PATIENT-SPECIFIC ACETABULAR GUIDES AND ASSOCIATED INSTRUMENTS

• US 20110184419A1
• Filed: 03/07/2011
• Published: 07/28/2011
• 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: Metzger, Robert, Meridew, Jason D., Witt, Tyler D., Siebeneck, Tony
• Granted Patent: US 8,608,749 B2
• Time in Patent Office: Days
• US Class Current: 606/80
• 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 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/1746 for the acetabulum
• 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: A61F 2/4609 of acetabular cups
• CPC Class Codes: A61F 2002/30617 Visible markings for adjusting, locating or measuring
• 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: A61F 2250/0097 Visible markings, e.g. indicia
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing

Abstract

A method for preparing a joint surface of a patient for an implant, such as, for example, an acetabular implant for a hip joint. According to the method, a patient-specific guide is attached to a complementary joint surface of the patient. The patient-specific guide includes a guiding element oriented along a patient-specific alignment axis. The alignment axis is determined during a preoperative plan of the patient for implant alignment. A shaft of a guiding tool is removably coupled to the guiding element of the guide. A three-dimensional orientation device is removably attached to the shaft of the guiding tool. A position of a bubble of the orientation device is marked with a mark on an outer transparent surface of the orientation device while the guiding tool is oriented along the alignment axis. The marked orientation device can be used for aligning other instruments during the procedure.

Claims

1. A method for preparing an acetabulum of a patient for an acetabular implant, the method comprising:

removably engaging an acetabular area of the patient to a complementary surface of a patient-specific acetabular guide, the acetabular guide having a guiding element oriented along a patient-specific alignment axis, the alignment axis determined during a preoperative plan of the patient for implant alignment;

removably coupling a shaft of a guiding tool to the guiding element of the acetabular guide such that the shaft of the guiding tool is oriented along the alignment axis;

removably attaching a three dimensional orientation device to the shaft of the guiding tool;

calibrating the orientation device to indicate the alignment axis orientation;

removing the acetabular guide and guiding tool;

removing the orientation device from the guiding tool;

removably attaching the orientation device to a shaft of an instrument; and

guiding the shaft of the instrument along the alignment axis using the orientation device.

2. The method of claim 1, wherein the instrument is a reamer and further comprising reaming the acetabulum with the reamer.

3. The method of claim 2, further comprising:

removing the orientation device from the shaft of the reamer;

removably attaching the orientation device to a shaft of an inserter coupled to an acetabular cup;

guiding the shaft of the inserter along the alignment axis using the orientation device; and

inserting the acetabular cup in the acetabulum.

4. The method of claim 2, further comprising:

drilling a pilot hole in the acetabulum through a bore of the guiding element; and

guiding an alignment pin of the reamer in the pilot hole.

5. The method of claim 4, wherein drilling a pilot hole in the acetabulum through a bore of the guiding element includes using a drilling element having a stop at a predetermined position for preventing over drilling of the acetabulum.

6. The method of claim 1, wherein calibrating the orientation device to indicate the alignment axis orientation comprises marking a position of a bubble inside the orientation device, the bubble viewable through an outer transparent surface of the orientation device.

7. The method of claim 1, further comprising keying the orientation device to the shaft of the instrument.

8. The method of claim 1, wherein the guiding tool is a guiding handle.

9. The method of claim 1, wherein the guiding tool is an acetabular inserter with a removable adapter tip couplable to the guiding element of the patient-specific acetabular guide.

10. A method for preparing a joint surface of a patient for an implant, the method comprising:

attaching a patient-specific guide to a complementary joint surface of the patient, the patient-specific guide having a guiding element oriented along a patient-specific alignment axis, the alignment axis determined during a preoperative plan of the patient for implant alignment;

removably coupling a shaft of a guiding tool to the guiding element of the patient-specific guide;

removably attaching a three-dimensional orientation device to the shaft of the guiding tool; and

marking a position of a bubble of the orientation device with a mark on an outer transparent surface of the orientation device while the guiding tool is oriented along the alignment axis.

11. The method of claim 10, further comprising:

removing the orientation device from the guiding tool for use intra-operatively with other instruments and preparing the joint surface.

12. The method of claim 11, further comprising:

removing the patient-specific guide and the guiding tool;

removably attaching the orientation device to a reamer;

aligning the reamer along the alignment axis using the orientation device; and

reaming the joint surface.

13. The method of claim 11, further comprising:

removably keying and attaching the orientation device to a shaft of a cutting tool;

aligning the shaft of the cutting tool along the alignment axis using the orientation device; and

preparing the joint surface with the cutting tool.

14. The method of claim 10, further comprising:

removably keying and attaching the orientation device to a shaft of an inserter holding an implant for the joint surface;

aligning the shaft of the inserter along the alignment axis using the orientation device; and

inserting the implant in the joint surface.

15. The method of claim 10, wherein the guiding tool is an acetabular inserter with an adapter tip couplable to the guiding element of the patient-specific guide and further comprising:

aligning the shaft of the acetabular inserter along the alignment axis using the orientation device; and

inserting the implant in the joint surface.

16. A surgical kit for preparing a joint surface to receive an implant, the surgical kit comprising:

a patient-specific guide for a joint surface, the patient-specific guide having a patient-specific surface complementary to a surface of the joint for nesting engagement and a guiding element oriented along a patient-specific alignment axis, the alignment axis determined during a preoperative plan of the specific patient for implant alignment;

a guiding tool couplable to the guiding element of the patient-specific guide; and

a three-dimensional orientation device removably couplable the guiding tool for intra-operative calibration, such that, after calibration, the orientation device can be removably coupled to a shaft of a surgical instrument to align the shaft along the alignment axis.

17. The surgical kit of claim 16, further comprising a reamer orientable along the alignment axis using the orientation device.

18. The surgical kit of claim 16, further comprising an implant inserter orientable along the alignment axis using the orientation device.

19. The surgical kit of claim 16, further comprising a plurality of orientation devices.

20. The surgical kit of claim 19, wherein the orientation devices are disposable.

21. The surgical kit of claim 16, wherein the orientation device includes a dome-shaped surface and a base, the orientation device including a leveling bubble.

22. The surgical kit of claim 21, wherein the dome-shaped surface is transparent for viewing the leveling bubble.

23. The surgical kit of claim 21, further comprising a coupler for keying and coupling the base of the orientation device to an instrument shaft.

24. The surgical kit of claim 23, wherein the coupler is removable coupled to the base.

25. The surgical kit of claim 16, further comprising a second patient-specific guide.

26. The surgical kit of claim 25, wherein the second patient-specific guide is designed to fit to a different portion of the joint surface.