Method for installing a femoral component

• US 5,445,642 A
• Filed: 09/01/1992
• Issued: 08/29/1995
• Est. Priority Date: 09/01/1992
• Status: Expired due to Term

• Current Assignee: DePuy Orthopaedics Incorporated (Johnson & Johnson)
• Original Assignee: DePuy Incorporated (Johnson & Johnson)
• Inventors: Kelman, David C., McNulty, Donald E., Hamm, John E., Moreland, John R.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Tucker, Guy V.
• Application Number:
  US07/937,704
• Time in Patent Office: 1,092 Days
• Field of Search: 606/87, 606/88, 606/102, 606/86, 606/82, 606/79, 623/18, 623/20
• US Class Current: 606/88
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2002/30616 Sets comprising a plurality of prosthetic parts of different sizes or orientations

Abstract

The invention relates to a method for reconstructing a femoral portion of a knee in a total knee replacement, the distal end of which has medial and lateral condyles and an intercondylar notch therebetween defining a distal patellar groove for the articulation of the patella with the femur during flexion of the knee. The method comprising the steps of:

locating and drilling a hole in the intercondylar notch to access an intermedullary canal of a femur;

installing a femoral alignment guide onto an intermedullary rod;

inserting the intermedullary rod through said hole toward a proximal end of the femur;

moving said femoral alignment guide into contact with the intercondylar notch of the knee;

positioning a femoral cutting block relative to the alignment guide;

securing the cutting block to the femur to align a guide surface of the cutting block at a predetermined proximal distance from said intercondylar notch;

removing the femoral alignment guide and rod from the femur;

resecting the distal lateral and medial condyles along a plane using the guide surface of the resection block as a resection reference, wherein the plane is displaced from what will become a new prosthetic joint line generally coincidental with the end of the distal end of the original lateral condyle, and wherein the distance from the resected surface of the distal end of the original lateral condyle is less than the distance from the resected surface of the distal end of the original medial condyle; and

determining an appropriate size of a femoral component having a size and condyle thickness which will reconstruct the lateral condyle and position the distal patellar groove at about the same distal locations to approximate the anatomy of the natural knee being replaced and to position the medial condyle of the femoral component at the same distal position as the original lateral condyle. The structures of the femoral alignment guide and cutting block are also disclosed.

Claims

1. A method for reconstructing a femoral portion of a knee in a total knee replacement of both the medial and lateral condyles to locate the intercondylar notch and distal patellar groove of the reconstructed knee in a position generally coinciding with the natural intercondylar notch and distal patellar groove, said method comprising the steps of:

locating the position of the intercondylar notch;

resecting the distal medial and lateral condyles along a plane to form a resected distal surface with reference to the intercondylar notch wherein the distance from the resected surface of the distal end of the original lateral condyle is less than the distance from the resected surface of the distal end of the original medial condyle;

selecting a femoral component sized to place the lateral condyle of the femoral component at a distal position approximately equal to the distal position of the original lateral condyle; and

installing the selected femoral component on the resected distal surface whereby the installed femoral component has an intercondylar notch and distal patellar groove at the same general distal position as the original natural intercondylar notch and distal patellar groove being replaced.

2. The method of claim 1, wherein the plane of the resected distal surface is generally perpendicular to the mechanical axis of the femur.

3. The method of claim 1, wherein the resected distal surface is spaced apart a predetermined distance proximal from the intercondylar notch using the intercondylar notch as a reference.

4. The method of claim 3, wherein the femoral component has a thickness in the area of a patellar groove substantially equal to said predetermined distance so that the distal patellar groove of the femoral component is positioned at substantially the natural location of the distal patellar groove.

5. The method of claim 1, wherein the selecting step includes the step of providing a plurality of femoral components having various anterior/posterior lengths and increasing distal and posterior condyle thicknesses as the anterior/posterior length increases and determining which of the plurality of femoral components has an appropriate distal and posterior condyle thickness to approximate the natural distal position of the resected lateral condyle.

6. The method of claim 1, wherein the selecting step includes the step of placing a sizer assembly on the resected distal end of the femur to determine an appropriate size femoral component.

