Abstract:
There are provided a knee joint prosthesis for a bi-compartmental knee replacement and surgical devices thereof, wherein the knee joint prosthesis for the bi-compartmental knee replacement, which is performed on a patient with degenerative arthritis at any one of an inside compartment and an outside compartment of the knee and between the femur and the patella, is configured to position a femoral component at the inside or outside of the femur of the patient, to position a tibial component at the inside or outside of the tibia, and to properly position a tibial bearing member between the femoral component and the tibial component, thereby having the effects of improving the range of sense and motion after surgery by preserving other normal joints and reducing blood loss compared to a conventional prosthesis; improving the accuracy of the surgery to prevent the malalignment of the prosthesis, reduce the shaking of the prosthesis and extend the use life of the prosthesis; significantly improving a securing force compared to a conventional prosthesis; and using the knee joint prosthesis for the bi-compartmental knee replacement for patients with bi-compartmental arthritis, genu varum and genu valgum and flexion deformity, and anterior cruciate ligament loss.

Description:
CROSS-REFERENCE TO RELATED PATENT APPLICATION 
       [0001]    This application claims the benefit of Korean Patent Application No. 10-2006-0113737, filed on Nov. 17, 2006 and 10-2007-0022798, filed on Mar. 8, 2007 in the Korean Intellectual Property Office, the disclosure of which is incorporated herein in its entirety by reference. 
       BACKGROUND OF THE INVENTION 
       [0002]    1. Field of the Invention 
         [0003]    The present invention relates to a knee joint prosthesis for a bi-compartmental knee replacement and surgical devices thereof, and more particularly, to a knee joint prosthesis for a bi-compartmental knee replacement which is performed on a patient with degenerative arthritis at any one of an inside compartment and an outside compartment of the knee and between the femur and the patella, and surgical device thereof. When using the knee joint prosthesis for the bi-compartmental knee replacement, a femoral component is positioned at any one of the inside and outside of the femur of the patient, the front part and the entire front corner part thereof; a tibial component is positioned at any one of the inside and outside of the tibia of the patient; and a tibial bearing member is properly positioned between the femoral component and the tibial component. Therefore, the knee joint prosthesis for the bi-compartmental replacement prevents the range of motion and proprioception from decreasing after the surgery and reduces surgery time and costs, compared to a conventional knee prosthesis for a total knee replacement used by removing the other normal joints when the surgery is performed on the patient with degenerative arthritis present at only any one of the inside and outside compartments of the knee. Further, since the knee joint prosthesis for the bi-compartmental knee replacement is used by preserving the normal joints upon the surgery, the flexion gap-extension gap and the ligament balance are easily adjusted, so that the malalignment of the prosthesis is prevented and the wear debris thereof is reduced, extending the use life of the prosthesis. 
         [0004]    2. Description of the Related Art 
         [0005]    Joint replacement surgery has been operated very general. Many people who are unable to normally do their activities before surgery are able to resume their normal activities after surgery. Artificial joints are made of metals, ceramic and/or plastic materials to be secured to the present bones. 
         [0006]    The knee arthroplasty is well-known surgery to replace a damaged or diseased knee joint with a prosthetic knee joint. A typical knee prosthesis includes a femoral component, a patellar component, a tibial tray or a tibial plateau, and a tibial support member. In general, the femoral component includes a pair of condyles which are spaced apart from each other laterally. The end surface of the femoral component is connected to complementary condylar elements which are formed in the tibial support member in the form of a joint. 
         [0007]    Further, in order for an artificial knee joint to properly act, the condylar area of the femoral component should be capable of doing free sliding and rolling operations over the joint surface formed of the condylar elements of the tibial support member. The natural friction of the replaced artificial joint removes particles of debris (i.e., metals or plastics separated from the prosthesis), thereby increasing the wear debris moving in the joint. The wear debris of the artificial joint interrupts a proper mechanical function of the artificial joint. 
         [0008]    Moreover, the wear debris may cause a bone to be broken and damaged. When the wear debris increases in the artificial joint, sometimes the surgery is needed to remove the debris or to replace the artificial joint. Then, while a properly implanted prosthetic knee joint is normally used, load and stress are applied to the tibial support member. 
