Tibial trial prosthesis and bone preparation system

• US 5,776,200 A
• Filed: 06/07/1995
• Issued: 07/07/1998
• 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: Steele, John, Vendrely, Tim, Naraghian, Khosrow, Carls, Thomas A., Whiteside, Leo A., Johnson, Chris E.
• Primary Examiner(s): SHAY, RANDY CITRIN
• Application Number:
  US08/472,815
• Time in Patent Office: 1,126 Days
• Field of Search: 623/16, 623/18, 623/19, 623/20, 623/22, 606/88
• US Class Current: 623/20.15
• 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 prosthesis kit for trial attachment to a patient'"'"'s long bone during knee joint replacement surgery comprising:

a) a trial prep tray member, the prep tray member providing a trial articulating surface and a connecting taper portion;

b) a plurality of elongated trial stems, each having a generally uniform diameter enabling the stem to fit within the patient'"'"'s long bone intramedullary canal; and

c) a pair of trial stem couplers that can each form a connection between the taper portion and a selected trial stem, each of said couplers providing a shaped connecting surface that forms a connection with a correspondingly-shaped connecting surface of the trial stem taper, the couplers defining different respective angular orientations between a selected trial prep tray member and a selected trial stem.

2. The trial prosthesis kit of claim 1 wherein the coupler comprises a generally cylindrically-shaped body having a first cylindrical section and a second cylindrical section, the second section having a larger diameter than the first section.

3. The trial prosthesis kit of claim 1 wherein the coupler comprises an externally threaded section and a non-threaded section having a socket, said socket being sized and shaped to form a connection with the trial stem taper, the non-threaded section having a larger diameter than the threaded section.

4. The trial prosthesis kit of claim 1 wherein the prep plate tray provides a central opening, and the trial stem taper forms a connection to the prep plate tray at the opening.

5. The trial prosthesis kit of claim 1 wherein the prep plate tray has a central opening and a V-shaped notch that communicates with the central opening.

6. The trial prosthesis kit of claim 1 wherein there are at least a pair of said couplers that can be fitted one at a time to the trial stem and trial stem coupler, one of said couplers having a central longitudinal axis and a socket uniformly disposed about said axis.

7. The trial prosthesis kit of claim 1 wherein the coupler has a frustoconically-shaped socket and the trial stem taper has a corresponding frustoconically-shaped projecting portion that forms a connection with the socket of the coupler.

8. The trial prosthesis kit of claim 1 wherein the assembly of the trial taper, coupler, and trial stem has a generally uniform external diameter.

9. The trial prosthesis kit of claim 1 wherein the assembly of the trial stem, coupler, and trial taper is generally cylindrically shaped.

10. The trial prosthesis kit of claim 1 wherein the stem has a connecting end portion that forms a connection with the coupler, said end portion having a socket for receiving a projecting portion of the coupler.

11. The trial prosthesis kit of claim 1 wherein said socket is internally threaded and wherein said coupler provides an externally threaded section that forms a connection with the internally threaded socket.

12. A tibial trial prosthesis kit comprising:

a) a prep plate tray having an opening therethrough;

b) an elongated trial stem that is capable of fitting inside the patient'"'"'s intramedullary canal;

c) a trial stem taper that is removably attachable to the prep plate tray at the opening; and

d) a trial stem coupler that forms a connection between the trial stem taper and the trial stem, said coupler comprising first and second sections, the first section being smaller in diameter than the second section, the first section adapted to form a connection with the top of the trial stem and the second section adapted to form a connection with the bottom of the trial stem taper, said second section providing a shaped connecting surface that forms a connection with a correspondingly-shaped surface of the trial stem taper;

e) wherein there are at least a pair of said couplers that can be fitted one at a time to the trial stem and trial stem taper, one of said couplers having a central longitudinal axis and a socket uniformly disposed about said axis; and

f) wherein at least one of said couplers has a central longitudinal axis and includes a socket having a socket axis that is angled with reference to the coupler axis.

13. A trial prosthesis kit for trial attachment to a patient'"'"'s long bone during knee joint replacement surgery comprising:

a) a trial prep tray member, the prep tray member providing a trial articulating surface;

b) a plurality of elongated trial stems, each having a generally uniform diameter enabling the stem to fit within the patient'"'"'s long bone intramedullary canal;

c) a trial stem taper that is removably attachable to the prep tray member; and

d) a pair of trial stem couplers that can each form a connection between the trial stem taper and the trial stem, said couplers comprising a first and a second section, the first section having a smaller diameter than the second section, wherein the first section forms a connection with the trial stem and the second section forms a connection with the trial stem taper, said second section providing a shaped connecting surface that forms a connection with a correspondingly-shaped connecting surface of the trial stem taper, the couplers defining different angular orientations between a selected trial stem coupler and a selected trial stem;

e) wherein there are at least a pair of said couplers that can be fitted one at a time to the trial stem and trial stem coupler, one of said couplers having a central longitudinal axis and a longitudinally extending socket uniformly disposed about said axis; and

f) wherein at least one of said couplers has a central longitudinal axis and includes a socket having a socket axis that is angled with reference to the coupler axis.

14. The trial prosthesis kit of claim 13 wherein the coupler comprises a generally cylindrically-shaped body having first and second cylindrical sections, the first section being of a smaller diameter than the second cylindrical section.

15. The trial prosthesis kit of claim 13 wherein the coupler comprises an externally threaded section and a non-threaded section having a socket, the non-threaded section having a larger diameter than the threaded section said socket being sized and shaped to form a connection with the trial stem taper, said stem forming an attachment with said coupler at the threaded section of the coupler.

16. The trial prosthesis kit of claim 13 wherein the prep plate tray provides a central opening, and the trial stem taper forms connection to the prep plate tray at the central opening.

17. The trial prosthesis kit of claim 13 wherein the prep plate member has a central opening and a V-shaped notch that communicates with the central opening.

18. The trial prosthesis kit of claim 13 wherein the coupler has a frustoconically-shaped socket and the trial stem taper has a corresponding frustoconically-shaped projecting portion that forms a taper-lock fit with the socket of the coupler.

19. The trial prosthesis kit of claim 13 wherein the assembly of the trial taper, coupler, and trial stem has a generally uniform external diameter.

20. The trial prosthesis kit of claim 13 wherein the assembly of the trial stem, coupler, and trial taper is generally cylindrically shaped.

21. The trial prosthesis kit of claim 13 wherein the stem has a connecting end portion that forms a connection with the coupler, said end portion having a socket for receiving a projecting portion of the coupler.

22. The trial prosthesis kit of claim 21 wherein said socket is internally threaded and wherein said coupler provides an externally threaded section that forms a connection with the internally threaded socket.