System and method for joint resurface repair

• US 8,540,717 B2
• Filed: 03/16/2010
• Issued: 09/24/2013
• Est. Priority Date: 05/01/2000
• Status: Expired due to Term

• Current Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Original Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Inventors: Tallarida, Steven J., Ek, Steven W.
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US12/725,181
• Publication Number:
  US 20100204701A1
• Time in Patent Office: 1,288 Days
• Field of Search: 606/87, 606/80, 606/96, 606/304, 606/102, 606/98, 606/97, 606/99, 606/167, 606/170, 606/71, 606/104, 623/20.14, 623/20.15, 623/20.11, 623/20.27, 623/20.29, 623/20.35, 623/20.36
• US Class Current: 606/80
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• 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 17/1635 for grafts, harvesting or transplants
• CPC Class Codes: A61B 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/7098 wherein the implant is permeable or has openings, e.g. fenestrated screw hollow surgical screws A61B17/864
• CPC Class Codes: A61B 17/8615 at the central region of the screw head
• CPC Class Codes: A61B 17/8625 Shanks, i.e. parts contacting bone tissue
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 17/8695 Washers surrounding screw head in plate hole A61B17/8047, between bone plate and bone A61B17/8028
• CPC Class Codes: A61B 17/888 the driver bit acting on the central region of the screw head
• CPC Class Codes: A61B 17/8894 holding the implant into or through which the screw is to be inserted A61B17/7082, A61B17/7091 take precedence
• CPC Class Codes: A61B 2017/00238 Type of minimally invasive operation A61B2017/00805 takes precedence
• CPC Class Codes: A61B 2017/00464 for use with different instruments with hole for different instruments A61B2017/22072
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/044 : with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0445 : cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0448 : Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/045 : snug fit within the anchor
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 5/4528 : Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 90/06 : Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2/30756 : Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/30767 : Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/30942 : for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
• CPC Class Codes: A61F 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/3859 : Femoral components
• CPC Class Codes: A61F 2/4603 : for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4618 : of cartilage
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30065 : thermoplastic, i.e. softening or fusing when heated, and hardening and becoming rigid again when cooled
• CPC Class Codes: A61F 2002/30069 : elastomeric
• CPC Class Codes: A61F 2002/30113 : circular
• CPC Class Codes: A61F 2002/30143 : hexagonal
• CPC Class Codes: A61F 2002/30225 : Flat cylinders, i.e. discs
• CPC Class Codes: A61F 2002/30299 : umbrella-shaped or mushroom-shaped
• CPC Class Codes: A61F 2002/30324 : differing in thickness
• CPC Class Codes: A61F 2002/30332 : Conically- or frustoconically-shaped protrusion and recess
• CPC Class Codes: A61F 2002/30354 : Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis
• CPC Class Codes: A61F 2002/30433 : using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30448 : using adhesives
• CPC Class Codes: A61F 2002/30451 : soldered or brazed or welded
• CPC Class Codes: A61F 2002/30563 : having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
• CPC Class Codes: A61F 2002/30604 : modular
• CPC Class Codes: A61F 2002/30719 : Means for cleaning prostheses
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30831 : perpendicular with respect to each other
• CPC Class Codes: A61F 2002/30858 : Threads interrupted by grooves or sidewalls, e.g. flat sidewalls
• CPC Class Codes: A61F 2002/30871 : Trapezoidal threads
• CPC Class Codes: A61F 2002/30873 : Threadings machined on non-cylindrical external surfaces
• CPC Class Codes: A61F 2002/30878 : with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/30879 : Ribs
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/30896 : perpendicular with respect to each other
• CPC Class Codes: A61F 2002/30943 : using mathematical models
• CPC Class Codes: A61F 2002/30948 : using computerized tomography, i.e. CT scans
• CPC Class Codes: A61F 2002/30952 : using CAD-CAM techniques or NC-techniques
• CPC Class Codes: A61F 2002/30957 : using a positive or a negative model, e.g. moulds
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4658 : for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4661 : for measuring thickness
• CPC Class Codes: A61F 2002/4662 : for measuring penetration depth
• CPC Class Codes: A61F 2002/4663 : for measuring volumes or other three-dimensional shapes
• CPC Class Codes: A61F 2002/4681 : by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61F 2210/0071 : thermoplastic
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0041 : using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2220/005 : using adhesives
• CPC Class Codes: A61F 2220/0058 : soldered or brazed or welded
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0093 : Umbrella-shaped, e.g. mushroom-shaped
• CPC Class Codes: A61F 2250/0036 : differing in thickness
• CPC Class Codes: A61F 2250/0092 : Means for cleaning prostheses
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00059 : Chromium or Cr-based alloys
• CPC Class Codes: A61F 2310/00089 : Zirconium or Zr-based alloys
• CPC Class Codes: A61F 2310/00095 : Niobium or Nb-based alloys
• CPC Class Codes: A61F 2310/00203 : containing alumina or aluminium oxide
• CPC Class Codes: A61F 2310/00239 : containing zirconia or zirconium oxide ZrO2
• CPC Class Codes: A61F 2310/00796 : Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite

