Knee joint prosthesis system and method for implantation

• US 8,562,616 B2
• Filed: 10/09/2008
• Issued: 10/22/2013
• Est. Priority Date: 10/10/2007
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: May, Brian M., Fox, Duke A.
• Primary Examiner(s): Woodall, Nicholas
• Assistant Examiner(s): NELSON, CHRISTINE L
• Application Number:
  US12/248,509
• Publication Number:
  US 20090149964A1
• Time in Patent Office: 1,839 Days
• Field of Search: 606/88, 623/20.14, 623/20.15, 623/20.21, 623/20.34, 623/20.35, 623/20.36, 623/20.27, 623/20.29
• 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 17/1675 for the knee
• CPC Class Codes: A61B 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61F 2/30721 Accessories
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3836 Special connection between upper and lower leg, e.g. constrained
• CPC Class Codes: A61F 2/385 also provided with condylar bearing surfaces
• CPC Class Codes: A61F 2/3868 with sliding tibial bearing
• CPC Class Codes: A61F 2002/30332 Conically- or frustoconically-shaped protrusion and recess
• CPC Class Codes: A61F 2002/30339 Double cones, i.e. connecting element having two conical connections, one at each of its opposite ends
• CPC Class Codes: A61F 2002/30604 modular
• CPC Class Codes: A61F 2002/30616 Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
• 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 2220/0033 made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit

Abstract

A method for preparing at least a first bone for receiving a prosthesis can include positioning an IM member in a bone. A scaffold, skeleton or frame can be located onto the bone at a desired location. An alignment assembly can be coupled to the frame. The alignment assembly can be moved relative to the IM member to position the frame at a desired location relative to the bone. The frame can be fixed to the bone at the desired location. A cavity can be reamed into the bone using at least a portion of the alignment assembly as a guide. The alignment assembly can be removed from the frame. A cutting block can be coupled to the first attachment portion. Cuts can be prepared in the bone using the cutting block as a guide.

Claims

1. A method for preparing at least a first bone for receiving a prosthesis, the method comprising:

positioning an intramedullary (IM) member in a bone;

locating a frame onto the bone at a desired location;

coupling an alignment assembly to the frame, the alignment assembly comprising an alignment member and a locating bushing, the alignment member having a receiving portion;

moving the alignment assembly relative to the IM member to position the frame at a desired location relative to the bone wherein moving the alignment assembly comprises;

positioning the locating bushing into the receiving portion, the locating bushing defining a bore configured to accept the IM member therethrough; and

rotating the locating bushing within the receiving portion until the frame locates at the desired location relative to the bone;

fixing the frame to the bone at the desired location;

removing the locating bushing from the alignment member and the IM member from the bone;

inserting a reamer bushing into the receiving portion of the alignment member;

reaming a cavity into the bone using the reamer bushing as a guide;

removing the alignment assembly from the frame;

coupling a cutting block to the frame; and

preparing cuts on the bone using the cutting block as a guide.

2. The method of claim 1, further comprising:

removing the cutting block from the frame;

coupling a posterior stabilized (PS) box guide assembly to the frame; and

preparing PS box cuts on the bone using the PS box guide assembly as a guide.

3. The method of claim 1, further comprising:

coupling a posterior foot to the frame; and

locating a joint line associated with the bone by referencing a position of the posterior foot.

4. The method of claim 1, further comprising:

identifying a first indicia mark on the locating bushing relative to a mark on the alignment member once the desired location is reached; and

rotating the reamer bushing within the receiving portion until a second indicia mark on the reamer bushing aligns with the mark on the alignment member, wherein the first and second indicia marks correspond to each other.

5. The method of claim 1, further comprising:

selecting the locating bushing from a plurality of locating bushings each having a bore that is offset from the longitudinal axis of the bushing a distinct distance; and

selecting the reaming bushing from a plurality of reaming bushings each having a reaming bore that is offset a distance that corresponds to the bores of the locating bushings.

6. The method of claim 1, wherein inserting a reamer bushing into the receiving portion further comprises:

moving an engaging portion provided on the alignment member from a disengaged position to an engaged position, the engaging portion nesting in an annular groove formed around the reaming bushing in the engaged position substantially inhibiting movement of the bushing along the longitudinal axis while permitting rotation of the reaming bushing around the longitudinal axis.

7. The method of claim 6 wherein moving the engaging portion from a disengaged position to an engaged position comprises:

rotating a knob coupled to afoot, wherein rotation of the knob causes the foot to move from a position generally away from engagement with the annular groove to a position generally nested into the annular groove of the reamer bushing.

8. The method of claim 1 wherein coupling the alignment assembly to the frame comprises:

depressing a rail associated with one of the frame or the alignment assembly; and

slidably advancing the rail along a guide slot defined on the other of the frame or the alignment assembly; and

slidably advancing the rail along a guide slot defined on the other of the frame or the alignment assembly until the rail retracts from the depressed position and located into a locking slot coupling the alignment assembly to the frame.

9. The method of claim 1, further comprising:

removing a previously implanted prosthesis from the bone; and

implanting a revision prosthesis into the bone.

10. The method of claim 1 wherein positioning the IM member includes reaming the bone with a reamer until cortical bone contact is achieved.

