Multiple-cam, posterior-stabilized knee prosthesis

Description

FIELD OF THE INVENTION

This invention relates generally to orthopedic surgery and, in particular, to a posterior stabilized knee prosthesis.

BACKGROUND OF THE INVENTION

In total knee-replacement (TKR) surgery, there are four broad classes of implants used for resurfacing of the distal femur. In one configuration, the posterior cruciate ligament is retained. In another design the ligament is sacrificed, relying on the articular geometry to provide stability. The third type of device is constrained, in the sense that an actual linkage is used between the femoral and tibial components. According to a fourth arrangement, the posterior cruciate is replaced with a cam on the femoral component and a post on the tibial component.

Many patents have been issued in relation to these design configurations, including the cam-and-post design configuration. Some of the earlier patents in this area include U.S. Pat. No. 4,213,209 to Insall et al; U.S. Pat. No. 4,298,992 to Burstein et al.

Other patents include U.S. Pat. No. 4,888,021 to Forte et al., which teaches a cam-and-post mechanism as well as a linking mechanism. Essentially, each component includes a varying surface and a cam member, so that both the tibial and the femoral component have separate and distinct cams that cooperate with a single tibial post.

U.S. Pat. No. 5,824,100 to Kester et al. discloses a cam/post type of arrangement with a unique type of cam and box enclosure. A portion of the box enclosure is intended to prevent hyperextension and posterior translation. As noted in particular in FIGS. 3 and 4 of the '100 patent, a large space exists between the cam 110 and the post 100 which permits a translation to occur prior to engagement of the cam left of post.

U.S. Pat. No. 5,997,577 to Herrington et al. provides a cam on the femur with a geometry meant to contact the post through a large range of motion. This design attempts to provide the function of multiple cams by providing an area that acts as a separate bearing surface. As such, the cam effectively moves through a range of motion while contacting the post. Depending on the articular geometry which differs than the geometry of the cam post mechanism, this could lead to a variety of problems as well as significantly constrained motion, either between the cam and the post or between the two articulating surfaces.

U.S. Pat. No. 5,658,342 to Draganich et al. describes a cam member with including a bearing surface at complimenting an articulating surface. As in other previous designs, this represents a complex cam geometry meant to capture the post in certain degrees of the range of motion.

U.S. Pat. No. 5,147,405 to Van Zyle et al. Discloses a femoral component with two distinct cam structures, one located at point 44, the other located at 46 in the drawings. The cam member 44 is meant to contact the anterior surface of the post 24 to prevent hyperextension, while cam surface 46 is a posterior located cam meant to have contact throughout the range of flexion. As noted in FIG. 6A of the '405 patent, there is a space between the cam and the post when the knee is in extension, necessitating anterior translation of the femur on the tibia prior to contacting the posterior cam.

Many other patents directed to knee-replacement surgery include cam-and-post mechanisms. But in all cases, either the full range of joint motion is precluded, or translation is allowed to occur which could lead to premature wear. FIG. 1 is a drawing which illustrates a typical prior-art cam-and-post mechanism. Item 102 is a tibial insert or tibial component having a post 103 protruding into a box-like recess of the femoral component 100. FIG. 1A shows the system in extension, whereas FIG. 1B shows the system in flexion. In FIG. 1A, a femoral component 100 includes a cam 101 which has not yet engaged with a post 103.

In FIG. 1B, following a considerable amount of flexion, the cam 101 finally engages with the post 103. Until engagement occurs, however, the component 100 may be permitted to slide relative to the tibial insert. The need remains, therefore, for an improved distal femoral prosthesis having multiple distinct cams contacting a post on its posterior surface to provide more normal range of motion for cruciate substituting knee replacement.

SUMMARY OF THE INVENTION

The present invention resides in a distal femoral knee-replacement component configured for use in a cruciate-substituting situation involving a tibial component having a bearing surface and a superior post with a posterior aspect. As with existing configurations, the component is comprised of a body having a pair of medial and lateral condylar protrusions and an intercondylar region therebetween dimensioned to receive the tibial post. In contrast to prior-art devices, however, the inventive component provides additional points of cam action to facilitate a more normal range of knee motion.

In the preferred embodiment, the invention facilitates a more normal rollback while inhibiting initial translation which could lead to increased wear and sub-optimal patella femoral mechanics. To accomplish this goal, the inventive component includes a distinct point of cam action to prevent early translation at the initiation of flexion, and a distinct point of cam action to prevent a dislocation of the femoral component over the tibial post which is known to occur in cruciate-substituting designs. According to the invention, these points of cam action may be used separately or in combination.

In the preferred embodiment, the component includes three distinct points of cam action. The first is preferably located substantially where existing cams are found, namely, at a point spaced apart a slight distance posteriorly relative to the post in full extension. According to the invention, however, a second point of cam action is located immediately adjacent the posterior aspect of the superior post to minimize and, ideally, prevent anterior translation at the initiation of flexion. The third point of cam action is preferably located more posteriorly to allow enhanced flexion without a dislocation of the knee.

In terms of structure, the points of cam action may be implemented using any member or combination of elements operative to provide distinct stages of cooperation with the posterior aspect of the superior post. For example, transverse bars may be used which bridge, or partially bridge, the intercondylar space. The members or elements need not be straight across, but may instead be curved, with the post being curved to allow for a rotation, if so desired. The cam structures according to the invention may also be connected to one another forming points of contact as opposed to complete transverse elements such as distinct bars.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1A is a drawing which illustrates a prior-art cam-and-post mechanism in extension;

FIG. 1B is a drawing which illustrates the prior-art cam-and-post mechanism of FIG. 1B in flexion;

FIG. 2A illustrates a preferred embodiment of the invention in extension;

FIG. 2B shows the system of FIG. 2A at 90 degrees flexion;

FIG. 2C illustrates the system of FIG. 2A in flexion at 120 degrees or more;

FIG. 2D illustrates the alternative use of interconnected cams with physically separate contact points;

FIG. 2E illustrates the distal femoral component of FIG. 2D and the post configuration of FIG. 6A at full extension;

FIG. 2F shows the distal femoral component of FIG. 2D and the post configuration of FIG. 6A at 90 degrees of flexion;

FIG. 2G illustrates the distal femoral component of FIG. 2D and the post configuration of FIG. 6A in flexion beyond 90 degrees;

FIG. 2H shows a degree of hyperflexion wherein the extended cam in FIG. 2D first makes contact with the posterior surface of the post;

FIG. 3 shows an anterior view of a prior-art cruciate-substituting knee-replacement component;

FIG. 4 shows a knee prosthesis according to the invention having multiple cams as seen in a distal-to-proximal view;

FIG. 5 is a drawing which shows how cam-acting members according to the invention need not be straight across, but may be curved in conjunction with a curved post to facilitate rotation; and

FIGS. 6A through 6E illustrate various alternative post configurations, all of which are applicable to the invention.

