Patient Selectable Joint Arthroplasty Devices and Surgical Tools

• US 20110213368A1
• Filed: 01/26/2011
• Published: 09/01/2011
• Est. Priority Date: 11/25/2003
• Status: Active Grant

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Lang, Philipp, Fitz, Wolfgang
• Granted Patent: US 9,381,025 B2
• Time in Patent Office: Days
• US Class Current: 606/80
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/158 Cutting patella
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1677 for the patella
• CPC Class Codes: A61B 17/1682 for the foot or ankle
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/1767 for the patella
• 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 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4523 : Tendons
• CPC Class Codes: A61B 5/4528 : Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4533 : Ligaments
• 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
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: B33Y 80/00 : Products made by additive manufacturing
• CPC Class Codes: G06F 30/00 : Computer-aided design [CAD]
• CPC Class Codes: G06F 30/10 : Geometric CAD
• CPC Class Codes: Y10T 29/49 : Method of mechanical manufacture

Abstract

Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Claims

1. A surgical instrument for use in surgically repairing a hip joint of a patient, comprising:

a block having a patient-specific surface and a guide sized to accommodate a surgical tool;

wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of an acetabular rim surface adjacent the hip joint; and

wherein the guide has a position and orientation relative to the patient-specific surface to define a predetermined path for the surgical tool that is aligned through a portion of tissue associated with the hip joint when the patient specific surface is placed against and aligned with the acetabular rim surface.

2. The surgical instrument of claim 1, wherein at least a portion of the patient-specific surface includes substantially a negative of a cartilage surface at or adjacent to the acetabular rim surface.

3. The surgical instrument of claim 1, wherein at least a portion of the patient-specific surface includes substantially a negative of a cortical bone surface at or adjacent to the acetabular rim surface.

4. The surgical instrument of claim 1, wherein at least a portion of the patient-specific surface is substantially a negative of a subchondral bone surface at or adjacent to the acetabular rim surface.

5. The surgical instrument of claim 1, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the first portion is substantially a negative of a cartilage surface at or adjacent to the acetabular rim surface and the second portion is substantially a negative of a subchondral bone surface at or adjacent to the acetabular rim surface, and wherein the second portion is configured to align with the subchondral bone surface when the first portion is placed against and aligned with the cartilage surface.

6. The surgical instrument of claim 1, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the first portion is substantially a negative of a cartilage surface at or adjacent to the acetabular rim surface and the second portion is substantially a negative of a cortical bone surface at or adjacent to the acetabular rim surface, and wherein the second portion is configured to align with the cortical bone surface when the first portion is placed against and aligned with the cartilage surface.

7. The surgical instrument of claim 1, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the first portion is substantially a negative of a cortical bone surface at or adjacent to the acetabular rim surface and the second portion is substantially a negative of a subchondral bone surface at or adjacent to the acetabular rim surface, and wherein the second portion is configured to align with the subchondral bone surface when the first portion is placed against and aligned with the cortical surface.

8. The surgical instrument of claim 1, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the second portion is substantially a negative of a subchondral bone surface adjacent the acetabular rim surface, and wherein the second portion is configured to align with the subchondral bone surface when the first portion is placed against and aligned with the corresponding portion of the acetabular rim.

9. The surgical instrument of claim 1, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the second portion is substantially a negative of a cartilage surface adjacent the acetabular rim surface, and wherein the second portion is configured to align with the cartilage surface when the first portion is placed against and aligned with the corresponding portion of the acetabular rim.

10. The surgical instrument of claim 1, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the second portion is substantially a negative of a tissue surface adjacent the acetabular rim surface, and wherein the second portion is configured to align with the tissue surface when the first portion is placed against and aligned with the corresponding portion of the acetabular rim.

11. The surgical instrument of claim 1, wherein said predetermined path is based on image data of the hip joint to define an orientation of an acetabular component.

12. The surgical instrument of claim 1, wherein said predetermined path is based on image data of the hip joint to define an anteversion or retroversion of an acetabular component.

13. The surgical instrument of claim 1, wherein said predetermined path is based on image data of the hip joint to define a rotational position of an acetabular component.

14. The surgical instrument of claim 1, wherein the block further comprises a stabilizing groove configured to abut an acetabular rim associated with the joint when the patient specific surface is placed against and aligned with the acetabular rim surface.

