Customized Patient-Specific Bone Cutting Instrumentation

• US 20090088760A1
• 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: Sheaks-Hoffman, Janell, Aram, Luke J., Lester, Mark B.
• Granted Patent: US 8,419,740 B2
• Time in Patent Office: Days
• US Class Current: 606/87
• 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. An orthopaedic instrument assembly, comprising:

a customized patient-specific femoral cutting block having (i) a customized patient-specific negative contour surface that is configured to receive a portion of a distal femur of a patient that has a corresponding contour, and (ii) a cutting guide,

a customized patient-specific tibial cutting block having (i) a customized patient-specific negative contour surface that is configured to receive a portion of a proximal tibia of a patient that has a corresponding contour, and (ii) a cutting guide, and

a mechanical linkage positioned between the customized patient-specific femoral cutting block and the customized patient-specific tibial cutting block, wherein the mechanical linkage is operable to move the customized patient-specific femoral cutting block and the customized patient-specific tibial cutting block away from and toward one another.

2. The orthopaedic instrument assembly of claim 1, wherein:

the mechanical linkage comprises a number of threaded shafts,

rotation of the threaded shafts in a first direction causes the customized patient-specific femoral cutting block and the customized patient-specific tibial cutting block to be moved away from one another, and

rotation of the threaded shafts in a second, opposite direction causes the customized patient-specific femoral cutting block and the customized patient-specific tibial cutting block to be moved toward one another.

3. The orthopaedic instrument assembly of claim 2, wherein:

the mechanical linkage comprises a number of thumbscrews coupled to the number of threaded shafts,

rotation of the thumbscrews in the first direction cause rotation of the threaded shafts in the first direction, and

rotation of the thumbscrews in the second direction cause rotation of the threaded shafts in the second direction.

4. The orthopaedic instrument assembly of claim 1, wherein:

the mechanical linkage comprises a number of thumbscrews,

rotation of the thumbscrews in a first direction causes the customized patient-specific femoral cutting block and the customized patient-specific tibial cutting block to be moved away from one another, and

rotation of the thumbscrews in a second, opposite direction causes the customized patient-specific femoral cutting block and the customized patient-specific tibial cutting block to be moved toward one another.

5. The orthopaedic instrument assembly of claim 1, wherein both the customized patient-specific femoral cutting block and the customized patient-specific tibial cutting block have a number of guide pin holes defined therein.

6. The orthopaedic instrument assembly of claim 1, wherein the cutting guide of the customized patient-specific femoral cutting block is substantially parallel to the cutting guide of the customized patient-specific tibial cutting block.

7. An orthopaedic instrument assembly, comprising:

a customized patient-specific femoral cutting block having (i) a customized patient-specific negative contour surface that is configured to receive a portion of a distal femur of a patient that has a corresponding contour, and (ii) a cutting guide, and

a ligament balancer secured to the femoral cutting block, wherein the ligament balancer has (i) a tibial base plate, and (ii) a pair of femoral paddles each of which is movable relative to the tibial base plate.

8. The orthopaedic instrument assembly of claim 7, further comprising a bracket having a first end secured to the femoral cutting block and a second end secured to the ligament balancer.

9. The orthopaedic instrument assembly of claim 8, wherein the second end of the bracket is secured to the tibial base plate of the ligament balancer.

10. The orthopaedic instrument assembly of claim 8, wherein the first end of the bracket has a pair of guide pin holes defined therein.

11. The orthopaedic instrument assembly of claim 7, wherein the customized patient-specific femoral cutting block comprises (i) a customized patient-specific anterior bone-facing surface configured to receive a portion of an anterior side of a femur of a patient, and (ii) a customized patient-specific distal bone-facing surface configured to receive a portion of a distal side of the femur of the patient.

12. The orthopaedic instrument assembly of claim 7, wherein:

the ligament balancer has a pair of cylinders secured to the tibial base plate, and each of the pair of femoral paddles is received into a respective one of the pair of cylinders.

13. The orthopaedic instrument assembly of claim 7, further comprising a bracket having a first end secured to the femoral cutting block and a second end secured to the ligament balancer, wherein the bracket has a receiver defined therein, the receiver being configured to receive an intramedullary rod.

14. A method of performing an orthopaedic surgical procedure on a patient, comprising:

securing a customized patient-specific femoral cutting block to the femur of the patient,

securing a ligament balancer to the tibia of the patient,

securing the ligament balancer to the customized patient-specific femoral cutting block,

operating the ligament balancer to position the femur of the patient in a desired position relative to the tibia, and

making a cut in the femur of the patient with the customized patient-specific cutting block.

15. The method of claim 14, wherein securing the customized patient-specific femoral cutting block comprises:

positioning the customized patient-specific femoral cutting block in contact with the femur of the patient, and

inserting at least one guide pin into at least one guide pin hole defined in the customized patient-specific femoral cutting block so as to secure the customized patient-specific femoral cutting block to the femur of the patient.

16. The method of claim 15, wherein:

the ligament balancer has a first end of a bracket secured thereto,

a second end of the bracket has at least one guide pin hole defined therein, and

securing the ligament balancer to the customized patient-specific femoral cutting block comprises advancing the at least one guide pin into the at least one guide pin hole of the bracket so as to secure the second end of the bracket to the customized patient-specific femoral cutting block.

17. The method of claim 14, wherein:

the ligament balancer has a first end of a bracket secured thereto, and

securing the ligament balancer to the customized patient-specific femoral cutting block comprises securing a second end of the bracket to the customized patient-specific femoral cutting block.

18. The method of claim 14, wherein securing the ligament balancer to the customized patient-specific femoral cutting block comprises independently moving each of a pair of femoral paddles of the ligament balancer.