Osteotomy system

• US 20080195099A1
• Filed: 12/05/2007
• Published: 08/14/2008
• Est. Priority Date: 02/13/2007
• Status: Abandoned Application

• Current Assignee: Brigham and Women's Hospital Incorporated
• Original Assignee: Brigham and Women's Hospital Incorporated
• Inventors: Minas, Tom
• Application Number:
  US11/999,287
• Publication Number:
  US 20080195099A1
• Time in Patent Office: Days
• US Class Current: 606/70
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/8061 specially adapted for particular bones A61B17/70 and A61B17/74 take precedence
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 2090/067 for measuring angles
• CPC Class Codes: A61B 50/33 Trays

Abstract

The invention provides a suite of instruments, implants and associated techniques for performing procedures to correct deformities of the knee of a patient. In accordance with a preferred embodiment of the invention, implants, a kit and associated methods are provided for correcting varus and valgus deformities of the knee.

Claims

1. A multi-part implant for supporting an opening wedge osteotomy, comprising:

a) a spacer for insertion into an opening created during the osteotomy procedure, the spacer having a first contoured surface; and

b) a plate for spanning the opening created during the osteotomy procedure, the plate having;

i) a first portion for attachment to bony tissue proximate a first side of the opening;

ii) a second portion for attachment to bony tissue proximate a second side of the opening; and

iii) a third portion for attachment to the spacer, the third portion of the plate including a second contoured surface that complements the first contoured surface to provide alignment between the spacer and plate when they are attached.

2. The multi-part implant of claim 1, wherein the plate defines a length along a direction that spans an opening created during an osteotomy procedure and a width generally transverse to the length, wherein the average width of the plate is between about 1.5 cm and about 2.5 cm.

3. The multi-part implant of claim 1, wherein the plate has a width sufficient to cover at least 50% of the width of the medial surface of the tibia.

4. The multi-part implant of claim 1, wherein the plate has a width sufficient to cover at least 60% of the width of the medial surface of the tibia.

5. The multi-part implant of claim 2, wherein the plate includes two rows of alternating holes along a majority of its length.

6. The multi-part implant of claim 2, wherein the plate further includes a widened portion proximate an end of the plate adapted and configured to be attached to a head of a tibia.

7. The multi-part implant of claim 2, wherein the plate has a thickness between about three and a half millimeters and about four and a half millimeters.

8. The multi-part implant of claim 1, wherein the spacer includes at least two opposed bone engagement surfaces for engaging cortical bone created by an osteotomy.

9. The multi-part implant of claim 8, wherein the opposed bone engagement surfaces are substantially parallel.

10. The multi-part implant of claim 8, wherein the opposed bone engagement surfaces are tapered along an anterior-posterior direction.

11. The multi-part implant of claim 10, wherein the opposed bone engagement surfaces diverge along an anterior-posterior direction.

12. The multi-part implant of claim 10, wherein the opposed bone engagement surfaces converge along an anterior-posterior direction.

13. The multi-part implant of claim 10, wherein the opposed bone engagement surfaces taper with respect to each other at an angle of about five degrees.

14. The multi-part implant of claim 1, wherein the spacer defines an interior volume adapted and configured for receiving material therein.

15. The multi-part implant of claim 14, further comprising material disposed in the interior volume to facilitate growth of bony tissue therethrough.

16. The multi-part implant of claim 14, wherein the spacer is shaped and sized to fill a substantial portion of an opening created during an opening wedge osteotomy procedure.

17. The multi-part implant of claim 16, wherein the spacer is defined by an annular body surrounding a hollow core.

18. The multi-part implant of claim 16, wherein the spacer is defined by an annular body made from a first material surrounding a core made from a second material.

19. The multi-part implant of claim 18, wherein the first material includes a non-resorbable material and the second material includes a resorbable material.