7. A method for reconstructing a femoral portion of a knee in a total knee replacement of both the medial and lateral condyles so that both the medial and lateral condyles of the reconstructed knee are located at about the same distal position as the original natural lateral condyle, said method comprising the steps of:

locating the position of the intercondylar notch;

resecting the distal medial and lateral condyles along a plane to form a resected distal surface with reference to the intercondylar notch wherein the distance from the resected surface of the distal end of the original lateral condyle is less than the distance from the resected surface of the distal end of the original medial condyle;

selecting a femoral component sized to place the lateral condyle of the femoral component at a distal position approximately equal to the distal position of the original lateral condyle; and

installing the selected femoral component on the resected distal surface whereby the installed femoral component has both the medial and lateral condyles at the same general distal position as the original natural lateral condyle being replaced.

8. The method of claim 7, wherein the plane of the resected distal surface is generally perpendicular to the mechanical axis of the femur.

9. The method of claim 7, wherein the selecting step includes the step of providing a plurality of femoral components having various anterior/posterior lengths and increasing distal and posterior condyle thicknesses as the anterior/posterior length increases and determining which of the plurality of femoral components has an appropriate distal and posterior condyle thickness to approximate the natural distal position of the resected lateral condyle.

10. The method of claim 9, wherein the determining step includes the step of placing a sizer assembly on the resected end of the femur to indicate which one of the plurality of femoral components is appropriately sized for the resected femur.

11. The method of claim 7, wherein the resected distal surface is spaced apart a predetermined distance proximal from the intercondylar notch using the intercondylar notch as a reference.

12. The method of claim 11, wherein the resecting step includes the step of positioning a cutting block at a predetermined position relative to the intercondylar notch so that the resected distal surface of the femur is located said predetermined distance from the position of the intercondylar notch of the femur.

13. The method of claim 12, wherein the step of positioning the cutting block relative to the intercondylar notch includes the steps of:

locating and drilling a hole in the intercondylar notch to access an intermedullary canal of the femur;

installing a femoral alignment guide onto an intermedullary rod;

inserting the intermedullary rod through said hole toward a proximal end of the femur;

moving said femoral alignment guide into contact with the intercondylar notch of the knee;

positioning said femoral cutting block relative to the alignment guide; and

securing said cutting block to the femur to align a guide surface of the cutting block at a predetermined proximal distance from said intercondylar notch.

14. The method of claim 12, wherein the step of positioning the cutting block relative to the intercondylar notch includes the step of aligning a notch formed in the cutting block with the intercondylar notch, the cutting block having a saw guide spaced said predetermined distance from the notch in the cutting block.

15. The method of claim 11, wherein the resected distal surface is spaced apart a predetermined distance proximal from the intercondylar notch and the femoral component has a thickness in the area of a patellar groove substantially equal to said predetermined distance so that the distal patellar groove of the femoral component is positioned at substantially the natural location of the distal patellar groove.

16. A method for reconstructing a femoral portion of a knee in a total knee replacement, the distal end of which has medial and lateral condyles and an intercondylar notch therebetween defining a distal patellar groove for the articulation of the patella with the femur during flexion of the knee, the method comprising the steps of:

locating and drilling a hole in the intercondylar notch to access an intermedullary canal of a femur;

installing a femoral alignment guide onto an intermedullary rod;

inserting the intermedullary rod through said hole toward a proximal end of the femur;

moving said femoral alignment guide into contact with the intercondylar notch of the knee;

positioning a femoral cutting block relative to the alignment guide;

securing the cutting block to the femur to align a guide surface of the cutting block at a predetermined proximal distance from said intercondylar notch;

removing the femoral alignment guide and rod from the femur;

resecting the distal lateral and medial condyles along a plane using the guide surface of the resection block as a resection reference, wherein the distance from the resected surface of the distal end of the original lateral condyle is less than the distance from the resected surface of the distal end of the original medial condyle; and

determining an appropriate size of a femoral component having a size and condyle thickness which will reconstruct the lateral condyle and position the distal patellar groove at about the same distal locations to approximate the anatomy of the natural knee being replaced and to position the medial condyle of the femoral component at the same distal position as the original lateral condyle.

17. The method of claim 16, wherein the step of moving the femoral alignment guide into contact with the intercondylar notch of the knee includes the step positioning an intercondylar saddle on the alignment guide in engagement with the intercondylar notch.

18. The method of claim 17, wherein the step of positioning the femoral cutting block relative to the alignment guide includes the step of positioning the cutting block on an arm of the alignment guide at a selected position spaced apart from the intercondylar saddle by predetermined distance so that the femur is resected a predetermined distance proximal to the intercondylar notch.

19. The method of claim 16, wherein the step of determining an appropriate size of a femoral component includes the step of placing a sizer assembly on the resected distal end of the femur to determine an appropriate size femoral component.