Tibial trial prosthesis and bone preparation system

• US 5,683,469 A
• Filed: 06/07/1995
• Issued: 11/04/1997
• Est. Priority Date: 02/15/1995
• Status: Expired due to Term

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Carls, Thomas A. "Tommy", Steele, John, Vendrely, Tim, Whiteside, Leo A., Johnson, Chris E., Naraghian, Khosrow
• Primary Examiner(s): ISABELLA, DAVID J
• Application Number:
  US08/473,144
• Time in Patent Office: 881 Days
• Field of Search: 623/16-23, 606/86, 606/87, 606/88, 606/99
• US Class Current: 623/20.32
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2017/1602 Mills
• CPC Class Codes: A61B 2090/033 Abutting means, stops, e.g. abutting on tissue or skin
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/461 of knees
• CPC Class Codes: A61F 2/4684 Trial or dummy prostheses
• CPC Class Codes: A61F 2002/30433 using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30594 slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
• CPC Class Codes: A61F 2002/30616 Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
• CPC Class Codes: A61F 2002/4681 by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61F 2220/0041 using additional screws, bolts, dowels or rivets, e.g. connecting screws

Abstract

The method of implanting a femoral and a tibial knee prosthesis and instruments for surgically implanting the femoral and tibial prosthesis component as disclosed. The method includes the formation of a plurality of surgical cuts on the patient'"'"'s distal femur. A trial tibial prosthesis is then fitted to the surgically prepared distal femur. The trial prosthesis has a femoral articulating surface and a non-articulating surface that fits the patient'"'"'s distal femur at the surgical cuts. A surgeon then forms a transverse cut on the patient'"'"'s proximal tibia. The surgeon places a tibial trial prosthesis on the patient'"'"'s proximal tibia, the trial prosthesis including a tibial trial stem that fits the patient'"'"'s intramedullary canal, a tibial trial metallic tray or plate, and a plastic trial insert that fits the tibial tray or plate. The plastic insert includes a tibial articulating surface that can articulate with the femoral articulating surface. The respective articulating surfaces are placed in contact and the surgeon then moves the patient'"'"'s knee through a full range of motion. During this movement of patient'"'"'s knee through a full range of motion, the surgeon uses a lever that is attached to the trial tibial prosthesis to rotate the trial tibial prosthesis about its stem. The surgeon can try different rotational positions of the tibial trial prosthesis each time moving the knee through a full range of motion to ensure proper orientation and an accurate fit.

Claims

1. A trial knee prosthesis instrumentation system comprising:

a) a femoral trial prosthesis;

b) a tibial trial prosthesis having a periphery with an open ended socket at the periphery;

c) a handle for manipulating the femoral trial prosthesis and tibial trial prosthesis relative to one another; and

d) said handle being slideably attachable to the tibial trial prosthesis at the socket, said handle comprising in part a tab member that closely fits within the socket of the tibial trial prosthesis, and wherein the tab member and socket are correspondly sized and shaped.

2. The trial knee prosthesis instrumentation system of claim 1 wherein the trial femoral prosthesis comprises a metallic trial member having a condylar articulating surface and a non-articulating surface adapted to fit the patient'"'"'s distal femur.

3. The trial knee prosthesis instrumentation system of claim 1 wherein the tibial trial prosthesis comprises a trial tibial tray and a plastic trial articular insert having an articulating surface.

4. The trial knee prosthesis instrumentation system of claim 1 further comprising an elongated linear socket carried by the trial tibial prosthesis for receiving one end portion of the handle to define therewith a sliding removable connection.

5. The trial knee prosthesis instrumentation system of claim 1 wherein the tibial trial prosthesis comprises a plastic tibial trial prosthesis articular insert having the socket, and wherein the handle forms a connection with the plastic insert at the socket.

6. The trial knee prosthesis instrumentation system of claim 1 wherein the trial tibial prosthesis comprises a trial tibial tray having proximal and distal end portions and a tibial articular insert that fits the proximal end portion of the tray.

7. The trial knee prosthesis instrumentation system of claim 1 wherein the tibial trial prosthesis comprises a trial tibial tray that fits the patient'"'"'s proximal tibia and a plastic articular insert that fits the trial tibial tray and wherein the open ended socket is formed in the plastic articular insert and the handle forms a sliding connection with the articular insert at the socket.

8. The trial knee prosthesis instrumentation system of claim 7 wherein the connection between the handle and the insert is a removable connection that is positioned at the periphery of the trial tibial prosthesis.

9. The trial knee prosthesis instrumentation system of claim 7 wherein the removable connection includes said socket, and the socket is positioned so that the handle enables the surgeon to pry the insert and tray apart when a portion of the handle is placed within the socket.

10. The trial knee prosthesis instrumentation system of claim 1 further comprising a manipulating tab portion carried by one end portion of the handle for forming a connection with one of the trial prosthesis, said tab having a smaller cross-sectional area than the cross-sectional area of a majority of the handle.

16. The tibial trial prosthesis instrumentation system of claim 1 further comprising a femoral trial prosthesis that has a femoral articulating surface that engages the tibial articulating surface.

17. The tibial trial prosthesis instrumentation system of claim 16 wherein the femoral trial prosthesis has a pair of condylar articulating surfaces and the tibial trial prosthesis has a correspondingly shaped articulating surface.

11. A trial knee prosthesis instrumentation system for articulating with a patient'"'"'s femoral condylar articulating surface comprising;

a) a tibial trial prosthesis that includes a metallic trial tibial tray with a stem that fits the patient'"'"'s intramedullary canal and a plastic articular insert that is connectable to the tray, the insert having an articulating surface for receiving and articulating with a patient'"'"'s correspondingly shaped femoral condylar articulating surface;

b) a handle for manipulating the trial tibial prosthesis, said handle having a portion that forms a detachable connection with the tibial trial prosthesis; and

c) said tibial trial prosthesis and said handle being rotationally movable together, independently of said femoral articulating surface, for enabling a surgeon to use the handle to selectively position the trial tibial prosthesis in a desired rotational position relative to the femoral condylar articulating surface.

12. The trial knee prosthesis instrumentation system of claim 11 wherein the handle comprises a gripping portion that can be grasped by the surgeon and a tab portion that removably engages the tibial trial prosthesis.

13. The tibial trial prosthesis instrumentation system of claim 11 wherein the handle forms a connection with the articular insert.

14. The tibial trial prosthesis instrumentation system of claim 11 wherein the handle enables a surgeon to remove the insert from the tray while the tray remains implanted on the patient'"'"'s proximal tibia.

15. The tibial trial prosthesis instrumentation system of claim 11 wherein the detachable connection is a sliding connection.