11. The method of claim 1, further comprising:

coupling a posterior foot to the frame;

confirming the position of the bone relative to a second bone while the bone and second bone are in a first orientation; and

fixing the frame to the bone at the desired location once a desired position of the bone and second bone in the first orientation is confirmed.

12. The method of claim 1, further comprising:

preparing a second bone for receiving a prosthesis, wherein the bone is a femur and the second bone is a tibia.

13. A method for preparing at least a first bone for receiving a prosthesis, the method comprising:

positioning an intramedullary (IM) member in a first bone;

locating a frame having a first attachment portion and a second attachment portion onto the first bone;

coupling an alignment assembly to the first attachment portion, the alignment assembly including an alignment member and a locating bushing, the alignment member having a receiving portion;

moving the alignment assembly relative to the IM member to position the frame at a desired location relative to the first bone, wherein moving the alignment assembly comprises;

positioning the locating bushing into the receiving portion, the locating bushing defining a bore configured to accept the IM member therethrough; and

rotating the locating bushing within the receiving portion until the frame locates at the desired location relative to the first bone;

coupling a posterior foot to the second attachment portion, confirming a position of the first bone relative to a second bone while the first and second bones are in a first orientation while referencing the posterior foot;

fixing the frame to the first bone at the desired location once a desired position of the first and second bones in the first orientation is confirmed;

removing the locating bushing from the alignment member;

removing the IM member from the first bone;

inserting a reamer bushing into the receiving portion of the alignment member; and

reaming a cavity into the first bone using the reamer bushing as a guide.

14. The method of claim 13, further comprising:

selecting the frame from a plurality of frames having different sizes; and

selecting another frame from the plurality of frames if the desired location cannot be attained.

15. The method of claim 13 wherein the first bone is a femur and the second bone is a tibia and wherein the first orientation is defined when the femur and tibia are in flexion.

16. The method of claim 15 wherein confirming the position of the first bone relative to the second bone further comprises locating a tibial spacer onto a proximal end of the tibia while the posterior foot is located along a posterior side of the femur and in a position generally opposed to the tibial spacer.

17. The method of claim 16, further comprising:

positioning a femoral spacer relative to a distal femur; and

confirming a position of the femur relative to the tibia while the femur and the tibia are in extension while referencing the femoral spacer and the tibial spacer.

18. The method of claim 13, further comprising:

removing a previously implanted prosthesis from the bone.

19. The method of claim 13 wherein positioning the IM member includes reaming the bone with a reamer until cortical bone contact is achieved.

20. The method of claim 13, further comprising:

removing the alignment assembly from the frame;

coupling a cutting block to the first attachment portion; and

preparing cuts on the first bone using the cutting block as a guide.

21. The method of claim 20, further comprising:

removing the cutting block from the frame;

coupling a posterior stabilized (PS) box guide assembly to the first attachment portion; and

preparing PS box cuts on the first bone using the PS box guide assembly as a guide.

22. The method of claim 13, further comprising:

identifying a first indicia mark on the locating bushing relative to a mark on the alignment member once the desired location is reached; and

rotating the reamer bushing within the receiving portion until a second indicia mark on the reamer bushing aligns with the mark on the alignment member, wherein the first and second indicia marks correspond to each other.

23. The method of claim 22, further comprising:

selecting the locating bushing from a plurality of locating bushings each having a bore that is offset from the longitudinal axis of the bushing a distinct distance; and

selecting the reaming bushing from a plurality of reaming bushings each having a reaming bore that is offset a distance that corresponds to the bores of the locating bushings.

24. A method for preparing at least a first bone for receiving a prosthesis, the method comprising:

positioning an intramedullary (IM) member in a bone;

locating a frame onto the bone at a desired location;

coupling an alignment assembly to the frame wherein the coupling comprises;

depressing a rail associated with one of the frame or the alignment assembly;

slidably advancing the rail along a guide slot defined on the other of the frame or the alignment assembly until the rail retracts from the depressed position and locates into a locking slot in the other of the frame or the alignment assembly;

moving the alignment assembly relative to the IM member to position the frame at a desired location relative to the bone;

fixing the frame to the bone at the desired location;

reaming a cavity into the bone using at least a portion of the alignment assembly as a guide;

removing the alignment assembly from the frame;

coupling a cutting block to the frame; and

preparing cuts on the bone using the cutting block as a guide.

25. The method of claim 24 wherein moving the alignment assembly comprises:

positioning a locating bushing into a receiving portion of the alignment assembly, the locating bushing defining a bore configured to accept the IM member therethrough; and

rotating the locating bushing within the receiving portion until the frame locates at the desired location relative to the bone.

26. The method of claim 25, further comprising:

removing the locating bushing from the receiving portion;

inserting a reamer bushing into the receiving portion;

moving an engaging portion provided on the alignment assembly from a disengaged position to an engaged position, the engaging portion nesting in an annular groove formed around the reaming bushing in the engaged position substantially inhibiting movement of the reaming bushing along a longitudinal axis while permitting rotation of the reaming bushing around the longitudinal axis.

27. The method of claim 26 wherein moving the engaging portion from a disengaged position to an engaged position comprises:

rotating a (nob coupled to a foot, wherein rotation of the knob causes the foot to move from a position generally away from engagement with the annular groove to a position generally nested into the annular groove of the reamer bushing.