U.S. patent number 3,728,742 [Application Number 05/154,542] was granted by the patent office on 1973-04-24 for knee or elbow prosthesis.
This patent grant is currently assigned to Howmedica, Inc.. Invention is credited to Robert G. Averill, Alex Khowaylo.
United States Patent |
3,728,742 |
Averill , et al. |
April 24, 1973 |
KNEE OR ELBOW PROSTHESIS
Abstract
A total knee or elbow joint prosthesis having opposing condyle
and plateau replacing members for attachment respectively to the
upper and lower arm or leg bones, the members having respectively
convex and concave spherical mating surfaces.
Inventors: |
Averill; Robert G. (Ringwood,
NJ), Khowaylo; Alex (Westwood, NJ) |
Assignee: |
Howmedica, Inc. (Rutherford,
NJ)
|
Family
ID: |
22551741 |
Appl.
No.: |
05/154,542 |
Filed: |
June 18, 1971 |
Current U.S.
Class: |
623/20.21 |
Current CPC
Class: |
A61F
2/3804 (20130101); A61F 2/38 (20130101) |
Current International
Class: |
A61F
2/38 (20060101); A61f 001/24 () |
Field of
Search: |
;3/1
;128/92C,92CA,92R |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
923,383 |
|
Feb 1955 |
|
DT |
|
1,047,640 |
|
Jul 1953 |
|
FR |
|
Other References
Vitallium Surgical Appliance (catalog), Austenal Medical Div.,
Howmet Corp., New York, N.Y., 1964, page 62 relied upon, M.G.H.
Femoral Condyle Replacements/No. 6662..
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Frinks; Ronald L.
Claims
What is claimed is:
1. A joint prosthesis suitable for knee or elbow comprising an
upper member and a mating lower member, the upper member having a
pair of spaced condyle portions joined by an intercondyloidal
segment, each condyle portion being formed with a spherically
curved downwardly facing convex surface, and the lower member
having a pair of spaced plateau portions joined by an interplateau
segment, each plateau portion being formed with a spherically
curved upwardly facing concave surface engageable with the
corresponding convex surface, the radius of each spherical condyle
surface being no greater than that of the corresponding spherical
plateau surface, said upper and lower members including means for
attachment to a bone structure and providing for substantial
articulation of such bone members in a single plane, and said
intercondyloidal segment and interplateau segment being
substantially narrower than the respective condyle portions and
plateau portions thereby providing intercondyloidal and
interplateau apertures for receiving cruciate ligaments connecting
upper and lower bone structures to which the prosthesis is adapted
to be attached.
2. A joint prosthesis according to claim 1 in which the upper
member is metallic and the lower bone member is made mainly of an
organic polymer.
3. A joint prosthesis according to claim 1 in which the radius of
each spherical condyle surface is less than the radius of curvature
of each mating spherical plateau surface.
4. A joint prosthesis according to claim 1 in which both upper and
lower members are metallic.
5. A joint prosthesis according to claim 1 in which the upper
member is metallic and comprises individually formed and surfaced
condyle portions attached to said intercondyloidal segment.
6. A joint prosthesis according to claim 1 in which each
spherically curved condyle portion and plateau portion has a
front-to-back dimension that is substantially greater than its
side-to-side dimension.
7. A joint prosthesis according to claim 6 in which the
front-to-back dimension is substantially twice the side-to-side
dimension.
Description
BACKGROUND OF THE INVENTION
Prosthetic surgery involving the excision and removal of
deteriorated and diseased bone tissue in knee and hip joints for
example has now become quite common. Typically, artificial members
of plastic and/or metal compatible with the body system are
substituted for the removed natural bone segments and anchored to
the remaining bone structure.
The bearing surfaces of the knee joint are vulnerable to stress,
arthritic and other disease induced deterioration. Prosthetic
correction is indicated when the tissues become so damaged that
other less drastic techniques have little or no prospect of
success. To date hinge type prostheses have been employed most
frequently in such cases to restore the joint to some degree of
normalcy. Although the surgical technique of implantation as such
has been quite successful, the precise construction and shape of
the implanted artificial members has not been entirely satisfactory
due to the complexity of the knee joint movement, the desirability
of minimum bone removal, and the need for preserving potentially
functional cruciate and colateral ligaments. Further, the design
and fabrication technique suited to that design must result in a
bearing with long term high performance capabilities.
It is the purpose of the present invention to provide a prosthesis
wherein these problems are resolved and which can be easily
installed by the surgeon with greatly improved postoperative
results.
SUMMARY OF THE INVENTION
In accordance with the present invention, a knee or elbow joint
prosthesis comprises an artificial upper bone member and a mating
lower bone member, the upper bone member having a pair of spaced
condyle portions joined by an intercondyloidal segment. Each
condyle portion is formed with a spherically curved downwardly
facing convex surface. The lower bone member has a pair of
similarly spaced plateau portions joined by an interplateau
segment, each plateau portion being formed with a spherically
curved upwardly facing concave surface. The radius of each
spherical condyle surface is no greater than that of the
corresponding spherical plateau surface, and may with advantage be
a little less to make for easy articulation in an
anterior-posterior plane.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 is an elevational view of a knee joint in its anterior
aspect, incorporating the prosthesis of the present invention;
FIG. 2 is a side view, lateral aspect of the knee joint in FIG.
