Patient-specific femoroacetabular impingement instruments and methods

• US 10,456,205 B2
• Filed: 06/10/2016
• Issued: 10/29/2019
• Est. Priority Date: 09/29/2011
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Meridew, Jason D., Scott, Paige, Corten, Kristoff
• Primary Examiner(s): Yang, Andrew
• Application Number:
  US15/179,218
• Publication Number:
  US 20160278793A1
• Time in Patent Office: 1,236 Days
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion
• CPC Class Codes: A61B 2017/1602 Mills
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 34/00 Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing

Abstract

A device for a patient-specific acetabular and/or femoral guide. The guides can be used in a selected resection of at least one of a femur and an acetabulum to increase a range of motion of the femur relative to the acetabulum. Generally, a natural acetabulum and femoral head are maintained.

Claims

1. A method of resecting a selected portion of an anatomy to improve range of motion of a femur relative to a pelvis in a specific patient, comprising:

accessing from a first non-transitory storage medium image data of the patient including at least a portion of the pelvis and a portion of the femur at least including a femoral head of the femur and an acetabulum of the pelvis;

generating and displaying on a computer display a three dimensional (3D) model of at least a portion of the femur and the acetabulum based on the accessed image data;

determining using an interactive surgical planning software program in communication with the first non-transitory storage medium and computer display an appropriate resection of a defect portion of a femoral neck positioned to impinge on the acetabulum to obtain a selected range of motion of the femur relative to the pelvis after a resection;

designing a patient specific guide instrument configured to guide the resection relative to the femoral neck, the patient specific guide instrument including a portion having an inner surface configured to specifically engage the femur of the patient based on the generated 3D model of at least the femur;

transferring to a second non-transitory storage medium a surgical plan including the appropriate resection and the patient specific guide instrument;

manufacturing the designed patient specific guide instrument based on the surgical plan; and

sending the manufactured patient specific guide instrument to a user to perform the resection.

2. The method of claim 1, further comprising preparing a surgical plan from the 3D model to assist in designing the patient specific guide instrument, the surgical plan including anatomic data of the femur derived from the 3D model.

3. The method of claim 2, wherein the anatomic data includes a center edge angle between a first line that extends from a center of the femoral head to a superior rim of the acetabulum and a second line that extends from the center of the femoral head substantially, parallel with a long axis of the femur.

4. The method of claim 2, wherein the anatomic data includes an alpha angle between a first line extending from a center of the femoral head down a center of a long axis of the femoral neck and a second line extending from the center of the femoral head to intersect a circle defined by the center of the femoral head having a radius from the center to an edge of the spherical portion of the femoral head and where the circle intersects a non-spherical portion of the femoral head by the femoral neck.

5. The method of claim 2, wherein the anatomic data includes a head-to-neck offset defining a difference between a diameter of the femoral head and a diameter of the neck of the femur.

6. The method of claim 2, wherein the patient specific guide instrument is sized using the anatomic data.

7. The method of claim 2, wherein the surgical plan includes a graphical representation of a range of motion for the femoral head or an illustrated depiction of a planned removal region of the femur.

8. The method of claim 1, wherein designing the patient specific guide instrument comprises designing a patient specific tissue removal template to guide the resection relative to the femoral neck to determine when a selected resection of the femoral neck including the defect portion is complete, wherein the patient specific tissue removal template includes a template portion having the inner surface.

9. The method of claim 8, wherein the patient specific removal template is designed to comprise:

the template portion having the inner surface, wherein the inner surfaces is shaped to mate with the selected resection of the femoral neck;

a handle portion extending from the template portion; and

femoral contacting tangs extending from the template portion to contact a greater trochanter and the femoral head, respectively.

10. The method of claim 9, further comprising:

engaging a first of the contacting tangs with the greater trochanter of the specific patient during a surgical procedure;

engaging a second of the contacting tangs with the femoral head of the specific patient during the surgical procedure; and

verifying that the inner surface of the template portion engages flush with a resected surface resulting from the selected resection.

11. The method of claim 1, wherein designing the patient specific guide instrument comprises designing a patient specific resection guide to guide a resection instrument relative to the femoral neck to perform the resection, wherein the patient specific resection guide includes a guide portion having the inner surface and a guide surface to guide a guide arm to move relative to the guide portion based on the generated 3D model of at least the femur.

12. The method of claim 1, further comprising selecting a range of motion after a selected resection, wherein the appropriate resection is determined based on selecting the range of motion.

13. The method of claim 12, wherein designing the patient specific guide instrument is based on a finalized plan of the surgical plan, wherein the finalized plan is at least partially determined using at least one of the selected range of motion or the determined appropriate resection.

14. The method of claim 13, further comprising generating an initial plan that includes at least one of the selected range of motion or the determined appropriate resection and wherein the finalized plan is a revision of the initial plan.

22. The method of claim 1, wherein the defect portion comprises a bone abnormality located on the femoral neck between the femoral head and a greater trochanter.

23. The method of claim 22, wherein the resection is positioned to remove only the defect portion of the femoral neck and to maintain attachment of the femoral head.

15. A method of resecting a selected portion of an anatomy to improve range of motion of a femur relative to a pelvis in a specific patient, comprising:

using an interactive surgical planning software program, analyzing a three dimensional (3D) model of at least a portion of the femur and the acetabulum based on image data stored on a first non-transitory storage medium;

manipulating images of implant components on the 3D model using the interactive surgical planning software program to determine an appropriate resection of at least one of a femoral neck relative to another portion of the femur or the acetabulum to obtain a selected range of motion of the femur relative to the pelvis after the resection based on the 3D model;

designing a patient specific guide instrument configured to guide a resection relative to the femoral neck using the interactive surgical planning software program to remove a defect portion of the femoral neck while leaving the femoral head intact, the patient specific guide instrument including a portion having an inner surface configured to specifically engage the femur of the patient based on the 3D model;

outputting a manipulatable surgical plan from the 3D model to a second non-transitory storage medium to assist in designing the patient specific guide instrument, the surgical plan including anatomic data of the femur derived from the 3D model; and

resecting the femur of the specific patient during a surgical procedure conducted according to the surgical plan.

16. The method of claim 15, wherein the anatomic data includes a center edge angle of the femoral head.

17. The method of claim 15, wherein the anatomic data includes an alpha angle of the femoral head.

18. The method of claim 15, wherein the surgical plan includes a graphical representation of a range of motion for the femoral head.

19. The method of claim 15, wherein the surgical plan includes an illustrated depiction of a planned removal region of the femur.

20. The method of claim 15, further comprising receiving a manufactured patient specific guide instrument manufactured according to the surgical plan.

21. The method of claim 15, wherein the manipulatable surgical plan is an initial plan recorded in a computer file that can be altered by a surgeon into a final plan.