Apparatus used in performing femoral and tibial resection in knee surgery

• US 6,685,711 B2
• Filed: 03/17/2001
• Issued: 02/03/2004
• Est. Priority Date: 02/28/2001
• Status: Expired due to Term

• Current Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Original Assignee: Howmedica Osteonics Corp. (Stryker Corporation)
• Inventors: Axelson, Stuart L. Jr., Walsh, Gearoid, Moctezuma, Jose Luis
• Primary Examiner(s): Shaver, Kevin
• Assistant Examiner(s): Priddy, Michael B.
• Application Number:
  US09/811,318
• Publication Number:
  US 20020133163A1
• Time in Patent Office: 1,053 Days
• Field of Search: 606/86-89, 606/96
• US Class Current: 606/88
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Abstract

Tools for resecting tibia and femur include anchoring devices, a three-way alignment guide attachable to the anchoring devices, two embodiments of a resection guide attachable to the alignment guide and equipped with couplings for trackers, a plane probe for examining the resected plane, and apparatus for EM alignment of the resection guide in the event of a computer failure. The methods of the invention include operating a computer aided navigation apparatus in the conventional manner including attaching one or more trackers to the bone to be resected; choosing a location for the anchoring device with or without guidance from the computer and installing the anchoring device; attaching the three-way alignment guide to the anchoring device; attaching a resection guide to the alignment guide; attaching one or two trackers to the resection guide; locating the resection guide with the aid of the alignment guide and the computer; fixing the resection guide to the bone with pins. After the bone is resected, the resection plane probe may be attached to a tracker and moved about the resected plane to obtain feedback from the computer navigation system. In the event of computer failure, the methods include attaching the EM alignment guide to the resection guide; attaching the EM rod to the EM alignment guide; and locating the resection guide by visual location of the EM rod rather than by feedback from the computer navigation system.

Claims

1. An apparatus for guiding the resection of a bone during arthroplasty, comprising:

a) anchoring means for anchoring the apparatus to the bone;

b) a resection guide coupled to said anchoring means; and

c) means for locating the resection guide relative to the anchoring means, said means providing three degrees of freedom arid being infinitely adjustable.

2. An apparatus according to claim 1 wherein said anchoring means comprises a pin.

3. An apparatus according to claim 1 wherein said anchoring means has an angled body and a side slot adapted to receive a pin.

4. An apparatus according to claim 1 wherein said three degrees of freedom include two rotations and one translation.

5. An apparatus according to claim 1 wherein said three degrees of freedom include flexion-extension, varus-valgus, and proximal-distal.

6. An apparatus according to claim 1, wherein said resection guide has a guiding slot.

7. An apparatus according to claim 1 wherein said resection guide includes means for attaching a computer navigation tracker.

8. An apparatus according to claim 1 wherein said resection guide includes a rotatable pin guide.

9. An apparatus according to claim 1 wherein said resection guide includes means for attaching a manual alignment device.

10. An apparatus according to claim 1 further comprising a manual alignment device removably coupled to the resection guide.

11. An apparatus according to claim 10 wherein said manual alignment device includes an alignment handle and an EM rod coupled to said handle.

12. An apparatus according to claim 11 wherein said alignment handle has two ends, one of which is adapted to rest against the distal femur and the other of which is adapted to rest against the proximal tibia.

13. An apparatus according to claim 1 further comprising a plane probe, said plane probe including a planar surface and coupling means for coupling said plane probe to a computer navigation tracker.

14. An apparatus according to claim 1 wherein said means for locating further comprises means for selectively positioning and locking a selected alignment means position with said three degrees of freedom.

15. An apparatus as set forth in claim 14 wherein said means for selectively positioning and locking includes a plurality of cam locks.

16. An apparatus for guiding the resection of a bone during arthroplasty, comprising:

a) anchoring means for anchoring the apparatus to the bone;

b) a resection guide coupled to said anchoring means; and

c) means for locating the resection guide relative to the anchoring means, said means providing three degrees of freedom, wherein said anchoring means and said alignment means need not be removed from the bone prior to resection.

17. An apparatus according to claim 16 wherein said anchoring means comprises a pin.

18. An apparatus according to claim 16 wherein said anchoring means has an angled body and a side slot adapted to receive a pin.

19. An apparatus according to claim 16 wherein said three degrees of freedom include two rotations and one translation.

20. An apparatus according to claim 16 wherein said three degrees of freedom include flexion-extension, varus-valgus, and proximal-distal.

21. An apparatus according to claim 16 wherein said resection guide has a guiding slot.

22. An apparatus according to claim 16 wherein said resection guide includes means for attaching a computer navigation tracker.

