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EP1411870A1 - Endoprothese pour articulation du genou - Google Patents

Endoprothese pour articulation du genou

Info

Publication number
EP1411870A1
EP1411870A1 EP01929244A EP01929244A EP1411870A1 EP 1411870 A1 EP1411870 A1 EP 1411870A1 EP 01929244 A EP01929244 A EP 01929244A EP 01929244 A EP01929244 A EP 01929244A EP 1411870 A1 EP1411870 A1 EP 1411870A1
Authority
EP
European Patent Office
Prior art keywords
tibia
meniscus
further features
endoprosthesis according
bearing
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP01929244A
Other languages
German (de)
English (en)
Inventor
Günter Rehder
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Saint-Paul Bernd
Original Assignee
Saint-Paul Bernd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Saint-Paul Bernd filed Critical Saint-Paul Bernd
Publication of EP1411870A1 publication Critical patent/EP1411870A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/3868—Joints for elbows or knees with sliding tibial bearing

Definitions

  • the present invention relates to an endoprosthesis for a knee joint, with a femur part and a tibia part that can be anchored in the respective bones. and a meniscus part with bearing shells which is displaceably mounted dorsally / ventrally in a guide between the Fermur part and the tibia part on a flat tibial plateau as a meniscus part with bearing shells which are in engagement with the condylar running surfaces of the femur part.
  • Such an endoprosthesis is known from EP 0 529 408 AI.
  • a knee joint can largely carry out the previous natural sequence of movements after implantation of a knee joint prosthesis.
  • a simple hinge movement between the femur part and the tibia part does not do justice to this special physiological kinematics and statics. which resulted in not inconsiderable difficulties in terms of functional reliability, durability and resilience in the known prostheses.
  • the human knee has five degrees of freedom of movement.
  • the sequence of movements in a natural knee joint is relatively complicated due to a superimposed rolling and sliding movement when bending or stretching a leg.
  • a knee joint is primarily a hinge joint that is fully locked in the stretched state, but thanks to the design as a double joint when the leg is bent, it also allows the lower leg to rotate about its longitudinal axis. It is essentially formed by only two bones, namely the two "articulated rollers" (condyles) and the plateau-like articular surface of the tibia (tibia), while the fibula is not directly involved in the formation of the joint and only serves as an approach for a side ligament Equalization of the articular surfaces serve two crescent-shaped wedge-shaped intervertebral discs (inner and outer meniscus) which not only absorb shocks and pressure when walking, running and jumping, but also ensure due to their relative mobility to the femur and the tibia that it does not cause bending of the knee joint
  • the known knee prostheses have so far not been able to replicate the five degrees of freedom of movement of the human knee.
  • Endoprostheses for a partial or complete replacement of a knee joint are also known as sled or unicondilar prostheses or as bicondylar prostheses in a wide variety of configurations, the selection of the prostheses to be implanted being determined by different aspects. So the choice of the type of prosthesis depends e.g. B. from it. whether the ligamentous apparatus of the patient's knee is still functioning or has been completely destroyed.
  • the invention here deals specifically with endoprostheses for knee joints in which the ligamentous apparatus is still present or is still largely available. so that a positive connection between the femur and tibia part. which connects the two parts, for example by means of a flexible joint, can be dispensed with.
  • the invention is therefore based on the object of developing the endoprosthesis of the type mentioned in such a way that the physiological knee function movement and loading and the knee joint can largely perform the previous natural movement sequence after implantation of a prosthetic knee joint.
  • the forces should be transferable to the largest possible area and local load peaks, especially as a result of line and point contact, should be avoided.
  • the prosthesis should have small dimensions and the physiological kinematics and statics should also be ensured even if the ligament function is only partially intact. Furthermore, good tribological properties with regard to the parts that can be moved relative to one another and a high static strength of the force-transmitting parts should be ensured. Frictional forces between the individual components that can be moved relative to one another should be minimized, in particular the static friction at the start of a movement.
  • the present invention proposes the features which are shown in the characterizing part of patent claim 1. Further advantageous features for fulfilling the task are set out in the characterizing features of the subclaims.
  • the endoprosthesis proposed by the invention ensures an optimal implementation of the physiological kinematics and statics of the human knee with reliable and compact construction, with local stress peaks being reliably avoided. Due to the special design of the meniscus part, the translational and rotational five degrees of freedom of movement of the human knee are guaranteed.
  • FIG. 3 shows the endoprosthesis according to FIG. 2 in a dorsal view
  • FIG. 4 shows the exploded view of the endoprosthesis according to FIG. 2,
  • FIG. 5 shows an exploded view of the endoprosthesis according to FIG.
  • 6a to 6d show a section approximately along AB in FIGS. 2 and 3 with different rotations about the imaginary vertical axis through the knee joint, elements outside the cutting plane also being adopted for better illustration of the function.
  • FIGS. 6 and 7c a section in the assembled state.
  • 1 shows the five degrees of freedom of the movements of the human knee to illustrate its function.
  • the X axis determines the sagittal, the Y axis the vertical and the Z axis the transverse direction.
