Milling system with guide paths and related methods for resecting a joint articulation surface

• US 20060293682A1
• Filed: 06/10/2005
• Published: 12/28/2006
• Est. Priority Date: 06/10/2005
• Status: Active Grant

• Current Assignee: Medicinelodge, Inc (Nelso Antolotti), Zimmer Technology Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Medicinelodge, Inc (Nelso Antolotti), Zimmer Technology Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Justin, Daniel F., Goble, E. Marlowe, Hodorek, Robert A., Creger, Carlyle J.
• Granted Patent: US 7,727,239 B2
• Time in Patent Office: Days
• US Class Current: 606/88
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2017/1602 Mills
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself

Abstract

A milling system for use in resecting at least a portion of a joint articulation surface of a bone includes an alignment guide having a top surface and an opposing bottom surface with an opening extending therebetween. Fasteners are used to secure the alignment guide to the bone so that the alignment guide is suspended above the bone. A template is removably mounted to the alignment guide so that a plurality of guide paths extending through the template are aligned with the opening in the alignment guide. A mill extends down through the guide path and has a burr on the end thereof for resecting the bone.

Claims

1. A milling system for use in resecting at least a portion of a joint articulation surface of a bone, the system comprising:

an alignment guide comprising a base having a top surface and an opposing bottom surface with an opening extending therebetween;

a positioning guide removably secured to the alignment guide, the positioning guide having a support portion passing through the opening of the alignment guide and projecting below the bottom surface thereof so that the support portion can suspend the alignment guide off of a bone; and

means for removably mounting the alignment guide to the bone so that the alignment guide is securely suspended above the bone when the positioning guide is removed from the alignment guide.

2. The milling system as recited in claim 1, wherein the alignment guide further comprises a bracket projecting from the base and having at least one mounting hole extending therethrough.

3. The milling system as recited in claim 1, wherein the base completely encircles the opening of the alignment guide.

4. The milling system as recited in claim 1, wherein the support of the positioning guide forms a continuous loop.

5. The milling system as recited in claim 1, wherein the support of the positioning guide comprises at least three spaced apart support legs.

6. The milling system as recited in claim 1, wherein the means for removably mounting comprises a plurality of fasteners configured to pass through mounting holes formed on the alignment guide and engage the bone.

7. The milling system as recited in claim 6, wherein the fasteners comprise screws.

8. The milling system as recited in claim 1, further comprising an elongated handle removably coupling the alignment guide to the positioning guide.

9. A milling system for use in resecting at least a portion of a joint articulation surface of a bone, the system comprising:

an alignment guide having a top surface and an opposing bottom surface with an opening extending therebetween;

means for removably mounting the alignment guide to a bone;

a template having a top surface and an opposing bottom surface with a plurality of guide paths extending therebetween; and

means for removably securing the template to the alignment guide so that the plurality of guide paths are aligned with the opening of the alignment guide.

10. The milling system as recited in claim 9, wherein at least a portion of the plurality of channels are interconnected.

11. The milling system as recited in claim 9, wherein the top surface of the template has a convex curvature.

12. The milling system as recited in claim 11, wherein the guide paths intersect with the top surface of the template at an orientation substantially normal to the top surface of the template.

13. The milling system as recited in claim 9, wherein the template comprises:

a body that at least partially bounds an opening extending through the base; and

a plurality of partition walls disposed within the opening of the body and connected to the body.

14. A milling system for use in resecting at least a portion of a joint articulation surface of a bone, the system comprising:

a mill comprising an elongated shaft having a burr mounted on an end thereof, the burr radially outwardly projecting beyond at least a portion of the shaft; and

a template having a top surface and an opposing bottom surface with a guide path extending therebetween, the guide path having a first portion sized so that the burr can pass therethrough and a second portion sized so that the shaft can pass therethrough but the burr cannot pass therethrough.

15. The milling system as recited in claim 14, further comprising a bearing housing mounted on the shaft of the mill and at least one bearing disposed within the bearing housing.

16. The milling system as recited in claim 14, wherein the template comprises a plurality of guide paths extending between the top surface and the opposing bottom surface, each guide path having a portion sized so that the shaft can pass therethrough but the burr cannot pass therethrough.

17. The milling system as recited in claim 14, wherein the top surface of the template has a convex curvature.

18. The milling system as recited in claim 17, wherein the template comprises a plurality of guide paths extending between the top surface and the opposing bottom surface, each guide path intersecting with the top surface of the template at an orientation substantially normal to the top surface of the template.

19. The milling system as recited in claim 17, wherein the template comprises a plurality of guide paths extending between the top surface and the opposing bottom surface, at least a portion of the plurality of guide paths intersecting with the top surface of the template at an orientation that is not normal to the top surface of the template.

20. The milling system as recited in claim 14, further comprising an alignment guide having a top surface and an opposing bottom surface with an opening extending therebetween, the template being removably mounted on the alignment guide so that the guide path of the template is aligned with the opening of the alignment guide.

21. A milling system for use in resecting at least a portion of a joint articulation surface of a bone, the system comprising:

a mill comprising;

an elongated shaft having an exterior surface extending between a first end and an opposing second end; and

a burr mounted on the first end of the shaft, the burr having an effective radius radially outwardly extending from the exterior surface of the shaft to a maximum outer radius of the burr; and

a template comprising;

a body at least partially bounding an opening; and

a partition wall disposed within the opening of the body and connected to the body, the partition wall having opposing side surfaces with a thickness extending therebetween, the thickness being not more than twice the effective radius of the burr.

22. The milling system as recited in claim 21, further comprising a plurality of partition walls disposed within the opening of the body and connected to the body, the plurality of partition walls bounding a plurality of guide paths.

23. The milling system as recited in claim 21, further comprising a tubular bearing housing encircling the shaft of the mill such that the mill can freely rotate within the bearing housing, the bearing housing having a lower stem portion received within a guide path of the template and an annular shoulder resting on a top surface of the template.

24. A method for resecting at least a portion of a joint articulation surface of a bone, the method comprising the steps of:

securing an alignment guide having an opening formed thereon to a bone so that the opening is aligned with a joint articulation surface of the bone, the alignment guide being secured so as to be suspended above the bone;

securing a template to the alignment guide so that a guide path extending through the template is aligned with the opening of the alignment guide;

passing a mill through the guide path of the template so that a burr on the mill contacts the joint articulation surface; and

moving the mill along the guide path of the template while the mill is rotating so that the mill resects at least a portion of the joint articulation surface.

25. The method as recited in claim 24, wherein the step of securing the alignment guide comprises:

removably securing a positioning guide to the alignment guide such that a support portion of the positioning guide projects below a bottom surface of the alignment guide;

resting the support portion of the positioning guide on the articulation surface so that the alignment guide is suspended above the articulation surface;

passing one or more fasteners through the alignment guide and into the bone so as to secure the alignment guide to the bone; and

removing the positioning guide from the alignment guide.

26. The method as recited in claim 24, wherein the template has a plurality of interconnect guide paths formed thereon and the mill is moved along each of the plurality of guide paths so as to form a recessed pocket on the articulation surface.

27. The method as recited in claim 26, further comprising:

removing the template and the alignment guide from the bone; and

mounting an implant within the recessed pocket.

28. The method as recited in claim 24, wherein moving the mill along the guide path comprise:

advancing the mill down through the guide path until a shoulder of a bearing housing mounted on the mill rests on a top surface of the template; and

moving the mill along the guide path while the shoulder of the bearing housing rests against the top surface of the template.