Surgical instrument and positioning method

• US 20040122436A1
• Filed: 12/20/2002
• Published: 06/24/2004
• Est. Priority Date: 12/20/2002
• Status: Active Grant

• Current Assignee: Zimmer Technology Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Technology Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Grimm, James E.
• Granted Patent: US 7,029,477 B2
• Time in Patent Office: Days
• US Class Current: 606/87
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery

Abstract

A surgical instrument having an anchoring member securable to an anatomical structure and an implement portion which is adjustably repositionable relative to the anchoring member. The implement portion is selectively translatably adjustable and selectively rotatably adjustable relative to the anchoring member. The implement portion may be selectively translatable along and/or selectively rotatable about at least two substantially perpendicular axes. The implement portion may be selectively translatable about three substantially perpendicular axes and/or selectively rotatable about three substantially perpendicular axes. The instrument may also include at least one reference element to facilitate the registration of the implement portion in a computer implemented guidance system. The reference element may be three non-linearly positioned elements disposed on a member which is removably mounted to the instrument. The implement portion may be a resection guide and the instrument may be used in the resection of a tibia when implanting a prosthetic knee joint.

Claims

1. A surgical instrument for use with an anatomical structure, said instrument comprising:

an anchoring member having a first portion securable to the anatomical structure;

an instrument body having an implement portion wherein said implement portion is selectively translatable relative to said anchoring member along at least two substantially perpendicular translational axes and said implement portion is selectively rotatable relative to said anchoring member about at least two substantially perpendicular rotational axes;

at least one translation securement member for positively securing said implement portion in a selected translational position along one of said translational axes; and

at least one rotational securement member for positively securing said implement portion in a selected rotational position about one of said rotational axes.

2. The surgical instrument of claim 1 wherein said implement portion is selectively translatable along three substantially mutually perpendicular translational axes.

3. The surgical instrument of claim 1 wherein said implement portion is selectively rotatable about three substantially mutually perpendicular rotational axes.

4. The surgical instrument of claim 1 wherein said implement portion is selectively translatable along three substantially mutually perpendicular translational axes and wherein said implement portion is selectively rotatable about three substantially mutually perpendicular rotational axes.

5. The surgical instrument of claim 4 wherein said at least one translational securement member comprises at least two translational securement members, each of said translational securement members positively securing said implement portion in a selected translational position along one of said translational axes.

6. The surgical instrument of claim 4 wherein said at least one rotational securement member comprises at least two rotational securement members, each of said rotational securement members positively securing said implement portion in a selected rotational position about one of said rotational axes.

7. The surgical instrument of claim 1 further comprising at least one reference element registerable in a computer implemented image guidance system, said at least one reference element positioned at a predetermined orientation relative to said implement portion.

8. The surgical instrument of claim 7 wherein said at least one reference element comprises at least three non-linearly positioned reference elements.

9. The surgical instrument of claim 7 wherein said at least one reference element is removeably mountable on said instrument at a predetermined orientation relative to said implement portion.

10. The surgical instrument of claim 7 wherein said at least one reference element comprises at least three non-linearly positioned reference elements disposed on a reference member, said reference member being removably mountable on said instrument at a predetermined orientation relative to said implement portion.

11. The surgical instrument of claim 1 further comprising first and second carriage portions, said first carriage portion secured to said anchoring member wherein said first carriage portion and said anchoring member are relatively and selectively repositionable;

said second carriage portion secured to said first carriage portion wherein said second carriage portion and said first carriage portion are relatively and selectively repositionable;

said implement portion secured to said second carriage portion wherein said implement portion and said second carriage portion are relatively and selectively repositionable.

12. The surgical instrument of claim 11 wherein said first portion of said anchoring member comprises a threaded shaft engageable with the anatomical structure and said implement portion comprises an instrument guide.

13. A surgical instrument for use with an anatomical structure, said instrument comprising:

an anchoring member having a first portion securable to the anatomical structure;

an instrument body having an implement portion, said implement portion being selectively translatably adjustable and selectively rotatably adjustable relative to said anchoring member; and

at least one reference element registerable in a computer implemented image guidance system wherein said at least one reference element is moved relative to said anchoring member by movement of said implement portion relative to said anchor member.

14. The surgical instrument of claim 13 further comprising at least one translation securement member for positively securing said implement portion in a selected translational position and at least one rotational securement member for positively securing said implement portion in a selected rotational position.

15. The surgical instrument of claim 13 wherein said implement portion is selectively translatable along at least two substantially perpendicular translational axes and said implement portion is selectively rotatable about at least two substantially perpendicular rotational axes.

16. The surgical instrument of claim 15 further comprising:

at least one translation securement member for positively securing said implement portion in a selected translational position along one of said translational axes; and

at least one rotational securement member for positively securing said implement portion in a selected rotational position about one of said rotational axes.

17. The surgical instrument of claim 13 wherein said implement portion is selectively translatable along three substantially mutually perpendicular translational axes and said implement portion is selectively rotatable about three substantially mutually perpendicular rotational axes.

18. The surgical instrument of claim 17 further comprising:

at least two translation securement members, each of said translational securment members positively securing said implement portion in a selected translational position along one of said translational axes; and

at least two rotational securement members, each of said rotational securement members positively securing said implement portion in a selected rotational position about one of said rotational axes.

