公开(公告)号：WO2012040277A1

公开(公告)日：2012-03-29

申请号：PCT/US2011052475

申请日：2011-09-21

Applicant: BIOQUEST PROSTHETICS ,  TOWNSEND BARRY W ,  CLAUDINO BYRON K ,  MOSHIER MONTY ,  LEACH DALLIN

Inventor： TOWNSEND BARRY W ,  CLAUDINO BYRON K ,  MOSHIER MONTY ,  LEACH DALLIN

IPC: A61F2/66

CPC classification number: A61F2/66 ,  A61F2/60 ,  A61F2/6607 ,  A61F2/76 ,  A61F2002/30434 ,  A61F2002/30438 ,  A61F2002/30464 ,  A61F2002/30466 ,  A61F2002/5003 ,  A61F2002/5007 ,  A61F2002/5009 ,  A61F2002/503 ,  A61F2002/5032 ,  A61F2002/5033 ,  A61F2002/5056 ,  A61F2002/5075 ,  A61F2002/5079 ,  A61F2002/6614 ,  A61F2002/6621 ,  A61F2002/6642 ,  A61F2002/665 ,  A61F2002/6657 ,  A61F2002/6664 ,  A61F2002/6671 ,  A61F2002/6678 ,  A61F2002/6685 ,  A61F2002/6692 ,  A61F2002/704 ,  A61F2002/745 ,  A61F2002/747 ,  A61F2002/7615 ,  A61F2220/0041 ,  A61F2220/0075

Abstract: A method of making a resilient prosthetic/orthotic component, particularly a shank for a lower extremity prosthesis in which the shank includes multiple sections which are unbounded in one or more portions of each other, and wherein the shank sections incorporate at least one voids and inserted materials between one or more shank sections to enhance shank flexibility while reducing stresses which can cause premature failure.

Abstract translation: 制造弹性假体/矫形部件的方法，特别是用于下肢假体的柄，其中柄部包括在彼此的一个或多个部分中无界的多个部分，并且其中柄部分包括至少一个空隙并插入 一个或多个柄部分之间的材料，以增强柄的柔性，同时减少可能导致过早失效的应力。

公开(公告)号：WO2009002975A1

公开(公告)日：2008-12-31

申请号：PCT/US2008/068022

申请日：2008-06-24

Applicant: DEPUY SPINE, INC. ,  HAWKINS, John Riley ,  UPAL, Anwar ,  O'NEIL, Michael J. ,  SLIVKA, Michael A. ,  FISHER, Michael

Inventor： HAWKINS, John Riley ,  UPAL, Anwar ,  O'NEIL, Michael J. ,  SLIVKA, Michael A. ,  FISHER, Michael

IPC: A61F2/44

CPC classification number: A61F2/447 ,  A61F2/30744 ,  A61F2/30771 ,  A61F2/30965 ,  A61F2/442 ,  A61F2/4455 ,  A61F2/4611 ,  A61F2002/30062 ,  A61F2002/3008 ,  A61F2002/30331 ,  A61F2002/3038 ,  A61F2002/30387 ,  A61F2002/30403 ,  A61F2002/30438 ,  A61F2002/30448 ,  A61F2002/30457 ,  A61F2002/30481 ,  A61F2002/30579 ,  A61F2002/30604 ,  A61F2002/30685 ,  A61F2002/30841 ,  A61F2002/30904 ,  A61F2002/3093 ,  A61F2002/30975 ,  A61F2002/4475 ,  A61F2002/448 ,  A61F2002/4627 ,  A61F2002/4629 ,  A61F2210/0004 ,  A61F2220/0016 ,  A61F2220/0025 ,  A61F2220/0033 ,  A61F2250/0098 ,  A61F2310/00017 ,  A61F2310/00023 ,  A61F2310/00029 ,  A61F2310/00059 ,  A61F2310/00161 ,  A61F2310/00203 ,  A61F2310/00239

Abstract: A two-piece fusion cage having opposed interior surfaces, vertical and lateral throughholes adapted to enhance fusion and a dovetail feature mating the opposed interior surfaces.

