Universal positioning block assembly

• US 20060195111A1
• Filed: 01/25/2005
• Published: 08/31/2006
• Est. Priority Date: 01/25/2005
• Status: Abandoned Application

• Current Assignee: Orthosoft Inc. (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Orthosoft Inc. (Zimmer Biomet Holdings, Inc.)
• Inventors: Couture, Pierre
• Application Number:
  US11/042,264
• Publication Number:
  US 20060195111A1
• Time in Patent Office: Days
• US Class Current: 606/86.00R
• 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 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Abstract

A universal positioning block for use in bone surgery, permitting up to six degrees-of-freedom movement relative to a bone element to which it is fixed. The positioning block comprises a main block element that is releasably engageable to the bone element such that the main block element is rotatable in a flexion-extension rotation plane and translatable along a medio-lateral axis relative to the bone element. A slider element is engaged with the main block element such that it is translatable along an antero-posterior axis and rotatable in a varus-valgus rotation plane relative thereto and a holder element is engaged with the slider element such that it is translatable relative thereto along a proximal-distal axis and may also further be rotatable in a medio-lateral rotation plane, the holder element being habilitated for engaging a surgical tool guide element.

Claims

1. A positioning block assembly (100) for use in bone surgery, to be releasably affixed to a bone element (4) to undergo surgery, said positioning block assembly (100) comprising:

a main block element (20) being releasably attachable to said bone element (4) such that said main block element (20) is rotatable in a flexion-extension rotation plane and translatable along a medio-lateral axis relative to said bone element (4);

a slider element (30) being slidably engaged with said main block element (20) such that it is translatable along an antero-posterior axis and rotatable in a varus-valgus rotation plane relative to said main block element (20); and

a holder element (40) being slidably engaged with said slider element (30) such that it is translatable relative to said slider element (30) along a proximal-distal axis, said holder element (40) being configured and disposed to releasably engage a surgical tool guide element (70).

2. The apparatus as defined in claim 1, wherein said holder element (40) is further rotatable in a medio-lateral rotation plane.

3. The apparatus as defined in claim 2 wherein said holder element (40) comprises an adjustment mechanism (44) for adjusting the rotation of said holder element (40) in said medio-lateral rotation plane and the translation of said holder element (40) in said proximal-distal axis.

4. The apparatus as defined in claim 3, wherein said adjustment mechanism (44) is selected from a group comprising an endless screw and a screw.

5. The apparatus as defined in claim 4, wherein said endless screw is operationally engaged to said slider element (30) providing substantially isolated adjustment in said medio-lateral rotation plane.

6. The apparatus as defined in claim 1, further comprising a bone anchoring element (10) having opposed first (11) and second (13) extremities, said first extremity (11) being releasably anchorable into said bone element (4) and said second extremity (13) being configured and disposed to be slidably and rotationaly engaged with said main block element (20).

7. The apparatus as defined in claim 6, wherein said second extremity (13) has a cylindrical cross section.

8. The apparatus as defined in claim 1, wherein said main block element (20) comprises a first adjustment mechanism (24) for adjusting the rotation of said main block element (20) in said flexion-extension plane and the translation of said main block element (20) in said medial-lateral axis.

9. The apparatus as defined in claim 8 wherein said main block element (20) further comprises a second adjustment mechanism (28) for adjusting the rotation of said slider element (30) in said varus-valgus rotation plane and the translation of said slider element (30) in said anterior-posterior axis.

10. The apparatus as defined in claim 9 wherein said holder element (40) comprises a third adjustment mechanism (44) for adjusting the translation of said holder element (40) in said proximal-distal axis.

11. The apparatus as defined in claim 8, wherein said first adjustment mechanism (24) is selected from a group comprising an endless screw and a screw.

12. The apparatus as defined in claim 9 wherein said second adjustment mechanism (28) is selected from a group comprising an endless screw and a screw.

