WO2013159697A1

WO2013159697A1 - Knee joint prosthesis pad, shinbone base element, and knee joint prosthesis

Info

Publication number: WO2013159697A1
Application number: PCT/CN2013/074602
Authority: WO
Inventors: 王岩; 郑诚功; 侯丽丽; 刘华玮; 丁玉宝; 宋大勇; 高相飞; 王建; 赵军
Original assignee: 北京纳通科技集团有限公司
Priority date: 2012-04-24
Filing date: 2013-04-24
Publication date: 2013-10-31

Abstract

A knee joint prosthesis, a knee joint prosthesis pad (3), and a shinbone base element (2). The knee joint shinbone base element is combined with a shinbone, and comprises a base (21), a boss (23) is arranged on the base (21), and a guide channel (25) through which an anterior cruciate ligament (4) passes is formed on the boss (23) and the base (21). The knee joint prosthesis pad (3) is provided with a pad opening (31') or a pad through hole (31) for accommodating the boss (23) of the shinbone base element (2). The knee joint prosthesis comprises the shinbone base element (2), the knee joint prosthesis pad (3) and a shinbone element (1) combined with the shinbone. The attaching position of the anterior cruciate ligament (4) relative to the shinbone base element (2) can be kept consistent with the attaching position of a human body anterior cruciate ligament in anatomy on the shinbone, so that the knee joint prosthesis can be used to rebuild an anterior cruciate ligament, and a patient regains the body feel and moves well after replacement of the knee joint prosthesis.

Description

Knee prosthesis liner, humeral base component and knee prosthesis

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a knee joint prosthesis, and more particularly to a knee joint prosthesis that retains a posterior cruciate ligament while reconstructing a anterior cruciate ligament, and a knee joint prosthetic pad and a tibial base member. BACKGROUND OF THE INVENTION The concept of knee prosthesis design is generally based on the same principle of providing a biomechanical motion pattern similar to a normal knee joint with an implanted knee joint component, and obtaining static and by means of the implant itself and knee ligament and soft tissue balance. Dynamic stability. These knee component designs are designed to restore the natural human knee joint movement and to adjust and control the forces generated during knee flexion and extension. However, all current knee prosthesis designs have not reached this standard.

Conventional knee prostheses primarily include a femoral component for engagement with the femur, a tibial base component for engagement with the tibia, and a cushion disposed over the tibial base component. Wherein the sum of the heights of the tibial base member and the pad is approximately equal to the sum of the height of the truncated portion of the proximal tibia of the patient and the height of the cartilage on the tibia.

Most of the commercially available posterior cruciate ligament retaining knee prosthesis (CR) and posterior stable knee prosthesis (PS) are of the anterior cruciate ligament design, and the function of the anterior cruciate ligament disappears. The study found that patients with knee arthroplasty were significantly inferior to age and gender in activities that required the biomechanical effects of the knee (such as squatting, squatting, lateral movement, turning, lifting, playing tennis, dancing, etc.). Normal person. Although knee replacement can significantly relieve pain and improve function, the kinematics of the knee joint are significantly altered. Knee prostheses without anterior cruciate ligament may also cause a decrease in the function of the quadriceps muscle and result in decreased joint stability.

Based on the above problems, knee prostheses retaining the anterior cruciate ligament type and knee prostheses reconstructing the anterior cruciate ligament type have emerged. Since the anatomical attachment position of the anterior cruciate ligament is near the tibial ridge, in order to retain the anterior cruciate ligament when using the anterior cruciate ligament type knee prosthesis, the tibial base component and the pad of the knee prosthesis need to be made. Horseshoe shape, around the humeral ridge, that is, the humeral base component and pad require a large opening to allow sufficient space for the anterior cruciate ligament. This reduces the fixed area of the tibial base component and the tibia, which may lead to early loosening and subsidence of the component, shortening the service life of the knee prosthesis, and surgery due to the anterior cruciate ligament always attached to the tibia during surgery. Exposure is extremely difficult, and it is easy to cause errors such as rotation of the knee prosthesis and poor alignment.

Therefore, after the patient replaces the existing reconstructed anterior cruciate ligament type knee prosthesis, the proprioception cannot be restored, and even the function is affected; since the anterior cruciate ligament has a change in length and angle during the knee joint activity, the anterior cruciate ligament is caused. Wear in the tibia base element or liner, severely rupture of the anterior cruciate ligament, which not only shortens the knee prosthesis The service life, but also brings pain to the replacement. SUMMARY OF THE INVENTION In view of the problems in the prior art, it is an object of the present invention to provide a knee prosthesis capable of restoring a proprioception after replacing a prosthesis, and a knee prosthesis pad and a tibial base member;

Another object of the present invention is to provide a knee prosthesis and a tibial base member that is small in trauma, secure in ligament fixation, and suitable for a wide range of people.

In order to achieve the above object, the technical solution of the present invention is as follows:

The knee joint tibia base member of the present invention is configured to be coupled with the tibia, and includes a base, the base is provided with a boss, and the boss and the base are provided with a guide for the anterior cruciate ligament to pass through. aisle.

The sum of the heights of the bosses and the pedestal is equal to the sum of the heights of the proximal humerus bone and the cartilage removed during the replacement of the knee joint prosthesis.

The angle between the projection of the center line of the guiding channel at the end face of the base and the sagittal plane of the human body is 10°-30°. The center line of the guiding channel has an angle between the projection of the sagittal plane of the human body and the end surface of the base of 60°-80°. The boss has a rectangular cross section.

One end of the guiding channel is located on an upper surface of the boss, and the other end opening is located on a lower surface of the base. A stem portion is formed under the base, and one end of the guiding passage is located on an upper surface of the boss, and the other end opening is located on a side of the stem.

The guiding channel is located at an opening position of the upper surface of the boss and coincides with the attachment position of the anterior cruciate ligament at the tibia. Therein, a fixing structure for fixing the anterior cruciate ligament to the guiding channel is further included.

