Minimally invasive total knee arthroplasty method and instrumentation
First Claim
Patent Images
1. A tibial resection guide for use in resectioning a proximal end of a tibia while preventing damage to medial or lateral collateral ligaments positioned adjacent said tibia proximal end comprising:
- (a) an engagement surface following a contoured path permitting engagement with two spaced apart portions of said tibia, one of said portions being in the vicinity of an anterior cortex and the other of said portions being in the vicinity of either a medial cortex adjacent a medial collateral ligament or a lateral cortex adjacent a lateral collateral ligament;
(b) an opposed surface spaced from said engagement surface;
(c) a proximal surface adapted for positioning in the vicinity of said tibia proximal end; and
(d) a slot for receiving and guiding the path of a saw extending therethrough, said slot extending between said opposed surface and said engagement surface and permitting positioning of said saw medially in the vicinity of said medial collateral ligament or laterally in the vicinity of said lateral collateral ligament.
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Abstract
A method and apparatus for performing total knee arthroplasty which is minimally invasive includes components with guide surfaces and slots for controlling the path of a cutting saw. The instrumentation permits resection of the proximal end of the tibia and distal end of the femur to be performed either medially or laterally with minimal cutting of soft tissue.
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Citations
47 Claims
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1. A tibial resection guide for use in resectioning a proximal end of a tibia while preventing damage to medial or lateral collateral ligaments positioned adjacent said tibia proximal end comprising:
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(a) an engagement surface following a contoured path permitting engagement with two spaced apart portions of said tibia, one of said portions being in the vicinity of an anterior cortex and the other of said portions being in the vicinity of either a medial cortex adjacent a medial collateral ligament or a lateral cortex adjacent a lateral collateral ligament;
(b) an opposed surface spaced from said engagement surface;
(c) a proximal surface adapted for positioning in the vicinity of said tibia proximal end; and
(d) a slot for receiving and guiding the path of a saw extending therethrough, said slot extending between said opposed surface and said engagement surface and permitting positioning of said saw medially in the vicinity of said medial collateral ligament or laterally in the vicinity of said lateral collateral ligament. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A method for resectioning the proximal end of a tibia comprising the steps of
(a) providing a tibial resection guide having (i) an engagement surface following a contoured path permitting engagement with two spaced apart portions of said tibia, one of said portions being in the vicinity of an anterior cortex and the other of said portions being in the vicinity of either a medial cortex adjacent a medial collateral ligament or a lateral cortex adjacent a lateral collateral ligament; -
(ii) an opposed surface spaced from said engagement surface;
(iii) a first end between said engagement surface and said opposed surface;
(iv) a second end between said engagement surface and said opposed surface;
(v) a proximal surface; and
(vi) a slot for receiving and guiding the path of a saw extending therethrough, said slot extending between said opposed surface and said engagement surface and permitting positioning of said saw medially in the vicinity of a medial collateral ligament or laterally in the vicinity of a lateral collateral ligament;
(b) positioning said resection guide with said engagement surface in the area of said tibia proximal end and in contact with said tibia in the area of said anterior cortex and either said medial cortex or said lateral cortex and with said slot being substantially perpendicular to the mechanical axis of said tibia;
(c) displacing said medial collateral ligament or said lateral collateral ligament with said first end; and
(d) resecting said tibia proximal end with a saw extending through said slot. - View Dependent Claims (8)
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9. A cutting guide assembly for use in resectioning the distal end of a femur comprising
(a) a cutting guide having (i) first and second spaced apart surfaces, (ii) a slot for guiding a cutting instrument extending between said first and second surfaces, said slot extending anteriorly to posteriorly when said cutting guide is positioned for cutting with said first surface engaged to the lateral or medial aspect adjacent the distal end of a femur and (iii) an edge having a recess extending between said first and second surfaces; - and
(b) an arm assembly engaged to said cutting guide for adjustable movement thereon, said arm assembly including (i) an engagement member secured to said edge, (ii) a stylus arm extending from said engagement member along a path parallel to the path of said slot, said stylus having an elongated surface adapted to engage the distal end of a femur, and (iii) an alignment member adapted to be received in a prepared intramedullary femoral canal, said alignment member being disposed at an angle to said stylus arm in the range of 90°
to 100°
;
said cutting guide being movable relative to said arm assembly to position said first side against the lateral or medial aspect of a femur in which said alignment member is positioned in said prepared intramedullary femoral canal. - View Dependent Claims (10, 11, 12, 13, 14, 15)
