Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
WO95130389 2 ~ 29 p .,~
The present invention relates to orthopeaic
prosthetic ~oint devices for implantation lnto or
rOrl ~. of a joint of the human or animal body.
A numher o~ ~lly avOilahle prosthetic
d~vicos for ~ nt:~t~nn into a patie3t's ~oint or
l~or total joint rorlnl include a tnetallic part
and a pla~tics line~ for~ing at lea6t in part, the
~i~.lAr;n~ surface of the joint. For example, in
~S Patent No. 4,a28,s65 thP~re is provided a
cotylioaal for a n~- . ~od hip
rr~sthoq~q. The _ haa two parts, a
tita~u~ hom~rh~r;cl1 shell and a cup of poly~er
which is engagea into it.
Other patent8 and patent applications which
descrihe acetabular cups include Europ~an Patent
l~rrl;~Atinn No. 212,087 pl~hl~qho~ April 3, 19~7,
whcrein metallic pina projecC ~rom the surface o~
the cup and contain holes in whlch tissue may grow.
In European Pate~t No. 341,198 pl-hliqho~ November
B, 1989, aD ~P~h~ r cup haa a metal outer ahell
~5 and a plastic hody for retaining the hip joint
head .
The uae of a - n~ nn of a plastlc-q ll~er
and a base member is al90 a feature o~ other joint
prosthese6 such as those ~or i l.ln1~;on i~to the
sho~lder or k~e One example o~ a ti.bLal
prostheis which has a plate or insert forming an
SU~$71TU7E SHEE7 (RULE 26)
21 9G0~9
Wo 9sl30389
r~"8~ . 7L~
~rticulatlng Gurf~ce for the joint is rl~y~lhc~
US Patcnt No. 4462120.
The present invention Frovldes an improved
orthop~dic ~oint prosthesis wherel~ the prosthesis
body has a b~e me~er (e.g. tray, cup or Rhell)and
a polymeric liner~ The pol~eric liner affixes to
the prosthesis body and provides an artl~t;n3
s;urface ~or er:gaging a~other rrnRfh~Ri~ member.
~0
The prosthesl3 body ha~ a non-art~ t;
mirrored or polished _ur~ace that receive6 th~
plastlc lin~r. Thls surface ha~ a poli_hed
surface that faces the 11ner for ret~rding liner
1~ dehri6 ~n~rat~n The pollshed surface has a
~uyl~ o~ preferably les~ than eight ta) mlcro-
inches .
The ~ n~l lo~n o~ th~ polymeric liner and
orthopedic bas~ with mirrored or poli~hed surface
~ini8h provldes numsrous adv ' _ . Fir~t, it
pr~rides a low frictio~ and low abrasion surface
for ~ ntr;h~ n~ the contact force~ between the
polyethylene li~er ~e.g., ~1HNWPi~) and th~l
rrnRth~ body shell mis reduc~s the abr_sive
gr-l~r~ n of polyethylene debris resulting ~rom
motlon between th~s liner atld the body.
This motion may cone from a varlety of
; which i~clud2 Poi~son volum~tric
di3tortlon of the poly~thylene resulting in
WO 951tO389
2 1 9 0 0 2 9 PCT/US95/05710
lnr~l t~7ed q~TAnn;nn and cnnt~tnr~ of the sur~;~ce
of thc liner agalnst the body ao ;~ re6ult of
loading the liner, a~d thc mi~ tnn which
occurs f~om ~orces ~rom a liner within an~ Oround
5 the confineo of thc prostheOis body interior. Por
example, in tke CEI8e of an A~tAh~ r ~rnrth~ n,
the femoral head is loadcd at the liner.
rlicro-motio~ c~n occur in hip 1 t.h~oA~R ~rom
10 forces g~n~rAtq-l by the ~emoral head pushlng the
liner within a~d around the confines of the
proothesis body, namely an acetabular Qlp hody with
a concave polished surf~ce that receiveo the liner.
