Patient Selectable Joint Arthroplasty Devices and Surgical Tools

• US 20110238073A1
• Filed: 01/25/2011
• Published: 09/29/2011
• Est. Priority Date: 11/25/2003
• Status: Abandoned Application

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Lang, Philipp, Steines, Daniel, Fitz, Wolfgang
• Application Number:
  US13/013,461
• Publication Number:
  US 20110238073A1
• Time in Patent Office: Days
• US Class Current: 606/89
• 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 patient-specific surgical instrumentation system for use in surgery on a hip joint of a patient, comprising:

a jig having a patient-specific surface and a guide;

wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a surface of a proximal femur of the patient; and

wherein the guide is configured relative to the patient-specific surface to define a predetermined guide path relative to a femoral neck or shaft axis of the femur when the patient-specific surface is placed against and aligned with the corresponding portion of the surface of the femur.

2. The instrumentation system of claim 1, wherein the guide path extends through a femoral head and femoral neck of the femur.

3. The instrumentation system of claim 1, wherein the guide path extends along the femoral neck axis in a sagittal plane.

4. The instrumentation system of claim 1, wherein the guide path extends along the femoral neck axis in a coronal plane.

5. The instrumentation system of claim 1, wherein the guide path extends along the femoral neck axis.

6. The instrumentation system of claim 1, wherein the guide path extends along the femoral neck axis through at least a portion of the femoral neck.

7. The instrumentation system of claim 1, wherein the guide path extends through at least a portion of the femoral neck.

8. The instrumentation system of claim 1, wherein the patient specific surface is substantially a negative of at least a portion of one of a femoral head or femoral neck.

9. The instrumentation system of claim 1, wherein the guide includes a hole shaped to accommodate a surgical drill.

10. The instrumentation system of claim 1, wherein the guide includes an opening shaped to create a bore along the guide path.

11. The instrumentation system of claim 1, wherein the guide includes a hole or opening shaped to create a cylindrical space along the guide path.

12. The instrumentation system of claim 1, wherein the guide includes a slot shaped to accommodate a surgical saw.

13. The instrumentation system of claim 1, wherein the guide includes an opening shaped to accommodate a reaming device.

14. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a femoral neck of a proximal femur of the hip joint.

15. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a femoral head of a proximal femur of the hip joint.

16. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cartilage of a femoral head of a proximal femur of the hip joint.

17. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cortical bone of a femoral neck of a proximal femur of the hip joint.

18. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone of a femoral head of a proximal femur of the hip joint.

19. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cartilage adjacent to a femoral neck of a proximal femur of the hip joint.

20. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cortical bone adjacent to a femoral neck of a proximal femur of the hip joint.

21. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone adjacent to a femoral neck of a proximal femur of the hip joint.

22. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of normal or diseased cartilage of a femoral head of a proximal femur of the hip joint.

23. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of bone of a femoral head of a proximal femur of the hip joint.

24. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone of a femoral head of a proximal femur of the hip joint.

25. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cartilage adjacent to a femoral head of a proximal femur of the hip joint.

26. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cortical bone adjacent to a femoral head of a proximal femur of the hip joint.

27. The instrumentation system of claim 1, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone adjacent a femoral head of a proximal femur of the hip joint.

28. The instrumentation system of claim 1, wherein the portion of the patient-specific surface is a first portion that is substantially a negative of a cartilage surface and the patient-specific surface further comprises a second portion that is substantially a negative of a corresponding cortical bone surface of a proximal femur of the hip joint;

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.

29. The instrumentation system of claim 1, wherein the portion of the patient-specific surface is a first portion that is substantially a negative of a cartilage surface and the patient-specific surface further comprises a second portion that is substantially a negative of a corresponding subchondral bone surface of a proximal femur of the hip joint;

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.

30. The instrumentation system of claim 1, wherein the portion of the patient-specific surface is a first portion that is substantially a negative of a subchondral bone surface and the patient-specific surface further comprises a second portion that is substantially a negative of a corresponding cortical bone surface of a proximal femur of the hip joint;

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 subchondral bone surface.

31. The instrumentation system of claim 1, wherein the jig further comprises multiple components.

32. The instrumentation system of claim 1, wherein a first component of the jig includes the patient-specific surface and a second component of the jig includes the guide.

33. The instrumentation system of claim 1, wherein the jig is a single component.

34. A patient-specific surgical instrumentation system for use in surgery on a hip joint of a patient, comprising:

a jig having a patient-specific surface and a guide;

wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a surface of a proximal femur of the patient; and

wherein the guide is configured relative to the patient-specific surface to define a predetermined guide path relative to at least one of an anatomical or biomechanical axis of the femur when the patient-specific surface is placed against and aligned with the corresponding portion of the surface of the proximal femur.

35. The surgical instrumentation system of claim 34, wherein the axis is an axis relative to a femoral neck of the femur.

36. The surgical instrumentation system of claim 34, wherein the axis is a femoral neck axis of the femur.

37. The surgical instrumentation system of claim 34, wherein the axis extends through at least a portion of a femoral neck of the femur.

38. The surgical instrumentation system of claim 34, wherein the axis extends along a femoral neck of the femur in a sagittal plane.

39. The surgical instrumentation system of claim 34, wherein the axis is an axis extends along a femoral neck of the femur in a coronal plane.

