Joint arthroplasty devices and surgical tools

• US 8,641,716 B2
• Filed: 07/19/2012
• Issued: 02/04/2014
• 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:
  US13/553,057
• Publication Number:
  US 20120296337A1
• Time in Patent Office: 565 Days
• Field of Search: 606/80, 606 82- 85, 606/86.R, 606 87- 89, 606/96, 606/99, 606/101, 623/14.12
• US Class Current: 606/80
• 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 method of performing a surgical procedure on a knee joint of a patient using a patient specific tool, comprising:

engaging an internal surface of the tool against a corresponding portion of a diseased or damaged cartilage surface of a femoral condyle of the knee joint such that at least a portion of the internal surface substantially conforms to the corresponding portion of the diseased or damaged cartilage surface;

wherein a drill hole configured to guide a surgical drill is thereby aligned in a predetermined orientation relative to the corresponding portion of the diseased or damaged cartilage surface to define a drilling path through at least a portion of the femoral condyle; and

drilling a hole in the femoral condyle along the drilling path to facilitate the placement of an articular repair system in a predetermined orientation relative to the knee joint of the patient using the drill hole.

2. The method of claim 1, further comprising applying an instrument guide to the joint such that the instrument guide has a predetermined orientation relative to the three-dimensional anatomy of the joint that is determined by the orientation of the tool.

3. The method of claim 1, further comprising placing an articular repair system in a predetermined position relative to the joint of the patient using the drill hole.

4. The method of claim 1, further comprising placing an instrument guide over the cartilage surface in a predetermined orientation defined by the tool.

5. The method of claim 1, further comprising drilling a second hole in another femoral condyle of the knee joint along a drilling path defined by a second drill hole defined by the tool.

6. The method of claim 4, further comprising cutting along an anatomically desirable cut plane or drilling path defined by the orientation of the instrument guide.

7. The method of claim 6, further comprising placing an articular repair system in the joint of the patient, wherein the placement is facilitated by the orientation of the instrument guide.

8. The method of claim 1, further comprising cutting along an anatomically desirable cut plane defined by the orientation of the tool.

9. The method of claim 8, further comprising placing an articular repair system in the joint of the patient, wherein the placement is facilitated by the orientation of the drill hole.

10. The method of claim 1, further comprising controlling the depth of the drill.

11. The method of claim 1, further comprising controlling the depth of a surgical instrument.

12. The method of claim 1, wherein the size of the drilling hole in the tool is designed to essentially match the size of a portion of the articular repair system.

13. The method of claim 1, wherein the size of the drilling hole in the tool is designed to be larger than the size of a portion of the articular repair system.

14. The method of claim 1, wherein the size of the drilling hole in the tool is designed to be smaller than the size of a portion of the articular repair system.

15. The method of claim 1, wherein the drilling path has a predetermined alignment relative to an axis of the joint.

16. The method of claim 1, wherein the internal surface of the tool conforms to a non-articular shape of at least a portion of the joint.

17. The method of claim 1, further comprising adjusting the instrument guide.

18. The method of claim 17, wherein the adjustment affects biomechanical alignment and joint laxity.

19. The method of claim 17, wherein the adjustment affects biomechanical alignment and joint function.

20. The method of claim 17, wherein the adjustment affects a flexion or extension gap of the joint.

21. The method of claim 17, wherein the adjustment is performed using a mechanical or electrical adjustment.

22. The method of claim 1, further comprising adjusting joint laxity or joint alignment.

23. The method of claim 1, further comprising adjusting flexion or extension of the articular repair system.

24. The method of claim 1, further comprising adjusting abduction or adduction of the articular repair system.

25. The method of claim 1, further comprising adjusting internal or external rotation of the articular repair system.

26. The method of claim 1, wherein the predetermined orientation of the drill hole is aligned in relationship to other joints.

27. The method of claim 1, wherein the predetermined orientation of the drill hole is predetermined relative to an axis of the joint.

28. A method of performing a surgical procedure on an articular joint of a patient using a patient specific instrument, comprising:

engaging an internal surface of the instrument against a corresponding portion of a diseased or damaged cartilage surface of the joint such that the internal surface substantially conforms to the corresponding portion of the diseased or damaged cartilage surface;

wherein a drill hole guide configured to guide a surgical drill is thereby aligned in a predetermined orientation relative to the internal surface to define a drilling path through at least a portion of the joint;

drilling a hole in the joint along the drilling path; and

placing an articular repair system in a predetermined orientation relative to the joint of the patient using the drill hole, wherein the predetermined orientation is aligned relative to one or more other joints of the patient.

29. A method of performing a surgical procedure on an articular joint of a patient using a patient specific instrument, comprising:

engaging an internal surface of the instrument against a corresponding portion of a cartilage surface of the joint such that the internal surface substantially conforms to the corresponding portion of the cartilage surface;

wherein one or more drill hole guides configured to guide a surgical drill are thereby aligned in a predetermined position relative to the internal surface to define one or more drilling paths through at least a portion of the joint;

drilling one or more holes in the joint along the one or more drilling paths;

applying an instrument guide to the joint such that the instrument guide has a predetermined orientation relative to the three-dimensional anatomy of the joint that is determined by the orientation of the one or more holes; and

placing an articular repair system in a predetermined position relative to the joint of the patient using the predetermined orientation of the instrument guide.

30. A method of performing a surgical procedure on an articular joint of a patient using a patient specific instrument, comprising:

engaging an internal surface of the instrument against a corresponding portion of a cartilage surface of the joint such that the internal surface substantially conforms to the corresponding portion of the cartilage surface;

wherein one or more drill hole guides configured to guide a surgical drill are thereby aligned in a predetermined position relative to the internal surface to define one or more drilling paths through at least a portion of the joint;

drilling one or more holes in the joint along the one or more drilling paths;

applying an instrument guide to the joint such that the instrument guide has a predetermined orientation relative to the three-dimensional anatomy of the joint that is determined by the orientation of the one or more holes; and

placing an articular repair system in a predetermined position relative to the joint of the patient using the instrument guide.