1. Field of the Invention
The present invention relates generally to orthopedic prosthetic devices and, in particular, to distal femoral knee prostheses.
2. Description of the Related Art
Disease and trauma affecting the articular surfaces of a knee joint are commonly effectively treated by surgically replacing the articulating ends of the femur and tibia with prosthetic femoral and tibial implants or prostheses according to a procedure known as a total knee replacement (“TKR”) or a total knee arthroplasty (“TKA”). The femoral and tibial implants are made of materials that exhibit a low coefficient of friction as they articulate against one another to restore normal knee function.
Although distal femoral knee prostheses are provided in a range of varying sizes and are selected by surgeons to best fit the anatomy of a particular patient, improvements in the design of distal femoral knee prostheses are desired.
The present invention provides a set of distal femoral knee prostheses which are designed to be more narrow in medial/lateral (“M/L”) dimensions with increasing anterior/posterior (“A/P”) size than existing prostheses to more closely correspond to the physical anatomy of female patients. The prostheses are designed to have a substantially trapezoidal shape or profile when viewed distally which features a more pronounced narrowing of the M/L dimensions beginning at the posterior end of the prostheses and progressing anteriorly to the anterior end of the prostheses. Additionally, the prostheses each include a reduced profile patellar sulcus and reduced profile anterior condyles to more closely conform to the anatomy of a resected femur, and also include sulcus tracking which is optimized to conform to female anatomy.
In one form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of standard aspect ratio prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and having increasingly greater distal taper angles defined between a lateral line connecting the anterior end and the posterior end of the distal nonarticulating surface and a medial line connecting the anterior end and the posterior end of the distal nonarticulating surface on each prosthesis; at least some of the prostheses having a distal taper angle greater than or equal to approximately 21°.
In another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of standard aspect ratio prostheses each having an overall anterior/posterior dimension defined between points located most anteriorly and most posteriorly on each prosthesis and a medial/lateral dimension defined between points located most medially and most laterally at anterior/posterior locations substantially equidistant from the anterior end of the distal nonarticulating surface and the posterior end of the distal nonarticulating surface; at least some of the prostheses having an overall anterior/posterior dimension and a medial/lateral dimension falling below a conceptual boundary defined by a line connecting a first point and a second point, the first point having an approximately 52.0 overall anterior/posterior dimension and an approximately 55.0 medial/lateral dimension, and the second point having an approximately 77.0 overall anterior/posterior dimension and an approximately 78.5 medial/lateral dimension; wherein the line is defined by the following equation: (medial/lateral dimension)=(0.94*overall anterior/posterior dimension)+6.12.
In yet another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of standard aspect ratio prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and respectively having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location defined by the anterior end of the distal nonarticulating surface on each prosthesis; at least some of the prostheses having an overall anterior/posterior dimension and a medial/lateral dimension falling below a conceptual boundary defined by a line connecting a first point and a second point, the first point having an approximately 52.0 overall anterior/posterior dimension and an approximately 50.0 medial/lateral dimension, and the second point having an approximately 77.0 overall anterior/posterior dimension and an approximately 70.5 medial/lateral dimension; wherein the line is defined by the following equation: (medial/lateral dimension)=(0.82*overall anterior/posterior dimension)+7.36.
In still another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface and an anterior nonarticulating surface, including a plurality of standard aspect ratio prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and respectively having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location defined by a distal most point on the anterior nonarticulating surface on each prosthesis; at least some of the prostheses having an overall anterior/posterior dimension and a medial/lateral dimension falling below a conceptual boundary defined by a line connecting a first point and a second point, the first point having an approximately 52.0 overall anterior/posterior dimension and an approximately 40.1 medial/lateral dimension, and the second point having an approximately 77.0 overall anterior/posterior dimension and an approximately 53.5 medial/lateral dimension; wherein the line is defined by the following equation: (medial/lateral dimension)=(0.54*overall anterior/posterior dimension)+12.23.
In another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface and an anterior nonarticulating surface, including a plurality of prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and respectively having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location defined by a distal most point on the anterior nonarticulating surface on each prosthesis; at least some of the prostheses having an overall anterior/posterior dimension and a medial/lateral dimension falling below a conceptual boundary defined by a line connecting a first point and a second point, the first point having an approximately 52.0 overall anterior/posterior dimension and an approximately 40.3 medial/lateral dimension, and the second point having an approximately 77.0 overall anterior/posterior dimension and an approximately 51.8 medial/lateral dimension; wherein the line is defined by the following equation: (medial/lateral dimension)=(0.46*overall anterior/posterior dimension)+16.38.
