Patient selectable joint arthroplasty devices and surgical tools facilitating increased accuracy, speed and simplicity in performing total and partial joint arthroplasty

• US 20040236424A1
• Filed: 11/25/2003
• Published: 11/25/2004
• Est. Priority Date: 05/25/2001
• Status: Active Grant

• Current Assignee: Conformis Incorporated
• Original Assignee: Imaging Therapeutics, Inc. (Conformis Incorporated)
• Inventors: Lang, Philipp, Steines, Daniel, Vargas-Voracek, Rene, Fitz, Wolfgang, Tsougarakis, Konstantinos, Snyder, Cecily Anne, Berez, Aaron
• Granted Patent: US 7,618,451 B2
• Time in Patent Office: Days
• US Class Current: 623/14.12
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• 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 17/1662 for particular parts of the body
• 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 17/7098 wherein the implant is permeable or has openings, e.g. fenestrated screw hollow surgical screws A61B17/864
• CPC Class Codes: A61B 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• 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 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 5/1075 for measuring dimensions by non-invasive methods, e.g. for determining thickness of tissue layer A61B8/0858 takes precedence
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/1077 Measuring of profiles
• CPC Class Codes: A61B 5/4504 : Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4514 : Cartilage
• CPC Class Codes: A61B 5/4528 : Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61F 2/30756 : Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/30767 : Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/30942 : for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
• CPC Class Codes: A61F 2/36 : Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/3859 : Femoral components
• CPC Class Codes: A61F 2/4202 : for ankles
• CPC Class Codes: A61F 2/4261 : for wrists
• CPC Class Codes: A61F 2/4405 : for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• CPC Class Codes: A61F 2/441 : made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• CPC Class Codes: A61F 2/442 : Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2/46 : Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
• CPC Class Codes: A61F 2/4603 : for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30581 : having a pocket filled with fluid, e.g. liquid
• CPC Class Codes: A61F 2002/30583 : filled with hardenable fluid, e.g. curable in-situ
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30733 : Inserts placed into an endoprosthetic cavity, e.g. for modifying a material property
• CPC Class Codes: A61F 2002/30878 : with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/30884 : Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/30894 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30909 : Nets
• CPC Class Codes: A61F 2002/30948 : using computerized tomography, i.e. CT scans
• CPC Class Codes: A61F 2002/30957 : using a positive or a negative model, e.g. moulds
• CPC Class Codes: A61F 2002/30962 : using stereolithography
• CPC Class Codes: A61F 2210/0085 : hardenable in situ, e.g. epoxy resins
• 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 2310/00047 : Aluminium or Al-based alloys
• CPC Class Codes: A61F 2310/00065 : Manganese or Mn-based alloys
• CPC Class Codes: A61F 2310/00071 : Nickel or Ni-based alloys
• CPC Class Codes: A61F 2310/00077 : Copper or Cu-based alloys
• CPC Class Codes: A61F 2310/00083 : Zinc or Zn-based alloys
• CPC Class Codes: A61F 2310/00107 : Palladium or Pd-based alloys
• CPC Class Codes: A61F 2310/00113 : Silver or Ag-based alloys
• CPC Class Codes: A61F 2310/00119 : Tin or Sn-based alloys
• CPC Class Codes: A61F 2310/00131 : Tantalum or Ta-based alloys
• CPC Class Codes: A61F 2310/00143 : Iridium or Ir-based alloys
• CPC Class Codes: A61F 2310/00149 : Platinum or Pt-based alloys
• CPC Class Codes: A61F 2310/00155 : Gold or Au-based alloys
• CPC Class Codes: B33Y 80/00 : Products made by additive manufacturing

Abstract

Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Claims

1. A customizable implant configured for placement between joint surfaces formed by inserting a hollow device having an aperture and a lumen into a target joint, and injecting material into the hollow device to form an implant.

3. The implant of claims 1 or 2 wherein the implant is removed from the joint after the material is injected.

4. The implant of claims 1 or 2 wherein the implant is processed after the material is injected.

5. The implant of claim 3 wherein the implant is installed between the joint surfaces.

6. The implants of claim 1 or 2 wherein the implant is formed outside the joint.

7. The implants of claims 1 or 2 wherein the implant is formed inside the joint.

8. The implants of claim 1 or 2 wherein the implant is fixed within the joint.

9. The implants of claim 1 or 2 wherein the fit of the implant is tested in situ.

10. The implant of claim 1 wherein a second hollow device having an aperture and a lumen is inserted into the first hollow device.

11. The implant of claim 1 wherein a second hollow device having an aperture and a lumen is inserted into the joint adjacent the first hollow device.

12. The implant of claims 10 or 11 wherein a third hollow device is inserted into the joint wherein the third hollow device communicates with at least one of the first hollow device and second hollow device.

13. The implant of claim 10 wherein the hollow device has a lumen of variable thickness.

14. The implant of claim 10 wherein the hollow device has a lumen of variable stiffness.

15. The implant of claims 10 or 11 wherein the device conforms to at least one joint surface.

16. The implant of claims 10 or 11 wherein the device abuts at least one joint surface.

17. The implant of claims 10 or 11 wherein the device surrounds a defect within a joint.

18. The implant of claims 10 or 11 wherein the device extends beyond at least one perimeter of the joint.

19. The implant of claim 11 wherein the retaining device has an aperture.

20. The implant of claim 11 wherein the retaining device engages a joint surface along its perimeter and forms a cavity thereunder.

