Patient selectable joint arthroplasty devices and surgical tools

• US 8,439,926 B2
• Filed: 03/05/2009
• Issued: 05/14/2013
• Est. Priority Date: 05/25/2001
• Status: Active Grant

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Bojarski, Raymond, Fitz, Wolfgang, Lang, Philipp
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US12/398,753
• Publication Number:
  US 20090222014A1
• Time in Patent Office: 1,531 Days
• Field of Search: 606/88, 606/87, 606/80, 606/76.R, 606/79, 606/86.R
• US Class Current: 606/88
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/158 Cutting patella
• 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 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/1767 for the patella
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing

Abstract

Disclosed herein are tools for repairing articular surfaces repair materials and for repairing an articular surface. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Claims

1. A patient-specific surgical tool for use in partial replacement of a knee joint of a patient, comprising:

a block having a patient-specific surface and a guide,

at least a portion of the patient-specific surface having a shape that is substantially a negative of a corresponding surface portion of a proximal end of a tibia of the knee joint of the patient; and

the guide having a shape to accommodate a cutting or drilling tool and being oriented in a substantially vertical position relative to a tibial plateau,

wherein the guide defines a cutting or drilling path extending through at least a portion of the proximal end of the tibia in a substantially vertical plane relative to the tibial plateau.

2. The patient-specific surgical tool of claim 1, wherein the at least a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding surface portion of at least one of subchondral bone, cartilage, and bone of the tibial plateau.

3. The patient-specific surgical tool of claim 1, wherein the at least a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding portion of a diseased or damaged cartilage surface of the tibial plateau.

4. The patient-specific surgical tool of claim 1, wherein the at least a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding anterior surface portion of the proximal end of the tibia.

5. The patient-specific surgical tool of claim 1, wherein the at least a portion of the patient-specific surface has an outer edge that substantially matches with a corresponding portion of the outer periphery of the tibial plateau.

6. The patient-specific surgical tool of claim 1, wherein the guide is configured to include a stop that defines a desired end of the cutting or drilling path.

7. The patient-specific surgical tool of claim 1, further including a second guide configured to accommodate a cutting or drilling tool and being oriented at a predetermined slope relative to the tibial plateau, wherein the second guide defines a cutting or drilling path extending through at least a portion of the proximal end of the tibia in a substantially horizontal plane at a predetermined slope relative to the tibial plateau.

8. The patient-specific surgical tool of claim 7, wherein the predetermined slope is configured based on patient-specific information.

9. The patient-specific surgical tool of claim 8, wherein the patient-specific information includes information derived from a preoperative scan or an intraoperative measurement.

10. The patient-specific surgical tool of claim 1, further including a linkage configured to cross reference a femoral surgical tool configured to prepare a femur of the knee joint of the patient.

11. The patient-specific surgical tool of claim 10, wherein the linkage is configured to cross reference a guide of the femoral surgical tool configured to direct a cutting or drilling tool for preparing the femur of the knee joint of the patient.

12. The patient-specific surgical tool of claim 11, wherein the linkage is configured to cross reference at least a portion of the prepared femur of the knee joint of the patient.

13. The patient-specific surgical tool of claim 10, wherein the linkage is configured to cross reference a sample implant configured for the femur of the knee joint of the patient.

14. The patient-specific surgical tool of claim 10, wherein the linkage includes an attachment.

15. The patient-specific surgical tool of claim 1, wherein the substantially vertical plane relative to the tibial plateau is configured to match a medial edge of a tibial component for the partial replacement of the knee joint of the patient.

16. The patient-specific surgical tool of claim 1, wherein the surgical tool is configured to include patient-specific information that defines optimal implant rotation.

17. The patient-specific surgical tool of claim 1, wherein the patient-specific surface includes joint information derived from image data of the knee joint of the patient.

18. The patient-specific surgical tool of claim 17, wherein the joint information includes cartilage information.

24. The patient-specific surgical tool of claim 1, wherein the at least a portion of the patient-specific surface has an outer edge that substantially matches with a corresponding portion of the outer periphery of the tibial plateau.

19. A patient-specific surgical tool for use in partial replacement of a knee joint of a patient, comprising:

a block having a patient-specific surface and a guide,

at least a portion of the patient-specific surface including joint information derived from image data of a proximal end of a tibia of the knee joint of the patient; and

the guide having a shape to accommodate a cutting or drilling tool and being oriented in a generally vertical position relative to a tibial plateau,

wherein the guide defines a cutting or drilling path extending through at least a portion of the proximal end of the tibia in a generally vertical plane relative to the tibial plateau.

20. The patient-specific surgical tool of claim 19, wherein the guide is orientated in a substantially vertical position relative to the tibial plateau and defines a cutting or drilling path extending through at least a portion of the proximal end of the tibia in a substantially vertical plane relative to the tibial plateau.

21. The patient-specific surgical tool of claim 19, wherein the at least a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding surface portion of at least one of subchondral bone, cartilage, and bone of the tibial plateau.

22. The patient-specific surgical tool of claim 19, wherein the at least a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding portion of a diseased or damaged cartilage surface of the tibial plateau.

23. The patient-specific surgical tool of claim 19, wherein the at least a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding anterior surface portion of the proximal end of the tibia.

25. The patient-specific surgical tool of claim 19, wherein a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding surface portion of a proximal end of the tibia of the knee joint of the patient.

26. A patient-specific surgical tool for use in partial replacement of a knee joint of a patient, comprising:

a block having a patient-specific surface and a guide;

at least a portion of the patient-specific surface including information derived from image data of a diseased or damaged cartilage surface of a tibial plateau of a tibia of the knee joint of the patient; and

the guide having a shape to accommodate a cutting or drilling tool and being oriented in a substantially vertical position,

wherein the guide defines a cutting or drilling path extending through at least a portion of the proximal end of the tibia in a substantially vertical plane.

27. The patient-specific surgical tool of claim 26, wherein the at least a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding anterior surface portion of the proximal end of the tibia.

28. The patient-specific surgical tool of claim 26, wherein the at least a portion of the patient-specific surface has an outer edge that substantially matches with a corresponding portion of the outer periphery of the tibial plateau.

29. The patient-specific surgical tool of claim 26, wherein a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding portion of the diseased or damaged cartilage surface of the tibial plateau.