23. An apparatus according to claim 16 wherein said resection guide includes a rotatable pin guide.

24. An apparatus according to claim 16 wherein said resection guide includes means for attaching a manual alignment device.

25. An apparatus according to claim 16 further comprising a manual alignment device removably coupled to the resection guide.

26. An apparatus according to claim 25 wherein said manual alignment device includes an alignment handle and an EM rod coupled to said handle.

27. An apparatus according to claim 26 wherein said alignment handle has two ends, one of which is adapted to rest against the distal femur and the other of which is adapted to rest against the proximal tibia.

28. An apparatus according to claim 16 further comprising a plane probe, said plane probe including a planar surface and coupling means for coupling said plane probe to a computer navigation tracker.

29. An apparatus according to claim 16 wherein said means for locating further comprises means for selectively positioning and locking the position of a selected one of said means for locating with said three degrees of freedom.

30. An apparatus as set forth in claim 29 wherein said means for selectively positioning and locking includes a plurality of cam locks.

31. An apparatus for guiding the resection of a bone during arthroplasty, comprising:

a) anchoring means for anchoring the apparatus to the bone;

b) a resection guide coupled to said anchoring means; and

c) means for locating the resection guide relative to the anchoring means, said means providing three degrees of freedom, wherein said apparatus is adapted for use in resecting femurs and tibias.

32. An apparatus according to claim 31 wherein said anchoring means comprises a pin.

33. An apparatus according to claim 31 wherein said anchoring means has an angled body and a side slot adapted to receive a pin.

34. An apparatus according to claim 31 wherein said three degrees of freedom include two rotations and one translation.

35. An apparatus according to claim 31 wherein said three degrees of freedom include flexion-extension, varus-valgus, and proximal-distal.

36. An apparatus according to claim 31 wherein said resection guide has a guiding slot.

37. An apparatus according to claim 31 wherein said resection guide includes means for attaching a computer navigation tracker.

38. An apparatus according to claim 31 wherein said resection guide includes a rotatable pin guide.

39. An apparatus according to claim 31 wherein said resection guide includes means for attaching a manual alignment device.

40. An apparatus according to claim 31 further comprising a manual alignment device removably coupled to the resection guide.

41. An apparatus according to claim 40 wherein said manual alignment device includes an alignment handle and an EM rod coupled to said handle.

42. An apparatus according to claim 41 wherein said alignment handle has two ends, one of which is adapted to rest against the distal femur and the other of which is adapted to rest against the proximal tibia.

43. An apparatus according to claim 31 further comprising a plane probe, said plane probe including a planar surface and coupling means for coupling said plane probe to a computer navigation tracker.

44. An apparatus according to claim 31 wherein said means for locating further comprises means for selectively positioning and locking the position of a selected one of said means for locating with said three degrees of freedom.

45. An apparatus as set forth in claim 44 wherein said means for selectively positioning and locking includes a plurality of cam locks.

46. An apparatus for guiding the resection of a patient'"'"'s bone during arthroplasty, said apparatus comprising a resection guide adapted for guiding a cutting device relative to a patient'"'"'s bone during arthroplasty, and an alignment guide coupled to said resection guide and adapted for attachment to the patient'"'"'s bone, said alignment guide including a first assembly for positioning said resection guide along a translational path, a second assembly for positioning said resection guide along a first rotational path, and a third assembly for positioning said resection guide along a second rotational path.

47. The apparatus of claim 46, wherein said first and second rotational paths are about different axes.

48. The apparatus of claim 47, wherein said axes are transverse to each other.

49. The apparatus of claim 46, wherein said first, second and third assemblies each include a locking device for securing said resection guide along said translational path and said first and second rotational paths.

50. The apparatus of claim 46, further including an anchoring pin adapted to secure said alignment guide to a patient'"'"'s bone.

51. The apparatus of claim 46, further including a plane probe.

52. An apparatus for guiding the resection of a patient'"'"'s bone during arthroplasty, said apparatus comprising a resection guide adapted for guiding a cutting device relative to a patient'"'"'s bone during arthroplasty, and an alignment guide coupled to said resection guide and adapted for attachment to the patient'"'"'s bone, said alignment guide including a first assembly for positioning said resection guide along a translational path and a second assembly for positioning said resection guide along a first rotational path and a second rotational path.

53. The apparatus of claim 52, wherein said first and second rotational paths are about different axes.

54. The apparatus of claim 53, wherein said axes are transverse to each other.

55. The apparatus of claim 52, wherein said first and second assemblies each include a locking device for securing said resection guide along said translational path and said first and second rotational paths.