In a still further form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of prostheses each having an overall anterior/posterior dimension defined between points located most anteriorly and most posteriorly on each prosthesis and a medial/lateral dimension defined between points located most medially and most laterally at anterior/posterior locations substantially equidistant from the anterior end of the distal nonarticulating surface and the posterior end of the distal nonarticulating surface; at least some of the overall anterior/posterior dimensions and the medial/lateral dimensions falling within a conceptual boundary defined by an upper line and a lower line, the upper line connecting a first point and a third point, the lower line connecting a second point and a fourth point, the first point having an approximately 52.0 overall anterior/posterior dimension and an approximately 55.0 medial/lateral dimension, the second point having an approximately 52.0 overall anterior/posterior dimension and an approximately 47.0 medial/lateral dimension, the third point having an approximately 77.0 overall anterior/posterior dimension and an approximately 78.5 medial/lateral dimension, and the fourth point having an approximately 77.0 overall anterior/posterior dimension and an approximately 70.0 medial/lateral dimension; wherein the upper line is defined by the following equation: (medial/lateral dimension)=(0.94*overall anterior/posterior dimension)+6.12; and wherein the lower line is defined by the following equation: (medial/lateral dimension)=(0.92*overall anterior/posterior dimension)−0.84.
In yet another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of standard aspect ratio prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location substantially equidistant from the anterior end of the distal nonarticulating surface and the posterior end of the distal nonarticulating surface on each prosthesis; the medial/lateral dimensions of the prostheses respectively increasing at a first rate, the overall anterior/posterior dimensions respectively increasing at a second rate, the first rate and the second rate defining a ratio substantially equal to or less than 0.89.
In still another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location substantially equidistant from the anterior end of the distal nonarticulating surface and the posterior end of the distal nonarticulating surface on each prosthesis; the medial/lateral dimensions of the prostheses respectively increasing at a first rate, the overall anterior/posterior dimensions respectively increasing at a second rate, the first rate and the second rate defining a ratio substantially equal to or less than 0.75.
In a further form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, including a plurality of standard aspect ratio prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location defined at a location proximate the most posteriorly located point on each prosthesis; the medial/lateral dimensions of the prostheses respectively increasing at a first rate, the overall anterior/posterior dimensions respectively increasing at a second rate, the first rate and the second rate defining a ratio substantially equal to or less than 0.96.
In another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, including a plurality of prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location defined at a location proximate the most posteriorly located point on each prosthesis; the medial/lateral dimensions of the prostheses respectively increasing at a first rate, the overall anterior/posterior dimensions respectively increasing at a second rate, the first rate and the second rate defining a ratio substantially equal to or less than 0.84.
In still another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of standard aspect ratio prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and respectively having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location defined by the anterior end of the distal nonarticulating surface on each prosthesis; the medial/lateral dimensions of the prostheses respectively increasing at a first rate, the overall anterior/posterior dimensions respectively increasing at a second rate, the first rate and the second rate defining a ratio substantially equal to or less than 0.78.
In yet another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and respectively having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location defined by the anterior end of the distal nonarticulating surface on each prosthesis; the medial/lateral dimensions of the prostheses respectively increasing at a first rate, the overall anterior/posterior dimensions respectively increasing at a second rate, the first rate and the second rate defining a ratio substantially equal to or less than 0.76.
In another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface and an anterior nonarticulating surface, including a plurality of standard aspect ratio prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and respectively having increasingly greater medial/lateral dimensions defined between points located most medially and most laterally at an anterior/posterior location defined by a distal most point on the anterior nonarticulating surface on each prosthesis; the medial/lateral dimensions of the prostheses respectively increasing at a first rate, the overall anterior/posterior dimensions respectively increasing at a second rate, the first rate and the second rate defining a ratio substantially equal to or less than 0.44.
In a further form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and having increasingly greater distal taper angles defined between a lateral line connecting the anterior end and the posterior end of the distal nonarticulating surface and a medial line connecting the anterior end and the posterior end of the distal nonarticulating surface on each prosthesis; the distal taper angles of the prostheses respectively increasing at a first rate, the overall anterior/posterior dimensions of the prostheses respectively increasing at a second rate, the first rate and the second rate defining a ratio substantially equal to or greater than 0.22.
In still another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and having increasingly greater distal taper angles defined between a lateral line connecting the anterior end and the posterior end of the distal nonarticulating surface and a medial line connecting the anterior end and the posterior end of the distal nonarticulating surface on each prosthesis; at least some of the overall anterior/posterior dimensions and the distal taper angles falling within a conceptual boundary defined by an upper boundary and a lower boundary, the upper boundary defined by a line connecting a first point and a third point, the lower boundary defined by a line connecting a second point and a fourth point, the first point having an approximately 52.0 overall anterior/posterior dimension and an approximately 27.0° distal taper angle, the second point having an approximately 58.0 overall anterior/posterior dimension and an approximately 22.5° distal taper angle, the third point having an approximately 77.0 overall anterior/posterior dimension and an approximately 32.0° distal taper angle, and the fourth point having an approximately 77.0 overall anterior/posterior dimension and an approximately 26.0° distal taper angle.
In yet another form thereof, the present disclosure provides a set of distal femoral prostheses particularly adapted for female anatomy, each femoral prosthesis including a distal nonarticulating surface having an anterior end and a posterior end, including a plurality of prostheses respectively having increasingly greater overall anterior/posterior dimensions defined between points located most anteriorly and most posteriorly on each prosthesis and having increasingly greater distal taper angles defined between a lateral line connecting the anterior end and the posterior end of the distal nonarticulating surface and a medial line connecting the anterior end and the posterior end of the distal nonarticulating surface on each prosthesis; at least some of the overall anterior/posterior dimensions and the distal taper angles falling within a conceptual boundary defined by an upper boundary and a lower boundary, the upper boundary defined by a line connecting a first point and a third point, the lower boundary defined by a line connecting a second point and a fourth point, the first point having an approximately 52.0 overall anterior/posterior dimension and an approximately 34.0° distal taper angle, the second point having an approximately 58.0 overall anterior/posterior dimension and an approximately 22.5° distal taper angle, the third point having an approximately 77.0 overall anterior/posterior dimension and an approximately 32.0° distal taper angle, and the fourth point having an approximately 77.0 overall anterior/posterior dimension and an approximately 26.0° distal taper angle.
