Joint arthroplasty devices and surgical tools

• US 8,617,172 B2
• Filed: 07/20/2012
• Issued: 12/31/2013
• 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, Tsougarakis, Konstantinos, Vargas-Voracek, Rene
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US13/554,453
• Publication Number:
  US 20120289966A1
• Time in Patent Office: 529 Days
• Field of Search: 606/86.R, 606/86.A, 606/79, 606/80, 606/84, 606/85, 606/87, 606/88, 606/89
• 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 surgical instrument for use in surgically repairing a joint of a patient, comprising:

a mold having an internal surface that substantially conforms to a shape of a cartilage surface of the joint of the patient; and

one or more drill hole guides configured to guide a surgical drill, wherein the one or more drill hole guides include anatomical information of the joint to facilitate the placement of an articular repair system when the internal surface of the mold is aligned with and substantially conforms to the shape of the cartilage surface of the joint.

2. The surgical instrument of claim 1, wherein the joint is one of a hip, knee, ankle, shoulder, elbow and wrist joint.

3. The surgical instrument of claim 1, wherein the anatomical information is information regarding an axis of the joint of the patient.

4. The surgical instrument of claim 1, wherein the anatomical information is information regarding a femoral shaft or femoral neck axis of the patient.

5. The surgical instrument of claim 1, wherein the anatomical information is information regarding a femoral condyle axis of the patient.

6. The surgical instrument of claim 1, wherein the anatomical information is information regarding a tibial axis of the patient.

7. The surgical instrument of claim 1, wherein the anatomical information is information regarding a deformity of the joint of the patient.

8. The surgical instrument of claim 1, wherein the anatomical information is information regarding an alignment of the joint of the patient.

9. The surgical instrument of claim 1, wherein the anatomical information is information regarding a varus alignment of the joint of the patient.

10. The surgical instrument of claim 1, wherein the anatomical information is information regarding a valgus alignment of the joint of the patient.

11. The surgical instrument of claim 1, wherein the anatomical information is information regarding an articular alignment of the joint of the patient.

12. The surgical instrument of claim 1, wherein the anatomical information is information regarding another joint of the patient.

13. The surgical instrument of claim 1, wherein the one or more drill hole guides further comprises a stop configured to cooperate with a surgical drill to provide a predetermined drilling depth.

14. The surgical instrument of claim 1, wherein the one or more drill hole guides define a tibial implant rotation.

15. The surgical instrument of claim 1, wherein the one or more drill hole guides define a femoral implant rotation.

16. The surgical instrument of claim 14, further comprising one or more adjustment means for adjusting the tibial implant rotation.

17. The surgical instrument of claim 15, further comprising one or more adjustment means for adjusting the femoral implant rotation.

18. The surgical instrument of claim 1, further comprising an adjustment mechanism to provide a rotational motion of the surgical drill.

19. The surgical instrument of claim 1, wherein the internal surface includes information regarding an estimated cartilage thickness of the joint of the patient.

20. The surgical instrument of claim 1 including two or more drill hole guides, wherein the two or more drill hole guides are substantially parallel.

21. The surgical instrument of claim 1, wherein the one or more drill hole guides are not substantially perpendicular to the cartilage surface.

22. The surgical instrument of claim 1, wherein the one or more drill hole guides are perpendicular to the cartilage surface.

23. The surgical instrument of claim 1, further comprising a cutting block.

24. The surgical instrument of claim 1, wherein the internal surface is a continuous surface.

25. The surgical instrument of claim 1, wherein a width of the one or more drill hole guides is smaller than a dimension of an attachment mechanism of the articular repair system.

26. The surgical instrument of claim 1, wherein a width of the one or more drill hole guides is the same as that of a dimension of an attachment mechanism of the articular repair system.

27. The surgical instrument of claim 1, wherein the a of the one or more drill hole guides is larger than a dimension of an attachment mechanism of the articular repair system.

28. A surgical instrument for use in surgically repairing a knee joint of a patient, comprising:

a mold having an internal surface that substantially conforms to the shape of a cartilage surface of the knee joint of the patient; and

one or more drill hole guides configured to guide a surgical drill, wherein the one or more drill hole guides include a desired orientation of an articular repair system for the knee joint to facilitate the placement of the articular repair system when the internal surface of the mold is aligned with and substantially conforms to the shape of the cartilage surface of the knee joint.

29. A surgical instrument for use in surgically repairing a hip joint of a patient, comprising:

a mold having an internal surface that substantially conforms to the shape of a cartilage surface of the hip joint of the patient; and

one or more drill hole guides configured to guide a surgical drill, wherein the one or more drill hole guides include axis information and anatomical information of the hip joint to facilitate the placement of an articular repair system when the internal surface of the mold is aligned with and substantially conforms to the shape of the cartilage surface of the hip joint.

30. A surgical instrument for use in surgically repairing a diseased or damaged joint of a patient, comprising:

an internal surface that substantially conforms to a corresponding shape of a cartilage surface of the diseased or damaged joint of the patient and a drill hole guide configured to guide a surgical drill,

wherein the drill hole guide includes anatomical information of the diseased or damaged joint such that the drill hole guide is aligned in a predetermined orientation relative to the internal surface to define a drilling path through at least a portion of the joint when the internal surface is aligned with the corresponding shape of the cartilage surface of the joint, the orientation of the drill hole guide thereby facilitating the placement of an articular repair system in a predetermined position relative to the diseased or damaged joint of the patient.