Navigated lateral/medial femoral resection guide

• US 20050261697A1
• Filed: 05/19/2004
• Published: 11/24/2005
• Est. Priority Date: 05/19/2004
• Status: Active Grant

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Inventors: Cusick, Michael J., Chauhan, Sandeep K., Canonaco, Alex F.
• Granted Patent: US 7,182,767 B2
• Time in Patent Office: Days
• US Class Current: 606/89
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Abstract

A multi-piece knee resection instrument for use in forming an anterior cut, an anterior chamfer cut, a posterior cut and a posterior chamfer cut on a distal femur which has already had a distal surface thereof resected which cuts are for the mounting of a prosthetic implant, has a first resection guide for attachment to the medial or lateral side of the distal femur. The first resection guide has a first surface facing generally anteriorly when mounted and a second surface extending distally from the first surface and angled thereto and a third surface extending generally parallel to the resected distal surface of the femur. A second resection guide is mounted on the first and second surfaces of the first resection guide for performing the anterior and anterior chamfer cuts. A third resection guide is mounted on the third surface of the first resection guide and extends in a medial-lateral direction therefrom across at least part of the resected distal femoral surface.

Claims

1. A method for making an anterior bone cut, an anterior chamfer bone cut, a posterior chamfer bone cut and a posterior bone cut on a distal femur having a resected planar distal surface comprising:

placing a first portion of a resection guide block adjacent either the medial or lateral side of the distal femur;

locating the resection guide block in an anterior/posterior direction by contacting an anterior surface of the distal femur with an anterior referencing arm mounted on said resection guide block, said resection guide block having a medial-laterally extending second portion having a surface for contacting said resected distal femur and including saw guide slots for making the posterior bone cut and posterior chamfer bone cut;

orienting said resection guide block in internal/external rotation and thereafter mounting said guide block on said femur;

performing the anterior bone cut with a saw blade guided on a first surface of the resection guide block first portion;

performing the anterior chamfer cut with a saw blade guided on a second surface of said resection guide block first portion; and

performing the posterior and posterior chamfer cuts with said second portion of said cutting block.

2. The method as set forth in claim 1 further comprising placing a modular cutting guide on said first and second surfaces of said first portion to perform said anterior and anterior chamfer cuts.

3. The method as set forth in claim 1 wherein said saw blade is oriented at an oblique angle to a plane perpendicular to the plane of the resected distal surface.

4. The method as set forth in claim 1 wherein said first portion of said resection guide has a distally extending coupling element and said second portion has first and second ends each with a coupling element engageable with said first portion coupling element wherein coupling the first portion with the second portion first end forms a resection guide block for the right knee from the medial side or the lateral side of the femur and engaging the second end of the second portion with said first portion coupling forms a cutting block for the left knee from the medial side or the lateral side of the right knee.

5. The method as set forth in claim 1 wherein said resection guide block is oriented in internal/external rotation on said lateral femur by aligning the guide block with respect to the distal femur with an optical tracker.

6. The method as set forth in claim 5 wherein a modular tracker is mounted on said first resection guide portion and is removed prior to making the anterior bone cut with said cutting guide.

7. The method as set forth in claim 6 wherein said modular optical tracker is mounted on said first surface of said first portion.

8. The method as set forth in claim 1 wherein said mounting of said resection guide block includes pinning said first portion of said resection block to the lateral femur after setting said anterior/posterior location and said internal/external rotation.

9. The method as set forth in claim 8 wherein said mounting of said resection guide block includes pinning said second portion of said resection guide block to said distal femur.

10. The method as set forth in claim 1 wherein said anterior bone cut is made with said cutting guide placed on an anteriorly facing surface of said resection guide first portion.

11. The method as set forth in claim 10 wherein said anterior chamfer bone cut is made with said cutting guide placed on a surface on said first portion of said resection guide which slopes distally in the anterior to posterior direction.

12. The method as set forth in claim 10 wherein a modular anterior referencing arm is located on said anteriorly facing surface and the method includes removing the arm prior to placing said cutting guide on said anteriorly facing surface.