56. The apparatus of claim 52, further including an anchoring pin adapted to secure said alignment guide to a patient'"'"'s bone.

57. The apparatus of claim 52, further including a plane probe.

58. An apparatus for guiding the resection of a patient'"'"'s bone during arthroplasty, said apparatus comprising a resection guide adapted for guiding a cutting device relative to a patient'"'"'s bone during arthroplasty, and an alignment guide coupled to said resection guide, said alignment guide including a first assembly for positioning said resection guide along a translational path and a second assembly for positioning said resection guide along a first rotational path and along a second rotational path.

59. The apparatus of claim 58, wherein said first and second rotational paths are about different axes.

60. The apparatus of claim 59, wherein said axes are transverse to each other.

61. The apparatus of claim 58, wherein said first and second assemblies each include a locking device for securing said resection guide along said translational path and said first and second rotational paths.

62. The apparatus of claim 58, further including an anchoring pin adapted to secure said alignment guide to a patient'"'"'s bone.

63. The apparatus of claim 58, further including a plane probe.

64. An apparatus for guiding the resection of a patient'"'"'s bone during arthroplasty, said apparatus including a resection guide adapted for guiding a cutting device relative to a patient'"'"'s bone during arthroplasty, and an alignment guide adapted for positioning said resection guide along a translational path and along a plurality of rotational paths.

65. The apparatus of claim 64, wherein said plurality of rotational paths are about different axes.

66. The apparatus of claim 65, wherein said axes are transverse to each other.

67. The apparatus of claim 64, wherein said alignment guide includes first and second assemblies each including at least one locking device.

68. The apparatus of claim 67, wherein said locking device of said first assembly is adapted for securing said resection guide along said translational path.

69. The apparatus of claim 67, wherein said locking device of said second assembly is adapted for securing said resection guide along said plurality of rotational paths.

70. The apparatus of claim 69, wherein said second assembly includes a pair of locking devices, each of said locking devices adapted for securing said resection guide along separate rotational paths.

71. The apparatus of claim 64, further including an anchoring pin adapted to secure said alignment guide to a patient'"'"'s bone.

72. The apparatus of claim 64, further including a plane probe.

73. An apparatus for guiding the resection of a bone during arthroplasty, comprising:

a) anchoring means for anchoring the apparatus to the bone;

b) a resection guide coupled to said anchoring means; and

c) means for locating the resection guide relative to the anchoring means.

74. An apparatus according to claim 73 wherein said means for locating provides three degrees of freedom including two rotations and one translation.

75. An apparatus according to claim 74 wherein said three degrees of freedom include flexion-extension, varus-valgus, and proximal-distal.

76. An apparatus according to claim 73 further comprising a plane probe, said plane probe including a planar surface and coupling means for coupling said plane probe to a computer navigation tracker.

77. An apparatus according to claim 73 wherein said means for locating further comprises means for selectively locking the position of said resection guide with three degrees of freedom.

78. An apparatus for guiding the resection of a bone during arthroplasty, comprising:

a) anchoring means for anchoring the apparatus to the bone;

b) a resection guide coupled to said anchoring means; and

c) means for locating the resection guide relative to the anchoring means, wherein said anchoring means need not be removed from the bone prior to resection.

79. An apparatus according to claim 78 wherein said means for locating provides three degrees of freedom including two rotations and one translation.

80. An apparatus according to claim 79 wherein said three degrees of freedom include flexion-extension, varus-valgus, and proximal-distal.

81. An apparatus according to claim 78 further comprising a plane probe, said plane probe including a planar surface and coupling means for coupling said plane probe to a computer navigation tracker.

82. An apparatus according to claim 78 wherein said means for locating further comprises means for selectively locking a selected means position with three degrees of freedom.

83. An apparatus for guiding the resection of a bone during arthroplasty, comprising:

a) anchoring means for anchoring the apparatus to the bone;

b) a resection guide coupled to said anchoring means; and

c) means for locating the resection guide relative to the anchoring means, wherein said apparatus is adapted for use in resecting femurs and tibias.

84. An apparatus according to claim 83 wherein said means for locating provides three degrees of freedom including two rotations and one translation.

85. An apparatus according to claim 84 wherein said three degrees of freedom include flexion-extension, varus-valgus, and proximal-distal.

86. An apparatus according to claim 83 further comprising a plane probe, said plane probe including a planar surface and coupling means for coupling said plane probe to a computer navigation tracker.

87. An apparatus according to claim 83 wherein said means for locating further comprises means for selectively locking a selected means position with three degrees of freedom.