Tibial resection instrumentation and surgical method

• US 5,667,511 A
• Filed: 06/07/1995
• Issued: 09/16/1997
• Est. Priority Date: 02/15/1995
• Status: Expired due to Term

• Current Assignee: Smith & Nephew Richards Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Richards Incorporated (Smith & Nephew PLC)
• Inventors: Carls, Thomas A. Tommy, Steele, John, Vendrely, Tim, Whiteside, Leo A., Johnson, Chris E.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): LEONARDO, MARK
• Application Number:
  US08/484,611
• Time in Patent Office: 832 Days
• Field of Search: 606/80, 606/82, 606/86, 606/87, 606/88, 606/96, 606/102
• US Class Current: 606/88
• CPC Class Codes: A61B 17/157 Cutting tibia

Abstract

A method of preparing a patient'"'"'s proximal tibia with a surgical saw and cutting instrumentation is disclosed. The method of the present invention prepares the patient'"'"'s proximal tibial to receive a tibial implant. The patient'"'"'s intramedullary canal is first reamed and then an intramedullary rod is placed in the intramedullary canal as a reference. A first cutting instrument is bound on the rod above the patient'"'"'s proximal tibia. The first cutting instrument includes a stylus that is used to set the depth of cut by referencing the top of the proximal tibia. The proximal tibia is then transversely cut with the saw by tracking the first cutting guide surfaces with the saw. The first cutting instrument is removed together with its stylus. A secondary cutting instrument is then placed on the rod above the proximal tibia. The second cutting instrument has a cutter at its center for cutting longitudinally into the proximal tibia. A secondary cut is made on the proximal tibia by tracking the secondary cutting instrument and a guide surface provided on the upper end of the cutters that engage the center of the proximal tibia.

Claims

1. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having a primary cutting surface thereon for guiding a surgeon'"'"'s cutting knife during a reshaping of a patient'"'"'s proximal tibia to receive a tibial prosthesis member;

b) a blade portion for forming a connection between the instrument body and the patient'"'"'s proximal tibia, the blade member having a sharp edge portion that can cut into the cancellous tissue of the patient'"'"'s proximal tibia and a trailing edge that defined a secondary cutting guide surface;

c) a rod for tracking the patient'"'"'s intramedullary canal, said rod being connectable to the instrument body so that the primary cutting guide surfaces are referenced to the patient'"'"'s intramedullary canal; and

d) wherein the embedded blade member secondary cutting guide surface defines a plane with the primary cutting guide surface so that the cutting instrument abuts both the primary cutting guide surface and the secondary cutting guide surface during use.

2. The tibial cutting guide instrument of claim 1 wherein the instrument body is generally U-shaped.

3. The tibial cutting guide instrument of claim 1 further comprising an anvil portion that enables a user to drive the instrument body at the blade member into the patient'"'"'s proximal tibia.

4. The tibial cutting guide instrument of claim 1 wherein the blade member comprises a plurality of radially spaced blade members.

5. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having a primary cutting surface thereon for guiding a surgeon'"'"'s cutting knife during a reshaping of a patient'"'"'s proximal tibia to receive a tibial prosthesis member;

b) means for forming a connection between the instrument body and the patient'"'"'s proximal tibia, said means including a blade member that can cut into the cancellous tissue of the patient'"'"'s proximal tibia;

c) a rod for tracking the patient'"'"'s intramedullary canal, said rod being connectable to the instrument body so that the primary cutting guide surfaces are referenced to the patient'"'"'s intramedullary canal;

d) wherein the blade member has a secondary cutting guide surface that defines a plane with the primary cutting guide surface so that the cutting instrument abuts both the primary cutting guide surface and the secondary cutting guide surface during use; and

e) wherein the secondary cutting guide surface is imbedded in the tibia during use.

6. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having a primary cutting surface thereon for guiding a surgeon'"'"'s cutting knife during a reshaping of a patient'"'"'s proximal tibia to receive a tibial prosthesis member;

b) means for forming a connection between the instrument body and the patient'"'"'s proximal tibia, said means including a blade member that can cut into the cancellous tissue of the patient'"'"'s proximal tibia;

c) a rod for tracking the patient'"'"'s intramedullary canal, said rod being connectable to the instrument body so that the primary cutting guide surfaces are referenced to the patient'"'"'s intramedullary canal;

d) wherein the blade member has a secondary cutting guide surface that defines a plane with the primary cutting guide surface so that the cutting instrument abuts both the primary cutting guide surface and the secondary cutting guide surface during use;

e) an anvil portion that enables a user to drive the instrument body at the blade member into the patient'"'"'s proximal tibia; and

f) where in the blade is embedded during use within the tibia cancellous bone.

7. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having a primary cutting surface thereon for guiding a surgeon'"'"'s cutting knife during a reshaping of a patient'"'"'s proximal tibia to receive a tibial prosthesis member;

b) means for forming a connection between the instrument body and the patient'"'"'s proximal tibia, said means including a blade member that can cut into the cancellous tissue of the patient'"'"'s proximal tibia;

c) a rod for tracking the patient'"'"'s intramedullary canal, said rod being connectable to the instrument body so that the primary cutting guide surfaces are referenced to the patient'"'"'s intramedullary canal;

d) wherein the blade member has a secondary cutting guide surface that defines a plane with the primary cutting guide surface so that the cutting instrument abuts both the primary cutting guide surface and the secondary cutting guide surface during use; and

e) wherein the instrument body is generally U-shaped, having a pair of generally parallel leg members connected by a bridge member, and wherein the primary cutting surfaces and secondary cutting surfaces are attached respectively to the leg members.

8. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having a primary cutting surface thereon for guiding a surgeon'"'"'s cutting knife during a reshaping of a patient'"'"'s proximal tibia to receive a tibial prosthesis member;

b) means for forming a connection between the instrument body and the patient'"'"'s proximal tibia, said means including a blade member that can cut into the cancellous tissue of the patient'"'"'s proximal tibia;

c) a rod for tracking the patient'"'"'s intramedullary canal, said rod being connectable to the instrument body so that the primary cutting guide surfaces are referenced to the patient'"'"'s intramedullary canal;

d) wherein the blade member has a secondary cutting guide surface that defines a plane with the primary cutting guide surface so that the cutting instrument abuts both the primary cutting guide surface and the secondary cutting guide surface during use; and

e) wherein the rod has an axis that defines an axial line that tracks the patient'"'"'s intramedullary canal, and the blade member occupies a plane that intersects said rod axis.

9. The tibial cutting guide instrument of claim 8 wherein there are a plurality of blade members, each intersecting said rod axis.

10. The tibial cutting guide instrument of claim 9 wherein said rod tracks an axial line that coincides with the patient'"'"'s intramedullary axis and wherein the cutting guide surfaces are generally parallel to said rod and said axis.

11. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having a primary cutting surface thereon for guiding a surgeon'"'"'s cutting knife during a reshaping of a patient'"'"'s proximal tibia to receive a tibial prosthesis member;

b) means for forming a connection between the instrument body and the patient'"'"'s proximal tibia, said means including a blade member that can cut into the cancellous tissue of the patient'"'"'s proximal tibia;

c) a rod for tracking the patient'"'"'s intramedullary canal, said rod being connectable to the instrument body so that the primary cutting guide surfaces are referenced to the patient'"'"'s intramedullary canal;

d) wherein the blade member has a secondary cutting guide surface that defines a plane with the primary cutting guide surface so that the cutting instrument abuts both the primary cutting guide surface and the secondary cutting guide surface during use; and

e) wherein there are at least a pair of blade members, each disposed about a bushing that attaches to the rod, each of said blade members forming a flat plane, and the planes being generally perpendicular to the rod.

12. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having a primary cutting surface thereon for guiding a surgeon'"'"'s cutting knife during a reshaping of a patient'"'"'s proximal tibia to receive a tibial prosthesis member;

b) means for forming a connection between the instrument body and the patient'"'"'s proximal tibia, said means including a blade member that can cut into the cancellous tissue of the patient'"'"'s proximal tibia;

c) a rod for tracking the patient'"'"'s intramedullary canal, said rod being connectable to the instrument body so that the primary cutting guide surfaces are referenced to the patient'"'"'s intramedullary canal;

d) wherein the blade member has a secondary cutting guide surface that defines a plane with the primary cutting guide surface so that the cutting instrument abuts both the primary cutting guide surface and the secondary cutting guide surface during use; and

e) wherein the instrument body is generally U-shaped, having a pair of spaced apart generally parallel leg portions and a transversely extending bridge member that is generally perpendicular to the leg portions, and further comprising an opening that extends through one of the leg portions for supporting the body on the rod at the opening.

13. The tibial cutting guide instrument of claim 12 wherein the bridge member has an anvil surface thereon that enables the user to apply hammer blows thereto for driving the blades into the patient'"'"'s tibial cancellous bone tissue.

14. The tibial cutting guide instrument of claim 13 wherein the cutting blade has a cutting edge that defines a plane generally aligned with the tibial intramedullary canal, and an opposite proximal edge that defines that secondary cutting guide, said secondary cutting guide surface being an elongated linear cutting guide surface that is generally transverse to the intramedullary rod during use.

15. The tibial cutting guide instrument of claim 13 wherein there are a plurality of cutting blade members mounted on the second end portion of the body, each of the cutting blades forming an angle with the other.

16. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia with a generally flat cutting blade to receive a tibial prosthesis comprising:

a) an instrument body having first and second end portions;

b) the first end portion of the instrument body having a first cutting guide surface thereon for guiding the flat cutting blade in preparing a patient'"'"'s proximal tibia with generally flat transverse cuts to receive a tibial prosthesis;

c) an intramedullary rod for referencing the patient'"'"'s tibial intramedullary canal;

d) the second end portion of the instrument body having an intramedullary rod opening that enables the instrument body to be mounted to the intramedullary rod and transverse cutting guide surfaces that extend generally transverse to the intramedullary rod opening; and

f) the second end portion of the instrument body including longitudinally extending cutting blade having a cutting edge that defines a plane generally aligned with the intramedullary canal and generally perpendicular to the first cutting guide surface, said longitudinally extending cutting blade being positioned in the patient'"'"'s cancellous tibial bone tissue during use; and

g) the second end portion of the instrument body having a second cutting guide surface thereon that occupies a common cutting guide plane with the first cutting guide surface and being defined by a flat trailing edge of the longitudinal cutting blade.

17. The tibial cutting guide instrument of claim 16 wherein the opening is generally cylindrical.

18. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having first and second end portions;

b) the first end portion of the instrument body having cutting guide surfaces thereon for preparing a patient'"'"'s proximal tibia with transverse cuts flat to receive a tibial prosthesis;

c) an intramedullary rod for referencing the patient'"'"'s tibial intramedullary canal;

d) the second end portion of the instrument body having an intramedullary rod opening that enables the instrument body to be mounted to the intramedullary rod;

e) the transverse cutting guide surfaces being generally transverse to the intramedullary rod opening;

f) a cutting blade mounted on the second end portion of the instrument body, said cutting blade having a cutting edge that defines a plane generally aligned with the intramedullary canal, said cutting blade being sized and shaped to cut into the patient'"'"'s cancellous tibial bone tissue; and

g) wherein the cutting blade is sized and shaped to fit within the patient'"'"'s tibia.

19. The tibial cutting guide instrument of claim 18 wherein the cutting blade is sized to fit within the patient'"'"'s tibia cancellous bone tissue.

20. The tibial cutting guide instrument of claim 19 wherein the blade has a distal cutting surface and a proximal cutting surface, the proximal cutting surface being the secondary cutting guide surface.

21. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having a transverse primary cutting surface thereon for guiding a surgeon'"'"'s cutting knife during a reshaping of a patient'"'"'s proximal tibia to receive a tibial prosthesis member;

b) a blade for forming a connection between the instrument body and the patient'"'"'s proximal tibia, said blade member having a cutting edge that cuts into the medullary tissue of the patient'"'"'s proximal tibia during use, embedding the blade in the medullary tissue;

c) a rod for tracking the patient'"'"'s intramedullary canal, said rod being connectable to the instrument body so that the primary cutting surfaces are referenced to the patient'"'"'s intramedullary canal; and

d) wherein the blade member has a secondary cutting guide surface that defines a plane with the primary cutting guide surface so that the cutting instrument engages both the primary cutting guide surface and the secondary cutting guide surface during use.

22. A tibial cutting guide instrument for resecting a patient'"'"'s transversely cut proximal tibia to receive a tibial prosthesis comprising:

a) an instrument body having first and second end portions;

b) the first end portion of the instrument body having cutting guide surfaces thereon for preparing a patient'"'"'s proximal tibia to receive a tibial prosthesis;

c) an intramedullary rod for referencing the patient'"'"'s tibial intramedullary canal;

d) the second end portion of the instrument body having an intramedullary rod opening that enables the instrument body to be mounted to the intramedullary rod;

e) the transverse cutting guide surfaces being generally transverse to the intramedullary rod opening; and

f) a cutting blade mounted on the second end portion of the intramedullary canal, said cutting blade having a cutting edge that defines a plane generally aligned with the intramedullary canal, said cutting blade having a cutting edge that is sized and shaped to cut into the patient'"'"'s cancellous tibial bone tissue, embedding the blade in said bone tissue during use.

23. A tibial cutting instrument for preparing a patient'"'"'s proximal tibia to receive a tibial prothesis comprising:

a) an instrument body having first and second end portions;

b) the first end portion of the instrument body having first transverse cutting guide surface thereon for preparing a patient'"'"'s proximal tibia to receive a tibial prosthesis;

c) the transverse cutting guide surfaces being generally perpendicular to the patient'"'"'s tibia;

d) a cutting blade mounted on the second end portion of the intramedullary canal, said cutting blade having a cutting edge that defines a plane generally aligned with the tibia, said cutting blade being embedded within the patient'"'"'s cancellous tibial bone tissue during use;

e) the cutting blade having a second transverse cutting guide surface that defines a plane with the first cutting guide surface; and

f) wherein the surgeon can track the first and second cutting guide surfaces during a resection of the patient'"'"'s proximal tibia.

24. The tibial cutting guide instrument of claim 23 wherein the blade is embedded within the patient'"'"'s tibial cancellous bone tissue during use.