15. The surgical instrument of claim 14, wherein the guide has a predetermined position relative to the groove to control rotation of an acetabular component.

16. The surgical instrument of claim 14, wherein the guide has a predetermined position relative to the groove to place an acetabular component in a predetermined orientation relative to the acetabular rim.

17. The surgical instrument of claim 1, wherein the patient specific surface further comprises a stabilizing groove portion configured to abut an acetabular rim associated with the joint when the patient specific surface is placed against and aligned with the acetabular rim surface.

18. The surgical instrument of claim 1, wherein the predetermined path is aligned with an acetabular wall and is configured to accommodate a reaming device for reaming the acetabular wall.

19. The surgical instrument of claim 1, wherein the guide provides a linkage for a reaming component.

20. The surgical instrument of claim 19, further comprising a reaming component having an attachment mechanism for attachment to the guide and having a reaming device for reaming an acetabular wall, wherein the reaming device is configured in a predetermined orientation relative to the patient-specific surface when the attachment mechanism is connected to the guide.

21. The surgical instrument of claim 1, wherein the guide path extends through an acetabulum of the hip joint.

22. The surgical instrument of claim 1, wherein the guide path extends through at least a portion of an acetabulum of the hip joint.

23. The surgical instrument of claim 1, wherein the guide is a hole sized to accommodate a surgical drill.

24. The surgical instrument of claim 1, wherein the guide is a hole sized to create a bore along the guide path.

25. The surgical instrument of claim 1, wherein the guide is a slot sized to accommodate a surgical saw.

26. The surgical instrument of claim 1, wherein the guide is a hole sized to accommodate a reaming device.

27. The surgical instrument of claim 1, wherein the portion of the acetabular rim is the entire acetabular rim.

28. The surgical instrument of claim 1, wherein the jig further comprises multiple components.

29. The surgical instrument of claim 28, wherein a first component of the jig includes the patient-specific surface and a second component of the jig includes the guide.

30. The surgical instrument of claim 1, wherein the jig is a single component.

31. A surgical tool for use in surgery on a hip joint of a patient, comprising:

a jig having a patient-specific surface and a guide to direct or accommodate a surgical tool;

wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of an acetabular rim of a hip joint; and

wherein the guide has a position or orientation relative to the patient-specific surface to define a predetermined path for the surgical tool that is aligned through a portion of tissue associated with the hip joint when the patient specific surface is placed against and aligned with the acetabular rim.

32. The surgical tool of claim 31, wherein at least a portion of the patient-specific surface is substantially a negative of a cartilage surface of the acetabular rim surface.

33. The surgical tool of claim 31, wherein at least a portion of the patient-specific surface is substantially a negative of a cortical bone surface of the acetabular rim surface.

34. The surgical tool of claim 31, wherein at least a portion of the patient-specific surface is substantially a negative of a subchondral bone surface of the acetabular rim surface.

35. The surgical tool of claim 31, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the first portion is substantially a negative of a cartilage surface of the acetabular rim surface and the second portion is substantially a negative of a subchondral bone surface of the acetabular rim surface, and wherein the second portion is configured to align with the subchondral bone surface when the first portion is placed against and aligned with the cartilage surface.

36. The surgical tool of claim 31, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the first portion is substantially a negative of a cartilage surface of the acetabular rim surface and the second portion is substantially a negative of a cortical bone surface of the acetabular rim surface, and wherein the second portion is configured to align with the cortical bone surface when the first portion is placed against and aligned with the cartilage surface.

37. The surgical tool of claim 31, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the first portion is substantially a negative of a cortical bone surface of the acetabular rim surface and the second portion is substantially a negative of a subchondral bone surface of the acetabular rim surface, and wherein the second portion is configured to align with the subchondral bone surface when the first portion is placed against and aligned with the cortical surface.

38. The surgical tool of claim 31, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the second portion is substantially a negative of a subchondral bone surface adjacent the acetabular rim surface, and wherein the second portion is configured to align with the subchondral bone surface when the first portion is placed against and aligned with the corresponding portion of the acetabular rim.

39. The surgical tool of claim 31, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the second portion is substantially a negative of a cartilage surface adjacent the acetabular rim surface, and wherein the second portion is configured to align with the cartilage surface when the first portion is placed against and aligned with the corresponding portion of the acetabular rim.

