Minimally invasive joint implant with 3-dimensional geometry matching the articular surfaces

• US 8,709,089 B2
• Filed: 05/03/2010
• Issued: 04/29/2014
• Est. Priority Date: 10/07/2002
• Status: Expired due to Fees

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Lang, Philipp, Steines, Daniel, Bouadi, Hacene, Miller, David
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US12/772,683
• Publication Number:
  US 20110066245A1
• Time in Patent Office: 1,457 Days
• Field of Search: 623 2014- 2017, 623 2028- 2035, 623/18.11, 623/16.11, 623/14.12, 623/23.28, 295/92
• US Class Current: 623/18.11
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 2/30942 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 2/32 for the hip
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/3603 implanted without ablation of the whole natural femoral head endoprosthetic cartilage A61F2/30756
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3804 for elbows
• CPC Class Codes: A61F 2/40 for shoulders
• CPC Class Codes: A61F 2/4081 Glenoid components, e.g. cups
• CPC Class Codes: A61F 2/42 for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
• CPC Class Codes: A61F 2/4202 for ankles
• CPC Class Codes: A61F 2/4261 for wrists
• CPC Class Codes: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30016 differing in hardness, e.g. Vickers, Shore, Brinell
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/3007 Coating or prosthesis-covering structure made of elastic material, e.g. of elastomer
• CPC Class Codes: A61F 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30113 : circular
• CPC Class Codes: A61F 2002/30125 : elliptical or oval
• CPC Class Codes: A61F 2002/30133 : kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30179 : X-shaped
• CPC Class Codes: A61F 2002/30242 : spherical
• CPC Class Codes: A61F 2002/30245 : Partial spheres
• CPC Class Codes: A61F 2002/30253 : ellipsoidal or ovoid
• CPC Class Codes: A61F 2002/30324 : differing in thickness
• 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 2002/30822 : Circumferential grooves
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/30843 : Pyramidally-shaped
• 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 2002/30884 : Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/30894 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30948 : using computerized tomography, i.e. CT scans
• CPC Class Codes: A61F 2002/30952 : using CAD-CAM techniques or NC-techniques
• 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 2002/3208 : Bipolar or multipolar joints, e.g. having a femoral head articulating within an intermediate acetabular shell whilst said shell articulates within the natural acetabular socket or within an artificial outer shell
• CPC Class Codes: A61F 2002/3216 : tripolar
• CPC Class Codes: A61F 2002/3412 : with pins or protrusions, e.g. non-sharp pins or protrusions projecting from a shell surface
• CPC Class Codes: A61F 2002/3414 : Polar protrusion, e.g. for centering two concentric shells
• CPC Class Codes: A61F 2002/4007 : implanted without ablation of the whole natural humeral head
• CPC Class Codes: A61F 2002/4233 : for metatarso-phalangeal joints, i.e. MTP joints
• CPC Class Codes: A61F 2002/4251 : for metacarpo-phalangeal joints, i.e. MCP or MP joints, e.g. knuckle joints
• CPC Class Codes: A61F 2002/4631 : the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2210/0014 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0008 : elliptical or oval
• CPC Class Codes: A61F 2230/0015 : Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2230/0058 : X-shaped
• CPC Class Codes: A61F 2230/0071 : spherical
• CPC Class Codes: A61F 2230/0076 : ellipsoidal or ovoid
• CPC Class Codes: A61F 2250/0019 : differing in hardness, e.g. Vickers, Shore, Brinell
• CPC Class Codes: A61F 2250/0036 : differing in thickness
• CPC Class Codes: A61F 2310/00011 : Metals or alloys
• CPC Class Codes: A61F 2310/00179 : Ceramics or ceramic-like structures
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite
• CPC Class Codes: A61F 2310/00365 : Proteins; Polypeptides; Degradation products thereof
• 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: B33Y 80/00 : Products made by additive manufacturing
• CPC Class Codes: Y10S 264/30 : Use of anatomy in making a mold or using said mold
• CPC Class Codes: Y10T 29/49 : Method of mechanical manufacture

Abstract

This invention is directed to orthopedic implants and systems. The invention also relates to methods of implant design, manufacture, modeling and implantation as well as to surgical tools and kits used therewith. The implants are designed by analyzing the articular surface to be corrected and creating a device with an anatomic or near anatomic fit; or selecting a pre-designed implant having characteristics that give the implant the best fit to the existing defect.

