and described femur adapter have conjunction
Suitable size and dimension so that described femoral sleeves may be mounted on described adapter, and makes institute
State adapter to be stretched out by the described passage of described sleeve pipe, and be locked to frictionally on described sleeve pipe.
19. modularity knee prosthesis kits according to claim 12, also include for shape
Becoming to receive the milling guide of the cavity of described sleeve pipe, described milling guide includes:
Modular shuttering element, described modular shuttering element has the inner surface limiting elongated milling pilot hole, described
Elongated milling pilot hole has the first lateral dimension and the second lateral dimension, described elongated milling pilot hole
Described first lateral dimension at least with the described ladder of described first end near described sleeve pipe
Described first lateral dimension is the biggest, and the second lateral dimension of described elongated milling pilot hole is less than described
First lateral dimension of elongated milling pilot hole；
Pedestal, described pedestal is spaced apart with described modular shuttering element, and described pedestal includes and described milling
The bulb-shaped recess of pilot hole alignment；And
Sidewall, described sidewall connects described modular shuttering element and described pedestal.
20. modularity knee prosthesis kits according to claim 19, also include adjustable stem,
Described adjustable stem and described milling guide have leads for described adjustable stem is connected to described milling
Complementary characteristic on the described pedestal of device.
21. modularity knee prosthesis kits according to claim 20, also include having
One end, the second end and the reamer of central longitudinal axis, described first end of described reamer
Including the spherical surface protruded, the spherical surface of described protrusion has right dimensions and shapes so that
In the described bulb-shaped recess of the described pedestal that can be received into described milling guide, described reaming
Drilling tool has right dimensions and shapes so that can stretch out from the described pedestal of described milling guide,
And through described elongated milling pilot hole.
22. modularity knee prosthesis kits according to claim 21, also include the second expansion
Hole drill, it is straight that described second reamer has the first end, the second end, central longitudinal axis and maximum
Footpath, the maximum gauge of wherein said second reamer is more than described the second of described elongated milling pilot hole
Lateral dimension.
23. modularity knee prosthesis kits according to claim 22, wherein said sleeve pipe
Described middle part there is maximum gauge, and the maximum gauge of wherein said second reamer is equal to described
The maximum gauge at the described middle part of sleeve pipe.
24. modularity knee prosthesis kits according to claim 21, wherein said pedestal
Described bulb-shaped recess there is right dimensions and shapes, can by described reamer described first end
The translational motion of the spherical surface of the described protrusion of end is limited to less than the institute of described elongated milling pilot hole
State in the distance of the first lateral dimension.
25. modularity knee prosthesis kits according to claim 19, wherein longitudinal axis
Stretch out from the center of described elongated milling pilot hole, and pass the described bulb-shaped recess of described pedestal
Center.
26. 1 kinds of knee prosthesis kits, including:
Sleeve pipe, described sleeve pipe includes that main body, described main body have restriction the first end and the second end
Central longitudinal axis, middle part, the first shoulder portion and limit along described central longitudinal axis
The inwall of passage, described passage is tapered between described first end and described second end；
Described main body has the outer surface including multiple adjacent steps, and each ladder is respectively provided with around it
The outward flange of periphery, the described outward flange of each ladder is positioned at and is substantially perpendicular to the described of described main body
In the plane of central longitudinal axis；
At the described middle part of described main body, the described outward flange of each ladder include a pair the most right
The sweep put, described diametrically opposite sweep defines the described center of described main body
Described outer peripheral summit；
At described first shoulder portion of described main body, the described outward flange of each ladder is connected to institute
State diametrically opposite sweep, and there is the described diametrically opposite bending with described middle part
The bent back ends section of part spaced apart, described bent back ends section defines described the of described main body
Described outer peripheral summit at one shoulder portion；
Each ladder has the described outer peripheral described apex being positioned at described first flank section office
The first lateral dimension, and described outer peripheral described diametrically opposite between described center
The second lateral dimension between the described summit of sweep；
Wherein, described first lateral dimension near the described ladder of described first end is more than institute
State described first lateral dimension of adjacent steps, near described in the described ladder of described first end
Second lateral dimension is more than described second lateral dimension of described adjacent steps；
It is non-pooled scarce that the outer surface of wherein said main body is configured in one of filling knee joint osseous tissue
Damage；
Described external member also includes:
For forming the milling guide of the cavity receiving described sleeve pipe, described milling guide
Including:
Modular shuttering element, described modular shuttering element has the inner surface limiting elongated milling pilot hole, described
Elongated milling pilot hole has the first lateral dimension and the second lateral dimension, described elongated milling pilot hole
Described first lateral dimension at least with the described sleeve pipe of described first end near described sleeve pipe
Described first lateral dimension of described ladder is the biggest, the second horizontal chi of described elongated milling pilot hole
Very little the first lateral dimension less than described elongated milling pilot hole；
Pedestal, described pedestal is spaced apart with described modular shuttering element, and described pedestal includes with described
The bulb-shaped recess of milling pilot hole alignment；And
Sidewall, described sidewall connects described modular shuttering element and described pedestal；
Described external member also includes:
There is the first end, the second end and the reamer of central longitudinal axis, described reamer
Described first end includes the spherical surface protruded, and the spherical surface of described protrusion has suitably sized
And shape so that the described bulb-shaped recess of the described pedestal of described milling guide can be received into
In, described reamer has right dimensions and shapes so that can be from described milling guide
Described pedestal stretches out, and through described elongated milling pilot hole.
27. knee prosthesis kits according to claim 26, also include adjustable stem, described
Adjustable stem and described milling guide have for described adjustable stem is connected to described milling guiding dress
The complementary characteristic on described pedestal put.