DETAILED DESCRIPTION OF THE INVENTION

FIGS. 2A through 2C illustrate one embodiment of the invention. FIG. 2A shows the configuration in extension, FIG. 2B shows the system at 90 degrees flexion, and FIG. 2C illustrates flexion of 120 degrees or more. In addition to a conventionally placed cam at 101, two additional points of cam action are preferably provided. In particular, a feature at 201 acts to prevent translation from extension into the initiation of the flexion. Feature 201 preferably disengages as conventional cam 101 is engaged. As the knee follows through a range of motion to 90° of flexion, and beyond, cam 101 disengages and feature 202 engages, if necessary, to prevent dislocation of the component.

In FIG. 2B, the cam which is usually present at 101 is engaging the tibial post, cam 201 has disengaged, and cam 202 has not yet engaged but is available for engagement on further flexion. In FIG. 2C, cam 202 is now engaged the post in the presence of additional flexion. Cam 101 can now disengage, cam 201 had disengaged earlier. FIG. 2D illustrates the alternative use of interconnected cams with physically separate contact points.

In FIGS. 2A through 4, the features depicted to provide the various stages of cam/pivoting function are depicted as bars which cross the intercondylar recess or box portion of a cruciate substituting design knee. However, although the terms “cam” or “bar” are used to reference the stages of cam action, it should be understood that the responsible structures may be implemented using any member or combination of elements operative to provide distinct stages of cooperation with the posterior aspect of the superior post. Thus, the members or elements need not be complete or straight across, but may instead be curved, with the post being curved to allow for a rotation, if so desired. The cam structures according to the invention may also be connected to one another forming points of contact as opposed to complete transverse elements. The structure may be provided as part of an open- or closed-type of a box structure, both being familiar to those of skill in the art.

Whereas FIGS. 1 and 2 represent lateral or side views of a knee through various ranges of motion, FIG. 3 shows an anterior view of a prior-art cruciate substituting knee component at 300 having an open-type box 302 including a single transverse member 301 for illustrative purposes. FIG. 4 shows a knee prosthesis 400 according to the invention, viewed again from the distal-to-proximal perspective, having three distinct points of cam action. In particular, cam 401 is conventionally located, an anterior cam is disposed at 402 in support of a greater range of enhanced flexion, and a more posterior cam at 403 is used primarily to prevent dislocation of the cams over the post, as discussed above.

FIG. 5 is a drawing which shows various cams from a top view looking down. Note that bars of need not be straight across, but may be curved with the post being curved so that it allows for a rotation to occur if desired. The cam structures according to the invention may be individual distinct bars or may be connected to one another forming points of contact as opposed to distinct structures themselves. It should also be noted that the cam structures may be located at different locations from the posterior to the anterior aspect of the knee design, as well as from the distal or proximal, depending upon implant size, patient physiology, desired range of motion, and other requirements. It should further be noted that as opposed to using three separate cams, one could use two cams intended to contact the posterior aspect of the post or for that matter, use more than three if desired.

It will also be apparent to one of skill in the art that the posterior aspect of the post may be modified to affect the timing and/or operation of the cam engagement. FIGS. 6A through 6E illustrate various alternative post configurations, all of which are applicable to the invention. As opposed to a substantially straight configuration, as depicted in FIG. 6A, the post may be posteriorly oriented along the posterior aspect, as shown in FIG. 6B. Alternatively, the post may be anteriorly oriented along the posterior aspect, as shown in FIG. 6C. As further alternatives, the post may be stepped, as shown in FIG. 6D, or curved, as shown in FIG. 6E. Also, as opposed to the sharp corners shown, they may be rounded off, and the bars or recesses may be adjusted from the positions shown in FIG. 2 through 5 to achieve a desired operation.

Claims

1. A total knee replacement system comprising: a distal femoral knee-replacement component and a tibial component having a bearing surface and a tibial post with a posterior surface, wherein the distal femoral knee-replacement component comprises:a body having a pair of medial and lateral condylar protrusions and an intercondylar region therebetween dimensioned to receive the tibial post, the body further having a cam mechanism bridging the intercondylar region, the cam mechanism having at least a first, second and third cam surface areas, with each of the first, second and third cam surface areas having a convex shape in a sagittal plane with different centers of radius;the first convex cam surface area engaged with the posterior surface of the tibial post at approximately ninety degrees of flexion;the second convex cam surface area being located anterior to the first cam surface area, when the knee is in extension and positioned posterior of the tibial post; andthe third convex cam surface area being located posterior to the first cam surface area, when the knee is in extension, and engaging the posterior surface of the tibial post after ninety degrees of flexion;wherein none of the first, second and third cam surface areas engage the posterior surface of the tibial post when the knee is in extension; andwherein the cam mechanism includes at least one concave cam surface area in the sagittal plane between at least two of the three convex cam surface areas.
2. The total knee replacement system of claim 1, wherein a portion of the cam mechanism between at least two of the first, second and third cam surface areas does not make contact with the posterior surface of the tibial post during flexion of the knee.
3. The total knee replacement system of claim 1, wherein at least a portion of the third cam surface area is more proximal than the second cam surface area when the knee is in extension.
4. The total knee replacement system of claim 1, wherein at least a portion of the cam mechanism on the distal femoral knee-replacement component is concave in a transverse plane.
5. The total knee replacement system of claim 1, wherein at least a portion of the tibial post is convex in a transverse plane.
6. The total knee replacement system of claim 1, wherein at least a portion of the first cam surface area, having a convex cam surface area in the sagittal plane, and a concave cam surface area in the sagittal plane, create a region of cam surface with an s-shaped profile in the sagittal plane.

REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 14/276,407, filed May 13, 2014, now U.S. Pat. No. 9,492,280, which is a continuation of U.S. patent application Ser. No. 12/337,280, filed Dec. 17, 2008, now U.S. Pat. No. 8,721,730, which is a continuation of U.S. patent application Ser. No. 10/430,548, filed May 6, 2003, now U.S. Pat. No. 8,273,132, which is a divisional of U.S. patent application Ser. No. 09/724,100, filed Nov. 28, 2000, now U.S. Pat. No. 6,558,426, the content of all of which are incorporated herein in their entirety by reference.

