HIP RESURFACING SURGICAL GUIDE TOOL

• US 20090222015A1
• Filed: 02/23/2009
• Published: 09/03/2009
• Est. Priority Date: 02/29/2008
• Status: Active Grant

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Otismed Corporation (Stryker Corporation)
• Inventors: Park, Ilwhan, Deveza, Lorenzo R., Koehle, Michael
• Granted Patent: US 8,734,455 B2
• Time in Patent Office: Days
• US Class Current: 606/89
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion
• 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 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61F 2/3603 implanted without ablation of the whole natural femoral head endoprosthetic cartilage A61F2/30756
• CPC Class Codes: A61F 2/3609 Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts A61F2/3601 takes precedence
• 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 2002/505 using CAD-CAM techniques or NC-techniques
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing
• CPC Class Codes: G05B 19/41885 characterised by modeling, simulation of the manufacturing system
• CPC Class Codes: Y02P 90/02 Total factory control, e.g. smart factories, flexible manufacturing systems [FMS] or integrated manufacturing systems [IMS]

Abstract

Disclosed herein is a tool for guiding a drill hole along a central axis of a femur head and neck for preparation of a femur head that is the subject of a hip resurfacing surgery. In one embodiment, the tool includes a mating region and a guide hole. The mating region is configured to matingly receive a predetermined surface of the femur. The mating region and guide hole are positionally correlated or referenced with each other such that when the mating region matingly receives the predetermined surface of the femur, the guide hole will be generally coaxial with a central axis extending through the femur head and the femur neck.

Claims

1. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through a centroid of the head and a centroid of the neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region.

2. The tool of claim 1, wherein the surface region includes a region that may be accessed via a posterior approach.

3. The tool of claim 1, wherein the surface region includes a region that may be accessed via an anterior-lateral approach.

4. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through centers of the head and neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region, the surface region including at least a portion of a superior-posterior region of the neck, the at least a portion of a superior-posterior region of the neck starting between approximately 1 mm and approximately 5 mm after a cartilage covering the head terminates distally and extending between approximately 15 mm and approximately 35 mm to a trochanteric fossa.

5. The tool of claim 4, wherein the at least a portion of a superior-posterior region of the neck has an inferior border that begins approximately midway along an intertrochanteric crest and follows along the axis of the neck.

6. The tool of claim 5, wherein the at least a portion of a superior-posterior region of the neck has a superior border between approximately 1 mm and approximately 3 mm below a junction between superior and anterior surfaces of the neck.

7. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through centers of the head and neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region, the surface region including at least a portion of a superior-posterior region of the neck, the at least a portion of a superior-posterior region of the neck including a narrow band that follows along an intertrochanteric crest and has a medial-lateral width of between approximately 0.5 mm and approximately 8 mm.

8. The tool of claim 7, wherein the at least a portion of a superior-posterior region of the neck begins approximately midway along the intertrochanteric crest and extends at least approximately 5 mm towards a most superior tip of a posterior surface of a greater trochanter.

9. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through centers of the head and neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region, the surface region including at least a portion of a superior-anterior region of the neck, the at least a portion of a superior-anterior region of the neck starting between approximately 1 mm and approximately 5 mm after a cartilage covering the head terminates distally and extending between approximately 15 mm and approximately 35 mm to terminate before a tubercle.

10. The tool of claim 9, wherein the at least a portion of a superior-anterior region of the neck has a superior border approximately 1 mm to approximately 3 mm below a junction between superior and anterior surfaces of the neck.

11. The tool of claim 10, wherein the at least a portion of a superior-anterior region of the neck has an inferior border that is between approximately 5 mm and approximately 10 mm from the superior boarder.

12. The tool of claim 9, wherein the at least a portion of a superior-anterior region of the neck lies on an anterior greater trochanter, distal to a tubercle, and inferior to an origin of an obturator internus.

13. The tool of claim 12, wherein the at least a portion of a superior-anterior region has a medial-lateral distance that measures between approximately 3 mm to approximately 14 mm.

14. The tool of claim 12, wherein the at least a portion of a superior-anterior region has an inferior-superior distance that measures between approximately 3 mm to approximately 10 mm.

15. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through centers of the head and neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region, the surface region including at least a portion of a superior-posterior region of the neck and at least a portion of a superior-anterior region of the neck, but does not include a junction between the superior-posterior and superior-anterior regions of the neck.

16. The tool of claim 15, wherein the at least a portion of the superior-posterior region of the neck includes an area that extends along the intertrochanteric chest, but does not include an area that spans portions of a trochanteric fossa.