Abstract translation: 具有相对的内表面的两件式熔合笼，适于增强熔化的垂直和横向通孔以及与相对的内表面相配合的燕尾形特征。

公开(公告)号：WO2006033659A3

公开(公告)日：2006-11-02

申请号：PCT/US2004041539

申请日：2004-12-10

Applicant: ARCHUS ORTHOPEDICS INC ,  REILEY MARK A ,  STINSON DAVID T ,  SCRIBNER ROBERT M ,  TOKISH LEONARD J JR

Inventor： REILEY MARK A ,  STINSON DAVID T ,  SCRIBNER ROBERT M ,  TOKISH LEONARD J JR

IPC: A61F2/44 ,  A61B17/70 ,  A61B17/86 ,  A61F2/00 ,  A61F2/02 ,  A61F2/30 ,  A61F2/46

CPC classification number: A61F2/4405 ,  A61B17/7064 ,  A61B17/86 ,  A61F2/4637 ,  A61F2002/30365 ,  A61F2002/30367 ,  A61F2002/30373 ,  A61F2002/30375 ,  A61F2002/30438 ,  A61F2002/30443 ,  A61F2002/30507 ,  A61F2002/30512 ,  A61F2002/30538 ,  A61F2002/3055 ,  A61F2002/30553 ,  A61F2002/30604 ,  A61F2002/30616 ,  A61F2002/30649 ,  A61F2002/448 ,  A61F2002/4631 ,  A61F2002/4642 ,  A61F2220/0025 ,  A61F2220/0033 ,  A61F2220/0041 ,  A61F2250/0006 ,  A61F2250/0007 ,  A61F2250/0008 ,  A61F2310/00017 ,  A61F2310/00023 ,  A61F2310/00029 ,  A61F2310/00047 ,  A61F2310/00131 ,  A61F2310/00179

Abstract: Prostheses, systems, and methods are provided for replacement of natural facet joints between adjacent vertebrae using polyaxial attachment mechanisms (41, 115) for securing the prostheses to the vertebrae. A cephalad prosthesis (40) attached to a superior adjacent vertebra replaces the inferior half of a natural facet joint. A caudal prosthesis (100) attached to an inferior adjacent vertebra replaces the superior half of a natural facet joint. Both the cephalad and caudal prostheses are configured with artificial facet joint structures that include articulating surfaces (74, 118) that cooperate and form an artificial articular configuration. The polyaxial attachment mechanism permits adjustment of the position of the artificial facet joint structure along more than one axis at or after the time the cephalad or caudal prosthesis is attached to a vertebra.

Abstract translation: 提供假体，系统和方法用于使用用于将假体固定到椎骨的多轴连接机构（41,115）来替换相邻椎骨之间的天然小关节。 附着于上部相邻椎骨的头部假体（40）代替天然小关节的下半部。 附接到下相邻椎骨的尾部假体（100）代替天然小关节的上半部。 头部和尾部假体都配置有人造小关节结构，其包括协作并形成人造关节构造的关节表面（74,118）。 多轴连接机构允许在头部或尾部假体附接到椎骨的时间或之后沿多于一个轴线调节人造小关节结构的位置。

公开(公告)号：WO2002078578A1

公开(公告)日：2002-10-10

申请号：PCT/US2002/009589

申请日：2002-03-29

Applicant: TOWNSEND, Barry, W. ,  CLAUDINO, Byron, K.

Inventor： TOWNSEND, Barry, W. ,  CLAUDINO, Byron, K.

IPC: A61F2/80

CPC classification number: A61F2/66 ,  A61F2/60 ,  A61F2/6607 ,  A61F2/76 ,  A61F2002/30433 ,  A61F2002/30434 ,  A61F2002/30438 ,  A61F2002/30464 ,  A61F2002/30466 ,  A61F2002/5001 ,  A61F2002/5003 ,  A61F2002/5006 ,  A61F2002/5007 ,  A61F2002/5009 ,  A61F2002/503 ,  A61F2002/5032 ,  A61F2002/5033 ,  A61F2002/5075 ,  A61F2002/5079 ,  A61F2002/5083 ,  A61F2002/607 ,  A61F2002/6614 ,  A61F2002/6621 ,  A61F2002/6628 ,  A61F2002/6635 ,  A61F2002/6642 ,  A61F2002/665 ,  A61F2002/6657 ,  A61F2002/6664 ,  A61F2002/6671 ,  A61F2002/6678 ,  A61F2002/6685 ,  A61F2002/704 ,  A61F2002/745 ,  A61F2002/747 ,  A61F2002/7615 ,  A61F2220/0041 ,  A61F2220/0075 ,  A61K9/4816

