Patient Selectable Joint Arthroplasty Devices and Surgical Tools

• US 20110218539A1
• Filed: 01/25/2011
• Published: 09/08/2011
• 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 9,375,222 B2
• Time in Patent Office: Days
• US Class Current: 606/87
• 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 implanting an acetabular component of a hip implant in 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 substantially matches a corresponding surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface to provide a predefined 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 corresponding surface of the hip joint; and

wherein the path for the surgical tool has a predefined position based on a desired orientation of the acetabular component of the hip implant when the patient specific surface is placed against and aligned with the corresponding surface of the hip joint.

2. The surgical instrument of claim 1, wherein the orientation includes a predefined anteversion or retroversion of the acetabular component.

3. The surgical instrument of claim 1, wherein the orientation includes a predefined tilting of the acetabular component.

4. The surgical instrument of claim 1, wherein the orientation includes a predefined rotational position of the acetabular component.

5. The surgical instrument of claim 1, wherein the acetabular component is an acetabular cup.

6. The surgical instrument of claim 1, wherein the corresponding surface of the hip is an acetabular surface of the hip.

7. The surgical instrument of claim 2, wherein the acetabular surface includes at least portions of an acetabular fossa of the hip.

8. The surgical instrument of claim 2, wherein the acetabular surface includes at least portions of an acetabular rim of the hip.

9. The surgical instrument of claim 2, wherein the acetabular surface includes at least portions of an acetabular wall of the hip.

10. The surgical instrument of claim 2, wherein the acetabular surface includes a cartilage surface.

11. The surgical instrument of claim 2, wherein the acetabular surface includes a normal cartilage surface.

12. The surgical instrument of claim 2, wherein the acetabular surface includes a diseased cartilage surface.

13. The surgical instrument of claim 2, wherein the acetabular surface includes a normal cartilage surface and a diseased cartilage surface.

14. The surgical instrument of claim 2, wherein the acetabular surface includes a subchondral bone surface.

15. The surgical instrument of claim 2, wherein the acetabular surface includes a cortical bone surface.

16. The surgical instrument of claim 2, wherein the acetabular surface includes the surface of at least one osteophyte.

17. The surgical instrument of claim 1, wherein the acetabular surface includes a cartilage surface.

18. The surgical instrument of claim 1, wherein the corresponding surface of the hip includes a normal cartilage surface.

19. The surgical instrument of claim 1, wherein the corresponding surface of the hip includes a diseased cartilage surface.

20. The surgical instrument of claim 1, wherein the corresponding surface of the hip includes a normal cartilage surface and a diseased cartilage surface.

21. The surgical instrument of claim 1, wherein the corresponding surface of the hip includes a subchondral bone surface.

22. The surgical instrument of claim 1, wherein the corresponding surface of the hip includes a cortical bone surface.

23. The surgical instrument of claim 1, wherein the corresponding surface of the hip includes the surface of at least one osteophyte.

24. The surgical instrument of claim 1, wherein surgical tool is a reaming device.

25. The surgical instrument of claim 1, wherein surgical tool is a drill.

26. The surgical instrument of claim 1, wherein surgical tool is a saw.

27. The surgical instrument of claim 1, wherein surgical tool is a trial implant.

28. A surgical instrument for use in surgically implanting a femoral component of a hip implant for replacing or resurfacing 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 substantially matches a corresponding femoral surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface to provide a predefined 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 corresponding surface of the hip joint; and

wherein the path for the surgical tool has a predefined position based on a desired orientation of the femoral component of the hip implant when the patient specific surface is placed against and aligned with the corresponding surface of the hip joint.

29. The surgical instrument of claim 28, wherein the orientation includes a predefined anteversion or retroversion of the femoral component.

30. The surgical instrument of claim 28, wherein the orientation includes a predefined tilting of the femoral component.

31. The surgical instrument of claim 28, wherein the orientation includes a predefined rotational position of the femoral component.

32. The surgical instrument of claim 28, wherein the femoral component is a femoral head component.

33. The surgical instrument of claim 28, wherein the corresponding femoral surface of the hip is at least a portion of a femoral neck surface of the hip.

34. The surgical instrument of claim 28, wherein the corresponding femoral surface of the hip is at least a portion of a femoral head surface of the hip.

35. The surgical instrument of claim 28, wherein the corresponding femoral surface of the hip is at least a portion of a junction of the femoral head and femoral neck surface of the hip.

36. The surgical instrument of claim 28, wherein the femoral surface includes a cartilage surface.

37. The surgical instrument of claim 28, wherein the corresponding surface of the hip includes a normal cartilage surface.

38. The surgical instrument of claim 28, wherein the corresponding surface of the hip includes a diseased cartilage surface.