In a further form thereof, the present disclosure provides a distal femoral prosthesis, including a non-articulating surface including a distal plane and an anterior non-articular surface; lateral and medial anterior condyles; a patellar sulcus defined between the condyles, the patellar sulcus having a maximum thickness between approximately 2.5 mm and 3.2 mm between an anterior most point on the sulcus and the anterior non-articular surface.
In another form thereof, the present disclosure provides a distal femoral prosthesis, including a non-articulating surface including a distal plane and an anterior non-articular surface; lateral and medial anterior condyles each defining an anterior articular surface, at least one of the condyles having a maximum thickness between approximately 4.0 mm and 6.1 mm between an anterior most point on the anterior articular surface of the condyle and the anterior non-articular surface.
In yet another form thereof, the present disclosure provides a distal femoral prosthesis, including a patellar sulcus disposed between lateral and medial anterior condyles of the prosthesis, the sulcus having an end point; a non-articulating surface having a distal plane; and a lateralization distance defined at the end point between a first line extending from an intersection of the distal plane and the sulcus and the end point, the lateralization distance greater than 5.0 mm.
The above-mentioned and other features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:
Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate exemplary embodiments of the invention, and such exemplifications are not to be construed as limiting the scope of the invention any manner.
As used herein, the following directional definitions apply. Anterior and posterior mean nearer the front or nearer the rear of the body, respectively. Thus, with respect to the prostheses described herein, anterior refers to that portion of the knee that is nearer the front of the body, when the leg is in an extended position. Proximal and distal mean nearer to or further from the root of a structure, respectively. For example, the distal femur is a part of the knee joint while the proximal femur is part of the hip joint. Finally, the adjectives medial and lateral mean nearer the sagittal plane or further from the sagittal plane, respectfully. The sagittal plane is an imaginary vertical plane through the middle of the body that divides the body into right and left halves.
Distal femoral knee prostheses made in accordance with the present invention are intended to be used to restore knee joint function in patients with severe pain and disability due, for example, to Rheumatoid arthritis, osteoarthritis, traumatic arthritis polyarthritis; collagen disorders, and/or avascular necrosis of the femoral condyle; post-traumatic loss of joint configuration, particularly when there is patellofemoral erosion, dysfunction or prior patellectomy; moderate valgus, varus, flexion deformities, or other conditions.
Referring initially to
Referring to
In a preferred embodiment, prosthesis 50 comprises a plurality of chamfer surfaces corresponding to a plurality of chamfer surfaces or “box cuts” made in the distal femur. Non-articular surface 54 may comprise a porous metal surface or any surface likely to promote the growth of bone therein. Non-articular surface 54 of prosthesis 50 preferably comprises anterior non-articular surface 76, distal anterior non-articular surface 78, distal non-articular surface 80, two distal posterior non-articular surfaces 82, and two posterior non-articular surfaces 84.
Distal non-articular surface 80 is generally flat and adapted to receive the distal-most surface of the resected femur. Distal non-articular surface 80 comprises an anterior end and a posterior end. The anterior end of distal non-articular surface 80 abuts one end of distal anterior non-articular surface 78, which surface 78 also includes an anterior end and a posterior end. Surface 78 extends from surface 80 anteriorly and superiorly such that an obtuse angle is formed between surfaces 78 and 80. Anterior non-articular surface 76 extends superiorly from the anterior end of surface 78.
The posterior end of distal non-articular surface 80 abuts one end of each distal posterior non-articular surface 82, which surfaces 82 also include an anterior end and a posterior end. Surfaces 82 extend from surface 80 posteriorly and superiorly such that an obtuse angle is formed between surfaces 82 and 80. Posterior non-articular surfaces 84 extend superiorly from the posterior ends of surfaces 82, respectively.
As discussed in detail below, for many patients, particularly female patients, it is desirable to construct a set of prostheses 50 of varying size wherein the medial/lateral (“M/L”) width dimensions of the prostheses correspond more closely to the actual anatomical M/L width dimensions of the female femur and articulating surfaces. As described below, prostheses 50 addresses this concern by offering the surgeon a set of narrower prostheses in the M/L dimensions for a given set of anterior/posterior (“A/P”) prosthesis sizes which will allow the surgeon to use a prosthesis with both a correct A/P size and more accurate and optimized M/L dimensions to provide optimal prosthesis sizing and joint kinematics as compared to conventional prostheses.