20. The multi-part implant of claim 19, wherein the first material includes a material selected from the group consisting of titanium, aluminum, tantalum, a polymeric material, a composite material, and combinations thereof.

21. The multi-part implant of claim 19, wherein at least one of the first and second materials is sufficiently porous to permit the growth of bony tissue therethrough.

22. The multi-part implant of claim 1, wherein the first and second portions of the plate include protrusions to facilitate anchoring the plate to bony tissue of a patient.

23. The multi-part implant of claim 1, wherein the first and second contoured surfaces include at least one alignment feature for aligning the spacer with the plate.

24. The multi-part implant of claim 1, wherein the first and second contoured surfaces comprise a dovetailed joint.

25. The multi-part implant of claim 1, wherein the spacer includes a plurality of displaceable arms that anchor into adjacent bony tissue when a threaded connection between the spacer and plate is tightened.

26. A kit for performing an opening wedge osteotomy, comprising:

a) a plurality of spacers for insertion into an opening created during the osteotomy procedure, each spacer having a first contoured surface; and

b) a plurality of plates for spanning the opening created during the osteotomy procedure, each plate having;

i) a first portion for attachment to bony tissue proximate a first side of the opening;

ii) a second portion for attachment to bony tissue proximate a second side of the opening; and

iii) a third portion for attachment to the spacer, the third portion of the plate including a second contoured surface that complements the first contoured surface to provide alignment between the spacer and plate when they are attached.

27. The kit of claim 26, further including a plurality of screws for attaching the plates to bony tissue, each screws having at least one polished surfaces.

28. The kit of claim 26, wherein each screw has a head adapted and configured to attach to the plate.

29. The kit of claim 26, wherein at least two of the spacers are different sizes.

30. The kit of claim 26, wherein at least two of the plates are different sizes.

31. The kit of claim 26, wherein at one of the spacers is tapered along the anterior-posterior direction.

32. The kit of claim 26, further comprising at least one fastener for connecting a spacer to a plate.

33. The kit of claim 26, further comprising a cutting guide for attachment to bony tissue of a patient, the cutting guide defining a groove for receiving and guiding a bone saw.

34. The kit of claim 33, further comprising an adjustable bone spreader for spreading open a cut formed in bony tissue of a patient by a surgeon.

35. The kit of claim 26, further comprising a retractor for retracting a patient'"'"'s patellar tendon including a pointed distal tip adapted and configured to be anchored into bony tissue to facilitate retraction of the patellar tendon.

36. The kit of claim 26, further including at least one staple for implantation into bony tissue opposite an opening defined in a patient'"'"'s bony tissue during an opening wedge osteotomy procedure.

37. A bone plate adapted and configured for spanning a gap formed in a tibia in a patient subsequent to performing an opening wedge osteotomy, comprising a generally rectangular body having a length along a direction that spans the gap and a width generally transverse to the length, wherein the average width of the plate is between about 1.5 cm and about 2.5 cm.

38. The bone plate of claim 37, wherein the plate has a width sufficient to cover at least 50% of the width of the medial surface of a tibia of a patient.

39. The bone plate of claim 37, wherein the plate has a width sufficient to cover at least 60% of the width of the medial surface of a tibia of a patient.

40. The bone plate of claim 37, wherein the plate includes two rows of alternating holes along a majority of the length of the plate.

41. The bone plate of claim 37, wherein the plate further includes a widened portion proximate an end of the plate shaped for attachment to a head of a patient'"'"'s tibia.

42. The bone plate of claim 37, wherein first and second portions of the plate include protrusions for anchoring the plate to bony tissue of a patient.

43. The bone plate of claim 37, wherein the plate further includes a spacer disposed on an anatomically-facing surface for maintaining an open wedge osteotomy.

44. The bone plate of claim 43, wherein the spacer and plate are removably attached to each other by a fastener.

45. The bone plate of claim 44, wherein each of the spacer and plate include cooperating alignment features for maintaining registration between the spacer and plate.