         [0009]    Generally, the knee joint is generally divided into three compartments, that is, an inside compartment between the inside femur and the inside tibia, an outside compartment between the outside femur and the outside tibia, and a joint compartment between the femur and the patella. Generally, many patients have bi-compartmental degenerative arthritis. Bi-compartmental degenerative arthritis is caused when the cartilage of the inside compartment or the outside compartment and the cartilage of the femur-patella joint are worn out. At present, the knee arthroplasty for treating bi-compartmental degenerative arthritis is typically performed by a tri-compartmental knee replacement for replacing the inside compartment, the outside compartment and the patella, and a uni-compartmental knee replacement is performed by replacing only one compartment. The total knee replacement is performed on a patient with degenerative arthritis which is present at only any one of the inside compartment and the outside compartment of the knee of the patient. When the knee prosthesis is used for the total knee replacement, the other normal compartments are removed. Accordingly, soft tissues are damaged and blood loss increases. Moreover, the prosthesis used for the total knee replacement has the difficult in adjusting the flexion-extension gap and the ligament balance upon the total knee replacement surgery, compared to the uni-compartmental knee replacement surgery performed without removing the other normal compartments. As a result, the prosthesis is likely to be misaligned and shaken, and the use life of the prosthesis is shortened. Further, when the uni-compartmental knee replacement is performed on the patient with degenerative arthritis which is present at any one of the inside compartment and the outside compartment of the knee of the patient, a prosthesis is used without removing the other normal compartments. However, the prosthesis for the uni-compartmental knee replacement is weak in a securing force. Moreover, the prosthesis for the uni-compartmental knee replacement cannot be used for the patient with bi-compartmental degenerative arthritis, the patient with severe deformity, such as genu varum and genu valgum, or flexion deformity, and the patient with anterior cruciate ligament loss. Moreover, since the bone deficit of the tibia at which the prosthesis is positioned is severe, there are considerable difficulties upon re-replacement surgery. Moreover, the prosthesis for the uni-compartmental knee replacement is less used because its use life is shorter, compared to the prosthesis of the total knee replacement. 
         [0010]    Further, the tibial support member is made of ultra high molecular weight poly ethylene. Friction, continuous circulation and stress would cause some wear and debris of the tibial support member, resulting in wear debris, i.e., wear debris caused by Inaccurate and incomplete implantation of the prosthesis or by normal use thereof. Upon malalignment, the load applied to the tibial support member is not evenly distributed. Rather, the excessive load acts on a certain area of the tibial support member. The uneven distribution of the load (or edge load) can accelerate the increase of the wear debris. The contact stress to the tibial support member is substantially increased by the malalignment of the joint. Therefore, when the prosthetic knee joint is misaligned, the risk of generating wear debris increases. 
       SUMMARY OF THE INVENTION 
       [0011]    The present invention provides a knee joint prosthesis for a bi-compartmental knee replacement performed on a patient with degenerative arthritis at any one of an inside compartment and an outside compartment of the knee and between the femur and the patella, in which a femoral component is positioned at any one of an inside and an outside of the femur of the patient, a front part and the entire front corner part; a tibial component is positioned at any one of an inside and an outside of the tibia of the patient; and a tibial bearing member is positioned between the femoral component and the tibial component. Since lower ends and back parts of the inside and outside of a normal joint which performs the most important function in sliding and rolling operations as the basic motion of a knee joint are preserved, the range of sense and motion is improved. Since only the part of the knee joint which is damaged by arthritis undergoes the surgery, preserving the normal knee joint, a ligament balance and flexion-extension gaps are easily controlled, thereby preventing malalignment or shaking of the knee joint caused by a surgical error. 
         [0012]    The present invention also provides a knee joint prosthesis for a bi-compartmental knee replacement, in which a contact area with a bone to be cut is wide, one peg for securing the prosthesis to the bone is positioned at a lower end of the prosthesis, and the other peg is positioned at a front corner part to be opposite to the lower end thereof, thereby increasing the adhesiveness and securing force; in which a smooth joint curve surface is formed so as not to be raised where the normal joint surface contacts with the prosthesis in the front corner part of the femur and so as to be progressively thicker from the end; and in which a tibial prosthesis is connected after removing the anterior cruciate ligament, cutting the surface of the tibial up to a front part of the posterior cruciate ligament on the extension line of the intertibial spine inside the tibial tuberosity, and cutting the inside or outside tibial condyle damaged by arthritis. Therefore, the tibial prosthesis is deeply held in the tibia like the total knee replacement, and since the keel is formed in a corrugated wing shape, the adhesiveness is more reinforced. Furthermore, since the bone deficit is less, re-replacement surgery is easy. 
         [0013]    The present invention also provides a knee joint prosthesis for a bi-compartmental knee replacement, in which a front part of an upper surface of the tibial bearing member in a concave (deep dish) shape is higher than a back part thereof, so as to prevent shaking of the front part which occurs since the anterior cruciate ligament is removed. Therefore, the knee joint prosthesis improves the stability of a joint. Further, when arthritis is present between the femur and the patella, the bi-compartmental knee replacement is done by attaching the patella component after cutting the patella. 
         [0014]    The present invention also provides surgical devices of the knee joint prosthesis for the bi-compartmental knee replacement performed on a patient with degenerative arthritis in any one of the inside compartment and the outside compartment and between the femur and the patella, which enables surgery to be performed for only any one of the inside compartment and the outside compartment of the knee while preserving the normal joint of the patient. Therefore, the bi-compartmental knee replacement is easily and accurately performed. 
         [0015]    A knee joint prosthesis for a bi-compartmental knee replacement and surgical devices thereof according to the embodiments of the present invention have the following characteristics. 
