Tibial plateau resection guide

• US 6,090,114 A
• Filed: 06/29/1999
• Issued: 07/18/2000
• Est. Priority Date: 02/10/1997
• Status: Expired due to Term

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Stryker Howmedica Osteonics Corporation
• Inventors: Gertner, Michael Eric, Collazo, Carlos Esteban, Matsuno, Shigeo, Axelson, Stuart L. Jr.
• Primary Examiner(s): Mancene, Gene
• Assistant Examiner(s): Philogene, Pedro
• Application Number:
  US09/343,058
• Time in Patent Office: 385 Days
• Field of Search: 606/87, 606/88, 606/89, 606/86, 606/96, 606/80, 606/79, 606/102
• US Class Current: 606/88
• CPC Class Codes: A61B 17/157 Cutting tibia

Abstract

An apparatus and method for tibial alignment which allows the independent establishment of two separate geometric planes to be used as a reference for the cutting of the tibial plateau during total knee arthroplasty. Two separate frame assemblies with extending rods are coupled to the tibia with a fixed relative angle between them, thereby allowing alignment with the mechanical axis of the bone. A cutting block is mounted on one of the assembly frames and is positioned against the tibia. Stabilizing pins are then placed in the cutting block, allowing the proper tibial plateau resection plane to be created.

Claims

1. A tibial resection guide comprising:

a first distally extending guide rod assembly having a first and second end, coupled with a second distally extending guide rod assembly, said second rod assembly is configured and dimensioned so as to be releasably coupled to said first rod assembly between the first and second end of said first rod assembly, wherein said tibial resection guide is oriented in the sagittal reference plane, and has a cutting block connected to the first rod assembly.

2. A tibial resection guide for aligning the tibial plateau with the mechanical axis of the tibia comprising:

(a) a first distally extending guide rod assembly having a first and second end, said first end is attachable to the tibia, wherein said first distally extending guide rod assembly has a cutting block coupled thereto; and

(b) a second distally extending guide rod assembly comprising a top bar positioned below the first end of the first distally extending guide rod and an extending rod slidably coupled to a rod anchoring block, said rod anchoring block slidably coupled to said top bar, said top bar slidably coupled to a side bar, said extending rod extending toward the ankle to a point below the tibial plateau, said second distally extending guide rod assembly configured and dimensioned so as to be removably coupled to a support arm of the first distally extending guide rod assembly.

3. The apparatus of claim 2 wherein the proximal end of the first distally extending guide rod assembly is set at a fixed relative angle of 90 degrees to the proximal end of the second distally extending guide rod assembly.

4. The apparatus of claim 2 wherein the top bar and the side bar are set a fixed relative angle of 90 degrees to each other.

12. The apparatus of claim 2 wherein the first distally extending guide rod assembly includes a pivot block;

the side bar of the second distally extending guide rod assembly is removably coupled at its proximal end below the cutting block of the first distally extending guide rod assembly; and

the extending rod of the second distally extending guide rod assembly extends downwardly from the top bar of the second distally extending guide rod assembly.

13. The apparatus of claim 12 wherein the side bar of the second distally extending guide rod assembly couples to the support arm by a dovetail or groove.

14. The apparatus of claim 12 wherein the side bar of the second distally extending guide rod assembly couples to the support arm by an aperture that is configured and dimensioned to have a mating geometry with that of the support arm.

5. A tibial resection guide for aligning the tibial plateau with the mechanical axis of the tibia comprising

(a) a first distally extending guide rod assembly having a first and second end which is attachable to the tibia and comprised of a block having at least one hole;

a support arm which is coupled to the block which extends downward from and is slidably coupled to the block;

a cutting block which is removably coupled to the support arm; and

a frontal telescoping rod which is coupled to the support arm; and

(b) a second distally extending guide rod assembly comprising a top bar, an extending rod transverse and slidably coupled to a rod anchoring block, said rod anchoring block slidably coupled to said top bar, said top bar slidably coupled to a side bar, said second distally extending guide rod assembly configured and dimensioned so as to be releasably coupled to the first distally extending guide rod assembly between the first and second end.

6. The apparatus of claim 5 further comprising at least one anchoring pin dimensioned to fit through a hole in the block.

