Open wedge osteotomy system and surgical method

• US 20050251147A1
• Filed: 01/31/2005
• Published: 11/10/2005
• Est. Priority Date: 05/07/2004
• Status: Abandoned Application

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Novak, Vincent P.
• Application Number:
  US11/047,159
• Publication Number:
  US 20050251147A1
• Time in Patent Office: Days
• US Class Current: 606/87
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 17/1732 for bone breaking devices
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 17/8858 laterally or radially expansible inflatable A61B17/8855
• CPC Class Codes: A61B 17/8866 for gripping or pushing bones, e.g. approximators joint distractors A61B17/025
• CPC Class Codes: A61B 2090/067 for measuring angles

Abstract

An osteotomy implant for supporting an open wedge osteotomy, the osteotomy implant comprising: a first component for disposition in a posterior portion of the open wedge osteotomy; a second component for disposition in an anterior portion of the open wedge osteotomy; and a connection device for selectively connecting the first component and the second component to one another.

Claims

1. An osteotomy implant for supporting an open wedge osteotomy, the osteotomy implant comprising:

a first component for disposition in a posterior portion of the open wedge osteotomy;

a second component for disposition in an anterior portion of the open wedge osteotomy; and

a connection device for selectively connecting the first component and the second component to one another.

2. An osteotomy implant according to claim 1 wherein the connection device comprises a base component having a first side and second side in opposition to one another, wherein the first side is configured for selective attachment with the first component, and wherein the second side is configured for selective attachment with the second component.

3. An osteotomy implant according to claim 2 wherein the base component forms a fixation hole therein so as to allow placement of a fixation device therethrough for anchoring the multi-part implant to the tibia.

4. An osteotomy implant according to claim 1 wherein the connection device comprises a slotted fitting between the first component and the second component.

5. A multi-part osteotomy implant for supporting an open wedge osteotomy, the osteotomy implant comprising:

a first component for disposition in a posterior portion of the open wedge osteotomy;

a second component for disposition in an anterior portion of the open wedge osteotomy;

a third component for disposition in a medial portion of the open wedge osteotomy;

a first connection mechanism for selectively connecting the first component to the third component; and

a second connection mechanism for selectively connecting the second component to the third component.

6. A multi-part osteotomy implant according to claim 5 wherein the first connection mechanism comprises a first slotted fitting formed between the first component and the third component, and wherein the second connection mechanism comprises a second slotted fitting formed between the second component and the third component.

7. An osteotomy implant according to claim 6 wherein the first slotted fitting comprising a first male projection and a first female recess configured for attachment to one another, and further wherein the first male projection extends from one of the first component and the third component, and the first female recess is configured in the other one of the first component and the third component.

8. An osteotomy implant according to claim 7 wherein the first male projection extends from the third component, and the first female recess is configured in the first component.

9. A multi-part osteotomy implant according to claim 6, wherein the second slotted fitting comprises a second male projection and a second female recess configured for attachment to one another, and further wherein the second male projection extends from one of the second component and the third component, and the second female recess is configured in the other one of the second component and the third component.

10. A multi-part osteotomy implant according to claim 9 wherein the second male projection extends from the third component, and the second female recess is configured in the second component.

11. A multi-part osteotomy implant according to claim 5 wherein the first component, the second component and the third component form a void therebetween when connected together, and wherein the void corresponds substantially to a center region of the open wedge osteotomy.

12. A multi-part osteotomy implant according to claim 11 wherein the first component, the second component and the third component are configured to allow placement of graft material into the void.

13. A multi-part osteotomy implant according to claim 12 wherein the first component, the second component and the third component are configured to allow compaction of graft material in the void.

14. A multi-part osteotomy implant according to claim 5 wherein the first component comprises a first wall having a first set of dimensions, the second component comprises a second wall having a second set of dimensions, and further wherein the first set of dimensions of the first component and the second set of dimensions of the second component are different from one another so as to enable accurate disposition of the AP tibial slope.

15. A multi-part osteotomy implant according to claim 5 wherein the first component has a first surface and a second surface, the first surface configured for placement in the mouth of the osteotomy void and the second surface configured for placement adjacent to a bone surface of the open wedge osteotomy, and further wherein the first component forms a first channel therein between the first surface and the second surface so as to allow injection of a material through the first channel, from the first surface to the second surface, and provide the material to a bone/implant interface formed between the first component and the bone.

16. A multi-part implant according to claim 15 wherein the first component forms a first injection port at the first surface into the first channel, and further wherein the first injection port is configured to be accessible by a surgeon subsequent to placement of the first component adjacent to the bone.

17. A multi-part implant according to claim 16 wherein the first component forms multiple exit ports at the second surface.