40. The surgical tool of claim 31, wherein the at least a portion of the patient-specific surface is a first portion and the patient-specific surface further comprises a second portion, wherein the second portion is substantially a negative of a tissue surface adjacent the acetabular rim surface, and wherein the second portion is configured to align with the tissue surface when the first portion is placed against and aligned with the corresponding portion of the acetabular rim.

41. The surgical tool of claim 31, wherein said predetermined path is based on image data of the hip joint to define an orientation of an acetabular component.

42. The surgical tool of claim 31, wherein said predetermined path is based on image data of the hip joint to define an anteversion or retroversion of an acetabular component.

43. The surgical tool of claim 31, wherein said predetermined path is based on image data of the hip joint to define a rotational position of an acetabular component.

44. The surgical tool of claim 31, wherein the jig further comprises a stabilizing groove configured to abut an acetabular rim associated with the joint when the patient specific surface is placed against and aligned with the acetabular rim surface.

45. The surgical tool of claim 44, wherein the guide has a predetermined position relative to the groove to control rotation of an acetabular component.

46. The surgical tool of claim 44, wherein the guide has a predetermined position relative to the groove to place an acetabular component in a predetermined orientation relative to the acetabular rim.

47. The surgical tool of claim 31, wherein the patient specific surface further comprises a stabilizing groove portion configured to abut an acetabular rim associated with the joint when the patient specific surface is placed against and aligned with the acetabular rim surface.

48. The surgical tool of claim 31, wherein the predetermined path is aligned with an acetabular wall and is configured to accommodate a reaming device for reaming the acetabular wall.

49. The surgical tool of claim 31, wherein the guide provides a linkage for a reaming component.

50. The surgical tool of claim 49, further comprising a reaming component having an attachment mechanism for attachment to the guide and having a reaming device for reaming an acetabular wall, wherein the reaming device is configured in a predetermined orientation relative to the patient-specific surface when the attachment mechanism is connected to the guide.

51. The surgical tool of claim 31, wherein the guide path extends through an acetabulum of the hip joint.

52. The surgical tool of claim 31, wherein the guide path extends through at least a portion of an acetabulum of the hip joint.

53. The surgical tool of claim 31, wherein the guide is a hole sized to accommodate a surgical drill.

54. The surgical tool of claim 31, wherein the guide is a hole sized to create a bore along the guide path.

55. The surgical tool of claim 31, wherein the guide is a slot sized to accommodate a surgical saw.

56. The surgical tool of claim 31, wherein the guide is a hole sized to accommodate a reaming device.

57. The surgical tool of claim 31, wherein the portion of the acetabular rim is the entire acetabular rim.

58. The surgical tool of claim 31, wherein the jig further comprises multiple components.

59. The surgical tool of claim 58, wherein a first component of the jig includes the patient-specific surface and a second component of the jig includes the guide.

60. The surgical tool of claim 31, wherein the jig is a single component.

61. A surgical instrument for use in surgically repairing a hip joint of a patient, comprising:

a jig having a patient-specific surface and a guide sized to accommodate a surgical tool;

wherein the patient-specific surface is based on image data of at least a portion of an acetabular rim of the hip joint of the patient; and

wherein the guide has a position and orientation relative to the patient-specific surface to define a predetermined path for the surgical tool that defines at least in part an anteversion or retroversion of an acetabular component when the patient specific surface is placed against and aligned with the acetabular rim surface.

62. A surgical instrument for use in surgically repairing a hip joint of a patient, comprising:

a jig having a patient-specific surface and a guide sized to accommodate a surgical tool;

wherein the patient-specific surface is based on image data of at least a portion of an acetabular rim of the hip joint of the patient; and

wherein the guide has a position and orientation relative to the patient-specific surface to define a predetermined path for the surgical tool that defines at least in part a rotational position of an acetabular component when the patient specific surface is placed against and aligned with the acetabular rim surface.

63. A surgical instrument for use in surgically repairing a hip joint of a patient, comprising:

a jig having a patient-specific surface and a guide sized to accommodate a surgical tool;

wherein the patient-specific surface is based on image data of at least a portion of an acetabular rim of the hip joint of the patient; and

wherein the guide has a position and orientation relative to the patient-specific surface to define a predetermined path for the surgical tool that defines at least in part a tilt of an acetabular component when the patient specific surface is placed against and aligned with the acetabular rim surface.