System and method for joint resurface repair

• US 8,864,827 B2
• Filed: 05/14/2012
• Issued: 10/21/2014
• Est. Priority Date: 05/01/2000
• Status: Expired due to Fees

• Current Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Original Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Inventors: Ek, Steven W.
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US13/470,678
• Publication Number:
  US 20120271417A1
• Time in Patent Office: 890 Days
• Field of Search: 623/14.12, 623/20.31, 623/20.14, 623/20.32, 623/20.35, 623/20.3, 623/20.36, 623/908, 606/80, 606/96, 606/102
• US Class Current: 623/14.12
• CPC Class Codes: A61B 17/1635 for grafts, harvesting or transplants
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• 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 2/3859 Femoral components
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30112 Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2002/30116 partial circles, i.e. circular segments
• CPC Class Codes: A61F 2002/30607 Kits of prosthetic parts to be assembled in various combinations for forming different prostheses
• CPC Class Codes: A61F 2002/3085 with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• 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 2002/3895 unicompartimental
• CPC Class Codes: A61F 2002/4658 for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4663 for measuring volumes or other three-dimensional shapes
• CPC Class Codes: A61F 2230/0004 Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2230/0006 circular
• CPC Class Codes: A61F 2250/0062 Kits of prosthetic parts to be assembled in various combinations for forming different prostheses

Abstract

An implant comprising a first, second, and third segment wherein the second and third segments partially overlap the first segment and define a load bearing surface comprising an anterior-posterior (AP) curvature including at least two tangential curves of the portion of the articular surface of the femoral condyle, the tangential curves having different radii of curvature. A drill guide comprises a body portion including a first, second and third bushing spaced along the body portion to establish a first, second and third axes, respectively. Each axis may be substantially normal to the articular surface at three different points along a curvature of the articular surface comprising the two tangential curves. A measuring device comprises a housing defining a longitudinally passageway and an outrigger. A guide pin may be received in the longitudinal passageway and a measuring device determines how far the guide pin is in the passageway.

Claims

1. An implant for replacing a portion of an articular surface of a bone comprising:

at least a first and a second segment each comprising a truncated, generally arcuate perimeter corresponding to a first and a second overlapping generally circular excision site to be formed in said articular surface, respectively, wherein said second segment partially overlaps said first segment on a first end of said first segment, and wherein said first and said second segments comprise a bone contacting surface and a load bearing surface, said load bearing surface comprising curvature corresponding to a curvature of said replaced portion of said articular surface of said bone.

2. The implant of claim 1, wherein said bone contacting surface comprises a first mounting feature configured to secure said implant to said bone.

3. The implant of claim 1, further comprising a third segment comprising a truncated, generally arcuate perimeter corresponding to a third generally circular excision site formed in said articular surface, said third generally circular excision site overlapping with said second generally circular excision site, wherein said third segment partially overlaps said first segment on a second end of said first segment, said third segment comprising a portion of said bone contacting surface and said load bearing surface.

4. The implant of claim 2, wherein said first mounting feature is configured to securely engage with a fastening element, said fastening element configured to be secured to said bone.

5. The implant of claim 4, wherein said fastening element includes a mounting screw.

6. The implant of claim 4, wherein said first mounting feature includes a tapered opening configured to engage with a tapered post of said fastening element.

7. The implant of claim 4, wherein said first mounting feature includes a tapered post configured to engage with a tapered opening of said fastening element.

8. The implant of claim 2, wherein said bone contacting surface further comprises a second mounting feature configured to secure said implant to said bone.

9. The implant of claim 8, wherein said second mounting feature includes a protrusion extending generally outwardly from said bone facing surface.

10. The implant of claim 3, wherein said bone facing surface of said first segment includes a first mounting feature and wherein said bone facing surface of said second segment includes a second mounting feature.