         [0016]    According to an aspect of the present invention, there is provided a knee joint prosthesis for a bi-compartmental knee replacement, which is used for metical treatment for a patient with degenerative arthritis present any one of an inside compartment and an outside compartment and between the femur and the patella, comprising: a femoral component, a tibial component and a tibial bearing member. The femoral component comprises: a femoral distal surface including pegs, wherein one peg protrudes to be fixedly positioned at a lower end part of the femur of the patient, and the other peg is positioned to be spaced apart from the peg in a direction towards a front corner part; a femoral bottom surface formed in a bending curve, so as to contact with the tibia; a femoral anterior part protruding upward, to contact with a front patella, along the femoral distal surface; and a femoral posterior part formed to be opposite to the femoral anterior part and protruding vertically and upward, along the femoral distal surface. The tibial component comprises: a tibial connection part protruding in a corrugated wing shape, so as to be inserted into the tibia of the patient, corresponding to the femoral component; and tibial plateau part formed in a single body with an upper end of the tibial connection part and including a connection groove formed on a top surface thereof. The tibial bearing member which is positioned between the femoral component and the tibial component comprises: a bearing top surface formed in a concave shape, so as to contact with the bottom surface of the femoral component, and formed in the manner that a front part of the bearing top surface is higher vertically and upward than a rear part thereof; and a bearing bottom surface including a connection member to be mechanically inserted into the connection groove of the tibial plateau part. 
         [0017]    According to another aspect of the present invention, there is provided surgical devices for the knee joint prosthesis which is used for medical treatment for the patient with degenerative arthritis present the inside compartment or the outside compartment and between the femur and the patella and which comprises the femoral component to be positioned at the lower end part of the femur of the patient, the tibial component to be inserted into the tibia of the patient and the tibial bearing member to be positioned between the femoral component and the tibial component, comprising: a femoral sizer, a femoral cutting block, a femoral trial component, a tibial resection block, a tibial alignment guide, a tibial template, a punch guide, a keel punch, and a trial insert. Before the surgery is performed for the femur of the patient, the femoral sizer is positioned at the lower end part of the femur, to measure the size of the femur to decide the size of the femoral component. The femoral cutting block is formed to be adjusted for the inner circumference surface of the femoral component based on the size measured by the femoral sizer, thereby enabling the surgery to be performed for only any one of the inside and outside compartments of the lower end part of the femur and the front part and the front corner part of the femur. The femoral trial component includes a number of apertures formed at one side, to form a hole distal side and anterior chaffer of the femur after undergoing by the femoral cutting block, so that the femoral component is fitted into the distal part of the femur of the patient. The tibial resection block is formed to cut horizontally the section of any one of the inside and outside compartments of the patient&#39;s tibia into which the tibial component is inserted. The tibial alignment guide including one end to which the tibial resection block is attached is applied to the leg (about the fibula) of the patient, so that the tibial resection block is prevented from being shaken upon the surgery. The tibial template includes: an insertion opening formed through one side of the tibial template, for operating an insertion hole on the section of any one of the inside and outside compartments of the tibia so that the tibial component is inserted into the patient&#39;s tibia being cut by the tibial resection block; and a number of fixing apertures formed at the side where the insertion opening is formed so that the tibial template positioned on the section of the tibia is prevented from being shaken upon the surgery; and a number of connection apertures formed at one side, to be connected to a punch guide. The punch guide includes: movable pins fitted into and connected to the connection apertures of the tibial template; and a guide opening formed in the same shape as the insertion opening of the tibial template, so that the insertion opening and the guide opening are positioned at the same position when the punch guide is connected to the tibial template. The keel punch includes: a keel protrusion with the teeth of a saw formed at one side of the keel punch and inserted into the guide opening of the punch guide, for forming an insertion groove on the tibia of the patient, the keel protrusion formed in the same shape as the insertion opening and the guide opening. A number of trial inserts are formed in various sizes, for determining the size of the tibial bearing member before performing the surgery operation of the tibial bearing member, and formed in the same sectional shape as the tibial template, so as to be attached to or detached from the tibial template. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0018]    The above and other features and advantages of the present invention will become more apparent by describing in detail exemplary embodiments thereof with reference to the attached drawings in which: 
           [0019]      FIG. 1  is a dissembled perspective view of a knee joint prosthesis for a bi-compartmental replacement according to an embodiment of the present invention; 
           [0020]      FIG. 2  is a side view of a femoral component of  FIG. 1 ; 
           [0021]      FIG. 3  is a perspective view of the femoral component of  FIG. 1 ; 
           [0022]      FIG. 4  is a side view of a tibial component of  FIG. 1 ; 
           [0023]      FIG. 5  is a side view of a tibial bearing member of  FIG. 1 ; 
           [0024]      FIG. 6  is a plan view of a femoral sizer according to an embodiment of the present invention; 
           [0025]      FIG. 7  is a side view of the femoral sizer; 
           [0026]      FIG. 8  is a perspective view of a femoral cutting block according to an embodiment of the present invention; 
           [0027]      FIG. 9  is a side view of the femoral cutting block; 
           [0028]      FIG. 10  is a perspective view of a femoral trial component according to an embodiment of the present invention; 
           [0029]      FIG. 11  is a side perspective view of the femoral trial component; 
           [0030]      FIG. 12  is a perspective view of a tibial resection block according to an embodiment of the present invention; 
           [0031]      FIG. 13  is a perspective view of a tibial alignment guide according to an embodiment of the present invention; 
           [0032]      FIG. 14  is a side view of the tibial alignment guide; 
           [0033]      FIG. 15  is a perspective view of a tibial template according to an embodiment of the present invention; 
           [0034]      FIG. 16  is a perspective view of a punch guide according to an embodiment of the present invention; 
           [0035]      FIG. 17  is a perspective view of a keel punch according to an embodiment of the present invention; 
           [0036]      FIG. 18  is a perspective view of the tibial template, the punch guide and the keel punch being connected together; and 
           [0037]      FIG. 19  is a perspective view of a trial insert according to an embodiment of the present invention. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0038]    The present invention will now be described more fully hereinafter with reference to the accompanying drawings, in which preferred embodiments of the invention are shown. This invention may, however, be embodied in many different forms and should not be construed as being limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. 
