Femoral slideway
A femoral slideway and femoral slideway/femur-size template combination is employed to create an installed knee prosthesis that creates a reduced amount of stress in the collateral ligaments relative to previous prosthesis. In one embodiment, the reduced stress is achieved by employing a femoral slideway/femur-size template combination which results in installation of a femoral slideway which has a smaller dorsal-ventral dimension than a corresponding dimension of the femur prior to resection.
1. A system for sizing and installing a femoral slideway implant, comprising:
a femur size template comprising:
a base plate having at least one hole,
at least one condyle engaging surface extending from the base plate, and a measurement tongue slidably mounted to the base plate, the tongue being movable between a plurality of discrete positions relative to the condyle engaging surface,
a first dimension of the femur size template is defined by a distance between a central axis of the hole in the base plate and the condyle engaging surface; and
a femoral slideway implant comprising:
at least one condyle shell having an outer dorsal sliding surface defining an outermost posterior point of the at least one condyle shell,
a patellar shield located anterior to the at least one condyle shell,
at least one peg on an inner surface of the implant and located between the patellar shield and the condyle shell, and
a second dimension of the femoral slideway implant is defined by a distance between a plane tangent to the dorsal sliding surface at the outermost posterior point of the at least one condyle shell and a longitudinal axis of the at least one peg, and
the first dimension of the femur size template is larger than the second dimension of the femoral slideway implant by a permanently specified distance that defines a fixed absolute difference between the first dimension and the second dimension; and
wherein the first dimension is a permanently specified distance of the femur size template irrespective of the size of the femoral slideway implant; and
wherein the femoral slideway implant comprises a plurality of femoral slideway implants of different sizes, wherein the second dimension is a constant amount for the plurality of femoral slideway implants.
2. The system of claim 1 , wherein the at least one condyle shell comprises first and second convexly curved condyle shells.
3. The system of claim 2 , wherein a patellar pit between the condyle shells of the femoral slideway has a depth measured from a most dorsal point on the condyle shells that has a ratio in the range of about 0.4 to 0.5 in comparison to a maximal anterior-posterior extent of the femoral slideway.
4. The system of claim 1 , wherein the first dimension is at least 5% larger than the second dimension.
5. The system of claim 1 , wherein the first dimension is between 5% and 15% larger than the second dimension.
6. The system of claim 5 , wherein the first dimension is about 10% larger than the second dimension.
7. The system of claim 1 , further comprising a third dimension defined by a distance between the plane tangent to the dorsal sliding surface and a ventral surface of the patellar shield, the third dimension corresponding to one of the discrete positions of the measurement tongue.
8. The system of claim 1 , wherein the base plate and the at least one condyle engaging surface are defined by a single-piece unitary structure.
9. The system of claim 1 , wherein the first dimension is defined by a perpendicular distance between the central axis of the hole and the condyle engaging surface.
10. The system of claim 1 , wherein the at least one condyle engaging surface has a permanently fixed position on the base plate with respect to the at least one hole.
11. A system for installing a femoral slideway implant, comprising:
a femur size template comprising:
at least one condyle engaging surface, a measurement tongue configured to measure a maximal anterior posterior extent of at least one condyle of the femur, said at least one condyle abutting the condyle engaging surface, said measurement tongue being movable between a plurality of discrete positions relative to the at least one condyle engaging surface; and
a base plate between said condyle engaging surface and said tongue, the base plate having at least one hole configured to receive a drill,
a first dimension of the femur size template is defined by a distance between a central axis of the hole in the base plate and the condyle engaging surface; and
a femoral slideway implant comprising:
at least one condyle shell having an outer dorsal sliding surface defining an outermost posterior point of the at least one condyle shell,
a patellar shield located anterior to the at least one condyle shell,
at least one peg on an inner surface of the implant and located between the patellar shield and the at least one condyle shell, the peg configured to mount in a hole in a condyle measured by the template and drilled into the condyle through the at least one hole in the base plate,
a second dimension of the femoral slideway implant is defined by a distance between a plane tangent to the dorsal sliding surface at the outermost posterior point of the at least one condyle shell and a longitudinal axis of the at least one peg, and
a maximal anterior posterior extent of the condyle shell is less than the maximal anterior posterior extent of the at least one condyle of the femur by a fixed amount, and the first dimension of the femur size template is larger than the second dimension of the femoral slideway implant to thereby define a fixed absolute difference between the first dimension and the second dimension; and
wherein the first dimension is a permanently specified distance of the femur size template irrespective of the size of the femoral slideway implant; and
wherein the femoral slideway implant comprises a plurality of femoral slideway implants of different sizes, wherein the second dimension is a constant distance for the plurality of femoral slideway implants.