Mlcro-motlon can occur in a knee ~ oLL~._18 _o a
15 tiblal tray llner recevea i'orce gqnor~t~td by a
femoral rrnth~n;q. A shoulder or glenoid
also has ~orce transmitted at the joint to a
plAstic liner of the glenoid metallic
The mirror finl~h Al GO allows the us~ of
optical non-contact in~E~e~ttnn of the interior of
the metallic _ 8urface for checking the
~ J~ L of the ~ -. Thc use of
norl-contact optical ;nRI~ectton methods allow
complete checking of whole two and three
~'t~ innJ'l surfaceo at one time. The usual method
of optical three-~li ~nn~l tn~p~ct~nn is to
prbject a regulisr pattern of light onto the suriace
which i8 to be inqp~rte~ The reOultant two
~t; lnnAl proje~tion of the scene may be u8ed to
give highly accurate total ourfacc ~
WO9~/30389 21 90Q~q PCr/US95/05710
.
Diatortions in the regular pattern indicate
distortions in the part surface and i~dicate
deYlations from the desired part geometry~ Thls
5 method i8 in~fferl-lye on highly smooth ~urface3
~ince the projected light of the regular pattern
bounce~ o~_ th~ - - r ~ ' target and no two
~li ~; nn-l mapplng is pos~ible . In thitt devlce
the h,ighly fimooth surfac~ is ~urther poli6hed to
10 act a~ a re~lectiYe mirror. Thi~ ~urface mirror
then iB used aa a lens to view a two~ nn511
pat~ern such a~ ~ grid drawn on a white sheet of
papcr or a serie~t o~ c ~i~gs. Distortion~
in the Y~ewed image then are a re~ult o~
15 dlstortion~ o~ tbe lenfl and hence the surface which
i~ desired to be mea5ured. It i~ thereby po6slble
to ~ nspect the highly smooth sur_ace o~ the
prosthe~ig body due to this pnl; F:h~nrJ,
Th~ met~od of; , ~' i nn may be both by trained
huloan inRrectora and by image analysi~ t' by
c~rt~rtn~ the reflected image by a Yldeo camera,
digitlzing the image, and using computer analy~ia
to measure tho amount o~ deviatio~ of the pattern
from the allowed sur~ace geometry t~ nrc~.
The adva..l,-,y~s o~ thi~ ~mooth ~nd poli~hed
sur~ace is theref ore to provide non - contact, and
therefore non-destructive (~on-~irr~trll;ng),
30 measurement of the interior of an ~ h~llwr
device. Th~ ;n~p~ctinn methods ~equire a surface
Wo g~l30389 2 ~ 9 0 0 29 ~ o
~hich allows ~ reflective re~ t~nr 6~ff;rif~nt to
provide adequate re~lectlve image ~uality for
analyais. Current ;n~pe~r~;nn limits requirc a
surface finish of les6 than eight (8) micro-lnches
to ~ t;~:h thia r~u~tity of r~c~ntl~ti~n-
In one . ` ~ , th~ present inventionprovides an improved aret~ r prosthesis. For an
~IratAhlll:zr pro3thesis, ~n ~r~t~hl-lAr cup body
10 pre~erably include~ openinga therethrough which can
funotion as drill guides for the sUrgeon after the
cup has been ~laced in the patient'g ~re~A~
A sccond . ' `'-- of the invention 18 a
1~ glenoid pro~the~i~ for; _lpnt::lt;~n into a
shoulder .
A further ' -~' of the invention m~y be a
knee r~3thA-i~ fiuch as tho~e generally used for
ZO eot~l l=ee r~ Dt-.