11. The implant of claim 3, wherein said bone facing surface of said third segment includes a third mounting feature.

12. The implant of claim 11, wherein said first, said second, and said third mounting features are axially aligned with said first, said second, and said third overlapping generally circular excision site formed in said articular surface, respectively.

13. The implant of claim 1, wherein said load bearing surface comprises an anterior-posterior (AP) curvature and a medial lateral (ML) curvature.

14. The implant of claim 1, wherein said curvature of said load bearing surface comprises at least two tangential curves of said portion of said articular surface of said bone, said tangential curves having different radii of curvature.

15. The implant of claim 3, wherein said bone facing surface of said first segment includes a first mounting feature.

16. The implant of claim 1, wherein said first and said second segments of said bone facing surface each have a non-planar surface.

17. The implant of claim 1, wherein said first and said second bone facing surfaces are further defined by a first and a second lip, respectively, each of said lips defining a portion of an outer perimeter of said implant and at least one recess, wherein said first lip partially intersects with said second lip.

18. The implant of claim 1, wherein at least a portion of said first and said second bone facing surfaces are generally symmetrical about a center of said first and said second generally circular excision site.

19. The implant of claim 1, wherein truncated, generally arcuate perimeters of said first and said second segments each comprise a center corresponding to said first and said second generally circular excision site, respectively.

20. A method for replacing a portion of an articular surface, said method comprising:

reaming a first portion of said articular surface to form a first generally circular excision site;

reaming a second portion of said articular surface to form a second generally circular excision site partially overlapping said first generally circular excision site; and

selecting an implant having first and second segments each comprising a truncated, generally arcuate perimeter corresponding to said first and said second overlapping generally circular excision sites, respectively, wherein said second segments partially overlaps said first segment on a first end of said first segment, and wherein said first and said second segments comprise a bone contacting surface and a load bearing surface, said load bearing surface comprising curvature corresponding to a curvature of said replaced portion of said articular surface of said bone.

21. The method of claim 20, further comprising a placing a drill guide onto said articular surface and establishing a plurality of axes in said articular surface corresponding to said second and said third excision sites using said drill guide.

22. The method of claim 21, wherein reaming said second and said third excision sites comprises advancing at least one reamer along said plurality of axes towards said articular surface, wherein said at least one reamer is rotated about said plurality of axes.

23. The method of claim 20, further comprising securing said implant to bone beneath said articular surface.

24. The method of claim 23, wherein securing said implant further comprises securing a fastening element into said bone and securing said implant to said fastening element.

25. The method of claim 24, wherein said fastening element comprises a screw, and wherein securing said fastening element into said bone further comprises advancing said screw into said bone.

26. The method of claim 24, wherein said implant and said fastening element are secured using a tapered frictional coupling.

27. The method claim 20, further comprising reaming a third portion of said articular surface to form a third generally circular excision site partially overlapping said first generally circular excision site on a second end of said first segment;

and

wherein said selecting further comprises selecting an implant having first, second, and second third segments each comprising a truncated, generally arcuate perimeter corresponding to said first, said second, and said second third overlapping generally circular excision sites, respectively.

28. An implant for replacing a portion of an articular surface of a bone comprising:

a bone facing surface comprising at least a first, a second, and a third segment each corresponding to at least a first, a second, and a third intersecting excision site to be formed in said articular surface, respectively, wherein said first, said second, and said third segments of said bone facing surface each have a non-planar surface, and wherein said bone facing surface further comprises a plurality of fixation elements configured to secure said implant to said excision sites; and

a load bearing surface comprising a curvature generally corresponding to a curvature of said replaced portion of said articular surface of said bone, wherein said curvature of said load bearing surface comprises at least two tangential curves of said replaced portion of said articular surface of said bone, said tangential curves having different radii of curvature.

29. The implant of claim 28, wherein said implant is a femoral implant, and wherein said curvature of said load bearing surface generally corresponds to a portion of a femoral articular surface.

30. The implant of claim 29, wherein said load bearing surface comprises an anterior-posterior (AP) curvature and a medial lateral (ML) curvature.

