ORTHOPEDIC PROSTHESIS SYSTEM FOR A HINGED KNEE PROSTHESIS - Patent application

Abstract

To provide an orthopedic prosthesis.SOLUTION: An orthopedic prosthesis includes a femoral component including a pair of condyles spaced to define an intercondylar notch. A tibial component includes a tray and a platform pivotally coupled to the tray. A modular insert is configured to be selectively coupled to the femoral component to couple the femoral component to the tibial component.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present disclosure relates generally to orthopaedic prosthetic systems, including prosthetic components and methods for assembling the prosthetic components during an orthopaedic joint replacement procedure, and more particularly to orthopaedic prosthetic components and methods for assembling the prosthetic components during a knee replacement procedure. [Background technology]

[0002] Natural human knee joint motion (e.g., flexion and extension) involves the motion of the femur and tibia. Specifically, during flexion and extension, the distal end of the femur and the proximal end of the tibia articulate relative to one another through a series of complex motions. Injury (e.g., trauma) or disease can deteriorate the bones, articular cartilage, and ligaments of the knee joint, ultimately affecting the knee joint's ability to function naturally. For this reason, artificial knee joints have been developed, which are implanted into the surgically prepared ends of the femur and tibia.

[0003] A typical knee prosthesis for total knee replacement includes, for example, a tibial component or tibial tray that is connected to the patient's tibia, a femoral component that is connected to the patient's femur, and a tibial insert component that is positioned between the tibial tray and the femoral component and includes a surface that accommodates the condyles of the femoral component. However, constrained knee prostheses may be used when the patient's collateral ligaments are damaged or otherwise unable to provide adequate support and stability to the knee joint. One such constrained knee prosthesis is a hinged knee prosthesis, which typically includes a hinge mechanism for connecting the femoral component to one or both of the bearing component and the tibial component to constrain and mechanically connect the components of the knee prosthesis together. Existing hinged knee prosthesis designs require either a dedicated hinged knee prosthesis femoral component or a hinge shaft that is to be inserted into the femur, which can be difficult if there is no adequate exposure to the hinge shaft. Summary of the Invention [Means for solving the problem]

[0004] In accordance with aspects of the disclosed embodiment, an orthopaedic prosthesis assembly includes a femoral component configured to couple to a surgically-prepared distal end of a patient's femur. The femoral component includes a pair of spaced apart condyles defining an intercondylar notch. The condyles each include a convexly curved condyle surface. The tibial component includes a tray configured to couple to a surgically-prepared proximal end of the patient's tibia and a platform pivotally coupled to the tray. The platform includes a pair of concavely curved surfaces corresponding to the convexly curved condyle surfaces of the femoral component and a proximal opening positioned between the concavely curved surfaces. A modular insert is configured to selectively couple to the femoral component. The modular insert includes a bracket sized to be positioned in the intercondylar notch of the femoral component. The elongated stem is sized to be received in an opening defined in the platform of the tibial component. A hinge pin pivotally couples the elongated stem to the bracket. The fastener is configured to secure the femoral component to the bracket of the modular insert. The platform is configured to pivot about a first axis extending in an inferior-superior direction, and the elongated stem is configured to pivot relative to the bracket and the femoral component about a second axis extending in a medial-lateral direction perpendicular to the first axis.

[0005] In some embodiments, the fastener can extend transversely to the hinge pin. The fastener can extend along an axis angled relative to the inferior / superior axis of the elongated stem. The fastener can be configured to extend through a hole formed through the bracket of the modular insert. The fastener can be configured to extend through a post of the femoral component. The bracket can include a lower surface and an upper surface. The hole formed through the bracket can extend from an opening in the lower surface to an opening in the upper surface.

[0006] In some embodiments, the hinge pin may be sized to be positioned in the intercondylar notch of the femoral component.

[0007] In some embodiments, a flange may extend from the bracket of the modular insert and may be configured to engage a surface of the femoral component. The flange may extend from a posterior end of the bracket. The flange may be received in a groove formed in a front surface of a posterior cam of the femoral component.

[0008] According to another aspect of the disclosed embodiment, an orthopaedic prosthesis assembly includes a femoral component configured to couple to a surgically-prepared distal end of a patient's femur. The femoral component includes a pair of condyles spaced apart to define an intercondylar notch. Each of the condyles includes a convexly curved condyle surface. The femoral component also includes a bottom surface and a pair of planar internal sidewalls extending from the bottom surface. The bottom surface and the internal sidewalls define, in part, the intercondylar notch. The tibial component includes a tray configured to couple to a surgically-prepared proximal end of the patient's tibia and a platform pivotally coupled to the tray. The platform includes a pair of concavely curved surfaces corresponding to the convexly curved condyle surfaces of the femoral component and a proximal opening positioned between the concavely curved surfaces. A modular insert is configured to selectively couple to the femoral component. The modular insert includes a bracket sized to be positioned in the intercondylar notch of the femoral component. The elongated stem is sized to be received within an opening defined in the platform of the tibial component. The hinge pin pivotally connects the elongated stem to the bracket. The hinge pin has a length that is less than a distance between the interior sidewalls of the femoral component. The modular insert also includes a fastener configured to secure the femoral component to the bracket of the hinge insert. The platform is configured to pivot about a first axis extending in an inferior-superior direction, and the elongated stem is configured to pivot about a second axis relative to the bracket and the femoral component. The second axis extends in a medial-lateral direction perpendicular to the first axis.

[0009] In some embodiments, the hinge pin may be sized to be positioned between the inner side walls of the femoral component. The bracket may include a pair of outer side walls spaced apart a distance less than the distance between the inner side walls of the femoral component. The inner side walls of the femoral component may include a medial wall and a lateral wall. The outer side walls of the bracket may include a medial wall and a lateral wall.

[0010] In some embodiments, the fastener can extend transversely to the hinge pin. The fastener can extend along an axis that is angled relative to the inferior / superior axis of the elongated stem.

