High performance knee prostheses
Knee prostheses featuring components that more faithfully replicate the structure and function of the human knee joint in order to provide, among other benefits: greater flexion of the knee in a more natural way by promoting or at least accommodating internal tibial rotation in a controlled way, replication of the natural screw home mechanism, and controlled articulation of the tibia and femur respective to each other in a more natural way. In a preferred embodiment, such prostheses include an insert component disposed between a femoral component and a tibial component, the insert component preferably featuring among other things a reversely contoured posterolateral bearing surface that helps impart internal rotation to the tibia as the knee flexes. Other surfaces can also be specially shaped to achieve similar results, preferably using iterative automated techniques that allow testing and iterative design taking into account a manageable set of major forces acting on the knee during normal functioning, together with information that is known about natural knee joint kinetics and kinematics.
1. A prosthetic knee implant, comprising:
a tibial insert having a medial bearing surface and a lateral bearing surface; and
a femoral component having a medial condylar surface and a lateral condylar surface, the medial condylar surface being configured to contact the medial bearing surface and the lateral condylar surface being configured to contact the lateral bearing surface:
(i) such that the femoral component and the tibial insert can move in flexion and extension with respect to one another;
(ii) such that moving the femoral component and the tibial insert in flexion moves a contact point between the lateral bearing surface and the lateral condylar surface posteriorly along a track in an arcuate fashion from an anterior portion of the lateral bearing surface to a posterior portion of the lateral bearing surface;
(iii) such that moving the femoral component and the tibial insert in flexion moves a contact point between the medial bearing surface and the medial condylar surface posteriorly from an anterior portion of the medial bearing surface to a posterior portion of the medial bearing surface; and
(iv) such that moving the femoral component and the tibial insert in flexion permits an internal rotation of the tibial insert relative to the femoral component;
wherein the lateral condylar surface is configured to move along a convex arc of the lateral bearing surface, the convex arc sloping in a distal-posterior direction;
wherein the lateral bearing surface comprises a curved generally concave portion, and wherein the curved generally concave portion sweeps laterally from the anterior portion of the lateral bearing surface toward a middle portion of the lateral bearing surface and sweeps medially from the middle portion toward the posterior portion of the lateral bearing surface;
and
wherein the lateral bearing surface and the medial bearing surface have different contours.
2. The prosthetic implant of claim 1 , wherein the femoral component and the tibial insert can move in flexion from substantially full extension to substantially 120°.
3. The prosthetic implant of claim 1 , wherein when moving the femoral component and the tibial insert in flexion greater than 120° , the lateral and medial condylar surfaces move primarily posteriorly relative to the tibial insert.
4. The prosthetic implant of claim 1 , wherein the tibial insert internally rotates at least substantially 8° relative to the femoral component at substantially 120° of flexion and greater flexion angles.
5. The prosthetic implant of claim 1 , wherein the tibial insert is thicker in at least some areas that cooperate with the lateral condylar surface of the femoral component than in corresponding areas that cooperate with the medial condylar surface of the femoral component.
6. A prosthetic knee implant, comprising:
a tibial insert having a medial bearing surface and a lateral bearing surface; and
a femoral component having a medial condyle and a lateral condyle, the medial condyle
being configured to contact the medial bearing surface and the lateral condyle being configured to contact the lateral bearing surface:
(i) such that the femoral component and the tibial insert can move in flexion and extension with respect to one another;
(ii) such that moving the femoral component and the tibial insert in flexion from substantially full extension to substantially 120° allows the lateral condyle to move posteriorly in an arcuate fashion on the lateral bearing surface from an anterior portion of the lateral bearing surface to a posterior portion of the lateral bearing surface;
(iii) such that moving the femoral component and the tibial insert in flexion from substantially full extension to substantially 120° allows the medial condyle to move posteriorly from an anterior portion of the medial bearing surface to a posterior portion of the medial bearing surface; and
(iv) such that moving the femoral component and the tibial insert in flexion from substantially full extension to substantially 120° permits an internal rotation of the tibial insert relative to the femoral component;
wherein the tibial component and femoral component are configured to engage such that moving the femoral component and the tibial insert in flexion moves a contact point between the lateral bearing surface and the lateral condylar surface posteriorly along a track in an arcuate fashion;
wherein the lateral condylar surface is configured to move along a convex arc of the lateral bearing surface, the convex arc sloping in a distal-posterior direction;
wherein the lateral bearing surface comprises a curved generally concave portion, and wherein the curved generally concave portion sweeps laterally from the anterior portion of the lateral bearing surface toward a middle portion of the lateral bearing surface and sweeps medially from the middle portion toward the posterior portion of the lateral bearing surface; and
wherein the lateral bearing surface and the medial bearing surface have different contours.
7. The prosthetic implant of claim 6 , wherein when moving the femoral component and the tibial insert in flexion greater than 120° , the lateral and medial condyles move primarily posteriorly relative to the tibial insert.
8. The prosthetic implant of claim 6 , wherein the tibial insert internally rotates at least substantially 8° relative to the femoral component at substantially 120° of flexion and greater flexion angles.
9. A prosthetic knee implant, comprising:
a tibial insert having a medial bearing surface and a lateral bearing surface; and
a femoral component having a medial condyle and a lateral condyle, wherein:
the femoral component has an anterior portion and a posterior portion, the anterior
portion having a first bone interface surface that is substantially planar, and the posterior portion having a second bone interface surface that is substantially planar, and the second bone interface surface is oriented such that a plane along the second bone interface surface converges with a plane along the first bone interface surface proximal to the femoral component; and
wherein the medial condyle is configured to contact the medial bearing surface and the lateral condyle is configured to contact the lateral bearing surface:
(i) such that the femoral component and the tibial insert can move in flexion and extension with respect to one another;
(ii) such that moving the femoral component and the tibial insert in flexion from substantially full extension to substantially 120° allows the lateral condyle to move posteriorly in an arcuate fashion on the lateral bearing surface from an anterior portion of the lateral bearing surface to a posterior portion of the lateral bearing surface;
(iii) such that moving the femoral component and the tibial insert in flexion from substantially full extension to substantially 120° allows the medial condyle to move posteriorly from an anterior portion of the medial bearing surface to a posterior portion of the medial bearing surface; and
(iv) such that moving the femoral component and the tibial insert in flexion from substantially full extension to substantially 120° permits an internal rotation of the tibial insert relative to the femoral component;
wherein the tibial component and femoral component are configured to engage such that moving the femoral component and the tibial insert in flexion moves a contact point between the lateral bearing surface and the lateral condylar surface posteriorly along a track in an arcuate fashion;
wherein the lateral condylar surface is configured to move along a convex arc of the lateral bearing surface, the convex arc sloping in a distal-posterior direction;
wherein the lateral bearing surface comprises a curved generally concave portion, and wherein the curved generally concave portion sweeps laterally from the anterior portion of the lateral bearing surface toward a middle portion of the lateral bearing surface and sweeps medially from the middle portion toward the posterior portion of the lateral bearing surface; and
wherein the lateral bearing surface and the medial bearing surface have different contours.
10. The prosthetic implant of claim 9 , wherein the tibial implant is formed of a radiation-treated ultra-high molecular weight polyethylene material.
11. The prosthetic implant of claim 9 , wherein the femoral component has a rounded medial profile that has a single radius from 10° to 160° of flexion.