ASYMMETRIC TIBIAL COMPONENTS FOR A KNEE PROSTHESIS

• US 20120022660A1
• Filed: 07/22/2011
• Published: 01/26/2012
• Est. Priority Date: 07/24/2010
• Status: Active Grant

• Current Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Wentorf, Mary S.S.
• Granted Patent: US 8,568,486 B2
• Time in Patent Office: Days
• US Class Current: 623/20.32
• CPC Class Codes: A61F 2/3868 with sliding tibial bearing
• CPC Class Codes: A61F 2/3886 for stabilising knees against anterior or lateral dislocations
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30326 differing in height or in length
• CPC Class Codes: A61F 2002/30387 Dovetail connection
• CPC Class Codes: A61F 2002/30616 Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30883 dovetail-shaped
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements

Abstract

An orthopaedic tibial prosthesis includes a tibial baseplate with an asymmetric periphery which promotes proper positioning and orientation on a resected tibia, while also facilitating enhanced kinematics, soft-tissue interaction, and long-term fixation of the complete knee prosthesis. The asymmetric baseplate periphery is sized and shaped to substantially match portions of the periphery of a typical resected proximal tibial surface, such that proper location and orientation is evident by resting the baseplate on the tibia. The baseplate periphery provides strategically positioned relief and/or clearance between the baseplate periphery and bone periphery, such as in the posterior-medial portion to prevent deep-flexion component impingement, and in the anterior-lateral portion to avoid undue interaction between the anatomic iliotibial band and prosthesis components.

Claims

1. A family of tibial prostheses sized for attachment to a proximal tibia, the family comprising:

a plurality of tibial prostheses defining a plurality of prosthesis peripheries, each said prosthesis periphery defining;

a centroid,

an anteroposterior axis dividing said prosthesis periphery into a medial compartment and a lateral compartment;

a posterior-medial distance extending from said centroid to a posterior-medial corner of said prosthesis periphery;

a posterior-lateral distance extending from said centroid to a posterior-lateral corner of said prosthesis periphery;

said plurality of prosthesis peripheries including;

a small periphery corresponding to a small prosthesis size, said small periphery defining said posterior-medial distance having a small posterior-medial extent and said posterior-lateral distance having a small posterior-lateral extent;

a medium periphery corresponding a medium prosthesis size that is the next-largest consecutive prosthesis size as compared to said small prosthesis size, said medium periphery defining said posterior-medial distance having a medium posterior-medial extent larger than said small posterior-medial extent to exhibit a first posterior-medial growth, said medium periphery further defining said posterior-lateral distance having a medium posterior-lateral extent larger than said small posterior-lateral extent to exhibit a first posterior-lateral growth; and

a large periphery corresponding a large prosthesis size that is the next-largest consecutive prosthesis size as compared to said medium prosthesis size, said large periphery defining said posterior-medial distance having a large posterior-medial extent larger than said medium posterior-medial extent to exhibit a second posterior-medial growth, said large periphery further defining said posterior-lateral distance having a large posterior-lateral extent larger than said medium posterior-lateral extent to exhibit a second posterior-lateral growth,

said second posterior-medial growth larger than said first posterior-medial growth, and

said second posterior-lateral growth larger than said first posterior-lateral growth,

whereby said plurality of tibial prostheses exhibit non-linear, asymmetric growth in medial and lateral posterior corners of said prosthesis peripheries as sizes of said tibial prostheses consecutively increase.

2. The family of tibial prostheses of claim 1, wherein:

said first posterior-medial growth is larger than said first posterior-lateral growth, whereby said medial compartment grows faster than said lateral compartment in said medium periphery as compared to said small periphery.

3. The family of tibial prostheses of claim 1, wherein:

said second posterior-medial growth is larger than said second posterior-lateral growth, whereby said medial compartment grows faster than said lateral compartment in said large periphery as compared to said medium periphery.

4. The family of tibial prostheses of claim 1, wherein said second posterior-medial growth is about 20% larger than said first posterior-medial growth.

5. The family of tibial prostheses of claim 1, wherein said second posterior-lateral growth is about 4% larger than said first posterior-lateral growth.

