Instruments and methods for use in performing knee surgery
First Claim
1. An instrument for aligning a leg during a knee replacement procedure, the instrument comprising:
- a first member configured to contact a distal femur and to exert a force on the distal femur in a first direction; and
a second member configured to contact a proximal tibia and to exert a force on the proximal tibia in a second direction substantially opposite the first direction, the second member being movable in the second direction in a substantially fixed orientation with respect to the first member to move the tibia relative to the femur;
wherein the first and second members are laterally disposed with respect to each other and are elongated and extending at least substantially parallel to a longitudinal axis between proximal and distal ends, the distal end of the first member having a thickness that is sufficiently thin to be manually, slidably inserted at a first lateral location between the distal femur and the proximal tibia, the distal end of the second member having a thickness that is sufficiently thin to be manually, slidably inserted at a second lateral location between the distal femur and the proximal tibia, the second lateral location being distinct from the first lateral location.
1 Assignment
0 Petitions
Accused Products
Abstract
A system and method for aligning a patient'"'"'s leg, for establishing the ultimate alignment of the leg prior to making a horizontal femoral cut or a horizontal tibial cut, for preparing the distal femur for receiving a femoral implant, and for making the horizontal, femoral and tibial cuts. The system and method incorporate a spacer, a cutting guide, and a template. The spacer is insertable between a distal femur and a proximal tibia to rotate the tibia with respect to the femur into the desired alignment. The cutting guide is engageable with the spacer, and can be fixed to the proximal tibia and the distal femur. The cutting guide has openings sized and shaped to guide a surgical saw to make the horizontal femoral cut and the horizontal tibial cut. The template is shaped to closely conform with the distal femur to allow the leg to be extended and to allow the procedure to be performed without dislocating a patella. Through one method of the present invention, the practitioner can select the desired ultimate alignment of the leg prior to making the horizontal, tibial and femoral cuts. As a result, when a replacement knee is implanted, the leg will be in the desired alignment.
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Citations
49 Claims
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1. An instrument for aligning a leg during a knee replacement procedure, the instrument comprising:
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a first member configured to contact a distal femur and to exert a force on the distal femur in a first direction; and
a second member configured to contact a proximal tibia and to exert a force on the proximal tibia in a second direction substantially opposite the first direction, the second member being movable in the second direction in a substantially fixed orientation with respect to the first member to move the tibia relative to the femur;
whereinthe first and second members are laterally disposed with respect to each other and are elongated and extending at least substantially parallel to a longitudinal axis between proximal and distal ends, the distal end of the first member having a thickness that is sufficiently thin to be manually, slidably inserted at a first lateral location between the distal femur and the proximal tibia, the distal end of the second member having a thickness that is sufficiently thin to be manually, slidably inserted at a second lateral location between the distal femur and the proximal tibia, the second lateral location being distinct from the first lateral location. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
an actuator coupled to the first and second members, the actuator being controllable to move the second member with respect to the first member in a lateral direction with respect to the longitudinal axis, and to thereby move the tibia with respect to the femur; and
an elongated shaft projecting from the proximal end of at least one of the first and second members, the shaft being engageable with an alignment rod for assisting a practitioner in determining the alignment of the leg.
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3. The instrument of claim 1 wherein the first and second members are sized and shaped to be slidably inserted between one of the lateral and medial distal femur and a corresponding one of the lateral and medial proximal tibia.
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4. The instrument of claim 1 wherein the first member has a first contact surface configured to contact one of the distal femur and proximal tibia, and the second member has a second contact surface configured to contact the other of the distal femur and proximal tibia.
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5. The instrument of claim 1 wherein the first member has a first contact surface facing a first direction and configured to contact one of the distal femur and proximal tibia, the second member has a second contact surface facing a second direction and configured to contact the other of the distal femur and proximal tibia, the second direction being substantially opposite the first direction, and the second member being movable in the second direction with respect to the first member.