WO 95/303
89 ~ 0 ;2 9 PCTIUS95/0571
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Tl~ n~ l OF 1!~ DR~
For ~ Surt~er ~ d~ ,~dlng cr thc naturc and ob~ct or
the prasent invcntion, rcrencc should oe b~d to tho
rollowing detallod ~cscription ttlccn in con~unction wlth the
,~lng drllwings, in which likc parts l~ro giv n llke
rerQrence nu~Qrals, ~nd whcrQin
FIG~RE 1 13 ~ ~ld~ scctional vi~w oS thQ ~.~L~
' ' ~ or the ~pparatUs Or thc pre--nt inYention sho~lng
~n D_e~ h~ nr cup;
PIG~RE 2 ls a sldc ~ection~l view Or the prer~rrcd
' ,t'' l of th~ Or the present inv~ntlon sl~Owing
~n ~91 ~h~ll~r cup;
PIGllRI~ J i~ an cxploded p rspcotlve view or th~ L~.,.
Or the ~ r~ o~ the pr~sQnt invention showing
n ~ h - l ~ r cup;
CC~ q is ~ top viow or the prefcrrcd ~A' ' Or thQ
~ppar~tus oS the ~rQaert invention showing ~ glenoid
co~ponent;
FIC~RF 5 ls ~ botto~ vlow Or thc L"~''~ J - ' ~ Or
th ~pp~r~tus Or thc present inventlon showing ~ glonoid
E~G~RE 6 is ~n olcv~tional vicw o~ tho prefarrlad
. .A~ t or the appar~tu~ Or the pre~ent lnvQntion ahol,ring
~I glenoid oo~ponont;
2~ FIG~IRF ~ ls ~ ~id~ vl~w Or th- I ,cr.~ ' ' o~
~he ~ppsr~tUs Or the prasent invontion _howing ~ gl~noid
co~ponsnt
FIG~ a ~s a bottoD~ view oS tha ~ rCL~ ' ' `' Or
'~he appar~tus or thc present lnventlon showing a tlbi~l
3 0 co~ponent;
wogsl30389 21q~2~ P~ o
F~GL1R}~ ~ is an ~lcvational vlew Or tbc pre~err¢d
'~ ~ of th~ appar~tus of th- pre8ent lnY ntion taken
~long llnes 9-9 if rigurc 8, ~howing ~ tibi~l oo~lpon~nt;
FICI~RE 10 is ~ aeo'cionnl view taken ~long lineG 10 - 10
5 Or Pigure 8;
PIG~IR} ll is an el-vation~l view Or the prQrerred
' ' ' Or th~ app~r~tua Or th- prc~ent invention ahowlng
tibi~
FIGUi~E 12 15 ~ ~idQ view Or the pr~ r~rred ' '' Or
the ~pp~ratus Or the present inv ntion ~howing ~n h.~ ' 'C
tibial co~ponent;
FIGURE 13 is ~ top Vi-Y Or thc prererrcd ' '~ Or
the ~ppar~tua oS th~ pr~s nt invention ~bow~ng nn ~ r
tibi~l qlenola { , ';
lS FIGURE 14 is an ~ rrl~l view cS the prererred
o~ the apparatus o~ the prQS nt invention showing
~n ~y ~ ' r eibial - '; and
FIGTIRE 15 ls a bottcll vl~w of the pr~ferred ' ' ' ' or
the ~pp~r~tus of th~ present inv~ntion sho rin~ ~n ~syr~etric
tibi~
FIC~RE 16 i~ ~ ache~tic ~li~gra~ Or the grid u~-d to
inspcct th- polished surr~c~ rOr di5tortionst
F~Gt~RE 17 is ~ s-cond ' Or a test grid p~ttQrn
used to inspQCt the hiqhly polished sUrr~eQ portion Or th~
~r~ - CUp prosthcsil Or the pre2~nt i, ~ nn;
FIGUR~ l~ ls ~ di~gr~ of ~ teat grld showing
r o surf ace dcrects; and
FIG~E lg is sche~ati~ ~isgr~ showing loc~l d-fects for
~ pollshed ~urfscc that h~ been inspect¢~l uslng thc grid
W09~l30389 2 ~ ~0~2~ P~u~ o
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In F~ 1 th~rQ can bo ~en a ~ctional vlQw Or tbe