18. An osteotomy implant according to claim 15 wherein the selected material comprises at least one chosen from a group consisting of biocompatible adhesive glue, bone cement, biologic material, growth factor, and grafting material.

19. A multi-part osteotomy implant according to claim 15 wherein the second component has a third surface and a fourth surface, the third surface configured for placement the osteotomy void and the fourth surface configured for placement adjacent to a bone surface of the open wedge osteotomy, and further wherein the second component forms a second channel therein between the third surface and the fourth surface so as to allow injection of a material through the second channel, from the third surface to the fourth surface, and provide the material to the bone/implant interface formed between the second component and the bone.

20. A multi-part implant according to claim 16 wherein the second component forms a second injection port at the third surface into the second channel, and further wherein the second injection port is configured to be accessible by a surgeon subsequent to placement of the second component adjacent to the bone.

21. A multi-part implant according to claim 20 wherein the second component forms multiple exit ports at the fourth surface.

22. A multi-part implant according to claim 19 wherein the second channel is configured to allow injection of one selected from a group consisting of bone glue, cement, biologic material, and grafting material.

23. A multi-part implant according to claim 5 wherein the first component has a first resorption rate into bone, the second component has a second resorption rate into the bone, the third component has a third resorption rate into bone, wherein the first resorption rate and the second resorption rate are substantially the same as one another, and the third resorption rate is substantially different from the first resorption rate and the second resorption rate.

24. A multi-part implant according to claim 23 wherein the third component differs from the first component and the second component by at least one chosen from the group consisting of:

different biomaterial composition from one another;

different biocomposite composition from one another; and

different formulation from one another.

25. A multi-part implant according to claim 5 wherein the third component forms a first fixation hole therein so as to allow placement of a first fixation device therethrough for anchoring the multi-part implant to the tibia.

26. A multi-part implant according to claim 25 wherein the third component forms a second fixation hole therein so as to allow placement of a second fixation device therethrough for anchoring the multi-part implant to the tibia.

27. A multi-part implant according to claim 26 wherein the first fixation hole has an entry portion and an exit portion on the third component, the first fixation hole defines a first longitudinal axis from the entry portion to the exit portion of the third component, the second fixation hole has an entry portion and an exit portion on the third component, the second fixation hole defines a second longitudinal axis from the entry portion to the exit portion of the third component, and the first longitudinal axis and the second longitudinal axis are non-parallel to one another so as to direct the first fixation device into a first portion of the tibia and to direct the second fixation device into a second portion of the tibia, with the first portion of the tibia and the second portion of the tibia being on opposing sides of the third component.

28. A multi-part osteotomy implant according to claim 5 wherein the first component, the second component, and the third component are each configured for assembly together with one another while within a bone cut of the open wedge osteotomy.

29. A multi-part osteotomy implant according to claim 5 wherein the first component, the second component and the third component are each configured for assembly together with one another while outside of a bone cut of the open wedge osteotomy.

30. A multi-part osteotomy implant according to claim 5 wherein the first component, the second component and the third component are configured to support a bone cut of the open wedge osteotomy from an anterior aspect thereof to a posterior aspect thereof.

31. An osteotomy implant for supporting an open wedge osteotomy, the osteotomy implant comprising:

a leading edge having a first height, a first width, and the first height configured for placement into a distal portion of the open wedge osteotomy;

a base portion in opposition to the leading edge, the base portion having a second height, a second width, and the second height configured to substantially close a proximal end of the open wedge osteotomy; and

two opposing side walls connecting the leading edge to the base portion, the opposing side walls having a first length equal to the distance from the leading edge to the base portion, and the opposing side walls having a tapered height from the first height of the leading edge to the second height of the base portion.

32. An osteotomy implant according to claim 31 further comprising a floor portion extending between the two opposing side walls and from the base portion to the leading edge, and wherein the floor portion has a third height, and the first height of the base portion is greater than the third height of the floor portion so as to form an open portion between the two opposing sides.

33. An osteotomy implant according to claim 31 wherein the base portion forms at least one opening therethrough for insertion of a material therethrough.

34. An osteotomy implant according to claim 33 wherein the material is at least one selected from the group consisting of:

allograft bone;

autograft bone;

demineralized bone substitutes;

bone graft material; and

bone cement.

35. An osteotomy implant according to claim 31 wherein the two opposing sides are substantially parallel with one another.

36. An osteotomy implant according to claim 31 further comprising a series of projections extending from bone interface surfaces of the two opposing side walls, wherein the projections are configured to allow insertion of the opposing side walls into the open wedge osteotomy and prevent migration of the opposing side walls out of the open wedge osteotomy.

37. An osteotomy implant according to claim 31 wherein the two opposing side walls define channels therein for delivering selected material therethrough.

