Bone Resurfacing System and Method

• US 20090216285A1
• Filed: 03/03/2009
• Published: 08/27/2009
• Est. Priority Date: 05/01/2000
• Status: Active Grant

• Current Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Original Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Inventors: Sikora, George, Ek, Steven W.
• Granted Patent: US 7,896,883 B2
• Time in Patent Office: Days
• US Class Current: 606/86.R
• CPC Class Codes: A61B 17/1635 for grafts, harvesting or transplants
• CPC Class Codes: A61B 17/1742 for the hip
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/1775 for the foot or ankle
• CPC Class Codes: A61B 17/1778 for the shoulder
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/461 of knees
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2/4684 Trial or dummy prostheses
• CPC Class Codes: A61F 2002/30112 Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2002/30607 Kits of prosthetic parts to be assembled in various combinations for forming different prostheses
• CPC Class Codes: A61F 2002/3085 with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30878 with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/3895 unicompartimental
• CPC Class Codes: A61F 2002/4658 for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4663 for measuring volumes or other three-dimensional shapes
• CPC Class Codes: A61F 2002/4685 by means of vacuum
• CPC Class Codes: A61F 2230/0004 Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2250/0062 Kits of prosthetic parts to be assembled in various combinations for forming different prostheses

Abstract

The present disclosure relates to bone resurfacing. One embodiment includes a method for preparing an implant site in bone, comprising establishing a first working axis extending from said bone; establishing a second working axis extending from said bone, the second working axis is displaced from the first working axis; creating a first socket in the bone by reaming about the first working axis; and creating a second socket in the bone, adjacent the first socket, by reaming about the second working axis.

Claims

1. A method for preparing an implant site in bone, comprising:

establishing a first working axis extending from said bone;

establishing a second working axis extending from said bone, said second working axis is displaced from said first working axis;

creating a first socket in said bone by reaming about said first working axis; and

creating a second socket in said bone, adjacent said first socket, by reaming about said second working axis.

2. The method of claim 1, wherein said first and second working axes are established, in part, by advancing first and second guide pins into said bone, said guide pins extending from said bone.

3. The method of claim 1, wherein said first and second working axes are established by placing a guide block onto the surface of the bone such that at least two opposing points of the guide blocks contact said bone, said guide block having first and second bores therein defining the location of said first and second working axes with respect to said bone.

4. The method of claim 1, further comprising:

establishing a third working axis extending from said bone, said third working axis is displaced from said first and second working axes; and

creating a third socket in said bone, adjacent said first and second sockets, by reaming about said third working axis.

5. The method of claim 1, further comprising:

advancing a centering shaft into and extending from said bone along said first working axis;

measuring a plurality of points from a fixed position along said centering shaft to said bone, said plurality of point indicative of the curvature of said bone in at least one plane; and

selecting, based on said plurality of points, an implant having a bone-facing surface and a load-bearing surface that substantially matches said curvature of said bone.

6. The method of claim 5, further comprising:

selecting a guide block having a curvature based on said plurality of points;

advancing said guide block to said bone about said first working axis, said guide block comprising at least two opposing points configured to contact said bone at different locations and first and second bores therein defining the location of said first and second working axes with respect to said bone.

7. The method of claim 5, further comprising:

advancing a sizing trial implant into, at least in part, said first and second sockets, said sizing trial implant having a curvature of at least one surface thereof based on said plurality of points; and

confirming that said sizing trial implant fits within said first and second sockets.

8. The method of claim 5, further comprising:

applying bone adhesive to said implant; and

installing said implant, at least in part, into said first and second sockets in the bone.

9. The method of claim 1, further comprising:

advancing a cannulated drill guide to contact said bone, said canulated drill guide comprising a cannulated handle and a first arcuate tip section removably coupled to a distal end of said cannulated handle, said first arcuate tip section comprising first and second bone contacting points and a bore aligned with a lumen of said cannulated handle, wherein said first working axis is defined extending from said bone through said bore and said lumen; and

installing a first guide pin into said bone through said lumen and said bore and along said first working axis.

10. The method of claim 9, further comprising:

advancing a cannulated bone centering shaft over said first guide pin, said bone centering shaft comprising a cannulated tap portion and a cannulated shaft, a shoulder portion between said tap portion and said shaft, and at least one visual marker on said cannulated shaft;

driving said tap portion into said bone to a predetermined depth;

advancing a cannulated contact probe over said centering shaft, said contact probe comprising an outrigger extending radially from a cannulated shaft, said outrigger comprising a contact point, and a handle comprising visual measuring indicia configured to align with said visual marker, wherein said visual measuring indicia and said visual marker configured to visually display a depth of said contact point when said contact point is advanced to contact said bone;

determining a plurality of depth measurements in at least one plane and determining a curvature based on at least one said depth measurement; and

advancing a first reamer over said centering shaft and rotating said reamer about said centering shaft to create said first socket in said bone.

11. The method of claim 9, further comprising:

removably coupling a guide block onto said distal end of said cannulated handle, said guide block comprising a body portion having a curvature based on at least one said depth measurement, first and second bone contacting points, a first bore aligned with a lumen of said cannulated handle, and a second bore spaced apart from said first bore, said second bore defining said second working axis;

advancing said guide block and cannulated handle over said first guide pin; and

installing a second guide pin into said bone through said second bore and along said second working axis.

12. The method of claim 11, further comprising:

removably coupling a cannulated bushing into said second bore prior to installing said second guide pin.

13. The method of claim 11, further comprising:

advancing a second reamer over said second guide pin and rotating said reamer about said second guide pin to create said second socket in said bone.

14. The method of claim 11, further comprising:

advancing a cannulated tap over said first guide pin and into said bone to tap area of bone surrounding said first guide pin;

advancing a tapered post over said first guide pin into the tapped area of bone to secure said tapered post into said bone.

15. The method of claim 14, further comprising:

selecting an implant comprising a load-bearing surface that substantially matches said curvature of said bone and having a curvature based on at least one said depth measurement, said implant is dimensioned to fit within, at least, said first and second sockets, said implant also comprising a bone-facing surface comprising a recess configured to mate with the taper of said tapered post;

installing said implant into said first and second sockets by mating said recess with said tapered post.

16. The method of claim 15, further comprising:

applying adhesive to said bone-facing surface prior to said installing said implant.