rirst ~ ~nl cr thQ ~ppar~tu_ Or the pressnt $nvention
~l~e~51n~ g~nerally by thc nun-ral 10 In PIGOR~ 1, thsre
c~ be seen ~ hip ~L~ ~ber 11 ~cunted in a re3ur 12
Or A p~tient The hip prosthe5i5 11 inclu~c an upper b~ll
portion 1~ tbat reglstor3 with tb- r-e~ Ar
app_r_tus lo or th~ pressnt inVention
Th- -c~3tAh~ r ~ 10 inclUdQ~ a cup or shell
pro th~sis body 14, prerably or 2 met llic material witb a
plastlo llner 15 portion The n~t_llic cup body 14 incl~d~c
An inner conoAYe ~urracs 16 _nd an out conYex ur~ace 17
Tbo ~ur~acos 16, 17 ar~ cpAc-~ apar'c, ~lerinlng tho thickn~ss
Or the cup or sholl 14 Th~ cup body 14 crn pro-ldo a thr~e-
~ n-~ ~ur~ac~ ; ' thAt iS sintered to the outsidc
-ur~Ace 17 (such as sintsrsd ~tal beAds) The surface 17 can
bs rachined arter sintoring Another type Or rougheneC outor
surr_c~ ~7 could bQ proviaed ~uch a~ pla~a sprayed m~tal,
pla~a sprayed hydroxyl npatite, or a - ~Ally texturod or
roughoned surSacs Th~ ~hsll or cup body 14 could ha~Q ~m
xterior curr~¢o 17 optimized ~or use with bone ce~ent
A plur~lity Or openingg 18 in on~ or prsrcrably
clongate~l boros extend botwoon th~ inn r conc~re surSaco 16
~ml th~l outer conYex surrac~ 17 ThesQ openlnys are in th~
ror~ Or bores having a bore ~11 19 The opsning~ 18 can
unction ~Y drill guiaes ~or the surgeon , once the
mct_llic cup body 14 portion Or the A~-et-l.h..l :~r cup procth~io
10 ls placsd ln pocition in the patient~s ~t~ as sho~n
in F~GU~l!; 1, ths ourgQon can simply drill throuyh any ons Or
~O tho plurality or bores rorming an opening in the underlying
bone tissus dR~l~AtR~l gooer lly be the nurer_l 20
W0951303Qv9 2 ~ 9~029 r~-~u~
_ 9 _
When tho surqeon places th- oup body 14 in th~ position
~ho~n in Figure l, the plurality cf bor~ 18 can nct as
drill r,uide rOr the surgeon The borc 19 walls of each oponing
18 can h~ 6h~pl/d to d~rin~ ~ gul~e rOr a CVLL~ n~1Y
s shaped ~nd ~i~ed drill opening5 18 allow the sUrgcon to rOr3
urgical openings ~n th~ Underlying bone tl~su~l 20
A JQlected ~urgic~lly rormed op~ning 18 is then occupled
by ~ peg tcnd not necQ~sarily ~ch ~pen~ng 18), sUch aL one Or
the pcgs 25 - 28, a~ s-en in Pigure l In the p~r"L,~
~ ~, eac21 of th~ pugs 25 - Z8 extends $nto tho bone
tl~-u~ ~t n dLrre~snt angular poQltion with respect to th-
other pegs to proYid~ ~ rigid nchor rOr the cup 14 Pegs zS-
z8 c~n be polymer, ~ctal, or reFnrh~hl~ poly3 r In l'igur~ ~,
cup _ody 14 is ~ecured with ~ plurclity Or bonQ screws 30-33
Each bon~ scrc~r has a ~L~I~L. ~ iCal soction 34 t~t rorms a
wedg~-lock or t~p r lock rn~ rt~ n~ with a L., LL~ ical
openlng or bore 3 5 in cup body 14 when the threaded shank 3 6
Or each bon~ ~cre~ 30-33 rully eng~ges underlying bone tiscuo
Zo .