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6. The instrument of claim 1, further comprising an actuator coupled to the first and second members, the actuator being controllable to move the second member with respect to the first member in a lateral direction with respect to the longitudinal axis, and to thereby move the tibia with respect to the femur.
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7. The instrument of claim 1 wherein the distal ends of the first and second members each being sized and shaped to be manually, slidably inserted between one of the medial and lateral sides of the distal femur and a corresponding one of the medial and lateral sides of the proximal tibia, and further comprising:
an actuator coupled to the first and second members, the actuator being controllable to move the second member with respect to the first member in a lateral direction with respect to the longitudinal axis, and to thereby rotate the tibia with respect to the femur.
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8. The instrument of claim 1 wherein the distal ends of the first and second members each being sized and shaped to be manually, slidably inserted between one of the medial and lateral sides of the distal femur and a corresponding one of the medial and lateral sides of the proximal tibia, and further comprising:
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an actuator coupled to the first and second members, the actuator being controllable to move the second member with respect to the first member in a lateral direction with respect to the longitudinal axis, and to thereby rotate the tibia with respect to the femur; and
an alignment rod coupled with at least one of the first and second members, the alignment rod being alignable in the lateral direction for assisting a practitioner in determining the alignment of the leg.
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9. A system for use during at least a portion of a knee replacement procedure, the system comprising:
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a first member configured to contact a distal femur and to exert a force on the distal femur in a first direction;
a second member configured to contact a proximal tibia and to exert a force on the proximal tibia in a second direction substantially opposite the first direction, the second member being movable in the second direction with respect to the first member such that a practitioner can move the tibia relative to the femur into a desired alignment;
an actuator coupled to the first and second members, the actuator being controllable to move the second member with respect to the first member and retain the second member in a desired position; and
a cutting guide removably coupled to at least one of the first and second members, the cutting guide having at least one opening therein sized and shaped to receive a surgical cutting implement, the opening being aligned to guide the cutting implement to a selected location in a selected alignment for cutting one of the distal femur and proximal tibia when the system is engaged with the knee. - View Dependent Claims (10, 11, 12)
an elongated shaft projecting from the proximal end of one of the first and second members; and
an alignment rod removably coupleable to the shaft, and wherein the cutting guide is removably coupleable to the shaft such that the alignment rod can be coupled to the shaft to assist in aligning a patient'"'"'s leg and the cutting guide can be coupled to the shaft to assist in cutting at least one of the patient'"'"'s proximal tibia and distal femur.
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12. The system of claim 9 wherein the distal ends of the first and second members are sized and shaped to be manually, slidably inserted between one of the medial and lateral sides of the distal femur and a corresponding one of the medial and lateral sides of the proximal tibia.
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13. A system for use during at least a portion of a knee replacement procedure, the system comprising:
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a first member configured to contact a distal femur and to exert a force on the distal femur in a first direction;
a second member configured to contact a proximal tibia and to exert a force on the proximal tibia in a second direction substantially opposite the first direction, the second member being movable in the second direction with respect to the first member such that a practitioner can move the tibia relative to the femur into a desired alignment;
an actuator coupled to the first and second members, the actuator being controllable to move the second member with respect to the first member and retain the second member in a desired position; and
a cutting guide configured to be temporarily fixed with respect to at least one of the proximal tibia and distal femur, the cutting guide having at least one opening therein sized and shaped to receive a surgical cutting implement, the opening being aligned to guide the cutting implement to a selected location in a selected alignment for cutting one of the distal femur and proximal tibia when the system is engaged with the knee, and wherein the cutting guide comprises a plurality of holes for receiving a corresponding plurality of fasteners, the holes being aligned to direct the fasteners into the distal femur and proximal tibia to fix the cutting guide with respect to the distal femur and proximal tibia during the portion of the procedure. - View Dependent Claims (14)