In
As described below, the profiles of a set of prostheses 50 can also be described in terms of an increasing narrowing of the M/L dimensions relative to known prostheses on a per size basis. It has been observed that, for given female femurs, for example, the M/L dimensions are sometimes smaller than those of known prostheses of the proper A/P dimension. This discrepancy is small on the smaller A/P size prostheses and increases as the A/P size increases. For example, referring to
In
As an exemplary comparison, the dimensions “Posterior”, “B-B”, “A-A”, and “Overall A/P” and the ratios of these values for conventional prostheses (“Conventional 1”, including five increasing sizes C through G) are compared with corresponding dimensions and ratios of a set of prostheses designed in accordance with the present invention (“Embodiment 1”, including five increasing sizes C through G). These values are presented in Table 1 below. Unless otherwise indicated, all numerical dimensional values presented herein are in millimeters (“mm”).
Table 2 below sets forth the results of a first order equation fit to data sets for several sets of prostheses including Conventional 1, Conventional 2 (which is similar to Conventional 1), Embodiment 1, Embodiment 2 (which is similar to Embodiment 1), as well as five other sets of known competitive prostheses, designated Competitive 1, Competitive 2, Competitive 3, Competitive 4, and Competitive 5. The data sets include Posterior M/L vs. Overall A/P and the Ratio (Posterior M/L vs. Overall A/P) vs. Overall A/P.
From the data in Table 2, it may be seen that there is a difference in the slopes of the sets of prostheses of Embodiments 1 and 2 as compared to the slopes of the sets of the known prostheses. In particular, it may be seen from the data in Table 2 that the sets of prostheses of Embodiments 1 and 2 have a narrowing posterior M/L dimension with increasing A/P size, as indicated by slopes less than 0.93, for example, as opposed to a substantially parallel or one-to-one relationship between the posterior M/L dimension and the A/P dimension with increasing A/P size as in the sets of known prostheses, as indicated by slopes of 0.93 and above. Thus, in the sets of known prostheses, the posterior M/L dimension and the A/P dimension increase at substantially the same rate with increasing A/P size. Also, the slope of the ratio (posterior M/L/overall A/P) vs. overall A/P is less than −0.0032 for the sets of prostheses of Embodiments 1 and 2 while the corresponding slope for the known sets of prostheses is greater than −0.0032, indicating that the sets of prostheses of Embodiments 1 and 2 have an increasingly more pronounced narrowing of the posterior M/L dimension with increasing A/P size. In this manner, the sets of prostheses designed in accordance with the present invention offer a surgeon a unique combination of implant posterior M/L widths with varying A/P size for an overall system or set of prostheses, wherein such sets of prostheses are more anatomically optimized for the female anatomy as compared with the sets of known prostheses.
Table 3 below sets forth the results of a first order equation fit to data sets for several sets of prostheses including Conventional 1, Conventional 2 (which is similar to Conventional 1), Embodiment 1, Embodiment 2 (which is similar to Embodiment 1), as well as five other sets of known competitive prostheses, designated Competitive 1, Competitive 2, Competitive 3, Competitive 4, and Competitive 5. The data sets include B-B M/L vs. Overall A/P and the Ratio (B-B M/L vs. Overall A/P) vs. Overall A/P.
From the data in Table 3, it may be seen that there is a significant difference in slope for the sets of prostheses of Embodiments 1 and 2 as compared with the slopes of the known sets of prostheses. The magnitudes of the anterior M/L “B-B” values for a given A/P dimension are more pronounced, i.e., the variance in width at dimension B-B, namely, an anterior width, over various A/P sizes between the sets of prostheses of Embodiments 1 and 2 and the known sets of prostheses is more dramatically pronounced. Specifically, sets of prostheses of Embodiments 1 and 2 have a narrowing anterior M/L dimension with increasing A/P size, as indicated by slopes less than 0.78, for example, as opposed to a substantially parallel or one-to-one relationship between the anterior M/L dimension and the A/P dimension with increasing A/P size as in the sets of known prostheses, as indicated by slopes of 0.78 and above. Thus, in the sets of known prostheses, the anterior M/L dimension and the A/P dimension increase at substantially the same rate with increasing A/P size. Also, the slope of the ratio (anterior M/L “B-B”/overall A/P) vs. overall A/P is greater than −0.0038 for the sets of prostheses of Embodiments 1 and 2, while the corresponding slope for the known sets of prostheses is less than −0.0038, indicating that the sets of prostheses of Embodiments 1 and 2 have increasingly more pronounced narrowing of the anterior M/L “B-B” dimension with increasing A/P size. In this manner, the prostheses designed in accordance with the present invention offer a surgeon a unique combination of implant M/L widths as an overall system of prostheses, wherein such sets of prostheses are more anatomically optimized for the female anatomy as compared with the sets of known prostheses.
As another exemplary comparison, the dimensions “Posterior”, “MB”, “B-B”, and “Overall A/P” for conventional prostheses (“Conventional 3”, “Conventional 4”, and “Conventional 5” including five increasing sizes C through G) are compared with corresponding dimensions of a set of prostheses designed in accordance with the present invention (“Embodiment 3”, “Embodiment 4”, and “Embodiment 5” including five increasing sizes C through G). In one embodiment, the values for Conventional 5 and Embodiment 5 may be average values of Conventionals 3 and 4 and Embodiments 3 and 4, respectively. These values are presented in Table 4 below.