Cup body 12 i3 prer r~bly ~ctallio having an annul~r b~
38 thct de~ines a plcnQ ~e~ Pigu~e 3~ Th~ cup body 12
conc~v~ ~urrccQ 16 is a ~hiny pollshed surrllce that fcces thQ
convex surracQ 39 of polymeric liner 15 The polish~ concav-
iur~l~ce 16 h~s ~ ~ _ Or l-ss thcn ~lxteen ~16~ llicro-
zs lnches, cnd pref~r~bly 1-~ than eight (8) ~icro-inches Such
a highly polished sUrr~C~ 16 apPears llirro~-like The
poli~h~d conczve surraco 16 inhibits poly~r l~ner debris
g~nerctlon ~iner lS has ~n inncr concsv~l surr~ce 40 th t
r~ceives fe~ur bcll portlon 13 during use (6ee Figures l and
2)
Figurus 4-7, the pr~i~erred ~ nt of the ~pparatus oi'
the present invQntion lo i5 sho;~n in the for~ or a glenoid
_ _ _ _ _
W0 9'i/30389
r~ o
2 1 ~0029
prosthesis, ~he slOnoid r rr~ h.. e~ 10 includes ~ r t 41
that can cooperate with ~ humeral coDponent (not shown) The
use Or glenoid 1~ pnrt Or a tot~l shoulder ~yste~
can be neen for ~xaDple in Smith ~ Nephew RicbArcs~ r ~bl i O~t l t~n
s entitled "Cofield Tot~l Should~lr Sy~teD 5urslcal Te~hn; ~,
~nd ln U S P~tent 5,108,396, i~ L~ od h~r~in by
rerer-nce ThQ qlenoid coDponent 41 has A bone insrowth
~ur~ce 42 th~t can bo, rOr ~aDpl~, a plurality of ~otsllic
~intered b~d- 43 30n~ ingrowth ~urr~co 42 is attnchOd to
th~ p~tiont's bon~ tissue wlth bone C~Dent ~md screws ror
exaDpl~ ns d~scribed Dore ~ully in the Co~i~ld Total shoulder
Syste~ sursical ~ '~_- Qnd in IJ S i?~tont 5,1~,396
Sur~co 44 i& ~I nirror ~urr~ce th~t r~coiveo n
polyethyleno or lilco insQrt that pro~ide8 On ~i ..-~ q
&urfacs rOr arttr~A~ q lrlth n huneral Thus, th~
Dirror urrace 44 is A non~ ng surr~ce thrlt enq~gen
th- rear or non-ar~ tin~ surracQ er the polyethyl~ne
in3ert The glenoid , ~ can includO a ~t~m 4s and
eylindric~l hcllcw l~ev s 46 th~t ~ ' bons 6crO~&
AnnulAr ~hould r 47 projeot3 ~Yay ~ror~ nlrror sur~Ace 44,
definlng a structUre that e~n hold th~ polyethylen~ lnz rt
ourin~ use
In Figures 8-11, the pra~OrrOd ~ 10 of the
App~ratus of the present inventicn ic &hown ln th~ form o~ a
tibial prosthe~3is The tibial LJLooi ~ is 10 includOs a tiblAl
conponent 48 having A ste~ 49 thAt oeeupies a eurclcally
~crmc~d opening in the p~tiOnt'~ tiblA Th~ di3t~1 ~ld~ o~
tr~y Sl registO~s against th- patlent's proxiDAl tibia, once
3urgicAlly shnped to recelve ti~i~l , 48 Ti~ial
conponent 48 has ~ nirror 6urrace 50 that receivec polymeric
incert 5Z ~see l!igure 1~ Mirror surrace 5~ $s providcd on
the proxlnal side of tray 51
Wo95/30389 - 11 - 2 ~ 9 0 Q29 P~ , _J/-O
During use, poly3eric in ert 52 artlcnlates Yith ~emoral