19. The surgical instrument of claim 13 wherein said at least one reference element comprises at least three non-linearly positioned reference elements.

20. The surgical instrument of claim 13 wherein said at least one reference element is removably mountable on said instrument at a predetermined orientation relative to said implement portion.

21. The surgical instrument of claim 13 wherein said at least one reference element comprises at least three non-linearly positioned reference elements disposed on a reference member, said reference member being removably mountable on said instrument at a predetermined orientation relative to said implement portion.

22. A surgical instrument for resecting a tibia, said instrument comprising:

an anchoring member having a first portion securable to the tibia;

an instrument body having a resection guide, said resection guide being selectively translatable relative to said anchoring member and selectively rotatable relative to said anchoring member; and

at least one reference element registerable in a computer implemented image guidance system, said at least one reference element mounted in a predetermined orientation relative to said resection guide.

23. The instrument of claim 22 wherein said at least one reference element comprises at least three non-linearly positioned reference elements mounted on a reference member, said reference member being removably mountable to said instrument in a known orientation relative to said resection guide.

24. The instrument of claim 22 wherein said instrument body comprises a first carriage portion adjustably mounted on said anchoring member and a second carriage portion adjustably mounted on said first carriage portion, said resection guide being adjustably mounted on said second carriage portion.

25. The instrument of claim 24 wherein said first carriage portion is rotatably mounted on said anchoring member, said second carriage portion is rotatably and translatably mounted on said first carriage portion and said resection guide is translatably mounted on said second carriage portion.

26. A method of positioning a surgical instrument relative to an anatomical structure, said method comprising:

providing an instrument having an anchoring member and a selectively repositionable implement portion;

securing said anchoring member to the anatomical structure; and

selectively adjusting the position of said implement portion relative to said anchoring member after securing said anchoring member to the anatomical structure, said selective adjustment including selectively translating said implement portion along at least two substantially perpendicular translational axes and selectively rotating said implement portion about at least two substantially perpendicular rotational axes.

27. The method of claim 26 further comprising the step of registering the position of said implement portion in a computer implemented image guidance system after said step of securing said anchoring member.

28. The method of claim 27 wherein said step of registering the position of said implement portion comprises removably mounting at least three non-linearly positioned reference elements detectable by the computer implemented image guidance system on the instrument body.

29. The method of claim 26 wherein said step of selectively adjusting the position of said implement portion includes selectively translating said implement portion along three substantially mutually perpendicular translational axes.

30. The method of claim 26 wherein said step of selectively adjusting the position of said implement portion includes selectively rotating said implement portion relative to said anchoring member about three substantially mutually perpendicular rotational axes.

31. The method of claim 30 wherein said step of selectively adjusting the position of said implement portion includes selectively translating said implement portion along three substantially mutually perpendicular translational axes.

32. The method of claim 31 further comprising the step of registering the position of said implement portion in a computer implemented image guidance system after said step of securing said anchoring member.

33. A method of positioning a surgical instrument with respect to an anatomical structure, said method comprising:

providing an instrument having an anchoring member and a selectively repositionable implement portion;

securing said anchoring member to the anatomical structure;

registering the position of said implement portion in a computer implemented image guidance system after said step of securing said anchoring member; and

selectively adjusting the position of said implement portion relative to said anchoring member, said selective adjustment including positioning said implement portion in a selected translational position along at least one translational axis and positioning said implement portion in a selected rotational position about at least one rotational axis.

34. The method of claim 33 wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected translational positions along at least two substantially perpendicular translational axes.

35. The method of claim 33 wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected rotational positions about at least two substantially perpendicular rotational axes.

36. The method of claim 35 wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected translational positions along at least two substantially perpendicular translational axes.

37. The method of claim 33 wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected translational positions along three substantially mutually perpendicular translational axes.

38. The method of claim 33 wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected rotational positions about three substantially mutually perpendicular rotational axes.

39. The method of claim 38 wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected translational positions along three substantially mutually perpendicular translational axes.

40. The method of claim 33 wherein said step of selectively adjusting the position of said implement portion comprises securing said implement portion in said selected translational position and independently securing said implement portion in said selected rotational position.

41. A method of resecting a tibia, said method comprising:

providing an instrument having an anchoring member and a resection guide;

securing said anchoring member to the tibia;

registering the position of said resection guide in a computer generated guidance system after said step of securing said anchoring member; and

selectively adjusting the position of said resection guide relative to the anchoring member after said step of registering the position of said resection guide.

42. The method of claim 41 wherein said step of selectively adjusting the position of said resection guide comprises securing said resection guide in said selected translational position and independently securing said resection guide in said selected rotational position.

43. The method of claim 41 further comprising the step of directly securing said resection guide to the tibia after said step of selectively adjusting the position of said resection guide.

44. The method of claim 41 wherein said step of selectively adjusting the position of said resection guide comprises positioning said resection guide in selected translational positions along at least two substantially perpendicular translational axes and positioning said resection guide in selected rotational positions about at least two substantially perpendicular rotational axes.

45. The method of claim 41 wherein said step of selectively adjusting the position of said resection guide comprises positioning said resection guide in selected translational positions along three substantially mutually perpendicular translational axes and positioning said resection guide in selected rotational positions about three substantially mutually perpendicular rotational axes.