         [0039]      FIG. 1  is a dissembled perspective view of a knee joint prosthesis for a bi-compartmental replacement according to an embodiment of the present invention,  FIG. 2  is a side view of a femoral component of  FIG. 1 ,  FIG. 3  is a perspective view of the femoral component of  FIG. 1 ,  FIG. 4  is a side view of a tibial component of  FIG. 1 ,  FIG. 5  is a side view of a tibial bearing member of  FIG. 1 ,  FIG. 6  is a plan view of a femoral sizer according to an embodiment of the present invention,  FIG. 7  is a side view of the femoral sizer,  FIG. 8  is a perspective view of a femoral cutting block according to an embodiment of the present invention,  FIG. 9  is a side view of the femoral cutting block,  FIG. 10  is a perspective view of a femoral trial component according to an embodiment of the present invention,  FIG. 11  is a side perspective view of the femoral trial component,  FIG. 12  is a perspective view of a tibial resection block according to an embodiment of the present invention,  FIG. 13  is a perspective view of a tibial alignment guide according to an embodiment of the present invention,  FIG. 14  is a side view of the tibial alignment guide,  FIG. 15  is a perspective view of a tibial template according to an embodiment of the present invention,  FIG. 16  is a perspective view of a punch guide according to an embodiment of the present invention,  FIG. 17  is a perspective view of a keel punch according to an embodiment of the present invention,  FIG. 18  is a perspective view of the tibial template, the punch guide and the keel punch being connected together, and  FIG. 19  is a perspective view of a trial insert according to an embodiment of the present invention. 
         [0040]    As illustrated in  FIGS. 1 through 5 , the knee join prosthesis for a bi-compartmental knee replacement comprises: a femoral component  100  positioned at one end of the femur of a patient; a tibial component  200  positioned at one end of the tibia; and a tibial bearing member  300  positioned between the femoral component  100  and the tibial component  200 . 
         [0041]    The femoral component  100  comprises: a femoral distal surface  110  contacting with an end of the femur of the patient; a femoral bottom surface  120  corresponding to the tibial component  200 ; a femoral anterior part  130  formed in the front of the femoral component  100 , along the femoral distal surface  110 ; and a femoral posterior part  140  formed to be opposite to the femoral anterior part  130 . 
         [0042]    The femoral distal surface  110  is formed to be fitted into the end of the femur of the patient. A peg  110   a  is formed in the middle part of the femoral distal surface  110 , so as to protrude upward to be secured to the femur. Another peg  110   a  is formed to be spaced apart from the peg  110   a , towards the femoral anterior part  130 . A number of the pegs  110   a  are inserted into the femur of the patient so that the femoral component  100  is secured. 
         [0043]    The femoral bottom surface  120  is formed in a bending curve shape for contact with the tibial bearing member  300 . The femoral bottom surface  120  is processed using cobalt-chrome and ceramic. The femoral anterior part  130  is formed at the front of the femoral component  100 , along the femoral distal surface  110  and the femoral bottom surface  120 . The femoral anterior part  130  is formed in the middle part of the femoral distal surface  110  so as to tilt in a front upward direction at a constant angle at a predetermined length and thereafter to protrude vertically at the angle of 90°. Then, the outer circumferential surface of the femoral anterior part  130  contacts with or is secured to the patella. 
         [0044]    The femoral posterior part  140  is formed at the posterior of the femoral component  100 , along the femoral distal surface  110  and the femoral bottom surface  120 . Like the femoral anterior part  130 , the femoral posterior part  140  is formed in the middle part of the femoral distal surface  110  so as to tilt in a rear upward direction at a constant angle at a predetermined length and thereafter to protrude vertically at the angle of 90°. Then, the protruding length of the femoral anterior part  130  is relatively longer than that of the femoral posterior part  140 . 
         [0045]    The femoral component  100  is formed of a half of a conventional prosthesis for a total knee replacement, so that it is positioned at only any one of an inside compartment and an outside compartment in a plan sectional view of the femur. All corner parts of the femoral component  100  are formed in a curve shape, to minimize friction by the structure in which a femoral component and the joint surface of a cut femoral condyle are smoothly connected not to be raised to maintain the shape of a normal condyle, and to cause no damage to the femur bone during connecting the femur of the patient or no pain to the patient and to reduce the wear of the prosthesis. 