53 Femor~l 53 is attached to the
patient's ~e~ur 54 (as shown in Fiqure 11), nr~t- lR~ng
ng~lnst polymerlc lnsert 52 th~t ls supported upon the mlrror
curr~ce 50 surrnce 50 ls the proximnl ~urr~oc o~ tray 51
TllUs, thQ r~irror surrnCQ ls a non-Ar~ lRti"q surrace that
enqag-s thc r~r or dlstAl sUrrace Or the polymeric in~ert 52
The proxi~l sUr~rc~L o~ polymerlc ~n~rt 52 1~ an art~ a
surS~cQ th~t r~c~iv-~ ~ poll~h-d m~tallic ~irT lAtinq sur~cc
o~ ~emor~l ccmponent 53
In Plqures 12-15, the ~, re~ ' ' lO Or the
Apparatus Or the prcsent invention is Ghown in the rOrm Or an
~ n tibial ~ P..~ 10 lnclud~s ~n
asl n tlbial c~sponent 56 thnt hnl ~ bone e;n~aging
~uri'~ce 57 that enqages he proxlDlal, curqically prepnred
wr~ce o~ thC p~t~ent ~ ~ tibi~ The oppo~ing aurr~ce ~rom
bon~ engaginq sUr~ce 57 is A proxinal, ~irror ~urrAc~ sa thnt
r~c~iv~s a polyneric insert ~not shown) Peripher~l ~hculder
r;g and mirror sUr~ace 5ri derine non-art~ lntinq urraces thst
r~c~lve the poly~ceric insert, much in th- ~nm~ fnshion tb~t
polynQric inA~rt 52 ls held wlth trny 51 nt surrace 50 An
op ning 60 ~llows tlbinl 56 to be AttaCh~d to ~c
pati~nt's tibia Using a bone scroW, l~or exallpl~
~t should be ~ (1 th~lt the _ L or a
polyQthyl n- or polymerlc ins~rt to a tlbinl component (~uch
81~ tray 51 ), or to ~n a~ ~ tibial compon mt (such a~
compon~nt 56) i6 per ~ lcnoYn ~n th~ ~rt Such ln~l~rtc ~re
shown and described in the smith ~ Nephew R1Chards p~hl~ tir~n
entltl~d n~ enesis ~otal Xn~Q System Surgical Technique"
~0 pu~llshed ln ls92 and lr ~ AL-i hereln by L~r~.,.. ~
nowever, the present lnventlon proYlde~ ~n i ~ th t
~e~tures a rirror surr2ce portion ln nRti~n Ylth ~
_ _ _ _ _ _ _
WO 95130389 ~1 9 e~ (~29 PC~ J/10
.
-- 12 --
polyD~eric in~ort as af.,LG' '~ 2s part Or An
prosthesis 10
Fisur~s 16-19 qrid eharts 200, 20~ that ean be cr2Yn on
a ~rhlt~ ~h~-t Or p~per rOr QxD3ple nd u8ed to lnspect the
highly poll~hed innQr coneavQ surface 16)0f ~cetah~lA eup
body 14 ror deroct6 In Flgure 16, n e,rid Z00 is in the forD
cr 2 plurality ~r concontrie rinqs 201, 202, 203, etc A
c ntrsl o2ening Z04 allovs tho u~Der to vi~ually in3p~ct the
ln~ldD surraee 16 Or th~ oup body 14 uhen the rlat lJrid 200 iD
pl~eed on top Or the eup body 14 with th- print of chart 200
raclng the nirror like polish~d concavu gu~sce 16 In thi~
ra~hionl the user si~ply vl-Ys tho lin~d pattern Or the
C~rRn1~r~ r1n5~ Z01-203 Or srid chart 200 a~ rP1'lec~l orr
th~ r~irror ~urrsee Or the in ~ido, conesvo Isur~sce 16 Or thQ
oup body 14
In Pisure 17, ~ generslly rPc~n~ rly Ghaped te6t srid
