Method for performing an open wedge, high tibial osteotomy

• US 7,935,119 B2
• Filed: 12/22/2006
• Issued: 05/03/2011
• Est. Priority Date: 01/31/2005
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: iBalance Medical, Inc. (Arthrex Incorporated)
• Inventors: Burns, Ralph E., Novak, Vincent P., Schneider, Robert E., Ammann, Kelly G.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): COMSTOCK, DAVID C
• Application Number:
  US11/644,218
• Publication Number:
  US 20070213830A1
• Time in Patent Office: 1,593 Days
• Field of Search: 606/79, 606/82, 606/86.R, 606/87, 606/88, 606/105, 623/17.11, 623/20.32
• US Class Current: 606/87
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1732 for bone breaking devices
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 2017/1602 Mills
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/067 for measuring angles
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect

Abstract

Method for performing an open wedge, high tibial osteotomy, utilizing an apparatus comprising a wedge-shaped implant for disposition in a wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises at least one key for disposition in at least one corresponding keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia, wherein each of the at least one keys comprises an interior bore for receiving a fixation screw, at least one fixation screw for disposition in the interior bore of the at least one key, and further wherein the apparatus is configured so that when the at least one fixation screw is received in the interior bore, the at least one fixation screw terminates within the bore.

Claims

1. A method for performing an open wedge, high tibial osteotomy, the method comprising:

cutting the bone along a cutting plane, with the cut terminating at a boundary line, and forming at least one keyhole in the tibia adjacent to the cut;

moving the bone on either side of the cut apart so as to form a wedge-like opening in the bone;

positioning a wedge-shaped implant in the wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises at least one key for disposition in at least one corresponding keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia, wherein each of the at least one keys comprises an interior bore for receiving a fixation screw; and

positioning at least one fixation screw in the interior bore of the at least one key;

wherein the apparatus is configured so that when the at least one fixation screw is received in the interior bore, the at least one fixation screw terminates within the bore;

and further wherein the at least one key is disposed in the at least one keyhole formed in the tibia.

2. A method according to claim 1 wherein the wedge-shaped implant comprises at least two separate components.

3. A method according to claim 2 wherein the wedge-shaped implant comprises three separate components.

4. A method according to claim 3 wherein the wedge-shaped implant comprises:

a base component;

a posterior component; and

an anterior component.

5. A method according to claim 4 wherein the at least one key is disposed on the base.

6. A method according to claim 2 wherein the wedge-shaped implant is assembled prior to positioning in the tibia.

7. A method according to claim 2 wherein the wedge-shaped implant is assembled after positioning in the tibia.

8. A method according to claim 1 wherein the interior bore is axially aligned with the longitudinal axis of its host key.

9. A method according to claim 1 wherein each of the at least one keys is slotted longitudinally so as to permit expansion when a fixation screw is received by the key.

10. A method according to claim 1 wherein each of the at least one keys includes external ribs to facilitate fixation of the key relative to the keyhole.

11. A method according to claim 10 wherein the external ribs extend longitudinally along the at least one key.

12. A method according to claim 10 wherein the external ribs extend circumferentially along the at least one key.

13. A method according to claim 1 wherein each of the at least one keys includes at least two interior bores for receiving a fixation screw therein.

14. A method according to claim 1 wherein the wedge-shaped implant comprises a shear rib, laterally offset from the at least one key, for disposition in a corresponding shear rib keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia.

15. A method for performing an open wedge, high tibial osteotomy, the method comprising:

cutting the bone along a cutting plane, with the cut terminating at a boundary line, and forming at least one keyhole in the tibia adjacent to the cut;

moving the bone on either side of the cut apart so as to form a wedge-like opening in the bone; and

positioning a wedge-shaped implant in the wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises;

at least one key for disposition in at least one corresponding keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia, wherein each of the at least one keys comprises an interior bore for receiving an interior fixation screw, and a counterbore communicating with the interior bore;

at least one distal draw nut disposed in the counterbore, wherein the draw nut comprises an interior bore for receiving the distal end of a fixation screw; and

positioning a fixation screw in the interior bore of the at least one key and the interior bore of the draw nut.