         [0046]    The tibial component  200  comprises a tibial connection part  210  inserted into the tibia of the patient; and a tibial plateau part  220  formed in a single body with an upper end of the tibial connection part  210 . When the tibial component  200  is inserted into the tibia, the anterior cruciate ligament is removed and the posterior cruciate ligament is preserved, and the tibia is removed only at any one of the inside and outside undergoing the surgery. 
         [0047]    The tibial connection part  210  is formed to protrude in a corrugated wing shape to be inserted into the tibia of the patient and has a hollow inside. A bolt  240  passes through the hollow inside of the tibial connection part  210 , to secure the tibial component  200  to the tibia of the patient. Then, since the tibial connection part  210  is formed in the corrugated wind shape, the adhesiveness is more enforced when the tibial connection part  210  is inserted into the tibia. Further, since the bone deficit is less, surgery is easy upon knee re-replacement. 
         [0048]    The tibial plateau part  220  is formed in the single body with the upper end of the tibial connection part  210  and includes a connection opening  220   a  formed on the top surface thereof. A connection groove  220   b  is formed on the inner circumferential surface of the connection opening  220   a , to be connected to the tibial bearing member  300 . 
         [0049]    The tibial component  200  is characterized in that it is formed of the half of the conventional prosthesis for the total knee replacement, so that it is positioned at only any one of the inside compartment and the outside compartment in the plan sectional view of the tibia. 
         [0050]    The tibial bearing member  300  comprises: a bearing top surface  310 ; and a bearing bottom surface  320 . The tibial bearing member  300  is positioned between the femoral component  100  and the tibial component  200  and the bearing top surface  310  contacts with the femoral bottom surface  120  of the femoral component  100 . The bearing bottom surface  320  is connected to the tibial component  200 . 
         [0051]    The bearing top surface  310  includes a contact surface  310   a  formed in a concave shape. The contact surface  310   a  is curved at the front, rear, middle and both sides thereof so as to be in contact with the femoral bottom surface  120  of the femoral component  100 . The concave surface of the contact surface  310   a  of the bearing top surface  310  is changed in shape so as to be fitted into the curved surface formed in the femoral bottom surface  120  of the femoral component  100 . Then, the front of the contact surface  310   a  is bent to be relatively longer upward than the posterior of the contact surface  310   a , so that the femur is prevented from being bent forward. 
         [0052]    The bearing bottom surface  320  includes a connection member  320   a  and a connection protrusion  320   b . The connection member  320   a  is formed so as to be connected to the connection opening  220   a  formed on the top surface of the tibial component  200 . The connection protrusion  320   b  is formed outward on the outer circumferential surface of the connection member  320   a , so as to be mechanically inserted into the connection groove  220   b  formed in the inner circumferential surface of the connection opening  220   a.    
         [0053]    The tibial bearing member  300  is characterized in that it is formed of the half of the conventional prosthesis for the total knee replacement, so that it is positioned at only any one of the inside compartment and the outside compartment in the plan sectional view, depending on the femoral component  100  and the tibial component  200 . 
         [0054]    In this application, no description of a patella component used in the convention prosthesis is presented. However, to describe the patella component in brief, the patella component comprises a bottom surface including a number of protrusions formed to be attached to the patella, and a top surface formed to be convex to contact with the femoral component. 
         [0055]    The above-described knee joint prosthesis for the bi-compartmental replacement according to the embodiment of the present invention is made of various biocompatible materials with high strength, durability and wear debris resistance. Examples of the materials are cobalt-potassium alloy, cobalt-chrome alloy, titanium-aluminum-vanadium alloy, stainless steel, ceramic and implantable bone prostheses. In general, the femoral component  100  is made of cobalt-potassium (chrome) or ceramic, the tibial component  200  is made of a metal alloy, such as titanium alloy, and the tibial bearing member  300  is made of a polymer, such as ultra high molecular weight poly ethylene. 
         [0056]    Surgical devices of the knee joint prosthesis for the bi-compartmental knee replacement according to an embodiment of the present invention include: a femoral sizer; a femoral cutting block, a femoral trial component, a tibial resection block, a tibial alignment guide, a tibial template, a punch guide, a keel punch, and a trial insert. The surgical devices will be described with reference to  FIGS. 6 through 19 . 
         [0057]      FIG. 6  is a plan view of a femoral sizer  10  according to an embodiment of the present invention, and  FIG. 7  is a side view of the femoral sizer. 
         [0058]    Referring to  FIGS. 6 and 7 , before the femoral component is operated on the femur of the patient, the femoral sizer  10  is positioned at the lower end part of the femur and measures the size of the femur to determine the femoral component. The femoral sizer  10  comprises a body  11 , a movable unit  14 , a measurement unit  16  and a support unit  17 , to measure inside and outside, front and rear, and left and right diameters of the femur of the patient and to determine the size of the femoral prosthesis. 
         [0059]    The femoral sizer  10  to decide the size of the femoral prosthesis before the surgery of the femur of the patient is started is formed in a “         ” shape and is inserted between the front surface and the posterior surface of the femur. 
