SURGICAL GUIDING TOOL, METHODS FOR MANUFACTURE AND USES THEREOF

• US 20110015637A1
• Filed: 07/17/2009
• Published: 01/20/2011
• Est. Priority Date: 07/17/2009
• Status: Active Grant

• Current Assignee: Materialise NV
• Original Assignee: Materialise NV
• Inventors: Gelaude, Frederik, De Smedt, Karla, Clijmans, Tim
• Granted Patent: US 8,414,591 B2
• Time in Patent Office: Days
• US Class Current: 606/89
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing
• CPC Class Codes: Y10T 29/49826 Assembling or joining

Abstract

Surgical guiding tools for surgery on a bone head which include a cutting component, a guiding component and a collar having a patient-specific component are disclosed. The surgical guiding tools are interconnected which ensures secure and accurate placement of the guiding tool and thus guarantees accurate implementation of the pre-operative planning of the surgical intervention.

Claims

1. A patient-specific surgical guiding tool for a head of a major limb bone comprising:

(i) a guiding component for guiding a surgical instrument,

(ii) a cutting component comprising two or more cutting elements, positioned so as to cut in the cartilage of the head of the bone upon placement of the surgical guiding tool on the bone head,

(iii) a collar spanning at least a part of the contour of the neck of the bone but retaining an opening which allows passage of the neck at at least its smallest diameter and comprising a patient-specific component, and

(iv) a connecting structure connecting said collar to said cutting component and/or to said guiding component, such that said collar, said cutting component and said guiding component are interconnected;

wherein said connecting structure forms at least one aperture allowing the passage of the bone head and ensuring placement of the guiding component on the bone head upon placement of the collar on the bone neck, and

wherein at least two of the two or more cutting elements are positioned each at a different side of said at least one aperture and each at a maximal angle of 90°

from the interior bisector of the angle formed by the lines connecting the edges of the aperture and the central axis of the head of the bone upon placement of the surgical guiding tool on the bone head.

2. The surgical guiding tool according to claim 1, wherein the edges of said two or more cutting elements are all positioned in the same plane.

3. The surgical guiding tool according to claim 1, wherein the edges of said two or more cutting elements are all positioned in a plane perpendicular to the position of the central axis of the head of the bone upon placement of the surgical guiding tool on the bone head.

4. The surgical tool of claim 1, wherein at least two of the two or more cutting elements are positioned each at a different side of the aperture and each at an angle of about 75°

from the interior bisector of the angle formed by the lines connecting the edges of the aperture and the central axis of the head of the bone.

5. The surgical tool of claim 1, wherein at least two of the two or more cutting elements are positioned each at a different side of the aperture and each at an angle of 80°

from the interior bisector of the angle formed by the lines connecting the edges of the aperture and the central axis of the head of the bone.

6. The surgical guiding tool of claim 1, wherein said two or more cutting elements are interconnected by one or more ring structures spanning the contour of the bone head by at least 180°

.

7. The surgical guiding tool according to claim 1, wherein the central axis of the guiding component is positioned in or in the extension of the central axis of the head of the bone upon placement of the surgical guiding tool on the bone head.

8. The surgical guiding tool according to claim 1, wherein said guiding component is positioned perpendicular to the plane formed by the edges of the two or more cutting elements.

9. The surgical guiding tool of claim 1, wherein said collar spans the contour of the neck of the bone over about 180°

.

10. The surgical guiding tool of claim 1, wherein said collar spans the contour of the neck of the bone over more than 180°

.

11. The surgical guiding tool of claim 1, wherein the collar spans the bone neck over more than 180°

and wherein the collar forms a plane with one longitudinal axis and said opening is positioned such that the axis connecting the ends of the opening is not perpendicular to the longitudinal axis of the plane formed by the collar.

12. The surgical guiding tool of claim 11, wherein the opening is positioned such that it is parallel with the longitudinal axis of the plane formed by the collar.

