Patient Selectable Joint Arthroplasty Devices and Surgical Tools

• US 20080281329A1
• Filed: 06/09/2008
• Published: 11/13/2008
• Est. Priority Date: 05/25/2001
• Status: Active Grant

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Lang, Philipp, Steines, Daniel, Bojarski, Raymond A., Fitz, Wolfgang
• Granted Patent: US 8,105,330 B2
• Time in Patent Office: Days
• US Class Current: 606/88
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/158 Cutting patella
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/1767 for the patella
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/063 for measuring volume
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4514 : Cartilage
• CPC Class Codes: A61B 5/4523 : Tendons
• CPC Class Codes: A61B 5/4528 : Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4533 : Ligaments
• CPC Class Codes: A61B 90/06 : Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2/30756 : Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/30942 : for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/3877 : Patellae or trochleae
• CPC Class Codes: A61F 2002/3895 : unicompartimental
• CPC Class Codes: B33Y 80/00 : Products made by additive manufacturing

Abstract

A patellar 3-D guidance tool includes a template. The template includes at least one contact surface for engaging a surface of the patella. The at least one contact surface substantially conforms with the surface associated with the patellar. At least one guide aperture directs movement of a surgical instrument, wherein the shape and/or position of the guide aperture is based, at least in part, on three or more anatomic reference points associated with the patellar.

Claims

1. A surgical tool for a patella, comprising:

a first component having a contact surface for engaging an uncut patella surface, wherein the contact surface is a substantial mirror image of the uncut patella surface; and

a guide for directing a surgical instrument in preparing the patellar surface for receiving a patellar implant.

2. The tool of claim 1, wherein the tool comprises a plurality of guides.

3. The tool of claim 1, wherein the shape and/or position of the guide is adapted to optimize patellar tracking with a femoral trochlea or the trochlear portion of a femoral implant.

4. The tool of claim 1, further comprising one or more of a groove, slot, hole and extension for accepting the surgical instrument.

5. The tool of claim 4, wherein the surgical instrument is selected from the group consisting of a saw, a mill, a drill, a reamer, a blade, and a curette.

6. The tool of claim 1, further comprising a linkage for attaching a surgical instrument.

7. The tool of claim 1, wherein the patella surface includes one of at least cartilage, subchondral bone or cortical bone.

8. The tool of claim 1, wherein shape and/or position of the guide is adapted to optimize at least one of a flexion gap or extension gap.

9. The tool of claim 1, wherein the guide includes a metal insert.

10. The tool of claim 1, further comprising a component selected from the group consisting of spacers, shims, ratchets, trial implants, linkages, hinges, tensiometers, jacks, and telescoping devices, for intraoperatively adjusting the space between the guide and the patellar surface.

11. A surgical tool for a patella, comprising:

a mold having a patient-specific interior mold having an anterior surface which mates or substantially mates with the patients'"'"' uncut patellar geography; and

a posterior surface for mating with an attachment;

an attachment having an anterior surface that mates with the posterior surface of the mold;

the attachment designed to hold the mold on the patella; and

at least one guide in the mold or the attachment for directing a surgical instrument in preparing the patellar surface for receiving a patellar implant.

12. The tool of claim 11, wherein the mold and/or the attachment have a plurality of guides.

13. The tool of claim 11, further comprising one or more of a groove, slot, hole and extension for accepting the surgical instrument.

14. The tool of claim 13, wherein the surgical instrument is selected from the group consisting of a saw, a mill, a drill, a reamer, a blade, and a curette.

15. The tool of claim 11, wherein a surface of the mold that communicates with a surface of the attachment is configured to prevent at least one movement selected from the group consisting of axial, lateral and rotational.

16. The tool of claim 11, wherein the patellar geography includes one of at least cartilage, subchondral bone or cortical bone.

17. The tool of claim 11, further comprising attachment mechanism for attaching the attachment to the mold.

18. A method of preparing a patella for receiving a patellar implant, comprising:

mating, to an uncut patella surface, a first component comprising a contact surface for engaging an uncut patella surface, wherein the contact surface is a substantial mirror image of the uncut patella surface, and a guide for directing a surgical instrument in preparing the patellar surface for receiving a patellar implant; and

guiding a surgical instrument via the guide so as to modify the patella to result in a modified patellar surface.

19. The method of claim 18, wherein guiding a surgical instrument including cutting through three or more anatomical reference points.

20. The method of claim 18, further comprising attaching one or more surgical implants to the modified patellar surface.