FR2701387A1 - Postero-stabilised knee prosthesis - Google Patents

Postero-stabilised knee prosthesis Download PDF

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Publication number
FR2701387A1
FR2701387A1 FR9301740A FR9301740A FR2701387A1 FR 2701387 A1 FR2701387 A1 FR 2701387A1 FR 9301740 A FR9301740 A FR 9301740A FR 9301740 A FR9301740 A FR 9301740A FR 2701387 A1 FR2701387 A1 FR 2701387A1
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France
Prior art keywords
tibial
prosthesis according
keel
boss
opening
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Granted
Application number
FR9301740A
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French (fr)
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FR2701387B1 (en
Inventor
Docteur Berger Michel
Allal Michel
Benoliel Jean
Berger Michel
Bost Joelbraud Gerard
Broutart Jean-Claude
Caillol Michel
Calas Philippe
Cartier Jean-Loup
Castera Gerard
Castresana Fernando
Cohen Emile
Cohen Gerald
Dubart Alain-Michel
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Individual
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Individual
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Priority to FR9301740A priority Critical patent/FR2701387B1/en
Publication of FR2701387A1 publication Critical patent/FR2701387A1/en
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Publication of FR2701387B1 publication Critical patent/FR2701387B1/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A61F2/3886—Joints for elbows or knees for stabilising knees against anterior or lateral dislocations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30433—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws

Abstract

Postero-stabilised knee prosthesis, comprising a femoral implant (1) and a tibial implant (2-3), noteworthy in that the implants (1) (2-3) are mounted so that they can slide and so that they bear on one another and have, in combination, complementary shapes for guiding and positioning (1a) (3a), in extension and in flexion, the said shapes (1a) (3a) being capable of allowing guiding of the said implants as flexion occurs, with a capacity for controlled angular rotation.

Description

Prothèse du genou postéro-stabilisée. Posterior stabilized knee prosthesis.

Généralement, une prothèse du genou présente essentiellement un implant tibial et un implant fémoral. Generally, a knee prosthesis essentially has a tibial implant and a femoral implant.

Plus particulièrement, l'invention concerne une prothèse du genou, dite à glissement, c'est-à-dire sans aucune liaison mécanique entre les implants tibial et fémoral. Ce type de prothèse peut présenter différentes formes de réalisation. L'objectif que se propose d'atteindre ces différentes prothèses, est de tenir compte des mouvements naturels de l'articulation anatomique du genou, à savoir essentiellement, le mouvement de rotation du tibia par rapport au fémur, qui apparait au début de la flexion de la jambe et du fait que les condyles fémoraux roulent et glissent à la fois sur le plateau tibial. More particularly, the invention relates to a knee prosthesis, called a sliding prosthesis, that is to say without any mechanical connection between the tibial and femoral implants. This type of prosthesis can have different embodiments. The aim of these different prostheses is to take into account the natural movements of the anatomical knee joint, namely essentially the rotational movement of the tibia relative to the femur, which appears at the start of flexion of the leg and the fact that the femoral condyles roll and slide both on the tibial plateau.

Le problème que se propose de résoudre l'invention, est de réaliser une prothèse du genou permettant d'obtenir une postérostabilisation par un appui positif, une possibilité de rotation en cours de flexion, une stabilité en extension et enfin une postéro-stabilisation dès le début de la flexion. The problem which the invention proposes to solve is to produce a knee prosthesis allowing postero-stabilization to be obtained by positive support, a possibility of rotation during flexion, stability in extension and finally postero-stabilization from the start of flexion.

Pour résoudre un tel problème, il a été conçu et mis au point, une prothèse du genou postéro-stabilisée qui comprend un implant fémoral et un implant tibial, les implants étant montés à glissement et en appui et présentent en combinaison des formes complémentaires de guidage et de positionnement, en extension et en flexion, lesdites formes étant aptes à permettre le guidage desdits implants, au fur et à mesure de la flexion, avec capacité de rotation angulaire contrôlée. To solve such a problem, a postero-stabilized knee prosthesis has been designed and developed which includes a femoral implant and a tibial implant, the implants being mounted to slide and rest and have in combination complementary forms of guidance. and positioning, in extension and in flexion, said forms being able to allow the guiding of said implants, as and when flexion, with controlled angular rotation capacity.

