Patient-Specific Hip Joint Devices

• US 20110093086A1
• Filed: 12/23/2010
• Published: 04/21/2011
• Est. Priority Date: 02/27/2006
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Witt, Tyler D., White, John R., Metzger, Robert, Meridew, Jason D., Hershberger, Troy W.
• Granted Patent: US 8,568,487 B2
• Time in Patent Office: Days
• US Class Current: 623/22.15
• CPC Class Codes: A61B 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• 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 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61F 2/30771 applied in original prostheses, e.g. holes or grooves
• CPC Class Codes: A61F 2/34 Acetabular cups
• 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 2/4609 of acetabular cups
• CPC Class Codes: A61F 2002/302 toroidal, e.g. rings
• CPC Class Codes: A61F 2002/30604 modular
• CPC Class Codes: A61F 2002/30617 Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
• 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 2002/30934 Special articulating surfaces
• CPC Class Codes: A61F 2002/30952 using CAD-CAM techniques or NC-techniques
• CPC Class Codes: A61F 2002/30962 using stereolithography
• CPC Class Codes: A61F 2002/4633 for selection of endoprosthetic joints or for pre-operative planning
• CPC Class Codes: A61F 2002/4662 : for measuring penetration depth
• CPC Class Codes: A61F 2002/4668 : for measuring angles
• CPC Class Codes: A61F 2002/4687 : Mechanical guides for implantation instruments
• CPC Class Codes: B33Y 80/00 : Products made by additive manufacturing

Abstract

A patient-specific acetabular resection guide includes a dome-shaped surface bounded by a periphery. The dome-shaped surface is a three-dimensional patient-specific surface designed to anatomically match and be received into an acetabulum of the patient, based on a three-dimensional image of a hip joint of the patient reconstructed from a medical scan of the hip joint. The resection guide includes a plurality of guiding formations defined on the resection guide and having patient-specific shapes and orientations for guiding corresponding osteotomies relative to the acetabulum for correcting hip dysplasia.

Claims

1. A hip-joint device comprising:

a patient-specific acetabular resection guide including;

a dome-shaped surface bounded by a periphery, wherein the dome-shaped surface is patient-specific three-dimensional surface designed to anatomically match and be received into an acetabulum of the patient in one position, based on a three-dimensional image of a hip joint of the patient reconstructed from a medical scan of the hip joint; and

a plurality of guiding formations defined on the resection guide, the guiding formations having patient-specific shapes and orientations for guiding corresponding osteotomies relative to the acetabulum for correcting hip dysplasia

2. The hip-joint device of claim 1, wherein the acetabular resection guide includes an annular flange extending from the periphery of the dome-shaped surface, the annular flange having a bone-engaging surface positionable on a periacetabular area of the acetabulum of the patient, and wherein the plurality of resection guiding formations are defined through the annular flange.

3. The hip-joint device of claim 2, wherein the bone-engaging surface of the annular flange is patient-specific.

4. The hip-joint device of claim 2, wherein the guiding formations are elongated slots for guiding a cutting blade.

5. The hip-joint device of claim 4, wherein at least two of the elongating slots are intersecting.

6. The hip-joint device of claim 2, wherein the elongated slots are arranged peripherally around the periphery of the dome-shaped surface.

7. The hip-joint device of claim 2, wherein at least one guiding formation is an elongated slot designed for an optional single open osteotomy.

8. The hip-joint device of claim 2, wherein at least one guiding formation is an elongated arcuate slot.

9. The hip-joint device of claim 1, further comprising:

an implantable acetabular shell receivable in the patient'"'"'s acetabulum; and

an implantable patient-specific acetabular augment prepared based on a three-dimensional image of the hip joint of the patient showing an acetabular defect, the acetabular augment having a first patient-specific surface correcting the acetabular defect and an opposite second surface mateable with an outer surface of the acetabular shell.