[0011] In some embodiments, a flange may extend from the bracket of the modular insert and may be configured to engage a surface of the femoral component. The flange may extend from a posterior end of the bracket. The flange may be received in a groove formed in a front surface of a posterior cam of the femoral component.

[0012] In accordance with yet another aspect of the disclosed embodiment, an orthopaedic femoral component includes a pair of condyles spaced apart to define an intercondylar notch. Each of the condyles includes a convexly curved condylar surface. A bottom surface and a pair of planar internal sidewalls extend from the bottom surface. The bottom surface and the internal sidewalls define a cavity that partially defines the intercondylar notch. A posterior cam is positioned within the intercondylar notch. A groove is formed in an anterior surface of the posterior cam. The cavity is sized to receive a bracket of a modular insert. The groove is configured to receive a flange of the modular insert.

[0013] In some embodiments, a post may be provided with an aperture extending therethrough. The aperture may be sized to accommodate a fastener for securing the femoral component to the modular insert. The opening may be formed in the anterior surface of the posterior cam. A groove may extend from the opening. [Brief description of the drawings]

[0014] The detailed description makes particular reference to the following drawings: [Figure 1] FIG. 1 is an exploded perspective view of an orthopaedic knee prosthesis system. [Diagram 2] FIG. 2 is a rear perspective view of the tibial component of the orthopaedic knee prosthesis system of FIG. 1 . [Diagram 3]FIG. 2 is a distal plan view of the femoral component of the orthopaedic knee prosthesis system of FIG. 1 . [Figure 4] FIG. 4 is a cross-sectional side elevation view of the femoral component taken along line 4-4 in FIG. 3. [Diagram 5] FIG. 2 is an exploded perspective view of a modular insert for the orthopaedic knee prosthesis system of FIG. 1. [Figure 6] FIG. 6 is a perspective view of a bracket of the modular insert of FIG. 5. [Figure 7] 7 is a side perspective view of the modular insert of FIGS. 5-6 and the fastener of the orthopaedic knee prosthesis system of FIG. 1. FIG. [Figure 8] 8 is a view similar to FIG. 7 illustrating the plug of the orthopaedic knee prosthesis system of FIG. 1. [Figure 9] FIG. 9 is a perspective view of the plug of FIG. 8. [Figure 10] FIG. 11 is a side elevational view of the plug of FIGS. 9-10. [Figure 11] FIG. 2 is a rear perspective view of the assembled orthopaedic knee prosthesis of the system of FIG. 1 . [Figure 12] FIG. 12 is a cross-sectional side elevation view of the assembled orthopaedic knee prosthesis taken along line 12-12 in FIG. 11. [Figure 13] FIG. 13 is a view similar to FIG. 12 showing the assembled orthopaedic knee prosthesis in flexion. [Figure 14] FIG. 13 is an exploded perspective view of another embodiment of an orthopaedic knee prosthesis system. [Figure 15] FIG. 15 is a perspective view of a bracket of the orthopaedic knee prosthesis system of FIG. 14. [Figure 16] 16 is a cross-sectional side elevational view of the femoral component of the orthopaedic knee prosthesis system taken along line 16-16 in FIG. 14. [Figure 17] FIG. 15 is a cross-sectional side elevation view of a portion of the orthopaedic knee prosthesis system of FIG. [Figure 18] FIG. 13 is an exploded view of another embodiment of an orthopaedic knee prosthesis system. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] While the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific illustrative embodiments thereof are shown by way of example in the drawings and are herein described in detail, it being understood, however, that there is no intention to limit the concepts of the present disclosure to the particular forms disclosed, but on the contrary, the invention is intended to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.

[0016] Terms denoting anatomical references, such as anterior, posterior, medial, lateral, superior, inferior, etc., may be used throughout this specification with respect to the orthopedic implants and orthopedic surgical instruments described herein, as well as with respect to the patient's biological anatomy. Such terms have well-understood meanings both in the study of anatomy and in the field of orthopedic surgery. Use of such anatomical reference terms in the written description and claims is intended to be consistent with their well-understood meanings, unless otherwise specified.

[0017] 1, an orthopaedic knee prosthesis system 10 is shown. The orthopaedic knee prosthesis system 10 includes a femoral component 12 configured to be coupled to a distal end of a patient's femur, a tibial tray 16 configured to be coupled to a proximal end of the patient's femur, and a pair of tibial inserts 18, 20 configured to be individually assembled with the tibial tray 16. As described in more detail below, the femoral component 12, the tibial tray 16, and the tibial insert 18 can be assembled to form one type of orthopaedic knee prosthesis, specifically a rotating platform orthopaedic knee prosthesis. The femoral component 12, the tibial tray 16, the tibial insert 20, and the modular insert 22 can be assembled to form another type of orthopaedic knee prosthesis, specifically a hinged orthopaedic knee prosthesis, described below.

[0018] In the illustrative embodiment, the femoral component 12 includes a post 24 configured for implantation into the distal end of a patient's femur. The post 24 is attached to a body 26 having a pair of spaced apart lateral and medial condyles 28. The condyles 28 include respective lateral and medial condyle surfaces 30, 32 that are convexly curved. An intercondylar notch 34 is defined between the lateral and medial condyles 28 and is sized to receive the modular insert 22.

[0019] The femoral component 12 and the tibial tray 16 are each formed from an implant-grade metallic material, such as, for example, cobalt chrome. As shown in FIGURE 1, the tibial tray 16 includes a base 36 and an anchor 38 extending downwardly from a distal surface 40 of the base 36. The base 36 is sized and shaped to conform to the shape of a surgically-prepared proximal surface of the patient's tibia, and the anchor 38 is sized and shaped for implantation into a surgically-prepared medullary canal of the patient's tibia.