Abstract: A prosthetic foot (70) incorporates a foot keel (77) and a calf shank (72) connected to the foot keel to form an ankle joint area of the prosthetic foot. The foot keel has forefoot and hindfoot portions and an upwardly arched midfoot portion extending between the forefoot and midfoot portions. The calf shank includes a downward convexly curved lower end which is adjustably attached at a portion thereof to the foot keel by way of a releasable fastener arrangement. The upper end of the calf shank is movable longitudinally of the foot keel in response to force loading and unloading the calf shank during use of the prosthetic foot. A device (71) connected between the ends of the calf shank limits the extent of the motion of the upper end of the calf shank relative to the lower end and foot keel. The upper end of the calf shank can include an alignment coupler device (92) thereon having adjustable slide mechanisms to adjust the media/lateral and anterior/posterior position of the calf shank relative to a supporting structure on the leg of the person using the prosthetic foot.

Abstract translation: 假脚（70）包括足龙骨（77）和连接到脚龙骨的小腿胫骨（72），以形成假脚的踝关节区域。 脚龙骨具有前脚掌和后脚部分，以及在前脚掌和中足部分之间延伸的向上拱形的中足部分。 小腿柄包括向下凸出的弯曲的下端，该下端通过可释放的紧固件装置可调节地附接到脚龙骨的一部分。 小腿胫骨的上端可以在使用假脚期间响应于加载和卸载小腿胫骨而在脚龙骨的纵向移动。 连接在小腿胫骨端部之间的装置（71）限制了小腿胫骨上端相对于下端和脚骨龙骨运动的程度。 小腿胫骨的上端可以包括对准联接器装置（92），其上具有可调节的滑动机构，以相对于人的腿上的支撑结构来调节小腿胫骨的介质/侧向和前/后位置， 脚丫子。

公开(公告)号：WO2002078567A2

公开(公告)日：2002-10-10

申请号：PCT/US2002/009573

申请日：2002-03-29

Applicant: TOWNSEND, Barry, W. ,  CLAUDINO, Byron, K.

Inventor： TOWNSEND, Barry, W. ,  CLAUDINO, Byron, K.

IPC: A61F

CPC classification number: A61F2/66 ,  A61F2/60 ,  A61F2/6607 ,  A61F2/76 ,  A61F2002/30433 ,  A61F2002/30434 ,  A61F2002/30438 ,  A61F2002/30464 ,  A61F2002/30466 ,  A61F2002/5001 ,  A61F2002/5003 ,  A61F2002/5006 ,  A61F2002/5007 ,  A61F2002/5009 ,  A61F2002/503 ,  A61F2002/5032 ,  A61F2002/5033 ,  A61F2002/5075 ,  A61F2002/5079 ,  A61F2002/5083 ,  A61F2002/607 ,  A61F2002/6614 ,  A61F2002/6621 ,  A61F2002/6628 ,  A61F2002/6635 ,  A61F2002/6642 ,  A61F2002/665 ,  A61F2002/6657 ,  A61F2002/6664 ,  A61F2002/6671 ,  A61F2002/6678 ,  A61F2002/6685 ,  A61F2002/704 ,  A61F2002/745 ,  A61F2002/747 ,  A61F2002/7615 ,  A61F2220/0041 ,  A61F2220/0075 ,  A61K9/4816

Abstract: A prosthetic foot (70) incorporates a foot keel (71) and a calf shank (72) connected to the foot keel to form an ankle joint area of the prosthetic foot. The foot keel has forefoot and hindfoot portions and an upwardly arched midfoot portion extending between the forefoot and midfoot portions. The calf shank includes a downward convexly curved lower end which is adjustably attached at a portion thereof to the foot keel by way of a releasable fastener arrangement which includes a coupling element (73) intermediate the calf shank and foot keel. The coupling element includes a resilient material forming a joint permitting subtalar joint-like motion of the prosthetic foot in gait.