Pour résoudre le problème posé d'obtenir le guidage constant des éléments tibial et fémoral en position d'extension et au fur et à mesure de la flexion, les formes complémentaires de guidage et de positionnement sont constituées par une ouverture et un bossage profilés. To solve the problem of obtaining constant guidance of the tibial and femoral elements in the extended position and as the flexion progresses, the complementary forms of guidance and positioning are constituted by a profiled opening and boss.

L'ouverture profilée est formée entre les patins condyliens de l'implant fémoral. The profiled opening is formed between the condylar pads of the femoral implant.

Le bossage est formé en débordement de la partie médiane de l'implant tibial, notamment en débordement d'un plateau tibial fixé sur une embase tibiale. The boss is formed in overflow from the middle part of the tibial implant, in particular in overflow of a tibial plate fixed on a tibial base.

Pour résoudre le problème posé d'obtenir un contact linéaire entre l'élément fémoral et l'élément tibial, quelle que soit la position considérée de l'articulation du genou, l'ouverture présente, entre les patins condyliens, une butée profilée coopérant avec un profil complémentaire du bossage, pour assurer le guidage au fur et à mesure de la flexion. To solve the problem posed of obtaining a linear contact between the femoral element and the tibial element, whatever the considered position of the knee joint, the opening has, between the condylar pads, a profiled stop cooperating with a complementary profile of the boss, to provide guidance as and when bending.

La butée et le profil du bossage sont de section arrondie de rayon de courbure déterminé pour être en contact au fur et à mesure de la flexion. The stop and the profile of the boss have a rounded section with a radius of curvature determined to be in contact as and when bending.

L'ouverture présente un rebord périphérique interne. The opening has an internal peripheral rim.

Pour résoudre le problème posé d'assurer la fixation de l'implant tibial, l'embase tibiale présente une quille de stabilité et d'ancrage. To solve the problem of securing the tibial implant, the tibial base has a keel for stability and anchoring.

Un autre problème que se propose de résoudre l'invention est d'assurer le centrage du plateau tibial qui constitue la surface de glissement. Another problem which the invention proposes to solve is to ensure the centering of the tibial plateau which constitutes the sliding surface.

Un tel problème est résolu en ce que la quille est fixée à l'embase en combinaison avec le plateau tibial, au moyen d'une vis. Such a problem is solved in that the keel is fixed to the base in combination with the tibial plateau, by means of a screw.

L'embase tibiale présente en débordement de sa face de dessous, une portée interne conique de centrage, pour le positionnement d'une portée complémentaire formée en bout de la quille, la vis de fixation du plateau coopérant avec la portée de la quille d'ancrage. The tibial base has an internal conical centering bearing beyond its underside, for positioning a complementary bearing formed at the end of the keel, the plate fixing screw cooperating with the bearing of the keel. anchoring.

Dans une forme de réalisation, l'extrémité de la portée conique mâle de la quille, présente une portée cylindrique filetée coopérant avec une portée cylindrique taraudée formée en bout de la portée femelle conique de l'embase tibiale. In one embodiment, the end of the male conical bearing surface of the keel has a threaded cylindrical bearing surface cooperating with a tapped cylindrical bearing surface formed at the end of the conical female bearing surface of the tibial base.

L'invention est exposée, ci-après plus en détail à l'aide des dessins annexés, dans lesquels:
La figure 1 est une vue en perspective de l'implan ttibial et de l'implant fémoral selon l'invention.The invention is set out below in more detail using the appended drawings, in which:
Figure 1 is a perspective view of the ttibial implant and the femoral implant according to the invention.

La figure 2 est une vue en coupe longitudinale avant assemblage des différents éléments constitutifs de la prothèse. Figure 2 is a longitudinal sectional view before assembly of the various components of the prosthesis.

La figure 3 est une vue en coupe correspondant à la figure 2, après assemblage des éléments constitutifs de la prothèse et impaction des implants fémoral ou tibial. Figure 3 is a sectional view corresponding to Figure 2, after assembly of the components of the prosthesis and impaction of the femoral or tibial implants.

La figure 4 est une vue de face de la prothèse en position extension. Figure 4 is a front view of the prosthesis in the extended position.

La figure 5 est une vue en plan correspondant à la figure 4. FIG. 5 is a plan view corresponding to FIG. 4.

