Patient selectable joint arthroplasty devices and surgical tools

• US 9,308,005 B2
• Filed: 01/26/2011
• Issued: 04/12/2016
• Est. Priority Date: 11/25/2003
• Status: Active Grant

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Fitz, Wolfgang, Lang, Philipp
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US13/014,466
• Publication Number:
  US 20110213431A1
• Time in Patent Office: 1,903 Days
• Field of Search: 606/79, 606 87- 89, 606/86.R, 606/102, 606/91, 606/96, 606/80, 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 method of surgically repairing, replacing or resurfacing a hip joint of a patient, comprising:

placing a patient-specific surface of a surgical instrument on a corresponding surface portion of a hip joint of a patient to define a predetermined guide path relative to an axis of the hip joint extending through a femoral neck of the hip joint of the patient, wherein at least a portion of the patient-specific surface has a shape that substantially matches a shape of the corresponding surface portion of the hip joint and the patient-specific surface and a position and/or orientation of the guide path are each configured based at least in part on image data of the hip joint of the patient;

removing tissue along the guide path; and

implanting a prosthesis at a site associated with the removed tissue.

2. The method of claim 1, wherein the guide path extends along at least a portion of the axis.

3. The method of claim 1, wherein the guide path extends along at least a portion of a femoral neck axis.

4. A method of surgically repairing, replacing or resurfacing a hip joint of a patient, comprising:

placing a patient-specific surface of a surgical instrument on a corresponding cartilage surface portion of a hip joint of a patient to position a guide configured to provide a guide path in a predetermined location and/or orientation relative to the cartilage surface of the hip joint, wherein at least a portion of the patient-specific surface has a shape that substantially matches a shape of the corresponding cartilage surface portion of the hip joint and wherein the patient-specific surface and the location and/or orientation of the guide path are each configured based at least in part on image data of the hip joint of the patient;

using the guide to surgically alter the proximal femur by cutting, drilling or reaming tissue of the proximal end of the femur; and

implanting a prosthesis having a location based at least in part on the location of the cut, drilled or reamed tissue.

5. A method of surgically repairing, replacing or resurfacing a hip joint of a patient, comprising:

placing a patient-specific surface of a surgical instrument on a corresponding femoral surface portion of a hip joint of a patient to position a guide configured to provide a guide path in a predetermined location and/or orientation relative to the corresponding femoral surface of the hip joint, wherein at least a portion of the patient-specific surface has a shape that substantially matches a shape of the corresponding femoral surface portion of the hip joint and the patient-specific surface and the location and/or orientation of the guide path are each configured based at least in part on image data of the hip joint of the patient;

guiding a surgical tool with the guide to surgically alter tissue of the hip joint; and

orienting at least one component of a hip prosthesis based at least in part on the location of the guide.

6. The method of claim 5, wherein the step of guiding a surgical tool to surgically alter tissue of the hip joint includes at least one of cutting, drilling and reaming the tissue.

7. The method of claim 5, wherein the step of orienting at least one component of a hip prosthesis comprises establishing a predetermined anteversion of the at least one component.

8. The method of claim 5, wherein the step of orienting at least one component of a hip prosthesis comprises establishing a predetermined retroversion of the at least one component.

9. The method of claim 5, wherein the step of orienting at least one component of a hip prosthesis comprises establishing a predetermined rotation of the at least one component.

10. The method of claim 5, wherein the step of orienting at least one component of a hip prosthesis comprises establishing a predetermined tilt of the at least one component.

11. The method of claim 5, wherein the step of orienting at least one component of a hip prosthesis comprises orienting an acetabular component.

12. The method of claim 5, wherein the step of orienting at least one component of a hip prosthesis comprises orienting an acetabular cup.

13. The method of claim 5, wherein the step of orienting at least one component of a hip prosthesis comprises orienting a femoral component.

14. The method of claim 5, wherein the step of orienting at least one component of a hip prosthesis comprises orienting a femoral head component.

15. A method of surgically repairing, replacing or resurfacing a hip joint of a patient, comprising:

placing a patient-specific surface of a surgical instrument on a corresponding surface portion of an acetabulum of a hip joint of a patient to position a guide configured to provide a guide path in a predetermined location and/or orientation relative to the acetabulum of the hip joint, wherein at least a portion of the patient-specific surface has a shape that substantially matches a shape of the corresponding surface portion of the acetabulum of the hip joint and the patient-specific surface and the location and/or orientation of the guide path are each configured based at least in part on image data of the hip joint of the patient, wherein the corresponding surface portion of the acetabulum of the hip joint includes a surface portion selected from the group consisting of;

an acetabular wall surface portion, an acetabular rim surface portion;

an acetabular fossa surface portion, and any combination thereof;

guiding a surgical tool with the guide to surgically alter tissue of the hip joint; and

implanting a hip joint prosthesis having a location based at least in part on the location of the surgically altered tissue.

16. The method of claim 15, wherein the step of guiding a surgical tool to surgically alter tissue of the hip joint includes at least one of cutting, drilling and reaming the tissue.