Claims

1. A method of designing, using a computer system, a patient-specific surgical tool for use in surgery on a joint of a patient, the method comprising:

creating a model representing at least a portion of an articular surface of the patient'"'"'s joint based on electronic image data of the patient'"'"'s joint;

providing the model to make an altered model by removing at least a portion of an osteophyte of the joint to accommodate the implantation of an implant; and

designing a surgical implantation tool based at least in part on the altered model of the patient'"'"'s joint.

2. The method of claim 1, wherein the surgical implantation tool includes at least one outer surface that matches or nearly matches the contour of an underlying articular surface of the joint.

3. The method of claim 1, wherein the surgical implantation tool conforms to measurements of the patient'"'"'s joint.

4. The method of claim 1, further comprising defining a biomechanical axis of the joint from the electronic image data.

5. The method of claim 1, further comprising defining a biomechanical axis of the joint from an imaging test of the joint.

6. The method of claim 5, wherein the imaging test is one of a CT scan, an MRI scan and a weight-bearing radiograph.

7. The method of claim 1, wherein the altered model is a projected model of the joint in a corrected condition.

8. The method of claim 1, wherein further comprising creating a physical model of at least a portion of the joint in a corrected condition.

9. The method of claim 1, wherein the articular surface includes a cartilage surface.

10. The method of claim 1, wherein the articular surface includes a bone surface.

11. The method of claim 1, wherein the surgical implantation tool is designed to correct malalignment of articular structures of the joint of the patient.

12. The method of claim 1, wherein the joint is a knee joint and wherein the surgical implantation tool is designed to balance the joint of the patient.

13. The method of claim 1, wherein the surgical implantation tool includes an opening for preparing a bone to create a cavity to accept a bone anchor.

14. The method of claim 1, wherein the surgical implantation tool is further designed based in part on a movement pattern of the joint.

15. A method of designing, using a computer system, a patient-specific implant for use in surgery on a joint of a patient, the method comprising:

creating a model representing at least a portion of an articular surface of the patient'"'"'s joint based on electronic image data of the patient'"'"'s joint;

providing the model for creating an altered model by removing at least a portion of an osteophyte of the joint to accommodate the implantation of an implant; and

designing an implant based at least in part on the altered model of the patient'"'"'s joint.

16. The method of claim 15, wherein the implant includes at least one outer surface that matches or nearly matches the contour of an underlying articular surface of the joint.

17. The method of claim 15, further comprising defining a biomechanical axis of the joint from the electronic image data.

18. The method of claim 15, further comprising defining a biomechanical axis of the joint from an imaging test of the joint.

19. The method of claim 15, wherein the articular surface includes a cartilage surface.

20. The method of claim 15, wherein the articular surface includes a bone surface.

21. The method of claim 15, wherein the implant is designed to correct malalignment of articular structures of the joint of the patient.

22. The method of claim 15, wherein the implant is further designed based in part on a movement pattern of the joint.

25. The method of claim 15, wherein the model includes a physical model.

26. The method of claim 15, wherein the patient'"'"'s joint is a knee joint, wherein the model represents a portion of the knee joint selected from the group consisting of:

a medial condyle of the knee joint, a lateral condyle of the knee joint, both femoral condyles of the knee joint, an intercondylar notch region of the knee joint, a medial tibial plateau of the knee joint, a lateral tibial plateau of the knee joint, the entire tibial plateau of the knee joint, a medial patella of the knee joint, a lateral patella of the knee joint, a patella of the knee joint, and any combination thereof.

23. A method of designing, using a computer system, a patient-specific surgical tool for use in surgery on a joint of a patient, the method comprising:

designing a surgical implantation tool based at least in part on a model of a patient'"'"'s joint, wherein the model is based on one or more electronic images of at least a portion of an articular surface of the patient'"'"'s joint and further wherein the model is altered to remove at least a portion of an osteophyte of the patient'"'"'s joint.

24. A method of designing, using a computer system, a patient-specific implant for use in surgery on a joint of a patient, the method comprising:

designing an implant based at least in part on a model of a patient'"'"'s joint, wherein the model is based on one or more electronic images of at least a portion of an articular surface of the patient'"'"'s joint and further wherein the model is altered to remove at least a portion of an osteophyte of the patient'"'"'s joint.