13. A multi-piece knee resection instrument for resecting the distal femur comprising:

a first resection guide for attachment to the medial or lateral side of the distal femur having a first surface facing generally anteriorly and a second surface extending distally from said first surface at an angle thereto and a third surface extending generally parallel to a distal surface of the femur;

a second resection guide for mounting on at least one of said first and second surfaces of said first resection guide; and

a third resection guide mounted on third surface of said first resection guide and extending in a medial-lateral direction therefrom across at least part of a distal surface of the femur.

14. The multi-piece resection instrument as set forth in claim 13 wherein said second resection guide is mountable on both said first surface and said second surface of said first resection guide.

15. The multi-piece resection instrument as set forth in claim 13 further comprising an anterior referencing guide for selective mounting on said first surface of said first resection guide.

16. The multi-piece resection instrument as set forth in claim 15 wherein said anterior referencing guide includes an arm extending in a medial-lateral direction for contacting the anterior surface of the femur.

17. The multi-piece resection instrument as set forth in claim 13 further including an optical tracker selectively mountable on said first resection guide.

18. The multi-piece resection instrument as set forth in claim 17 wherein said tracker is mounted on an adapter coupled to said first surface of said first resection guide.

19. The multi-piece resection instrument as set forth in claim 13 wherein the third resection guide has a first saw guide slot extending in a proximal-distal direction or resecting a posterior surface of a distal femur and a second saw guide slot extending in an anterior/posterior direction along a plane angled with respect to the coronal plane for making a posterior chamfer cut on a distal femur.

20. The multi-piece resection instrument as set forth in claim 13 wherein the first resection guide includes a plurality of bores extending in a medial-lateral direction for receiving pins for mounting said first resection guide to the femur.

21. The multi-piece resection instrument as set forth in claim 20 wherein said third resection guide includes a plurality of bores for receiving pins for mounting said third resection guide to the distal femur.

22. The multi-piece resection guide as set forth in claim 13 wherein an optical tracker for use in computer-aided navigation is mountable on said first surface of said first resection guide.

23. A kit of instruments for performing an anterior bone cut, an anterior chamfer cut, a posterior cut and a posterior chamfer cut on the distal femur comprising:

at least one resection block having a first portion for mounting on the medial or lateral distal femur and a medial-laterally extending second portion for mounting adjacent a resected surface on a distal femur;

at least one cutting guide for mounting on said first portion of said resection block;

at least one modular tracker for use with a computer-aided navigation system for mounting on said resection block; and

at least one anterior referencing arm for mounting on said resection block.

24. The kit as set forth in claim 23 wherein said resection block comprises separate first and second portions.

25. The kit as set forth in claim 24 wherein said first portion has a distally facing coupling element and said second portion has first and second ends each end having a coupling element engageable with said first portion coupling element.

26. The kit as set forth in claim 23 further comprising multiple resection blocks of various sizes for mounting on various size distal femurs.

27. The kit as set forth in claim 23 further comprising a plurality of bone pins for mounting said resection block in the distal femur.

28. The kit as set forth in claim 23 wherein said resection guide first portion has at least two separated locations for mounting said cutting guide.

29. A resection guide block for preparing the distal femur for receiving a prosthetic femoral component comprising:

a resection guide block first portion for mounting on the medial or lateral side of the femur having an anterior surface and a distal surface connected by an angled surface, said distal surface having a first coupling element, said angled surface having a second coupling element and said anterior surface having a third coupling element;

a resection guide block second portion for mounting on a resected distal surface of the femur having a coupling element for engaging the first coupling element on the distal surface of said first portion;

an anterior referencing instrument having a coupling element engageable with the third coupling element on said anterior surface of said first portion for coupling said referencing instrument to said first portion; and

an optical tracker mounting element having a coupling element engageable with at least one of said first portion coupling elements for coupling said tracker mounting element thereto.

30. The resection guide block as set forth in claim 29 further comprising a cutting guide having a coupling element engageable with the second and third coupling elements on both said anterior surface of said first portion and said angled surface of said first portion for non-rotatably coupling said cutting guide to said first portion.