6. The family of tibial prostheses of claim 1, wherein said prosthesis periphery comprises:

an anterior edge;

a lateral periphery corresponding to said lateral compartment, said lateral periphery including;

a lateral posterior edge generally opposite said anterior edge and forming a posterior boundary of said lateral compartment;

a lateral edge defining a substantially perpendicular tangent with respect to said anterior edge; and

an anterior-lateral corner traversing an angular sweep between said anterior edge and said lateral edge,

said posterior-lateral corner opposite said anterior-lateral corner with respect to said lateral edge, said posterior-lateral corner traversing an angular sweep between said lateral edge and said lateral posterior edge.

7. The family of tibial prostheses of claim 1, wherein said posterior-lateral distance extends from said centroid to said prosthesis periphery along a line defining an angle of 120 degrees from said anteroposterior axis.

8. The family of tibial prostheses of claim 1, wherein said prosthesis periphery comprises:

an anterior edge;

a medial periphery corresponding to said medial compartment, said medial periphery including;

a medial posterior edge generally opposite said anterior edge and forming a posterior boundary of said medial compartment;

a medial edge defining a substantially perpendicular tangent with respect to said anterior edge; and

an anterior-medial corner traversing an angular sweep between said anterior edge and said medial edge,

said posterior-medial corner opposite said anterior-medial corner with respect to said medial edge, said posterior-medial corner traversing an angular sweep between said medial edge and said medial posterior edge.

9. The family of tibial prostheses of claim 1, wherein said posterior-medial distance extends from said centroid to said prosthesis periphery along a line defining an angle of 130 degrees from said anteroposterior axis.

10. The family of tibial prostheses of claim 1, wherein said plurality of tibial prostheses comprises at least seven tibial prostheses, each of said tibial prostheses consecutively larger,

each of said tibial prostheses defining a respective posterior-medial growth larger than a posterior-medial growth of a next consecutive smaller posterior-medial growth, and

each of said tibial prostheses defining a respective posterior-lateral growth larger than a posterior-lateral growth of the next consecutive smaller posterior-medial growth.

11. The family of tibial prostheses of claim 1, wherein said plurality of tibial prostheses comprises at least eight tibial prostheses, each of said tibial prostheses consecutively larger,

each of said tibial prostheses defining a respective posterior-medial growth larger than a posterior-medial growth of a next consecutive smaller posterior-medial growth, and

each of said tibial prostheses defining a respective posterior-lateral growth larger than a posterior-lateral growth of the next consecutive smaller posterior-medial growth.

12. The family of tibial prostheses of claim 1, wherein said plurality of tibial prostheses comprises at least nine tibial prostheses, each of said tibial prostheses consecutively larger,

each of said tibial prostheses defining a respective posterior-medial growth larger than a posterior-medial growth of a next consecutive smaller posterior-medial growth, and

each of said tibial prostheses defining a respective posterior-lateral growth larger than a posterior-lateral growth of the next consecutive smaller posterior-medial growth.

13. The family of tibial prostheses of claim 1, wherein said plurality of tibial prostheses comprises a plurality of tibial baseplates.

14. The family of tibial prostheses of claim 13, in combination with a plurality of tibial bearing components, each of said plurality of tibial bearing components comprising:

a lateral portion which substantially corresponds to said prosthesis periphery for said lateral compartment of one of said plurality of tibial prostheses; and

a medial portion which is at least partially incongruent with said prosthesis periphery for said medial compartment of one of said plurality of tibial prostheses.

15. The family of tibial prostheses of claim 14, wherein:

each of said plurality of tibial baseplates includes a posteromedial baseplate chamfer in said medial compartment;

each of said plurality of tibial bearing components includes a posteromedial bearing chamfer formed thereon in said medial portion; and

each of said plurality of tibial bearing components adapted to mount to a respective one of said plurality of tibial baseplates to form a respective tibial prosthesis assembly, said baseplate chamfer and said bearing chamfer cooperating to form a substantially continuous chamfer in said tibial prosthesis assembly.