21. The implant of claim 11 wherein the joint surface is at least one of meniscal surface and subchondral bone.

22. The implant of claim 11 wherein the joint surface is prepared prior to injection by at least one of meniscal removal, aperture creation, and abrasion.

23. The implant of claims 10 or 11 wherein the injection material is selected from the group consisting of:

polymer, metal, gases, and crystal free metals.

24. The implant of claims 10 or 11 wherein the joint surface is prepared to provide a cylindrical opening.

25. The implant of claims 24 wherein the injecting material is located within the cylindrical opening on the joint surface and forms an anchoring device.

2. A customizable implant configured for placement between joint surfaces formed by inserting a retaining device that engages at least a portion of one joint surface in a joint and injecting material into an aperture of the retaining device to form an implant.

26. A tool comprising:

a mold having a surface for engaging a joint surface;

a block that communicates with the mold; and

at least one guide aperture in the block.

27. The tool of claim 26 wherein the mold and the block are integrally formed.

28. The tool of claim 26 wherein the mold is formed to conform to the joint surface on at least one surface.

29. The tool of claim 26 wherein the mold has at least one aperture positioned below the at least one guide aperture in the block.

30. The tool of claim 26 wherein the mold and the block have a plurality of apertures therein.

31. The tool of claim 30 wherein a first aperture of a plurality of apertures is configured at an angle to a second aperture of a plurality of apertures.

32. The tool of claim 30 wherein the mold has at least one stabilizer on the surface that engages the joint surface.

34. The tool of claim 26 wherein a surface of the mold that communicates with a surface of the block is configured to prevent at least one movement selected from the group consisting of axial, lateral and rotational.

35. The tool of claim 34 wherein the surface of the block that engages the mold is at least one of convex or concave.

36. The tool of claim 34 wherein the surface of the mold that engages the block is at least one of convex or concave.

37. The tool of claim 34 wherein the surface of at least one of the mold and block has an aperture for receiving at least one of a pin, post and peg located on a surface of the mold.

38. The tool of claim 37 wherein the aperture forms a groove providing rotational movement.

39. The tool of claim 37 wherein the mold is selected from a library of molds.

40. The tool of claim 36 wherein the mold is patient specific.

41. The tool of claim 36 wherein at least one of the mold and block has a reaming aperture.

42. The tool of claim 36 further comprising spacers.

43. The tool of claim 36 wherein block engages the mold in a snap fit.

44. The tool of claim 36 configured to be used in at least one of hip, knee, ankle, shoulder, elbow and wrist.

45. The tool of claim 36 configured to be used in a joint in the body.

53. The tool of claim 40 wherein the stabilizer is selected from the group consisting of pin, peg, post, and nub.

33. The tool of claim 70 wherein the stabilizer is selected from the group consisting of pin, peg, post, and nub.

46. A method of placing an implant into a joint, the method comprising the steps of imaging the joint using a C-arm system, obtaining a cross-sectional image with the C-arm system, and utilizing the image for placing the implant into a joint.

47. The method of claim 46 further comprising the step of obtaining a partial rotation with the C-arm system.

48. A tool formed at least partially in situ comprising:

a mold formed in situ using at least one of an inflatable hollow device or a retaining device to conform to the joint surface on at least one surface having a surface for engaging a joint surface;

a block that communicates with the mold; and

at least one guide aperture in the block.

49. The tool of claim 48 wherein the mold has at least one aperture positioned below the at least one guide aperture in the block.

50. The tool of claim 48 wherein the mold and the block have a plurality of guide apertures therein.

51. The tool of claim 50 wherein a first aperture of a plurality of guide apertures is configured at an angle to a second aperture of a plurality of guide apertures.

52. The tool of claim 50 wherein the mold has at least one stabilizer on the surface that engages the joint surface.

54. The tool of claim 48 wherein a surface of the mold that communicates with a surface of the block is configured to prevent at least one movement selected from the group consisting of axial, lateral and rotational.

55. The tool of claim 54 wherein the surface of the block that engages the mold is at least one of convex or concave.

56. The tool of claim 54 wherein the surface of the mold that engages the block is at least one of convex or concave.

57. The tool of claim 54 wherein the surface of at least one of the mold and block has an aperture for receiving at least one of a pin, post and peg located on a surface of the mold.

58. The tool of claim 57 wherein the aperture forms a groove providing rotational movement.

59. The tool of claim 48 wherein the mold patient specific.

60. The tool of claim 48 wherein at least one of the mold and block has a reaming aperture.

61. The tool of claim 60 further comprising spacers.

62. The tool of claim 48 wherein block engages the mold in a snap fit.

63. The tool of claim 48 configured to be used in at least one of hip, knee, ankle, shoulder, elbow and wrist.

64. The tool of claim 48 configured to be used in a joint in the body.