Table 5 below sets forth the results of a first order equation fit to each of the data sets shown in
From the data in Table 5, it may be seen that there is a difference in the slopes of the sets of prostheses of Embodiments 3, 4, and 5 as compared to the slopes of the sets of the known prostheses. In particular, it may be seen from the data in Table 5 that the sets of prostheses of Embodiments 3, 4, and 5 have a narrowing posterior M/L dimension with increasing A/P size, as indicated by slopes less than approximately 0.85, for example, as opposed to a substantially parallel or one-to-one relationship between the posterior M/L dimension and the A/P dimension with increasing A/P size as in the sets of known prostheses, as indicated by slopes of 0.86 and above. In exemplary embodiments, the slope of posterior M/L dimension with increasing A/P size for prostheses 50 may be as small as approximately 0.50, 0.55, 0.60, or 0.65 or as large as approximately 0.85, 0.84, 0.83, 0.81, 0.80, 0.75, or 0.70. In an exemplary embodiment, the slope of posterior M/L dimension with increasing A/P size for prostheses 50 is approximately 0.80. Thus, the posterior M/L dimension for prostheses 50 increases at a lesser rate than the corresponding overall A/P dimension. In contrast, in the sets of known prostheses, the posterior M/L dimension and the A/P dimension increase at substantially the same rate with increasing A/P size. In this manner, the sets of prostheses designed in accordance with the present invention offer a surgeon a unique combination of implant posterior M/L widths with varying A/P size for an overall system or set of prostheses, wherein such sets of prostheses are more anatomically optimized for the female anatomy as compared with the sets of known prostheses.
Furthermore, from the data in Table 5, it may be seen that there is a significant difference in slope for the sets of prostheses of Embodiments 3, 4, and 5 as compared with the slopes of the known sets of prostheses when looking at the B-B and MB dimensions. The magnitudes of the B-B values and MB values for a given A/P dimension are more pronounced, i.e., the variance in width at dimension B-B or MB over various A/P sizes between the sets of prostheses of Embodiments 3, 4, and 5 and the known sets of prostheses is more dramatically pronounced.
Specifically, sets of prostheses of Embodiments 3, 4, and 5 have a narrowing B-B M/L dimension with increasing A/P size, as indicated by slopes less than approximately 0.77, for example, as opposed to a substantially parallel or one-to-one relationship between the B-B M/L dimension and the A/P dimension with increasing A/P size as in the sets of known prostheses, as indicated by slopes of 0.78 and above. In exemplary embodiments, the slope of the B-B M/L dimension with increasing A/P size for prostheses 50 may be as small as approximately 0.30, 0.35, 0.40, or 0.45 or as large as 0.77, 0.76, 0.75, 0.74, 0.72, 0.70, 0.65, 0.60, or 0.50. In an exemplary embodiment, the slope is of the B-B M/L dimension with increasing A/P size for prostheses 50 is approximately 0.46. Thus, the B-B M/L dimension for prostheses 50 increases at a lesser rate than the corresponding overall A/P dimension. In contrast, in the sets of known prostheses, the B-B M/L dimension and the A/P dimension increase at substantially the same rate with increasing A/P size.
Furthermore, sets of prostheses of Embodiments 3, 4, and 5 have a narrowing MB M/L dimension with increasing A/P size, as indicated by slopes less than 0.76, for example, as opposed to a substantially parallel or one-to-one relationship between the MB M/L dimension and the A/P dimension with increasing A/P size as in the sets of known prostheses, as indicated by slopes of 0.77 and above. In exemplary embodiments, the slope of the MB M/L dimension with increasing A/P size for prostheses 50 may be as small as approximately 0.40, 0.45, 0.50, 0.55, or 0.57 or as large as approximately 0.76, 0.75, 0.74 0.73, 0.72, 0.71, 0.70, 0.65, or 0.60. In an exemplary embodiment, the slope of the MB M/L dimension with increasing A/P size for prostheses 50 is approximately 0.60. Thus, the MB M/L dimension for prostheses 50 increases at a lesser rate than the corresponding overall A/P dimension. In contrast, in the sets of known prostheses, the MB M/L dimension and the A/P dimension increase at substantially the same rate with increasing A/P size.
In this manner, the prostheses designed in accordance with the present invention offer a surgeon a unique combination of implant M/L widths as an overall system of prostheses, wherein such sets of prostheses are more anatomically optimized for the female anatomy as compared with the sets of known prostheses.
Referring again to
As set forth in Table 6 below, the Overall A/P dimensions and the ratios of the dimensions “Posterior”, “MB”, and “B-B” vs. “Overall A/P” are given for Embodiments 3, 4, and 5 as well as for conventional prostheses Conventional 3, 4, and 5.