The fixing structure includes a fixing screw, and a side of the boss is provided with a threaded hole communicating with the guiding passage, and the fixing screw is provided with a thread that cooperates with the threaded hole.

A groove is formed on a side wall of the guiding passage opposite to the threaded hole.

A stem is formed on the underside of the base, the opening of the guiding channel is located on the upper surface of the boss, the opening of the other end is located on the bottom surface of the stem, and the upper part of the guiding channel is provided with a lock for fixing the anterior cruciate ligament a tightening mechanism, the locking mechanism is provided with a through hole for the anterior cruciate ligament to pass through, and the stem end is mounted with a sealing rod sealing the opening of the lower end of the guiding passage, the sealing rod passing through the through hole The anterior cruciate ligament is sealed in the guiding channel after being fixed twice.

The guide channel extends through the boss and the stem along a longitudinal centerline of the stem.

The locking mechanism is a locking sleeve comprising a base and a side wall extending from the base and a through hole disposed along a longitudinal center line of the locking sleeve, the side wall having at least one through slot extending along a longitudinal direction thereof . The upper portion of the guiding passage has a tapered shape or a wedge shape, and the locking sleeve side wall cooperates with the upper portion of the guiding passage. The inner surface of the side wall of the locking sleeve is provided with a plurality of projections and/or a plurality of depressions and/or a plurality of serrations and/or a plurality of stripes and/or locking threads.

The base of the locking sleeve is mounted in the guide channel by a threaded fit.

The upper end surface of the sealing rod abuts against the lower end surface of the locking sleeve.

The locking mechanism is a snap ring, and a retaining ring extending into the guiding channel is disposed at an upper end of the guiding channel. The upper surface of the sealing rod abuts against the underside of the snap ring, and the snap ring is locked and installed in the guiding passage.

In the knee prosthesis pad of the present invention, the upper surface of the pad is provided with an articular surface, and the pad is provided with a pad opening or a pad through hole for receiving a boss of the tibial base member of the present invention.

The shape of the through hole matches the shape of the cross section of the boss.

The upper surface of the pad is flush with the upper surface of the boss or has a distance difference of -5 mm.

The knee prosthesis of the present invention includes a tibial base member for engaging the tibia, a femoral member for engaging the femur, and a knee prosthetic pad for engaging the tibial base member, the pad The upper surface is an articular surface, the femoral component is provided with a femoral articular surface matching the pad articular surface, the tibial base component is a tibial base component of the present invention, the knee prosthesis liner It is a knee prosthesis liner of the present invention.

The knee joint prosthesis further includes an anterior cruciate ligament penetrating in the locking mechanism, wherein the anterior cruciate ligament is fixed once in the guiding channel by a locking mechanism and is performed twice under the locking mechanism fixed.

The lower end portion of the anterior cruciate ligament has a stopper portion, and the stopper portion is secondarily fixed, and the outer contour of the stopper portion is larger than the opening size of the lower end portion of the through hole of the lock mechanism.

The top end portion of the sealing rod abuts against the locking mechanism, and has a groove on the upper surface of the sealing rod, and the stopper portion is received in the groove of the sealing rod.

The lower end portion of the anterior cruciate ligament has a floc structure, and the floc structure comprises secondary fixing, the floc structure comprises a plurality of batt, and the plurality of batt are dispersed around the end surface of the locking sleeve Side, and clamped between the sealing rod and the locking sleeve.

The tibial base member is made of a metal material and/or the pad is made of a high molecular polymer material.

It can be seen from the above technical solutions that the knee joint prosthesis of the present invention has the following advantages and positive effects: In the present invention, since the base of the tibial base member is provided with a boss and a guiding passage for accommodating the anterior cruciate ligament. When the current cruciate ligament is placed in the guiding channel, during the movement of the knee prosthesis, the angle of the anterior cruciate ligament changes, the torsion and the like are mainly based on the position of the opening on the upper surface guiding channel of the boss, so the use of the present The knee prosthesis of the invention not only can reconstruct the anterior cruciate ligament, but also enables the patient to restore the proprioception after replacing the knee prosthesis, and the exercise is good, especially compared with the existing The technology can achieve some activities that need to play the role of knee biomechanics, such as squatting, squatting, lateral movement, turning, lifting heavy objects, playing tennis, dancing, etc. At the same time, the wear of the anterior cruciate ligament in the prosthesis is avoided, ensuring the patient's exercise safety and prolonging the service life of the prosthesis. BRIEF DESCRIPTION OF THE DRAWINGS The invention will be further described in detail below with reference to the accompanying drawings:

Figure 1 is a perspective view showing the first embodiment of the knee joint prosthesis of the present invention;

Figure 2 is a perspective view showing the structure of the femoral component in the first embodiment of the knee joint prosthesis of the present invention;

Figure 3 is a perspective view showing the structure of the sacral base member in the first embodiment of the knee joint prosthesis of the present invention; Figure 4 is a cross-sectional view taken along line A-A of Figure 3;

5 is a cross-sectional structural view showing a non-fixed structure in a guiding channel in a tibial base member in a first embodiment of the knee prosthesis of the present invention;

Figure 6 is a plan view of Figure 3;

7 is a schematic structural view of a pad in a first embodiment of a knee joint prosthesis according to the present invention;

Figure 8 is a perspective view showing the assembled structure of the first embodiment of the knee prosthesis of the present invention and the sacral base member of the first embodiment of the knee prosthesis of the present invention;

9 is a schematic view showing a state in which a tibia base member and a horseshoe-shaped pad are engaged in a first embodiment of the knee joint prosthesis according to the present invention; FIG. 10 is a perspective view showing a three-dimensional structure of the fixing nail in the first embodiment of the knee joint prosthesis according to the present invention;

Figure 11 is a cross-sectional view showing the first embodiment of the knee prosthesis of the present invention in which the anterior cruciate ligament is fixed to the sacral base member;