38. An osteotomy implant according to claim 37 further comprising a delivery device comprising a tube having a length and a diameter, the tube forming a series of openings along the length thereof, the diameter configured for placement in a main portion of the channel, and the series of openings configured to correspond with a series of branch portions of the channel.

39. An osteotomy implant according to claim 31 wherein the two opposing side walls define channels opening on a bone interface surface thereof so as to allow delivery of a selected material therethrough.

40. An osteotomy implant according to claim 39 wherein the selected material comprises at least one chosen from the group consisting of:

biocompatible adhesive glue;

bone cement;

growth factor; and

grafting material.

41. An osteotomy implant for supporting an open wedge osteotomy, the osteotomy implant comprising:

a base portion having a first height, a first end and a second end, a width between the first end and the second end, the first height configured to substantially close a proximal end of the open wedge osteotomy;

two opposing side walls extending from the first end and the second end, respectively, the two opposing side walls having a third end and a fourth end, the third end extending from the base portion, a second height equal to the first height of the base portion at the third end, each one of the two opposing side walls at the fourth end having a third height, the third height being less than the second height so as to allow placement of the fourth end of each one of the two opposing side walls into a distal portion of the open wedge osteotomy.

42. An osteotomy implant according to claim 41 wherein the two opposing walls are substantially parallel with one another.

43. An osteotomy implant according to claim 41 wherein the two opposing side walls approach one another in a region between the third end and the fourth end of each one of the opposing side walls, respectively.

44. An osteotomy implant according to claim 41 wherein the base portion forms at least one opening therethrough for insertion of a material therethrough.

45. An osteotomy implant according to claim 41 wherein the material is at least one selected from the group consisting of allograft bone;

autograft bone;

demineralized bone substitutes;

bone graft material; and

bone cement.

46. An osteotomy implant according to claim 41 further comprising a connector extending between the two opposing side walls from a location between the third end and the fourth end of each one of the side walls, respectively.

47. An osteotomy implant according to claim 41 wherein the two side walls are selectively separable from one another.

48. An osteotomy implant according to claim 47 wherein the base portion is selectively separable from the two side walls.

49. An osteotomy implant according to claim 48 wherein the selected material comprises at least one chosen from the group consisting of biocompatible adhesive glue;

bone cement;

growth factor; and

grafting material.

50. An osteotomy implant according to claim 47 further comprising a series of projections extending from bone interface surfaces of the two opposing side walls, wherein the projections are configured to allow insertion of the opposing side walls into the open wedge osteotomy and prevent migration of opposing side walls out of the open wedge osteotomy.

51. An osteotomy implant according to claim 41 wherein the two opposing side walls define channels therein for delivering selected material therethrough.

52. An osteotomy implant according to claim 51 wherein the selected material comprises at least one chosen from the group consisting of biocompatible adhesive glue;

bone cement;

growth factor; and

grafting material.

53. An osteotomy implant according to claim 51 further comprising a delivery device comprising a tube having a length and a diameter, the tube forming a series of openings along the length thereof, the diameter configured for placement in a main portion of the channel, and the series of openings configured to correspond with a series of branch portions of the channel.

54. An osteotomy implant according to claim 41 wherein the two opposing side walls define channels on a bone interface surface thereof so as to allow delivery of selected material therein.

55. An osteotomy implant according to claim 54 wherein the selected material comprises at least one chosen from the group consisting of biocompatible adhesive glue;

bone cement;

growth factor; and

grafting material.

56. An osteotomy implant for supporting an open wedge osteotomy, the osteotomy wedge implant comprising:

two opposing side walls having a first end and a second end in opposition to one another, a pair of frame members extending between the first end and the second end of each of the two opposing side walls, an expandable material disposed between the pair of frame members of each of the two opposing side walls, the pair of frame members in connection with one another at the first end thereof, and the pair of frame members selectively separable from one another to a selected height at the second end thereof;

a base member having a given height and a given width, wherein the given height is substantially equal to the selected height of the pair of frame member of each of the two opposing side walls, and wherein the given width is substantially equal to a distance between the two opposing side walls when placed in the open wedge osteotomy; and

a set of connectors for connecting the base member to each of the two opposing side walls.

57. An osteotomy implant according to claim 56 wherein base member defines passageways therein for disposition of the set of connectors therethrough to connect the base member to each of the two opposing sides.

58. An osteotomy implant according to claim 56 wherein at least one chosen from a group consisting of the base portion and the two opposing side walls define an opening therethrough, and the opening is configured for inserting a selected material into the open wedge osteotomy between the two opposing side portions.

59. An osteotomy implant according to claim 58 wherein the selected material comprises at least one chosen from the group consisting of biocompatible adhesive glue;

bone cement;

growth factor; and

grafting material.