16. A method according to claim 15 wherein the wedge-shaped implant comprises at least two separate components.

17. A method according to claim 16 wherein the wedge-shaped implant comprises three separate components.

18. A method according to claim 17 wherein the wedge-shaped implant comprises:

a base component;

a posterior component; and

an anterior component.

19. A method according to claim 18 wherein the at least one key is disposed on the base.

20. A method according to claim 16 wherein the wedge-shaped implant is assembled prior to positioning in the tibia.

21. A method according to claim 16 wherein the wedge-shaped implant is assembled after positioning in the tibia.

22. A method according to claim 15 wherein the interior bore is axially aligned with the longitudinal axis of its host key.

23. A method according to claim 15 wherein each of the at least one keys is slotted longitudinally so as to permit expansion when a fixation screw is received by the key.

24. A method according to claim 15 wherein each of the at least one keys includes external ribs to facilitate fixation of the at least one key relative to the keyhole.

25. A method according to claim 24 wherein the external ribs extend longitudinally along the at least one key.

26. A method according to claim 24 wherein the external ribs extend circumferentially along the at least one key.

27. A method according to claim 15 wherein each of the at least one keys includes at least two interior bores for receiving a fixation screw therein.

28. A method according to claim 15 wherein the wedge-shaped implant comprises a shear rib, laterally offset from the at least one key, for disposition in a corresponding shear rib keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia.

29. A method for performing an open wedge, high tibial osteotomy, the method comprising:

cutting the bone along a cutting plane, with the cut terminating at a boundary line, and forming at least one keyhole in the tibia adjacent to the cut;

moving the bone on either side of the cut apart so as to form a wedge-like opening in the bone; and

positioning a wedge-shaped implant in the wedge-shaped opening created in the tibia, wherein the wedge-shaped implant comprises;

at least one open key for disposition in the at least one corresponding keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia, wherein each of the at least one open keys comprises opposed longitudinal edges, and further wherein each of the at least one keys comprises a threaded recess for receiving a fixation screw, and

at least one fixation screw for disposition in the interior bore of the at least one key;

positioning at least one fixation screw in the interior bore of the at least one key;

and further wherein the at least one key is disposed in the at least one keyhole formed in the tibia.

30. A method according to claim 29 wherein the wedge-shaped implant comprises at least two separate components.

31. A method according to claim 30 wherein the wedge-shaped implant comprises three separate components.

32. A method according to claim 31 wherein the wedge-shaped implant comprises:

a base component;

a posterior component; and

an anterior component.

33. A method according to claim 32 wherein the at least one open key is disposed on the base.

34. A method according to claim 30 wherein the wedge-shaped implant is assembled prior to positioning in the tibia.

35. A method according to claim 30 wherein the wedge-shaped implant is assembled after positioning in the tibia.

36. A method according to claim 29 wherein the threaded recess is axially aligned with the longitudinal axis of its host open key.

37. A method according to claim 29 wherein each of the at least one open keys is slotted longitudinally so as to permit expansion when a fixation screw is received by the at least one open key.

38. A method according to claim 29 wherein each of the at least one open keys includes external ribs to facilitate fixation of the at least one open key relative to the keyhole.

39. A method according to claim 38 wherein the external ribs extend longitudinally along the at least one open key.

40. A method according to claim 38 wherein the external ribs extend circumferentially along the at least one open key.

41. A method according to claim 29 wherein each of the at least one open keys includes at least two threaded recesses for receiving a fixation screw therein.

42. A method according to claim 29 wherein the wedge-shaped implant comprises a shear rib, laterally offset from the at least one key, for disposition in a corresponding shear rib keyhole formed in the tibia adjacent to the wedge-shaped opening created in the tibia.