  • the five degrees of freedom of the knee are:
  • the bicondular new endoprosthesis 1 shown in FIGS. 2 to 6 is a replacement for the sliding surfaces of the human knee with the ligament apparatus still or largely functioning. It essentially consists of the femoral part 2, the meniscus part 3 and the tibia part 4. The rotation and translation of the knee being controlled and limited by the ligamentous apparatus when the ligamentous apparatus exists.
  • the femur part 2 is anchored with a pin 19 in the medullary canal of the femur and the tibia part 4 by a shaft 20 in the medullary canal of the tibia, two additional rotation locks 21 being provided on the tibia part 4 in addition to the shaft 20 for further anchoring in the bone of the tibia.
  • the artificial meniscus part 3 is arranged, on the top of which two adjacent bearing shells 5 are introduced, which are in engagement with the two correspondingly adjacent and circularly shaped condyle treads 6 on the femur part 2, so that the treads 6 in the Bearing shells 5 slide and the femoral part 2 can rotate therein about the axis Z as Rz.
  • the meniscus part 3 On its ventral side between the bearing shells 5, the meniscus part 3 has a bridge 7, which stands above it and engages between the condyle running surfaces 6 on the femur part 2 and limits the transverse movement of the femur part 2, that is to say the translation Tz in the Z axis.
  • a guide pin 11 is inserted on the tibia plateau 8 of the tibia part 4, which protrudes into a lower, elongated ventral / dorsally formed guide groove 12 in the meniscus part 3 under the bridge 7 and limits its translation Tx to the length of this guide groove 12.
  • an upstanding collar is attached as a stop 9 on the ventral end of the tibial plateau 8, which engages in a crescent-shaped recess or recess 10, which is introduced into the lower ventral edge of the meniscus part 3 and in which the stop 9 slides laterally back and forth during rotation Ry about the y axis and the guide pin 11 resting against the ventral end of the recess 12 (see FIGS. 6a-c).
  • a medial and a lateral bearing part 13 for the meniscus part are located above the tibial plateau 8 3 arranged.
  • the bearing parts 13 are each displaceably arranged in a further, circumferentially closed storage pocket 14 in the tibial plateau 8 by means of the control rollers 16 running horizontally on their inner side surfaces and protruding top is spherical.
  • the curved heads 1 5 engage in a form-fitting manner in correspondingly dome-shaped bearing pockets 1 7 on the underside of the meniscus part 3 and thus enable its movement on the tibial plateau 8 within the limit specified by the dimensions of the bearing pocket 1 4, these dimensions of course being larger than the diameter the control rollers 16 are.
  • the control rollers 16 running in the bearing pocket 14 also limit the rotation Ry about the Y axis.
  • the meniscus part 3 is bevelled on its underside at its dorsal end.
  • the bevel 18 is preferably at an angle of 10 ° to the tibial plateau 8.
  • This beveling on the dorsal side facing the tibia and the spherical configuration of the bearing parts 13 which engage in the bearing pockets 1 7 result in the meniscus part 3 tipping over the bevel at the maximum deflection, that is to say the rotation Rz about the Z axis 18 reached the bottom of the meniscus part 3.
  • This tilting compensates for the change in the angle to the circular condyle running surfaces 6.
  • 6a-d show a rotation of the prosthesis from the extended position into the flexed position with simultaneous rotation about the Y-axis and its limitation by the stop of the control rollers 16 as well as the guide groove 12 and the stop 9 on the ventral recess 10.
  • 6a shows a schematic view of the meniscus part 3, the extended position of the prosthesis with ventral rotation and a ventral stop of the control rollers 16 taking place here
  • FIG. 6b shows the maximum deflection without a rotation stop of the control rollers 16 in the same view
  • FIG. 6c shows the position with a maximum diffraction with simultaneous medial rotation about Ry
  • FIG. 6d shows a corresponding bottom view at a flexion angle of 45 degrees with lateral rotation deflection.
  • the design of the condylar running surfaces 6, the meniscus part 3 and that of the various bearings can differ depending on the material used.
  • the individual configurations can be specified depending on the materials used.
  • the design of the individual components of the prosthesis make it possible for the articulating parts femur- 2nd tibia- 4th meniscus- 3, bearing part 13 and control rollers 16 made of metal optionally coated or uncoated, made of ceramic, optionally coated or uncoated, and the meniscus part 3 the prosthesis made of metal or ceramic can either be coated or uncoated made of plastic.
  • FIGS. 7a-c show an embodiment of the endoprosthesis which is suitable for use in the case of insufficient ligament tensioning of the remaining ligament apparatus.
  • the meniscus may dislocate from the tibial plateau. Therefore, in the embodiment according to FIGS. 7a-c, the meniscus part 3 is positively held or secured against lifting off from the tibia part 4 while maintaining the mobility. This takes place in that the former guide pin 11 is replaced by a guide pin 22 screwed into the tibial plateau 8, which has a head 23 of larger diameter with an internal hexagon.
  • the bolt 22 slides, similar to the guide pin 1 1 in the Guide groove 12 in Figures 2 to 6, ventral / dorsal in an elongated hole-like guide groove 24 penetrating the bridge 7 with an upper extension 25, wherein its head 23 comes to rest in this extension 25 and can slide in it.
  • the upper extension 25 is as wide as the head diameter and as long as the guide groove 24 plus two protrusions of the head 23 compared to the diameter of the bolt 22.
  • the play of this connection can be selected as required. This positive guidance or positive connection reliably prevents dislocation while maintaining the mobility of the meniscus part 3 sliding on the tibial plateau 8 and thus considerably improves the stability and wearing properties of the prosthesis.