1;
FIG. 3 is a section taken in the direction of arrows 3--3 of FIG.
1;
FIG. 4 is a section taken in the direction of arrows 4--4 of FIG.
2;
FIGS. 5 and 6 are respectively top and bottom views of a plateau
member constructed according to the present invention for
attachment to the tibia; and
FIG. 7 is a perspective of a condyle member according to the
present invention for attachment to the femur.
DESCRIPTION OF A PREFERRED EMBODIMENT
Referring now to the drawing, and initially to FIGS. 1 and 2
thereof, a knee joint showing the major upper and lower bones, the
femur 10, the tibia 11 and the fibula 12, has been illustrated.
Various ligaments and tendons which interconnect these bones and
regulate, restrict and determine the flexing or articulated
movement of the tibia with respect to the femur have not been
shown. Hinged movement naturally occurs between the condyle
portions 13 of the femur and between the plateau portions 14 of the
tibia.
It will be understood that the prosthesis of the present invention
shall be surgically implanted in substitution for diseased mating
portions of the femoral condyles and the tibial plateaus. The
prosthesis therefore includes a femoral condyloidal member 15 and a
mating tibial plateau member 16 which are uniquely constructed in
accordance with the present invention. Member 15 has a pair of
spaced condyloidal portions 17 and 18 which are integrally joined
by an intercondyloidal segment 19. The proximal posterior surface
of each segment 17 and 18 may be provided with a recess 20, 21 and
the proximal anterior portions thereof may similarly be provided
with recesses 22, 23 therein. These recesses receive cement and
facilitate secure attachment of the prothesis to the bone
structure. Each of the condyloidal portions 17 and 18 include
tapered pins 24, 25 which will be received within openings made by
the surgeon in the mating portions of the femur. Thus the member
can be joined to the femur (after diseased natural condyles have
been removed) and secured thereto in a manner which is known.
Member 15 may be cast integrally of a metal compatible for the
purpose, such as a cobalt-chromium-base alloy or a stainless steel.
Alternatively member 15 may be manufactured of separately produced
and surfaced condyle portions which are then welded to a plate
which provides the intercondyloidal segment 19. Member 16 also may
be metallic, but is preferably is formed mainly of a suitable high
density organic polymer. Other materials of construction also may
be used for either or both members, such as pyrolytic or vitreous
carbon, or a ceramic material.
In accordance with the present invention, the downwardly facing
convex surface 17a and 18a of each condyloidal portion 17 and 18 is
uniquely formed as a section of the surface of a sphere. That is to
say, in both anterior-posterior and in lateral-medial directions,
the curvature of each surface 17a, 18a will conform to that of a
sphere having a predetermined diameter, which in the present
embodiment is approximately the straight line distance between the
anterioral and posterioral extremities of each portion 17 and 18 as
shown in FIG. 2. The surfaces 17a, 18a being spherical lend
themselves to being given a surface finish of extremely high
quality by known machining and finishing techniques.
The member 16 as shown in FIGS. 1 to 4 attached to a tibia,
comprises a pair of spaced plateau portions 27, 28 joined by an
integral interplateau segment 29. Each plateau portion is provided
with a downwardly projecting pin 30, 31. The segment 29 and the
plateau portions 27, 28 have serrations 32 on their under surfaces
which together with the pins 30 and 31 permit the member 16 to be
firmly anchored by a suitable cement to the upper end of the tibia
after the latter has been suitably prepared surgically. As
indicated above, each of the plateau portions 27 and 28 has an
upwardly facing concave spherical surface 27a and 28a which may
have an identical center of curvature to that of each downwardly
convex spherical surface 17a, 18a of the member 15; or
advantageously, the radius of the concave surface may be made
somewhat greater than that of the convex surface to permit smooth
rotation in the anterior-posterior plane with limited
lateral-medial motion and axial rotation. A metal wire 34 is
preferably imbedded in the member 16 in known relationship with
respect to the geometrical dimensions of such member. This is done
to provide an X-ray opaque reference member, since the member 16 is
of insufficient density to be readily detected in X-ray photographs
of the prosthetic knee joint.
It will be noted that the intercondyloidal segment 19 and the
interplateau segment 29 are substantially narrower than the
respective condyle portions 17, 18 and plateau portions 27, 28.
This provides intercondyloidal and interplateau apertures 36 and 37
for receiving the posterior and anterior cruciate ligaments
connecting condyle portions 13 of the femur and corresponding
portions 14 of the tibia. As illustrated, each spherically curved
condyle portion and plateau portion has an anterioral-posterioral
dimension substantially greater than its lateral-medial dimension.
In the particular embodiment, such anterioral-posterioral dimension
is substantially twice the lateral-medial dimension.
The above-described prosthesis has the following significant
advantages in comparison with prior prosthetic joints. Members 15
and 16 each have mating portions which are entirely spherical. It
has been found that a prosthetic joint thus formed approximates the
natural movement of the knee very well. It had been thought by some
that such movement would require condylar surface of a more complex
nature closely following the anatomical, which could not be
accurately manufactured and which would not be necessarily the same
for all individuals. The spherical surfaces of members 15 and 16
can be manufactured and finished with great accuracy and quality
not possible in prior devices.
It will be understood that the foregoing description has related to
a particular embodiment of the invention and is therefore
representative. In order to fully appreciate the scope of the
invention, reference should be made to the appended claims.
* * * * *