Table 7 below sets forth the results of a first order equation fit to each of the data sets shown in
From the data in Table 7 it may be seen that there is a difference in the slopes of the sets of prostheses of Embodiments 3, 4, and 5 as compared to the slopes of the sets of the known prostheses. In particular, it may be seen from the data in Table 7 that the sets of prostheses of Embodiments 3, 4, and 5 have a narrowing posterior M/L dimension with increasing A/P size, as indicated by the slope of the ratio (posterior M/L/overall A/P) vs. overall A/P being less than −0.0032 for the sets of prostheses of Embodiments 3, 4, and 5 while the corresponding slope for the known sets of prostheses is greater than or equal to −0.0032, except for the Competitive 7 prosthesis, indicating that the sets of prostheses of Embodiments 3, 4, and 5 have an increasingly more pronounced narrowing of the posterior M/L dimension with increasing A/P size. In this manner, the sets of prostheses designed in accordance with the present invention offer a surgeon a unique combination of implant posterior M/L widths with varying A/P size for an overall system or set of prostheses, wherein such sets of prostheses are more anatomically optimized for the female anatomy as compared with the sets of known prostheses.
Furthermore, it may be seen that there is a significant difference in slope for the sets of prostheses of Embodiments 3, 4, and 5 as compared with the slopes of the known sets of prostheses when looking at the MB and B-B M/L dimensions. The magnitudes of the anterior M/L “B-B” values for a given A/P dimension are more pronounced, i.e., the variance in width at dimension B-B, namely, an anterior width, over various A/P sizes between the sets of prostheses of Embodiments 3, 4, and 5 and the known sets of prostheses is more dramatically pronounced. Specifically, the slope of the ratio (B-B M/L/overall A/P) vs. overall A/P is less than −0.0032 for the sets of prostheses of Embodiments 3, 4, and 5, while the corresponding slope for the known sets of prostheses is greater than or equal to −0.0032, indicating that the sets of prostheses of Embodiments 3, 4, and 5 have increasingly more pronounced narrowing of the B-B M/L dimension with increasing A/P size.
Furthermore, the slope of the ratio (MB M/L/Overall A/P) vs. Overall A/P is less than −0.0054 for the sets of prostheses of Embodiments 3, 4, and 5, while the corresponding slope for the known sets of prostheses is greater than or equal to −0.0054, indicating that the sets of prostheses of Embodiments 3, 4, and 5 have increasingly more pronounced narrowing of the B-B M/L dimension with increasing A/P size. Prostheses 50 may have slope values for the ratios of MB M/L/Overall A/P vs. Overall A/P with increasing A/P size which may be as small as −0.0075, −0.0072, −0.0069, −0.0066, or −0.0063 or as large as −0.0055, −0.0057, −0.0059, or −0.0061. In this manner, the prostheses designed in accordance with the present invention offer a surgeon a unique combination of implant M/L widths as an overall system of prostheses, wherein such sets of prostheses are more anatomically optimized for the female anatomy as compared with the sets of known prostheses.
Referring again to
As another exemplary comparison, the dimensions “A-A” and “Overall A/P” for conventional prostheses (“Conventional 3”, “Conventional 4”, and “Conventional 5” including five increasing sizes C through G) are compared with corresponding dimensions of a set of prostheses designed in accordance with the present invention (“Embodiment 3”, “Embodiment 4”, and “Embodiment 5” including five increasing sizes C through G). In one embodiment, the values for Conventional 5 and Embodiment 5 may be average values of Conventionals 3 and 4 and Embodiments 3 and 4, respectively. These values are presented in Table 8 below.
Table 9 below sets forth the results of a first order equation fit to the data sets shown in
From the data in Table 9, it may be seen that there is a difference in the slopes of the sets of prostheses of Embodiments 3, 4, and 5 as compared to the slopes of the sets of the known prostheses. In particular, it may be seen from the data in Table 9 that the sets of prostheses of Embodiments 3, 4, and 5 have a narrowing A-A M/L dimension with increasing A/P size, as indicated by slopes less than approximately 0.46, except for Competitive 5, for example, as opposed to a substantially parallel or one-to-one relationship between the posterior M/L dimension and the A/P dimension with increasing A/P size as in the sets of known prostheses, as indicated by slopes greater than or equal 0.46. In an exemplary embodiment, the slope of A-A M/L dimension with increasing A/P size for prostheses 50 is approximately 0.30.
As set forth in Table 10 below, the Overall A/P dimensions and the ratios of the dimension “A-A” vs. “Overall A/P” are given for Embodiments 3, 4, and 5 as well as for conventional prostheses Conventional 3, 4, and 5.
Table 11 below sets forth the results of a first order equation fit to the data sets shown in
From the data in Table 11 it may be seen that there is a difference in the slopes of the sets of prostheses of Embodiments 3, 4, and 5 as compared to the slopes of the sets of the known prostheses. In particular, it may be seen from the data in Table 7 that the sets of prostheses of Embodiments 3, 4, and 5 have a narrowing A-A M/L dimension with increasing A/P size, as indicated by the slope of the ratio (A-A M/L/overall A/P) vs. overall A/P being less than −0.0049, for the sets of prostheses of Embodiments 3, 4, and 5 while the corresponding slope for the known sets of prostheses is greater than or equal to −0.0049, except for the Competitive 5 prosthesis, indicating that the sets of prostheses of Embodiments 3, 4, and 5 have an increasingly more pronounced narrowing of the A-A M/L dimension with increasing A/P size. In this manner, the sets of prostheses designed in accordance with the present invention offer a surgeon a unique combination of implant A-A M/L widths with varying A/P size for an overall system or set of prostheses, wherein such sets of prostheses are more anatomically optimized for the female anatomy as compared with the sets of known prostheses.