Abstract translation: 假脚（70）包括连接到脚龙骨的脚龙骨（71）和小腿胫骨（72），以形成假脚的踝关节区域。 脚龙骨具有前脚掌和后脚部分，以及在前脚掌和中足部分之间延伸的向上拱形的中足部分。 小腿柄包括向下凸出的弯曲的下端，该下端通过可释放的紧固装置可调节地附接到足龙骨的一部分，所述可释放的紧固装置包括在小腿柄和脚龙骨之间的联接元件（73）。 联接元件包括形成接合部的弹性材料，其允许假脚在步态中的距离关节状运动。

公开(公告)号：WO1997006754A1

公开(公告)日：1997-02-27

申请号：PCT/GB1996001982

申请日：1996-08-14

Applicant: CHAS. A. BLATCHFORD & SONS LIMITED ,  SHORTER, John, Jeffrey ,  WOOLNOUGH, Victor, James ,  HARRIS, Graham, James

Inventor： CHAS. A. BLATCHFORD & SONS LIMITED

IPC: A61F02/60

CPC classification number: A61F2/60 ,  A61F2/5044 ,  A61F2/64 ,  A61F2/6607 ,  A61F2/76 ,  A61F2/80 ,  A61F2002/30065 ,  A61F2002/30166 ,  A61F2002/30377 ,  A61F2002/30434 ,  A61F2002/30438 ,  A61F2002/30443 ,  A61F2002/30448 ,  A61F2002/5001 ,  A61F2002/5007 ,  A61F2002/5055 ,  A61F2002/5079 ,  A61F2002/607 ,  A61F2002/6614 ,  A61F2002/6657 ,  A61F2210/0071 ,  A61F2220/0033 ,  A61F2220/0041 ,  A61F2220/005 ,  A61F2230/0028

Abstract: An artificial limb has an endoskeletal shin component (10A) which is of generally constant H-shaped cross section and is formed by injection moulding from thermoplastics material. In a preferred embodiment, the limb has a foot keel (10B) which is integrally moulded with the shin component (10A), the keel (10B) having a longitudinal web (20) which is coplanar with a central web (12) of the shin component (10A). The keel (10B) also has upper flanges (24, 26) which are contiguous with anterior and posterior flanges (14, 16) of the shin component (10A). Such a limb can be made light in weight yet strong in terms of resistance to transverse bending moments, and can be inexpensively produced. The constant cross section of the skin component allows it to be cut to a required length and clamped to an upper limb component (52, 60).

Abstract translation: 假肢具有通常恒定的H形横截面并通过从热塑性材料注射成型而形成的骨骼内骨组件（10A）。 在一个优选实施例中，肢体具有与龙骨部件（10A）整体模制的脚龙骨（10B），所述龙骨（10B）具有纵向腹板（20），所述纵向腹板与所述中心腹板（12）共面 （10A）。 龙骨（10B）还具有与所述胫部件（10A）的前后凸缘（14,16）邻接的上凸缘（24,26）。 这样的肢体可以在抗横向弯曲力方面变得轻巧而坚固，并且可以廉价地产生。 皮肤部件的恒定横截面允许将其切割成所需长度并夹紧到上肢部件（52,60）。

公开(公告)号：WO1996025898A1

公开(公告)日：1996-08-29

申请号：PCT/SE1996000215

申请日：1996-02-19

Applicant: GRAMTEC INNOVATION AB ,  GRAMNÄS, Finn

Inventor： GRAMTEC INNOVATION AB

IPC: A61F02/66

CPC classification number: A61F2/6607 ,  A61F2/76 ,  A61F2002/30069 ,  A61F2002/30434 ,  A61F2002/30438 ,  A61F2002/30443 ,  A61F2002/5003 ,  A61F2002/5006 ,  A61F2002/5007 ,  A61F2002/5009 ,  A61F2002/5012 ,  A61F2002/5018 ,  A61F2002/5043 ,  A61F2002/5055 ,  A61F2002/6614 ,  A61F2002/6642 ,  A61F2002/6657 ,  A61F2002/74 ,  A61F2002/748 ,  A61F2220/0041

Abstract: An adjustable prosthesis joint, such as a prosthesis ankle or a prosthesis foot, and intended primarily for causing setting of the angular relation between an attachment means (4) forming part thereof for affixing the prosthesis joint (1) to a cooperating body part, and a detail (17) being angularly displaceably connected thereto, whereby the prosthesis joint is provided with means adapted to be actuatable to permit or to prevent such angular displacement, respectively, whereby said means is constituted by two communicating chambers (3a, 3b) containing a flow medium, with a shiftable valve (13) provided between the chambers, and at least one body designed as a piston (8, 9), rotatably arranged in relation to said chambers and movably arranged therein and adapted to permit flow of flow medium between the two chambers, when the valve is open and under influence of an external shifting force being displaced in said chambers (3a, 3b) in order to alter the relative sizes thereof.