La figure 6 est une vue correspondant à la figure 4 en position de flexion. Figure 6 is a view corresponding to Figure 4 in the bending position.

La figure 7 est une vue en coupe longitudinale en position de flexion.  Figure 7 is a longitudinal sectional view in the bending position.

La figure 8 est une vue partielle en coupe d'une autre forme de réalisation de la fixation de l'ensemble de l'embase tibiale et de la quille de stabilité et d'ancrage. Figure 8 is a partial sectional view of another embodiment of the attachment of the entire tibial base and the stability and anchoring keel.

D'une manière parfaitement connue, la prothèse du genou comprend un implant fémoral (1) et un implant tibial composé d'une embase tibiale (2), d'un plateau tibial (3) et d'une quille de stabilité et d'ancrage (4). Le plateau (3) est en polyéthylène, les autres éléments (I), (2) et (4) étant exécutés en tout métal approprié. In a perfectly known manner, the knee prosthesis comprises a femoral implant (1) and a tibial implant composed of a tibial base (2), a tibial plateau (3) and a keel for stability and anchor (4). The plate (3) is made of polyethylene, the other elements (I), (2) and (4) being made of any suitable metal.

Selon l'invention, l'implant fémoral et l'implant tibial sont montés à glissement et en appui et présentent en combinaison, des formes complémentaires de guidage et de positionnement en extension et en flexion. Dans ce but et comme le montre la figure 1, ces formes complémentaires sont constituées par une ouverture (la) et un bossage (3a). L'ouverture (la) est formée entre les patins condyliens (1 b) et (il).  According to the invention, the femoral implant and the tibial implant are mounted to slide and to bear and have in combination, complementary forms of guidance and positioning in extension and in flexion. For this purpose and as shown in Figure 1, these complementary forms are constituted by an opening (la) and a boss (3a). The opening (la) is formed between the condylar pads (1b) and (il).

Cette ouverture présente un rebord périphérique interne (las) pour le guidage par rapport au bossage ou plot (3a). Le bossage (3a) est formé en débordement de la partie médiane du plateau tibial (3). Plus particulièrement, ce bossage est établi à partir du bord postérieur de l'implant tibial, notamment à partir de l'échancrure (3b) qui délimite les surfaces d'appui et de glissement du plateau tibial.This opening has an internal peripheral rim (las) for guiding relative to the boss or stud (3a). The boss (3a) is formed projecting from the middle part of the tibial plateau (3). More particularly, this boss is established from the posterior edge of the tibial implant, in particular from the notch (3b) which delimits the bearing and sliding surfaces of the tibial plateau.

Selon une caractéristique importante de l'invention et comme le montrent notamment les figures 5 et 7, l'ouverture (la) présente, entre les patins condyliens (lob) et (il), une butée profilée (1a2) apte à coopérer avec un profil complémentaire (3a1) du bossage. Ces dispositions sont destinées à assurer le guidage des implants tibial et fémoral, au fur et à mesure de la flexion. Plus particulièrement, la butée (la2) présente une section transversale arrondie dans le plan frontal et dans le plan sagittal. According to an important characteristic of the invention and as shown in particular in Figures 5 and 7, the opening (la) has, between the condylar pads (lob) and (il), a profiled stop (1a2) capable of cooperating with a complementary profile (3a1) of the boss. These provisions are intended to ensure the guidance of the tibial and femoral implants, as the flexion progresses. More particularly, the stop (la2) has a rounded cross section in the frontal plane and in the sagittal plane.

Cette section coopère avec le profil (3aI) du bossage (3) qui constitue une surface d'appui et de glissement de section transversale concave.This section cooperates with the profile (3aI) of the boss (3) which constitutes a bearing and sliding surface of concave cross section.

La conception particulière de l'ouverture (la) et du bossage (3a) assure en combinaison, le positionnement et le centrage de l'élément fémoral par rapport à l'élément tibial, quelle que soit la position considérée de l'articulation, depuis la position extension jusqu'à la position flexion, avec un guidage permanent. The particular design of the opening (la) and the boss (3a) ensures in combination, the positioning and the centering of the femoral element relative to the tibial element, whatever the considered position of the joint, from the extension position to the flexion position, with permanent guidance.