[0020] The base 36 includes a substantially planar proximal surface 42 positioned opposite the distal surface 40. A curved outer wall 44 extends from the surfaces 40, 42 and is sized and shaped to match the outer edge of the surgically-prepared proximal surface of the patient's tibia. An opening 46 is defined in the proximal surface 42, and the tray 16 includes an aperture 48 extending medially from the opening 46. The aperture 48 extends through the base 36 and into the anchor 38.

[0021] The tibial tray 16 can be assembled with one of the tibial inserts 18, 20 shown in FIG. 1 to form a tibial component. The inserts 18, 20 are each formed from an implant-grade plastic material, such as, for example, ultra-high molecular weight polyethylene (UHMWPE). The tibial insert 20 includes a platform 52 sized to be positioned on the proximal surface 42 of the tibial tray 16 and an elongated stem 54 extending downwardly from a distal surface 56 of the platform 52 along a longitudinal axis 58. Similar to the proximal surface 42 of the tibial tray 16, the distal surface 56 of the platform is substantially planar. The platform 52 also includes a pair of proximal concave curved surfaces 60, 62 that correspond to the lateral and medial condyle surfaces 30, 32 of the femoral component 12. The platform also includes a curved outer wall 64 extending between the surfaces 56, 60, 62.

[0022] 1, an opening 66 is defined in the proximal surfaces 60, 62 of the platform 52. The tibial insert 18 also includes an aperture 68 that extends medially from the opening 66, through the platform 52, and into the elongated stem 54. The aperture 68 then extends along the longitudinal axis 58 of the stem 54 to a closed end (not shown).

[0023] When coupled to the tibial tray 16, the distal surface 56 of the tibial insert 20 engages the proximal surface 42 of the tibial tray, as shown in FIG 2. The elongated stem 54 of the tibial insert 20 is sized to be received within the aperture 48 of the tibial tray 16 when the tibial insert is coupled to the tibial tray. In the illustrative embodiment, the stem 54 is sized and shaped to allow the tibial insert 20 to rotate about the longitudinal axis 58 when positioned in the tibial tray aperture 48, as indicated by arrow 70 in FIG 2.

[0024] As described above, the tibial tray 16 and tibial insert 20 can be combined with the femoral component 12 and modular insert 22 to form a hinged orthopaedic knee prosthesis. Referring now to FIGURE 3, the femoral component 12 includes an intercondylar notch 34 defined between the medial and lateral condyles 28. The condyles 28 each include a sidewall 80 extending distally from a respective condyle surface 30, 32 to a bottom wall 82. The intercondylar notch 34 has a width 84 defined between the sidewalls 80 that is sized to accommodate the proximal end of the modular insert 22, which is described in more detail below.

[0025] In the illustrative embodiment, the femoral component 12 also includes a posterior cam 90 extending between the side walls 80 at the posterior end 92 of the intercondylar notch 34. As shown in FIGS. 3-4 , the posterior cam 90 has a curved anterior surface 94. An opening 96 is defined in the anterior surface 94 adjacent the bottom wall 82. A number of walls 98 extend medially from the opening 96 to define a groove 100 in the anterior surface 94. The groove 100 is sized to receive a retaining flange 102 of the modular insert 22 for coupling the modular insert 22 to the femoral component 12, as described in more detail below.

[0026] 4, the femoral component 12 also includes an anterior flange 104 extending between the side walls 80 at the anterior end 106 of the intercondylar notch 34. An opening 110 is defined in the bottom wall 82 adjacent the anterior flange 104. An interior wall 112 extends proximally from the opening 110 through the post 24 to an opening 114 defined in the proximal end of the post. The interior wall 112 and the openings 110, 114 define a passageway 116 extending through the post 24. The interior wall 112 includes a substantially smooth distal section 118 connected to a threaded proximal section 120.

[0027] 5-6, the modular insert 22 includes an elongated stem 130 pivotally coupled to a bracket 132 sized to be positioned in the intercondylar notch 34 of the femoral component 12. The elongated stem 130 extends from a distal end 134 sized to be positioned in the aperture 68 of the tibial insert 20 to a proximal end 136 configured to couple to the bracket 132. The elongated stem 130 has a longitudinal axis 140 that is positioned to coincide with the longitudinal axis 58 of the tibial insert 20 when the stem is positioned in the aperture 68.

[0028] In the illustrative embodiment, the elongated stem 130 has a spine 142 extending distally from the proximal end 136 and is connected to a shaft 144 extending proximally from the distal end 134. The shaft 144 has a cylindrical distal section 146 and a faceted proximal section 148. The proximal section 148 includes a concave curved posterior surface 150 that defines a notch 152 that is sized and shaped to accommodate the curved anterior surface 94 of the femoral component 12.

[0029] The spine 142 of the elongated stem 130 has an inner opening (not shown), an outer opening 156 positioned opposite the inner opening, and an interior wall 160 extending between the openings 156, 158. The interior wall 160 defines a cylindrical passage 162 extending through the spine 142 that is sized to accommodate a hinge pin 164, as described in more detail below.

[0030] The modular insert 22 also includes a pair of bushings 166, 168 that are sized and shaped to be positioned at either end of the passageway 162 of the spine 142. Each bushing 166, 168 includes an internal flange 170 configured to engage a side of the spine 142 and a sleeve 172 extending outwardly from the flange 170. A passageway 174 extends through each bushing 166, 168, which are sized to receive an end of a hinge pin 164. The passageways 162, 174 and the hinge pin 164 cooperate to define an axis of rotation 176 about which the femoral component 12 articulates when assembled with the modular insert 22.

[0031] As described above, the modular insert 22 includes a bracket 132 that is sized to be positioned in the intercondylar notch 34 of the femoral component 12. As shown in FIG. 6, the bracket 132 includes a bottom plate 180 and a pair of arms 182, 184 extending downwardly from the bottom plate 180. The arms 182, 184 are spaced apart such that a channel 186 is defined therebetween that is sized to receive the spine 142 of the elongated stem 130. Each of the arms 182, 184 also has a bore 188 that opens into the channel 186. The bore 188 is aligned and sized to receive the sleeve 172 of the bushing 166, 168.