7. The apparatus of claim 5 further comprising at least one primary anchoring pin attached to the block.

8. The apparatus of claim 5 further comprising a block which is a pivot block having a primary hole and a secondary hole adjacent to the primary hole;

a pivot arm which is pivotally coupled to the pivot block at a hinge which permits the pivot arm to move in the sagittal plane;

a primary anchoring pin dimensioned to fit through the primary hole in the pivot block and a secondary anchoring pin dimensioned to fit through the secondary hole in the pivot block.

9. The apparatus of claim 5 further comprising a tightening means operatively associated with the support arm to selectively lock the slidable support arm in a selected position on the pivot arm.

10. The apparatus of claim 5 wherein the support arm has an elongated longitudinal aperture and the cutting block is coupled to the support arm by means of a screw which passes through the elongated aperture.

11. The apparatus of claim 5 wherein the cutting block contains one or more holes for insertion of one or more stabilizing pins therethrough for securing the cutting block to the tibia.

21. A method for positioning the tibial resection cutting block of claim 5 which comprises:

(a) anchoring a block of a first distally extending guide rod assembly to the tibial plateau using at least one anchoring pin, said first distally extending guide rod assembly having a cutting block attached thereto;

(b) attaching a second distally extending guide rod assembly to the first distally extending guide rod assembly;

(c) extending a frontal telescoping rod downwardly from the distal end of the first distally extending guide rod assembly so that it is positioned adjacent the anterior face of the distal end of the tibia;

(d) extending a side extending rod downwardly from the distal end of the second distally extending guide rod assembly so that it is positioned adjacent the lateral face of the distal end of the tibia;

(e) inserting at least one pin through an aperture of the cutting block to secure the cutting block to the tibia; and

(f) removing the first distally extending guide rod assembly and the second distally extending guide rod assembly from the cutting block.

15. A tibial resection guide for aligning the tibial plateau with the mechanical axis of the tibia comprising

(a) a first distally extending guide rod assembly having a first and second end which is attachable to the tibia and comprised of a pivot block having an orifice to removably accept an elongated rod that is formed to include a first end that is adapted to be inserted into a medullary canal in the tibia bone and a second end that extends upwardly out of the tibia bone when the first end is inserted into the bone, said second end removably coupled to said pivot block;

a pivot arm which is pivotally coupled to the pivot block at a hinge which permits the pivot arm to swivel in the sagittal plane;

a support arm which extends downward from and is slidably coupled to the pivot arm;

a cutting block which is removably coupled to the support arm; and

a frontal telescoping rod which is coupled to the support arm; and

(b) a second distally extending guide rod assembly comprising a top bar, an extending rod transverse and slidably coupled to a rod anchoring block, said rod anchoring block slidably coupled to said top bar, said top bar slidably coupled to a side bar, said second distally extending guide rod assembly configured and dimensioned so as to be removably coupled to the support arm of the first distally extending guide rod assembly between the first and second end.

16. The apparatus of claim 15 further comprising a tightening means operatively associated with the support arm to selectively lock the slidable support arm in a selected position on the pivot arm.

17. The apparatus of claim 15 wherein the support arm has an elongated longitudinal aperture therethrough and the cutting block is coupled to the support arm by means of a screw which passes through the elongated aperture.

18. The apparatus of claim 15 wherein the cutting block contains one or more holes for insertion of one or more stabilizing pins therethrough for securing the cutting block to the tibia.

19. The apparatus of claim 15 wherein the side bar of the second distally extending guide rod assembly attaches to the support arm by means of a dovetail or groove.

20. The apparatus of claim 15 wherein the side bar of the second distally extending guide rod assembly attaches to the support arm by means of an aperture that is configured and dimensioned to have a mating geometry with that of the support arm.

22. A method for positioning the tibial resection cutting block of claim 15 which comprises:

(a) inserting one end of an elongated rod into the medullary canal in the tibial bone and removably attaching the other end to a first distally extending guide rod assembly, said first distally extending guide rod assembly including a removable cutting block having plurality of apertures therethrough;

(b) attaching a second distally extending guide rod assembly to the first distally extending guide rod assembly;

(c) extending a side extending rod downwardly from the distal end of the second distally extending guide rod assembly so that it is positioned adjacent the medial face of the distal end of the tibia;

(d) inserting a plurality of pins through the cutting block apertures to secure the cutting block to the tibia; and

(e) removing the elongated rod from the medullary canal and the first distally extending guide rod assembly and the second distally extending guide rod assembly from the cutting block.