Methods of minimally invasive unicompartmental knee replacement
First Claim
1. A method of establishing the depth for a planar surface to be made along a tibial plateau to receive a prosthetic tibial component in a minimally invasive unicompartmental knee replacement procedure, comprising the steps of accessing a knee through a minimal incision;
- mounting a tibial cutting guide anteriorly along the tibia of the knee for movement along the long axis of the tibia;
mounting a stylus arm on the tibial cutting guide such that a resection slot of the tibial cutting guide is located a predetermined depth below the stylus arm;
positioning the stylus arm upon a tibial plateau of the tibia such that the resection slot is located the predetermined depth below the tibial plateau, said step of positioning including accommodating the corresponding femoral condyle in an anatomic contour of the stylus arm;
inserting a cutting member through the resection slot and into the tibia to effect a planar surface along the tibial plateau at the predetermined depth; and
withdrawing the cutting member from the resection slot.
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Accused Products
Abstract
A method of minimally invasive unicompartmental knee replacement includes accessing a knee through a minimal incision, forming a planar surface along a tibial plateau of the knee, forming a planar posterior surface along a posterior aspect of the corresponding femoral condyle, resurfacing a distal aspect of the femoral condyle to form a resurfaced area having a curved portion, implanting a prosthetic tibial component on the planar surface along the tibial plateau and implanting a prosthetic femoral component on the prepared surface of the femoral condyle formed by the planar posterior surface and the resurfaced area. The curved portion of the resurfaced area has an anterior-posterior curvature corresponding to a fixation surface of the prosthetic femoral component. Prior to implantation, the femur and tibia are prepared to receive fixation structure of the femoral and tibial components.
174 Citations
51 Claims
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1. A method of establishing the depth for a planar surface to be made along a tibial plateau to receive a prosthetic tibial component in a minimally invasive unicompartmental knee replacement procedure, comprising the steps of
accessing a knee through a minimal incision; -
mounting a tibial cutting guide anteriorly along the tibia of the knee for movement along the long axis of the tibia;
mounting a stylus arm on the tibial cutting guide such that a resection slot of the tibial cutting guide is located a predetermined depth below the stylus arm;
positioning the stylus arm upon a tibial plateau of the tibia such that the resection slot is located the predetermined depth below the tibial plateau, said step of positioning including accommodating the corresponding femoral condyle in an anatomic contour of the stylus arm;
inserting a cutting member through the resection slot and into the tibia to effect a planar surface along the tibial plateau at the predetermined depth; and
withdrawing the cutting member from the resection slot. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A method of surgically preparing a femoral condyle to receive a prosthetic femoral component in a minimally invasive unicompartmental knee replacement procedure, comprising the steps of
accessing a knee through a minimal incision; -
positioning a femoral resurfacing guide on a femoral condyle of the knee to externally delineate an area of the femoral condyle to be resurfaced to receive a prosthetic femoral component, said step of positioning including externally delineating the area with a rail member of the femoral resurfacing guide; and
removing anatomical tissue from the externally delineated area by moving a tissue removing instrument along the externally delineated area within the confines of the rail member. - View Dependent Claims (8, 9, 10, 11, 12, 13, 14)
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15. A method of surgically preparing a femoral condyle to receive a prosthetic femoral component in a minimally invasive unicompartmental knee replacement procedure, comprising the steps of
accessing a knee through a minimal incision; -
establishing a planar surface on a posterior aspect of a femoral condyle of the knee;
positioning a femoral resurfacing guide on the femoral condyle to externally delineate a distal aspect of the femoral condyle;
removing anatomical tissue from the externally delineated distal aspect; and
removing the femoral resurfacing guide from the femoral condyle. - View Dependent Claims (16, 17, 18, 19, 20, 21)
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22. A method of surgically preparing a femoral condyle to receive a prosthetic femoral component in a minimally invasive unicompartmental knee replacement procedure, comprising the steps of
accessing a knee through a minimal incision; -
positioning a resection block on the femur of the knee with the knee in flexion such that a planar resection slot through the resection block extends in a plane along a posterior aspect of a femoral condyle of the femur;
positioning a femoral resurfacing guide on the femoral condyle with the knee in flexion such that the femoral resurfacing guide externally delineates a distal aspect of the femoral condyle;
inserting a cutting member through the resection slot to effect a planar surface along the posterior aspect of the femoral condyle; and
moving a tissue removing member within the externally delineated distal aspect to effect a resurfaced area along the distal aspect of the femoral condyle merging with the planar surface. - View Dependent Claims (23, 24, 25, 26, 27, 28)
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29. A method of minimally invasive unicompartmental knee replacement comprising the steps of
accessing a knee through a minimal incision; -
forming a planar surface along a tibial plateau of the knee;
forming a planar posterior surface along a posterior aspect of the corresponding femoral condyle;
resurfacing a distal aspect of the femoral condyle to form a resurfaced area including a curved portion having an anterior-posterior curvature extending from the planar posterior surface and a planar portion extending from the curved portion;
implanting a prosthetic tibial component on the planar surface formed along the tibial plateau; and
implanting a prosthetic femoral component on the femoral condyle with a planar rearward section of a fixation surface of the femoral component disposed on the planar posterior surface, a planar forward section of the fixation surface disposed on the planar portion of the resurfaced area and a curved intermediate section of the fixation surface disposed on the curved portion of the resurfaced area. - View Dependent Claims (30, 31, 32)
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33. A method of minimally invasive unicompartmental knee replacement, comprising the steps of
accessing a knee through a minimal incision; -
forming a planar surface along a tibial plateau of the knee;
forming a planar posterior surface along a posterior aspect of the corresponding femoral condyle;
resurfacing a distal aspect of the femoral condyle to form a resurfaced area having a plurality of tangent radii in a sagittal plane matching the fixation surface of a prosthetic femoral component;
implanting a prosthetic tibial component on the planar surface formed along the tibial plateau; and
implanting the prosthetic femoral component on the prepared femoral surface formed by the planar posterior surface and the resurfaced area.
