Patient selectable joint arthroplasty devices and surgical tools

• US 9,241,724 B2
• Filed: 01/25/2011
• Issued: 01/26/2016
• Est. Priority Date: 11/25/2003
• Status: Active Grant

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Lang, Philipp, Fitz, Wolfgang
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US13/013,435
• Publication Number:
  US 20110213430A1
• Time in Patent Office: 1,827 Days
• Field of Search: 606/79, 606/80, 606/86.R, 606 87- 89, 606/91, 606/96, 606/102, 600/407, 600/587, 623/22.16, 623/22.15, 623/22.12, 623/22.11, 623/22.28, 623/23.26, 623/20.28, 623/20.31, 623/17.12, 701/1, 701/7, 701/11, 295/92
• US Class Current: 1/1
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• 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 17/1675 for the knee
• CPC Class Codes: A61B 17/1677 for the patella
• CPC Class Codes: A61B 17/1682 for the foot or ankle
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• 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 2034/105 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 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 5/4504 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: 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: B33Y 80/00 : Products made by additive manufacturing
• CPC Class Codes: G06F 30/00 : Computer-aided design [CAD]
• CPC Class Codes: G06F 30/10 : Geometric CAD
• CPC Class Codes: Y10T 29/49 : Method of mechanical manufacture

Abstract

Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Claims

1. A patient-specific surgical tool for use in surgery on a hip joint of a patient, comprising:

a block having a patient specific surface and a guide;

the patient specific surface being substantially a negative of a corresponding surface portion of the hip joint that includes an osteophyte, wherein the patient specific surface is configured to engage and has a shape that matches at least a portion of the osteophyte;

the guide being sized to accommodate a surgical instrument and have a position and orientation relative to the patient-specific surface to provide a predetermined path for the surgical instrument that is aligned through a portion of tissue of the hip joint.

2. The surgical tool of claim 1, wherein the surgical tool is configured such that the patient specific surface substantially does not engage a second osteophyte when the patient specific surface is engaged and aligned with the corresponding surface portion.

3. The surgical tool of claim 2, wherein the patient specific surgical tool is configured such that the patient specific surface extends over but does not engage the second osteophyte when the patient specific surface is engaged and aligned with the corresponding surface portion.

4. The surgical tool of claim 2, wherein the patient specific surgical tool is configured such that the patient specific surface extends over but substantially does not engage the second osteophyte when the patient specific surface is engaged and aligned with the corresponding surface portion.

5. The surgical tool of claim 1, wherein the patient specific surface substantially engages an entire osteophyte.

6. The surgical tool of claim 1, wherein the patient specific surface substantially engages an entire portion of a surface of an osteophyte.

7. The surgical tool of claim 1, wherein the surgical instrument is at least one of a drill or saw.

8. The surgical tool of claim 1, wherein the surgical instrument is a at least one of a burr or reamer.

9. The surgical tool of claim 1, further comprising an attachment mechanism.

10. The surgical tool of claim 9, further comprising a surgical device for use with the block and connectable to the block by the attachment mechanism.

11. The surgical tool of claim 1, wherein the tool is comprised of multiple components.

12. The surgical tool of claim 1, wherein the block containing the patient-specific surface and the guide is a single component.

13. The surgical tool of claim 1, wherein the surface of the joint is a femoral surface of the hip joint of the patient and the guide is configured to define a cutting path through a femoral surface when the patient specific surface is engaged and aligned with the corresponding surface.

14. The surgical tool of claim 13, wherein the cutting path is configured to extend through a portion of a femoral head when the patient specific surface is engaged and aligned with the corresponding surface portion of the joint.

15. The surgical tool of claim 14, wherein the cutting path is configured to extend through at least a portion of a femoral neck when the patient specific surface is engaged and aligned with the corresponding surface portion of the joint.

16. The surgical tool of claim 14, wherein the cutting path is configured to extend along a femoral neck axis when the patient specific surface is engaged and aligned with the corresponding surface portion of the hip joint.