On voit aux figures 5, 6 et 7, qu'il y a un guidage permanent depuis la position d'extension (figure 5) jusqu'à la position de flexion (figure 7), la butée profilée (la2) prenant appui et glissant le long de la portée concave d'appui (3a1) du bossage (3). We see in Figures 5, 6 and 7, that there is a permanent guide from the extension position (Figure 5) to the bending position (Figure 7), the profiled stop (la2) taking support and sliding along the concave bearing surface (3a1) of the boss (3).

Dans la forme de réalisation illustrée, l'embase tibiale (2) présente en débordement de sa face de dessous, une quille de stabilité et d'ancrage (2a). Cette quille est destinée à recevoir une tige d'ancrage (4). In the illustrated embodiment, the tibial base (2) has an overhang from its underside, a keel for stability and anchoring (2a). This keel is intended to receive an anchor rod (4).

La fixation de la tige (4) par rapport à l'embase (2), notamment par rapport à la quille (2a), s'effectue en combinaison avec la fixation du plateau tibial (3) au moyen d'une vis (5). The attachment of the rod (4) relative to the base (2), in particular relative to the keel (2a), is carried out in combination with the attachment of the tibial plateau (3) by means of a screw (5 ).

Le plateau tibial (3) est fixé dans l'embase tibiale (2) par clipsage. De telles dispositions ne sont pas décrites en détail, car parfaitement connues par un homme du métier. La quille (2a) présente une portée interne tronconique (2aI) dans laquelle est engagée une portée conique mâle complémentaire (4a) formée en bout de la tige (4). En outre, cette portée mâle tronconique (4a) présente un taraudage (4a1) destiné à recevoir la vis (5). Cette vis (5) est engagée librement dans l'épaisseur du plateau et de l'embase tibiale en y étant butée par sa tête (5a).  The tibial plateau (3) is fixed in the tibial base (2) by clipping. Such arrangements are not described in detail because they are perfectly known to a person skilled in the art. The keel (2a) has a frustoconical internal bearing (2aI) in which is engaged a complementary male conical bearing (4a) formed at the end of the rod (4). In addition, this tapered male bearing (4a) has a thread (4a1) intended to receive the screw (5). This screw (5) is freely engaged in the thickness of the plate and of the tibial base while being stopped there by its head (5a).

Dans une autre forme de réalisation (figure 8), l'extrémité de la portée conique mâle (4a) présente une portée cylindrique filetée (4b) coopérant avec une portée cylindrique taraudée (2b) formée en bout de la portée femelle tronconique (2aï).  In another embodiment (FIG. 8), the end of the male conical bearing (4a) has a threaded cylindrical bearing (4b) cooperating with a threaded cylindrical bearing (2b) formed at the end of the frustoconical female bearing (2ai) .

Bien évidemment, les patins condyliens (lob) et (1c) ont un
profil déterminé en combinaison avec le profil du plateau tibial, pour être
en contact permanent au fur et à mesure de la flexion. De même, l'implant
fémoral (1) peut présenter une partie (Id) faisant office de trochlée.Obviously, the condylar pads (lob) and (1c) have a
profile determined in combination with the profile of the tibial plateau, to be
in permanent contact as and when bending. Likewise, the implant
femoral (1) can present a part (Id) acting as a trochlea.

Les avantages ressortent bien de la description. The advantages are apparent from the description.

Claims (11)

