Patient-specific bone-cutting guidance instruments and methods

• US 8,764,760 B2
• Filed: 07/01/2011
• Issued: 07/01/2014
• Est. Priority Date: 07/01/2011
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Metzger, Robert, Hershberger, Troy W.
• Primary Examiner(s): LAWSON, MATTHEW JAMES
• Application Number:
  US13/175,142
• Publication Number:
  US 20130006250A1
• Time in Patent Office: 1,096 Days
• Field of Search: 606 79- 80, 606/86.R, 606 87- 89, 606 96- 98
• 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 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• 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 17/58 for osteosynthesis, e.g. bone plates, screws , setting implements or the like A61B17/14, A61B17/16 take precedence
• CPC Class Codes: A61B 2017/32006 with a cutting strip, band or chain, e.g. like a chainsaw
• 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

Abstract

An orthopedic device for cutting or resurfacing an outer bone surface of a bone of a patient includes first and second guides. Each guide has a patient-specific surface preoperatively configured as a negative surface of a portion of the outer bone surface of the bone and a plurality of elongated slots. The elongated slots of the second guide are offset relative to the elongated slots of the first guide and configured for guiding a tool to resurface the outer bone surface.

Claims

1. A method for cutting or resurfacing an outer bone surface of a bone of a patient comprising:

mating a patient-specific surface of a patient-specific alignment guide on the outer bone surface of the bone, the patient-specific surface of the patient-specific alignment guide preoperatively configured as a negative surface of the outer bone surface;

inserting a reference pin into the bone through a guiding aperture of the patient-specific alignment guide;

removing the patient-specific alignment guide without removing the reference pin;

coupling a patient-specific resurfacing guide to the reference pin;

mating a patient-specific surface of the patient-specific resurfacing guide on the outer bone surface, the patient-specific surface of the patient-specific resurfacing guide preoperatively configured as a negative surface of the outer bone surface;

guiding a shaft of a resurfacing tool along an elongated slot of the patient-specific resurfacing guide on a sagittal plane of the bone;

coupling a patient-specific resurfacing member to the shaft of the resurfacing tool through a side slot of the patient-specific resurfacing guide, the side slot communicating with the elongated slot of the patient-specific resurfacing guide; and

resurfacing the outer bone surface using the patient-specific resurfacing member.

2. The method of claim 1, further comprising removing articular cartilage from the outer bone surface.

3. The method of claim 1, wherein coupling the resurfacing member to the shaft includes coupling the resurfacing member perpendicularly to the shaft.

4. The method of claim 1, further comprising removing articular cartilage from a femoral condyle.

5. The method of claim 1, further comprising mating the patient-specific resurfacing guide between medial and lateral femoral condyles such that the medial and lateral femoral condyles are exposed for either simultaneous or sequential resurfacing.

6. The method of claim 1, further comprising:

resurfacing a medial condyle of a distal femur using the patient-specific resurfacing member coupled to the resurfacing tool and guided by the patient-specific resurfacing guide; and

resurfacing a lateral condyle of the distal femur using the patient-specific resurfacing member coupled to the resurfacing tool and guided by the patient-specific resurfacing guide.

7. A method for cutting or resurfacing an outer bone surface of a bone of a patient comprising:

mating a patient-specific surface of a patient-specific alignment guide on the outer bone surface of the bone, the patient-specific surface of the patient-specific alignment guide preoperatively configured as a negative surface of the outer bone surface;

inserting a reference pin into the bone through a guiding aperture of the patient-specific alignment guide;

removing the patient-specific alignment guide without removing the reference pin;

coupling a patient-specific resurfacing guide to the reference pin;

mating a patient-specific surface of the patient-specific resurfacing guide on the outer bone surface, the patient-specific surface of the patient-specific resurfacing guide preoperatively configured as a negative surface of the outer bone surface;

guiding a resurfacing tool having a resurfacing member along an elongated slot in the patient-specific resurfacing guide;

guiding a shaft of the resurfacing tool along the elongated slot of the patient-specific resurfacing guide to guide the resurfacing member along a side slot communicating with the elongated slot during resurfacing; and

resurfacing the outer bone surface using the resurfacing member coupled to the resurfacing tool.

8. The method of claim 7, further comprising resurfacing the outer bone surface using a patient-specific surface of the resurfacing member coupled to the resurfacing tool.

9. The method of claim 7, further comprising guiding the resurfacing tool along a sagittal plane of a distal femur.

10. The method of claim 7, wherein the side slot is positioned orthogonal to the elongated slot.

11. The method of claim 7, wherein resurfacing the outer bone surface includes resurfacing medial and lateral condyles of a distal femur either simultaneously or sequentially.

12. The method of claim 11, wherein mating the patient-specific surface of the patient-specific resurfacing guide includes mating the patient-specific surface of the patient-specific resurfacing guide between the medial and lateral condyles.

13. A method for cutting or resurfacing an outer bone surface of a bone of a patient, comprising:

mating a patient-specific surface of a patient-specific resurfacing guide on the outer bone surface, the patient-specific surface of the patient-specific resurfacing guide preoperatively configured as a negative surface of the outer bone surface;

guiding a shaft of a resurfacing tool along an elongated slot of the patient-specific resurfacing guide that extends along a sagittal plane of the bone;

coupling a patient-specific resurfacing member to the shaft through a side slot of the patient-specific resurfacing guide, the side slot communicating with the elongated slot of the patient-specific resurfacing guide; and

resurfacing the outer bone surface using the patient-specific resurfacing member coupled to the resurfacing tool.

14. The method of claim 13, wherein the resurfacing member is coupled perpendicularly to the shaft of the resurfacing tool.

15. The method of claim 13, further comprising resurfacing a condyle of a distal femur with the resurfacing member.

16. The method of claim 15, further comprising:

mating a patient-specific surface of a patient-specific alignment guide on the outer bone surface of the bone, the first patient-specific surface of the patient-specific alignment guide preoperatively configured as a negative surface of the outer bone surface;

inserting a reference pin into the bone through a guiding aperture of the patient-specific alignment guide;

removing the patient-specific alignment guide without removing the reference pin; and

coupling the patient-specific resurfacing guide to the reference pin.

17. The method of claim 13, further comprising mating the patient-specific resurfacing guide between medial and lateral femoral condyles such that the medial and lateral femoral condyles are exposed for either simultaneous or sequential resurfacing.