16. The family of tibial prostheses of claim 14, in combination with at least one femoral component adapted to articulate with at least one of said plurality of tibial bearing components through a range of flexion.

17. The family of tibial prostheses of claim 1, wherein said anteroposterior axis is aligned with a home axis when said a respective tibial prosthesis is mounted to a tibia, said home axis defined as a line extending from

a posterior point at a geometric center of an attachment area between a posterior cruciate ligament and the tibia, to

an anterior point disposed on an anterior tubercle of the tibia, the tubercle having a tubercle width W, said anterior point disposed on the tubercle at a location medially spaced from a midpoint of the tubercle by an amount equal to W/6.

18. The family of tibial prostheses of claim 1, wherein said plurality of tibial prostheses each comprise:

an anterior edge; and

a PCL cutout area generally opposite said anterior edge and between said lateral compartment and said medial compartment,

said anteroposterior axis bisecting said anterior edge and bisecting said PCL cutout area.

19. The family of tibial prostheses of claim 1, wherein said medial compartment is asymmetric with respect to said lateral compartment about said anteroposterior axis, whereby each said prosthesis periphery is sized and shaped to cover between about 60% and about 90% of a resected proximal surface of a correspondingly sized tibia.

20. The family of tibial prostheses of claim 19, wherein:

said medial compartment cooperates with said anteroposterior axis to bound a medial surface area,

said lateral compartment cooperates with said anteroposterior axis to bound a lateral surface area, and

said medial surface area is larger than said lateral surface area.

21. The family of tibial prostheses of claim 19, wherein said plurality of tibial prostheses each comprise:

an anterior edge;

a lateral posterior edge generally opposite said anterior edge and forming a posterior boundary of said lateral compartment, said lateral compartment defining a lateral anteroposterior extent extending from said anterior edge of said prosthesis periphery to said lateral posterior edge thereof; and

a medial posterior edge generally opposite said anterior edge and forming a posterior boundary of said medial compartment, said medial compartment defining a medial anteroposterior extent extending from said anterior edge of said prosthesis periphery to said medial posterior edge thereof,

said medial anteroposterior extent larger than said lateral anteroposterior extent.

22. The family of tibial prostheses of claim 19, wherein:

said posterior-medial corner defines a posterior-medial corner radius, and

said posterior-lateral corner defines a posterior-lateral corner radius that is substantially smaller than said posterior-medial corner radius.

23. The family of tibial prostheses of claim 19, wherein said plurality of prosthesis peripheries each comprise:

an anterior edge;

a lateral posterior edge generally opposite said anterior edge and forming a posterior boundary of said lateral compartment; and

a medial posterior edge generally opposite said anterior edge and forming a posterior boundary of said medial compartment,

said lateral compartment comprising a lateral periphery extending from said anterior edge to said lateral posterior edge, said lateral periphery defining a plurality of adjacent lateral arcs, a pair of said plurality of adjacent lateral arcs defining a first lateral radius and a second lateral radius, respectively, said first lateral radius larger than said second lateral radius by at least 100%, whereby said lateral periphery is relatively boxy; and

said medial compartment comprising a medial periphery extending from said anterior edge to said medial posterior edge, said medial periphery defining a plurality of adjacent medial arcs, a pair of said plurality of adjacent medial arcs defining a first medial radius and a second medial radius, respectively, said first medial radius larger than said second medial radius by less than 75%, whereby said medial periphery is generally rounded.

24. The family of tibial prostheses of claim 19, wherein:

said lateral compartment defines a plurality of adjacent lateral arcs, and

said medial compartment defines a plurality of adjacent medial arcs,

said plurality of adjacent lateral arcs greater in number as compared to said plurality of adjacent medial arcs.

25. The family of tibial prostheses of claim 19, each said prosthesis periphery defining an anterior edge, wherein:

said lateral compartment includes an anterior-lateral corner defining an anterior-lateral corner radius having a first radial center,

said medial compartment includes an anterior-medial corner defining an anterior-medial corner radius having a second radial center, and

a mediolateral axis defining the longest line segment within said prosthesis periphery that is also perpendicular to said anteroposterior axis,

said first radial center disposed between said mediolateral axis and said anterior edge, said second radial center disposed posterior of said mediolateral axis.