         [0060]    The body  11  is supported at the lower end part of the femur. The body  11  includes a number of measurement graduations  11   a  for representing the size of the femur, a measurement groove  12  in a cylindrical shape formed in the center of the body, and a number of guide pin apertures  13  formed to be spaced apart from the measurement graduations  11   a  at predetermined intervals. 
         [0061]    The guide pin apertures  13  are symmetrically formed at the right and left sides and formed in a multi-level shape from the outside to the inside (see  FIG. 6 ). The guide pin apertures  13  formed at each level are positioned at the same distances from the vertical center line of the body  11  but the guide pin apertures  13  formed at the vertical line are positioned to be slightly different from one another at about 3 degrees of external rotation. 
         [0062]    When the size of the femoral component is decided, a nail (not shown) corresponding to the size of the femoral component is inserted in each of the guide pin apertures  13 . When the opposite side of the femur needs to undergo the surgery, the femoral sizer  10  is turned over and positioned so that the guide pin apertures  13  externally rotated at 3 degrees at the opposite side may be used. 
         [0063]    The movable unit  14  is inserted into the measurement groove  12  of the body  11  and slides up and down to measure the femur. The movable unit  14  formed in the cylindrical shape and inserted into the measurement groove  12  is rotated at 360°. An indication line  14   a  indicating the measurement graduation  11   a  of the body  11  is formed at one end of the movable unit  14 . 
         [0064]    An opening  15  in a regular square shape is formed at one end of the movable unit  14 . The measurement unit  16  is formed to pass through the opening  15 . A support protrusion  14   b  is formed at the outer circumference surface of the lower end of the movable unit  14  and is inserted into the measurement groove  12  of the body  11 , to prevent the movable unit  14  from being completely separated from the body  11  outward when the movable unit  14  slides up and down. 
         [0065]    The measurement unit  16  is mounted to pass through the opening  15  formed at one end of the movable unit  14 . One end of the measurement unit  16  is bent at a right angle to measure the side of the femur by the rotation of the movable unit  14 . The measurement unit  16  slides back and forth to measure the side of the femur, depending on the size of the femur (the height of the side of the femur). 
         [0066]    A connection projection  16   a  is formed along the outer circumferential surface of the measurement unit  16  so that the measurement unit  16  is prevented from being completely separated when the end of the measurement unit  16  passing through the opening  15  of the movable unit  14  slides back and forth. 
         [0067]    The support unit  17  is attached at the end of the body  11  and protrudes from the end thereof opposite to the measurement unit  16 , at a predetermined distance. The support unit  17  supports the femur and is connected to the body  11  by a hinge  18 , so as to measure the opposite side of the femur. 
         [0068]    In the tri-compartmental knee replacement, a conventional femoral sizer is positioned after the lower end part of the femur is cut. However, unlike the tri-compartmental knee replacement, in the bi-compartmental knee replacement, the femoral sizer  10  is positioned before the lower end part of the femur is cut (prior to the surgery). When the conventional femoral sizer is used, the measurement is inaccurate because it does not reach the apex of the posterior surface of the femur. To complement the defect of the conventional femoral sizer, in the femoral sizer  10 , the length of the support unit  17  is constituted to be longer about 10 mm than that (about 20 mm) of the conventional femoral sizer. 
         [0069]    The support unit  17  is connected to the body  11  by the hinge  18  so as to be rotated at 180°. Therefore, the femoral sizer  10  is turned over to be used when the opposite side of the femur undergoes the surgery. 
         [0070]      FIG. 8  is a perspective view of a femoral cutting block  20  according to an embodiment of the present invention, and  FIG. 9  is a side view of the femoral cutting block  20 . 
         [0071]    As illustrated in  FIGS. 8 and 9 , the femoral cutting block  20  is formed to perform the surgery for any one of the inside compartment and outside compartment of the lower end part of the femur of the patient, to be fitted into the inner circumferential surface of the femoral component based on the size measured by the femoral sizer  10 . 
         [0072]    The femoral cutting block  20  comprises a first body  21  and a second body  22 . The first body  21  includes a femoral fixing pin  24  and a number of cutting member insertion grooves  23 . The femoral fixing pin  24  formed at one surface of the first body  21  secures the femoral cutting block  20  to the femur of the patient to undergo the surgery. The cutting member insertion grooves  23  are formed in a direction of the length of the first body  21 , so as to receive cutting members (mechanical saw blades) for cutting the lower end part of the femur where the femoral component is positioned. The cutting member insertion grooves  23  are spaced apart from one another at a predetermined interval. The second body  22  contacts with the normal femur of the patient by connecting to the side of the first body  21  so as to slide up and down and includes a pin opening  25  on one side thereof. The pin opening  25  is fixed to the normal femur by a pin (not shown). One end of the pin opening  25  is formed in a funnel or beaker shape so that the pin is easily inserted into the pin opening  25 . 
         [0073]    The first body  21  and the second body  22  in a single body may be formed on the same line in the manner the first body  21  is positioned at an upper level and the second level body  22  is positioned at a lower level centering the same line in a sectional view, or the first body  21  and the second body  22  in a single body are formed on the same line by sliding. Handles  26  are respectively formed at the ends of the first body  21  and second body  22 . A surgeon holds the handles  26  to prevent shaking occurring upon the surgery of cutting the femur. A fixing pin hole (not shown) is formed at both sides of the first body  21  and the second body  22 . 
