Joint arthroplasty devices and surgical tools

• US 8,551,103 B2
• Filed: 09/24/2012
• Issued: 10/08/2013
• Est. Priority Date: 05/25/2001
• Status: Expired due to Term

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Fitz, Wolfgang, Lang, Philipp, Steines, Daniel
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US13/625,728
• Publication Number:
  US 20130018380A1
• Time in Patent Office: 379 Days
• Field of Search: 606/80, 606/82, 606/85, 606/86.R, 606/87, 606/88, 606/89, 606/96, 606/102, 623/20.14, 623/20.3, 623/20.31, 623/20.32, 623/20.35
• US Class Current: 606/88
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• 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 17/158 Cutting patella
• CPC Class Codes: A61B 17/16 Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans arthroscopic bone cutters A61B17/320016; dental implant drills potentially for other surgical use A61C8/0089; bone grinders A61F2/4644, A22C17/06; A61B17/1662 takes precedence over all other subgroups except A61B17/17
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• 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 17/8805 for introducing fluid filler into bone or extracting it A61B17/7097, A61B17/8833 take precedence
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• 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 5/4504 : Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4514 : Cartilage
• CPC Class Codes: A61B 5/4528 : Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 6/508 : for non-human patients
• 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 2/30771 : applied in original prostheses, e.g. holes or grooves
• 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 2/36 : Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/3859 : Femoral components
• CPC Class Codes: A61F 2/4657 : Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30062 : (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30894 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/3092 : having an open-celled or open-pored structure
• CPC Class Codes: A61F 2002/30948 : using computerized tomography, i.e. CT scans
• CPC Class Codes: A61F 2002/30957 : using a positive or a negative model, e.g. moulds
• CPC Class Codes: A61F 2002/30962 : using stereolithography
• CPC Class Codes: A61F 2002/3097 : using laser
• CPC Class Codes: A61F 2002/4631 : the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2310/00011 : Metals or alloys
• 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 2310/00047 : Aluminium or Al-based alloys
• CPC Class Codes: A61F 2310/00065 : Manganese or Mn-based alloys
• CPC Class Codes: A61F 2310/00071 : Nickel or Ni-based alloys
• CPC Class Codes: A61F 2310/00077 : Copper or Cu-based alloys
• CPC Class Codes: A61F 2310/00083 : Zinc or Zn-based alloys
• CPC Class Codes: A61F 2310/00107 : Palladium or Pd-based alloys
• CPC Class Codes: A61F 2310/00113 : Silver or Ag-based alloys
• CPC Class Codes: A61F 2310/00119 : Tin or Sn-based alloys
• CPC Class Codes: A61F 2310/00131 : Tantalum or Ta-based alloys
• CPC Class Codes: A61F 2310/00143 : Iridium or Ir-based alloys
• CPC Class Codes: A61F 2310/00149 : Platinum or Pt-based alloys
• CPC Class Codes: A61F 2310/00155 : Gold or Au-based alloys
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite
• CPC Class Codes: A61F 2310/00383 : Gelatin
• CPC Class Codes: A61F 2310/00395 : Coating or prosthesis-covering structure made of metals or of alloys
• CPC Class Codes: A61F 2310/00592 : Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
• CPC Class Codes: B23Q 17/00 : Arrangements for observing, indicating or measuring on machine tools for automatic control or regulation of feed movement, cutting velocity or position of tool or work B23Q15/00
• CPC Class Codes: B33Y 80/00 : Products made by additive manufacturing
• CPC Class Codes: Y10T 29/49 : Method of mechanical manufacture
• CPC Class Codes: Y10T 29/49764 : with testing or indicating
• CPC Class Codes: Y10T 29/49778 : with aligning, guiding, or instruction

Abstract

Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. 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 instrument system for surgery of a knee joint of a patient, the system comprising:

a patient-specific surface for engaging a substantially uncut femoral condyle surface of the joint, the surface conforming to and being substantially a negative of the uncut femoral condyle surface;

a guide for directing a surgical instrument, wherein the guide defines one or more cutting or drilling paths through at least a portion of the joint,

wherein the one or more cutting or drilling paths define a desired implant rotation; and

an adjustment mechanism configured to adjust implant rotation relative to the patient-specific surface, wherein the adjustment mechanism provides a range of positions for adjusting the position of a cut guide.

2. The instrument system of claim 1, wherein the system includes two or more drill guides.

3. The instrument system of claim 1, wherein the system includes two or more drill guides and at least one cut guide.

4. The instrument system of claim 1, wherein the adjustment mechanism provides a range of rotational positions relative to the patient-specific surface.

