Method of performing surgery

• US 20030028196A1
• Filed: 07/08/2002
• Published: 02/06/2003
• Est. Priority Date: 01/14/2000
• Status: Active Grant

• Current Assignee: Bonutti Skeletal Innovations LLC (Acacia Research Corporation)
• Original Assignee: MarcTec LLC
• Inventors: Bonutti, Peter M.
• Granted Patent: US 7,104,996 B2
• Time in Patent Office: Days
• US Class Current: 606/87
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/158 Cutting patella
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• 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 17/1675 for the knee
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1717 for applying intramedullary nails or pins
• CPC Class Codes: A61B 17/1721 for applying pins along or parallel to the axis of the femoral neck
• CPC Class Codes: A61B 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0268 : for the knee
• CPC Class Codes: A61B 2017/0409 : Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 : having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• 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 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2217/005 : with suction drainage system
• CPC Class Codes: A61B 2217/007 : with irrigation system
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 2/30721 : Accessories
• CPC Class Codes: A61F 2/30724 : Spacers for centering an implant in a bone cavity, e.g. in a cement-receiving cavity
• CPC Class Codes: A61F 2/30767 : Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/30771 : applied in original prostheses, e.g. holes or grooves
• CPC Class Codes: A61F 2/34 : Acetabular cups
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/3859 : Femoral components
• CPC Class Codes: A61F 2/3868 : with sliding tibial bearing
• CPC Class Codes: A61F 2/3872 : Meniscus for implantation between the natural bone surfaces
• CPC Class Codes: A61F 2/3877 : Patellae or trochleae
• CPC Class Codes: A61F 2/389 : Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2/4609 : of acetabular cups
• CPC Class Codes: A61F 2/461 : of knees
• CPC Class Codes: A61F 2/4684 : Trial or dummy prostheses
• CPC Class Codes: A61F 2002/2817 : Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/2835 : Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30079 : magnetic
• CPC Class Codes: A61F 2002/30326 : differing in height or in length
• CPC Class Codes: A61F 2002/30331 : made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30364 : Rotation about the common longitudinal axis
• CPC Class Codes: A61F 2002/30387 : Dovetail connection
• CPC Class Codes: A61F 2002/30398 : Sliding
• CPC Class Codes: A61F 2002/30433 : using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30507 : using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30761 : Support means for artificial cartilage, e.g. cartilage defect covering membranes
• CPC Class Codes: A61F 2002/30883 : dovetail-shaped
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/3092 : having an open-celled or open-pored structure
• CPC Class Codes: A61F 2002/30934 : Special articulating surfaces
• CPC Class Codes: A61F 2002/30975 : made of two halves
• CPC Class Codes: A61F 2002/3401 : with radial apertures, e.g. radial bores for receiving fixation screws
• CPC Class Codes: A61F 2002/3403 : Polar aperture
• CPC Class Codes: A61F 2002/3895 : unicompartimental
• CPC Class Codes: A61F 2002/4631 : the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4677 : using a guide wire
• CPC Class Codes: A61F 2210/009 : magnetic
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0041 : using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2250/0037 : differing in height or in length
• CPC Class Codes: A61F 2310/00011 : Metals or alloys
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00131 : Tantalum or Ta-based alloys
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• CPC Class Codes: A61G 13/0045 : specially adapted for hand or wrist surgeries
• CPC Class Codes: A61G 13/0054 : specially adapted for back or spinal surgeries
• CPC Class Codes: A61G 13/0063 : specially adapted for knee surgeries
• CPC Class Codes: A61G 13/0072 : specially adapted for shoulder surgeries
• CPC Class Codes: A61G 13/0081 : specially adapted for hip surgeries
• CPC Class Codes: A61G 13/1245 : Knees, upper or lower legs
• CPC Class Codes: A61G 13/125 : Ankles or feet
• CPC Class Codes: A61M 1/77 : Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463

Abstract

An improved method of performing surgery on a joint in a patient'"'"'s body, such as a knee, includes making an incision in a knee portion of one leg while a lower portion of the one leg is extending downward from an upper portion of the one leg and while a foot connected with the lower portion of the one leg is below a support surface on which the patient is disposed. The incision is relatively short, for example, between seven and thirteen centimeters. A patella may be offset from its normal position with an inner side of the patella facing inward during cutting of a bone with a cutting tool. During cutting of the bone, one or more guide members having opposite ends which are spaced apart by a distance less than the width of an implant may be utilized to guide movement of a cutting tool.