31. The implant of claim 30, wherein said at least two tangential curves are disposed along an anterior-posterior (AP) surface of said femur.

32. The implant of claim 28, wherein at least one of said fixation elements includes a protrusion extending generally outwardly from said bone facing surface.

33. The implant of claim 28, wherein said first, said second, and said third segment of said bone facing surface each includes at least one of said plurality of fixation elements.

34. The implant of claim 28, wherein said curvature of said load bearing surface comprises a first, a second, and a third tangential curves each extending along a portion of said replaced portion of said articular surface of said bone, wherein said portion of said second curve is approximately tangential to said portion of said first curve and said portion of said third curve at opposite ends thereof.

35. The implant of claim 28, wherein said curvature of said load bearing surface comprises a first, a second, and a third tangential curves each extending along a portion of said replaced portion of said articular surface of said bone, wherein said portion of said second curve is approximately tangential to said portion of said first curve and said portion of said third curve at opposite ends thereof.

36. An implant for replacing a portion of an articular surface of a bone comprising:

a bone facing surface comprising a first segment which intersects with a second and a third segment, wherein said first, said second, and said third segment of said bone facing surface each correspond to at least a first, a second, and a third intersecting excision site to be formed in said articular surface, respectively, said first, said second, and said third segments of said bone facing surface each having a non-planar surface and each including at least one fixation element configured to secure said implant to said bone; and

a load bearing surface comprising an anterior-posterior (AP) curvature and a medial lateral (ML) curvature corresponding to an AP and a ML curvature of said replaced portion of said articular surface of said bone, respectively, wherein said AP curvature of said load bearing surface comprises at least two tangential curves of said replaced portion of said articular surface of said bone, said tangential curves having different radii of curvature.

37. The implant of claim 36, wherein said implant is a femoral implant, and wherein said curvature of said load bearing surface generally corresponds to a portion of a femoral articular surface.

38. The implant of claim 36, wherein at least one of said fixation elements includes a protrusion extending generally outwardly from said bone facing surface.

39. An implant for replacing a portion of an articular surface of a bone comprising:

a bone facing surface comprising a first, a second, and a third segment having a periphery defined by a first, a second, and a third lip, respectively, each of said lips defining a portion of an outer perimeter of said implant and at least one recess, wherein said first lip partially intersects with said second and said third lips;

a plurality of fixation elements extending outwardly from said bone facing surface configured to secure said implant to said bone; and

a load bearing surface comprising a curvature generally corresponding to a curvature of said replaced portion of said articular surface of said bone, wherein said curvature of said load bearing surface comprises at least two tangential curves of said replaced portion of said articular surface of said bone, said tangential curves having different radii of curvature.

40. The implant of claim 39, wherein said load bearing surface comprises an anterior-posterior (AP) curvature and a medial lateral (ML) curvature, and wherein said at least two tangential curves are disposed along an anterior-posterior (AP) surface of said femur.

41. The implant of claim 40, wherein said curvature of said load bearing surface comprises a first, a second, and a third tangential curves each extending along a portion of said replaced portion of said articular surface of said bone, wherein said portion of said second curve is approximately tangential to said portion of said first curve and said portion of said third curve at opposite ends thereof.

42. An implant for replacing a portion of an articular surface of a bone comprising:

a bone facing surface comprising a plurality of segments each corresponding to a respective one of a plurality of intersecting excision sites to be formed in said articular surface, wherein said plurality of segments of said bone facing surface each have a non-planar surface, and wherein said bone facing surface further comprises a plurality of fixation elements configured to secure said implant to said plurality of overlapping excision sites; and

a load bearing surface comprising a curvature generally corresponding to a curvature of said replaced portion of said articular surface of said bone, wherein said curvature of said load bearing surface comprises at least two tangential curves of said replaced portion of said articular surface of said bone, said tangential curves having different radii of curvature.