US Referenced Citations (378)

Number	Name	Date	Kind
3765033	Goldberg et al.	Oct 1973	A
3840905	Deane	Oct 1974	A
3852045	Wheeler et al.	Dec 1974	A
3855638	Pilliar	Dec 1974	A
3869731	Waugh et al.	Mar 1975	A
4081866	Upshaw et al.	Apr 1978	A
4156943	Collier	Jun 1979	A
4206516	Pilliar	Jun 1980	A
4209861	Walker et al.	Jul 1980	A
4213209	Insall et al.	Jul 1980	A
4215439	Gold et al.	Aug 1980	A
4249270	Bahler et al.	Feb 1981	A
4257129	Volz	Mar 1981	A
4262368	Lacey	Apr 1981	A
4298992	Burstein et al.	Nov 1981	A
4340978	Buechel et al.	Jul 1982	A
4470158	Pappas et al.	Sep 1984	A
4612160	Donlevy et al.	Sep 1986	A
4650490	Figgie, III	Mar 1987	A
4673407	Martin	Jun 1987	A
4714474	Brooks, Jr. et al.	Dec 1987	A
4795468	Hodorek et al.	Jan 1989	A
4808185	Penenberg et al.	Feb 1989	A
4822362	Walker et al.	Apr 1989	A
4838891	Branemark et al.	Jun 1989	A
4888021	Forte et al.	Dec 1989	A
4892547	Brown	Jan 1990	A
4936847	Manginelli	Jun 1990	A
4936853	Fabian et al.	Jun 1990	A
4938769	Shaw	Jul 1990	A
4944757	Martinez et al.	Jul 1990	A
4944760	Kenna	Jul 1990	A
4950298	Gustilo et al.	Aug 1990	A
4959071	Brown et al.	Sep 1990	A
4963152	Hofmann et al.	Oct 1990	A
4990163	Ducheyne et al.	Feb 1991	A
5007932	Bekki et al.	Apr 1991	A
5007933	Sidebotham et al.	Apr 1991	A
5011496	Forte et al.	Apr 1991	A
5019103	Van Zile et al.	May 1991	A
5037423	Kenna	Aug 1991	A
5071438	Jones et al.	Dec 1991	A
5080675	Lawes et al.	Jan 1992	A
5104410	Chowdhary	Apr 1992	A
5108442	Smith	Apr 1992	A
5116375	Hofmann	May 1992	A
5133758	Hollister	Jul 1992	A
5133759	Turner	Jul 1992	A
5147405	Van Zile et al.	Sep 1992	A
5147406	Houston et al.	Sep 1992	A
5152797	Luckman et al.	Oct 1992	A
5171283	Pappas et al.	Dec 1992	A
5201766	Georgette	Apr 1993	A
5219362	Tuke et al.	Jun 1993	A
5236461	Forte	Aug 1993	A
5251468	Lin et al.	Oct 1993	A
5258044	Lee	Nov 1993	A
5271737	Baldwin et al.	Dec 1993	A
5282861	Kaplan	Feb 1994	A
5308556	Bagley	May 1994	A
5309639	Lee	May 1994	A
5326361	Hollister	Jul 1994	A
5330533	Walker et al.	Jul 1994	A
5330534	Herrington et al.	Jul 1994	A
5344460	Turanyi et al.	Sep 1994	A
5344461	Phlipot	Sep 1994	A
5344494	Davidson et al.	Sep 1994	A
5358527	Forte	Oct 1994	A
5368881	Kelman et al.	Nov 1994	A
5370699	Hood et al.	Dec 1994	A
5387240	Pottenger et al.	Feb 1995	A
5395401	Bahler	Mar 1995	A
5405396	Heldreth et al.	Apr 1995	A
5413604	Hodge	May 1995	A
5414049	Sun et al.	May 1995	A
5449745	Sun et al.	Sep 1995	A
5458637	Hayes	Oct 1995	A
5480445	Burkinshaw	Jan 1996	A
5480446	Goodfellow et al.	Jan 1996	A
5543471	Sun et al.	Aug 1996	A
5549686	Johnson et al.	Aug 1996	A
5549687	Coates et al.	Aug 1996	A
D374078	Johnson et al.	Sep 1996	S
5554158	Vinciguerra et al.	Sep 1996	A
5571187	Devanathan	Nov 1996	A
5571194	Gabriel	Nov 1996	A
5609639	Walker et al.	Mar 1997	A
5609643	Colleran et al.	Mar 1997	A
5639279	Burkinshaw et al.	Jun 1997	A
5650485	Sun et al.	Jul 1997	A
5658333	Kelman et al.	Aug 1997	A
5658342	Draganich et al.	Aug 1997	A
5658344	Hurlburt	Aug 1997	A
5681354	Eckhoff	Oct 1997	A
5683468	Pappas	Nov 1997	A
5702458	Burstein et al.	Dec 1997	A
5702463	Pothier et al.	Dec 1997	A
5702464	Lackey et al.	Dec 1997	A
5702466	Pappas et al.	Dec 1997	A
5728748	Sun et al.	Mar 1998	A
5732469	Hamamoto et al.	Mar 1998	A
5755800	O'Neil et al.	May 1998	A
5755801	Walker et al.	May 1998	A
5755803	Haines et al.	May 1998	A
5765095	Flak et al.	Jun 1998	A
5766257	Goodman et al.	Jun 1998	A
5776201	Colleran et al.	Jul 1998	A
5800552	Forte	Sep 1998	A
5811543	Hao et al.	Sep 1998	A
5824100	Kester et al.	Oct 1998	A
5824102	Buscayret	Oct 1998	A
5824103	Williams	Oct 1998	A
5871543	Hofmann	Feb 1999	A
5871545	Goodfellow et al.	Feb 1999	A
5871546	Colleran et al.	Feb 1999	A
5879392	McMinn et al.	Mar 1999	A
5879394	Ashby et al.	Mar 1999	A
5879400	Merrill et al.	Mar 1999	A
5906644	Powell	May 1999	A
5935173	Roger et al.	Aug 1999	A
5951603	O'Neil et al.	Sep 1999	A
5957979	Beckman et al.	Sep 1999	A
5964808	Blaha et al.	Oct 1999	A
5976147	LaSalle et al.	Nov 1999	A
5984969	Matthews et al.	Nov 1999	A
5989027	Wagner et al.	Nov 1999	A
5997577	Herrington et al.	Dec 1999	A
6004351	Tomita et al.	Dec 1999	A
6005018	Cicierega et al.	Dec 1999	A
6010534	O'Neil et al.	Jan 2000	A
6013103	Kaufman et al.	Jan 2000	A
