Patient-Specific Joint Arthroplasty Devices for Ligament Repair

• US 20100298894A1
• Filed: 04/16/2010
• Published: 11/25/2010
• Est. Priority Date: 02/06/2006
• Status: Active Grant

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Bojarski, Ray, Lang, Philipp, Steines, Daniel, Fitz, Wolfgang
• Granted Patent: US 8,500,740 B2
• Time in Patent Office: Days
• US Class Current: 606/86.00R
• CPC Class Codes: A61B 17/1714 for applying tendons or ligaments implements for applying tendons or ligaments A61F2/0805
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• 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 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/1121 Determining geometric values, e.g. centre of rotation or angular range of movement
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4523 Tendons
• CPC Class Codes: A61B 5/4533 Ligaments
• CPC Class Codes: A61F 2/08 Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/30942 for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques

Abstract

Disclosed herein are methods, compositions and tools for repairing, replacing or otherwise treating bone ligaments using devices designed from patient-specific information, including without limitation, surgical alignment instruments that have a surface that conforms to at least a portion of a patient'"'"'s bone, cartilage or other component of the joint or ligament being treated.

Claims

1. A method for ligament repair, the method comprising:

obtaining electronic image data of at least one surface associated with a ligament; and

creating a first template based, at least in part, on the image data, the template having at least one contact surface that conforms with at least a portion of the surface, the template including at least one guide for directing movement of a surgical instrument involved with the ligament repair.

2. The method according to claim 1, wherein the ligament is an anterior cruciate ligament.

3. The method according to claim 1, wherein the ligament is a posterior cruciate ligament.

4. The method according to claim 1, further comprising determining a tunnel site for a ligament graft.

5. The method according to claim 4, wherein determining the tunnel site includes identifying an origin of the ligament on a first articular surface, and an insertion position onto a second articular surface opposing the first articular surface.

6. The method according to claim 4, wherein determining the tunnel site includes identifying at least one of a bony landmark and a remainder of a ligament based on the image data.

7. The method according to claim 4, wherein the surface is one of adjacent to the tunnel site and a non-weight bearing surface.

8. The method according to claim 1, wherein the first template includes a drill guide aperture, the method further comprising:

positioning the template such that the at least one contact surface contacts the at least a portion of the surface; and

drilling a ligament tunnel, wherein the drilling is guided by the drill guide aperture.

9. The method according to claim 8, wherein at least one of the shape, position and orientation of the drill guide aperture on the first template is based, at least in part, on a distance of the tunnel to adjacent cortical bone.

10. The method according to claim 9, wherein the drill guide aperture includes a stop, such that a desired drill depth is obtained.

11. The method according to claim 1, wherein the image data is obtained preoperatively.

12. The method according to claim 1, wherein the image data is obtained by at least one of a CT scan and an MRI scan.

13. The method according to claim 1, wherein the image data is obtained in at least one of joint flexion, joint extension, joint abduction, joint adduction, and joint rotation.

14. The method according to claim 1, further comprising:

identifying a graft harvest site based on the image data; and

using the first template to guide harvesting of at least one of ligament and bone form the graft harvest site.

15. The method according to claim 1, further comprising:

cross-referencing a second template to the first template to align position of the second template on a second surface associated with the ligament, the second template including at least one guide; and

directing movement of the surgical instrument using the at least one guide of the second template relative to said guide.

16. The method according to claim 15, wherein the first and second surfaces are opposing articular surfaces.

17. The method according to claim 16, wherein the first surface is a femoral surface and the second surface is a tibial surface.

18. The method according to claim 1, wherein the first template includes a tissue retractor.

19. The method according to claim 18, wherein the tissue retractor is one of a flange and an extender.

20. The method according to claim 1, further comprising using the template in at least one of a single bundle and a double bundle ligament reconstruction.