[0032] As noted above, the modular insert 22 includes a flange 102 that extends posteriorly from the bottom plate 180 and is sized to be received in the groove 100 of the femoral component 12. The modular insert 22 also includes a bore 190 that extends in an inferior-superior direction through the anterior end of the bottom plate 180. The bore 190 is sized to receive a fastener 192 that, together with the flange 102, is configured to couple the modular insert 22 to the femoral component 12, as described in more detail with respect to Figures 7-8.

[0033] As discussed above, the bracket 132 is sized to be positioned in the intercondylar notch 34 of the femoral component 12. In the exemplary embodiment, the bracket 132 has a medial-lateral width 194 defined between the side walls of the bottom plate 180. The medial-lateral width 194 is less than or equal to the width 84 of the notch to allow the bracket 132 to be inserted into the intercondylar notch 34. In the exemplary embodiment, the hinge pin 164 extends a length equal to the medial-lateral width 194 such that it may also be inserted into the notch 34.

[0034] In the exemplary embodiment, the elongated stem 130, bracket 132 and hinge pin 164 are formed from an implant grade metal material, such as, for example, cobalt chrome. The bushings 166, 168 are formed from an implant grade plastic material, such as, for example, ultra-high molecular weight polyethylene (UHMWPE). It should be understood that in other embodiments, for example, portions of the stem 130 or bracket 132 may be formed from an implant grade plastic material.

[0035] As shown in FIGS. 7-8 , the fastener 192 includes a head portion 200 and an elongated shaft 202 extending away from the head portion 200. The bracket 132 is also formed from an implant grade metallic material, such as, for example, cobalt chrome. The shaft 202 is illustratively cylindrical and includes a substantially smooth exterior surface 204. The shaft 202 extends outwardly from a bore 190 defined in the bracket 132 and is sized to engage the smooth distal wall section 118 of the femoral component 12. In the illustrative embodiment, the fastener 192 couples the bracket 132 (and thus the modular insert 22) to the femoral component 12 via a press fit between the wall section 118 and the shaft 202. It should be understood that in other embodiments, the section 118 and the shaft 202 can include corresponding grooves for coupling the component 12 to the insert 22.

[0036] The modular insert 22 also includes a plug 210 configured to couple to the head 200 of the fastener 192. The plug 210 is illustratively formed from an elastomeric material, such as rubber. The plug 210 includes a main body 212 and a pair of arms 214 extending outwardly from the main body 212. As shown in FIG. 9 , each arm 214 includes a curved inner surface 216 that is shaped to engage the head 200 of the fastener 192. The inner surfaces 216 cooperate with a top surface 218 of the main body 212 to form a slot 220 that is sized to receive and retain the head 200 of the fastener 192.

[0037] 10, the main body 212 is wedge-shaped and includes an anterior surface 222 that extends from a superior surface 218 to an inferior tip 224. A posterior surface 226, which extends at an oblique angle to the anterior surface 222, extends from the superior surface 218 to the inferior tip 224. As described in more detail below, the posterior surface 226 is configured to engage the anterior surface of the spine 142 of the modular insert 22 when the femoral component 12 is in an extended state.

[0038] Returning to FIG. 1 , the femoral component 12 and tibial tray 16 may also be combined with a tibial insert 18 to form another orthopaedic prosthesis as described above. The tibial insert 18 includes a platform 252 sized to be positioned on the proximal surface 42 of the tibial tray 16 and an elongated stem 254 extending downwardly from a distal surface 256 of the platform 252 along a longitudinal axis 258. The distal surface 256 of the platform 252 is substantially planar. The platform 252 also includes a pair of proximal concave curved surfaces 260, 262 that correspond to the lateral and medial condyle surfaces 30, 32 of the femoral component 12. The platform 252 also includes a curved outer wall 264 extending between the surfaces 260, 262, 256.

[0039] The tibial insert 18 also includes a spine 266 extending upwardly from the platform 252 between the pair of proximal concave curved surfaces. The spine 266 includes a convexly curved anterior surface 268 and a concavely curved posterior surface 270. The concavely curved posterior surface 270 is shaped to engage the convexly curved anterior surface 94 of the posterior cam 90 of the femoral component 12.

[0040] When coupled to the tibial tray 16, the distal surface 256 of the tibial insert 18 engages the proximal surface 42 of the tibial tray. The elongated stem 254 of the tibial insert 18 is sized to be received within the aperture 48 of the tibial tray 16 when the tibial insert 18 is coupled to the tibial tray 16. In the illustrative embodiment, the stem is sized and shaped to allow the tibial insert 18 to rotate about the longitudinal axis 258 when positioned in the aperture 48 of the tibial tray 16.

[0041] In use, a patient may first be implanted with a rotating platform orthopaedic prosthesis including, for example, the femoral component 12, the tibial tray 16, and the tibial insert 20. Due to injury, bone loss, or deterioration of the patient's mobility, a surgeon may determine that the existing orthopaedic prosthesis may need to be replaced with a hinged orthopaedic prosthesis. To do so, the surgeon may open the soft tissue in the area surrounding the patient's knee joint. The surgeon may then remove some or all of the components of the existing orthopaedic prosthesis, surgically prepare the patient's bone to receive the new femoral component 12, tibial tray 16, tibial insert 20, and modular insert 22, and implant those components into the patient's joint.

[0042] In some procedures, the surgeon may choose to remove the tibial insert 18 and leave one or both of the existing femoral component 12 and tibial tray 16 implanted in the patient's joint. The surgeon may perform a trial reduction to select the appropriately sized modular insert 22 and tibial insert 20. To attach the tibial insert 20 to the tibial tray 16, the surgeon may align the elongated stem 54 of the insert 20 with the aperture 48 of the tibial tray 16 and advance the distal tip of the stem 54 into the aperture 48 to engage the platform 52 with the bottom 36 of the tray 16. To connect the modular insert 22 to the tibial insert 20, the surgeon may align the shaft 144 of the modular insert 22 with the aperture 68 of the tibial insert 20 and advance the distal tip of the shaft 144 into the aperture 68 to seat the modular insert 22 on the tibial insert 20.