13. The apparatus as defined in claim 10 wherein said third adjustment mechanism (44) is a screw.

14. The apparatus as defined in claim 11, wherein said endless screw is operationally engaged to said bone anchoring element (10) providing substantially isolated adjustment in said flexion-extension rotation plane.

15. The apparatus as defined in claim 12, wherein said endless screw is operationally engaged to said slider element (30) providing substantially isolated adjustment in said varus-valgus rotation plane.

16. The apparatus as defined in claim 1, wherein said holder element (40) comprises opposed proximal (41) and distal (43) ends, said proximal end (41) comprising a lip component (46) configured and disposed to be releasably engaged to said surgical tool guide element (70).

17. The apparatus as defined in claim 16, wherein holder element (40) further comprises fixation means for releasably engaging said lip component (46) to said surgical tool guide element (70).

18. The apparatus as defined in claim 17 wherein fixation means comprises at least one screw (48) having oppose first (45) and second (49) ends, said screw (48) being capable of displacement so as to releasably impinge said surgical tool guide element (70) between said first end (45) and said lip component (46).

19. The apparatus as defined in claim 18 wherein said surgical tool guide element (70) comprises an aperture (72) configured and disposed to receive therein said lip component (46).

20. The apparatus as defined in claim 16, wherein said lip component (46) comprises a fixed first connector part (46a′

) and a displaceable second connector part (46b′

), said second connector part (46b′

) being displaceable between

a first position such that said second connector part (46b′

) and said first connector part (46a′

) are in horizontal alignment, and

a second position such that said second connector part (46b′

) is horizontally displaced from said first connector part (46a′

)

wherein said first connector part (46a′

) and said second connector part (46b′

) are both sized and configured to be inserted into said aperture (72) such that when said second connector part (46b′

) is in said second position, said surgical tool guide element (70) is releasably engaged to said holder element (40) and when said second connector part (46b′

) is in said first position, said surgical tool guide element (70) is disengaged from said holder element (40).

21. The apparatus as defined in claim 20 wherein said holder element (40) further comprises a screw (47′

) operationally connecting said second connector part (46b′

) to said holder element (40) such that rotation of said screw (47′

) in a first direction displaces said second connector part (46b′

) to said second position and rotating said screw (47′

) in a second direction displaces said second connector part (46b′

) to said first position.

22. The apparatus as defined in claim 1, wherein a tracker member (50) is connected to said holder element (40), said tracker member (50) comprises at least three detectable elements (52) configured and disposed so as to be tracked in three dimensional space by a computer assisted surgical system, thereby defining the location of said surgical tool guide element (70) releasably engaged to said holder element (40).

23. The apparatus as defined in claim 1, wherein said surgical tool guide element (70) is a surgical tool guide block.

24. The apparatus as defined in claim 23, wherein said surgical tool guide block comprises at least one of a group comprising a drill guide hole, a cutting guide slot, a rasp guide slot and a saw guide slot.

25. The apparatus as defined in claim 23, wherein said surgical tool guide block is a conventionally employed instrument used in non-computer assisted total joint replacement surgery.

26. The apparatus as defined in claim 1, wherein said bone surgery is joint replacement surgery.

27. The apparatus as defined in claim 26, wherein said joint is a knee.

28. A computer assisted bone surgery system comprising:

a positioning block assembly (100) to be releasably affixed to a bone element (4);

means for determining the position and orientation of said positioning block (100) relative to said bone element (4);

a surgical tool guide element (70) being releasably engaged to said positioning block assembly (100);

means for identifying a desired position of said positioning block assembly (100) relative to said bone element (4), such that said surgical tool guide element (70) is located in a selected position relative to said bone element (4), such that a cut can be made in said bone element (4) at said selected position; and

a display capable of indicating when said desired position of said positioning block assembly (100) is reached.

29. The apparatus as defined in claim 28, wherein said means for determining the position and orientation of said positioning block (100) is selected from a group comprising optical markers, electromagnetic markers and acoustic markers and further comprises a computer assisted surgery system.