20~ is shown In Flqure 18, a rerlectivo psttern ~or the tost
sria 205 is sho~n as patt rn 206, showing no derects In
~igure 19, another tnst qrid p~tt~rn r-rl~ctlon 207 is shown
th~t not~s two local derects z08, 209
Figur~ 16 illustrst~ thod of ~ , ' ^- that ~sy bo
usea by tr~in~d hu~ n ~~, ' , ~imply looking through the
c ntral opening 204 When such hu~sn insr~c~ion is ~rployed,
the inspector si~ply looks through tho openlng Z04 uhQn the
2!i grid ehart 200, 205 16 plseQd sgsinst ths eonc~v- 16 sidu o~
hlll ~-- eup body 14
another m-thod of; , ~ ~sy bo by imaqQ snsly-1
Perror~Qd by capturing the re~lected ir~age wlth 2 vldclo
~amera, ~t~ ng the l~nage and u~ing co~puter analysis to
Deasure the 22l0unt of devi2tion Or the pattern ~ro~ the
allow~d surrsce g~o lletry tolers"eo ~hu3, the surr~ce 16
dQrine6 a ~irrer that 15 used ~s a lerls te vle~f a two
WO9S130389 ~1 9002~ O
-- 13 --
n~ll pattern such as the grld p~ttorns ~00, 2C5 drawn
~Dr eYa Dple on 4 ~hlte shuE t of p~per Dlstortion~ in the
VieYQd iDmqe 4re thon a rosult of distDrtions Or the lon3
~ur ncc 16 ~nd henc- th- surf ~ce which 1~ desired to be
5 ~ea~ured
The ~ollowinq ~4blo 1 llst~i p4rt numb-rs ~nd
,,-~c_"v ~lng p4rt descrlptions as used herein ~nd in th~
drAwingL
~AB}.~! 1 - PI~S IIS~
P~`~ P~ P~
~oint r t~ h~q1~
11 hip prosthosis ~enhor
12 re~ur
13 b411 portion
14 cup hody
pla~tic lin
16 innor conc~v~ surr4ce
17 outer convex surr~c-
18 openins~
19 bor~ w~ll
hon~ tls~u~
25-28 pegs
30-33 bone scr-u~
34 ~ lc~l portion
r . L~ bore
3C thro~ded d~ank
3 8 annul~r b4su
3 9 liner con~reY surf ~ce
liner conc4ve sur~ace
41 glonola corlpon~nt
~2 bon~ inqrowth surrac~
~ 3 m-t411ic boad~
44 mirror surraco
~5 stem
46 hollow hULhinq
47 ~nnul~r ~houlder
~e tibi41 colzponent
49 ste~
So mirror sUr~ce
51 trny
W09SB0389 2 1 90029 r~.,L~ ~ rlO
.
-- 14 --
52 polymQric insert
53 fcnoral co~ponent
54 rcnur
ss tibi~
56 asymmetric tlbiP~l co~ponent
57 bone Imgaging surrac~
58 nirror surracQ
r r ~I~'A 1 should~r
op_nlng
200 circular grld pattern dart
~01 concentric ring
202 ~ ntr~-~ rlng
203 concontric ring
204 c~rtr_l opcning
205 r~tA~ P~ ~rld p~ttern chArt
206 r~rl~ctlvQ pattcrn - test grid
~07 rcrloctive pattQrs - tQst grid
20~ de~oct
209 de~ect
~GCaUs~ n_ny varying and dirfer ~nt ~ t~ nay be
s~de withLn the ccope or tbe invent~v~ conc~pt herein taught,
cnd bocau~e n~ny r~ A~ e nay b- nade ln tho ` ' '
h~r~ln detailed in ..~ ,lA..~.~ uith thQ degcriptive ro~ i
o~ th~ l~w, ~t is to be ~ L o~ that th d tail~ herein are
to b~ ~ L~ And nct ih ~ ~iritlng en Q
~hat is clai~cd as invention is