Abstract translation: 一种可调节的假体关节，例如假体脚踝或假体脚，并且主要用于引起构成其一部分的附接装置（4）之间的角度关系的设置，以将假体关节（1）固定到协作的身体部分，以及 细节（17）以角度方式可移动地连接到其上，由此假体关节设置有适于致动以允许或防止这种角位移的装置，由此所述装置由两个连通的腔室（3a，3b）构成， 流动介质，其具有设置在所述室之间的可移动阀（13）和设计为活塞（8,9）的至少一个主体，所述主体相对于所述室可旋转地布置并且可移动地布置在其中，并且适于允许流动介质在 两个腔室当阀打开并且在外部移动力的影响下在所述腔室（3a，3b）中移位时，以改变其相对尺寸。

公开(公告)号：WO1996016614A1

公开(公告)日：1996-06-06

申请号：PCT/US1995015451

申请日：1995-11-29

Applicant: TAYLOR, Douglas, A. ,  JOHNSON, Chris, L.

IPC: A61F02/62

CPC classification number: A61F2/76 ,  A61F2/60 ,  A61F2/64 ,  A61F2/6607 ,  A61F2/80 ,  A61F2002/30065 ,  A61F2002/30143 ,  A61F2002/30378 ,  A61F2002/30434 ,  A61F2002/30438 ,  A61F2002/30443 ,  A61F2002/30448 ,  A61F2002/30457 ,  A61F2002/30469 ,  A61F2002/30494 ,  A61F2002/30507 ,  A61F2002/5007 ,  A61F2002/5018 ,  A61F2002/5055 ,  A61F2002/6614 ,  A61F2210/0071 ,  A61F2220/0025 ,  A61F2220/0033 ,  A61F2220/0041 ,  A61F2220/005 ,  A61F2220/0058 ,  A61F2230/0017 ,  A61F2310/00047 ,  Y10T403/32286 ,  Y10T403/32311

Abstract: The prosthetic connector assembly (100) includes a prosthetic pylon (130) having a male end (134) with an opening (140) therein for receiving the shank of a bolt (186), a prosthetic base (200) having a female contact or bearing surface (204) for receiving the male end of the pylon and for anchoring the head of the bolt, and a clamping element (170) carried internally of the pylon for receiving the threaded shank of the securing bolt and, when the bolt is rotated, for clamping the male end of the pylon to releasably lock the pylon in a fixed position relative to the base. The male end of the pylon is preferably convexly hemispherical or domed, and the female contact or bearing surface of the base is preferably concavely spherical for fittingly receiving the male end of the pylon.

Abstract translation: 假体连接器组件（100）包括具有阳端（134）的假肢塔（130），其中具有用于接收螺栓（186）的柄的开口（140），具有阴接触件的假体基座（200） 承载表面（204），用于接收所述塔的阳端并用于锚定所述螺栓的头部;以及夹持元件（170），其承载在所述塔的内部，用于接收所述固定螺栓的螺纹柄，并且当所述螺栓旋转时 用于夹紧挂架的阳端以可拆卸地将吊架锁定在相对于底座的固定位置。 塔的阳端优选为凸半球形或圆顶形，并且基座的阴接触或支承表面优选为凹形球形，用于适配地容纳托架的阳端。