60. An osteotomy implant according to claim 56 further comprising a series of projections extending from bone interface surfaces of the two opposing side walls, wherein the projections are configured to allow insertion of the opposing side walls into the open wedge osteotomy and prevent migration of opposing side walls out of the open wedge osteotomy.

61. An osteotomy implant according to claim 56 further comprising an opening wedge plate device for opening each of the two opposing side walls at second end, the opening wedge plate having four attachment points configured for attachment to each ones of the pair of frame members of each of the two opposing side walls, and two connectors for attachment to a jack mechanism, wherein the opening wedge plate device is configured to support the two opposing side walls as the second end of each of the side walls are expanded relative to one another.

62. A multi-part osteotomy implant for supporting an open wedge osteotomy, the osteotomy implant comprising:

a first component configured for disposition in a posterior portion of the open wedge osteotomy; and

a second component configured for disposition in an anterior portion of the open wedge osteotomy;

wherein the first component and the second component form a U-shaped wall when disposed in the open wedge osteotomy.

63. A multi-part osteotomy implant according to claim 62 wherein the first component and the second component are configured for disposition adjacent to one another in the open wedge osteotomy so as to contact one another.

64. A multi-part osteotomy implant according to claim 63 wherein the first component and the second component are configured for disposition in the open wedge osteotomy unconnected with one another.

65. A multi-part osteotomy implant according to claim 62 wherein the first component and the second component are configured for disposition in the open wedge osteotomy unconnected with one another.

66. A multi-part osteotomy implant according to claim 62 further comprising a third component configured for disposition in a medial portion of the open wedge osteotomy, wherein the first component, the second component and the third component form the U-shaped wall when disposed in the open wedge osteotomy.

67. A multi-part osteotomy implant according to claim 66 wherein the first component and the second component are configured for disposition adjacent to one another in the open wedge osteotomy so as to contact one another, and the second component and the third component are configured for disposition adjacent to one another in the open wedge osteotomy so as to contact one another.

68. A multi-part osteotomy implant according to claim 67 wherein the first component and the second component are configured for disposition in the open wedge osteotomy without being in direct contact with one another.

69. An osteotomy implant for supporting an open wedge osteotomy, the osteotomy implant comprising:

a U-shaped wall configured for disposition in the open wedge osteotomy, an interior portion formed on a concave side of the wall, and an exterior portion formed on a convex side of the wall; and

the U-shaped wall forming an access port therethrough from the exterior portion into the interior portion, wherein the access port allows passage of a material between the exterior portion and the interior portion.

70. An osteotomy implant according to claim 69 wherein the access port is configured in a medial portion of the U-shaped wall when the osteotomy implant is disposed in the open wedge osteotomy.

71. An osteotomy implant according to claim 69 wherein the access port is configured in a posterior portion of the U-shaped wall when the osteotomy implant is disposed in the open wedge osteotomy.

72. An osteotomy implant according to claim 69 wherein the access port is configured in a anterior portion of the U-shaped wall when the osteotomy implant is disposed in the open wedge osteotomy.

73. An osteotomy implant according to claim 69 wherein the U-shaped wall forms an additional access port therethrough from the exterior portion into the interior portion.

74. An osteotomy implant according to claim 73 wherein one of the access port and the additional access port are configured to allow overflow of the material to exit from the interior portion as the material is injected through the other one thereof.

75. A multi-part osteotomy implant for supporting an open wedge osteotomy, the osteotomy implant comprising:

a first component configured for disposition in a posterior portion of the open wedge osteotomy; and

a second component configured for disposition in an anterior portion of the open wedge osteotomy;

wherein the first component comprises a first material, the second component comprises a second material, and the first material and the second material are different from one another.

76. A multi-part implant according to claim 75 wherein the first component and the second component are configured for disposition adjacent to one another in the open wedge osteotomy so as to contact one another.

77. A multi-part implant according to claim 76 wherein the first component and the second component form a U-shaped wall when disposed in the open wedge osteotomy.

78. A multi-part implant according to claim 75 further comprising a third component configured for disposition in a medical portion of the open wedge assembly, wherein the third component comprises a third material, and further wherein the first material, second material, and third material are each different from one another.

79. A multi-part implant for supporting an open wedge osteotomy, the osteotomy comprising:

a first component configured for disposition in a posterior portion of the open wedge osteotomy;

a second component configured for disposition in an anterior portion of the open wedge osteotomy;

a third component configured for disposition in a medial portion of the open wedge osteotomy; and

wherein the first component comprises a first material, the second component comprises a second material, the third material comprises a third material, and one selected from the group consisting of the first material, the second material, and the third material is different than another one selected from the group consisting of the first material, the second material, and the third material.

80. A multi-part implant according to claim 79 wherein the third material is different than the first material and the second material.

81. A multi-part implant according to claim 79 wherein each of the first material, the second material and the third material are different from one another.