39. The surgical instrument of claim 28, wherein the corresponding surface of the hip includes a normal cartilage surface and a diseased cartilage surface.

40. The surgical instrument of claim 28, wherein the corresponding surface of the hip includes a subchondral bone surface.

41. The surgical instrument of claim 28, wherein the corresponding surface of the hip includes a cortical bone surface.

42. The surgical instrument of claim 28, wherein the corresponding surface of the hip includes the surface of at least one osteophyte.

43. The surgical instrument of claim 28, wherein surgical tool is a reaming device.

44. The surgical instrument of claim 28, wherein surgical tool is a drill.

45. The surgical instrument of claim 28, wherein surgical tool is a saw.

46. The surgical instrument of claim 28, wherein surgical tool is a trial implant.

47. A surgical instrument for use in surgically implanting an acetabular component of a hip implant in 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 substantially matches a corresponding acetabular surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface based on a desired orientation of the acetabular component of the hip implant when the patient specific surface is placed against and aligned with the corresponding acetabular surface of the hip joint.

48. The surgical instrument of claim 47, wherein the orientation includes a predefined anteversion or retroversion of the femoral component.

49. The surgical instrument of claim 47, wherein the orientation includes a predefined tilting of the femoral component.

50. The surgical instrument of claim 47, wherein the orientation includes a predefined rotational position of the femoral component.

51. The surgical instrument of claim 47, wherein the jig is a single component.

52. The surgical instrument of claim 47, wherein the jig includes multiple components.

53. A surgical instrument for use in surgically implanting an acetabular component of a hip implant in 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 substantially matches a corresponding femoral surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface based on a desired orientation of the femoral component of the hip implant when the patient specific surface is placed against and aligned with the corresponding femoral surface of the hip joint.

54. The surgical instrument of claim 53, wherein the orientation includes a predefined anteversion or retroversion of the femoral component.

55. The surgical instrument of claim 53, wherein the orientation includes a predefined tilting of the femoral component.

56. The surgical instrument of claim 53, wherein the orientation includes a predefined rotational position of the femoral component.

57. A surgical instrument for use in surgically replacing or resurfacing portions of or an entire hip joint of a patient, comprising:

a body 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 substantially matches a corresponding surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface to provide a predefined 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 surface; and

wherein the path for the surgical tool is configured to provide a predefined orientation of at least one acetabular or femoral implant when the patient specific surface is placed against and aligned with the surface.

58. The surgical instrument of claim 57, wherein the orientation includes a predefined anteversion or retroversion of at least one acetabular or femoral implant when the patient specific surface is placed against and aligned with the surface.

59. The surgical instrument of claim 57, wherein the orientation includes a predefined rotation of at least one acetabular or femoral implant when the patient specific surface is placed against and aligned with the surface.

60. The surgical instrument of claim 57, wherein the orientation includes a predefined tilting of at least one acetabular implant when the patient specific surface is placed against and aligned with the surface.

61. A surgical instrument for use in surgically implanting one or more components of a hip implant in 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 substantially matches a corresponding cartilage surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface to provide a predefined 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 cartilage surface; and

wherein the path for the surgical tool has a predefined position based on a desired orientation of at least one component of the hip implant when the patient specific surface is placed against and aligned with the cartilage surface.

62. The surgical instrument of claim 61, wherein the orientation includes a predefined anteversion or retroversion of the at least one component.

63. The surgical instrument of claim 61, wherein the orientation includes a predefined tilting of the at least one component.

64. The surgical instrument of claim 61, wherein the orientation includes a predefined rotational position of the at least one component.

65. The surgical instrument of claim 61, wherein the at least one component is an acetabular component.

66. The surgical instrument of claim 61, wherein the at least one component is an acetabular cup.

67. The surgical instrument of claim 61, wherein the at least one component is a femoral component.

68. The surgical instrument of claim 61, wherein the at least one component is a femoral head.

69. A surgical instrument for use in surgically replacing or resurfacing portions of or an entire hip joint of a patient, comprising:

a body 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 substantially matches a corresponding subchondral bone surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface to provide a predefined 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 subchondral bone surface; and

wherein the path for the surgical tool is configured to provide a predefined orientation of at least one acetabular or femoral implant when the patient specific surface is placed against and aligned with the surface.

70. The surgical instrument of claim 69, wherein the orientation includes a predefined anteversion or retroversion of at least one acetabular or femoral implant when the patient specific surface is placed against and aligned with the subchondral bone surface.

71. The surgical instrument of claim 69, wherein the orientation includes a predefined rotation of at least one acetabular or femoral implant when the patient specific surface is placed against and aligned with the subchondral bone surface.