40. A patient-specific surgical instrument for use in surgery on a hip joint of a patient, comprising:

a jig having an alignment surface and a guide;

wherein the alignment surface has at least a portion that is substantially a negative of a corresponding portion of a surface of at least one of a femoral head and neck of the patient; and

wherein the guide is configured relative to the patient-specific surface to define a guide path in a predetermined position relative to an axis of the femur when the alignment surface is placed against and aligned with the corresponding portion of the surface of the femur.

41. The instrumentation system of claim 40, wherein the guide path extends through a femoral neck of the femur.

42. The instrumentation system of claim 40, wherein the guide path extends along the femoral neck axis in a sagittal plane.

43. The instrumentation system of claim 40, wherein the guide path extends along the femoral neck axis in a coronal plane.

44. The instrumentation system of claim 40, wherein the guide path extends along the femoral neck axis.

45. The instrumentation system of claim 40, wherein the guide path extends along the femoral neck axis through at least a portion of the femoral neck.

46. The instrumentation system of claim 40, wherein the guide path extends through at least a portion of the femoral neck.

47. The instrumentation system of claim 40, wherein the patient specific surface is substantially a negative of at least a portion of one of a femoral head or femoral neck.

48. The instrumentation system of claim 40, wherein the guide includes a hole shaped to accommodate a surgical drill.

49. The instrumentation system of claim 40, wherein the guide includes an opening shaped to create a bore along the guide path.

50. The instrumentation system of claim 40, wherein the guide includes an opening shaped to create a cylindrical space the guide path.

51. The instrumentation system of claim 40, wherein the guide includes a slot shaped to accommodate a surgical saw.

52. The instrumentation system of claim 40, wherein the guide aperture includes an opening shaped to accommodate a reaming device.

53. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a femoral neck of a proximal femur of the hip joint.

54. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a femoral head of a proximal femur of the hip joint.

55. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cartilage of a femoral head of a proximal femur of the hip joint.

56. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cortical bone of a femoral neck of a proximal femur of the hip joint.

57. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone of a femoral head of a proximal femur of the hip joint.

58. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cartilage adjacent to a femoral neck of a proximal femur of the hip joint.

59. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cortical bone adjacent to a femoral neck of a proximal femur of the hip joint.

60. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone adjacent to a femoral neck of a proximal femur of the hip joint.

61. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cartilage of a femoral head of a proximal femur of the hip joint.

62. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of bone of a femoral head of a proximal femur of the hip joint.

63. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone of a femoral head of a proximal femur of the hip joint.

64. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cartilage adjacent to a femoral head of a proximal femur of the hip joint.

65. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of cortical bone adjacent to a femoral head of a proximal femur of the hip joint.

66. The instrumentation system of claim 40, wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone adjacent to a femoral head of a proximal femur of the hip joint.

67. The instrumentation system of claim 40, wherein the portion of the patient-specific surface is a first portion that is substantially a negative of a cartilage surface and the patient-specific surface further comprises a second portion that is substantially a negative of a corresponding cortical bone surface of a proximal femur of the hip joint;

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.

68. The instrumentation system of claim 40, wherein the portion of the patient-specific surface is a first portion that is substantially a negative of a cartilage surface and the patient-specific surface further comprises a second portion that is substantially a negative of a corresponding subchondral bone surface of a proximal femur of the hip joint;

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.

69. The instrumentation system of claim 40, wherein the portion of the patient-specific surface is a first portion that is substantially a negative of a subchondral bone surface and the patient-specific surface further comprises a second portion that is substantially a negative of a corresponding cortical bone surface of a proximal femur of the hip joint;

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 subchondral bone surface.

70. The instrumentation system of claim 40, wherein the jig further comprises multiple components.

71. The instrumentation system of claim 70, wherein a first component of the jig includes the patient-specific surface and a second component of the jig includes the guide.

72. The instrumentation system of claim 40, wherein the jig is a single component.

73. The instrumentation system of claim 40, wherein the guide path extends through a femoral head of the femur.

74. A patient-specific surgical instrument for use in surgery on a hip joint of a patient, comprising:

a jig having a patient-specific surface and a guide;

wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a surface of at least one of a femoral head and neck of a femur of the patient; and

wherein the guide is configured relative to the patient-specific surface to define a guide path along an axis extending through at least a portion of the femoral neck of the patient when the patient-specific surface is placed against and aligned with the corresponding portion of the surface of the femur.

75. A patient-specific surgical instrumentation system for use in surgery on a hip joint of a patient, comprising:

a first jig having a patient-specific surface and a first guide; and

a second jig having a bone cut surface and a second guide;

wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a surface of a proximal femur of the patient;

wherein the guide is configured relative to the patient-specific surface to define a cutting path through bone associated with the hip joint;

wherein the second guide defines a second instrument path extending along an axis of the femur when the bone cut surface of the second jig is placed against a bone cut formed along the cutting path defined by the first guide.

76. A patient-specific surgical instrumentation system for use in surgery on a hip joint of a patient, comprising:

a jig having a patient-specific surface and a guide;

wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a surface of a proximal femur of the patient; and

wherein the guide is configured relative to the patient-specific surface to define a predetermined guide path extending relative to a femoral neck or shaft axis of the femur when the patient-specific surface is placed against and aligned with the corresponding portion of the surface of the femur.