6017975	Saum et al.	Jan 2000	A
6039764	Pottenger et al.	Mar 2000	A
6042780	Huang	Mar 2000	A
6053945	O'Neil et al.	Apr 2000	A
6059949	Gal-Or et al.	May 2000	A
6068658	Insall et al.	May 2000	A
6080195	Colleran et al.	Jun 2000	A
6090144	Letot et al.	Jul 2000	A
6123728	Brosnahan et al.	Sep 2000	A
6123729	Insall et al.	Sep 2000	A
6123896	Meeks, III et al.	Sep 2000	A
6126692	Robie et al.	Oct 2000	A
6135857	Shaw et al.	Oct 2000	A
6139581	Engh et al.	Oct 2000	A
6152960	Pappas	Nov 2000	A
6162254	Timoteo	Dec 2000	A
6174934	Sun et al.	Jan 2001	B1
6206926	Pappas	Mar 2001	B1
6210444	Webster et al.	Apr 2001	B1
6210445	Zawadzki	Apr 2001	B1
6217618	Hileman	Apr 2001	B1
6228900	Shen et al.	May 2001	B1
6238434	Pappas	May 2001	B1
6242507	Saum et al.	Jun 2001	B1
6245276	McNulty et al.	Jun 2001	B1
6258127	Schmotzer	Jul 2001	B1
6264697	Walker	Jul 2001	B1
6280476	Metzger et al.	Aug 2001	B1
6281264	Salovey et al.	Aug 2001	B1
6299646	Chambat et al.	Oct 2001	B1
6316158	Saum et al.	Nov 2001	B1
6319283	Insall et al.	Nov 2001	B1
6325828	Dennis et al.	Dec 2001	B1
6344059	Krakovits et al.	Feb 2002	B1
6361564	Marceaux et al.	Mar 2002	B1
6372814	Sun et al.	Apr 2002	B1
6379388	Ensign et al.	Apr 2002	B1
6428577	Evans et al.	Aug 2002	B1
6443991	Running	Sep 2002	B1
6475241	Pappas	Nov 2002	B2
6485519	Meyers et al.	Nov 2002	B2
6491726	Pappas	Dec 2002	B2
6494914	Brown et al.	Dec 2002	B2
6503280	Repicci	Jan 2003	B2
6506215	Letot et al.	Jan 2003	B1
6506216	McCue et al.	Jan 2003	B1
6524522	Vaidyanathan et al.	Feb 2003	B2
6540787	Biegun et al.	Apr 2003	B2
6558426	Masini	May 2003	B1
6569202	Whiteside	May 2003	B2
6582469	Tornier	Jun 2003	B1
6582470	Lee et al.	Jun 2003	B1
6589283	Metzger et al.	Jul 2003	B1
6592787	Pickrell et al.	Jul 2003	B2
6620198	Burstein et al.	Sep 2003	B2
6623526	Lloyd	Sep 2003	B1
6645251	Salehi et al.	Nov 2003	B2
6660039	Evans et al.	Dec 2003	B1
6660224	Lefebvre et al.	Dec 2003	B2
6664308	Sun et al.	Dec 2003	B2
6702821	Bonutti	Mar 2004	B2
6719800	Meyers et al.	Apr 2004	B2
6726724	Repicci	Apr 2004	B2
6730128	Burstein	May 2004	B2
6764516	Pappas	Jul 2004	B2
6770078	Bonutti	Aug 2004	B2
6770099	Andriacchi et al.	Aug 2004	B2
6773461	Meyers et al.	Aug 2004	B2
6797005	Pappas	Sep 2004	B2
6818020	Sun et al.	Nov 2004	B2
6846327	Khandkar et al.	Jan 2005	B2
6846329	McMinn	Jan 2005	B2
6849230	Feichtinger	Feb 2005	B1
6852272	Artz et al.	Feb 2005	B2
6869448	Tuke et al.	Mar 2005	B2
6893388	Reising et al.	May 2005	B2
6893467	Bercovy	May 2005	B1
6916340	Metzger et al.	Jul 2005	B2
6923832	Sharkey et al.	Aug 2005	B1
6926738	Wyss	Aug 2005	B2
6942670	Heldreth et al.	Sep 2005	B2
6972039	Metzger et al.	Dec 2005	B2
6986791	Metzger	Jan 2006	B1
7025788	Metzger et al.	Apr 2006	B2
7048741	Swanson	May 2006	B2
7066963	Naegerl	Jun 2006	B2
7070622	Brown et al.	Jul 2006	B1
7081137	Servidio	Jul 2006	B1
7094259	Tarabichi	Aug 2006	B2
7101401	Brack	Sep 2006	B2
7104996	Bonutti	Sep 2006	B2
7105027	Lipman et al.	Sep 2006	B2
7147819	Bram et al.	Dec 2006	B2
7160330	Axelson, Jr. et al.	Jan 2007	B2
7175665	German et al.	Feb 2007	B2
7255715	Metzger	Aug 2007	B2
7261740	Tuttle et al.	Aug 2007	B2
7297164	Johnson et al.	Nov 2007	B2
7326252	Otto et al.	Feb 2008	B2
7341602	Fell et al.	Mar 2008	B2
7344460	Gait	Mar 2008	B2
7357817	D'Alessio, II	Apr 2008	B2
7422605	Burstein et al.	Sep 2008	B2
7510557	Bonutti	Mar 2009	B1
7527650	Johnson et al.	May 2009	B2
7572292	Crabtree et al.	Aug 2009	B2
7578850	Kuczynski et al.	Aug 2009	B2
7608079	Blackwell et al.	Oct 2009	B1
7611519	Lefevre et al.	Nov 2009	B2
7615054	Bonutti	Nov 2009	B1
7618462	Ek	Nov 2009	B2
7628818	Hazebrouck et al.	Dec 2009	B2
7635390	Bonutti	Dec 2009	B1
7658767	Wyss	Feb 2010	B2
7678151	Ek	Mar 2010	B2
7678152	Suguro et al.	Mar 2010	B2
7708740	Bonutti	May 2010	B1
7708741	Bonutti	May 2010	B1
7740662	Barnett et al.	Jun 2010	B2
7749229	Bonutti	Jul 2010	B1
7753960	Cipolletti et al.	Jul 2010	B2
7771484	Campbell	Aug 2010	B2
7776044	Pendleton et al.	Aug 2010	B2
7806896	Bonutti	Oct 2010	B1
7806897	Bonutti	Oct 2010	B1
7837736	Bonutti	Nov 2010	B2
7842093	Peters et al.	Nov 2010	B2
7875081	Lipman et al.	Jan 2011	B2
7922771	Otto et al.	Apr 2011	B2
8273132	Masini	Sep 2012	B2
8721730	Masini	May 2014	B2
9492280	Masini	Nov 2016	B2