12A is a perspective view showing the structure of the tibial base member in the second embodiment of the knee joint prosthesis of the present invention; FIG. 12B is a front view showing the tibial base member shown in FIG. 12A with the locking mechanism and the sealing rod removed; 12C is a cross-sectional view taken along line BB in FIG. 12B;

Figure 13A is a schematic view showing the structure of a locking sleeve in a tibial base member in a second embodiment of the knee prosthesis of the present invention; Figure 13B is a left side view of Figure 13A;

Figure 14 is a cross-sectional view of the sealing rod in the tibial base member of the second embodiment of the knee prosthesis of the present invention; Figure 15 is a combination of the pad and the tibial base member of the second embodiment of the knee prosthesis of the present invention Rear perspective structure diagram;

Figure 16A is a schematic view showing the anterior cruciate ligament of the second embodiment of the knee prosthesis of the present invention mounted on the tibial base member, showing the first structure of the anterior cruciate ligament once fixed and twice fixed in the tibial base member; Figure 16B is a schematic view showing the anterior cruciate ligament of the second embodiment of the knee prosthesis of the present invention mounted on the sacral base member, showing a second structure in which the anterior cruciate ligament is fixed once and twice in the tibial base member;

Figure 16C is a schematic view showing the anterior cruciate ligament of the second embodiment of the knee prosthesis of the present invention mounted on the tibial base member, showing a third structure in which the anterior cruciate ligament is fixed once and twice in the tibial base member;

Figure 16D is a schematic view showing the anterior cruciate ligament of the second embodiment of the knee prosthesis of the present invention mounted on the tibial base member, showing a fourth structure in which the anterior cruciate ligament is once fixed and twice fixed in the tibial base member;

Figure 16E is a schematic illustration of the anterior cruciate ligament of the second embodiment of the knee prosthesis of the present invention mounted on the tibial base member, showing a fifth configuration of the anterior cruciate ligament once and twice fixed in the tibial base member. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Exemplary embodiments embodying the features and advantages of the present invention will be described in detail in the following description. It is to be understood that the invention is capable of various modifications in the various embodiments of the invention this invention.

In the present invention, the so-called "front", "back", "upper", and "lower" directions are consistent with the front, rear, upper, and lower directions when the knee prosthesis is implanted in the human body, and the present invention The left leg knee prosthesis is described as an example.

Example 1

As shown in Fig. 1, a first embodiment of the knee prosthesis of the present invention comprises a femoral component 1, a tibial base component 2 and a pad 3.

As shown in Fig. 2, the femoral component 1 is for fixation to the distal end of the human femur, and includes a femoral component body 11, an inner ankle portion 12 and an outer ankle portion 13 extending from one end of the femoral component body 11. The inner ankle portion 12 and the outer ankle portion 13 are respectively provided with femoral fixation portions 121, 131 for fixation to the human femur, and an intercondylar groove 14 is provided between the inner condyle portion 12 and the outer condyle portion 13. In the first embodiment, the femoral component 1 can also adopt a conventionally used structure. The femoral component 1 is provided with a femoral joint surface.

As shown in Figs. 3 to 9, in the first embodiment of the knee prosthesis of the present invention, the tibial base member 2 is used for fixation at the proximal end of the humerus. The humeral base member 2 includes a base 21, a stem portion 22, and a boss 23. The base 21 conforms to the shape of the outer contour of the humeral portion, and a base opening 211 is provided on the base 21 to avoid the posterior cruciate ligament. The stem portion 22 is located below the base 21, and an extension portion 24 is formed under the stem portion 22, and a tibial fixing portion 26 is further disposed under the base portion 21. When the prosthesis is replaced, the stem portion 22 and the extension portion 24 are inserted into the bone marrow cavity of the tibia, and the tibial fixation portion 26 is fixed to the human tibia.

The boss 23 is formed on the upper portion of the base 21, and the sum of the height of the boss 23 and the height of the base 21 is substantially equal to the side of the tibia The sum of the heights of the resected bone and cartilage. The term "roughly" is used to modify any relationship that can be changed slightly, because the bone and the cartilage covered thereon are non-planar and uneven, so there are errors in measurement and assembly, but this error does not change its nature. The boss 23 and the stem portion 22 are located on the same center line. Of course, in order to accommodate some special knee prosthesis structures, the boss 23 and the stem portion 22 may not be on the same center line. The cross-sectional shape of the boss 23 may be any shape such as a polygon such as a rectangle or a circle, and a rectangle is used in the present embodiment. A guide passage 25 is formed in the boss 23 and the stem portion 22. One end of the guide passage 25 is open to the upper surface of the boss 23, and the other end is open to the side surface of the stem portion 22. Further, the position of the opening on the upper surface guiding passage 25 of the boss 23 coincides with the attachment position of the anterior cruciate ligament on the tibia in the anatomy. Therefore, the knee joint prosthesis of the present invention is in the first embodiment. The attachment position of the anterior cruciate ligament relative to the tibial base member can be consistent with the anatomical attachment of the anterior cruciate ligament on the tibia. The angle c between the projection a' of the center line of the guiding channel 25 on the upper surface of the base 21 and the sagittal plane of the human body (cutting the human body into the left and right sections in the front-rear direction) c is shown in Fig. 6) It is 20°. The angle β between the projection a of the guide channel 25 on the sagittal plane of the human body and the upper surface b of the susceptor 21 (see Fig. 4) is 60° - 80°, and 70° is optimal in this embodiment.

Since the lengths of the tibial lateral bones (the passages formed on the tibia when the anterior cruciate ligament is worn) are different in different types of knee prostheses, the center line of the guiding passages 25 is at the base 21 in order to accommodate different lengths of the tibial lateral bones. The angle between the projection of the upper surface and the sagittal plane of the human body (both in the range of 10°-30° is feasible. The guiding channel 25 is used for the anterior cruciate ligament 4 to pass through. On the side of the boss 23 and adjacent to the convex The upper surface of the table 23 is provided with a threaded hole 231 communicating with the guide passage 25, and the threaded hole 231 can be inclined toward the stem portion 22 from the outside to the inside direction, and further, facing the threaded hole on the side wall of the guide passage 25 The position of 231 is provided with a recess 232.

