Patient-specific elbow guides and associated methods

• US 9,005,297 B2
• Filed: 01/17/2013
• Issued: 04/14/2015
• Est. Priority Date: 02/27/2006
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Katrana, Nicholas J., Vanasse, Thomas M., Metzger, Robert
• Primary Examiner(s): STEWART, ALVIN J
• Application Number:
  US13/744,022
• Publication Number:
  US 20130131681A1
• Time in Patent Office: 817 Days
• Field of Search: 606/87, 623/18.11, 623/19.14, 623 2011- 2013
• US Class Current: 623/20.11
• CPC Class Codes: A61B 17/14 Surgical saws A61B17/1637 takes precedence; tooth saws A61C3/12 ; Accessories therefor
• 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 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1725 for applying transverse screws or pins through intramedullary nails or pins
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/683 comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
• CPC Class Codes: A61B 17/8061 specially adapted for particular bones A61B17/70 and A61B17/74 take precedence
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 17/846 Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface A61B17/72, A61B17/86 take precedence
• 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 2/3804 for elbows
• CPC Class Codes: A61F 2/46 Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
• CPC Class Codes: A61F 2002/30617 Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2002/4662 for measuring penetration depth
• CPC Class Codes: A61F 2002/4668 for measuring angles
• CPC Class Codes: A61F 2250/0097 Visible markings, e.g. indicia

Abstract

A patient-specific alignment guide includes a three-dimensional engagement surface customized in a pre-operating planning stage by computer imaging to closely mate and conform to a corresponding bone portion of a patient'"'"'s elbow joint. The patient-specific alignment guide defines a first longitudinal guiding bore aligned with a reference axis associated with the elbow joint of patient when the alignment guide is mounted onto the corresponding bone portion.

Claims

1. A medical device for an elbow joint comprising:

a patient-specific alignment guide including a three-dimensional engagement surface customized in a pre-operating planning stage by computer imaging to closely mate and conform to a corresponding surface portion of a distal humerus of a patient'"'"'s elbow joint, the alignment guide defining a first longitudinal guiding bore and a second longitudinal guiding bore parallel to the first longitudinal bore, the first longitudinal bore configured to be aligned with a medial-lateral anatomic axis of the elbow joint of the patient when the alignment guide is mounted onto the corresponding surface portion.

2. The medical device of claim 1, wherein the anatomic axis is an axis of rotation of the elbow joint.

3. The medical device of claim 1, wherein the anatomic axis is an epicondylar axis of the elbow joint.

4. The medical device of claim 1, wherein the engagement surface is customized and configured for a corresponding lateral surface of the distal humerus.

5. The medical device of claim 1, wherein the three-dimensional engagement surface is shaped to conform to a lateral capitellum surface of the distal humerus of the elbow joint.

6. The medical device of claim 1, further comprising:

first and second alignment pins passing through the corresponding first and second guiding bores of the patient-specific alignment guide and configured for fixation to a lateral surface of the distal humerus; and

a posterior cutting guide including a posterior cutting component and a posterior guiding component, the posterior cutting component configured to abut a posterior surface of the humerus, the posterior cutting component having first and second elongated cutting slots configured to be aligned along a medial-lateral direction of the distal humerus, the posterior guiding component slidably coupled to the posterior cutting component, the posterior guiding component slidably mountable over the first and second alignment pins after the the patient-specific alignment guide is removed from the humerus without removing the first and second alignment pins.

7. The medical device of claim 6, wherein the posterior guiding component includes first and second planar sections defining an acute angle therebetween.

8. The medical device of claim 6, further comprising:

a distal cutting guide including a distal cutting component and a distal guiding component, the distal cutting component having a planar first surface for engaging a resected surface of the distal humerus and an opposite second surface, a first elongated slot along a first plane perpendicular to the second surface for guiding a first planar resection and a second elongated slot along a second plane at an oblique angle relative the first plane for guiding a second planar resection at an oblique angle relative to the first planar resection, the first and second elongated slots intersecting the second surface parallel to a medial-lateral longitudinal axis of the distal cutting component, the distal cutting component including an aperture extending between the first and second surfaces, the distal guiding component including first and second longitudinal bores receiving the first and second alignment pins after the posterior cutting guide is removed, the distal guiding component including an extension slidably received through the aperture of the distal cutting component such that the first and second longitudinal bores of the distal guiding component are parallel to the medial-lateral longitudinal axis of the distal cutting component and configured for orienting the first and second planes of the distal cutting component in pre-planned orientations relative to the resected surface.

9. A medical device for an elbow joint comprising:

a patient-specific alignment guide including a three-dimensional engagement surface customized in a pre-operating planning stage by computer imaging to closely mate and conform to a corresponding surface portion of a distal humerus of a patient'"'"'s elbow joint, the alignment guide defining a first longitudinal guiding bore and a second longitudinal guiding bore parallel to the first longitudinal bore, the first longitudinal bore configured to be aligned along a medial-lateral anatomic axis of the elbow joint of the patient when the alignment guide is mounted onto the corresponding surface portion;

first and second alignment pins received through the first and second longitudinal bores and configured to be affixed to the distal humerus in a medial-lateral direction; and

a posterior cutting guide including a posterior cutting component and a posterior guiding component, the posterior cutting component configured to abut a posterior surface of the humerus and having an elongated cutting slot aligned in the medial-lateral direction for cutting the distal humerus to form a distal resected surface, the posterior guiding component slidably coupled to the posterior cutting component, the posterior guiding component slidably mountable over the first and second alignment pins after the patient-specific alignment guide is removed from the humerus without removing the first and second alignment pins.

10. The medical device of claim 9, further comprising a distal cutting guide including a distal cutting component and a distal guiding component, the distal cutting component having a planar first surface for engaging the distal resected surface of the distal humerus and an opposite second surface, a first elongated slot along a first plane perpendicular to the second surface for guiding a first planar resection and a second elongated slot along a second plane at an oblique angle relative the first plane for guiding a second planar resection at an oblique angle relative to the first planar resection, the first and second elongated slots intersecting the second surface parallel to a medial-lateral longitudinal axis of the distal cutting component, the distal cutting component including an aperture extending between the first and second surfaces, the distal guiding component including first and second longitudinal bores receiving the first and second alignment pins after the posterior cutting guide is removed, the distal guiding component including an extension slidably received through the aperture of the distal cutting component such that the first and second longitudinal bores of the distal guiding component are parallel to the medial-lateral longitudinal axis of the distal cutting component and configured for orienting the first and second planes of the distal cutting component in pre-planned orientations relative to the distal resected surface.

11. The medical device of claim 10, wherein the extension is perpendicular to the first surface.

12. The medical device of claim 11, wherein the extension is non-rotatably keyed to the aperture of the distal cutting component.

13. The medical device of claim 12, wherein the extension is an elongated bar with an elongated cross-section.

14. The medical device of claim 9, further comprising an L-shaped connector coupling the posterior cutting component to the posterior guiding component.

15. The medical device of claim 14, wherein the L-shaped connector is removably coupled to posterior cutting component using a T-slot connection.

16. The medical device of claim 14, wherein the L-shaped connector is removably coupled to posterior cutting component using a rectangular slot and locking screw connection.

17. The medical device of claim 9, wherein the posterior guiding component includes first and second planar sections defining an acute angle therebetween.

18. The medical device of claim 17, wherein the posterior guiding component includes first, second and third guiding bores.

19. The medical device of claim 18, wherein the first and third guiding bores are mounted of the first and second alignment pins for a right humerus.

20. The medical device of claim 18, wherein the first and second guiding bores are mounted of the first and second alignment pins for a left humerus.