28. knee prosthesis kits according to claim 26, also include the second reamer,
Described second reamer has the first end, the second end, central longitudinal axis and maximum gauge, its
Described in the maximum gauge of the second reamer more than the described second horizontal chi of described elongated milling pilot hole
Very little.
29. knee prosthesis kits according to claim 28, also include extension rod, described
Second reamer and described extension rod have for described extension rod is connected to described second reamer
Complementary installation component.
30. knee prosthesis kits according to claim 29, wherein said sleeve pipe described
Middle part has maximum gauge, and the maximum gauge of wherein said second reamer is equal to described sleeve pipe
The maximum gauge at described middle part.
31. knee prosthesis kits according to claim 26, wherein said pedestal described
Bulb-shaped recess has right dimensions and shapes so that can be by described first end of described reamer
The translational motion of spherical surface of described protrusion be limited to less than the described of described elongated milling pilot hole
In the distance of the first lateral dimension.
32. knee prosthesis kits according to claim 26, wherein central longitudinal axis from
The center of described elongated milling pilot hole is stretched out, and passes in the described bulb-shaped recess of described pedestal
The heart.
33. knee prosthesis kits according to claim 32, wherein said elongated milling is led
Have edge to hole, described edge includes two parallel straight line portioies and two crooked ends, described
Two crooked ends straight line portion parallel with said two is connected, and each crooked end has summit,
Maximum first lateral dimension of described elongated milling pilot hole is positioned at the described summit of described crooked end
Place, described second lateral dimension of described elongated milling pilot hole is the straight line portion that said two is parallel
Between distance.
34. knee prosthesis kits according to claim 33, wherein:
The described summit of the described crooked end of described elongated milling pilot hole and described milling guide dress
The longitudinal axis put is coplanar；
The described bulb-shaped recess of the described pedestal of described milling guide has periphery and relative top
Point, the described summit of the described crooked end of described opposed apexes and described elongated milling pilot hole and
The described longitudinal axis of described milling guide is coplanar；
From each summit of the described crooked end of the described elongated milling pilot hole institute to described pedestal
Straight line between the nearest summit of the described periphery stating bulb-shaped recess is described with described milling guide
Longitudinal axis defines acute angle；And
Straight line between summit and the summit of described bulb-shaped recess of described crooked end defines milling
Enveloping surface.
35. knee prosthesis kits according to claim 34, wherein:
Described sleeve pipe includes the second shoulder portion；
At described second shoulder portion of described main body, the described outward flange of each ladder is connected to institute
State on diametrically opposite sweep, and have with described middle part described diametrically opposite curved
The bent back ends section that bent portions is spaced apart, described bent back ends section defines the described of described main body
The described outer peripheral summit of the second flank section office.
36. knee prosthesis kits according to claim 35, wherein:
The described outer peripheral described bent back ends section of the described first flank section office of described main body
The tangent line on described summit and the described central longitudinal axis of described main body define acute angle；
The described outer peripheral described bent back ends section of the described second flank section office of described main body
The tangent line on described summit and the described central longitudinal axis of described main body define acute angle；
Described tangent line defines sleeve pipe enveloping surface；And
Described milling enveloping surface is substantially the same with described sleeve pipe enveloping surface.
37. knee prosthesis kits according to claim 35, the most each ladder described
Outward flange is recessed with the joint of described first shoulder portion and described second shoulder portion at described middle part
Enter.
38. knee prosthesis kits according to claim 26, wherein:
Described elongated milling pilot hole has edge, and described edge includes two parallel straight line portioies
With two crooked ends, the said two crooked end straight line portion parallel with said two is connected, often
Individual crooked end all has summit, and maximum first lateral dimension of described elongated milling pilot hole is positioned at institute
Stating the described apex of crooked end, described second lateral dimension of described elongated milling pilot hole is institute
State the distance between two parallel straight line portioies；
Central longitudinal axis stretches out from the center of described elongated milling pilot hole, and from described pedestal
The center of described bulb-shaped recess pass；
The described summit of the described crooked end of described elongated milling pilot hole and described milling guide dress
The described central longitudinal axis put is coplanar；
The described bulb-shaped recess of the described pedestal of described milling guide has periphery and relative top
Point, the described summit of the described crooked end of described opposed apexes and described elongated milling pilot hole and
The described central longitudinal axis of described milling guide is coplanar；And
From each summit of the described crooked end of the described elongated milling pilot hole institute to described pedestal
Straight line between the nearest summit of the described periphery stating bulb-shaped recess is described with described milling guide
Central longitudinal axis defines acute angle.
39. according to the knee prosthesis kit described in claim 38, also includes from described pedestal edge
The outwardly directed adjustable stem of described central longitudinal axis of described milling guide.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US11017408P | 2008-10-31 | 2008-10-31 | |
| US61/110174 | 2008-10-31 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101744675A CN101744675A (en) | 2010-06-23 |
| CN101744675B true CN101744675B (en) | 2016-12-14 |
Family
ID=
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4790852A (en) * | 1986-09-15 | 1988-12-13 | Joint Medical Products Corporation | Sleeves for affixing artificial joints to bone |
| US6071311A (en) * | 1998-08-14 | 2000-06-06 | Johnson & Johnson Professional, Inc. | Cylindrical box femoral stem |
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4790852A (en) * | 1986-09-15 | 1988-12-13 | Joint Medical Products Corporation | Sleeves for affixing artificial joints to bone |
| US6071311A (en) * | 1998-08-14 | 2000-06-06 | Johnson & Johnson Professional, Inc. | Cylindrical box femoral stem |
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