The tibial base member 2 may also be configured without the use of the stem portion 22 to be inserted into the medullary cavity. For example, the sacral base member 2 may be attached to the proximal end of the humerus without a stem portion and only a reinforcing wing or the like. 25 penetrates the boss 23 and the base 21, and is inclined by 10 to 30 degrees from the center line of the boss 23.

As shown in Fig. 7, in the first embodiment of the knee prosthesis of the present invention, the shape of the pad 3 coincides with the shape of the base 21, and the pad 3 has a pad through hole 31 for accommodating the boss 23, the pad. The through hole 31 may be of any shape. Preferentially, the through hole 31 is a rectangular or the like that matches the cross section of the boss 23, and when the polygonal boss 23 is accommodated in the correspondingly shaped through hole 31, The pad 3 can be restricted from rotating relative to the base 21. The upper surface of the boss 23 may be flush with the upper surface of the pad 3 around it, and may of course be l-5 mm higher or lower than the upper surface of the pad 3. The upper surface of the pad 3 is the articular surface, and the pad 3 and the femoral component 1 are fitted by matching articular surfaces. The pad 3 can also adopt other existing structures. For example, as shown in FIG. 9, the horseshoe-shaped pad 3' can also be used in the first embodiment, and the pad 3' is provided with a pad opening 31' for accommodating Boss 23.

The knee of the first embodiment of the knee prosthesis of the present invention is compared to a conventional knee prosthesis retaining the anterior cruciate ligament type The base opening 211 on the base 21 in the joint prosthesis is relatively small, so that the contact area of the base 21 with the tibia is relatively large, and the connection strength between the base 21 and the tibia is improved. In the first embodiment, the sum of the heights of the base 21 and the pad 3 is approximately equal to the sum of the heights of the bone and cartilage of the portion of the patient whose proximal tibia is cut off.

As shown in FIG. 3, FIG. 4, FIG. 10 and FIG. 11, a further preferred technical solution of the first embodiment of the knee prosthesis of the present invention is: in order to prevent the anterior cruciate ligament 4 from being twisted, stretched, etc. in the guiding channel 25 Wear occurs, and in the first embodiment, the fixing screw 8 (see FIG. 10) for re-fixing has a spherical shape at one end, and of course other shapes; the other end of the fixing screw 8 is provided with a thread in the circumferential direction. 81. After the anterior cruciate ligament 4 is passed through the guiding channel 25, the fixing screw 8 is screwed into the threaded hole 231 through the thread 81 and is locked against the anterior cruciate ligament 4, and the anterior cruciate ligament 4 is fixed again, thereby effectively preventing the anterior cruciate ligament 4 from being fixed. The anterior cruciate ligament 4 is twisted or swayed in the guiding channel 25, so that the wear of the anterior cruciate ligament 4 can be reduced, which is advantageous for prolonging the service life of the anterior cruciate ligament 4, thereby prolonging the service life of the entire knee prosthesis; The position where the anterior cruciate ligament 4 is again fixed in the guiding channel 25 is adjacent to the upper end of the boss 23, so that the length of the anterior cruciate ligament 4 is close to the length of the patient's anterior cruciate ligament, which further restores the body of the patient who replaces the knee joint. Feel and make the knee prosthesis work better. It should be noted that the above fixing manner using the fixing screw 8 and the screw hole 231 is only a specific example, and the anterior cruciate ligament 4 may be secondarily fixed in the guiding channel 25 by any other method, for example, using a ring shape. The card is locked, fixed with a door nail, fixed with an expansion and self-locking method, and so on. Of course, as shown in Fig. 5, it is also possible to perform any fixation of the anterior cruciate ligament 4 in the guide channel 25.

In the first embodiment of the knee prosthesis of the present invention, the anterior cruciate ligament can be reconstructed while retaining the posterior cruciate ligament, and the procedure for performing the operation using the knee prosthesis of the first embodiment is:

1. After preparing for osteotomy on the femur and tibia, locate the anterior cruciate ligament on the corresponding part of the femur, and use the drill to enlarge the tunnel, then locate the anterior cruciate ligament on the corresponding part of the humerus, and expand the tunnel with the drill. .

2. The base member 21 of the femoral component 1 and the tibial base member are respectively mounted on the truncated femoral bone plane and the tibial bone plane, wherein the stem portion 22 and the extension portion 24 of the base 21 are inserted into the medullary cavity of the tibia.

3. Attach the anterior cruciate ligament 4 to the tibial base member 2. The lower end of the anterior cruciate ligament 4 is fixed (fixed by any existing means) on the anterior side of the iliac crest cavity, and the upper end passes through the guide channel in the stem 22 and the boss 23 of the sacral base member 2 inserted in the iliac crest cavity. 25, extending from the top end of the boss 23; the anterior cruciate ligament 4 is fixed to the groove 232 of the guiding channel 25 by a fixing screw 8.

4. Install the gasket 3. The pad through hole 31 of the pad 3 is aligned with the boss 23 of the tibial base member 2, and is mounted on the base 21 of the tibial base member 2. The mounting and fitting method can be any existing pad and base member. The method of fitting; the upper end of the anterior cruciate ligament 4 is inserted into the anterior cruciate ligament of the femoral component, and the length of the anterior cruciate ligament 4 is adjusted. The upper end of the anterior cruciate ligament 4 is then fixed to the femur.