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16. A femoral anterior-posterior sizer guide for a femur having a resectioned distal end comprising:
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(a) a base having a surface upon which a portion of the posterior or anterior femur adjacent said resectioned end may rest;
(b) a support extending upwardly from said base, said support having an elongated slot extending upwardly in a direction away from said base;
(c) a slideable member movably positioned in said slot; and
(d) a stylus movable with said slideable member toward and away from said base surface, said stylus having a femoral engagement surface substantially parallel to said base surface. - View Dependent Claims (17, 18, 19, 20, 21, 22, 23, 24, 25, 26)
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27. A combination for use in resectioning a femur comprising
(a) a guide pin adapted to be positioned in the medial or lateral aspect of a femur substantially parallel to a resectioned distal end of said femur; - and
(b) a resection guide including (i) a side resection guide adapted to engage said medial or lateral aspect, said side resection guide having an aperture positioned over said guide pin, and (ii) a chamfer block extending from said side resection guide in a position to engage said resectioned distal end when said side resection guide is engaged to said lateral or medial aspect. - View Dependent Claims (28)
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29. A resection guide comprising
(a) a side resection guide adapted to engage the lateral or medial aspect adjacent a resectioned distal end of a femur; - and
(b) a chamfer block extending from said side resection guide in a position to engage said distal end when said side resection guide is engaged to said lateral or medial aspect. - View Dependent Claims (30, 31, 32, 33, 34, 35, 36, 37)
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38. A method for resectioning the distal end of a femur having a prepared intramedullary canal comprising the steps of
(a) providing a cutting guide having first and second spaced apart surfaces, a slot for guiding a cutting instrument extending between said first and second surfaces, said slot extending anteriorly to posterior when said cutting guide is positioned for cutting with said first surface engaged to the lateral or medial aspect adjacent the distal end of a femur and an edge having a recess extending between said first and second surfaces; -
(b) providing an arm assembly engaged to said cutting guide for adjustable movement thereon, said arm assembly including (i) an engagement member secured to said edge, (ii) a stylus arm extending from said engagement member along a path parallel to the path of said slot, said stylus having an elongated surface adapted to engage the distal end of a femur, and (iii) an alignment member adapted to be received in a prepared intramedullary femoral canal, said alignment member being disposed at an angle to said stylus arm in the range of 90°
to 100°
;
said cutting guide being movable relative to said arm assembly to position said first side against the lateral or medial aspect of a femur in which said alignment member is positioned in said prepared intramedullary canal;
(c) selecting an arm assembly having the desired angle between said stylus arm and said alignment member, said selected arm assembly having an angle in the range of 90°
to 100°
;
(d) moving said alignment member into said intramedullary canal to a position at which said stylus arm contacts said femur distal end;
(e) moving said cutting guide on said arm assembly to a position at which said first side engages the lateral or medial aspect of said femur; and
(f) extending a cutting instrument through said slot to cut said distal end. - View Dependent Claims (39, 40)
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41. A method of resectioning the distal end of a femur comprising the steps of setting proper external rotation for the cuts to be made by positioning a guide rod in the medial or lateral aspect of a femur, positioning a cutting guide having guide surfaces over said guide rod and thereafter resectioning said femur with a cutting instrument while using said guide surfaces to guide said cutting instrument.
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42. A method of resectioning the distal end of a femur comprising the steps of
(a) providing a femoral anterior-posterior sizer guide having (i) a base having a surface upon which a portion of the posterior or anterior femur adjacent said resectioned end may rest; -
(ii) a support extending upwardly from said base, said support having an elongated slot extending upwardly in a direction away from said base;
(iii) A slideable member movably positioned in said slot, said slideable member having an aperture extending along an axis;
(iv) a stylus movable with said slideable member toward and away from said base surface, said stylus having a femoral engagement surface substantially parallel to said base surface;
(b) positioning said sizer guide on said femur with one of the posterior aspect or anterior aspect of said femur engaged to said base and the other of said posterior aspect or anterior aspect engaged to said stylus and with said slideable member facing the lateral or medial aspect of said femur;
(c) adjusting said axis relative to said femur; and
(d) causing a guide pin to be inserted into said femur using said aperture as a guide to direct the positioning of said guide pin. - View Dependent Claims (43, 44, 45, 46, 47)
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Specification