10. The hip-joint device of claim 9, wherein the acetabular shell is patient-specific.

11. An implant for a femoral head, the implant comprising a shell implantable on a femoral head of the patient and designed preoperatively to correct a defect of the femoral head, the shell having a patient-specific first surface for articulation with the patient'"'"'s acetabulum and a patient-specific periphery mateable with a periphery of the defect, such that the first surface of the shell is continuous to a remaining healthy surface of the femoral head and the shell replaces and corrects the defect.

12. The implant of claim 11, wherein the femoral implant includes a second surface opposite to the first surface and engageable with the femoral head.

13. The implant of claim 12, wherein the second surface is patient-specific.

14. The implant of claim 12, further comprising a fixator for coupling the femoral implant to the femoral head.

15. The implant of claim 14, wherein the fixator is modularly coupled to the shell.

16. The implant of claim 11, where the defect is a bone defect, a cartilage defect or a combination thereof.

17. The implant of claim 11, further comprising a resorbable stem extending from the implant for securing the implant to the femoral head.

18. A hip-joint device comprising:

a patient-specific acetabular resection guide including;

a dome-shaped surface bounded by a periphery, wherein the dome-shaped surface is a three-dimensional patient-specific surface designed to anatomically match and be received into an acetabulum of a pelvis of a patient, based on a three-dimensional image of a hip joint of the patient reconstructed from a medical scan of the hip joint;

an annular flange extending from the periphery of the dome-shaped surface, the annular flange having a patient-specific bone-engaging surface engageable to a periacetabular area of the acetabulum of the patient, and

a plurality of elongated slots defined by the flange and oriented around the periphery in a patient-specific orientation for guiding a cutting instrument to reorient the acetabulum relative to the pelvis.

19. The hip joint device of claim 18, further comprising:

an implantable acetabular shell receivable in the patient'"'"'s acetabulum; and

an implantable patient-specific acetabular augment prepared based on a three-dimensional image of the hip joint of the patient showing an acetabular defect, the acetabular augment having a first patient-specific surface correcting the acetabular defect and an opposite second surface mateable with an outer surface of the acetabular shell.

20. A method for repairing a hip-joint, the method comprising:

engaging an acetabulum of a pelvis of a patient with a patient-specific resection guide;

positioning a patient-specific dome-shaped surface of the resection guide into a complementary surface of the acetabulum;

guiding a cutting instrument through a first patient-specific elongated slot in a flange surrounding the dome-shaped surface;

performing a first osteotomy through the first elongated slot; and

correcting an orientation of the acetabulum.

21. The method of claim 20, wherein correcting an orientation of the acetabulum includes opening the first osteotomy while the acetabulum is hinged to the pelvis in a patient-specific location.

22. The method of claim 20, further comprising performing a plurality of additional osteotomies through corresponding patient-specific slots arranged peripherally around a periphery of the dome-shaped surface of the resection guide and rotating the acetabulum relative to the pelvis.

23. The method of claim 20, further comprising:

positioning a patient-specific acetabular augment into a defect area extending from the acetabulum; and

coupling the augment to an acetabular shell received in the acetabulum.

24. The method of claim 20, further comprising positioning a patient-specific femoral implant into a bone defect area of a femoral head of the hip joint of the patient.

25. The method of claim 20, further comprising positioning a patient-specific implant into a cartilage defect area of a femoral head of the hip joint of the patient.

26. A method for repairing a hip-joint, the method comprising:

determining a first patient-specific osteotomy for re-orienting a patient'"'"'s acetabulum to correct hip dysplasia;

designing a patient-specific resection guide having a patient-specific dome-shaped surface complementary to the patient'"'"'s acetabulum and a flange surrounding the dome shaped surface; and

designing a first patient-specific slot for guiding the first patient-specific osteotomy.

27. The method of claim 26, wherein determining a first patient-specific osteotomy for re-orienting a patient'"'"'s acetabulum to correct hip dysplasia includes determining a location for hinging the acetabulum.

28. The method of claim 26, further comprising designing a plurality of patient specific slots surrounding a periphery of the dome-shaped surface for guiding a plurality of periacetabular osteotomies for rotating the acetabulum.