12. The system of claim 11 , wherein the at least one condyle shell comprises first and second convexly curved condyle shells.
13. The system of claim 11 , wherein a patellar pit between the condyle shells of the femoral slideway has a depth measured from the from a most dorsal point on the condyle shells that has a ratio in the range of about 0.4 to 0.5 in comparison to a maximal anterior-posterior extent of the femoral slideway.
14. The system of claim 11 , wherein the maximal anterior posterior extent of the at least one condyle of the femur is between 5% and 15% larger than the maximal anterior posterior extent of the condyle shells.
15. The system of claim 14 , wherein the maximal anterior posterior extent of the at least one condyle of the femur is 10% larger than the maximal anterior posterior extent of the condyle shells.
16. The system of claim 11 , wherein the tongue slidably engages the at least one condyle, the tongue being movable between a plurality of discrete positions relative to the condyle engaging surface, wherein a first dimension is defined by a distance between a plane tangent to a dorsal sliding surface of the at least one condyle and a ventral surface of a patellar shield of the femur; the first dimension corresponding to one of the discrete positions of the tongue such that each discrete position of the tongue indicates a required size for the femoral slideway.
17. The system of claim 11 , wherein the base plate and the at least one condyle engaging surface are defined by a single-piece unitary structure.
18. The system of claim 11 , wherein the first dimension is at least 5% larger than the second dimension.
19. The system of claim 11 , wherein the first dimension is between 5% and 15% larger than the second dimension.
20. The system of claim 11 , wherein the first dimension is about 10% larger than the second dimension.
21. The system of claim 11 , wherein the at least one condyle engaging surface is permanently attached to the base plate to provide the permanently specified distance of the first dimension of the femur template.
22. A system, comprising:
a plurality of femoral slideway implants, each comprising:
at least one condyle shell having an outer dorsal sliding surface defining an outermost posterior point of the at least one condyle shell,
a patellar shield located anterior to the at least one condyle shell;
at least one peg on an inner surface of the implant and located between the patellar shield and the at least one condyle shell; and
a first dimension defined by a distance between a plane tangent to the dorsal sliding surface at the outermost posterior point of the at least one condyle shell and a longitudinal axis of the at least one peg;
wherein each of the plurality of femoral slideway implants has a different implant size; and
wherein the first dimension is constant throughout the plurality of femoral slideway implants irrespective of the implant size;
a femur size template for determining an appropriate implant size corresponding to one of the different implant sizes and for installing the femoral slideway implant having the implant size corresponding to the appropriate implant size, the femur size template comprising:
a base plate having at least one hole;
at least one condyle engaging surface extending from the base plate, the at least one condyle surface having a permanently fixed location with respect to the at least one hole in the base plate;
a measurement tongue slidably mounted to the base plate, the tongue being movable between a plurality of discrete positions relative to the condyle engaging surface; and
a second dimension defined by a distance between a central axis of the hole in the base plate and the permanently fixed location of the at least one condyle engaging surface;
wherein the second dimension of the femur size template is larger than the constant first dimension of the plurality of the femoral slideway implants by a permanently specified distance.
23. The system of claim 22 , wherein each of the femoral slideway implants has a maximal anterior-posterior extent, wherein each of the implant sizes has a different maximal anterior-posterior-extent, and wherein each of the plurality of discrete positions of the measurement tongue corresponds to the maximal anterior-posterior extent of one of the implant sizes.