The present invention relates to a tibial component for use in an artificial knee joint.
An artificial knee joint replaces a knee joint of a patient having, for example, knee osteoarthritis, chronic rheumatoid arthritis, osteoma, or an external wound. The artificial knee joint includes a femoral component and a tibial component. The femoral component substitutes for a part of a femur. The tibial component substitutes for a part of a tibia. In some cases, the artificial knee joint includes a patellar component.
In general, the femoral component includes a medial condyle and a lateral condyle, and the tibial component includes an inner sliding surface that receives the medial condyle and an outer sliding surface that receives the lateral condyle (see Patent Literature 1).
To be more specific, the tibial component includes a plate-shaped base that is fixed to an upper resection surface of the tibia. The inner sliding surface and the outer sliding surface are formed on the upper surface of the base.
In some cases, the proximal portion (femur-side end portion) of the tibia is resected planarly such that the upper resection surface, which receives the lower surface of the base of the tibial component, is formed as a flat surface. In other cases, the proximal portion (femur-side end portion) of the tibia is resected in such a manner that an enthesis at which the posterior cruciate ligament connects to the tibia is left in an island shape on the upper resection surface. In either case, it is necessary to avoid interference between the base of the tibial component and the posterior cruciate ligament or to avoid interference between the base of the tibial component and the enthesis at which the posterior cruciate ligament connects to the tibia. In order to do so, a recess whose opening faces backward is formed in the base.
In a conventional tibial component, the recess is formed at the center of the base in the medial-lateral direction. The “medial-lateral direction” herein refers to a direction in which the lowest point of the medial condyle and the lowest point of the lateral condyle of the femoral component in a knee extended position are arranged. However, in the case of the tibial component having such a shape, particularly in a case where the enthesis at which the posterior cruciate ligament connects to the tibia is left in an island shape on the upper resection surface, there is a risk of interference between the base of the tibial component and the posterior cruciate ligament enthesis.
In view of the above, an object of the present invention is to provide a tibial component that is usable with no problem regardless of how the proximal portion of the tibia is resected.
In order to solve the above-described problems, the inventors of the present invention conducted diligent studies. As a result, the inventors of the present invention have found that the enthesis at which the posterior cruciate ligament connects to the tibia is not positioned at, but positioned inward relative to, the center of the proximal portion of the tibia in the medial-lateral direction. The present invention has been made from such a point of view.
Specifically, a tibial component of the present invention is a tibial component for use in an artificial knee joint, the tibial component including a base fixed to an upper resection surface of a tibia, the base including an inner sliding surface and an outer sliding surface that are formed on an upper surface of the base, the inner sliding surface receiving a medial condyle of a femoral component, the outer sliding surface receiving a lateral condyle of the femoral component. The base includes a recess for avoiding interference between the base and a posterior cruciate ligament or for avoiding interference between the base and an enthesis at which the posterior cruciate ligament connects to the tibia, the recess being formed in the base such that an opening of the recess faces backward. In a medial-lateral direction, a center of the recess is positioned inward relative to a center of the base.
According to the above configuration, the recess is positioned inward in the medial-lateral direction. Therefore, in a case where the proximal portion of the tibia is resected flat, the recess makes it possible to avoid interference between the posterior cruciate ligament and the base, whereas in a case where the proximal portion of the tibia is resected such that the enthesis at which the posterior cruciate ligament connects to the tibia is left in an island shape, the recess allows the posterior cruciate ligament enthesis to be positioned therein. Therefore, the tibial component is usable with no problem regardless of how the proximal portion of the tibia is resected.
For example, in the medial-lateral direction, a distance from the center of the base to the center of the recess may be 2 to 10% of a width of the base.
In the medial-lateral direction, the inner sliding surface may be positioned inward relative to the center of the recess, and the outer sliding surface may be positioned outward relative to the center of the recess. According to this configuration, in the medial-lateral direction, the relative positional relationship between the femur and the tibia of a patient to whom the artificial knee joint is attached is the same as the relative positional relationship between the femur and the tibia of a healthy person.
The present invention provides a tibial component that is usable with no problem regardless of how the proximal portion of the tibia is resected.
The artificial knee joint 1 includes a femoral component 2 in addition to the tibial component 3. Although not illustrated, the artificial knee joint 1 may include a patellar component. The femoral component 2 substitutes for a resected part of a femur 11. The tibial component 3 substitutes for a resected part of a tibia 12. It should be noted that, in
The femoral component 2 is made of metal, such as a cobalt-chromium alloy or a titanium alloy. The femoral component 2 includes an anterior wall 21, a medial condyle 22, and a lateral condyle 23. The anterior wall 21 is fixed to an anterior resection surface of the femur 11. Each of the medial condyle 22 and the lateral condyle 23 extends from the lower end of the anterior wall 21 to the posterior side of the femur 11 in a manner to pass under the femur 11.
