A tibial prosthetic implant includes a base or base plate with an offset tibial stem. The base includes an inferior surface adapted to abut a resected surface of a patient's tibia and forms a base for articulating surfaces adapted to articulate with the patient's femoral condyles. The longitudinal center axis of the tibial stem extends from the inferior surface of the base and is offset from a center of the base. The offset places the stem in position to extend into the central canal of the tibia so that it does not substantially interfere with the cortical bone when the inferior surface of the base substantially abuts and aligns with the resected surface of the tibia.
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7. A base plate for a modular tibial prosthetic implant, the base plate comprising:
(a) a plate of material having an inferior surface adapted to substantially abut a resected surface of a patient's tibia; and (b) a tibial stem extending from the inferior surface of the plate, the tibial stem having a longitudinal center axis that is offset medially from a center of the plate, such that the stem is in position to extend into the central canal of the patient's tibia without substantially interfering with the cortical bone of the tibia when the inferior surface of the plate substantially abuts the resected surface of the tibia and the center of the plate aligns with a center of the resected surface of the tibia.
11. A tibial prosthetic implant of the type having a base that includes an inferior surface adapted to substantially abut a resected surface of a patient's tibia so as to support articulating surfaces that are adapted to articulate with the patient's femoral condyles, wherein the improvement comprises:
(a) a tibial stem extending from the inferior surface of the base, the tibial stem having a longitudinal center axis that is offset medially from a center of the base such that the stem is in position to extend into a central canal of the patient's tibia when the inferior surface of the base abuts the resected surface of the tibia and the center of the base aligns with a center of the resected surface of the tibia.
3. A tibial prosthetic implant comprising:
(a) a base having an inferior surface adapted to substantially abut a resected surface of a patient's tibia and a transverse cross-sectional shape adapted to approximate a peripheral shape of the resected surface of the tibia; (b) an articulating portion connected to the base, the articulating portion of the implant having articulating surfaces opposite the inferior surface of the base for articulating with a patient's femoral condyles; (c) attachment means for securing the base to the resected surface of the tibia so that the inferior surface of the base substantially abuts and aligns with the resected surface of the tibia; and (d) a tibia stem extending from the inferior surface of the base, the tibial stem having a longitudinal center axis that is offset medially from a center of the base such that the stem is in position to extend into the central canal of the patient's tibia without substantially interfering with the cortical bone of the tibia when the inferior surface of the base abuts and aligns with the resected surface of the tibia.
5. A base plate for a modular tibial prosthetic implant for patients having normally shaped tibias, the base plate comprising:
(a) a plate of material having an inferior surface adapted to substantially abut a resected surface of a patient's tibia; and (b) a tibial stem extending from the inferior surface of the plate, the tibial stem having a longitudinal center axis that is offset anteriorly and medially from a center of the plate such that the stem is in position to extend into the central canal of the patient's tibia without substantially interfering with the cortical bone of the tibia when the inferior surface of the plate substantially abuts the resected surface of the tibia and the center of the plate aligns with a center of the resected surface of the tibia. and (c) wherein the longitudinal center axis of the tibial stem of offset anteriorly from the center of the plate a distance that is between 59% to 68% of a total anterior-posterior medial condyle depth dimension of the plate as measured from an outermost posterior edge of the plate, and wherein the longitudinal center axis of the tibial stem is offset medially from the center of the plate a distance that is between 52% to 55% of a total medial-lateral width dimension of the plate as measured from an outermost lateral edge of the plate.
9. A tibial prosthetic implant of the type having a base that includes an inferior surface adapted to substantially abut a resected surface of a patient's tibia so as to support articulating surfaces that are adapted to articulate with the patient's femoral condyles, wherein the improvement comprises:
(a) a tibial stem extending from the inferior surface of the base, the tibial stem having a longitudinal center axis that is offset anteriorly and medially from a center of the base such that the stem is in position to extend into the central canal of the patient's tibia without substantially interfering with the cortical bone of the tibia when the inferior surface of the base abuts the resected surface of the tibia and the center of the base aligns with a center of the resected surface of the tibia. and (b) wherein the longitudinal center axis of the tibial stem is offset anteriorly from the center of the base a distance that is between 59% to 68% of a total anterior-posterior medial condyle depth dimension of the base as measured from an outermost posterior edge of the base, and wherein the longitudinal center axis of the tibial stem is offset medially from the center of the base a distance that is between 52% to 55% of a total medial-lateral width dimension of the base as measured from an outermost lateral edge of the base.
1. A tibial prosthetic implant for patients having normally shaped tibias, the implant comprising:
(a) a base having an inferior surface adapted to substantially abut a resected surface of a patient's tibia and a transverse cross-sectional shape adapted to approximate a peripheral shape of the resected surface of the tibia; (b) an articulating portion connected to the base, the articulating portion of the implant having articulating surfaces opposite the inferior surface of the base for articulating with a patient's femoral condyles; (c) attachment means for securing the base to the resected surface of the tibia so that the inferior surface of the base substantially abuts and aligns with the resected surface of the tibia; and (d) a tibial stem extending from the inferior surface of the base, the tibial stem having a longitudinal center axis that is offset anteriorly and medially from a center of the base such that the stem is in position to extend into the central canal of the patient's tibia without substantially interfering with the cortical bone of the tibia when the inferior surface of the base abuts and aligns with the resected surface of the tibia. ; and (e) wherein the longitudinal center axis of the tibial stem is offset anteriorly from the center of the base a distance that is between 59% to 68% of a total anterior-posterior medial condyle depth dimension of the base as measured from an outermost posterior edge of the base, and wherein the longitudinal center axis of the tibial stem is offset medially from the center of the base a distance that is between 52% to 55% of a total medial-lateral width dimension of the base as measured from an outermost lateral edge of the base.