26. A family of tibial prostheses sized for attachment to a proximal tibia, the family comprising:

a plurality of tibial prostheses defining a plurality of prosthesis peripheries, each said prosthesis periphery defining;

a centroid,

an anteroposterior axis dividing said prosthesis periphery into a medial compartment and a lateral compartment;

a posterior-medial distance extending from said centroid to a posterior-medial corner of said prosthesis periphery;

a posterior-lateral distance extending from said centroid to a posterior-lateral corner of said prosthesis periphery;

said plurality of prosthesis peripheries including;

a small periphery defining said posterior-medial distance having a small posterior-medial extent and said posterior-lateral distance having a small posterior-lateral extent; and

a large periphery defining said posterior-medial distance having a large posterior-medial extent larger than said large posterior-medial extent to exhibit a posterior-medial growth, said large periphery further defining said posterior-lateral distance having a large posterior-lateral extent larger than said small posterior-lateral extent to exhibit a posterior-lateral growth,

said posterior-medial growth larger than said posterior-lateral growth,

whereby said medial compartment grows faster than said lateral compartment in said large periphery as compared to said small periphery.

27. The family of tibial prostheses of claim 26, wherein each said prosthesis periphery comprises:

an anterior edge;

a lateral periphery corresponding to said lateral compartment, said lateral periphery including;

a lateral posterior edge generally opposite said anterior edge and forming a posterior boundary of said lateral compartment;

a lateral edge defining a substantially perpendicular tangent with respect to said anterior edge; and

an anterior-lateral corner traversing an angular sweep between said anterior edge and said lateral edge,

said posterior-lateral corner opposite said anterior-lateral corner with respect to said lateral edge, said posterior-lateral corner traversing an angular sweep between said lateral edge and said lateral posterior edge.

28. The family of tibial prostheses of claim 26, wherein said posterior-lateral distance extends from said centroid to said prosthesis periphery along a line defining an angle of 120 degrees from said anteroposterior axis.

29. The family of tibial prostheses of claim 26, wherein each said prosthesis periphery comprises:

an anterior edge;

a medial periphery corresponding to said medial compartment, said medial periphery including;

a medial posterior edge generally opposite said anterior edge and forming a posterior boundary of said medial compartment;

a medial edge defining a substantially perpendicular tangent with respect to said anterior edge; and

an anterior-medial corner traversing an angular sweep between said anterior edge and said medial edge,

said posterior-medial corner opposite said anterior-medial corner with respect to said medial edge, said posterior-medial corner traversing an angular sweep between said medial edge and said medial posterior edge.

30. The family of tibial prostheses of claim 26, wherein said posterior-medial distance extends from said centroid to said prosthesis periphery along a line defining an angle of 130 degrees from said anteroposterior axis.

31. The family of tibial prostheses of claim 26, wherein said plurality of tibial prostheses comprises a plurality of tibial baseplates.

32. The family of tibial prostheses of claim 31, in combination with a plurality of tibial bearing components, each of said plurality of tibial bearing components comprising:

a lateral portion which substantially corresponds to said prosthesis periphery for said lateral compartment of one of said plurality of tibial prostheses; and

a medial portion which is at least partially incongruent with said prosthesis periphery for said medial compartment of one of said plurality of tibial prostheses.

33. The family of tibial prostheses of claim 32, wherein:

each of said plurality of tibial baseplates includes a posteromedial baseplate chamfer in said medial compartment;

each of said plurality of tibial bearing components includes a posteromedial bearing chamfer formed thereon in said medial portion; and

each of said plurality of tibial bearing components adapted to mount to a respective one of said plurality of tibial baseplates to form a respective tibial prosthesis assembly, said baseplate chamfer and said bearing chamfer cooperating to form a substantially continuous chamfer in said tibial prosthesis assembly.

34. The family of tibial prostheses of claim 32, in combination with at least one femoral component adapted to articulate with at least one of said plurality of tibial bearing components through a range of flexion.

