Trochlear Resurfacing System and Method

• US 20100191245A1
• Filed: 02/25/2010
• Published: 07/29/2010
• Est. Priority Date: 02/24/2003
• 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 8,388,624 B2
• Time in Patent Office: Days
• US Class Current: 606/88
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• 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 2002/4631 the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4658 for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4662 for measuring penetration depth
• 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 2002/4687 Mechanical guides for implantation instruments
• 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
• CPC Class Codes: A61F 2250/0097 : Visible markings, e.g. indicia

Abstract

A system for repairing a defect on an articular surface of a patient'"'"'s trochlear region, the system comprising a guide block comprising a body having an exterior surface configured to engage with the saddle portion and ridge portions of the patient'"'"'s trochlear region, a protrusion extending generally from the body and configured to be received in a first bore formed in the articular surface along a reference axis, and a first cavity extending through the body configured to establish a first working axis displaced from the reference axis, wherein the exterior surface of the body and the protrusion are configured to secure the location of the guide block about the patient'"'"'s trochlear region. A method for preparing an implant site in bone, comprising: establishing a reference axis extending from the bone; creating a bore in the bone by reaming about the reference axis; securing a guide block about the articular surface; establishing a first working axis extending from the bone using the guide block, the first working axis is displaced from the reference axis; and creating a first socket in the bone by reaming about the first working axis, wherein the first socket partially overlaps with the bore.

Claims

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

establishing a reference axis extending from said bone;

creating a bore in said bone by reaming about said reference axis;

securing a guide block about said articular surface;

establishing a first working axis extending from said bone using said guide block, said first working axis is displaced from said reference axis; and

creating a first socket in said bone by reaming about said first working axis, wherein said first socket partially overlaps with said bore.

2. The method of claim 1, wherein said guide block comprises a body including a base portion and sidewall portions having a generally arcuate shaped exterior surface generally configured to engage with the saddle portion and ridge portions of a patient'"'"'s trochlear region, respectively.

3. The method of claim 2, wherein securing said guide block further comprises advancing a protrusion extending generally from a body of said guide into said bore.

4. The method of claim 2, wherein securing said guide block further comprises advancing at least one pin through a passageway in said body and into bone proximate to said trochlear region.

5. The method of claim 2, further comprising:

establishing a second working axis extending from said bone using said guide block, said first working axis is displaced from said reference axis; and

creating a second socket in said bone by reaming about said first working axis, wherein said second socket partially overlaps with said bore and wherein said first and second sockets and said bore are generally aligned along an inferior-superior plane of said articular surface.

6. The method of claim 2, further comprising:

advancing a reamer through a cavity extending through said body of said guide block after said guide block is secured to said articular surface;

inserting a guide bushing into said cavity subsequent to advancing said reamer, said guide block comprising a first excision passageway configured to receive a shaft of said reamer along said first working axis, wherein a said radial cutter of said reamer is disposed adjacent to said articular surface; and

rotating said reamer within said first excision passageway and advancing said radial cutter into said articular surface to form create said first socket.

7. A system for repairing a defect on an articular surface of a patient'"'"'s trochlear region, said system comprising:

a guide block comprising;

a body having an exterior surface configured to engage with the saddle portion and ridge portions of said patient'"'"'s trochlear region;

a protrusion extending generally from said body and configured to be received in a first bore formed in said articular surface along a reference axis; and

a first cavity extending through said body configured to establish a first working axis displaced from said reference axis;

wherein said exterior surface of said body and said protrusion are configured to secure the location of said guide block about said patient'"'"'s trochlear region.

8. The system of claim 7, wherein said body includes a base portion and sidewall portions having a generally arcuate shaped exterior surface generally configured to engage with the saddle portion and ridge portions of said patient'"'"'s trochlear region, respectively.

9. The system of claim 8, further comprising a pin and a first passageway extending through said body configured to receive said first pin, wherein said first pin is configured to engage bone proximate to said trochlear region, and wherein said exterior surface of said body, said protrusion, and said first pin extending through said first passageway are configured to secure the location of said guide block about said patient'"'"'s trochlear region.

10. The system of claim 9, further comprising a second pin and a second passageway extending through said body configured to receive said second pin, wherein said second pin is configured to engage bone proximate to said trochlear region, and wherein said exterior surface of said body, said protrusion, and said first and said second pins extending through said first and second passageways are configured to secure the location of said guide block about said patient'"'"'s trochlear region.

11. The system of claim 7, wherein said protrusion is configured to be received in said first bore in a generally interference-type fit.

12. The system of claim 7, further comprising a first guide bushing configured to be removably received in said first cavity, said first guide bushing defining a first excision passageway generally aligned with said first working axis.

13. The system of claim 12, wherein said first guide bushing is configured to threadably engage said first cavity.

14. The system of claim 12, further comprising an excision device, said excision device comprising:

a shaft; and

a radial cutter comprising a cutting surface disposed about a distal end of said shaft.

15. The system of claim 14, wherein said first excision passageway is configured to receive said shaft of said excision device for forming a second bore in said articular surface partially overlapping with said first bore, wherein said second bore is centered around said second working axis.

16. The system of claim 15, wherein said guide bushing is configured to be received in said first cavity such that said shaft of said reamer extends through said first excision passageway and said radial cutter is disposed adjacent to said articular surface.

17. The system of claim 16, wherein said first cavity is configured allow said radial cutter to pass through to said articular surface in a direction along said second working axis.

18. The system of claim 16, further comprising indicia on said shaft configured to be aligned with said first excision passageway to define a depth of said second bore.

19. The system of claim 7, further comprising a second cavity extending through said body configured to establish a second working axis displaced from said reference axis, wherein said second working axis is configured to define a center point of a third bore in said articular surface partially overlapping with said first bore.

20. The system of claim 19, wherein said first and second cavities and said protrusion are configured to be generally aligned along an inferior-superior plane of said articular surface.

21. The system of claim 7, further comprising a drill guide configured to establish said reference axis substantially perpendicular to said articular surface.

22. The system of claim 21, wherein said drill guide comprises:

a cannulated shaft; and

a proximal end comprising a first and second groove contacting tip configured to contact said articular surface in saddle the saddle portion of said trochlear region along the inferior-superior plane and a first and second tip configured to contact said articular surface generally along the inferior-superior plane.

23. The system of claim 22, wherein said first and said second groove contacting tips are fixedly coupled to the cannulated shaft and wherein said first and said second ridge contacting tips are moveable with respect to said cannulated shaft and are biased towards to an extended position.

24. The system of claim 22, further comprising a reference pin configured to be received through said cannulated shaft and secured into bone beneath said articular surface generally along said reference axis.

25. The system of claim 24, further comprising an excision device, said excision device comprising a cannulated shaft and a radial cutter comprising a cutting surface disposed about a distal end of said shaft, wherein said excision device is configured to be received over said reference pin to form said first bore, said first bore being centered around said reference axis.