17. The tool of claim 16, wherein the at least a portion of a superior-anterior region of the neck lies on an anterior greater trochanter, distal to a tubercle, and inferior to an origin of an obturator internus, but does not include portions of the tubercle.

18. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through centers of the head and neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region, the surface region including at least a portion of a posterior region of the neck, the at least a portion of the posterior region of the neck including an area that extends towards a trochanteric fossa between approximately 15 mm and approximately 35 mm from a first point being between approximately 1 mm and approximately 5 mm distal of a distal termination of a cartilage covering the head.

19. The tool of claim 18, wherein the at least a portion of a posterior region of the neck has an inferior border that terminates up to approximately 5 mm superior to a border between posterior and inferior surfaces of the neck.

20. The tool of claim 18, wherein the at least a portion of a posterior region of the neck has a superior border that terminates approximately 0 mm to approximately 5 mm posterior of a border between posterior and anterior surfaces of the neck.

21. The tool of claim 18, wherein the at least a portion of a posterior region of the neck extends along an intertrochanteric crest from a lesser trochanter to a point near a tip of a greater trochanter.

22. The tool of claim 21, wherein the at least a portion of a posterior region of the neck does not include at least one of a portion of the trochanteric fossa and a portion of posterior region of the greater trochanter.

23. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through centers of the head and neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region, the surface region including at least a portion of a posterior region of the neck, the at least a portion of the posterior region of the neck including an area that includes a narrow band measuring between approximately 0.5 mm and approximately 12 mm and following along an intertrochanteric crest.

24. The tool of claim 23, wherein the narrow band begins approximately 0 mm to approximately 12 mm superior to a lesser trochanter.

25. The tool of claim 24, wherein the narrow band extends approximately 0 mm to approximately 18 mm inferior to a most superior tip of a posterior surface of a greater trochanter.

26. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through centers of the head and neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region, the surface region including at least a portion of a posterior region of the neck, the at least a portion of the posterior region of the neck including an area that extends towards a trochanteric fossa from a first point being between approximately 1 mm and approximately 5 mm distal of a distal termination of a cartilage covering the head, but does not include an area spanning portions of the trochanteric fossa.

27. The tool of claim 26, wherein the area spanning portions of the trochanteric fossa has a width generally transverse to a femoral longitudinal axis of between approximately 0 mm and approximately 20 mm.

28. The tool of claim 26, wherein the at least a portion of the posterior region of the neck further includes an area that includes a band following along an intertrochanteric crest, but does not include portions of a posterior greater trochanter.

29. The tool of claim 28, wherein the portions of the posterior greater trochanter has a distally extending dimension of between approximately 0 mm and approximately 12 mm.

30. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through centers of the head and neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region, the surface region including at least a portion of an anterior region of the neck, the at least a portion of an anterior region of the neck extending up to approximately 8 mm laterally past an intertrochanteric line.

31. The tool of claim 30, wherein the surface region includes a medial surface of a greater trochanter.

32. A surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, a surface region distal the head, and a bone axis extending through centers of the head and neck, the tool comprising:

a body including a guide hole and a mating region configured to matingly contact the surface region, the guide hole including a hole axis, the guide hole and mating region being positioned relative to each other so the hole axis is generally coaxially aligned with the bone axis when the mating region matingly contacts the surface region, the surface region including at least a portion of a lateral posterior greater trochanter.

33. The tool of claim 32, wherein the surface region further includes at least a portion of a medial posterior greater trochanter.

34. The tool of claim 33, wherein the surface region does not include at least a portion of an intertrochanteric crest.

35. The tool of claim 32, wherein the surface region further includes at least a portion of a posterior region of the neck.

36. The tool of claim 35, wherein the surface region does not include at least a portion of an trochanteric fossa.

37. The tool of claim 33, wherein the surface region further includes at least a portion of a medial posterior greater trochanter and at least a portion of a posterior region of the neck, and wherein the surface region does not include at least a portion of an intertrochanteric crest and does not include at least a portion of an trochanteric fossa.

38. A method of manufacturing a surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, and a surface region distal the head, the method comprising:

a) generating medical imaging data associated with the proximal portion of the femur;

b) employing the imaging data to generate a three-dimensional computer-generated femur model of the proximal portion of the femur;

c) identifying a bone axis generally extending through a centroid of a head and a centroid of a neck of the femur model;

d) providing a three-dimensional computer-generated tool model of at least portions of at least a surgical guide tool and a surgical guide tool blank;

e) positionally referencing the bone axis with surface data associated with a surface of the femur model;

f) merging the tool model and the positionally referenced bone axis and surface data so the bone axis and a hole axis associated with a guide hole of the tool model are generally coaxially aligned;

g) computer generating manufacturing instructions from data determined from step f; and

h) employing the manufacturing instructions at a manufacturing machine to generate the surgical guide tool from a surgical guide tool blank.