[0043] To couple the modular insert 22 to the femoral component 12, the surgeon may advance the retaining flange 102 of the bracket 132 of the modular insert 22 into the groove 100 defined in the posterior cam 90 of the femoral component 12, as shown in FIG. 12. The surgeon may also align the hole 190 with the passageway 116 of the femoral component 12 and advance the elongated shaft 202 of the fastener 192 through the hole 190 and into the passageway 116. When the head 200 of the fastener 192 engages the bracket 132, the bracket 132 (and thus the modular insert 22) is coupled to the femoral component 12 by a press fit between the wall section 118 that defines the passageway 116 and the shaft 202. The surgeon may attach a plug 210 to the head 200 of the fastener 192 to form the hinged orthopedic prosthesis shown in FIG. 12.

[0044] When the orthopaedic prosthesis is in extension as shown in FIG. 12, the plug 210 engages the anterior surface of the spine 142 of the modular insert 22 and the femoral condyles 28 engage the proximal surfaces 60, 62 of the tibial insert 20. When the knee joint moves from extension to flexion, the femoral component 12 is pivoted about an axis 176 extending through the hinge pin 164. Due to the surface configuration of the femoral condyles, as the femoral component 12 pivots, the modular insert 22 advances in an upward direction as indicated by arrow 280 in FIG. 12 while keeping the tibial insert 20 engaged with the tibial tray 16. In full flexion, the posterior cam 90 is positioned in a notch 152 defined in the modular insert 22 with the anterior surface 94 engaged with the posterior surface 150 of the modular insert 22, thereby preventing further flexion. It should be understood that the femoral component 12, the tibial insert 20 and the modular insert 22 are configured to pivot about an axis 58, which extends perpendicular to the hinge pin axis 176 during normal movement and use of the orthopaedic prosthesis.

[0045] 14-17, another embodiment of a hinged orthopaedic prosthesis (hereinafter prosthesis 310) is shown. The orthopaedic knee prosthesis 310 includes a femoral component 312 configured to be coupled to a distal end of a patient's femur, a tibial tray 16 configured to be coupled to a proximal end of a patient's femur, and a tibial insert 20 configured to assemble with the tibial tray 16. It should be understood that the tibial insert and tibial tray of the prosthesis 310 are identical to the tibial insert and tibial tray described above with respect to FIGS. 1-13, and the same reference numbers are used to identify the features of those components. Additionally, some of the features of the other components of the prosthesis 310 are identical or similar to the features described above with respect to FIGS. 1-13, and the same reference numbers are used to identify those features. As shown in FIG. 14, the prosthesis 310 also includes a modular insert 322 configured to couple the tibial insert 20 to the femoral component 312.

[0046] Similar to the femoral component 12, the femoral component 312 is formed from an implant grade metallic material, such as cobalt chrome. As shown in FIG. 16, the femoral component 312 includes a post 324 configured for implantation into the distal end of a patient's femur. The post 24 is attached to a body 326 having a pair of spaced apart lateral and medial condyles 328. The condyles 328 include respective lateral and medial condyle surfaces 330, 332 that are convexly curved. An intercondylar notch 334 is defined between the lateral and medial condyles 28 and is sized to receive the modular insert 322.

[0047] Each condyle 328 includes a sidewall 380 extending distally from a respective condyle surface 330, 332 to a bottom wall 382. The intercondylar notch 334 has a width defined between the sidewalls 380 that is sized to receive a proximal end of the modular insert 322, as described in more detail below. The bottom wall 382 includes a posterior edge 384 that is sized to be received in a retention groove 400 defined in the modular insert 322, also as described in more detail below.

[0048] An opening 110 is defined in the bottom wall 382 and an interior wall 112 extends proximally from the opening 110 through the post 324 to an opening 114 defined in the proximal end of the post. The interior wall 112 and the openings 110, 114 define a passageway 116 that extends through the post 24. The interior wall 112 includes a substantially smooth distal section 118 that is connected to a threaded proximal section 120.

[0049] 14 , the modular insert 322 includes an elongated stem 430 pivotally coupled to a bracket 432 sized to be positioned in the intercondylar notch 334 of the femoral component 312. The elongated stem 430 extends from a distal end 434 sized to be positioned in the aperture 68 of the tibial insert 20 to a proximal end 436 configured to couple to the bracket 432. The elongated stem 430 has a longitudinal axis 440 that is positioned to coincide with the longitudinal axis 58 of the tibial insert 20 when the stem is positioned in the aperture 68.

[0050] In the exemplary embodiment, the elongated stem 430 has a spine 142 extending distally from a proximal end 436 and is connected to a body 444 extending proximally from the distal end 434. As shown in FIG. 14, the body 444 has a cylindrical body. The spine 142 of the elongated stem 130 has a cylindrical passage 162 (see FIG. 17) that is sized to accommodate a hinge pin 164. The modular insert 322 also includes a pair of bushings 166, 168 that are sized and shaped to be positioned at either end of the passage 162 of the spine 142. A passage 174 extends through each bushing 166, 168, which are sized to accommodate an end of the hinge pin 164. The passageways 162, 174 and the hinge pin 164 cooperate to define an axis of rotation 176 about which the femoral component 312 articulates when assembled with the modular insert 322.

[0051] As described above, the modular insert 322 includes a bracket 432 that is sized to be positioned in the intercondylar notch 334 of the femoral component 312. As shown in FIG. 15 , the bracket 432 includes a bottom plate 480 and a pair of arms 182, 184 extending downwardly from the bottom plate 480. The arms 182, 184 are spaced apart such that a channel 186 is defined therebetween that is sized to accommodate the spine 142 of the elongated stem 430. Each of the arms 182, 184 also has a bore 188 that opens into the channel 186. The bore 188 is aligned and sized to accommodate the sleeve 172 of the bushing 166, 168.