20030009232	Metzger et al.	Jan 2003	A1
20030035747	Anderson et al.	Feb 2003	A1
20030044301	Lefebvre et al.	Mar 2003	A1
20030075013	Grohowski	Apr 2003	A1
20030139817	Tuke et al.	Jul 2003	A1
20030153981	Wang et al.	Aug 2003	A1
20030171820	Wilshaw et al.	Sep 2003	A1
20030199985	Masini	Oct 2003	A1
20030212161	McKellop et al.	Nov 2003	A1
20030225456	Ek	Dec 2003	A1
20040015770	Kimoto	Jan 2004	A1
20040039450	Griner et al.	Feb 2004	A1
20040167633	Wen et al.	Aug 2004	A1
20040186583	Keller	Sep 2004	A1
20040215345	Perrone et al.	Oct 2004	A1
20040243244	Otto et al.	Dec 2004	A1
20040243245	Plumet et al.	Dec 2004	A1
20050021147	Tarabichi	Jan 2005	A1
20050055102	Tornier et al.	Mar 2005	A1
20050059750	Sun et al.	Mar 2005	A1
20050069629	Becker et al.	Mar 2005	A1
20050096747	Tuttle et al.	May 2005	A1
20050100578	Schmid et al.	May 2005	A1
20050123672	Justin et al.	Jun 2005	A1
20050143832	Carson	Jun 2005	A1
20050154472	Afriat	Jul 2005	A1
20050203631	Daniels et al.	Sep 2005	A1
20050209701	Suguro et al.	Sep 2005	A1
20050209702	Todd et al.	Sep 2005	A1
20050249625	Bram et al.	Nov 2005	A1
20060002810	Grohowski	Jan 2006	A1
20060015185	Chambat et al.	Jan 2006	A1
20060036329	Webster et al.	Feb 2006	A1
20060052875	Bernero et al.	Mar 2006	A1
20060100714	Ensign	May 2006	A1
20060178749	Pendleton et al.	Aug 2006	A1
20060195195	Burstein et al.	Aug 2006	A1
20060228247	Grohowski	Oct 2006	A1
20060231402	Clasen et al.	Oct 2006	A1
20060241781	Brown et al.	Oct 2006	A1
20060257358	Wen et al.	Nov 2006	A1
20060271191	Hermansson	Nov 2006	A1
20060289388	Yang et al.	Dec 2006	A1
20070061014	Naegerl	Mar 2007	A1
20070073409	Cooney et al.	Mar 2007	A1
20070078521	Overholser et al.	Apr 2007	A1
20070100463	Aram et al.	May 2007	A1
20070129809	Meridew et al.	Jun 2007	A1
20070135926	Walker	Jun 2007	A1
20070173948	Meridew et al.	Jul 2007	A1
20070196230	Hamman et al.	Aug 2007	A1
20070203582	Campbell	Aug 2007	A1
20070219639	Otto et al.	Sep 2007	A1
20070293647	McKellop et al.	Dec 2007	A1
20080004708	Wyss	Jan 2008	A1
20080021566	Peters et al.	Jan 2008	A1
20080091272	Aram et al.	Apr 2008	A1
20080097616	Meyers et al.	Apr 2008	A1
20080114462	Guidera et al.	May 2008	A1
20080114464	Barnett et al.	May 2008	A1
20080119940	Otto et al.	May 2008	A1
20080161927	Savage et al.	Jul 2008	A1
20080195108	Bhatnagar et al.	Aug 2008	A1
20080199720	Liu	Aug 2008	A1
20080206297	Roeder et al.	Aug 2008	A1
20080269596	Revie et al.	Oct 2008	A1
20090043396	Komistek	Feb 2009	A1
20090048680	Naegerl	Feb 2009	A1
20090082873	Hazebrouck et al.	Mar 2009	A1
20090084491	Uthgenannt et al.	Apr 2009	A1
20090088859	Hazebrouck et al.	Apr 2009	A1
20090125114	May et al.	May 2009	A1
20090192610	Case et al.	Jul 2009	A1
20090265012	Engh et al.	Oct 2009	A1
20090265013	Mandell	Oct 2009	A1
20090292365	Smith et al.	Nov 2009	A1
20090295035	Evans	Dec 2009	A1
20090306785	Farrar et al.	Dec 2009	A1
20090319047	Walker	Dec 2009	A1
20090326663	Dun	Dec 2009	A1
20090326664	Wagner et al.	Dec 2009	A1
20090326665	Wyss et al.	Dec 2009	A1
20090326666	Wyss et al.	Dec 2009	A1
20090326667	Williams et al.	Dec 2009	A1
20090326674	Liu et al.	Dec 2009	A1
20100016979	Wyss et al.	Jan 2010	A1
20100036499	Pinskerova	Feb 2010	A1
20100036500	Heldreth et al.	Feb 2010	A1
20100042224	Otto et al.	Feb 2010	A1
20100042225	Shur	Feb 2010	A1
20100063594	Hazebrouck et al.	Mar 2010	A1
20100070045	Ek	Mar 2010	A1
20100076563	Otto et al.	Mar 2010	A1
20100076564	Schilling et al.	Mar 2010	A1
20100094429	Otto	Apr 2010	A1
20100098574	Liu et al.	Apr 2010	A1
20100100189	Metzger	Apr 2010	A1
20100100190	May et al.	Apr 2010	A1
20100100191	May et al.	Apr 2010	A1
20100125337	Grecco et al.	May 2010	A1
20100161067	Saleh et al.	Jun 2010	A1
20100191341	Byrd	Jul 2010	A1
20100222890	Barnett et al.	Sep 2010	A1
20100286788	Komistek	Nov 2010	A1
20100292804	Samuelson	Nov 2010	A1
20100305710	Metzger et al.	Dec 2010	A1
20100312350	Bonutti	Dec 2010	A1
20110029090	Zannis et al.	Feb 2011	A1
20110029092	Deruntz et al.	Feb 2011	A1
20110035017	Deffenbaugh et al.	Feb 2011	A1
20110035018	Deffenbaugh et al.	Feb 2011	A1
20110106268	Deffenbaugh et al.	May 2011	A1
20110118847	Lipman et al.	May 2011	A1
20110125280	Otto et al.	May 2011	A1
20110153026	Heggendorn et al.	Jun 2011	A1