REVENDICATIONS -1- Prothèse du genou postéro-stabilisée comprenant un implant fémoral (1) et un implant tibial (2-3), caractérisé en ce que les implants (1) (2-3) sont montés à glissement et en appui et présentent en combinaison des formes complémentaires de guidage et de positionnement (la) (3a), en extension et en flexion, lesdites formes (la) (3a) étant aptes à permettre le guidage desdits implants, au fur et à mesure de la flexion, avec capacité de rotation angulaire contrôlée.-1- Posterior stabilized knee prosthesis comprising a femoral implant (1) and a tibial implant (2-3), characterized in that the implants (1) (2-3) are mounted to slide and rest and present in combination of complementary forms of guidance and positioning (la) (3a), in extension and in flexion, said forms (la) (3a) being able to allow the guidance of said implants, as and when flexion, with capacity controlled angular rotation. -2- Prothèse selon la revendication 1, caractérisée en ce que les formes complémentaires de guidage et de positionnement sont constituées par une ouverture (la) et un bossage (3a) profilés.-2- Prosthesis according to claim 1, characterized in that the complementary forms of guidance and positioning are constituted by an opening (la) and a boss (3a) profiled. -3- Prothèse selon la revendication 2, caractérisée en ce que l'ouverture profilée (la) est formée entre les patins condyliens (lob) (1c) de l'implant fémoral (1). -3- Prosthesis according to claim 2, characterized in that the profiled opening (la) is formed between the condylar pads (lob) (1c) of the femoral implant (1). -4- Prothèse selon la revendication 2, caractérisée en ce que le bossage (3a) est formé en débordement de la partie médiane de l'implant tibial, notamment en débordement d'un plateau tibial (3) fixé sur une embase tibiale (2).-4- Prosthesis according to claim 2, characterized in that the boss (3a) is formed in overflow of the middle part of the tibial implant, in particular in overflow of a tibial plate (3) fixed on a tibial base (2 ). -5- Prothèse selon la revendication 2, caractérisée en ce que l'ouverture (la) présente, entre les patins condyliens (lob) (il), une butée profilée (1a2) coopérant avec un profil complémentaire (3a1) du bossage (3a), pour assurer le guidage au fur et à mesure de la flexion.-5- Prosthesis according to claim 2, characterized in that the opening (la) has, between the condylar pads (lob) (it), a profiled stop (1a2) cooperating with a complementary profile (3a1) of the boss (3a ), to provide guidance as and when bending. -6- Prothèse selon la revendication 5, caractérisée en ce que la butée (la2) et le profil (3aï) du bossage (3a) sont de section arrondie de rayon de courbure déterminé pour être en contact au fur et à mesure de la flexion.-6- Prosthesis according to claim 5, characterized in that the stop (la2) and the profile (3ai) of the boss (3a) are of rounded section of radius of curvature determined to be in contact as the bending . -7- Prothèse selon la revendication 2, caractérisée en ce que l'ouverture (la) présente un rebord périphérique interne (lal).-7- Prosthesis according to claim 2, characterized in that the opening (la) has an internal peripheral rim (lal). -8- Prothèse selon la revendication 1, caractérisée en ce que l'embase tibiale (2) présente une quille de stabilité et d'ancrage (4).-8- Prosthesis according to claim 1, characterized in that the tibial base (2) has a keel for stability and anchoring (4). -9- Prothèse selon la revendication 8, caractérisée en ce que la quille (4) est fixée à l'embase (2) en combinaison avec le plateau tibial (3), au moyen d'une vis (5). -9- Prosthesis according to claim 8, characterized in that the keel (4) is fixed to the base (2) in combination with the tibial plateau (3), by means of a screw (5). -10- Prothèse selon la revendication 9, caractérisée en ce que l'embase tibiale (2) présente en débordement de sa face de dessous, une portée interne conique de centrage (2aï), pour le positionnement d'une portée complémentaire (4a) formée en bout de la quille (4), la vis de fixation (5) du plateau (2) coopérant avec la portée de la quille d'ancrage.-10- Prosthesis according to claim 9, characterized in that the tibial base (2) has an internal conical centering surface (2ai) projecting from its underside, for positioning a complementary surface (4a) formed at the end of the keel (4), the fixing screw (5) of the plate (2) cooperating with the bearing surface of the anchoring keel. -11- Prothèse selon la revendication 10, caractérisée en ce que l'extrémité de la portée conique mâle (4a) de la quille (4), présente une portée cylindrique filetée (4b) coopérant avec une portée cylindrique taraudée (2b) formée en bout de la portée femelle conique (2a) de l'embase tibiale. -11- Prosthesis according to claim 10, characterized in that the end of the male conical bearing (4a) of the keel (4) has a threaded cylindrical bearing (4b) cooperating with a threaded cylindrical bearing (2b) formed in end of the tapered female seat (2a) of the tibial base.
FR9301740A 1993-02-10 1993-02-10 POSTERO-STABILIZED KNEE PROSTHESIS. Expired - Fee Related FR2701387B1 (en)

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EP2826444A1 (en) * 2013-07-16 2015-01-21 Howmedica Osteonics Corp. Femoral component with curved central box

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