13. A method for manufacturing a patient-specific surgical guiding tool for a surgical intervention on a into a head of a major limb bone according to claim 1, said method comprising:

(a) obtaining volume information of the bone head and neck;

(b) identifying and selecting one or more parts of the bone neck, which contain sufficient features to be patient-specific;

(c) determining the appropriate position of the guiding component with regard to the bone head, based on the pre-operative planning of the desired path of the surgical tool in the bone head; and

(d) preparing the surgical guiding tool wherein;

(i) the position of the connecting structure, the cutting component and the collar is determined based on the image of the bone head and neck obtained in step (a),

(ii) the collar comprises a patient-specific component comprising at least one patient-specific area based on the patient-specific parts of the neck identified in step (b), and

(iii) the guiding component is positioned in the surgical guiding tool such that, upon placement of the guiding tool on the bone head and neck, the guiding component is positioned as determined in step (c).

14. A method for introducing a surgical instrument into a head of a major limb bone, which method comprises:

(a) providing a surgical guiding tool as defined in claim 1, whereby

the patient-specific component is made complementary to a surface of the bone neck of the patient and

the guiding component is designed to guide said surgical instrument in a predefined trajectory;

(b) securing the surgical guiding tool on the bone head and neck by

positioning the surgical guiding tool with the opening of the collar facing the bone neck such that the patient specific component of the collar is aligned at an angle with its complementary surface on the bone neck,

moving the surgical guiding tool over the bone head such that the central axis of the bone head or neck is perpendicular to the direction of the movement until the tool is positioned over the bone head and neck,

rotating the surgical guiding tool to align the collar with the neck of the bone such that the patient-specific component of the collar locks into the complementary surface of the neck of the bone, thereby applying pressure on the two or more cutting elements that are positioned at opposite sides of the aperture so as to cut a groove in the cartilage of the bone head; and

(c) introducing the surgical instrument through the guiding component.

15. The method for introducing a surgical instrument into a head of a major limb bone according to claim 14, which method comprises:

(a) providing the surgical guiding tool according to claim 14, wherein the collar spans the bone neck over more than 180° and

wherein the collar forms a plane with one longitudinal axis and said opening is positioned such that the axis connecting the ends of the opening is not perpendicular to the longitudinal axis of the plane formed by the collar, whereby

the patient-specific component is made complementary to a surface of the bone neck of the patient and

the guiding component is designed to guide said surgical instrument in a predefined trajectory;

(b) securing the surgical guiding tool on the bone head and neck by

introducing the smallest diameter of the bone neck through the opening of the collar and placing the surgical guiding tool over the bone head; and

rotating the surgical guiding tool to align the collar with the neck of the bone such that the patient-specific component of the collar locks into the complementary surface of the neck of the bone, thereby applying pressure on the two or more cutting elements that are positioned at opposite sides of the aperture so as to cut a groove in the cartilage of the bone head; and

(c) introducing the surgical instrument through the guiding component.

16. A method for introducing a surgical instrument into a head of a major limb bone, which method comprises:

(a) providing a surgical guiding tool as defined in claim 1, whereby

the patient-specific component is made complementary to a surface of the bone neck of the patient and

the guiding component is designed to guide said surgical instrument in a predefined trajectory;

(b) securing the surgical guiding tool on the bone head and neck by

positioning the surgical guiding tool with the opening of the collar facing the bone neck such that the patient specific component of the collar is aligned in parallel with its complementary surface on the bone neck, and

moving the surgical guiding tool over the bone head such that the central axis of the bone head or neck is perpendicular to the direction of the movement until the patient-specific component of the collar locks into the complementary surface of the neck of the bone, thereby applying pressure to said at least two of the two or more cutting elements that are positioned at opposite sides of the aperture so as to cut a groove in the cartilage of the bone head; and

(c) introducing the surgical instrument through the guiding component.

17. The method of claim 14, which is a method for transferring a pre-planned intervention in the bone head to surgery.

18. The method of claim 16, which is a method for transferring a pre-planned intervention in the bone head to surgery.