Customized Patient-Specific Instrumentation for Use in Orthopaedic Surgical Procedures

• US 20090088755A1
• Filed: 09/29/2008
• Published: 04/02/2009
• Est. Priority Date: 09/30/2007
• Status: Active Grant

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Inventors: Smith, Matthew D., Zajac, Eric, Aker, Chris, Auger, Daniel D., Rhodes, Matt, Lester, Mark B., Bennett, Travis
• Granted Patent: US 8,377,068 B2
• Time in Patent Office: Days
• US Class Current: 606/79
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: Y10T 409/30084 with regulation of operation by templet, card, or other replaceable information supply

Abstract

A number of orthopaedic surgical instruments are also disclosed. A method, apparatus, and system for fabricating such instruments are also disclosed.

Claims

1. A customized patient-specific orthopaedic instrument, comprising:

a customized patient-specific cutting block having a body that comprises (i) a bone-facing surface having a customized patient-specific negative contour configured to receive a portion of a bone of a patient that has a corresponding contour, (ii) an outer surface opposite the bone-facing surface, (iii) a first cutting guide corresponding to a predetermined customized patient-specific cutting plane, and (iv) a second cutting guide that is parallel to the first cutting guide and spaced apart from the first cutting guide by a predetermined distance.

2. The orthopaedic instrument of claim 1, wherein the second cutting guide is usable to remove a greater amount of the bone of the patient relative to the first cutting guide when the customized patient-specific cutting block is secured to the bone of the patient.

3. The orthopaedic instrument of claim 1, wherein:

the body of the customized patient-specific cutting block further comprises a third cutting guide,

the third cutting guide is parallel to the first cutting guide and spaced apart from the first cutting guide by the predetermined distance, and

the first cutting guide is positioned between the second cutting guide and the third cutting guide.

4. The orthopaedic instrument of claim 3, wherein:

the second cutting guide is usable to remove a greater amount of the bone of the patient relative to the first cutting guide when the customized patient-specific cutting block is secured to the bone of the patient, and

the third cutting guide is usable to remove a lesser amount of the bone of the patient relative to the first cutting guide when the customized patient-specific cutting block is secured to the bone of the patient.

5. The orthopaedic instrument of claim 1, wherein:

the body of the customized patient-specific cutting block further comprises at least one guide pin hole defined therein, and

the at least one guide pin hole extends from the outer surface to the bone-facing surface.

6. The orthopaedic instrument of claim 1, wherein the customized patient-specific cutting block comprises a customized patient-specific femoral cutting block.

7. The orthopaedic instrument of claim 1, wherein the customized patient-specific cutting block comprises a customized patient-specific tibial cutting block.

8. The orthopaedic instrument of claim 1, further comprising a breakaway tab covering the second cutting guide.

9. The orthopaedic instrument of claim 8, wherein the breakaway tab is transparent.

10. The orthopaedic instrument of claim 1, wherein (i) the body of the customized patient-specific cutting block further comprises a third cutting guide, (ii) the third cutting guide is parallel to the first cutting guide and spaced apart from the first cutting guide by the predetermined distance, and (iii) the first cutting guide is positioned between the second cutting guide and the third cutting guide, further comprising:

a first transparent breakaway tab covering the second cutting guide, and

a second transparent breakaway tab covering the third cutting guide.

11. A customized patient-specific orthopaedic instrument, comprising:

a customized patient-specific cutting block having a body that comprises (i) a bone-facing surface having a customized patient-specific negative contour configured to receive a portion of a bone of a patient that has a corresponding contour, (ii) an outer surface opposite the bone-facing surface, and (iii) an aperture extending through the body, and

a plurality of insert blocks each of which is configured to be received into the aperture of the customized patient-specific cutting block, wherein each of the plurality of insert blocks has a cutting guide defined therein.

12. The customized patient-specific orthopaedic instrument of claim 11, wherein:

a first insert block of the plurality of insert blocks includes a first cutting guide corresponding to a predetermined customized patient-specific cutting plane when the first insert block is positioned in the aperture of the customized patient-specific cutting block, and

a second insert block of the plurality of insert blocks includes a second cutting guide that, when the second insert block is positioned in the aperture of the customized patient-specific cutting block, is (i) arranged in a parallel relationship relative to the orientation in which the first cutting guide is arranged when the first insert block is positioned in the aperture of the customized patient-specific cutting block, and (ii) positioned in a position that is spaced apart by a first predetermined distance from the position in which the first cutting guide is positioned when the first insert block is positioned in the aperture of the customized patient-specific cutting block.

13. The customized patient-specific orthopaedic instrument of claim 12, wherein:

a third insert block of the plurality of insert blocks includes a third cutting guide that, when the third insert block is positioned in the aperture of the customized patient-specific cutting block, is (i) arranged in a parallel relationship relative to the orientation in which the first cutting guide is arranged when the first insert block is positioned in the aperture of the customized patient-specific cutting block, and (ii) positioned in a position that is spaced apart by a second predetermined distance from the position in which the first cutting guide is positioned when the first insert block is positioned in the aperture of the customized patient-specific cutting block, the second predetermined distance being greater than the first predetermined distance.

14. The customized patient-specific orthopaedic instrument of claim 12, wherein the second cutting guide is usable to remove a greater amount of the bone of the patient relative to the first cutting guide.

15. The customized patient-specific orthopaedic instrument of claim 11, wherein:

a first insert block of the plurality of insert blocks is rectangular in shape and includes a first cutting guide which extends through the center of the first insert block in the direction of the long axis of the first insert block, and

a second insert block of the plurality of insert blocks is rectangular in shape and includes a second cutting guide which extends in the direction of the long axis of the second insert block at a positioned that is spaced apart from the center of the second insert block.

16. The customized patient-specific orthopaedic instrument of claim 11, wherein:

the body of the customized patient-specific cutting block further comprises at least one guide pin hole defined therein, and

the at least one guide pin hole extends from the outer surface to the bone-facing surface.

17. The customized patient-specific orthopaedic instrument of claim 11, wherein the customized patient-specific cutting block comprises a customized patient-specific femoral cutting block.

18. The customized patient-specific orthopaedic instrument of claim 11, wherein the customized patient-specific cutting block comprises a customized patient-specific tibial cutting block.

19. The customized patient-specific orthopaedic instrument of claim 11, wherein a first block of the plurality of insert blocks includes a first cutting guide, the first block being positionable in the aperture in a first orientation and a second orientation, the first cutting guide being offset from a longitudinal axis of the first block such the first cutting guide defines a first cutting plane when in the first orientation and a second cutting plane within the second orientation, wherein the first cutting guide is usable by a surgeon when in the first orientation to remove a greater amount of the bone of the patient relative to the first cutting guide when in the second orientation.

20. A customized patient-specific orthopaedic instrument, comprising:

a customized patient-specific cutting block having a body that comprises (i) a bone-facing surface having a customized patient-specific negative contour configured to receive a portion of a bone of a patient that has a corresponding positive contour, (ii) an outer surface opposite the bone-facing surface, (iii) an aperture extending through the body, and (iv) an adjustable cutting guide positioned in the aperture, the adjustable cutting guide corresponding to a cutting plane of the bone of the patient and being movable within the aperture to modify the position of the cutting plane.

21. The customized patient-specific orthopaedic instrument of claim 20, wherein the body includes a thumbwheel coupled to the adjustable cutting guide, the thumbwheel being operable to move the adjustable cutting guide.