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15. A system for use during at least a portion of a knee replacement procedure, the system comprising:
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a first member configured to contact a distal femur and to exert a force on the distal femur in a first direction;
a second member configured to contact a proximal tibia and to exert a force on the proximal tibia in a second direction substantially opposite the first direction, the second member being movable in the second direction with respect to the first member such that a practitioner can move the tibia relative to the femur into a desired alignment;
an actuator coupled to the first and second members, the actuator being controllable to move the second member with respect to the first member and retain the second member in a desired position; and
a cutting guide configured to be temporarily fixed with respect to at least one of the proximal tibia and distal femur, the cutting guide having at least a first opening and a second opening, each sized and shaped to receive a surgical cutting implement, the first opening being oriented on the cutting guide to align the cutting implement for making a horizontal tibial cut and the second opening being oriented on the cutting guide to align the cutting implement for making a horizontal femoral cut. - View Dependent Claims (16, 17)
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18. A system for use during a portion of a knee replacement procedure, the system comprising:
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a spacer being insertable between a distal femur and a proximal tibia to temporarily fix the proximal tibia in a selected position relative to the distal femur during the portion of the procedure; and
a cutting guide having a plurality of holes for receiving a corresponding plurality of fasteners, the holes being aligned to direct the fasteners into the distal femur and proximal tibia to fix the cutting guide with respect to the distal femur and proximal tibia during the portion of the procedure, the cutting guide having at least one opening therein sized and shaped to receive a surgical cutting implement, the opening being aligned to guide the implement to a selected location in a selected alignment for cutting one of the distal femur and proximal tibia. - View Dependent Claims (19, 20, 21)
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22. A system for use during a portion of a knee replacement procedure, the system comprising:
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a spacer being insertable between a distal femur and a proximal tibia to temporarily fix the proximal tibia in a selected position relative to the distal femur during the portion of the procedure;
a cutting guide configured to be temporarily fixed to at least one of the proximal tibia and distal femur, the cutting guide having at least one opening therein sized and shaped to receive a surgical cutting implement, the opening being aligned to guide the implement to a selected location in a selected alignment for cutting one of the distal femur and proximal tibia;
an elongated shaft projecting from the spacer; and
an alignment rod removably coupleable to the shaft, and wherein the cutting guide is removably coupleable to the shaft such that the alignment rod can be coupled to the shaft to assist a practitioner in aligning a patient'"'"'s leg, and the cutting guide can be coupled to the shaft to assist the practitioner in cutting at least one of the patient'"'"'s proximal tibia and distal femur. - View Dependent Claims (23, 24, 25, 26, 27, 28)
a plurality of spacers, each spacer having a distinct thickness, and wherein each spacer is sized and shaped to be manually, slidably inserted between one of the medial and lateral sides of the distal femur and a corresponding one of the medial and lateral sides of the proximal tibia, the spacers being selectable by a practitioner to create a desired alignment between the tibia and the femur;
an elongated shaft projecting from each of the spacers; and
an alignment rod removably coupleable to the shaft, and wherein the cutting guide is removably coupleable to the shaft;
wherebythe alignment rod can be coupled to the selected shaft to assist a practitioner in selecting the proper spacer for aligning a patient'"'"'s leg, and the cutting guide can be coupled to the shaft to assist the practitioner in cutting at least one of the patient'"'"'s proximal tibia and distal femur.
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27. The system of claim 22 wherein the cutting guide has a first opening and a second opening therethrough, the first opening being oriented on the cutting guide to align the cutting implement for making a horizontal tibial cut and the second opening being oriented on the cutting guide to align the cutting implement for making a horizontal femoral cut.
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28. The system of claim 22 wherein the cutting guide has a first opening and a second opening therethrough, the first opening being oriented on the cutting guide to align the cutting implement for making a horizontal tibial cut and the second opening being oriented on the cutting guide to align the cutting implement for making a horizontal femoral cut, the second opening being spaced from the first opening by a selected distance to provide a desired spacing for a prosthetic implant such that the knee with the prosthetic implant will be in the desired alignment.