17. The method of claim 15, wherein the corresponding surface of the acetabulum includes at least a portion of a cartilage surface of the acetabulum.

18. The method of claim 15, wherein the corresponding surface of the acetabulum includes at least a portion of a subchondral bone surface of the acetabulum.

19. The method of claim 15, wherein the corresponding surface of the acetabulum includes at least a portion of a cortical bone surface of the acetabulum.

20. The method of claim 15, wherein the corresponding surface of the acetabulum includes at least a portion of an osteophyte of the acetabulum.

21. A method of surgically repairing, replacing or resurfacing a hip joint of a patient, comprising:

placing a patient-specific surface of a surgical instrument on a corresponding surface portion of a proximal end of a femur of a hip joint of a patient to position a guide configured to provide a guide path in a predetermined location and/or orientation relative to the proximal end of the femur of the hip joint, wherein at least a portion of the patient-specific surface has a shape that substantially matches a shape of the corresponding surface portion of the proximal end of the femur of the hip joint and the patient-specific surface and the location and/or orientation of the guide path are each based at least in part on image data of the hip joint of the patient;

guiding a surgical tool with the guide to surgically alter tissue of the hip joint; and

implanting a hip joint prosthesis having a location based at least in part on the location of the surgically altered tissue.

22. The method of claim 21, wherein the step of guiding a surgical tool to surgically alter tissue of the hip joint includes at least one of cutting, drilling and reaming the tissue.

23. The method of claim 21, wherein the corresponding surface of the proximal end of the femur includes at least a portion of a femoral neck of the femur.

24. The method of claim 21, wherein the corresponding surface of the proximal end of the femur includes at least a portion of a femoral head of the femur.

25. The method of claim 21, wherein the corresponding surface of the proximal end of the femur includes at least a portion of a junction of a femoral neck and a femoral head of the femur.

26. The method of claim 21, wherein the corresponding surface of the proximal end of the femur includes at least a portion of a cartilage surface of the femur.

27. The method of claim 21, wherein the corresponding surface of the proximal end of the femur includes at least a portion of a subchondral bone surface of the femur.

28. The method of claim 21, wherein the corresponding surface of the proximal end of the femur includes at least a portion of a cortical bone surface of the femur.

29. The method of claim 21, wherein the corresponding surface of the proximal end of the femur includes at least a portion of an osteophyte of the femur.

30. A method of surgically repairing, replacing or resurfacing a hip joint of a patient, comprising:

placing a patient-specific surface of a surgical instrument on a corresponding surface portion of a femoral neck of a hip joint of a patient to position a guide configured to provide a guide path in a predetermined location and/or orientation relative to a femur of the hip joint, wherein at least a portion of the patient-specific surface has a shape that substantially matches a shape of the corresponding surface portion of the femoral neck;

resecting the femoral neck based at least in part on the location of the guide; and

implanting a prosthesis based at least in part on the location of the resected tissue.

31. The method of claim 30, wherein the guide path is configured to extend through the femoral neck and the femoral shaft, and wherein the step of resecting further comprises directing a surgical tool along the guide to resect the femoral neck.

32. A method of surgically repairing, replacing or resurfacing a hip joint of a patient, comprising:

placing a patient-specific surface of a surgical instrument on a corresponding femoral surface portion of a hip joint of a patient to define a predetermined guide path relative to an axis of the hip extending through a femoral head of the patient, wherein at least a portion of the patient-specific surface has a shape that substantially matches a shape of the corresponding femoral surface portion of the hip joint and the patient-specific surface and the guide path are each configured based at least in part on image data of the hip joint of the patient;

removing tissue along the guide path; and

implanting a prosthesis at the site of the removed tissue.

33. The method of claim 32, wherein the guide path extends along at least a portion of the axis.

34. The method of claim 32, wherein the guide path extends along at least a portion of a femoral head axis.

35. The method of claim 32, wherein the guide path extends along at least a portion of a femoral neck axis.

36. The method of claim 32, wherein the guide path extends along at least a portion of a femoral shaft axis.

37. A method of surgically repairing, replacing or resurfacing a hip joint of a patient, comprising:

placing a patient-specific surface of a surgical instrument on a corresponding femoral surface portion of a hip joint of a patient to define a predetermined guide path relative to an axis of the hip extending through a femoral shaft of the patient, wherein at least a portion of the patient-specific surface has a shape that substantially matches a shape of the corresponding femoral surface portion of the hip joint and the patient-specific surface and the guide path are each configured based at least in part on image data of the hip joint of the patient;

removing tissue along the guide path; and

implanting a prosthesis at the site of the removed tissue.

38. The method of claim 37, wherein the guide path extends along at least a portion of the axis.

39. The method of claim 37, wherein the guide path extends along at least a portion of a femoral head axis.

40. The method of claim 37, wherein the guide path extends along at least a portion of a femoral neck axis.

41. The method of claim 37, wherein the guide path extends along at least a portion of a femoral shaft axis.