[0052] As described above, the modular insert 322 includes a retaining groove 400 defined between the rearward end of a bottom plate 480 and a retaining flange 482 extending outwardly from the bottom plate 480. As shown in FIG. 15 , the flange 482 includes an arm 484 extending upwardly from the bottom plate 480 and another arm 486 extending forwardly from the end of the arm 484. The arm 486 is spaced apart from the bottom plate 480 such that the groove 400 is defined between the arms 484, 486 and the bottom plate 480.

[0053] The modular insert 322 also includes a bore 190 extending in an inferior-superior direction through the anterior end of the bottom plate 180. The bore 190 is sized to receive a fastener 192 (see FIG. 14 ) that is configured to couple the modular insert 322, along with the flange 102, to the femoral component 312, as described above with respect to FIGS.

[0054] As described above, the bracket 432 is sized to be positioned in the intercondylar notch 334 of the femoral component 312. In the exemplary embodiment, the bracket 432 has a medial-lateral width 194 defined between the side walls of the bottom plate 480. The medial-lateral width 194 is less than or equal to the width of the intercondylar notch 334 to allow the bracket 432 to be inserted into the notch. In the exemplary embodiment, the hinge pin 164 extends a length equal to the medial-lateral width 194 such that the hinge pin may also be inserted into the notch 334.

[0055] 17, the surgeon may couple the modular insert 322 to the femoral component 312 by inserting the retaining edge 384 of the femoral component 312 into the groove 400 of the bracket 432. The surgeon may also align the hole 190 with the passageway 116 of the femoral component 312 and insert the elongated shaft 202 of the fastener 192 through the hole 190 and into the passageway 116. When the head 200 of the fastener 192 engages the bracket 132, the bracket 132 (and thus the modular insert 322) is coupled to the femoral component 312 by a press fit between the wall section 118 that defines the passageway 116 and the shaft 202. The surgeon may attach a plug 210 to the head 200 of the fastener 192 to form the hinged orthopedic prosthesis shown in FIG. When the orthopaedic prosthesis is in the extended state shown in FIG. 17, the plug 210 engages with the anterior surface of the spine 142 of the modular insert 22, and the femoral condyles 28 engage with the proximal surfaces 60, 62 of the tibial insert 20 (not shown in FIG. 17).

[0056] 18 , another embodiment of an orthopaedic knee prosthesis 510 includes several similar components to the orthopaedic knee prosthesis system 10, which components are referenced by the same reference numbers. The prosthesis 510 includes a modular insert 552 configured to couple the tibial insert 20 to a femoral component 554. In some embodiments, the femoral component 554 may be the same as the femoral component 12. In other embodiments, the femoral component 554 does not include a groove formed on the anterior surface of the posterior cam 556.

[0057] The modular insert 552 includes an elongated stem 560 coupled to a bracket 562. The elongated stem 560 is configured to be inserted into the aperture 68 of the platform 52 of the tibial insert 20 and extends in an inferior-superior direction. The bracket 562 is hinged to a spine 564 of the elongated stem 260. The bracket 562 includes a hole (not shown) extending in a medial-lateral direction and configured to receive the hinge pin 164. The hinge pin 570 extends through an opening (not shown) in the spine 564 of the elongated stem 560. In the illustrative embodiment, a pair of bushings 572 are positioned in the holes 566 such that the hinge pin 570 extends through an opening 574 in the bushings 572. The bracket 562 pivots about the hinge pin 570 relative to the elongated stem 560.

[0058] The bracket 562 includes a flange 580 extending from a posterior end 582 of the bracket 562. The flange 580 includes a posterior arm 584 extending from the posterior end 582 of the bracket 562. An arm 586 extends downwardly from the posterior arm 584. The arms 584, 586 form a notch 590. The flange 580 is configured to couple to a posterior cam 556 of the femoral component 554 to at least partially secure the bracket 562 to the femoral component 554.

[0059] The hole 600 extends through the anterior end 602 of the bracket 562. The hole 600 is configured to receive a fastener 610 that extends into the passage 116 in the post 24 of the femoral component 554. The fastener 610 extends transversely to the hinge pin 164. In some embodiments, the fastener 610 is a screw that is threaded into the hole 600 that extends through the post 24. In some embodiments, the fastener 610 is a screw that is secured in the bracket 662 and can be rotated so that the fixation shaft can be threaded into the passage 116 that extends through the post 24. In some embodiments, a plug as described above can be positioned on the end 612 of the fastener 610. A plug can be provided to limit extension of the prosthesis 510.

[0060] Exemplary embodiments of the present disclosure are described and illustrated below to encompass knee prostheses and knee components, and methods for implanting and reconstructing a knee joint. It will still be apparent to those skilled in the art that the preferred embodiments discussed below are exemplary in nature and may be reconfigured without departing from the scope and spirit of the invention. However, for clarity and precision, the exemplary embodiments discussed below may include optional steps, methods, and features that a person skilled in the art would recognize as not necessary to fall within the scope of the invention.