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34. A method of minimally invasive unicompartmental knee replacement, comprising the steps of
accessing a knee through a minimal incision; -
forming a planar surface along a tibial plateau of the knee;
forming a planar posterior surface along a posterior aspect of the corresponding femoral condyle;
resurfacing a distal aspect of the femoral condyle extending from the planar posterior surface at a medial-lateral angle to obtain a resurfaced area;
implanting a prosthetic tibial component on the planar surface formed along the tibial plateau; and
implanting a prosthetic femoral component on the prepared femoral surface formed by the planar posterior surface and the resurfaced area.
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35. A method of preparing a femur to receive a femoral fixation peg and a femoral fixation fin of a prosthetic femoral component to be implanted on a prepared femoral condyle of the femur in a minimally invasive unicompartmental knee replacement, comprising the steps of
accessing the prepared femoral condyle through a minimal incision; -
attaching a trial femoral component to the prepared femoral condyle;
inserting a cutting member in a bore hole extending through the trial femoral component at a location corresponding to the location for the femoral fixation peg of the prosthetic femoral component;
advancing the cutting member through the bore hole and into the femur to form a peg hole in the femur for receiving the femoral fixation peg;
withdrawing the cutting member from the bore hole;
aligning a femoral fin punch with the trial femoral component to align a peg element of the femoral fin punch with the bore hole of the trial femoral component and a fin element of the femoral fin punch with a slot extending through the trial femoral component at a location corresponding to the location for the femoral fixation fin of the prosthetic femoral component;
advancing the peg element through the bore hole and into the peg hole;
advancing the fin element through the slot and into the femur to form a slot in the femur for receiving the femoral fixation fin; and
withdrawing the femoral fin punch from the trial femoral component. - View Dependent Claims (36, 37, 38)
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39. A method of preparing a tibia to receive anterior and posterior tibial fixation pegs of a prosthetic tibial component to be implanted on a prepared tibial plateau in a minimally invasive unicompartmental knee replacement, comprising the steps of
accessing the prepared tibial plateau through a minimal incision; -
attaching a trial tibial component on the prepared tibial plateau;
positioning a guide on the trial tibial component with a sleeve of the guide extending at an angle to the prepared tibial plateau and aligned with a posterior bore hole extending through the trial tibial component at a location corresponding to the location of the posterior tibial fixation peg of the prosthetic tibial component;
inserting a cutting member through the sleeve and the posterior bore hole into the tibia to form a posterior peg hole in the tibia for receiving the posterior tibial fixation peg;
withdrawing the cutting member from the sleeve;
inserting the cutting member through an anterior bore hole, extending through the trial tibial component at a location corresponding to the location of the anterior tibial fixation peg of the prosthetic tibial component, and into the tibia to form an anterior peg hole in the tibia for receiving the anterior tibial fixation peg; and
withdrawing the cutting member from the anterior bore hole. - View Dependent Claims (40, 41, 42, 43, 44, 45, 46)
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47. A method of implanting a prosthetic femoral component on a prepared femoral condyle, comprising the steps of
accessing a prepared femoral condyle through a minimal incision; -
applying cementitious material to a fixation surface of a prosthetic femoral component, in which the fixation surface has a border surrounding a cavity;
aligning a femoral fixation peg protruding from the fixation surface with a peg hole prepared in the femoral condyle;
aligning a femoral fixation fin protruding from the fixation surface with a slot prepared in the femoral condyle;
inserting the femoral fixation peg and femoral fixation fin in the peg hole and slot, respectively;
placing a planar rearward section of the border on a planar surface prepared along a posterior aspect of the femoral condyle;
placing a curved intermediate section of the border on a curved portion of a resurfaced area prepared along a distal aspect of the femoral condyle extending forwardly from the planar surface;
placing a planar forward section of the border on a planar portion of the resurfaced area extending forwardly from the curved portion; and
securing the prosthetic femoral component on the prepared femoral condyle via the cementitious material. - View Dependent Claims (48, 49)
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50. A method of implanting a prosthetic tibial component on a prepared tibial plateau in a minimally invasive unicompartmental knee replacement, comprising the steps of
accessing the prepared tibial plateau through a minimal incision; -
applying cementitious material to a fixation surface of a prosthetic tibial component;
aligning anterior and posterior tibial fixation pegs protruding from the fixation surface with anterior and posterior peg holes, respectively, prepared in the tibial plateau;
inserting the anterior and posterior tibial fixation pegs in the anterior and posterior peg holes, respectively;
supporting a continuously planar rim of the fixation surface upon a planar surface prepared along the tibial plateau with the anterior and posterior tibial fixation pegs received in the anterior and posterior peg holes, respectively;
confining the cementitious material to a cavity of the fixation surface, via a dovetail wall surrounding the cavity, as pressure is applied to the prosthetic tibial component; and
securing the prosthetic tibial component on the prepared tibial plateau via the cementitious material. - View Dependent Claims (51)
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Specification