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29. A system for use during a portion of a knee replacement procedure, the system comprising:
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a first spacer being insertable between a distal femur and a proximal tibia to temporarily fix the proximal tibia in a selected position relative to the distal femur during the portion of the procedure;
a cutting guide configured to be temporarily fixed to at least one of the proximal tibia and distal femur, the cutting guide having at least one opening therein sized and shaped to receive a surgical cutting implement, the opening being aligned to guide the implement to a selected location in a selected alignment for cutting one of the distal femur and proximal tibia;
a plurality of second spacers, each second spacer having a distinct thickness, and wherein each second spacer is sized and shaped to be manually, slidably inserted between one of the medial and lateral sides of the distal femur and a corresponding one of the medial and lateral sides of the proximal tibia, the second spacers being selectable by a practitioner to create a desired alignment between the tibia and the femur; and
an alignment rod coupleable with the first and second spacers, the alignment rod being alignable with at least one of the tibia and femur for assisting a practitioner in selecting the one of the first and second spacers that creates the desired alignment.
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30. A system for use during a portion of a knee replacement procedure, the system comprising:
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a spacer being insertable between a distal femur and a proximal tibia to temporarily fix the proximal tibia in a selected position relative to the distal femur during the portion of the procedure;
a cutting guide configured to be temporarily fixed to at least one of the proximal tibia and distal femur, the cutting guide having a first opening and a second opening, both sized and shaped to receive a surgical cutting implement, the first opening being oriented on the cutting guide to align the cutting implement for making a horizontal femoral cut and the second opening being oriented on the cutting guide to align the cutting implement for making a horizontal tibial cut, the second opening being spaced from the first opening by a variable distance such that the practitioner can provide a proper spacing for a prosthetic implant such that the knee with the prosthetic implant will be in the desired alignment.
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31. A cutting guide for use during a knee replacement procedure, the cutting guide comprising:
a body configured to be temporarily fixed with respect to a proximal tibia and a distal femur, the body having at least first and second openings therethrough, the first and second openings each being sized and shaped to receive a surgical cutting implement, the first opening being located in a first portion of the body and being aligned to guide the cutting implement for cutting the distal femur and the second opening being located in a second portion of the body and being aligned to guide the cutting implement for cutting the proximal tibia, and wherein the second portion of the body is movable with respect to the first portion of the body to adjust a distance between the first and second openings, the distance being variable to provide a desired spacing for a prosthetic implant. - View Dependent Claims (32, 33)
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34. A cutting guide for use during a knee replacement procedure, the cutting guide comprising:
a body configured to be temporarily fixed with respect to a proximal tibia and a distal femur, the body having at least first and second openings therethrough, the first and second openings each being sized and shaped to receive a surgical cutting implement, the first opening being aligned to guide the cutting implement for cutting the distal femur and the second opening being aligned to guide the cutting implement for cutting the proximal tibia, wherein the body is configured to be fixed to the proximal tibia and the distal femur. - View Dependent Claims (35, 36)
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37. A template for assisting an individual in preparing a distal femur for receiving a femoral implant during a knee replacement procedure, the template comprising:
a body having a proximal end, a distal end opposite the proximal end, a contact surface, and an outer surface facing away from the contact surface, the distal portion of the contact surface being curved to closely conform with a portion of the distal femur, the body having at least one attachment opening sized and shaped to receive a fastener, the attachment opening being aligned to direct the fastener into the distal femur when the contact surface of the body is conformed to the distal femur such that the fastener can retain the template to the distal femur, the outer surface near the proximal end of the body being sufficiently thin and shaped to closely conform with a posterior portion of the distal femur such that the knee can be extended with the template affixed to the distal femur, the body having at least one guide opening sized and shaped for receiving one of a drill bit and a saw blade, the guide opening being aligned to direct the one of a drill bit and a saw blade into the distal femur such that the distal femur can be prepared to receive the femoral implant, a central portion of the body between the proximal end and the distal end being sufficiently thin and shaped to fit between the distal femur and a portion of a patella such that the body can be affixed to the distal femur and the individual can perform the portion of the procedure without dislocating the patella. - View Dependent Claims (38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49)
Specification