Referring again to
Referring again to
Another way of characterizing the design of the present prostheses is by distal taper angle, “DT”. As used herein and referring to
As may be seen from the data in Table 12, the ratio between distal taper angle and overall A/P of the prostheses of Embodiments 3-5 differs from the known prostheses. In particular, the foregoing data indicates that prostheses of Embodiments 3-5 have a more pronounced and consistent increase in distal taper angle with increasing A/P size, as evidenced by a slope of greater than 0.20. Additionally, as may be seen from
As shown in
Referring again to
Referring again to
Referring to
Referring again to
Referring again to
Referring again to
Referring again to
Referring again to
Referring again to
Referring again to
Referring again to Table 5, Embodiments 3-5 have slopes of Posterior M/L dimension with increasing A/P size which are less than 0.98. Prostheses 50 may have slope values for the Posterior M/L dimension with increasing A/P size which may be as small as approximately 0.50, 0.55, 0.60, or 0.65 or as large as approximately 0.96, 0.95, 0.94, 0.91, 0.88, 0.85, 0.84, 0.83, 0.81, 0.80, 0.75, or 0.70. In contrast, all other standard aspect ratio prostheses have slopes of Posterior M/L dimension with increasing A/P size which are greater than or equal to 0.98.
Referring still to Table 5, Embodiments 3-5 have slopes of MB M/L dimension with increasing A/P size which are less than 0.91. Prostheses 50 may have slope values for the MB M/L dimension with increasing A/P size which may be as small as approximately 0.40, 0.45, 0.50, 0.55, or 0.57 or as large as approximately 0.90, 0.89, 0.87, 0.84, 0.81, 0.79, 0.76, 0.75, 0.74, 0.73, 0.72, 0.71, 0.70, 0.65, or 0.60. In contrast, all other standard aspect ratio prostheses have slopes of MB M/L dimension with increasing A/P size which are greater than or equal to 0.91.
Referring again to Table 5, Embodiments 3-5 have slopes of B-B M/L dimension with increasing A/P size which are less than 0.80. Prostheses 50 may have slope values for the B-B M/L dimension with increasing A/P size which may be as small as approximately 0.30, 0.35, 0.40, or 0.45 or as large as 0.79, 0.78, 0.77, 0.76, 0.75, 0.74, 0.72, 0.70, 0.65, 0.60, or 0.50. In contrast, all other standard aspect ratio prostheses have slopes of B-B M/L dimension with increasing A/P size which are greater than or equal to 0.80.
Referring to Table 9, Embodiments 3-5 have slopes of A-A M/L dimension with increasing A/P size which are less than 0.46. Prostheses 50 may have slope values for the A-A M/L dimension with increasing A/P size which may be as small as 0.15, 0.20, 0.25, or 0.30 or as large as 0.45, 0.44, 0.42, 0.40, 0.37, 0.34, or 0.31. In contrast, all other standard aspect ratio prostheses have slopes of A-A M/L dimension with increasing A/P size which are greater than or equal to 0.46.
Referring to Table 7, Embodiments 3-5 have slopes for the ratios of Posterior M/L/Overall A/P vs. Overall A/P with increasing A/P size which are less than −0.0020. Prostheses 50 may have slope values for the ratios of Posterior M/L/Overall A/P vs. Overall A/P with increasing A/P size which may be as small as −0.0060, −0.0055, −0.0050, −0.0045, −0.0040 or as large as −0.0021, −0.0022, −0.0025, −0.0030, or −0.0035. In contrast, all other standard aspect ratio prostheses have slopes for the ratios of Posterior M/L/Overall A/P vs. Overall A/P with increasing A/P size which are greater than or equal to −0.0020.
Referring again to Table 7, Embodiments 3-5 have slopes for the ratios of MB M/L/Overall A/P vs. Overall A/P with increasing A/P size which are less than −0.0023. Prostheses 50 may have slope values for the ratios of MB M/L/Overall A/P vs. Overall A/P with increasing A/P size which may be as small as −0.0075, −0.0072, −0.0069, −0.0066, or −0.0063 or as large as −0.0022, −0.0025, −0.0030, −0.0035, −0.0040, −0.0045, −0.0050, −0.0055, or −0.0060. In contrast, all other standard aspect ratio prostheses have slopes for the ratios of MB M/L/Overall A/P vs. Overall A/P with increasing A/P size which are greater than or equal to −0.0023.
Referring again to Table 7, Embodiments 3-5 have slopes for the ratios of B-B M/L/Overall A/P vs. Overall A/P with increasing A/P size which are less than −0.0032. Prostheses 50 may have slope values for the ratios of B-B M/L/Overall A/P vs. Overall A/P with increasing A/P size which may be as small as −0.0085, −0.0080, −0.0075, or −0.0070 or as large as −0.0031, −0.0032, −0.0034, −0.0037, −0.0040, −0.0045, −0.0050, −0.0055, −0.0060, or −0.0065. In an exemplary embodiment, the slope value for the ratio of B-B M/L/Overall A/P vs. Overall A/P with increasing A/P size is approximately −0.0069. In another exemplary embodiment, the slope value for the ratio of B-B M/L/Overall A/P vs. Overall A/P with increasing A/P size is approximately −0.0068. In yet another exemplary embodiment, the slope value for the ratio of B-B M/L/Overall A/P vs. Overall A/P with increasing A/P size is approximately −0.0071. In contrast, all other prostheses have slopes for the ratios of B-B M/L/Overall A/P vs. Overall A/P with increasing A/P size which are greater than or equal to −0.0032.