After the patient replaces the knee prosthesis, the femoral component 1 cooperates with the tibial base component 2, the pad 3, such that the tibial can support the femur through the knee prosthesis. The femoral component 1 and the sacral base component 2 are usually made of a metal material, and of course may be other materials such as ceramics. The gasket may be made of a high molecular polymer material, and the femoral component 1 and the cushion 3 can also cooperate with each other. To mimic the flexion and extension of the human knee joint. Moreover, in the first embodiment of the knee prosthesis of the present invention, the anterior cruciate ligament is reconstructed, in particular, the length of the anterior cruciate ligament 4 is close to the length of the patient's anterior cruciate ligament, and the attachment point of the anterior cruciate ligament 4 and the tibial base member 2 It is very close to the position of the patient's bioanatomical attachment point. Therefore, the patient can not only accurately simulate the knee flexion and extension, but also maximize the recovery of the proprioception.

Example 2

The second embodiment of the knee prosthesis of the present invention differs from the first embodiment of the knee prosthesis of the present invention as follows:

As shown in Figures 12A, 12B and 12C, in the second embodiment of the knee prosthesis of the present invention, the outer edge of the base 21 is provided with an upwardly extending flange 27 for assisting in the mounting of the cushion.

Guide passages 25 are formed in the base 21, the bosses 23, and the stem portions 22 along the longitudinal center line of the stem portion 22. One end of the guide passage 25 is open to the upper surface of the boss 23, and the other end is open to the lower end surface of the stem portion 22. . Further, since the opening of the upper surface of the boss 23, that is, the position of the opening on the guiding channel 25 coincides with the attachment position of the anterior cruciate ligament on the tibia in the anatomy, the attachment of the anterior cruciate ligament to the tibia base member in the present invention is The position is consistent with the anatomical attachment of the anterior cruciate ligament on the tibia. Of course, to accommodate certain special knee prosthetic structures, the guide channel 25 can also be offset from the longitudinal centerline of the stem 22. A locking mechanism is fixed in the guiding passage 25, and a through hole is formed in the locking mechanism, and the anterior cruciate ligament can be inserted through the through hole, and both ends are extended. After the lower end of the anterior cruciate ligament is secondarily fixed, it is sealed by a sealing rod 6 attached to the lower end of the stem portion 22. During the movement, the angle of change of the anterior cruciate ligament 4, the torsion and the like are mainly based on the position of the opening on the upper surface of the boss 23, so that the anterior cruciate ligament can be reconstructed by using the tibial base member of the present invention. Moreover, the patient can restore the proprioception after the replacement of the knee prosthesis, and the exercise is good, especially the activities that need to exert the biomechanical effects of the knee joint are better than the prior art, such as squatting, squatting, lateral movement, turning , lifting heavy objects, playing tennis, dancing, etc. At the same time, the wear of the anterior cruciate ligament in the sacral base component is avoided, ensuring the patient's motion safety and prolonging the service life of the prosthesis. At the same time, in the process of replacing the prosthesis, it is not necessary to consider retaining the bone when the proximal humerus is osteotomy, which greatly reduces the difficulty of the operation.

As shown in Figs. 13A, 13B and 14, in the second embodiment of the knee prosthesis of the present invention, the locking structure can be varied, for example, the locking sleeve 5. The locking sleeve 5 includes a base portion 50 and a side wall. The through sleeve 51 is disposed along the longitudinal center line of the locking sleeve 5. The side wall has four through slots 52 extending along the longitudinal direction thereof. The four through slots 52 are locked along the lock. Tightly arranged in 5 weeks, It is convenient for the locking sleeve 5 to shrink when locked. Of course, the number of the through slots 52 is not limited to four, and one, two, five, and the like are all feasible, and the specific diameter of the locking sleeve 5 is determined. The locking sleeve 5 can be fixed to the upper part of the guiding channel 25 in any manner. The preferred fixing manner is as follows: The upper part of the guiding channel 25 has a locking inclined surface, for example, the upper part of the guiding channel 25 has a conical shape, a pyramid shape or a wedge shape with a certain locking taper. The lower portion of the guide passage 25 may have a cylindrical shape or the like. The locking sleeve 5 can be clamped to the upper portion of the guiding channel 25. Further, the upper side wall of the locking sleeve 5 is provided with an inclined surface that cooperates with the locking inclined surface of the guiding passage 25, and the inclined angle of the inclined surface is not greater than the inclination angle of the locking inclined surface of the guiding passage 25. Of course, not limited thereto, it is also feasible to provide no inclined surface when the locking sleeve 5 has the through groove 52. In addition, as shown in FIG. 16D, the locking sleeve 5 can be externally threaded outside the base 50 of the locking sleeve 5 in addition to the aforementioned locking by the taper in the guiding passage 25, and is disposed on the guiding passage 25 The upper part of the inner wall is provided with an internal thread, and the locking sleeve 5 is further fixed in the guiding passage 25 by the thread, so that the locking sleeve 5 is fixed more firmly. In order to enhance the friction between the anterior cruciate ligament and the locking sleeve 5, the inner surface of the side wall of the locking sleeve 5 is provided with one or more of a plurality of protrusions, a plurality of dimples, a plurality of serrations, and a plurality of stripes, or A locking thread is arranged on the inner surface of the sleeve 5 side wall. The lower end portion of the guide passage 25 is provided with a thread (see Fig. 12C), and the sealing rod 6 is coupled to the lower end portion of the guide passage 25 by a threaded structure to cooperate with the cylindrical portion of the lower portion of the guide passage 25. The sealing rod 6 has a sealing effect on the guiding channel 25, and protects the anterior cruciate ligament in the guiding channel 25, and can also be used to withstand the locking sleeve 5 or the anterior cruciate ligament before assisting secondary fixation. Cruciate ligament. The sealing rod 6 can also be connected to the guiding passage 25 by other connecting structures such as pins, slots and the like.

As shown in Figs. 16A, 16B and 16C, the second embodiment of the knee prosthesis of the present invention further includes a anterior cruciate ligament 4. The anterior cruciate ligament 4 is disposed in the locking sleeve 5, and the upper and lower ends respectively extend out of the locking sleeve 5, and the upper end of the anterior cruciate ligament 4 is connected to the femur of the human body when the prosthesis is replaced. The lower end of the anterior cruciate ligament 4 can be further treated to achieve secondary fixation of the anterior cruciate ligament 4 relative to the tibial base element, as described in more detail below.