30. The apparatus as defined in claim 28, wherein said means for identifying a desired position of said positioning block assembly (100) is a computer assisted surgery system.

31. The system as defined in claim 28, wherein said surgical tool guide element (70) is a surgical tool guide block.

32. The system as defined in claim 31, wherein said surgical tool guide block comprises at least one of a drill guide hole, a cutting guide slot, a rasp guide slot and a sawguide slot.

33. The system as defined in claim 29, wherein said surgical tool guide block is a conventionally employed instrument used in non-computer assisted total joint replacement surgery.

34. The system as defined in claim 28, further comprising means for determining and indicating where to fasten said positioning block assembly (100) on said bone element (4) such that said positioning block assembly (100) is located in said desired position.

35. The system as defined in claim 34, wherein said means for determining and indicating where to fasten said positioning block assembly (100) is a computer assisted surgery system.

36. The system as defined in claim 28, further comprising a bone anchoring element (10) having opposed first (11) and second (13) extremities, said first extremity (11) being releasably anchorable into said bone element (4) and said second extremity (13) being configured and disposed to be slidably and rotationaly engaged with said positioning block assembly (100), such that said positioning block assembly (100) may be selectively adjusted into said desired position.

37. The system as defined in claim 36, wherein said positioning block (100) comprises a tracker member (50) thereon, said tracker member (50) having at least three detectable elements (52) that may be located and tracked in three dimensional space by said computer assisted surgical system, thereby defining the location of said surgical tool guide element (70) releasably engaged to said positioning block assembly (100).

38. The system as defined in claim 28, wherein said bone surgery is joint replacement surgery.

39. The system as defined in claim 38, wherein said joint is a knee.

40. A method of installing a surgical tool guide element (70) on a bone element (4), said surgical tool guide element (70) being releasably engaged to a positioning block assembly (100), said method comprising:

fastening said positioning block assembly (100) to said bone element (4);

determining a desired position of said surgical tool guide element (70) engaged to said positioning block assembly (100) relative to said bone element (4);

adjusting at least one of the position and orientation of said positioning block assembly (100) until said surgical tool guide element (70) is in said desired position; and

securing said surgical tool guide element (70) on said bone element (4) at said desired position.

41. The method as defined in claim 40, wherein said surgical tool guide element (70) is surgical tool guide block.

42. The method as defined in claim 41, wherein said surgical tool guide block comprises at least one of a drill guide hole, a cutting guide slot, a rasp guide slot and a saw guide slot.

43. The method as defined in claim 41, wherein said surgical tool guide block is a conventionally employed instrument used in non-computer assisted total joint replacement surgery.

44. The method as defined in claim 40, further comprising using a computer assisted surgical system, communicable with said positioning block assembly (100), to determine and display position and orientation of said positioning block assembly (100) in relation to said bone element (4).

45. The method as defined in claim 44, wherein said computer assisted surgical system is used to determine said desired position of said surgical tool guide element (70).

46. The method as defined in claim 44, wherein said computer assisted surgical system is used to adjust said positioning block (100) such that said surgical tool guide element (70) is in said desired position.

47. The method as defined in claim 44, wherein said computer assisted surgical system is used to fasten said positioning block assembly (100) to said bone element (4) in a predetermined position.

48. The method as defined in claim 47, wherein said computer assisted surgical system is used to adjust at least one of the position and orientation of said positioning block assembly (100) while fastening said positioning block assembly (100) such that said positioning block assembly (100) is in said predetermined position.

49. The method as defined in claim 40, further comprising using said positioning block assembly (100) for joint replacement surgery.

50. The apparatus as defined in claim 49, wherein said joint is a knee.

51. The method as defined in claim 40, further comprising using a bone anchoring element (10) to fasten said positioning block assembly (100) to said bone element (4), such that said positioning block assembly (100) may selectively be rotatably and translatively orientated relative to said bone element (4).