The medial condyle 22 and the lateral condyle 23 are spaced apart from each other. The gap between the medial condyle 22 and the lateral condyle 23 is intended for avoiding interference with the anterior cruciate ligament 15 and the posterior cruciate ligament 16. A patella groove, on which the patella or the patellar component slides, is formed in the lower portion of the anterior wall 21, such that the patella groove extends in the anterior-posterior direction that passes between the medial condyle 22 and the lateral condyle 23.
The external surface of the medial condyle 22 is a three-dimensional curved surface that is curved in the anterior-posterior direction and the medial-lateral direction. Similarly, the external surface of the lateral condyle 23 is also a three-dimensional curved surface that is curved in the anterior-posterior direction and the medial-lateral direction.
In the present embodiment, the tibial component 3 is of a type that is used in a case where the anterior cruciate ligament 15 is resected, but the posterior cruciate ligament 16 is preserved. Specifically, the tibial component 3 includes a plate-shaped base 4 and a stem 51. The base 4 is fixed to an upper resection surface of the tibia 12. The stem 51 extends downward from substantially the center of the base 4. As shown
The base 4 includes a metal plate 41 and a resin plate 42, which are stacked together. The above-described stem 51 and keels 52 are integrated with the metal plate 41. The metal plate 41 is made of, for example, a cobalt-chromium alloy or a titanium alloy. The resin plate 42 is made of, for example, polyethylene.
The inner sliding surface 43, which receives the medial condyle 22 of the femoral component 2, and the outer sliding surface 44, which receives the lateral condyle 23 of the femoral component 2, are formed on the upper surface of the resin plate 42 (which is also the upper surface of the base 4).
The inner sliding surface 43 is a three-dimensional curved surface that is curved in the anterior-posterior direction and the medial-lateral direction. Similarly, the outer sliding surface 44 is also a three-dimensional curved surface that is curved in the anterior-posterior direction and the medial-lateral direction.
The base 4 further includes a recess 31 for avoiding interference between the base 4 and the posterior cruciate ligament 16 or for avoiding interference between the base 4 and an enthesis at which the posterior cruciate ligament 16 connects to the tibia 12. The recess 31 is formed in the base 4 such that the opening of the recess 31 faces backward. As shown in
The “center 32 of the recess 31” herein refers to, as shown in
Similar to the recess 31, the inner sliding surface 43 and the outer sliding surface 44 are positioned inward. In the present embodiment, in the medial-lateral direction, the inner sliding surface 43 is positioned inward relative to the center 32 of the recess 31, and the outer sliding surface 44 is positioned outward relative to the center 32 of the recess 31.
Further, as shown in
As shown in
As described above, in the tibial component 3 of the present embodiment, the recess 31 is positioned inward in the medial-lateral direction. Therefore, in a case where the proximal portion of the tibia 12 is resected flat, the recess 31 makes it possible to avoid interference between the posterior cruciate ligament 16 and the base 4, whereas in a case where the proximal portion of the tibia 12 is resected such that the enthesis at which the posterior cruciate ligament 16 connects to the tibia 12 is left in an island shape, the recess 31 allows the posterior cruciate ligament enthesis to be positioned therein. Therefore, the tibial component 3 is usable with no problem regardless of how the proximal portion of the tibia 12 is resected.
(Variations)
The present invention is not limited to the above-described embodiment. Various modifications can be made without departing from the scope of the present invention.
For example, as shown in
Alternatively, as shown in
Further alternatively, although not illustrated, the tibial component 3 may be of a type that is used in a case where both the anterior cruciate ligament 15 and the posterior cruciate ligament 16 are resected. In this case, the tibial component 3 is provided with an upward projection that is positioned between the inner sliding surface 43 and the outer sliding surface 44.
It is not essential that the inner sliding surface 43 and the outer sliding surface 44 be positioned inward. Alternatively, the inner sliding surface 43 and the outer sliding surface 44 may be provided at bilateral symmetrical positions with respect to the center 40 of the base 4. However, in a case where the inner sliding surface 43 and the outer sliding surface 44 are positioned on both sides of the center 32 of the recess 31 as in the above-described embodiment, the relative positional relationship in the medial-lateral direction between the femur and the tibia of a patient to whom the artificial knee joint 1 is attached is the same as the relative positional relationship between the femur and the tibia of a healthy person.
Number | Date | Country | Kind |
---|---|---|---|
2019-075261 | Apr 2019 | JP | national |
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/JP2020/006159 | 2/18/2020 | WO | 00 |