Foreign Referenced Citations (63)

Number	Date	Country
4308563	Sep 1994	DE
19529824	Feb 1997	DE
495340	Jul 1992	EP
510178	Oct 1992	EP
634155	Jan 1995	EP
636352	Feb 1995	EP
732091	Sep 1996	EP
883388	Dec 1998	EP
634156	May 1999	EP
1129676	Sep 2001	EP
732092	Feb 2002	EP
1196118	Apr 2002	EP
765645	Aug 2003	EP
1374805	Jan 2004	EP
1421918	May 2004	EP
1440675	Jul 2004	EP
1470801	Oct 2004	EP
1518521	Mar 2005	EP
1226799	May 2005	EP
1591082	Nov 2005	EP
1779812	May 2007	EP
1923079	May 2008	EP
2417971	Sep 1979	FR
2621243	Apr 1989	FR
2653992	May 1991	FR
2780636	Jan 2000	FR
2787012	Jun 2000	FR
2809302	Nov 2001	FR
2835178	Aug 2003	FR
1065354	Apr 1967	GB
2014856	Sep 1979	GB
2293109	Mar 1996	GB
2335145	Sep 1999	GB
62205201	Sep 1987	JP
8500992	Feb 1996	JP
2004167255	Jun 2004	JP
WO-7900739	Oct 1979	WO
WO-8906947	Aug 1989	WO
WO-9014806	Dec 1990	WO
WO-9601725	Jan 1996	WO
WO-9623458	Aug 1996	WO
WO-9624311	Aug 1996	WO
WO-9624312	Aug 1996	WO
WO-9846171	Oct 1998	WO
WO-9927872	Jun 1999	WO
WO-9966864	Dec 1999	WO
WO-0209624	Feb 2002	WO
WO-03039609	May 2003	WO
WO-03101647	Dec 2003	WO
WO-2004058108	Jul 2004	WO
WO-2004069104	Aug 2004	WO
WO-2005009489	Feb 2005	WO
WO-2005009729	Feb 2005	WO
WO-2005072657	Aug 2005	WO
WO-2005087125	Sep 2005	WO
WO-2006014294	Feb 2006	WO
WO-2006130350	Dec 2006	WO
WO-2007106172	Sep 2007	WO
WO-2007108804	Sep 2007	WO
WO-2007119173	Oct 2007	WO
WO-2008100784	Aug 2008	WO
WO-2009046212	Apr 2009	WO
WO-2009128943	Oct 2009	WO

Non-Patent Literature Citations (92)