Claims

1. A cutting guide for making at least one cut on a bone comprising:

a base having first and second faces and positionable at a fixed location with respect to the bone;

at least one track on the base extending from the first face through the second face;

a pin member sized to travel within the track;

a locking element for setting the pin member at one of a number of positions within the track; and

a cutting edge coupled to the pin member for guiding a cutting tool to make a cut on the bone,

wherein movement of the pin member to a first position orients the cutting edge in a first orientation and movement of the pin member to a second position orients the cutting edge in a second orientation.

2. The cutting guide of claim 1 wherein the base is mounted on the bone.

3. The cutting guide of claim 1 wherein the bone is a femur and the first orientation is one extending substantially parallel to a longitudinal axis of the femur.

4. The cutting guide of claim 3 wherein the second orientation extends transverse to the first orientation.

5. The cutting guide of claim 1 wherein the at least one track includes a plurality of track members extending radially from a center hub.

6. The cutting guide of claim 5 wherein the bone is a femur and there are five track members, each track member for making one of an anterior cut, an anterior chamfer cut, a distal cut, a posterior chamfer cut, and a posterior cut.

7. The cutting guide of claim 1 wherein the cutting guide is mounted on a cutting jig.

8. The cutting guide of claim 7 wherein the cutting jig includes a shaft having a portion insertable in a medullary canal of the bone for positioning the base at the fixed location with respect to the bone.

9. The cutting guide of claim 8 wherein the cutting jig includes a length adjustment member slidable on the shaft to vary the location of the length adjustment member with respect to the shaft.

10. The cutting guide of claim 9 wherein the length adjustment member can rotate about the shaft axis.

11. The cutting guide of claim 10 wherein the cutting jig includes a first tightening member for fixing the location and rotational relationship between the shaft and the length adjustment member.

12. The cutting guide of claim 10 wherein the cutting jig includes an arm extending laterally from the length adjustment member.

13. The cutting guide of claim 12 wherein the length adjustment member includes a ring and the arm includes a head configured and dimensioned to be received in the ring.

14. The cutting guide of claim 13 wherein the head rotates within the ring to allow rotation of the arm.

15. The cutting guide of claim 14 further comprising a second tightening member for fixing the rotational relationship between the arm and the length adjustment member.

16. A cutting jig for preparing a bone to receive an implant comprising:

a shaft having a portion insertable in a medullary canal of the bone for coupling the cutting jig to the bone;

a length adjustment member slidable on the shaft to vary the length adjustment member location with respect to the shaft;

an arm extending laterally from the length adjustment member;

an extension extending from a lateral end of the arm; and

a cutting guide located on an end of the extension.

17. The cutting jig of claim 16 wherein the cutting guide comprises a single cutting edge movable to a plurality of positions for making cuts on the bone of different orientations.

18. The cutting jig of claim 17 wherein the cutting edge has a length smaller than a length of the implant.

19. The cutting jig of claim 16 wherein the cutting guide comprises a plurality of cutting edges.

20. The cutting jig of claim 19 wherein there are five cutting edges, with first and second cutting edges substantially parallel to each other, a third cutting edge substantially perpendicular to the first and second cutting, a fourth cutting edge extending transversely from the third cutting edge and connecting the third cutting edge to the first cutting edge, and a fifth cutting edge extending transversely from the third cutting edge and connecting the third cutting edge to the second cutting edge.