As shown in Fig. 16A, the lower end portion of the anterior cruciate ligament 4 has a stopper portion 41 having an outer contour size larger than that of the lower end portion of the lock sleeve 5, and the stopper portion 41 can be further prevented during the movement. The anterior cruciate ligament 4 is pulled upward by the locking sleeve 5, thereby making the fixation of the anterior cruciate ligament 4 within the tibial base member more secure. The stopper 41 may be formed by knotting, braiding, stitching, or any other manner at the lower end portion of the anterior cruciate ligament 4, and the knot cannot pass through the through hole 51 of the locking sleeve 5. In order to cooperate with the stopper portion 41 of the lower end portion of the anterior cruciate ligament 4, a groove 60 may be provided at the distal end portion of the sealing rod 6 to accommodate the partial stopper portion 41, and the peripheral portion of the groove 60 of the sealing rod 6 can be abutted against Lock the sleeve 5.

The process of fixing the anterior cruciate ligament 4 in the tibial base member 2 is: forming the stopper portion 41 by knotting, braiding, and suturing the upper end of the anterior cruciate ligament 4; and lowering the lower end of the anterior cruciate ligament 4 by the locking sleeve 5 Lower end (with base One end of 50 penetrates through hole 51 and passes through the upper end; pushes locking sleeve 5 from under the column 22 of the tibial base member 2 into the guiding channel 25, at which time the upper end of the cruciate ligament 4 protrudes The opening of the upper surface of the boss 23 has a certain length; the sealing rod 6 is screwed to the lower end of the guiding passage 25, and moves upward in the guiding passage 25 to withstand the locking sleeve 5, at which time the blocking portion 41 corresponds to the volume Placed in the groove at the top end of the sealing rod 6; continue to screw the sealing rod 6 to push the locking sleeve 5 to continue to move upward, and the upper portion of the locking sleeve 5 is pressed by the locking inclined surface of the guiding passage 25 to be gradually tightened until it will be The anterior cruciate ligament 4 is tightly clamped in the guiding channel 25 to achieve one fixation of the ligament. At the same time, the stopper portion 41 can block the anterior cruciate ligament 4 from being pulled out from the through hole 51 of the lock sleeve 5, thereby achieving secondary fixation of the anterior cruciate ligament 4.

In another embodiment as shown in FIG. 16D, the locking sleeve 5 can be engaged with the external thread provided in the outer wall of the base portion 50, and the internal thread provided in the guiding passage 25 to advance the locking sleeve to the guiding passage 25. The upper portion of the locking sleeve 5 is pressed by the locking inclined surface of the guiding passage 25 to be gradually tightened until the anterior cruciate ligament 4 is tightly clamped in the guiding passage 25, thereby achieving one fixation of the ligament. The stopper portion 41 formed by the method of knotting, braiding, and suturing of the anterior cruciate ligament 4 is located below the through hole 51 of the locking sleeve 5, and blocks the anterior cruciate ligament 4 from being pulled out from the through hole 51 of the locking sleeve 5, thereby realizing Secondary fixation of the anterior cruciate ligament 4. The sealing rod 6 seals the guide passage 25.

As shown in Fig. 16B, the lower end portion of the anterior cruciate ligament 4 is processed into a floc structure, and the floc structure includes a plurality of batts 42 which are dispersed on the peripheral side of the bottom end surface of the lock sleeve 5 and are clamped to the seal. Between the rod 6 and the locking sleeve 5, a secondary fixation of the anterior cruciate ligament 4 is achieved.

The process of fixing the anterior cruciate ligament 4 in the sacral base element 2 is to process one end of the anterior cruciate ligament 4 into a floc structure; the other end of the anterior cruciate ligament 4 is made up of the lower end of the locking sleeve 5 (with the base 50) One end) penetrates through the through hole 51 and passes through the upper end; pushes the locking sleeve 5 from below the column 22 of the sacral base member 2 into the guiding channel 25, at which time the upper end of the cruciate ligament 4 protrudes from the boss 23 The opening of the upper surface has a certain length, and a plurality of batts 42 of the floc structure are dispersed on the peripheral side of the bottom end surface of the locking sleeve 5; the sealing rod 6 is screwed to the lower end of the guiding passage 25, and is upward in the guiding passage 25. The square moves, against the locking sleeve 5, continues to twist the sealing rod 6 to push the locking sleeve 5 to continue to move upward, and the upper portion of the locking sleeve 5 is pressed by the locking inclined surface of the guiding passage 25 to gradually tighten until the front The cruciate ligament 4 is tightly clamped in the guiding channel 25 to achieve one fixation of the ligament; at the same time, a plurality of batts 42 are clamped between the sealing rod 6 and the locking sleeve 5 to realize the anterior cruciate ligament 4 Secondary fixation.

As shown in Fig. 16C, the lower end portion of the anterior cruciate ligament 4 has a floc structure, and the floc structure includes a plurality of batts 42 which are dispersed on the peripheral side of the bottom end surface of the lock sleeve 5, and the upper end portion of the sealing rod 6 A boss portion 61 is provided which abuts against the lower end portion of the anterior cruciate ligament 4, and a plurality of batts 42 are clamped between the boss portion 61 and the lock sleeve 5.

The process in which the anterior cruciate ligament 4 is fixed in the tibial base member 2 differs from the process in which the anterior cruciate ligament having the floc structure shown in Fig. 16B is fixed in the tibial base member 2 in that the sealing rod 6 passes through the boss portion thereof. 61 against the previous The lower end portion of the ligament 4 is fixed, and the anterior cruciate ligament 4 is fixed to the inner wall of the lock sleeve 5 to achieve secondary fixation. The other processes are the same and will not be described here.