Entry
Complaint for Patent Infringement filed by MedIdea, L.L.C. against DePuy Orthopaedics, Inc. dated Nov. 16, 2016 (121 pages including Exhibits 1-9).
First Amended Complaint for Patent Infringement filed by MedIdea, L.L.C. against DePuy Orthopaedics, Inc. dated Apr. 7, 2017(161 pages including Exhibits 1-11).
Defendant's Preliminary Invalidity Contentions filed by MedIdea, L.L.C. against DePuy Orthopaedics, Inc. dated Oct. 3, 2017(258 pages including Exhibits 1-8).
Petition for Inter Partes Review Under 37 C.F.R. § 42.100 of U.S. Pat. No. 6,558,426, filed on Dec. 15, 2017, Paper 1, IPR2018-00315.
Declaration of Darryl D'Lima, M.D., Ph.D. dated Dec. 14, 2017, filed in IPR2018-00315 (Exhibit 1003).
J. Rohen and C. Yokochi, “A Photographic Study of the Human Body” in Color Atlas of Anatomy 3rd Ed., pp. 414-422 (1993) filed in IPR2018-00315 (Exhibit 1004).
Waiver of the Service of Summons dated Dec. 16, 2016 in MedIdea, L.L.C. v. DePuy Orthopaedics, Inc., Civil Action No. 1:16-cv-10638, filed in IPR2018-00315 (Exhibit 1019).
MedIdea, L.L.C.'s First Supplemental Responses to Defendant's First Set of Interrogatories for MedIdea, L.L.C. v. DePuy Orthopaedics, Inc., Civil Action No. 1:16-cv-10638, filed in IPR2018-00315 (Exhibit 1020).
Declaration of Anthony T. Jacono dated Dec. 15, 2017 filed in IPR2018-00315 (Exhibit 1021).
Joint Claim Construction Chart—Exhibit 1 to Plaintiff's Claim Construction Brief (Mar. 9, 2018), MedIdea v. DePuy Orthopaedics, Inc., Civ. Action No. 1:17-cv-11172-GAO filed in IPR2018-00315 (Exhibit 2006).
Walker et al.: “Controlling the Motion of Total Knee Replacements using Intercondylar Guide Surfaces,” Journal of Orthopaedic Research, 2000.
S.I. Bin, T. S. Nam, “Early results of high-flex total knee arthroplasty: comparison study at 1 year after surgery,” Knee Surg. Sports Traumatol Arthrosc (2007) 15:350-355, Oct. 2006.
R E. Jones, “High-Flexion Rotating-Platform Knees: Rationale, Design and Patient Selection,” Orthopedics, vol. 29, No. 9, Sep. 2006.
G. Li, E. Most, P. Sultan, S. Schule, S. Zayontz, S. Park, H. Rubash, “Knee Kinematics with a High-Flexion Posterior Stabilized Total Knee Prosthesis: An In Vitro Robotic Experimental Investigation,” Journal of Bone and Joint Surgery, vol. 86, No. 8, Aug. 2004.
PubMed Abstracts, downloaded Jul. 18, 2007 (www.pubnned.gov).
European Search Report for European Patent Application No. 09164235.5-1526, dated Dec. 22, 2009, 6 pgs.
European Search Report for European Patent Application No. 09164168.8-1526, dated Jan. 4, 2010, 6 pgs.
“Vanguard Complete Knee System,” Biomet, available at: http://www.biomet.com/patients/vanguard_complete.cfm, downloaded on Feb. 2009, (3 pages).
“NexGen Complete Knee Solution Cruciate Retaining Knee (CR),” Zimmer, available at: http://zimmer.com.au/ctl?template=PC&op=global&action=&template=PC&id=356, downloaded on Feb. 18, 2009, (1 page).
P. Johal et al, “Tibio-femoral movement in the living knee. A study of weight bearing and non-weight bearing knee kinematics using ‘interventional’ MRI,” Journal of Biomechanics, vol. 38, Issue 2, Feb. 2005, pp. 269-276, (8 pages).
Andriacchi, T.P., “The Effect of Knee Kinematics, Gait and Wear on the Short and Long-Term Outcomes of Primary Knee Replacement,” NIH Consensus Development Conference on Total Knee Replacement, pp. 61-62, Dec. 8-10, 2003, (4 pages).
Asano et al. “In Vivo Three-Dimensional Knee Kinematics Using a Biplanar Image-Matching Technique,” Clin Orthop Rel Res, 388: 157-166, 2001, (10 pages).
European Search Report for European Patent Application No. 09164160.5-1526, dated Jan. 4, 2010, 4 pgs.
European Search Report for European Patent Application No. 09164228.0-1526, dated Feb. 2, 2010, 6 pgs.
Kessler et al., “Sagittal curvature of total knee replacements predicts in vivo kinematics,” Clinical Biomechanics 22(1): 52-58, 2007.
Wang et al., “Biomechanical differences exhibited during sit-to-stand between total knee arthroplasty designs of varying radii,” J Arthroplasty 21(8): 1196-9, 2006.
Saari et al., “The effect of tibial insert design on rising from a chair; motion analysis after total knee replacement,” Clin Biomech 19(9): 951-6, 2004.
Ranawat, “Design may be counterproductive for optimizing flexion after TKR,” Clin Orthop Rel Res 416: 174-6, 2003.
D'Lima et al., “Quadriceps moment arm and quadriceps forces after total knee arthroplasty,” Clin Orthop Rel Res 393:213-20, 2001.
Uvehammer et al., “In vivo kinematics of total knee anthroplasty: flat compared with concave tibial joint surface,” J Orthop Res 18(6): 856-64, 2000.
Dennis et al., “In vivo anteroposterior femorotibial translation of total knee arthroplasty: a multicenter analysis,” Clin Orthop Rel Res, 356: 47-57, 1998.
Clary et al., “Kinematics of Posterior Stabilized and Cruciate Retaining Knee Implants During an in Vitro Deep Knee Bend,” 54th Annual Meeting of the Orthopaedic Research Society, Poster No. 1983, Mar. 2008.
Wang et al., “A biomechanical comparison between the single-axis and multi-axis total knee arthroplasty systems for stand-to-sit movement,” Clin Biomech 20(4): 428-33, 2005.
Yoshiya et al., “In Vivo Kinematic Comparison of Posterior Cruciate-Retaining and Posterior Stabilized Total Knee Arthroplasties Under Passive and Weight-bearing Conditions,” J. Arthroplasty, vol. 20, No. 6, 2005, 7 pgs.
Bertin et al., “In Vivo Determination of Posterior Femoral Rollback for Subjects Having a NexGen Posterior Cruciate-Retaining Total Knee Arthroplasty,” J. Arthroplasty, vol. 17, No. 8, 2002, 9 pgs.
Suggs et al., “Three-Dimensional Tibiofemoral Articular Contact Kinematics of a Cruciate-Retaining Total Knee Arthroplasty,” JBJS-Am, vol. 88, No. 2, 2006, 10 pgs.
Dennis et al., “In Vivo Determination of Normal and Anterior Cruciate Ligament-Deficient Knee Kinematics,” J. Biomechanics, 38, 241-253, 2005, 13 pgs.
Li et al., “Anterior Cruciate Ligament Deficiency Alters the In Vivo Motion of the Tibiofemoral Cartilage Contact Points in Both Anteroposterior and Mediolateral Directions,” JBJS-Am, vol. 88, No. 8, Aug. 2006, 10 pgs.
Ries, “Effect of ACL Sacrifice, Retention, or Substitution on K After TKA,” http://www.orthosupersite.com/view.asp?rID=23134, Aug. 2007, 5 pgs.
European search report; European Application No. 10174439.9-1526; dated Dec. 20, 2010; 4 pages.
Cari Zeiss, Zeiss Surfcomm 5000—“Contour and Surface Measuring Machines”, 2005, 16 pages.
Zimmer Nexgen Trabecular Metal Tibial Tray, The Best Thing Next to Bone, 97-5954-001-00, 2007, 4 pages.
European Search Report for European Patent Application No. 08164994.4-2310-2042131, dated Mar. 16, 2009, 12 pgs.
European Search Report for European Patent Application No. 09164245.4-2310, dated Oct. 15, 2009, 5 pgs.
European Search Report for European Patent Application No. 11150648.1-2310, dated Apr. 7, 2011, 5 pgs.
Shaw et al., “The Longitudinal Axis of the Knee and the Role of the Cruciate Ligaments in Controlling Transverse Rotation”, J.Bone Joint Surg. Am. 1974:56:1603-1609, 8 pages.