17. The surgical tool of claim 16, wherein the cutting path is configured to extend along an axis that extends through a femoral head and next of the hip joint when the patient specific surface is engaged and aligned with the corresponding surface portion of the hip joint.

18. The surgical tool of claim 1, wherein the surface of the joint is a surface an acetabulum of the patient and the guide defines an axis through at least a portion of the acetabulum.

19. The surgical tool of claim 18, wherein the guide defines a path having a predetermined orientation relative to the acetabulum of the hip joint.

20. The surgical tool of claim 1, wherein the surface of the joint is a surface an acetabular rim of the patient.

21. The surgical tool of claim 20, wherein the guide defines a path having a predetermined orientation relative to the acetabulum of the hip joint.

22. The surgical tool of claim 1, further comprising a plurality of guides.

23. The surgical tool of claim 1, wherein the tool is configured to resist movement when the patient specific surface is placed against a surface of the joint.

24. The surgical tool of claim 1, wherein the tool is configured to resist rotation in at least one axis when the patient specific surface is placed against a surface of the joint.

25. The surgical tool of claim 1, wherein the guide defines a predetermined path oriented relative to a mechanical axis of the hip joint when the patient specific surface is placed against and aligned with the corresponding surface portion of the hip joint.

26. The surgical tool of claim 1, wherein the guide defines a predetermined path oriented relative to an anatomical axis of the hip joint when the patient specific surface is placed against and aligned with the corresponding surface portion of the hip joint.

27. The surgical tool of claim 1, wherein the surface of the joint includes portions of at least one of a femoral head and neck.

28. The surgical tool of claim 1, wherein the surface of the joint includes portions of at least one of an acetabulum or an acetabular rim.

29. The surgical tool of claim 1, wherein the guide includes a stop to control the depth of the path of the surgical instrument.

30. A surgical tool for use in surgically repairing a hip joint of a patient, comprising:

a block having a patient specific surface and a guide;

the patient specific surface having a first portion that is substantially a negative of a cartilage surface of the joint and a second portion that is substantially a negative of and is configured to engage and has a shape that matches at least a portion an osteophyte of the hip joint;

the guide shaped to accommodate a surgical instrument for cutting or drilling or reaming or burring and have a position and orientation relative to the patient specific surface to provide a predetermined path for the surgical instrument that is aligned through a portion of bone of the hip joint.

31. A surgical tool for use in surgically repairing a hip joint of a patient, comprising:

a block having a patient specific surface and a guide;

the patient specific surface having a first portion that is substantially a negative of at least a portion of surface of an acetabular rim of the hip joint including an osteophyte, wherein the patient specific surface is configured to engage and has a shape that matches at least a portion of the osteophyte;

the guide shaped to accommodate a surgical instrument for cutting or drilling and have a position and orientation relative to the patient specific surface to provide a predetermined path for the surgical instrument that is aligned through a portion of bone of the hip joint.

32. A system including a surgical tool for use in surgically repairing a joint of a patient, the surgical tool comprising:

a block having a patient specific surface and a guide to accommodate a surgical instrument,

the patient specific surface having at least a portion that is substantially a negative of a hip joint surface of the patient that includes an osteophyte, wherein the patient specific surface is configured to engage and has a shape that matches at least a portion of the osteophyte;

the guide having a position and orientation relative to the patient specific surface to provide a predetermined path for cutting or drilling when the patient specific surface is placed against the joint surface of the patient such that the guide has a predetermined alignment relative to an anatomical or biomechanical axis of the patient'"'"'s hip joint, and

one or more hip implant components.

33. The system of claim 32, wherein the tool is configured to resist movement when the patient specific surface is placed against the joint surface.

34. The system of claim 32, wherein the tool is configured to resist rotation in at least one axis when the patient specific surface is placed against the joint surface.

35. The system of claim 32, wherein the joint surface of the patient further includes a cartilage surface.

36. The system of claim 32, wherein the joint surface of the patient further includes a bone surface.

37. The system of claim 32, wherein the joint surface of the patient further includes a subchondral bone surface.

38. The system of claim 32, wherein the joint surface of the patient further includes a cortical bone surface.