公开(公告)号：WO1996015377A1

公开(公告)日：1996-05-23

申请号：PCT/FR1995001472

申请日：1995-11-08

Applicant: SOUBEIRAN, Arnaud, André

IPC: F16B07/14

CPC classification number: A61F2/3845 ,  A61B17/7014 ,  A61B17/72 ,  A61B17/7216 ,  A61F2/2448 ,  A61F2/30767 ,  A61F2/44 ,  A61F2002/2825 ,  A61F2002/2892 ,  A61F2002/30065 ,  A61F2002/30079 ,  A61F2002/30235 ,  A61F2002/30238 ,  A61F2002/30354 ,  A61F2002/30367 ,  A61F2002/3037 ,  A61F2002/30398 ,  A61F2002/30438 ,  A61F2002/30448 ,  A61F2002/30451 ,  A61F2002/30487 ,  A61F2002/30492 ,  A61F2002/30507 ,  A61F2002/30537 ,  A61F2002/3055 ,  A61F2002/30566 ,  A61F2002/30583 ,  A61F2002/30601 ,  A61F2002/30668 ,  A61F2002/30706 ,  A61F2002/30878 ,  A61F2002/30975 ,  A61F2002/465 ,  A61F2002/4651 ,  A61F2002/482 ,  A61F2210/0071 ,  A61F2210/0085 ,  A61F2210/009 ,  A61F2220/0025 ,  A61F2220/0033 ,  A61F2220/0041 ,  A61F2220/005 ,  A61F2220/0058 ,  A61F2230/0069 ,  A61F2250/0001 ,  A61F2250/0004 ,  A61F2250/0082 ,  A61F2310/00023 ,  A61F2310/00203 ,  A61F2310/00239 ,  A61F2310/00407 ,  A61F2310/00568 ,  A61F2310/00592

Abstract: A device for mutually moving two bodies, comprising two members (11, 12) each combined with a respective one of the two bodies (1, 2), a means (15) for applying a force between the two members, a projection (14) integral with one member (11), and a cavity (13) provided in the other member (12) and matching at least part of said projection (14). The members (11, 12) are mutually movably mounted in such a way that the projection engages the cavity, the member (12) with the cavity (13) being made of a first material that is changeable from a first hard solid state to a second soft pasty state, whereas the member (11) integral with the projection (14) is made of a second, substantially hard material. Means are also provided for controlling the change of at least one part (19) of the second material surrounding the cavity (13) from the first state to the second state, and vice versa. The device is particularly suitable for making implantable prostheses for the human body.

Abstract translation: 一种用于相互移动两个主体的装置，包括两个构件（11,12），每个构件与所述两个主体（1,2）中的相应一个组合，用于在所述两个构件之间施加力的装置（15），突出部 ）与一个构件（11）成一体，并且设置在另一个构件（12）中并匹配所述突起（14）的至少一部分的空腔（13）。 构件（11,12）可相互可移动地安装，使得突出部与空腔接合，具有空腔（13）的构件（12）由第一材料制成，该第一材料可从第一硬固体状态改变为 第二软糊状态，而与突起（14）成一体的构件（11）由第二基本上硬的材料制成。 还提供了用于控制围绕空腔（13）的第二材料的至少一个部分（19）从第一状态到第二状态的变化的装置，反之亦然。 该装置特别适用于为人体制造可植入的假体。

公开(公告)号：WO2015073618A1

公开(公告)日：2015-05-21

申请号：PCT/US2014/065363

申请日：2014-11-13

Applicant: ZIMMER, INC.

Inventor： ROBY, Keith A. ,  HOEMAN, Timothy A. ,  CHERNOSKY, John ,  ZUBOK, Ray

IPC: A61F2/30 ,  A61F2/38

CPC classification number: A61F2/389 ,  A61F2/30734 ,  A61F2002/30433 ,  A61F2002/30434 ,  A61F2002/30436 ,  A61F2002/30438 ,  A61F2002/30443 ,  A61F2220/0041

Abstract: Augments systems and methods for attaching two or more augments to an underside (50) of a tibial baseplate (16) are disclosed. An augment system (100) can include a first augment (102) having a superior surface (106) and an inferior surface (108), the superior surface configured for attachment to the underside of the tibial baseplate. The augment system can include a second augment (104) having a superior surface (110) and an inferior surface (112), the superior surface configured for attachment to the inferior surface of the first augment. The first and second augments can be formed of different materials. One or more additional augments can be used with the first and second augments, and the augment system can be stacked on a resected surface of the tibia. In an example, the augment that directly contacts the resected surface of the tibia can be formed of a porous material, such as to facilitate bone growth.

Abstract translation: 公开了用于将两个或更多个增量附接到胫骨基板（16）的下侧（50）的增强系统和方法。 增强系统（100）可以包括具有上表面（106）和下表面（108）的第一增强件（102），所述上表面被配置为附接到胫骨基板的下侧。 增强系统可以包括具有上表面（110）和下表面（112）的第二增强件（104），所述上表面被配置为附接到第一增量件的下表面。 第一和第二增加可以由不同的材料形成。 一个或多个另外的增加可以与第一和第二增强件一起使用，并且增强系统可以堆叠在胫骨的切除表面上。 在一个示例中，直接接触胫骨的切除表面的增加物可以由多孔材料形成，例如促进骨骼生长。