39. The method of claim 38, wherein the medical imaging data is generated via at least one of MRI and CT.

40. The method of claim 38, wherein the manufacturing machine is at least one of a CNC machine and a SLA.

41. The method of claim 38, further comprising subjecting the medical imaging data to a segmentation process that determines bone contour lines and then adjusting the bone contour lines outward in locations of the bone contour lines corresponding to regions of the proximal portion of the femur that have surface topography that rapidly varies.

42. The method of claim 41, further comprising employing the adjusted bone contour lines to generate the three-dimensional computer-generated femur model of the proximal portion of the femur.

43. The method of claim 38, wherein the regions of the proximal portion of the femur that have surface topography that rapidly varies includes at least one of a portion of a tubercle and a portion of a superior intersection between anterior and posterior regions of the neck.

44. The method of claim 38, wherein the regions of the proximal portion of the femur that have surface topography that rapidly varies includes at least one of a portion of a trochanteric fossa and a portion of a superior intersection between anterior and posterior regions of the neck.

45. The method of claim 38, wherein the regions of the proximal portion of the femur that have surface topography that rapidly varies includes at least one of a portion of a trochanteric fossa and a portion of a posterior greater trochanter near an intertrochanteric crest.

46. The method of claim 38, wherein the regions of the proximal portion of the femur that have surface topography that rapidly varies includes at least one of a portion of a trochanteric fossa and a portion of an intertrochanteric crest.

47. A method of manufacturing a surgical guide tool for use in hip resurfacing surgery on a proximal portion of a femur having a head, a neck extending distally from the head, and a surface region distal the head, the method comprising:

a) generating medical imaging data associated with the proximal portion of the femur;

b) employing the imaging data to generate a three-dimensional computer-generated femur model of the proximal portion of the femur;

c) providing a three-dimensional computer-generated pin model including a longitudinal axis;

d) superimposing the pin model and femur model;

e) identifying a bone axis extending through a head and a neck of the femur model as being an axis that is generally coaxial with the longitudinal axis of the pin model;

f) providing a three-dimensional computer-generated tool model of at least portions of at least a surgical guide tool and a surgical guide tool blank;

g) positionally referencing the bone axis with surface data associated with a surface of the femur model;

h) merging the tool model and the positionally referenced bone axis and surface data so the bone axis and a hole axis associated with a guide hole of the tool model are generally coaxially aligned;

i) computer generating manufacturing instructions from data determined from step h; and

j) employing the manufacturing instructions at a manufacturing machine to generate the surgical guide tool from a surgical guide tool blank.

48. The method of claim 47, wherein the medical imaging data is generated via at least one of MRI and CT.

49. The method of claim 47, wherein the manufacturing machine is at least one of a CNC machine and a SLA.

50. The method of claim 47, wherein the pin model further includes a sphere centered on the longitudinal axis and, when the pin model and femur model are superimposed, at least a portion of a surface of the sphere coincides with at least a portion of a surface of the head of the femur model.

51. The method of claim 50, wherein the at least a portion of a surface of the head of the femur model includes at least one of an inferior portion and a posterior portion.

52. The method of claim 47, wherein the pin model further includes at least one of a first feature and a second feature, the first feature corresponding to an outer diameter of a resurfacing prosthetic implant, the second feature corresponding to an inner diameter of the resurfacing prosthetic implant.

53. The method of claim 52, wherein the pin model further includes a cylinder and wherein the first feature is an outer diameter of the sphere and the second feature is a diameter of the cylinder.

54. The method of claim 47, wherein the pin model further includes a cylinder generally coaxially centered on the longitudinal axis and further comprising at least one of translating the pin model and increasing the size of the pin model if a portion of the neck radially extends through a wall of the cylinder.

55. The method of claim 47, further comprising segmenting the imaging data via sections oriented at an angle with a central axis of the neck as viewed posteriorly of between approximately thirty degrees an approximately sixty degrees.

56. The method of claim 47, wherein the pin model and femur model are initially superimposed such that the longitudinal axis of the pin model extends through both a centroid of a transverse cross-section of the neck and a centroid of a transverse cross-section of the head.