Kurosawa, et al., “Geometry and Motion of the Knee for Implant and Orthotic Design”, The Journal of Biomechanics 18 (1985), pp. 487-499, 12 pages.
Barnes, C.L., et al., “Kneeling is Safe for Patients Implanted With Medical-Pivot Total Knee Arthoplasty Designs, Journal of Arthoplasty”, vol. 00, No. 0 2010, 1-6, 6 pages.
Blaha, et al., “Kinematics of The Human Knee Using an Open Chain Cadaver Model”, Clinical Orthopaedics and Related Research, vol. 410 (2003); 25-34, 10 pages.
Dennis, et al., “A Multi-Center Analysis of Axial Femorotibial Rotation After Total Knee Arthoplasty”, Clinical Orthopaedics 428 (2004); 180-189, 10 pages.
Fan, Cheng-Yu, et al., “Primitive Results After Medical-Pivot Knee Arthroplasties: A Minimum 5 Year Follow-Up Study”, The Journal of Arthroplasty, vol. 25, No. 3 2010, 492-496, 5 pages.
Freeman, M.A.R., et al., “The Movement of the Normal Tibio-Femoral Joint”, The Journal of Biomechanics 38 (2005) (2), pp. 197-208, 12 pgs.
Fuller, et al., “A Comparison of Lower-Extremity Skeletal Kinematics Measured Using Skin and Pin-Mounted Markers”, Human Movement Science 16 (1997) 219-242, 24 pages.
Karachalios, et al., “A Mid-Term Clinical Outcome Study of the Advance Medial Pivot Knee Arthroplasty”, www.sciencedirect.com, The Knee 16 (2009); 484-488, 5 pages.
Komistek, et al., “In Vivo Flouroscopic Analysis of the Normal Human Knee”, Clinical Orthopaedics 410 (2003): 69-81, 13 pages.
Komistek, et al., “In Vivo Polyethylene Bearing Mobility Is Maintained in Posterior Stabilized Total Knee Arthroplasty”, Clinical Orthopaedics 428 (2004): 207-213, 7 pages.
Koo, et al., “The Knee Joint Center of Rotation Is Predominantly on the Lateral Side During Normal Walking”, Journal of Biomechanics, vol. 41 (2008): 1269-1273, 5 pages.
Mannan, et al., “The Medical Rotation Total Knee Replacement: A Clinical and Radiological Review At a Mean Follow-Up of Six Years”, The Journal of Bone and Joint Surgery, vol. 91-B, No. 6 (Jun. 2009): 750-756, 7 pages.
Moonot, et al., “Correlation Between the Oxford Knee and American Knee Society Scores At Mid-Term Follow-Up”, The Journal of Knee Surgery, vol. 22, No. 3 (Jul. 2009), 226-230, 5 pages.
Murphy, Michael Charles, “Geometry and the Kinematics of the Normal Human Knee”, Submitted to Massachusetts Institute of Technology (1990), 379 pages.
Nakagawa, et al., “Tibiofemoral Movement 3: Full Flexion of the Normal Human Knee”, J.Bone Joint Surg. Am, vol. 82-B, No. 8 (2000). 1199-1200, 2 pages.
Omori, et al., “The Effect of Geometry of the Tibial Polyethylene Insert on the Tibiofemoral Contact Kinematics in Advance Medical Pivot Total Knee Arthroplasty”, The Journal of Orthopaedics Science (2009), 14: 754-760, 7 pages.
Shakespeare, et al., “Flexion After Total Knee Replacement. A Comparison Between the Medical Pivot Knee and a Posterior Stabilised Knee”, www.sciencedirect.com, The Knee 13 (2006): 371-372, 3 pages.
Walker, et al., “Motion of a Mobile Bearing Knee Allowing Translation of Rotation”, Journal of Arthroplasty 17 (2002): 11-19, 9 pages.
European Patent Office, Search Report for App. No. 09164479.9-2310, dated Nov. 4, 2009, 6 pages.
2nd Int'l Johnson-Elloy Knee Meeting, Mar. 1987, 9 pages.
Operative Technique, Johnson Elloy Knee System, Chas F. Thackray, Ltd., 1988, 34 pgs.
Five to Eight Year Results of the Johnson/Elloy (Accord) Total Knee Arthroplasty, Johnson et al, The Journal of Arthroplasty, vol. 8, No. 1, Feb. 1993, 6 pages.
Factors Affecting the Range of Movement of Total Knee Arthroplasty, Harvey et al, The Journal of Bone and Joint Surgery, vol. 75-B, No. 6, Nov. 1993, 6 pages.
Advice Notice (NI) Mar. 2000, Defect & Investigation Centre, Mar. 13, 2000, 3 pages.
The Johnson Elloy (Accord) Total Knee Replacement, Norton et al, The Journal of Bone and Joint Surgery (BR), vol. 84, No. 6, Aug. 2002, 4 pages.
Midvastus Approach in Total Knee Arthroplasty, A Description and a Cadaveric Study Determining the Distance of the Popliteal Artery From the Patellar Margin of the Incision, Cooper et al., The Journal of Arthroplasty, vol. 14, No. 4, 1999, 4 pages.
Biomet, Vanguard Mono-Lock Tibial System, Patented Convertible Tibial Bearing Technology, 2009, 2 pages.
Can Zeiss, Zeiss Surfcomm 5000—“Contour and Surface Measuring Machines”, 2005, 16 pages.
DePuy Inc., “AMK Total Knee System Product Brochure”, 1996, 8 pages.
DePuy Knees International, “Sigma CR Porocoat®,” 1 page. 2007.
DePuy Orthopaedics, Inc., “AMK Total Knee System Legent II Surgical Technique”, 1998, 30 pages.
DePuy Orthopaedics, Inc., “Sigma Fixed Bearing Knees—Function with Wear Resistance”, 2010, 0612-65-508 (Rev. 1) 20 pages.
DePuy Pfc Sigma Rp, “PFC Sigma Knee System with Rotating Platform Technical Monograph”, 1999, 0611-29-050 (Rev. 3), 70 pages.
Effects of Coronal Plane Conformity on Tibial Loading in TKA: A Comparison of AGC Flat Versus Conforming Articulations, Brent, et al, Orthopaedic Surgery, Surgical Technology International, XVIII, 6 pages, 2009.
European Search Report for European Patent Application No. 08253140.1-2310, dated Dec. 23, 2008, 7 pgs.
European Search Report for European Patent Application No. 11150648.1-2310, dated Apr. 7, 2011, 4 pages.
European Search Report for European Patent Application No. 06739287.08-2310, dated Mar. 16, 2010, 3 pages.
European Search Report for European Patent Application No. 09164478.1-2310, dated Oct. 20, 2009, 6 pages.
European Search Report for European Patent Application No. 09164478.1-2310, dated Apr. 28, 2010, 12 pages.
European Search Report for European Patent Application No. 10162138.1, dated Aug. 30, 2010, 7 pages.
Japanese Search Report for Japanese Patent Application No. 2009-501393, dated Oct. 26, 2010, 5 pages.
Procedure, References Guide for Use with P.F.C. Sigma Knee Systems, 1998, 8 pages.
Signus Medizintechnik, “Peek-Optima®, The Polymer for Implants, Technical Information for the Medical Professional”, 7 pages. 1991.
The Effects of Conformity and Load in Total Knee Replacement, Kuster, et al, Clinical Orthopaedics and Related Research No. 375, Jun. 2000.
Zimmer, Trabecular Metal Monoblock Tibial Components, An Optimal Combination of Material and Design, www.zimmer.com, 2009, 3 pages.
Memorandum and Order on Claim Construction issued by the United States District Court for the District of Massachusetts on Nov. 7, 2018, in Civil Action No. 17-11172-LTS, MedIdea, L.L.C. v.DePuy Orthopaedics, Inc. et al. (19 pages).

Related Publications (1)

	Number	Date	Country
	20170086984 A1	Mar 2017	US

Divisions (1)

	Number	Date	Country
Parent	09724100	Nov 2000	US
Child	10430548		US

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	Number	Date	Country
Parent	14276407	May 2014	US
Child	15351288		US
Parent	12337280	Dec 2008	US
Child	14276407		US
Parent	10430548	May 2003	US
Child	12337280		US

Multiple-cam, posterior-stabilized knee prosthesis

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