As shown in FIG. 16E, the anterior cruciate ligament 4 can be fixed in the guiding channel 25 through the snap ring 7. At this time, the upper end of the guiding channel 25 is provided with a retaining ring 221 extending into the guiding channel 25 for blocking the snap ring 7 and avoiding the card. The ring 7 is detached from the upper end opening of the guide passage 25. The anterior cruciate ligament 4 is tightly caught by the snap ring 7 . The lower end portion of the extension clasp 7 of the anterior cruciate ligament 4 may be the same stopper portion 41 as described above. The upper surface of the sealing rod 6 abuts against the snap ring 7 to lock the snap ring 7 in the guiding passage 25, and the blocking portion 41 is partially received in the recess of the sealing rod 6.

The anterior cruciate ligament 4 used in the second embodiment of the knee prosthesis of the present invention may be an artificial ligament or a ligament taken from other parts of the human body.

In a second embodiment of the knee prosthesis of the present invention, the locking mechanism is provided with a through hole for the anterior cruciate ligament to pass through, and the anterior cruciate ligament is fixed in the guiding channel of the tibial base component by the locking mechanism; and the anterior cruciate ligament After the second fixing, it is sealed by the sealing rod in the guiding passage. Therefore, the use of the sacral pedicle component of the present invention avoids the fixation of the anterior cruciate ligament on the side of the human humerus, which reduces the damage to the tibia and facilitates the revision of the humeral base component in the future; the anterior cruciate ligament is in the guiding channel. The second fixation is performed, the ligament is not easy to occur, and the fixation is firm. At the same time, since the anterior cruciate ligament is not fixed on the tibia, but is fixed inside the sacral base member, the bone requirement for the tibia is greatly reduced. The sacral base component of the present invention is very versatile.

The second embodiment of the knee prosthesis of the present invention can rebuild the anterior cruciate ligament with the posterior cruciate ligament, and the procedure of the second embodiment of the knee prosthesis of the present invention is performed:

1. After the osteotomy is prepared on the femur and tibia, the anterior cruciate ligament is positioned on the corresponding part of the femur. 2. The anterior cruciate ligament 4 is fixed and twice fixed in the tibial base member 2, and the position of the anterior cruciate ligament 4 at the outlet of the boss 23 of the tibial base member 2 is appropriately determined.

3. The femoral component 1 and the tibial base component 2 are mounted on a truncated bone plane, wherein the stem 22 of the tibial base component 2 is inserted into the medullary canal of the tibia.

4. The pad through hole 31 of the pad 3 is aligned with the boss 23 of the tibial base member 2, and is mounted on the base 21 of the tibial base member 2. The mounting method can be any pad and tibia available. The method of fitting the base member; the upper end of the anterior cruciate ligament 4 is inserted into the anterior cruciate ligament of the femoral component 1, and the length of the anterior cruciate ligament 4 is adjusted, and the upper end of the anterior cruciate ligament 4 is fixed to the femur as appropriate.

After the patient replaces the knee prosthesis, the femoral component 1 cooperates with the tibial base component 2, the pad 3, such that the tibia can support the femur through the knee prosthesis. The femoral component 1 and the sacral base component 2 are usually made of a metal material, and of course other materials such as ceramics. The gasket may be made of a high molecular polymer material, between the femoral component 1 and the liner 3. It can also be used in conjunction with exercise to mimic the flexion and extension of the human knee joint. In particular, in the second embodiment of the knee prosthesis of the present invention, the anterior cruciate ligament is reconstructed, the length of the anterior cruciate ligament 4 is close to the length of the patient's anterior cruciate ligament, and the attachment point of the anterior cruciate ligament 4 to the tibial base member 2 is The position of the bioanatomical attachment point is very close, so the patient can not only accurately simulate the knee flexion and extension, but also maximize the recovery of the proprioception. At the same time, the second embodiment of the knee prosthesis of the present invention has the following advantages:

1. Cancel the humerus bone, reduce the humeral side injury, and reduce the surgical procedures, and at the same time facilitate the revision of the knee joint prosthesis.

2. The anterior cruciate ligament is fixed in the sacral base component, which reduces the bone requirement of the knee prosthesis and is suitable for more people.

3. The anterior cruciate ligament is treated with knotting and flocculation at the lower end of the locking mechanism to achieve secondary fixation and anti-exfoliation of the anterior cruciate ligament, thereby reducing the wear of the anterior cruciate ligament and prolonging the service life of the anterior cruciate ligament. Industrial Applicability The knee prosthesis of the present invention not only can reconstruct the anterior cruciate ligament, but also enables the patient to restore the proprioception after replacing the knee prosthesis, and the exercise is good, especially that the knee joint can be realized more than the prior art. The activities of biomechanical action are as follows: squatting, squatting, lateral movement, turning, lifting heavy objects, playing tennis, dancing, etc. At the same time, the wear of the anterior ligament in the prosthesis is avoided, the safety of the patient is ensured, the service life of the prosthesis is prolonged, and the utility is industrially practical.

While the invention has been described with respect to the preferred embodiments illustrated embodiments The present invention may be embodied in a variety of forms without departing from the spirit or scope of the invention. It is to be understood that the invention is not limited to the details of the invention. All changes and modifications that come within the scope of the claims and their equivalents are intended to be embraced by the appended claims.

Claims

Rights request

A knee joint prosthesis tibial base member, the tibial base member for engaging a tibia, comprising a base (21), wherein the base (21) is provided with a boss (23) ), the boss (23) and the base (21) have a guiding passage (25) through which the anterior cruciate ligament (4) passes.

The tibial base component according to claim 1, wherein the sum of the heights of the boss (23) and the base (21) is equal to the proximal humerus bone resected during replacement of the knee joint prosthesis The sum of the heights of the cartilage.

The tibial base member according to claim 1, wherein an angle between a projection of a center line of the guiding passage (25) on an upper surface of the base (21) and a sagittal plane of the human body (X is 10°-30°.

