Patient specific alignment guide and inter-operative adjustment

• US 8,070,752 B2
• Filed: 01/09/2008
• Issued: 12/06/2011
• Est. Priority Date: 02/27/2006
• Status: Expired due to Fees

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Metzger, Robert, Berend, Keith R., Berend, Michael E., Lombardi, Adolph V. Jr., Perry, Lance D., Schoenefeld, Ryan J., Serban, Radu, Donaldson, Thomas
• Primary Examiner(s): Barrett, Thomas C.
• Assistant Examiner(s): NELSON, CHRISTINE L
• Application Number:
  US11/971,390
• Publication Number:
  US 20080312659A1
• Time in Patent Office: 1,427 Days
• Field of Search: 606/87, 606/88
• 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 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A method of preparing a joint for a prosthesis in a patient. The method includes obtaining scan data associated with the joint of the patient, preparing a three-dimensional image of the joint based on the scan data, preparing a pre-operative surgical plan based on the scan data, and preparing an image of a patient-specific alignment guide, and intra-operatively modifying the surgical plan.

Claims

1. A method of preparing a joint for a prosthesis in a patient, the method comprising:

securing a patient-specific alignment guide to a joint surface of the patient, the patient-specific alignment guide having an inner three-dimensional surface configured to conform and mate in nesting relationship with the joint surface of the patient according to a preoperative surgical plan for the patient;

attaching a guide element through the alignment guide to the joint surface;

removing the alignment guide without removing the guide element;

supporting an adjustable cutting block having a body and an adjustable cutting guide on the guide element;

intraoperatively modifying the preoperative surgical plan of the patient by adjusting an orientation of the cutting guide relative to the body of the cutting block by rotating a rotational member, the rotational member pivotably coupled to the body of the adjustable cutting block at a first end and releasably connected to the body of the adjustable cutting block at a second end; and

resecting the joint surface using the adjustable cutting block.

2. The method of claim 1, further comprising intraoperatively changing the preoperative plan of the patient by linearly displacing the cutting guide relative to the body of the adjustable cutting block using a linear adjustment mechanism of the adjustable cutting block.

3. The method of claim 2, further comprising incrementally displacing the cutting guide relative to the body of the adjustable cutting block using a linear actuator.

4. The method of claim 1, wherein attaching a guide element through the alignment guide to the joint surface includes passing the guide element through a guiding aperture of the alignment guide.

5. A method of preparing a knee joint for a prosthesis in a patient, the method comprising:

mating a patient-specific femoral alignment guide onto a femoral joint surface of the patient, the femoral alignment guide configured to nestingly conform in a unique position on the femoral joint surface of the patient based on a three-dimensional image of the knee-joint of the patient created during a preoperative surgical plan from scans of the knee joint of the patient;

drilling a first locating hole into the femoral joint surface through the femoral alignment guide

inserting a first guide element into the first locating hole;

removing the femoral alignment guide without removing the first guide element;

supporting an adjustable resection device having a body and a cutting guide on the first guide element;

intraoperatively modifying the preoperative surgical plan of the patient by adjusting the orientation of the cutting guide relative to the resection device by rotating a rotational member, the rotational member pivotably coupled to the body of the adjustable resection device at a first end and releasably connected to the body of the adjustable resection device at a second end;

drilling a second locating hole into the femoral joint surface through the adjustable resection device;

inserting a second guide element into the second locating hole;

removing the adjustable resection device;

supporting a cutting block on the second guide element; and

resecting the femoral joint surface using the cutting block.

6. A method of preparing a knee joint for a prosthesis in a patient, the method comprising:

mating a patient-specific femoral alignment guide onto a femoral joint surface of the patient, the patient-specific alignment guide nestingly conforming in a unique position on the femoral joint surface of the patient in three-dimensional space according to a preoperative surgical plan based on scans of the knee joint of the patient;

inserting first and second guide elements through first and second resection-guiding apertures of the femoral alignment guide into the femoral joint surface;

removing the femoral alignment guide without removing the first and second guide elements;

supporting an adjustable resection device having a body and an adjustable cutting guide on the first and second guide elements;

intraoperatively modifying the preoperative surgical plan by adjusting a position of the cutting guide relative to the adjustable resection device by rotating a rotational member pivotably coupled to the body of the adjustable resection device at a first end and releasably connected to the body of the adjustable resection device at a second end; and

resecting the femoral joint surface.

7. The method of claim 6, further comprising linearly displacing the cutting guide using a linear adjustment mechanism of the adjustable resection device.

8. The method of claim 6, wherein the cutting guide comprises a guiding slot for guiding a resection.

9. The method of claim 6, wherein the cutting guide comprises first and second guiding slots for selectively resecting a right or left knee.

10. The method of claim 6, further comprising incrementally displacing the cutting guide relative to the body by a linear displacement.

11. The method of claim 10, further comprising rotating a knob threadably coupled to a cutting member that supports the cutting guide.

12. The method of claim 6, further comprising pressing a lever coupled to the rotational member for enabling pivoting of the rotational member.

13. The method of claim 12, further comprising biasing the lever in an engagement position preventing rotation between the rotational member and the body.