Method and apparatus for performing a high tibial, dome osteotomy

• US 20080147074A1
• Filed: 08/02/2007
• Published: 06/19/2008
• Est. Priority Date: 01/31/2005
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Novak, Vincent P., Schneider, Robert E., Ammann, Kelly G., Taber, Justin R.
• Granted Patent: US 8,062,301 B2
• Time in Patent Office: Days
• US Class Current: 606/88
• 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 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1655 for tapping
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1732 for bone breaking devices
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61B 17/8052 immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 2017/1602 Mills
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect

Abstract

A method for performing a high tibial, dome osteotomy to adjust the lateral and/or angular disposition of the tibial plateau relative to the lower portion of the tibia, the method comprising: forming an arcuate osteotomy cut in the tibia to subdivide it into upper and lower portions; manipulating the upper and lower portions to adjust their lateral and/or angular dispositions relative to one another; forming a pair of keyholes along the osteotomy cut; forming a keyhole slot to connect the two keyholes; forming a fixation hole in the tibia for each keyhole; providing an implant comprising a pair of keys connected by a bridge, each key comprising a bore for receiving a fixation screw therein; inserting the implant so that the keys are disposed in the keyholes, and so that the bores of the keys are aligned with the fixation holes; and inserting fixation screws through the bores of the keys and into the fixation holes of the keyholes so as to stabilize the upper and lower portions of the tibia.

Claims

1. A method for performing a high tibial, dome osteotomy so as to adjust the lateral and/or angular disposition of the tibial plateau relative to the lower portion of the tibia, the method comprising:

forming an arcuate osteotomy cut in the tibia so as to subdivide the tibia into an upper portion and a lower portion;

manipulating the upper portion and the lower portion so as to adjust the lateral and/or angular dispositions of the upper portion and the lower portion relative to one another;

forming a pair of keyholes in the tibia along the arcuate osteotomy cut;

forming a keyhole slot in the tibia so as to connect the two keyholes;

forming a fixation hole in the tibia for each keyhole;

providing an implant comprising a pair of keys connected by a bridge, each key comprising a bore for receiving a fixation screw therein;

inserting the implant into the tibia so that the keys are disposed in the keyholes, and so that the bores of the keys are aligned with the fixation holes of the keyholes; and

inserting fixation screws through the bores of the keys and into the fixation holes of the keyholes so as to stabilize the upper portion of the tibia and the lower portion of the tibia relative to one another while healing occurs.

2. A method according to claim 1 wherein the upper portion has a convex surface and the lower portion has a concave surface.

3. A method according to claim 1 wherein the upper portion has a concave surface and the lower portion has a convex surface.

5. A method according to claim 1 wherein the keyholes are disposed in an “

over-under”

configuration.

6. A method according to claim 1, wherein the fixation holes extend through the keyholes into different portions of the tibia so that one fixation hole extends into the upper portion of the tibia and one fixation hole extends into the lower portion of the tibia.

7. A method according to claim 6 wherein the fixation holes laterally deviate from one another.

8. A method according to claim 6 wherein the fixation holes laterally converge toward one another.

9. A method according to claim 6 wherein when the fixation screws are inserted through the bores of the keys and the fixation holes of the keyholes, one fixation screw extends into the upper portion of the tibia, and the other fixation screw extends into the lower portion of the tibia.

4. A method according to claim 4 wherein the keyholes are disposed in a “

side-by-side”

configuration.

10. A method for performing a high tibial, dome osteotomy so as to adjust the lateral and/or angular disposition of the tibial plateau relative to the lower portion of the tibia, the method comprising:

forming an arcuate osteotomy cut in the tibia so as to subdivide the tibia into an upper portion and a lower portion;

manipulating the upper portion and the lower portion so as to adjust the lateral and/or angular dispositions of the upper portion and the lower portion relative to one another;

forming a single keyhole in the tibia along the arcuate osteotomy cut;

forming a pair of fixation holes in the tibia;

providing an implant comprising a single key and a pair of bores for receiving fixation screws therein;

inserting the implant into the tibia so that the key is disposed in the keyhole and the bores of the implant are aligned with the fixation holes of the tibia; and

inserting fixation screws through the bores of the implant and into the fixation holes of the tibia so as to stabilize the upper portion of the tibia and the lower portion of the tibia relative to one another while healing occurs.

11. A method according to claim 10 wherein the upper portion has a convex surface and the lower portion has a concave surface.

12. A method according to claim 10 wherein the upper portion has a concave surface and the lower portion has a convex surface.

13. A method according to claim 10, wherein the fixation holes extend through different portions of the tibia so that one fixation hole extends into the upper portion of the tibia and one fixation hole extends into the lower portion of the tibia.

14. A method according to claim 13 wherein the fixation holes laterally deviate from one another.

15. A method according to claim 13 wherein the fixation holes laterally converge toward one another.

16. A method according to claim 13 wherein when the fixation screws are inserted through the bores of the implant and the fixation holes of the tibia, one fixation screw extends into the upper portion of the tibia, and the other fixation screw extends into the lower portion of the tibia.

17. A method according to claim 10 wherein the key has a circular cross-sectional shape.

18. A method according to claim 10 wherein the key has an ovoid cross-sectional shape.

19. A method according to claim 10 wherein the key has a polygonal cross-sectional shape.

20. A method according to claim 10 wherein the key has a triangular cross-sectional shape.

21. A method according to claim 10 wherein the key has a rectangular cross-sectional shape.

22. A method according to claim 10 wherein the key has a hexagonal cross-sectional shape.