2. The tibial prosthetic implant of
(a) a central root portion extending an entire length of the tibial stem; and (b) a medial-posterior web extending generally medially and posteriorly from the stem central root portion, a lateral-posterior web extending generally laterally and posteriorly from the stem central root portion, a medial-anterior web extending substantially medially and anteriorly from the stem central root portion, and a lateral-anterior web extending generally laterally and anteriorly from the stem central root portion, each web having an enlarged portion at an end of the stem proximal to the inferior surface of the base and a relatively narrower portion at an end of the stem distal of the base.
4. The tibial prosthetic implant of
(a) the longitudinal center axis of the tibial stem is offset medially from the center of the base a distance that is between 52% and 55% of a total medial-lateral width dimension of the base as measured from an outermost lateral edge of the base.
6. The tibial prosthetic implant of
(a) the longitudinal center axis of the tibial stem is offset anteriorly from the center axis of the plate a distance that is between 59% to 68% of a total anterior-posterior medial condyle depth dimension of the plate as measured from an outermost posterior edge of the plate; and (b) the longitudinal center axis of the tibial stem is offset medially from the center of the plate a distance that is between 52% to 55% of a total medial-lateral width dimension of the plate as measured from an outermost lateral edge of the plate.
8. The base plate of
(a) a longitudinal center axis of the tibial stem is offset medially from the center of the plate a distance that is between 52% to 55% of a total medial-lateral width dimension of the plate as measured from an outermost lateral edge of the plate.
10. The tibial prosthetic implant of
(a) a longitudinal center axis of the tibial stem is offset anteriorly from the center of the base a distance that is between 59% to 68% of a total anterior-posterior medial condyle depth dimension of the base as measured from an outermost posterior edge of the base; and (b) the longitudinal center axis of the tibial stem is offset medially from the center of the base a distance that is between 52% to 55% of a total medial-lateral width dimension of the base as measured from any outermost lateral edge of the base.
12. The tibial prosthetic implant of
(a) the longitudinal center axis of the tibial stem is offset medially from the center of the base a distance that is between 52% to 55% of a total medial-lateral width dimension of the base as measured from an outermost lateral edge of the base.
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This invention relates to implants for total knee arthroplasty, and more particularly, to an improved stemmed tibial prosthetic implant.
Total knee arthroplasty involves providing new articulating surfaces for the tibia, femur, and patella. The most common technique for providing new articulating surfaces for the tibia involves resecting an upper portion of the tibia and then attaching a prosthetic implant to the tibia over the resected surface. The tibial implant includes a base adapted to abut the resected surface of the tibia and an articulating portion which includes the new articulating surfaces. The base of the implant has a shape that is adapted to generally approximate the shape of the resected surface of the tibia so that the implant generally aligns with This medial offset in the range of 52% to 55% and anterior offset in the range between 59% to 68% produces the desired stem position in the cancellous bone of the tibial central canal for most normally shaped tibias such as the tibia illustrated in FIGS. 3 and 4.
Although any stem shape may be employed in a tibial implant embodying the principles of the invention, the preferred stem 16 forms a cruciate shape. The cruciate-shaped stem 16 includes a center root portion 60 and a plurality of longitudinally aligned webs extending from the root at different angular orientations about the stem longitudinal axis 48. In particular, the stem 16 includes a medial-posterior web 62, a lateral-posterior web 64, a medial-anterior web 66, and a lateral-anterior web 68. Each web includes an enlarged portion 70 at the end proximal to the base 12, narrowing down continuously to a relative narrower portion 72 at the end of the stem distal to the base. Also, as shown best in FIG. 2, the enlarged portions 70 of the lateral-posterior and medial-posterior webs 64 and 62 extend further from the center root 60 of the stem 16 than the enlarged portions of the lateral-anterior and medial-anterior webs 68 and 66. These web shapes generally follow the internal contour of the central canal 50 of the tibia to maximize contact with the cancellous bone in the canal.
Implanting the stemmed tibial implant 10 embodying the principles of the invention includes first resecting an upper portion of the patient's tibia 38 to remove the natural articulating surfaces and form a suitable resected surface 30. The resected surface 30 is preferably planar and extends substantially transversely to the longitudinal axis of the tibia 38 in the anterior-posterior view and parallel to the anatomic posterior slope of the tibia in the medial-lateral view of the tibia.
Once the desired resected surface 30 is produced, the base 12 of the implant 10 shown in FIGS. 1 through 4 is positioned with the inferior surface 22 abutting and generally aligned with the resected surface. The base 12 is fixed in place with bone screws 26 extending through the screw openings 24 in the base. With the inferior surface 22 of the base 12 abutting the resected surface 30 of the patient's tibia 38 and with the base properly aligned, the stem 16 extends into the central canal 50 of the tibia and does not interfere with the cortical bone 36. Although some broaching will be required to produce an opening for the stem 16, the offset position of the stem will necessitate little, if any, broaching of the cortical bone 36, only broaching of the much softer cancellous bone in the central tibial canal 50.
The above described preferred embodiments are intended to illustrate the principles of the invention, but not to limit the scope of the invention. Various other embodiments and modifications to these preferred embodiments may be made by those skilled in the art without departing from the scope of the following claims. For example, although the embodiment shown in the drawings includes a plurality of pegs 18, an implant embodying the principles of the invention may include only the offset stem 16. Also, although not shown specifically in the drawings, the inferior surface 22 of the base 12, the pegs 18 if present, and the stem 16 may all include a layer of porous material adapted to provide enhanced bonding to the bone.
Whitlock, Steven I., Baldwin, James L.
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