[0061] [Embodiment] (1) An orthopedic prosthesis, comprising: a femoral component configured to couple to a surgically-prepared distal end of a patient's femur, the femoral component including a pair of spaced apart condyles defining an intercondylar notch, the condyles each including a convexly curved condylar surface; a tibial component including a tray configured to couple to a surgically-prepared proximal end of a patient's tibia and a platform pivotally coupled to the tray, the platform including a pair of concavely curved surfaces corresponding to the convexly curved condyle surfaces of the femoral component, and a proximal opening positioned between the concavely curved surfaces; a modular insert configured to selectively couple to the femoral component, the modular insert including a bracket sized to be positioned in the intercondylar notch of the femoral component, an elongated stem sized to be received in the opening defined in the platform of the tibial component, a hinge pin pivotally connecting the elongated stem to the bracket, and a fastener configured to secure the femoral component to the bracket of the modular insert; The orthopedic prosthesis, wherein the platform is configured to pivot about a first axis extending in an inferior-superior direction, and the elongated stem is configured to pivot about a second axis relative to the bracket and the femoral component, the second axis extending in a medial-lateral direction perpendicular to the first axis. (2) The orthopedic prosthesis of claim 1, wherein the fastener extends transversely to the hinge pin. (3) the bracket of the modular insert includes a hole obliquely disposed from the elongated stem; 2. The orthopedic prosthesis of claim 1, wherein the fastener is configured to extend through the hole to connect the modular insert to the femoral component. (4) the femoral component includes a post positioned opposite the pair of condyles and a passageway extending into the post; 4. The orthopedic prosthesis of claim 3, wherein the fastener is configured to extend into the passageway. (5) The orthopedic prosthesis of embodiment 3, wherein the bracket includes a lower surface and an upper surface, and the hole extends from an opening in the lower surface to an opening in the upper surface.

[0062] (6) The orthopedic prosthesis of embodiment 1, wherein the hinge pin is sized to be positioned in the intercondylar notch of the femoral component between the pair of condyles. (7) The orthopedic prosthesis of claim 1, further comprising a flange extending from the bracket of the modular insert and configured to engage a surface of the femoral component. (8) The orthopedic prosthesis of claim 7, wherein the flange extends from a posterior end of the bracket. (9) the femoral component includes a posterior cam positioned in the intercondylar notch, the posterior cam including a front surface configured to engage a posterior surface of the elongated stem of the modular insert; 8. The orthopedic prosthesis of claim 7, wherein the flange is received in a groove formed in the anterior surface of the posterior cam of the femoral component. (10) The orthopedic prosthesis of embodiment 7, wherein the flange is a first flange, the bracket includes a second flange extending upwardly from a proximal surface of the bracket to the first flange, the first flange being angled from the proximal surface, such that a channel is defined between the first flange, the second flange, and the proximal surface, the channel being sized to accommodate a portion of the femoral component.

[0063] (11) An orthopedic prosthesis assembly, comprising: a femoral component configured for connection to a surgically-prepared distal end of a patient's femur, the femoral component including a pair of spaced apart condyles defining an intercondylar notch, each condyle including a convexly curved condylar surface, the femoral component further including a base surface and a pair of planar internal sidewalls extending from the base surface, the base surface and the internal sidewalls defining, in part, the intercondylar notch; a tibial component including a tray configured to couple to a surgically-prepared proximal end of a patient's tibia and a platform pivotally coupled to the tray, the platform including a pair of concavely curved surfaces corresponding to the convexly curved condyle surfaces of the femoral component, and a proximal opening positioned between the concavely curved surfaces; a modular insert configured to be selectively coupled to the femoral component, the modular insert including a bracket sized to be positioned in the intercondylar notch of the femoral component, an elongated stem sized to be received in the opening defined in the platform of the tibial component, and a hinge pin pivotally connecting the elongated stem to the bracket, the hinge pin having a length less than a distance between the interior sidewalls of the femoral component, the modular insert further including a fastener configured to secure the femoral component to the bracket of the modular insert; an orthopaedic prosthesis assembly, wherein the platform is configured to pivot about a first axis extending in an inferior-superior direction, and the elongated stem is configured to pivot about a second axis relative to the bracket and the femoral component, the second axis extending in a medial-lateral direction perpendicular to the first axis; (12) The assembly of claim 11, wherein the hinge pin is sized to be positioned between the inner side walls of the femoral component. (13) The assembly of claim 11, wherein the bracket includes a pair of exterior side walls spaced apart a distance less than the distance between the interior side walls of the femoral component. (14) The internal side wall of the femoral component includes a medial wall and a lateral wall, 14. The assembly of claim 13, wherein the exterior sidewall of the bracket includes an inner wall and an outer wall. (15) The assembly of claim 11, wherein the fastener extends transversely to the hinge pin.

[0064] (16) The assembly of claim 15, wherein the fastener extends along an axis that is angled relative to the inferior / superior axis of the elongated stem. (17) The assembly of claim 11, further comprising a flange extending from the bracket of the modular insert and configured to engage a surface of the femoral component. (18) The assembly of claim 17, wherein the flange extends from a rear end of the bracket. (19) The assembly of claim 17, wherein the flange is received in a groove formed in an anterior surface of the posterior cam of the femoral component. (20) An orthopaedic femoral component, comprising: a pair of spaced apart condyles defining an intercondylar notch, each condyle including a convexly curved condylar surface; a base surface and a pair of planar interior sidewalls extending from the base surface defining a cavity that partially defines the intercondylar notch; a posterior cam positioned in the intercondylar notch and a groove formed in a front surface of the posterior cam; An orthopaedic femoral component, wherein the cavity is sized to receive a bracket of a modular insert and the groove is configured to receive a flange of the modular insert.

