SURGICAL INSTRUMENT

• US 20140228853A1
• Filed: 08/28/2012
• Published: 08/14/2014
• Est. Priority Date: 09/07/2011
• Status: Active Grant

• Current Assignee: Depuy Ireland Unlimited Company (Johnson & Johnson)
• Original Assignee: Depuy (Johnson & Johnson)
• Inventors: Rock, Michael
• Granted Patent: US 9,750,619 B2
• Time in Patent Office: Days
• US Class Current: 606/88
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2017/0268 for the knee
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/4658 for measuring dimensions, e.g. length

Abstract

An adjustable spacer instrument and method of use in a knee arthroplasty procedure are described. The instrument comprises a first member having a substantially planar upper surface and a second member having a substantially planar lower surface. An angular adjustment mechanism is interposed between the first and second members and is operable to adjust the degree of tilt between the upper surface and the lower surface and includes a releasable lock which can maintain the degree of tilt.

Claims

1. An adjustable spacer instrument for use in a knee arthroplasty procedure, comprising:

a first member having a substantially planar upper surface;

a second member having a substantially planar lower surface; and

an angular adjustment mechanism interposed between the first member and the second member, the angular adjustment mechanism being operable to adjust the degree of tilt between the upper surface and the lower surface and including a releasable lock which can maintain the degree of tilt.

2. The adjustable spacer instrument of claim 1, wherein the angular adjustment mechanism is operable to continuously adjust the degree of tilt.

3. The adjustable spacer instrument of claim 1, wherein the adjustment mechanism is operable to discretely adjust the degree of tilt.

4. The adjustable spacer instrument of claim 1, wherein the adjustment mechanism is configured to tilt the upper surface and/or the lower surface about an axis extending in a generally anterior-posterior direction in use.

5. The adjustable spacer instrument of claim 1, wherein the adjustment mechanism comprises entirely integral parts of the first member and the second member which interact when the adjustment mechanism is operated.

6. The adjustable spacer instrument of claim 1, wherein the adjustment mechanism is operable by rotating the first member or the second member relative to each other.

7. The adjustable spacer instrument of claim 1, wherein the first member or the second member are rotatable about an axis substantially perpendicular to a plane of the adjustable spacer instrument.

8. The adjustable spacer instrument of claim 1 wherein a posterior part of the first member and/or a posterior part of the second member includes a recess configured to accept the posterior cruciate ligament in use.

9. The adjustable spacer instrument of claim 1, wherein the adjustable spacer instrument consists of only two parts.

10. The adjustable spacer instrument of claim 1, wherein the adjustment mechanism includes a rotatable part separate to the first member and the second member, and wherein the rotatable part is operable to adjust the degree if tilt, without the first and/or second members rotating.

11. The adjustable spacer instrument of claim 1, wherein the adjustment mechanism comprises a plurality of proud features and a plurality of regions of differing height positioned to engage the proud features in a plurality of different configurations each corresponding to a different degree of tilt between the upper surface and the lower surface.

12. The adjustable spacer instrument of claim 11, wherein the plurality of regions of differing height are in the form of recessed tracks into which the plurality of proud features respectively engage.

13. The adjustable spacer instrument of claim 12, wherein each recessed track includes a base providing a continuous camming surface.

14. The adjustable spacer instrument of claim 12, wherein each recessed track is in the form of a plurality of detents.

15. The adjustable spacer instrument of claim 1, and further comprising an attachment formation to which a cutting block can be directly or indirectly releasably attached.

16. The adjustable spacer instrument of claim 1, wherein the adjustable spacer instrument has an initial state in which the upper surface and lower surface are parallel and a plurality of tilted states in which the upper surface and lower surface are non-parallel and the adjustable spacer instrument is driveable between the initial state and the plurality of tilted states by operating the angular adjustment mechanism.

17. A adjustable spacer instrument of claim 1, wherein the thickness of the adjustable spacer instrument, when the upper and lower surfaces are parallel is not greater than 10 mm or 20 mm.

18. A kit of parts comprising:

the adjustable spacer instrument of claim 15; and

a cutting block, wherein the cutting block includes a mount with an attachment formation by which the cutting block can be releasably attached to the adjustable spacer instrument and wherein the cutting block includes a cutting guide, the cutting guide being positioned in the cutting block so as to be parallel to the upper surface or the lower surface of the adjustable spacer instrument.

19. The kit of parts of claim 18, wherein the mount is a separate part to the cutting block and includes an attachment mechanism by which the mount is releasably attachable to the cutting block.

20. The kit of parts of claim 18, wherein the mount is an integral part of the cutting block.

21. The kit of parts of claim 18, wherein the mount is adjustable to vary the separation between the cutting guide and the spacer instrument.

26. The method of claim 21, wherein the knee is in flexion.

27. The method of claim 26, wherein the proximal part of the tibia has been resected and wherein operating the adjustable spacer instrument also rotates the femur relative to the tibia.

28. The method of claim 27, and further comprising the steps of:

attaching a cutting block having a cutting guide to the adjustable spacer instrument, wherein the cutting guide is parallel to the lower surface of the adjustable spacer; and

using the cutting guide to resect an anterior part and/or a posterior part of the femur.

22. A method for carrying out a knee arthroplasty procedure, comprising:

resecting the proximal part of the tibia or the distal part of the femur to produce a substantially flat bone surface;

placing an adjustable spacer instrument having an upper surface and a lower surface on the flat bone surface in a gap between the tibia and the femur;

operating the adjustable spacer instrument to vary the degree of tilt between the upper surface and the lower surface; and

assessing the balance of ligaments of the knee.

23. The method of claim 22, and further comprising:

attaching a cutting block having a cutting guide to the adjustable spacer instrument, wherein the cutting guide is parallel to the upper or lower surface of the adjustable spacer; and

using the cutting guide to resect at least part of the proximal part of the tibia or the distal part of the femur not already resected.

24. The method of claim 22, wherein both the proximal part of the tibia and the distal part of the femur are resected to produce substantially flat bone surfaces, and further comprising:

attaching a cutting block having a cutting guide to the adjustable spacer instrument, wherein the cutting guide is parallel to the upper or lower surface of the adjustable spacer; and

using the cutting guide to re-cut the already resected proximal part of the tibia or the distal part of femur.

25. The method of claim 22, wherein the knee is in extension.