         [0074]      FIG. 10  is a perspective view of a femoral trial component  30  according to an embodiment of the present invention, and  FIG. 11  is a side perspective view of the femoral trial component. 
         [0075]    As illustrated in  FIGS. 10 and 11 , the femoral trial component  30  includes apertures  35 . One aperture  35  is formed at one end of the femoral trial component  30 , to form a hole at the distal surface of the femur of the patient so as to insert the femoral component peg into the distal surface of the femur after cutting the distal surface of the femur by the femoral cutting block  20 . The other aperture  35  is formed at one anterior chamfer part so as to be opposite to the aperture  35  formed at one end of the femoral trial component  30 . The hole for receiving the femoral component peg is formed on the lower end part of the femur, by using external mechanical equipment, such as a drill, passing through the apertures  35 . 
         [0076]    The femoral trial component  30  includes an upper surface  31 , a lower surface  32 , a front part  33  and a rear part  34 . The upper surface is bent at various angles to contact with the lower end part of the femur of the patient. The lower surface  32  is formed in a bending curve to contact with the tibial bearing member. The front part  33  protrudes upward to contact with the front patella, along the upper surface  31 . The rear part  34  is formed to be opposite to the front part  33  and protrudes upward vertically, along the upper surface  31 . 
         [0077]    Since a number of the apertures  35  through the upper surface  31  and the lower surface  32  are formed in the femoral trial component  30 , the surgeon performs the surgery for the front part, front corner part, lower end part, rear corner part and rear part in any one of the inside compartment and the outside compartment of the femur of the patient and for the front part and front corner part only in the other compartment. 
         [0078]      FIG. 12  is a perspective view of a tibial resection block according to an embodiment of the present invention. 
         [0079]    As illustrated in  FIG. 12 , the tibial resection block  40  is formed to cut horizontally the section of any one of the inside compartment and the outside compartment of the patient&#39;s tibia into which the tibial component is inserted. 
         [0080]    The front part of the tibial resection block  40  to contact with the side of the tibia is formed to be bent. The tibial resection block  40  includes a through-opening  41 . The through-opening  41  is formed horizontally to receive a cutting member (mechanical saw blade) for cutting an upper part of the tibia where the tibial component needs to be positioned. The through-opening  41  is divided into two sides by its middle part which discontinues the through-opening  41 , so that it enables the surgery for only any one of the inside compartment and the outside compartment of the tibia of the patient. The lower end of the tibial resection block  40  includes a connection opening  42  to be connected to a tibial alignment guide. 
         [0081]      FIG. 13  is a perspective view of a tibial alignment guide according to an embodiment of the present invention, and  FIG. 14  is a side view of the tibial alignment guide. 
         [0082]    As illustrated in  FIGS. 13 and 14 , the tibial alignment guide  50  is formed to be attached to the leg (about the fibula) of the patient, to prevent the shaking of the tibial resection block  40  with its one end being attached to the tibial alignment guide  50 , upon the surgery. 
         [0083]    The tibial alignment guide  50  comprises a first fixation unit  54  which includes a connection unit  51 , an axial bar  52 , a control unit  53  and a second fixation unit  55 . The connection unit  51  which contacts with one end of the tibial resection block  40  is connected to the connection opening  42  of the tibial resection block  40  by a connection member (bolt, pin, and the like). The axial bar  52  which passes through the inside of the connection unit  51  includes a saw tooth part  52   a  formed at one end thereof in a length direction. The control unit  53  includes a control lever  56  formed at the side thereof. The control lever  56  is connected to the saw tooth part  52   a , so that the connection unit  51  is accurately controlled vertically in the axial bar  52 . The tibial fixing pin  57  is formed at one side end of the first fixation unit  54 . The tibial fixing pin  57  is vertically positioned at the upper part of the axial bar  52 , to fix the tibial alignment guide  50 , without shaking, upon cutting the upper part of the tibia. The second fixation unit  55  includes a number of hooks  58  to connect one side end of the tibial alignment guide  50  to the leg (about the ankle and fibula) of the patient. The hooks  58  are vertically positioned at the lower part of the axial bar  52 , to fix the tibial alignment guide  50 , without shaking, upon cutting the upper part of the tibia. 
         [0084]    A spring  59  is positioned under the hooks  58  formed in the second fixation unit  55 , so that a force acts in a direction of the inside of the second fixation unit  55 . The hooks  58  are operated in the opposite direction to the direction of the inside of the second fixation unit  55 , so as to be applied around the leg of the patient. Thereafter, the hooks  58  are returned to their original positions by the elasticity of the spring  59 , to secure the leg of the patient to the tibial alignment guide  50 . 
         [0085]      FIG. 15  is a perspective view of a tibial template according to an embodiment of the present invention,  FIG. 16  is a perspective view of a punch guide according to an embodiment of the present invention,  FIG. 17  is a perspective view of a keel punch according to an embodiment of the present invention, and  FIG. 18  is a perspective view of the tibial template, the punch guide and the keel punch being connected together. 