Landscapes

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

Abstract

L'invention concerne une endoprothèse pour articulation du genou, qui comprend une partie fémorale et une partie tibiale, chacune des ces parties pouvant être ancrée dans l'os correspondant, ainsi qu'une partie méniscale placée dorsalement ou ventralement dans un guide, de façon à pouvoir se déplacer, entre la partie fémorale et la partie tibiale, sur un plateau tibial plan, et constituant ainsi un ménisque artificiel, cette partie méniscale étant pourvue de coquilles de support dans lesquelles s'engagent des surfaces de pivotement condyliennes de la partie fémorale. Ladite partie méniscale (3) comporte, sur son côté ventral, entre les coquilles de support (5), un pont (7) s'engageant entre les surfaces de pivotement condyliennes (6) de la partie fémorale (2). Sur le plateau tibial (8) de la partie tibiale (4) est inséré un téton de guidage (11) qui pénètre dans une rainure de guidage (12) située dans la partie méniscale (3), sous le pont (7). Sur l'extrémité ventrale du plateau tibial (8) est placée une butée (9) qui s'engage dans une cavité (10) ménagée dans le bord ventral inférieur de la partie méniscale (3) et glisse dans ladite cavité. Au-dessus du plateau tibial (8) sont placées des parties de support (13) qui sont destinées à la partie méniscale (3) et sont conçues pour pouvoir se déplacer dans des cuvettes de support (14) du plateau tibial (8), et dont la face supérieure présente une forme sphérique.
EP01929244A 2000-03-14 2001-03-14 Endoprothese pour articulation du genou Withdrawn EP1411870A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE10012060 2000-03-14
DE2000112060 DE10012060C2 (de) 2000-03-14 2000-03-14 Endoprothese für ein Kniegelenk
PCT/DE2001/000995 WO2001068001A1 (fr) 2000-03-14 2001-03-14 Endoprothese pour articulation du genou

