Patient-specific osteotomy devices and methods

• US 8,632,547 B2
• Filed: 05/12/2011
• Issued: 01/21/2014
• Est. Priority Date: 02/26/2010
• Status: Expired due to Fees

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Maxson, William, Stone, Kevin T., Pierce, Andrew L., Metzger, Robert
• Primary Examiner(s): Stewart, Alvin J.
• Application Number:
  US13/106,295
• Publication Number:
  US 20110213376A1
• Time in Patent Office: 985 Days
• Field of Search: 606 84- 88, 606/79, 606/89, 606/80, 606/82, 623/20.32, 623/18.11, 623/20.16, 623/20.17
• US Class Current: 606/88
• 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 17/1764 for the knee
• CPC Class Codes: A61B 17/58 for osteosynthesis, e.g. bone plates, screws , setting implements or the like A61B17/14, A61B17/16 take precedence
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• 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 2002/30617 Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/4662 for measuring penetration depth
• CPC Class Codes: A61F 2002/4668 for measuring angles
• CPC Class Codes: A61F 2250/0097 Visible markings, e.g. indicia

Abstract

An osteotomy method includes attaching a patient-specific osteotomy guide to a corresponding surface of a tibia of a patient and making an osteotomy at a patient-specific orientation through a resection slot of the osteotomy guide. The osteotomy guide is removed and first and second faces of the osteotomy are opened to form an implant insertion angle. The first and second faces of the osteotomy are secured at the implant insertion angle and an osteotomy implant having a patient-specific wedge angle that is smaller than the implant insertion angle is implanted. The first and second faces of the osteotomy are brought to the patient-specific wedge angle and in contact with the osteotomy implant.

Claims

1. An osteotomy method comprising:

attaching a patient-specific osteotomy guide to a corresponding surface of a tibia of a patient, the osteotomy guide having a three-dimensional engagement surface configured during a preoperative plan for the patient using computer imaging to mate as a negative surface of the corresponding surface of the tibia;

drilling a guiding hole into the tibia through a drill hole of the osteotomy guide;

making an osteotomy at a patient-specific orientation through a resection slot of the osteotomy guide, the resection slot intersecting the drill hole and configured for the specific patient during the preoperative plan of the patient;

removing the osteotomy guide; and

opening first and second faces of the osteotomy to form a first angle using a patient-specific osteotomy spreader.

2. The osteotomy method of claim 1, further comprising:

attaching an adjustable osteotomy securing device to span the osteotomy; and

securing the osteotomy at a second angle greater than the first angle.

3. The osteotomy method of claim 2, further comprising removing the osteotomy spreader;

and

implanting a patient-specific osteotomy implant into the osteotomy, the patient-specific osteotomy implant configured with a wedge angle equal to the first angle, the first angle preoperatively determined for correcting a joint misalignment of the patient.

4. An osteotomy method comprising:

attaching a patient-specific osteotomy guide to a corresponding surface of a tibia of a patient, the osteotomy guide configured during a preoperative plan for the patient to mate only in one position on the corresponding surface of the tibia;

drilling a guiding hole into the tibia through a drill hole of the osteotomy guide;

making an osteotomy at a patient-specific orientation through a resection slot of the osteotomy guide, the resection slot intersecting the drill hole and configured for the specific patient during the preoperative plan of the patient;

removing the osteotomy guide;

opening first and second faces of the osteotomy to form a first angle using a patient-specific osteotomy spreader; and

opening the osteotomy to form a second angle greater than the first angle using an osteotome stacked over the osteotomy spreader.

5. The osteotomy method of claim 4, further comprising:

attaching an adjustable osteotomy securing device to span the osteotomy; and

securing the osteotomy at the second angle.

6. The osteotomy method of claim 5, further comprising removing the osteotomy spreader and the osteotome;

and

implanting a patient-specific osteotomy implant into the osteotomy, the patient-specific osteotomy implant configured with a wedge angle equal to the first angle, the first angle preoperatively determined for correcting a joint misalignment of the patient.

7. The osteotomy method of claim 6, further comprising removing the osteotomy securing device.

8. The osteotomy method of claim 7, further comprising bringing the first and second faces of the osteotomy from the second angle to the first angle.

9. The osteotomy method of claim 8, further comprising attaching a fixation plate across the osteotomy.

10. The osteotomy method of claim 4, further comprising drilling a stress-relief hole along an end of the osteotomy guided by the osteotomy guide.

11. An osteotomy method comprising:

attaching a patient-specific osteotomy guide to a corresponding surface of a tibia of a patient, the osteotomy guide configured during a preoperative plan for the patient to mate only in one position on the corresponding surface of the tibia;

drilling a guiding hole into the tibia through a drill hole of the osteotomy guide

making an osteotomy at a patient-specific orientation through a resection slot of the osteotomy guide, the resection slot intersecting the drill hole and configured for the specific patient during the preoperative plan of the patient;

removing the osteotomy guide;

opening first and second faces of the osteotomy to form a first angle using a patient-specific spreader; and

inserting a blade guard against a posterior bone surface of the tibia.

12. An osteotomy method comprising:

attaching a patient-specific osteotomy guide to a corresponding surface of a tibia of a patient, the osteotomy guide having a patient-specific three-dimensional engagement surface made preoperatively to conform as a negative surface of the corresponding surface of the tibia;

making an osteotomy at a patient-specific orientation through a resection slot of the osteotomy guide;

removing the osteotomy guide;

opening first and second faces of the osteotomy to form an implant insertion angle;

securing the first and second faces of the osteotomy at the implant-insertion angle;

implanting an osteotomy implant having a patient-specific wedge angle that is smaller than the implant-insertion angle; and

bringing the first and second faces of the osteotomy to the patient-specific wedge angle and in contact with the osteotomy implant.

13. The osteotomy method of claim 12, further comprising attaching a fixation plate across the osteotomy.

14. The osteotomy method of claim 12, further comprising drilling a stress-relief hole along an end of the osteotomy guided by the osteotomy guide.