Marking template for installing a custom replacement device for resurfacing a femur and associated installation method

• US 8,936,601 B2
• Filed: 03/12/2014
• Issued: 01/20/2015
• Est. Priority Date: 03/17/2000
• Status: Expired due to Term

• Current Assignee: Kinamed Inc (VME Acquisition Corp)
• Original Assignee: Kinamed Inc (VME Acquisition Corp)
• Inventors: Carignan, Roger, Pratt, Clyde R.
• Primary Examiner(s): STEWART, ALVIN J
• Application Number:
  US14/206,494
• Publication Number:
  US 20140194997A1
• Time in Patent Office: 314 Days
• Field of Search: 623/20.35, 623 203- 2032, 623/20.18, 623/20.14, 623/20.15, 623/20.11, 623/18.11, 623/16.11, 623/20.19, 623/20.21, 606/80, 606/96, 606/53, 606 85- 88, 606/99, 606/101
• US Class Current: 606/96
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/1764 for the knee
• 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 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 2/3859 Femoral components
• CPC Class Codes: A61F 2/3877 Patellae or trochleae
• CPC Class Codes: A61F 2/461 of knees
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/30125 elliptical or oval
• CPC Class Codes: A61F 2002/30594 slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
• CPC Class Codes: A61F 2002/30685 Means for reducing or preventing the generation of wear particulates
• CPC Class Codes: A61F 2002/30892 parallel
• 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 2002/4658 for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2230/0008 elliptical or oval
• 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 2310/00203 : containing alumina or aluminium oxide
• CPC Class Codes: A61F 2310/00239 : containing zirconia or zirconium oxide ZrO2
• CPC Class Codes: A61F 2310/00407 : Coating made of titanium or of Ti-based alloys
• CPC Class Codes: A61F 2310/00796 : Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
• CPC Class Codes: Y10S 623/901 : Method of manufacturing prosthetic device
• CPC Class Codes: Y10T 29/49764 : with testing or indicating

Abstract

A replacement device for resurfacing a joint surface of a femur and a method of making and installing such a device is provided. The custom replacement device is designed to substantially fit the trochlear groove surface, of an individual femur, thereby creating a “customized” replacement device for that individual femur and maintaining the original kinematics of the joint. The top surface is designed so as to maintain centrally directed tracking of the patella perpendicular to the plane established by the distal end of the femoral condyles and aligned with the center of the femoral head.

Claims

1. An instrument comprising:

a body, the body including a femoral contacting side, the femoral contacting side having a three-dimensional shape substantially custom formed to match and fit at least a portion of a distal-anterior portion of a femur of a particular patient; and

a surgical tool guide, the surgical tool guide being customized for the particular patient wherein the surgical tool guide is in a pre-defined spatial arrangement with the three dimensional shape of the femoral contacting side and the particular patient.

2. The instrument of claim 1, wherein the femoral contacting side is pre-operatively configured to continuously match in shape a region of a femoral trochlea spanning from a medial side of the femoral trochlea to a lateral side of the femoral trochlea.

3. The instrument of claim 1, wherein the surgical tool guide comprises at least two drill guides configured to guide the formation of pin receiving openings in a distal portion of the femur of the particular patient.

4. The instrument of claim 1, wherein the femoral contacting side is a contiguous surface and is configured to contiguously match in shape to a femoral trochlea of the particular patient.

5. The instrument of claim 1, wherein the body defines an outer boundary surface configured to indicate an outer boundary of a femoral implant relative to the femur of the particular patient.

6. The instrument of claim 1, wherein the femoral contacting side is configured to match the particular patient'"'"'s femoral trochlea surface to establish a pre-defined spatial arrangement of the instrument relative to an axis of the particular patient.

7. The instrument of claim 1, wherein the femoral contacting side has a shape that is configured to match a subchondral bone surface of the femoral trochlea of the particular patient.

8. The instrument of claim 1, wherein the femoral contacting side is generally concavely shaped in an anterior-posterior dimension and generally convexly shaped in a medial-lateral dimension.