Publications (1)

Publication Number Publication Date
EP1411870A1 true EP1411870A1 (fr) 2004-04-28

Family

ID=7634466

Family Applications (1)

Application Number Title Priority Date Filing Date
EP01929244A Withdrawn EP1411870A1 (fr) 2000-03-14 2001-03-14 Endoprothese pour articulation du genou

Country Status (3)

Country Link
EP (1) EP1411870A1 (fr)
DE (1) DE10012060C2 (fr)
WO (1) WO2001068001A1 (fr)

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10320034A1 (de) * 2003-05-02 2004-11-18 Siebel, Thomas, Dr. Kniegelenkprothese
US8142510B2 (en) 2007-03-30 2012-03-27 Depuy Products, Inc. Mobile bearing assembly having a non-planar interface
US8147558B2 (en) * 2007-03-30 2012-04-03 Depuy Products, Inc. Mobile bearing assembly having multiple articulation interfaces
US8328874B2 (en) 2007-03-30 2012-12-11 Depuy Products, Inc. Mobile bearing assembly
US8147557B2 (en) 2007-03-30 2012-04-03 Depuy Products, Inc. Mobile bearing insert having offset dwell point
US8764841B2 (en) 2007-03-30 2014-07-01 DePuy Synthes Products, LLC Mobile bearing assembly having a closed track
DE102008017394B4 (de) 2008-04-05 2010-05-06 Aesculap Ag Knieendoprothese
DE102010000067A1 (de) * 2010-01-13 2011-07-14 Aesculap AG, 78532 Kniegelenkendoprothese
ES2443827T3 (es) 2010-10-05 2014-02-20 Aesculap Ag Endoprótesis de articulación de rodilla

Family Cites Families (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3431645A1 (de) * 1984-08-29 1986-03-13 GMT GESELLSCHAFT FüR MEDIZINISCHE TECHNIK MBH Endoprothese
FR2631814A1 (fr) * 1988-05-31 1989-12-01 Scernp Prothese a glissement pour le genou
GB2223950B (en) * 1988-10-18 1992-06-17 Univ London Knee prosthesis
US5007933A (en) * 1989-01-31 1991-04-16 Osteonics Corp. Modular knee prosthesis system
GB9005496D0 (en) * 1990-03-12 1990-05-09 Howmedica Tibial component for a replacement knee prosthesis and total knee prosthesis incorporating such a component
FR2663536B1 (fr) * 1990-06-22 1998-02-13 Implants Instr Ch Fab Prothese totale du genou de type a glissement.
FR2664492A1 (fr) * 1990-07-11 1992-01-17 Bousquet Gilles Prothese bicondylienne du genou.
CA2078228C (fr) * 1990-11-14 2000-04-11 Lawrence Pottenger Genou artificiel a coussinet flottant ameliore
DE4128171C1 (fr) * 1991-08-24 1993-04-01 Aesculap Ag, 7200 Tuttlingen, De
US5755802A (en) * 1993-12-30 1998-05-26 Bruno E. Gerber Knee-joint endoprosthesis
FR2714819B1 (fr) * 1994-01-10 1996-03-08 Billy Jean Louis Prothèse de genou.
GB2304051B (en) * 1995-08-09 1999-01-27 Corin Medical Ltd A knee prosthesis
US5964808A (en) * 1996-07-11 1999-10-12 Wright Medical Technology, Inc. Knee prosthesis
AU1178497A (en) * 1996-12-09 1998-07-03 Jacques Afriat Complete knee joint prosthesis
US6123728A (en) * 1997-09-17 2000-09-26 Smith & Nephew, Inc. Mobile bearing knee prosthesis
FR2776919B1 (fr) * 1998-04-02 2000-09-15 Beguec Pierre Le Prothese totale de genou a charniere

Non-Patent Citations (1)

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Title
See references of WO0168001A1 *

Also Published As

Publication number Publication date
DE10012060A1 (de) 2001-09-27
WO2001068001A1 (fr) 2001-09-20
DE10012060C2 (de) 2002-10-31

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