5. The instrument system of claim 1, wherein the adjustment mechanism provides a range of rotational positions relative to the desired implant rotation.

6. The instrument system of claim 1, wherein the adjustment mechanism comprises a set of rotationally arranged slots and pins configured to move slidably within the set of rotationally arranged slots.

7. The instrument system of claim 1, wherein the adjustment mechanism comprises a set of slots and pins configured to move slidably within the set of slots.

8. The instrument system of claim 1, wherein the adjustment mechanism comprises a set of spacers.

9. The instrument system of claim 1, wherein the adjustment mechanism comprises a set of pegs to engage and secure the cut guide.

10. The instrument system of claim 1, wherein the adjustment mechanism comprises a set of protrusions to engage and secure the cut guide.

11. The instrument system of claim 10, wherein the set of protrusions and the cut guide include separate components.

12. The instrument system of claim 11, wherein the adjustment mechanism uses a ratchet like mechanism.

13. The instrument system of claim 1, wherein the system has a plurality of guides therein.

14. The instrument system of claim 1, wherein a first guide is configured for drilling and a second guide is configured for cutting.

15. The instrument system of claim 1, wherein the desired implant rotation is selected by an operator.

16. A patient-specific instrument system for surgery of a joint of a patient, the system comprising:

a patient-specific surface for engaging a substantially uncut joint surface, the surface conforming to and being substantially a negative of the uncut joint surface;

one or more guides for directing a surgical instrument, wherein the one or more guides define one or more cutting or drilling paths through at least a portion of the joint; and

an adjustment mechanism configured to adjust the position of at least one guide of the one or more guides relative to the joint, wherein the adjustment mechanism provides a range of positions of the guide relative to the joint.

17. The instrument system of claim 16, wherein the positions of the one or more guides define at least one of an implant rotation, flexion, extension, anteversion, retroversion, anteroposterior position, mediolateral position, and superoinferior position.

18. A patient-specific instrument system for surgery of a knee joint of a patient, the system comprising:

a patient-specific surface for engaging a substantially uncut joint surface, the surface conforming to and being substantially a negative of the uncut joint surface;

a guide for directing a surgical instrument, wherein the guide defines a cutting or drilling path through at least a portion of the knee joint; and

an adjustment mechanism configured to adjust the position of the guide to a predetermined rotational position relative to the patient-specific surface, wherein the adjustment mechanism provides a range of rotational positions of the guide relative to the patient-specific surface.

19. The patient-specific instrument system of claim 18, wherein the predetermined rotational position is one of an internal or external rotational position.

20. The patient-specific instrument system of claim 18, wherein the predetermined rotational position is a rotational position relative to a femoral condyle of the knee joint.

21. The patient-specific instrument system of claim 18, wherein the predetermined rotational position is one of an internal and external rotational position relative to a femoral condyle of the knee joint.

22. The patient-specific instrument system of claim 18, wherein the predetermined rotational position is a rotational position relative to a tibia of the knee joint.

23. The patient-specific instrument system of claim 18, wherein the predetermined rotational position is one of an internal and external rotational position relative to a tibia of the knee joint.

24. The patient-specific instrument system of claim 18, wherein the predetermined rotational position is a rotational position relative to a tibial plateau of the knee joint.

25. The patient-specific instrument system of claim 18, wherein the predetermined rotational position is an internal rotational position relative to a tibial plateau of the knee joint.

26. The patient-specific instrument system of claim 18, wherein the predetermined rotational position is an external rotational position relative to a tibial plateau of the knee joint.

27. A patient-specific instrument system for surgery of a joint of a patient, the system comprising:

a patient-specific surface for engaging a substantially uncut joint surface, the surface conforming to and being substantially a negative of the uncut joint surface;

a guide for directing a surgical instrument, wherein the guide defines a cutting or drilling path through at least a portion of the joint; and

an adjustment mechanism configured to adjust the position of the guide relative to the joint, wherein the adjustment mechanism provides a range of rotational positions of the guide relative to a mechanical or anatomical axis of the joint of the patient.

28. The instrument system of claim 27, wherein the system includes two or more drill guides.

29. The instrument system of claim 27, wherein the system includes two or more drill guides and at least one cut guide.

30. The instrument system of claim 27, wherein the adjustment mechanism provides a range of rotational positions relative to the joint.