TIBIAL PLATEAU AND/OR FEMORAL CONDYLE RESECTION SYSTEM FOR PROSTHESIS IMPLANTATION

• US 20090228016A1
• Filed: 03/07/2008
• Published: 09/10/2009
• Est. Priority Date: 03/07/2008
• Status: Active Grant

• Current Assignee: Traiber, S.L.
• Original Assignee: Traiber, S.L.
• Inventors: Alvarez, Luis Marquez
• Granted Patent: US 8,273,090 B2
• Time in Patent Office: Days
• US Class Current: 606/88
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• 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 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 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 2/461 of knees

Abstract

According to the invention, the system enables a preoperative study to be carried out wherein the tibia and/or femur is modelled on a computer (6) in 3D, the ideal cutting plane is defined and the position of the resection instruments (1, 2, 3) used to cut the bone is modelled. Additionally, according to the invention, the system enables redefinition of the ideal cutting plane and the positioning and orientation of the resection instruments (1, 2, 3) on the tibia and/or femur, in such a manner that the plane of the slot (4) of the cutting guide (3) through which the cutting tool is introduced coincides with the ideal cutting plane.

Claims

1. Tibial plateau and/or femoral condyle resection system for prosthesis implantation that includes cutting or resectioning instruments (1, 2, 3) comprised of a fixing support (1) that is nailed to the tibia and/or femur, a guide holder (2) that is mounted on the fixing support (1), and a cutting guide (36) with a slot (4) for passage of the cutting tool (36) with which to perform the resection, which in turn is mounted on the guide holder (2), characterized in that it also comprises:

exploration means (5) for tibia and/or femur image capture;

a computer (6) whereto said images are sent and based on which it models the tibia and/or femur in 3D by means of the software that also defines the virtual position of the resection instruments along a cutting plane;

a removable reference plate (7) that is mounted on the fixing support (1) to send, by means of the exploration means (5), images of the position and orientation of the fixing support (1) to the computer (6), in order to redefine the cutting plane and position of the cutting instruments (1, 2, 3); and

a calibration tool (8) wherein the cutting instruments are adjusted.

2. Tibial plateau and/or femoral condyle resection system for prosthesis implantation, according to claim 1, characterized in that the fixing support (1) comprises a nail (5), a cylindrical central section (6) and a quasi-cylindrical upper section (37) that ends in a vertical plane, having a longitudinal bore (8) along its interior.

3. Tibial plateau and/or femoral condyle resection system for prosthesis implantation, according to claim 1, characterized in that the reference plate (7) comprises:

a central body (9) with a cavity (10) having an adaptable configuration to the upper section (37) of the fixing support (1);

an X-ray transparent body (11) that surrounds the central body (9) and radio-opaque spheres (12) integrated within the X-ray transparent body (11); and

a screw (13) that penetrates the cavity (10) and is threaded into the longitudinal bore (8) of the fixing support (1), thereby joining the reference plate (7) with said fixing support (1).

4. Tibial plateau and/or femoral condyle resection system for prosthesis implantation, according to claim 1, characterized in that the guide holder (2) comprises:

a positioning support for the cutting guide (14), wherein a groove (24) is defined for the purpose of receiving the cutting guide (3);

parallel shafts (15) solidly joined to the positioning support of the cutting guide (14), joined in turn by their opposing ends;

a carriage (16) mounted on said parallel shafts (15) and comprised of two plates (17), upper and lower, joined together by means of screws (18), which slide with respect to the shafts (15) and have corresponding central openings (19);

a ball-and-socket joint (20) disposed between the central openings (19) of the plates (17), with respect to which the carriage (16) rotates along a horizontal plane and vertical plane, wherein it encounters a central screw (21) that joins the guide holder (2) to the fixing support (1), having a socket housing (25) underneath, the configuration of which can be coupled to the upper section (7) of the fixing support (1); and

a fixing screw (22) used to hold the plates (17) against the ball-and-socket joint (20) and against one of the shafts (15) in order to fix the relative orientation of the guide holder (2) with respect to the central screw (21).

5. Tibial plateau and/or femoral condyle resection system for prosthesis implantation, according to claim 1, characterized in that the calibration tool (8) comprises:

a coupling shaft (28) having the same shape and size as the upper section (7) of the fixing support (1), whereto the ball-and-socket joint (20) of the guide holder (2) is coupled;

a support (29) disposed at a distance from the coupling shaft (28), onto which the positioning support of the cutting guide (14) is fitted;

a first block (30) whereon the support (29) that is actuated by a first control knob (31) is mounted, thereby enabling its linear displacement with respect to the coupling shaft (28), with the object of adjusting the distance between the positioning support of the cutting guide (14) and the ball-and-socket joint (20);

a second block (32) whereto the coupling shaft (28) of the calibration tool (8) is joined, which is actuated by a second control knob (34), thereby enabling its rotation along the vertical plane in order to adjust the relative tilt, along this vertical plane of the positioning support of the cutting guide (14), with respect to the ball-and-socket joint (20); and

a third block (33), with respect to which the second block (32) rotates, which is actuated by a third control knob (35), thereby enabling its rotation along the horizontal plane in order to adjust the angular position of the positioning support of the cutting guide (14) with respect to the ball-and-socket joint (20).

6. Tibial plateau and/or femoral condyle resection system for prosthesis implantation, according to claim 1, characterized in that the exploration means (5) are selected from amongst devices designed to carry out scanning, magnetic resonance imaging, X-ray and computerized tomography operations, and any other image capture means.

7. Method for modelling the tibia and/or femur and positional configuration of the resection instruments, characterized in that it comprises the following phases:

tibia image capture and generation of a first virtual 3D model of the tibia and/or femur in order to select the ideal cutting plane of the tibial plateau and/or femoral condyles;

determination of the position of the cutting instruments according to the ideal cutting plane, based on the virtual model of the tibia and/or femur;

tibia and/or femur image capture and generation of a second virtual model; and

determination of the differences between the first virtual model and second virtual model, and presentation of error correction data for the positional configuration of the cutting instruments.

8. Method for modelling the tibia and/or femur and positional configuration of the resection instruments, according to claim 7, characterized in that it does not require the use of intra or extramedullary guides.

9. Computer programme that comprises coding means adapted to execute all t h e phases of the method defined in accordance with claim 7, when said programme is run on a computer.