Claims

1. 1. An orthopedic prosthesis, comprising: a femoral component configured to couple to a surgically-prepared distal end of a patient's femur, the femoral component including a pair of spaced apart condyles defining an intercondylar notch, the pair of condyles each including a convexly curved condyle surface; a tibial component including a tray configured to couple to a surgically-prepared proximal end of a patient's tibia and a platform pivotally coupled to the tray, the platform including a pair of concavely curved surfaces corresponding to the convexly curved condyle surfaces of the femoral component, and a proximal opening positioned between the concavely curved surfaces; a modular insert configured to couple to the femoral component, the modular insert including: a bracket sized to be positioned in the intercondylar notch of the femoral component, an elongated stem sized to be received in the proximal opening defined in the platform of the tibial component, and a hinge pin pivotally coupling the elongated stem to the bracket; a fastener configured to secure the femoral component to the bracket of the modular insert; the bracket of the modular insert includes a lower surface, an upper surface, and an aperture extending from an opening in the lower surface to an opening in the upper surface; the fastener includes (i) a head configured to engage the underside of the bracket, and (ii) an elongated shaft extending away from the head, the elongated shaft configured to extend transversely to the hinge pin through the hole defined in the bracket to engage the femoral component; the platform is configured to pivot about a first axis extending in an inferior-superior direction, and the elongated stem is configured to pivot about a second axis relative to the bracket and the femoral component, the second axis extending in a medial-lateral direction perpendicular to the first axis; the femoral component is movable between extension and flexion; When the femoral component is in the extended state, the hole defined in the bracket is disposed obliquely from the elongated stem, and the fastener is configured to extend through the hole defined in the bracket to connect the modular insert to the femoral component.

2. The orthopedic prosthesis of claim 1 , wherein the head of the fastener has a larger diameter than the elongated shaft.

3. The orthopedic prosthesis of claim 1, wherein the modular insert further includes a plug configured to be coupled to the head of the fastener, the plug having a slot to receive and retain the head, the head and the plug are not received within the hole defined in the bracket but are located outside the hole defined in the bracket, and the plug is adapted to engage with the elongated stem when the femoral component is in the extended state.

4. the femoral component includes a bottom wall located in the intercondylar notch and a passageway defined in the bottom wall; 2. The orthopaedic prosthesis of claim 1, wherein the elongated shaft of the fastener is configured to extend through the hole defined in the bracket and into the passageway to couple the femoral component to the modular insert.

5. The orthopaedic prosthesis of claim 4 , wherein the femoral component includes a post positioned opposite the pair of condyles and the passageway extending into the post.

6. The orthopaedic prosthesis of claim 4 , wherein the elongated shaft and the passageway are sized to press-fit the fastener into the femoral component.

7. The orthopaedic prosthesis of claim 1 , wherein the elongated shaft is press-fit into the femoral component.

8. The orthopaedic prosthesis of claim 1 , wherein the hinge pin is sized to be positioned in the intercondylar notch of the femoral component between the pair of condyles.

9. The orthopaedic prosthesis of claim 1 , further comprising a flange extending from the bracket of the modular insert and configured to engage a surface of the femoral component.

10. The orthopedic prosthesis of claim 9 , wherein the flange extends from a posterior end of the bracket.

11. 10. The orthopaedic prosthesis of claim 9, wherein the flange is a first flange, the bracket includes a second flange extending upwardly from a proximal surface of the bracket to the first flange, the first flange being angled from the proximal surface such that a channel is defined between the first flange, the second flange, and the proximal surface, the channel being sized to accommodate a portion of the femoral component.

12. 1. An orthopaedic prosthesis assembly, comprising: a femoral component configured for connection to a surgically-prepared distal end of a patient's femur, the femoral component including a pair of spaced apart condyles defining an intercondylar notch, the pair of condyles each including a convexly curved condyle surface, the femoral component further including a base surface and a pair of planar internal sidewalls extending from the base surface, the base surface and the pair of planar internal sidewalls partially defining the intercondylar notch; a tibial component including a tray configured to couple to a surgically-prepared proximal end of a patient's tibia and a platform pivotally coupled to the tray, the platform including a pair of concavely curved surfaces corresponding to the convexly curved condyle surfaces of the femoral component, and a proximal opening positioned between the concavely curved surfaces; a modular insert coupled to the femoral component, the modular insert including a bracket sized to be positioned in the intercondylar notch of the femoral component, an elongated stem sized to be received in the proximal opening defined in the platform of the tibial component, and a hinge pin pivotally connecting the elongated stem to the bracket, the hinge pin having a length less than a distance between the pair of planar internal sidewalls of the femoral component; a fastener configured to extend through the bracket and secure the femoral component to the modular insert, the fastener including: (i) a ring-shaped head; and (ii) an elongated shaft extending away from the head through an opening defined in the bracket; the platform is configured to pivot about a first axis extending in an inferior-superior direction, and the elongated stem is configured to pivot about a second axis relative to the bracket and the femoral component, the second axis extending in a medial-lateral direction perpendicular to the first axis; the femoral component is movable between extension and flexion; an orthopaedic prosthesis assembly, wherein when the femoral component is in the extended state, the opening defined in the bracket is disposed obliquely from the elongated stem, and the fastener is configured to extend through the opening defined in the bracket to couple the modular insert to the femoral component.

13. The assembly of claim 12 , wherein the hinge pin is sized to be positioned between the pair of planar inner side walls of the femoral component.

14. The assembly of claim 12 , wherein the bracket includes a pair of exterior side walls spaced apart a distance less than the distance between the pair of planar interior side walls of the femoral component.

15. the pair of planar internal side walls of the femoral component include a medial wall and a lateral wall; The assembly of claim 14 , wherein the exterior sidewalls of the bracket include an inner wall and an outer wall.

16. The assembly of claim 12 , wherein the elongated shaft of the fastener extends transversely to the hinge pin.

17. An assembly as described in claim 16, wherein when the femoral component is in the extended state, the elongated shaft of the fastener extends along an axis angled relative to the lower / superior axis of the elongated stem.

18. The assembly of claim 12 , further comprising a flange extending from the bracket of the modular insert and configured to engage a surface of the femoral component.

19. The assembly of claim 12 , wherein the head of the fastener has a larger diameter than the elongated shaft.

20. The assembly of claim 12 , wherein the fastener is press-fit into the femoral component.

21. The assembly of claim 12, wherein the modular insert further includes a plug configured to be coupled to the head of the fastener, the plug having a slot to receive and retain the head, the head and the plug are not received in the opening defined in the bracket but are located outside the opening defined in the bracket, and the plug is adapted to engage with the elongated stem when the femoral component is in the extended state.

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