Patient-specific acetabular guides and associated instruments

• US 8,608,749 B2
• Filed: 03/07/2011
• Issued: 12/17/2013
• Est. Priority Date: 02/27/2006
• Status: Expired due to Fees

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Meridew, Jason D., Siebeneck, Tony, Witt, Tyler D., Metzger, Robert
• Primary Examiner(s): Isabella, David
• Assistant Examiner(s): SCHILLINGER, ANN M
• Application Number:
  US13/041,469
• Publication Number:
  US 20110184419A1
• Time in Patent Office: 1,016 Days
• Field of Search: 623 2211- 2338
• US Class Current: 606/91
• 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 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/1746 for the acetabulum
• 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 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61F 2/4609 of acetabular cups
• CPC Class Codes: A61F 2002/30617 Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/4633 for selection of endoprosthetic joints or for pre-operative planning
• CPC Class Codes: A61F 2002/4662 for measuring penetration depth
• CPC Class Codes: A61F 2002/4668 for measuring angles
• CPC Class Codes: A61F 2002/4687 Mechanical guides for implantation instruments
• CPC Class Codes: A61F 2250/0097 Visible markings, e.g. indicia
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing

Abstract

A method for preparing a joint surface of a patient for an implant, such as, for example, an acetabular implant for a hip joint. According to the method, a patient-specific guide is attached to a complementary joint surface of the patient. The patient-specific guide includes a guiding element oriented along a patient-specific alignment axis. The alignment axis is determined during a preoperative plan of the patient for implant alignment. A shaft of a guiding tool is removably coupled to the guiding element of the guide. A three-dimensional orientation device is removably attached to the shaft of the guiding tool. A position of a bubble of the orientation device is marked with a mark on an outer transparent surface of the orientation device while the guiding tool is oriented along the alignment axis. The marked orientation device can be used for aligning other instruments during the procedure.

Claims

1. A method for preparing an acetabulum of a patient for an acetabular implant, the method comprising:

removably engaging an acetabular area of the patient to a complementary surface of a patient-specific acetabular guide, the complementary surface of the patient-specific acetabular guide constructed as a mirror surface of the acetabular area from medical images of the patient obtained preoperatively, the acetabular guide having a guiding element oriented along a patient-specific alignment axis, the alignment axis determined during a preoperative plan of the patient for implant alignment;

removably coupling a shaft of a guiding tool to the guiding element of the acetabular guide such that the shaft of the guiding tool is oriented along the alignment axis;

removably attaching a three dimensional orientation device to the shaft of the guiding tool;

calibrating the orientation device to indicate the alignment axis orientation by marking with a mark a position of a bubble inside the orientation device, the bubble viewable through an outer transparent surface of the orientation device;

removing the acetabular guide and guiding tool;

removing the orientation device from the guiding tool;

removably attaching the orientation device to a shaft of an instrument; and

determining the alignment axis by changing the orientation of the shaft such that the bubble of the orientation device is centered around the mark;

guiding the shaft of the instrument along the alignment axis using the orientation device.

2. The method of claim 1, wherein the instrument is a reamer and further comprising reaming the acetabulum with the reamer.

3. The method of claim 2, further comprising:

removing the orientation device from the shaft of the reamer;

removably attaching the orientation device to a shaft of an inserter coupled to an acetabular cup;

guiding the shaft of the inserter along the alignment axis using the orientation device; and

inserting the acetabular cup in the acetabulum.

4. The method of claim 2, further comprising:

drilling a pilot hole in the acetabulum through a bore of the guiding element; and

guiding an alignment pin of the reamer in the pilot hole.

5. The method of claim 4, wherein drilling a pilot hole in the acetabulum through a bore of the guiding element includes using a drilling element having a stop at a predetermined position for preventing over drilling of the acetabulum.

6. The method of claim 1, further comprising keying the orientation device to the shaft of the instrument.

7. The method of claim 1, wherein the guiding tool is a guiding handle.

8. The method of claim 1, wherein the guiding tool is an acetabular inserter with a removable adapter tip couplable to the guiding element of the patient-specific acetabular guide.

9. The method of claim 1, wherein the orientation device includes a transparent dome-shaped surface and a base.

10. The method of claim 9, further comprising coupling the base of the orientation device to the shaft of the guiding tool with a coupler extending from the base.

11. A method for preparing a joint surface of a patient for an implant, the method comprising:

attaching a surface of a patient-specific guide to a complementary joint surface of the patient, the surface of the patient-specific guide constructed as a mirror surface of the complementary joint surface from medical images of the patient obtained preoperatively, the patient-specific guide having a guiding element oriented along a patient-specific alignment axis, the alignment axis determined during a preoperative plan of the patient for implant alignment;

removably coupling a shaft of a guiding tool to the guiding element of the patient-specific guide;

removably attaching a three-dimensional orientation device to the shaft of the guiding tool;

marking a position of a bubble of the orientation device with a mark on an outer transparent surface of the orientation device while the guiding tool is oriented along the alignment axis;

removing the orientation device from the guiding tool;

removing the patient-specific guide and the guiding tool;

removably attaching the orientation device to a reamer;

aligning the reamer along the alignment axis using the orientation device by changing the orientation of the reamer such that the bubble of the orientation device is centered around the mark; and

reaming the joint surface.

12. The method of claim 11, further comprising:

keying the orientation device to a shaft of the reamer.

13. The method of claim 11, wherein the orientation device includes a transparent dome-shaped surface, a base and a coupler extending from the base.

14. A method for preparing a joint surface of a patient for an implant, the method comprising:

attaching a surface of a patient-specific guide to a complementary joint surface of the patient, the surface of the patient-specific guide constructed as a mirror surface of the complementary joint surface from medical images of the patient obtained preoperatively, the patient-specific guide having a guiding element oriented along a patient-specific alignment axis, the alignment axis determined during a preoperative plan of the patient for implant alignment;

removably coupling a shaft of a guiding tool to the guiding element of the patient-specific guide;

removably attaching a three-dimensional orientation device to the shaft of the guiding tool;

marking a position of a bubble of the orientation device with a mark on an outer transparent surface of the orientation device while the guiding tool is oriented along the alignment axis;

removably keying and attaching the orientation device to a shaft of an inserter holding an implant for the joint surface;

aligning the shaft of the inserter along the alignment axis using the orientation device by changing the orientation of the shaft of the inserter such that the bubble of the orientation device is centered around the mark; and

inserting the implant in the joint surface.

15. The method of claim 14, wherein the inserter is an acetabular inserter with an adapter tip couplable to the guiding element of the patient-specific guide.

16. The method of claim 14, wherein the orientation device includes a transparent dome-shaped surface, a base and a coupler extending from the base.