         [0086]    As illustrated in  FIG. 15 , the tibial template  60  includes an insertion opening  61  and a number of fixing apertures  62 . The insertion opening  61  is formed through one side of the tibial template  60 . The insertion opening  61  function as an guide to form an insertion hole into which the tibial component is inserted on the section of any one of the inside compartment and the outside compartment of the tibia which is cut by the tibial resection block  40  to insert the tibial component. Before drilling the insertion hole, the tibial template  60  is positioned on the section of the tibia. A number of the fixing apertures  62  are formed at the side where the insertion opening  61 , to prevent the shaking upon the surgery. Fixing members (kinds of pins) are nailed down through the fixing apertures  62 , to prevent the tibial template  60  from being shaken. 
         [0087]    The tibial template  60  further comprises a number of connection apertures  63  and a connection opening  64 . The connection apertures  63  are formed at one end of the outer circumferential surface of the tibial template  60 , so as to be connected to the punch guide  70  laterally. The axial bar (not shown) may be positioned using the connection apertures  63 . The connection opening  64  is formed at one side of the tibial template  60 , so as to receive the trial insert  90 . 
         [0088]    As illustrated in  FIG. 16 , the punch guide  70  comprises a number of movable pins  71 , a guide opening  72  and a movable lever  73 . A number of movable pins  71  are formed to be combined with the connection apertures  63  of the tibial template  60 . The guide opening  72  is formed in the same shape as the insertion opening  61  of the tibial template  60 . The guide opening  72  formed in one side of the punch guide  70  is positioned at the same position as the insertion opening  61  when the punch guide  70  is connected to the tibial template  60 . 
         [0089]    The movable pins  71  are formed inside the punch guide  70  in a direction of the length of the punch guide  70 . One end of each movable pin  71  is inserted into each fixing aperture  62  of the tibial template  60 . When the movable pin  71  is inserted into the fixing aperture  62 , the movable pin  71  is moved back and forth by the movable lever  73  formed on the upper part of the punch guide  70  and connected to the outer circumferential surface of the movable pin  71 . 
         [0090]    As illustrated in  FIGS. 17 and 18 , the keel punch  80  comprises a keel protrusion  81 . The keel protrusion  81  with the teeth of a saw is formed at one side of the keel punch  80 . The keel protrusion  81  is inserted into the guide opening  72  of the punch guide  70 , to form an insertion hole on the tibia of the patient. The keel protrusion  81  is formed in the same sectional shape as the insertion opening  61  and the guide opening  72 . 
         [0091]    When the keel protrusion  81  is inserted into the insertion opening  61  and the guide opening  72 , the keel punch  80  forms the insertion hole on the upper part of the tibia at a predetermined interval, by applying an impact vertically to the other parts, using a medical mallet. 
         [0092]    Since the shape of the keel protrusion  81 , the insertion opening  61  and the guide opening  72  has an “L” shaped section, the insertion part of the tibial component is prevented from being damaged or separated by shaking or impact when the tibial component is inserted. 
         [0093]      FIG. 19  is a perspective view of a trial insert  90  according to an embodiment of the present invention. 
         [0094]    As illustrated in  FIG. 19 , a number of the trial inserts  90  are provided in various sizes, to determine the size of the tibial bearing member before the tibial bearing member is operated. The trial insert  90  is formed in the same sectional shape as the tibial template  60  so as to be attached to and detached from the tibial template  60 . 
         [0095]    The trial insert  90  is made of a rubber material and is formed in the shape of one compartment to perform the surgery for only any one of the inside compartment and the outside compartment of the knee of the patient to undergo the surgery. The trial insert  90  is formed to be the same as the surface of the bearing member contacting with the tibial component and the femoral component. 
         [0096]    As described above, in accordance with the knee joint prosthesis for the bi-compartmental knee replacement, which is performed on the patient with degenerative arthritis at any one of an inside compartment and an outside compartment of the knee and between the femur and the patella, according to the embodiment of the present invention, the femoral component is positioned at the inside or outside of the femur of the patient, the tibial component is positioned at the inside or outside of the tibia and the front part and the entire front corner part of the tibia of the patient, and the tibial bearing member is suitably positioned between the femoral component and the tibial component. Therefore, the knee joint prosthesis for the bi-compartmental replacement according to the embodiment of the present invention prevents the range of motion and proprioception from decreasing after the surgery and reduces surgery time and costs, compared to the conventional knee prosthesis for a total knee replacement used by removing the other healthy joints upon the surgery performed on the patient with degenerative arthritis present at only any one the inside compartment and the outside compartment of the knee. 
         [0097]    Furthermore, when the knee joint prosthesis for the bi-compartmental replacement according to the embodiment of the present invention is used, the surgery is performed by preserving the normal knee joints of the femur. Therefore, the flexion gap-extension gap and the ligament balance are easily adjusted, so that the malalignment of the prosthesis is prevented and the wear debris thereof is reduced to extend the use life of the prosthesis. 
         [0098]    While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it will be understood by those of ordinary skill in the art that various changes in form and details may be made therein without departing from the spirit and scope of the present invention as defined by the following claims.