Abstract

A system for repairing a defect on a patient'"'"'s articular surface comprising a guide, a guide pin, a reamer, and an implant. The guide is configured to be disposed about the defect and includes a passageway configured to establish a reference axis extending generally outwardly from the articular surface. The guide pin is configured to be received through the guide passageway along the reference axis and into bone beneath the articular surface. The reamer comprises a cannulated shaft configured to be advanced over the guide pin along the reference axis and further comprises a cutting surface configured to be rotated about the guide pin to form an excision site. The implant comprises a bone facing surface configured to be received in the excision site and a load bearing surface having a contour approximating a contour of the patient'"'"'s articular surface.

Claims

1. A system for repairing a defect on a patient'"'"'s articular surface, said system comprising:

a guide configured to be disposed about said defect, said guide comprising a passageway configured to establish a reference axis extending generally outwardly from said articular surface proximate to said defect;

a guide pin configured to be received through said passageway of said guide along said reference axis and into bone beneath said articular surface;

a reamer comprising a cannulated shaft configured to be advanced over said guide pin along said reference axis, said reamer further comprising a cutting surface configured to be rotated about said guide pin to form an excision site; and

an implant comprising a bone facing surface configured to be received in said excision site and a load bearing surface having a contour approximating a contour of said patient'"'"'s articular surface.

2. The system of claim 1, wherein said reamer defines a generally circular excision path as said reamer is rotated about said guide pin to form a generally circular excision site.

3. The system of claim 2, wherein said reamer includes a radius extending from said reference axis to a cutting surface, said radius corresponding to a diameter of the implant.

4. The system of claim 1, further comprising a bone scoring instrument configured to create a matching fit between the bone surfaces of said implant site and said bone facing surface of the implant.

5. The system of claim 4, wherein said bone scoring instrument comprises a cannulated handle configured to be advanced over said guide pin.

6. The system of claim 1, wherein said guide comprises a biaxial guide comprising a cannulated shaft configured to receive said guide pin.

7. The system of claim 1, wherein said guide comprises a gauge having predefined surfaces configured to be disposed against said articular surface.

8. The system of claim 7, wherein said gauge further comprises a handling tab for holding said gauge.

9. The system of claim 8, wherein said passageway extending through said guide is not coaxial with said handling tab.

10. The system of claim 7, wherein guide has an oval cross-section.

11. The system of claim 7, wherein guide has a circular cross-section.

12. The system of claim 7, wherein said guide comprises a contact surface having a plurality of points to surround said defect.

13. The system of claim 7, wherein said gauge comprises a plurality of cutaway areas.

14. The system of claim 12, wherein said plurality of points lie in the same plane.

15. The system of claim 12, wherein said plurality of points do not lie in the same plane.

16. The system of claim 1, wherein said reference axis is normal to said articular surface.

17. The system of claim 1, wherein said reference axis is non-normal to said articular surface.

18. The system of claim 1, further comprising a measuring device configured to configured to measure at least one point on said patient'"'"'s articular surface proximate to said defect, wherein said measurement corresponds to said contour of said load bearing surface of said implant.

19. The system of claim 18, wherein said measuring device further comprises:

a cannulated shaft configured to be advanced over said guide pin; and

an outrigger extending generally radially outwardly, said outrigger configured to be rotated about said reference axis and to contact said articular surface at said at least one point on said articular surface;

wherein said measurement corresponds to an axial displacement of said outrigger with respect to a point of origin defined by said guide pin.

20. The system of claim 1, wherein said system is configured to establish multiple reference axes extending outwardly from said articular surface.