Patient-specific elbow guides and associated methods

• US 8,377,066 B2
• Filed: 09/22/2010
• Issued: 02/19/2013
• Est. Priority Date: 02/27/2006
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Katrana, Nicholas J., Vanasse, Thomas M., Metzger, Robert
• Primary Examiner(s): Stewart, Alvin J.
• Application Number:
  US12/888,005
• Publication Number:
  US 20110015636A1
• Time in Patent Office: 881 Days
• Field of Search: 623 1911- 1914, 623 2011- 2015, 606 79- 85, 606/86.R, 606 87- 90, 606/96, 606/98, 606/99
• US Class Current: 606/86.R
• CPC Class Codes: A61B 17/14 Surgical saws A61B17/1637 takes precedence; tooth saws A61C3/12 ; Accessories therefor
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1725 for applying transverse screws or pins through intramedullary nails or pins
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/683 comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
• CPC Class Codes: A61B 17/8061 specially adapted for particular bones A61B17/70 and A61B17/74 take precedence
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 17/846 Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface A61B17/72, A61B17/86 take precedence
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61F 2/3804 for elbows
• CPC Class Codes: A61F 2/46 Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
• CPC Class Codes: A61F 2002/30617 Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/4662 for measuring penetration depth
• CPC Class Codes: A61F 2002/4668 for measuring angles
• CPC Class Codes: A61F 2250/0097 Visible markings, e.g. indicia

Abstract

A patient-specific alignment guide includes a three-dimensional engagement surface customized in a pre-operating planning stage by computer imaging to closely mate and conform to a corresponding bone portion of a patient'"'"'s elbow joint. The patient-specific alignment guide defines a first longitudinal guiding bore aligned with a reference axis associated with the elbow joint of patient when the alignment guide is mounted onto the corresponding bone portion.

Claims

1. A method of preparing an elbow joint for an implant, the method comprising:

mounting a patient-specific alignment guide including a three-dimensional engagement surface custom-made by computer imaging to a corresponding closely conforming bone portion of a distal humerus of a patient'"'"'s elbow joint;

inserting into the distal humerus a first pin along an anatomic axis of the elbow joint through a first longitudinal guiding bore of the patient-specific alignment guide;

inserting into the distal humerus a second pin through a second longitudinal guiding bore of the patient-specific alignment guide, the first and second longitudinal guiding bores being parallel to one another;

removing the patient-specific alignment guide without removing the first and second pins;

mounting a first resection guide on the distal humerus of the patient, wherein the first resection guide includes a first cutting component, a first guiding component and an L-shaped connector coupling the first cutting component to the first guiding component;

abutting the first cutting component against a posterior surface of the distal humerus of the patient such that first and second elongated cutting slots of the first cutting component are aligned along a medial-lateral direction of the distal humerus;

sliding the first guiding component over the first and second pins and abutting a lateral side of the distal humerus; and

resecting the distal humerus through one of the first and second elongated cutting slots and forming a distal cut surface for receiving an implant.

2. The method of claim 1, further comprising:

removing the first resection guide;

slidably mounting a second guiding component of a second resection guide over the first and second pins;

supporting a second cutting component of the second resection guide on the distal cut surface;

mounting the second cutting component over an extension of the second cutting guide, the extension oriented perpendicularly to the first and second guide pins;

making an anterior cut of the distal humerus through an elongated planar anterior cutting slot of the second cutting component; and

making a posterior angled cut of the distal humerus through an elongated planar posterior cutting slot of the second cutting component.

3. The method of claim 2, wherein the extension is received non-rotationally in an opening of the second cutting component.

4. The method of claim 3, wherein the opening is elongated.

5. The method of claim 4, wherein the extension is an elongated bar with an elongated cross-section.

6. The method of claim 2, wherein the L-shaped connector is removably coupled to the first cutting component using a T-slot connection.

7. The method of claim 2, wherein the L-shaped connector is removably coupled to the first cutting component using a rectangular slot and locking screw connection.

8. The method of claim 2, wherein the anterior planar cutting slot is perpendicular to a surface of the second cutting guide that contacts the distal cut surface.

9. The method of claim 8, wherein the posterior planar cutting slot is at an oblique angle to the surface of the second cutting guide that contacts the distal cut surface.

10. The method of claim 1, wherein the first and second elongated slots are aligned along preoperatively determined patient specific orientations when the first guiding component is mounted over the first and second pins.

11. The method of claim 1, wherein the first guiding component includes first and second planar portions defining an acute angle therebetween.

12. The method of claim 11, further comprising mounting the first and third guiding bores over the first and second pins for a right humerus.

13. The method of claim 11, wherein the first guiding component includes first, second and third parallel guiding bores.

14. The method of claim 13, further comprising mounting the first and second guiding bores over the first and second pins for a left humerus.

15. A method of preparing an elbow joint for an implant, the method comprising:

mounting a patient-specific alignment guide including a three-dimensional engagement surface custom-made by computer imaging to a corresponding closely conforming portion of a distal humerus portion of a patient'"'"'s elbow joint;

inserting into the distal humerus a first pin through a first longitudinal guiding bore of the patient-specific alignment guide along a medial-lateral direction;

inserting into the distal humerus a second pin through a second longitudinal guiding bore of the patient-specific alignment guide, the first and second longitudinal guiding bores being parallel to one another;

removing the patient-specific alignment guide without removing the first and second pins;

abutting a first cutting component against a posterior surface of the distal humerus of the patient such that first and second elongated cutting slots of the first cutting component are aligned along a medial-lateral direction of the distal humerus;

coupling the first cutting component to a first guiding component using an L-shaped connector;

sliding the first guiding component over the first and second pins and abutting a lateral side the distal humerus; and

resecting the distal humerus through one of the first and second elongated cutting slots and forming a distal cut surface for receiving an implant.

16. The method of claim 15, further comprising:

removing the first cutting component and the first guiding component without removing the first and second pins;

slidably mounting a second guiding component over the first and second pins;

supporting a second cutting component on the distal cut surface;

making an anterior cut of the distal humerus through an elongated planar anterior cutting slot of the second cutting component; and

making a posterior angled cut of the distal humerus through an elongated planar posterior cutting slot of the second cutting component.

17. The method of claim 16, further comprising passing an extension of the second guiding component through an elongated opening of the second cutting guide.

18. The method of claim 16, wherein the anterior planar cutting slot is perpendicular to a surface of the second cutting guide that contacts the distal cut surface.

19. The method of claim 18, wherein the posterior planar cutting slot is at an oblique angle to the surface of the second cutting guide that contacts the distal cut surface.