Surgical tools for arthroplasty

• US 9,023,050 B2
• Filed: 05/11/2010
• Issued: 05/05/2015
• Est. Priority Date: 05/25/2001
• Status: Expired due to Term

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Lang, Philipp, Fitz, Wolfgang, Bojarski, Raymond A., Steines, Daniel, Burdulis, Albert G. Jr., Vargas-Voracek, Rene
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US12/777,852
• Publication Number:
  US 20110066193A1
• Time in Patent Office: 1,820 Days
• Field of Search: 606/82, 606/87, 606/79, 606/88, 606/96, 606/84, 606/86.R, 606/86.A, 606/80, 606/85
• US Class Current: 606/86.R
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/158 Cutting patella
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/1767 for the patella
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/063 for measuring volume
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4514 : Cartilage
• CPC Class Codes: A61B 5/4523 : Tendons
• CPC Class Codes: A61B 5/4528 : Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4533 : Ligaments
• CPC Class Codes: A61B 90/06 : Measuring instruments not otherwise provided for
• 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 2/38 : for elbows or knees
• CPC Class Codes: A61F 2/3877 : Patellae or trochleae
• CPC Class Codes: A61F 2002/3895 : unicompartimental
• CPC Class Codes: B33Y 80/00 : Products made by additive manufacturing

Abstract

A patellar 3-D guidance tool includes a template. The template includes at least one contact surface for engaging a surface of the patella. The at least one contact surface substantially conforms with the surface associated with the patellar. At least one guide aperture directs movement of a surgical instrument, wherein the shape and/or position of the guide aperture is based, at least in part, on three or more anatomic reference points associated with the patellar.

Claims

1. A surgical tool for repairing a diseased or damaged joint of the patient comprising:

a plurality of components including a first component engaging a second component via an interlock mechanism;

the plurality of components including;

a patient-specific surface for engaging a surface portion of the diseased or damaged joint, at least a portion of the patient-specific surface including articular cartilage information derived from image data of the surface portion of the diseased or damaged joint of the patient; and

at least one guide configured to direct movement of a surgical instrument.

2. The surgical tool according to claim 1, wherein the shape and/or position of the guide aperture is based, at least in part, on one or more axes related to said joint of the patient.

3. The surgical tool according to claim 1, wherein the interlock mechanism includes a device selected from the group consisting of a screw, a pin, a thread, a ratchet-like mechanism, a hinge-like mechanism, a press-fit mechanism, and combinations thereof.

4. The surgical tool according to claim 1, wherein one or more of the plurality of components includes a mechanism selected from the group consisting of a hydraulic mechanism, an electronic mechanism, a mechanical mechanism, and combinations thereof.

5. The surgical tool according to claim 1, wherein at least one of the plurality of components includes a passageway for inserting a guide wire.

6. The surgical tool according to claim 1, wherein the plurality of components includes:

a first template having a first template surface for engaging a first portion of the joint, the first template surface including joint information derived from image data of the first portion of the joint; and

a second template having a second template surface for engaging a second portion of the joint, the second template surface that includes joint information derived from image data of the second portion of the joint; and

a linkage for cross-referencing the first template to the second template.

7. The surgical tool according to claim 6, wherein at least one of the first template and the second template includes one or more guides, each guide configured to direct movement of a surgical instrument.

8. The surgical tool according to claim 6, wherein the linkage cross-references the first template to the second template relative to one of an anatomical and a biomechanical axis.

9. The surgical tool according to claim 1, wherein the joint of the patient is selected from the group consisting of a hip joint, a knee joint, an ankle joint, a shoulder joint, an elbow joint and a wrist joint.

10. A patient-specific surgical tool for placing an implant for repairing a diseased or damaged joint of the patient comprising:

a plurality of components including a first component engaging a second component via an interlock mechanism, wherein the first component includes at least one patient-specific surface portion that is configured to engage a portion of the diseased or damaged joint and includes articular cartilage information derived from image data of the corresponding portion of the diseased or damaged joint of the patient and at least one guide configured to provide a cutting or drilling path for a surgical instrument, wherein the cutting or drilling path has a predetermined position or orientation to define a planned flexion, extension, abduction, adduction, anteversion, retroversion, internal rotation or external rotation angle of the implant.

11. The patient-specific surgical tool of claim 10, wherein the second component has a second patient-specific surface portion derived from image data of the joint of the patient.

12. The patient-specific surgical tool of claim 10, wherein the second component has at least one guide configured to provide a cutting or drilling path for a surgical instrument.

13. The patient-specific surgical tool of claim 10, wherein the second component is not patient-specific.

14. The patient-specific surgical tool of claim 10, wherein the first component is configured to guide the surgical instrument when the first component is engaged with the second component.

15. The patient-specific surgical tool of claim 10, wherein the first component is configured to guide the surgical instrument when the first component is not engaged with the second component.

16. The patient-specific surgical tool of claim 10, wherein the first component and second component are configured to engage to provide intraoperative adjustment of flexion, extension, abduction, adduction, internal rotation or external rotation of the joint of the patient.

17. A patient-specific surgical tool for placing an implant for repairing a diseased or damaged knee joint of the patient comprising:

a plurality of components including a first component engaging a second component via an interlock mechanism, wherein the first component includes at least one patient-specific surface portion that is configured to engage a portion of the diseased or damaged knee joint and includes articular cartilage information derived from image data of the corresponding portion of the diseased or damaged knee joint of the patient and at least one guide configured to provide a cutting or drilling path for a surgical instrument, wherein the cutting or drilling path has a predetermined position or orientation to define a planned flexion, extension, internal rotation or external rotation angle of the implant.

18. The patient-specific surgical tool of claim 17, wherein the at least one patient-specific surface portion of the first component is derived from image data of a femoral condyle of the knee joint of the patient.

19. The patient-specific surgical tool of claim 18, wherein the guide is configured to provide a drilling path through the femoral condyle.

20. The patient-specific surgical tool of claim 19, wherein the guide is configured to provide a cutting path through the femoral condyle.

21. The patient-specific surgical tool of claim 20, wherein the second component includes a surface portion configured to engage a cut surface of the femoral condyle prepared with the first component and the surgical instrument.

22. The patient-specific surgical tool of claim 21, wherein the second component includes a patient-specific portion derived from image data of the tibia of the knee joint of the patient.

23. The patient-specific surgical tool of claim 22, wherein the second component includes a second guide configured to provide a cutting or drilling path for a surgical instrument.

24. The patient-specific surgical tool of claim 22, wherein the second guide is configured to provide a cutting path through at least a portion of the tibia.

25. The patient-specific surgical tool of claim 22, wherein the second guide is configured to provide a drilling path through a plateau of the tibia.

26. The patient-specific surgical tool of claim 17, wherein the first component and second component are configured to engage to provide intraoperative adjustment of flexion, extension, internal rotation or external rotation of the knee joint of the patient.

27. The patient-specific surgical tool of claim 17, wherein the planned flexion, extension, internal rotation or external rotation angle of the implant is configured to correct a varus-valgus alignment of the knee joint of the patient.