35. The family of tibial prostheses of claim 26, wherein said anteroposterior axis is aligned with a home axis when said a respective tibial prosthesis is mounted to a tibia, said home axis defined as a line extending from

a posterior point at a geometric center of an attachment area between a posterior cruciate ligament and the tibia, to

an anterior point disposed on an anterior tubercle of the tibia, the tubercle having a tubercle width W, said anterior point disposed on the tubercle at a location medially spaced from a midpoint of the tubercle by an amount equal to W/6.

36. The family of tibial prostheses of claim 26, wherein said plurality of tibial prostheses each comprise:

an anterior edge; and

a PCL cutout area generally opposite said anterior edge and between said lateral compartment and said medial compartment,

said anteroposterior axis bisecting said anterior edge and bisecting said PCL cutout area.

37. The family of tibial prostheses of claim 26, wherein said medial compartment is asymmetric with respect to said lateral compartment about said anteroposterior axis, whereby each said prosthesis periphery is sized and shaped to cover between about 60% and about 90% of a resected proximal surface of a correspondingly sized tibia.

38. The family of tibial prostheses of claim 37, wherein:

said medial compartment cooperates with said anteroposterior axis to bound a medial surface area,

said lateral compartment cooperates with said anteroposterior axis to bound a lateral surface area, and

said medial surface area is larger than said lateral surface area.

39. The family of tibial prostheses of claim 37, wherein said plurality of tibial prostheses each comprise:

an anterior edge;

a lateral posterior edge generally opposite said anterior edge and forming a posterior boundary of said lateral compartment, said lateral compartment defining a lateral anteroposterior extent extending from said anterior edge of said prosthesis periphery to said lateral posterior edge thereof; and

a medial posterior edge generally opposite said anterior edge and forming a posterior boundary of said medial compartment, said medial compartment defining a medial anteroposterior extent extending from said anterior edge of said prosthesis periphery to said medial posterior edge thereof,

said medial anteroposterior extent larger than said lateral anteroposterior extent.

40. The family of tibial prostheses of claim 37, wherein:

said posterior-medial corner defines a posterior-medial corner radius, and

said posterior-lateral corner defines a posterior-lateral corner radius that is substantially smaller than said posterior-medial corner radius.

41. The family of tibial prostheses of claim 37, wherein said plurality of prosthesis peripheries each comprise:

an anterior edge;

a lateral posterior edge generally opposite said anterior edge and forming a posterior boundary of said lateral compartment; and

a medial posterior edge generally opposite said anterior edge and forming a posterior boundary of said medial compartment,

said lateral compartment comprising a lateral periphery extending from said anterior edge to said lateral posterior edge, said lateral periphery defining a plurality of adjacent lateral arcs, a pair of said plurality of adjacent lateral arcs defining a first lateral radius and a second lateral radius, respectively, said first lateral radius larger than said second lateral radius by at least 100%, whereby said lateral periphery is relatively boxy; and

said medial compartment comprising a medial periphery extending from said anterior edge to said medial posterior edge, said medial periphery defining a plurality of adjacent medial arcs, a pair of said plurality of adjacent medial arcs defining a first medial radius and a second medial radius, respectively, said first medial radius larger than said second medial radius by less than 75%, whereby said medial periphery is generally rounded.

42. The family of tibial prostheses of claim 37, wherein:

said lateral compartment defines a plurality of adjacent lateral arcs, and

said medial compartment defines a plurality of adjacent medial arcs,

said plurality of adjacent lateral arcs greater in number as compared to said plurality of adjacent medial arcs.

43. The family of tibial prostheses of claim 37, each said prosthesis periphery defining an anterior edge, wherein:

said lateral compartment includes an anterior-lateral corner defining an anterior-lateral corner radius having a first radial center,

said medial compartment includes an anterior-medial corner defining an anterior-medial corner radius having a second radial center, and

a mediolateral axis defining the longest line segment within said prosthesis periphery that is also perpendicular to said anteroposterior axis,

said first radial center disposed between said mediolateral axis and said anterior edge, said second radial center disposed posterior of said mediolateral axis.