4. The tibial base component according to claim 1, wherein the angle between the projection of the centerline of the guiding channel (25) on the sagittal plane of the human body and the upper surface of the base (21) is 60°- 80°.

The tibial base member according to claim 1, wherein the boss (23) has a rectangular cross section.

The tibial base member according to claim 1, wherein the guide passage (25) has an end opening on an upper surface of the boss (23) and an other end opening on the base (21). The lower surface of the).

The tibial base member according to claim 1, wherein a stem portion (22) is formed under the base (21), and an end opening of the guiding passage (25) is located at the boss ( 23) The upper surface, the other end opening is located on the side of the stem (22).

The tibial base member according to claim 6 or 7, wherein the guiding passage (25) is located at an opening position of the upper surface of the boss (23) and the anterior cruciate ligament (4) at the tibia The attachment positions are consistent.

9. The tibial base element of claim 1 further comprising a fixed structure for securing the anterior cruciate ligament (4) to the guide channel (25).

The sacrum base member according to claim 9, wherein the fixing structure comprises a fixing screw (8), and a side of the boss (23) is provided with a thread communicating with the guiding passage (25) The hole (231), the fixing screw (8) is provided with a thread that cooperates with the threaded hole (231).

The humeral base member according to claim 10, wherein a groove (232) is provided on a side wall of the guiding passage (25) opposite to the threaded hole (231).

The tibial base member according to claim 1, wherein a stem portion (22) is formed under the base (21), and the guide passage (25) has an end opening at the boss ( The upper surface of the 23) is located at the bottom surface of the stem portion (22), and the upper portion of the guiding passage (25) is provided with a locking mechanism for fixing the anterior cruciate ligament, and the locking mechanism is provided with a front cross a through hole through which the ligament passes, the lower end of the stem (22) is mounted a sealing rod (6) sealing the lower end opening of the guiding passage (25), the sealing rod (6) sealing the anterior cruciate ligament passing through the through hole and sealing in the guiding passage (25) .

13. The tibial base component according to claim 12, wherein the guiding channel (25) extends through the boss (23) and the stem along a longitudinal centerline of the stem (22) ( twenty two) .

14. A tibial base component according to claim 12, wherein the locking mechanism is a locking sleeve (5) comprising a base (50) and side walls and edges extending from the base (50) The locking sleeve (5) has a through hole (51) disposed in a longitudinal center line, and the side wall has at least one through groove (52) along a longitudinal direction thereof.

The tibial base member according to claim 14, wherein an upper portion of the guiding passage (25) has a tapered shape or a wedge shape, and a side wall of the locking sleeve (5) and the guiding passage ( 25) The upper part works together.

16. The tibial base component according to claim 14, wherein the inner surface of the side wall of the locking sleeve (5) is provided with a plurality of protrusions and/or a plurality of dimples and/or a plurality of serrations and/or several Stripes and/or locking threads.

17. A tibial base element according to claim 14, wherein the base (50) of the locking sleeve (5) is mounted in the guiding channel (25) by a threaded fit.

The tibial base member according to any one of claims 14-17, characterized in that the upper end surface of the sealing rod (6) abuts against the lower end surface of the locking sleeve (5).

The sacrum base member according to claim 1, wherein the locking mechanism is a snap ring (7), and the upper end of the guiding passage (25) is provided in the guiding passage (25) Extended retaining ring (221).

The tibial base component according to claim 19, wherein the upper surface of the sealing rod (6) abuts against the underside of the snap ring (7), and the snap ring (7) is locked and mounted on the guiding passage (25). ) Inside.

21. A knee prosthesis pad, the upper surface of the pad (3) being an articular surface, characterized in that the pad (3) is provided to accommodate the tibia of any one of claims 1 to 11. A gasket opening (3Γ) or a gasket through hole (31) of the boss (23) in the base member.

The knee prosthesis pad according to claim 21, wherein the shape of the pad through hole (31) matches the cross-sectional shape of the boss (23).

The knee joint prosthesis pad according to claim 21 or 22, wherein the upper surface of the pad (3) is flush with the upper surface of the boss (23) or has a l-5 mm The distance is poor.

24. A knee prosthesis comprising a tibial base member for engaging a tibia, a femoral component for engaging the femur, and a knee prosthetic pad mate with the tibial base member, the lining The upper surface of the pad is an articular surface, and the femoral component is provided with a femoral articular surface matching the pad articular surface, characterized in that the tibial base element is according to any one of claims 1-20 Tibial base element, the knee prosthesis liner A knee prosthesis liner according to any of claims 21-23.

The knee joint prosthesis according to claim 24, wherein the knee joint prosthesis further comprises an anterior cruciate ligament (4) penetrating in the locking mechanism, the anterior cruciate ligament (4) In the guiding channel (25), the fixing is performed once by the locking mechanism, and the fixing is performed twice under the locking mechanism.

The knee joint prosthesis according to claim 25, wherein a lower end portion of the anterior cruciate ligament (4) has a stopper portion (41), and the stopper portion (41) is secondarily fixed by the stopper portion (41). The outer contour of the stopping portion (41) is larger than the opening end of the lower end of the locking mechanism through hole.

The knee joint prosthesis according to claim 26, wherein a top end portion of the sealing rod (6) abuts against the locking mechanism, and a groove is formed on an upper surface of the sealing rod (6) (60), the stopping portion (41) is partially received in the recess (60) of the sealing rod (6).

The knee joint prosthesis according to claim 25, wherein the lower end portion of the anterior cruciate ligament (4) has a floc structure through which the flocculation structure includes secondary fixation, the floc structure including Several strips

(42), the plurality of strips (42) are dispersed on a peripheral side of the bottom end surface of the locking sleeve (5) and sandwiched between the sealing rod (6) and the locking sleeve (5) .

The knee joint prosthesis according to claim 24, wherein: the patella base member (2) is made of a metal material and/or the pad (3) is made of a polymer material. .