9. An instrument for use during an implant procedure and customized for a particular patient, the instrument comprising:

a body, the body including an articular region contacting surface, the articular region contacting surface having a three-dimensional shape substantially custom formed to match and fit at least a portion of a subchondral bone surface in a distal-anterior portion of a femur of the particular patient; and

a surgical tool guide, the surgical tool guide being customized for the particular patient wherein the surgical tool guide is in a pre-defined spatial arrangement with the three dimensional shape of the articular region contacting surface and the particular patient.

10. The instrument of claim 9, wherein the articular region contacting surface is configured to match in shape at least a bottom portion of a trochlear groove of the particular patient.

11. The instrument of claim 10, wherein the articular region contacting surface is further configured to match in shape an anterior portion of the femur of the particular patient.

12. The instrument of claim 10, wherein the articular region contacting surface is configured to match in shape at least a portion of a trochlea of the distal femur of the particular patient, the portion spanning the trochlea from a medial side to a lateral side of the trochlea.

13. The instrument of claim 9, wherein the articular region contacting surface is configured to match in shape at least a portion of an area of an anterior-distal femur of the particular patient between two condyles of the distal femur.

14. The instrument of claim 9, wherein the articular region contacting surface is configured to match in shape at least a portion of an area of an anterior-distal femur of the particular patient between a superior edge of a cartilage surface and a point of attachment of an anterior cruciate ligament.

15. An instrument for use during an implant procedure and customized for a particular patient, the instrument comprising:

a body, the body including an articular region contacting surface, the articular region contacting surface having a three-dimensional shape substantially custom formed to match and fit at least a portion of a cartilage surface in a distal-anterior portion of a femur of the particular patient; and

a surgical tool guide, the surgical tool guide being customized for the particular patient wherein the surgical tool guide is in a pre-defined spatial arrangement with the three dimensional shape of the articular region contacting surface and the particular patient.

16. The instrument of claim 15, wherein the articular region contacting surface is configured to match in shape at least a portion of a distal-anterior portion of the particular patient'"'"'s femur in an area inferior to a distal-anterior superior edge of the cartilage surface of the particular patient.

17. The instrument of claim 15, wherein the articular region contacting surface is configured to match in shape at least a portion of a distal-anterior portion of the particular patient'"'"'s femur in a defined spatial arrangement relative to an axis of the femur of the particular patient.

18. The instrument of claim 15, wherein the articular region contacting surface is configured to match in shape to a trochlear groove of the particular patient'"'"'s femur in a defined spatial arrangement relative to an axis of the femur that extends through a center of a femoral head of the particular patient.

19. An instrument for use during an implant procedure and customized for a particular patient, the instrument comprising:

a body and a surgical tool guide, the body comprising a femoral contacting side, the femoral contacting side substantially custom formed to match in shape and size at least a portion of a distal-anterior portion of a femur of the particular patient and the surgical tool guide is in a pre-defined spatial arrangement with the three dimensional shape of the femoral contacting side and the particular patient.

20. The instrument of claim 19, wherein the femoral contacting side is a surface that is configured to match in shape at least a portion of a subchondral bone surface of the distal-anterior portion of the particular patient'"'"'s femur.

21. The instrument of claim 19, wherein the femoral contacting side includes a surface configured to fit into a trochlear groove of the particular patient'"'"'s femur.

22. The instrument of claim 21, wherein the surface configured to fit into the trochlear groove is configured to match in shape the trochlear groove of the particular patient'"'"'s femur.

23. The instrument of claim 19, wherein the femoral contacting side is configured to match in shape the distal-anterior portion of the particular patient in a defined spatial arrangement relative to cartilage of the particular patient'"'"'s distal femur.

24. The instrument of claim 19, wherein the surgical tool guide comprises a hole or a slot extending through the body of the instrument.

25. The instrument of claim 19, wherein the surgical tool guide comprises a plurality of holes extending through the body of the instrument.

26. The instrument of claim 19, wherein the surgical tool guide comprises at least one hole extending through the body of the instrument, the at least one hole configured to guide a drill for drilling an opening in the femur of the particular patient.

27. The instrument of claim 19, wherein the surgical tool guide comprises at least one hole extending through the body of the instrument, the at least one hole configured to facilitate positioning at least one pin in the femur of the particular patient.

28. The instrument of claim 19, wherein the instrument comprises a marking template.