Referring again to Table 11, Embodiments 3-5 have slopes for the ratios of A-A M/L/Overall A/P vs. Overall A/P with increasing A/P size which are less than −0.0049. Prostheses 50 may have slope values for the ratios of A-A M/L/Overall A/P vs. Overall A/P with increasing A/P size which may be as small as −0.0080, −0.0075, −0.0070, or −0.0065 or as large as −0.0050, −0.0051, −0.0053, −0.0055, or −0.0060. In contrast, all other standard aspect ratio prostheses have slopes for the ratios of A-A M/L/Overall A/P vs. Overall A/P with increasing A/P size which are greater than or equal to −0.0049.
In accordance with another aspect of the present invention, the prosthesis 50 includes a recessed or reduced profile patellar sulcus as well as a thinned or reduced profile anterior flange condyles in comparison with known prostheses to alleviate the potential for the thicknesses of the patellar sulcus and the anterior flange condyles to be greater than the thickness of the femoral bone which is resected during the TKR/TKA procedure.
Referring to
Referring to
In Table 13 below, dimensions D1 and D2 described above are shown in accordance with a set of prostheses 50 (Embodiment 5) compared to a known set of prostheses (Conventional 5), as well as the differences between dimensions D1 and D2 of the present prosthesis and known prosthesis. Unless otherwise indicated, all numerical dimensional values presented herein are in millimeters (“mm”).
As may be seen from Table 13, the sulcus and condyle thicknesses D1 and D2 respectively, of prostheses of Embodiment 5 are considerably reduced as compared to the known prostheses (Conventional 5). In particular, the sulcus thickness D1 of an exemplary embodiment may range from about 2.5 mm to 3.2 mm and the condyle thickness D2 may range from about 5.0 mm to 6.4 mm. In exemplary embodiments, the sulcus thickness D1 of prostheses 50 may be as small as approximately 2.5, 2.6, 2.7, or 2.8 mm or as large as approximately 3.2, 3.1, 3.0, or 2.9 mm. In exemplary embodiments, the condyle thickness D2 of prostheses 50 may be as small as approximately 4.0, 4.3, 4.7, 5.0, 5.2, 5.4, or 5.6 mm or as large as approximately 6.4, 6.2, 6.1, 6.0, or 5.8 mm. As such, in an example, a ratio of the maximum condylar thickness D2 to the maximum sulcus thickness D1 can be in the range of 1.92:1 to 2.12:1, as is evident from Table 13. In another example, the maximum thickness D2 of the condyle is 1.92 to 2.12 times greater than the maximum thickness D1 of the sulcus, as is evident from Table 13. In yet another example, the maximum patellar sulcus thickness D1 of Embodiment 5 is less than the maximum patellar sulcus thickness D1 of Conventional 5 by 23.8 percent to 30.6 percent and the maximum condylar thickness D2 of Embodiment 5 is less than the maximum condylar thickness D2 of Conventional 5 by 12.3 percent to 19.4 percent, as is evident from Table 13.
The present prostheses further include a modified patellar sulcus tracking to further optimize conformance of the prostheses with female anatomy. The Q-angle (“quadriceps angle”) is formed in the frontal plane by a pair of line segments, one extending from the tibial tubercle to the middle of the patella and the other extending from the middle of the patella to the anterior superior iliac spine (ASIS). In adults, the Q-angle is typically 14° for males and 17° for females, wherein the Q-angle for females is approximately 3° more lateral than that of males. Responsive to this observation, and as described in detail below, the end point of the patellar sulcus 70 of prostheses 50 is shifted 3° laterally with respect to known prostheses, i.e., in an exemplary embodiment, lateralization angle 108 is approximately 7° in
As may be seen from Table 14, the lateralization distance of prostheses 50 is increased with respect to known prostheses to optimize patella tracking with the prostheses to more closely conform to female anatomy. In an exemplary embodiment, the lateralization distance is greater than 5.0 mm. In an exemplary embodiment, the lateralization distance for prostheses 50 may be as small as approximately 5.0, 5.3, 5.6, or 5.9 mm or as large as approximately 7.0, 6.7, 6.4, or 6.1 mm.
While this invention has been described as having exemplary designs, the present invention can be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains and which fall within the limits of the appended claims.
This application claims the benefit under Title 35, U.S.C. §119(e) of U.S. Provisional Patent Application Ser. No. 60/750,613, entitled Distal Femoral Knee Prostheses, filed Dec. 15, 2005, and U.S. Provisional Patent Application Ser. No. 60/805,933, entitled Distal Femoral Knee Prostheses, filed Jun. 27, 2006, the disclosures of which are each hereby expressly incorporated herein by reference.
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Number | Date | Country | |
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20070260323 A1 | Nov 2007 | US |
Number | Date | Country | |
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60750613 | Dec 2005 | US | |
60805933 | Jun 2006 | US |