Trochlear resurfacing system and method

• US 9,351,745 B2
• Filed: 03/05/2013
• Issued: 05/31/2016
• Est. Priority Date: 02/24/2003
• Status: Expired due to Term

• Current Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Original Assignee: Arthrosurface, Inc (Anika Therapeutics Incorporated)
• Inventors: Ek, Steven W., Sikora, George
• Primary Examiner(s): Philogene, Pedro
• Application Number:
  US13/785,867
• Publication Number:
  US 20140058395A1
• Time in Patent Office: 1,183 Days
• Field of Search: 606 79- 85, 606/86.R, 606 87- 89, 606 96- 98, 606/102, 606/104, 623/20.14
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/3859 Femoral components
• 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 2/4684 Trial or dummy prostheses
• CPC Class Codes: A61F 2002/30112 Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2002/30607 Kits of prosthetic parts to be assembled in various combinations for forming different prostheses
• CPC Class Codes: A61F 2002/3085 with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30878 with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/3895 unicompartimental
• CPC Class Codes: A61F 2002/4631 the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4658 for measuring dimensions, e.g. length
• CPC Class Codes: A61F 2002/4662 for measuring penetration depth
• CPC Class Codes: A61F 2002/4663 for measuring volumes or other three-dimensional shapes
• CPC Class Codes: A61F 2002/4685 by means of vacuum
• CPC Class Codes: A61F 2002/4687 Mechanical guides for implantation instruments
• CPC Class Codes: A61F 2230/0004 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2250/0062 : Kits of prosthetic parts to be assembled in various combinations for forming different prostheses
• CPC Class Codes: A61F 2250/0097 : Visible markings, e.g. indicia

Abstract

A system for repairing a defect on an articular surface of a patient'"'"'s trochlear region, the system comprising a guide block comprising a body having an exterior surface configured to engage with the saddle portion and ridge portions of the patient'"'"'s trochlear region, a protrusion extending generally from the body and configured to be received in a first bore formed in the articular surface along a reference axis, and a first cavity extending through the body configured to establish a first working axis displaced from the reference axis, wherein the exterior surface of the body and the protrusion are configured to secure the location of the guide block about the patient'"'"'s trochlear region. A method for preparing an implant site in bone, comprising: establishing a reference axis extending from the bone; creating a bore in the bone by reaming about the reference axis; securing a guide block about the articular surface; establishing a first working axis extending from the bone using the guide block, the first working axis is displaced from the reference axis; and creating a first socket in the bone by reaming about the first working axis, wherein the first socket partially overlaps with the bore.

Claims

1. A system for repairing a defect on a patient'"'"'s articular surface of a bone, said system comprising:

one or more reamers, each of which comprises a shaft and a cutting head extending radially outward beyond said shaft; and

a guide block comprising;

a body having an exterior surface configured to engage against said articular surface of said bone, said guide block including at least one opening and a first and a second passageway, said first and said second passageway extending from said at least one opening through said guide block along a first and a second working axis, respectively, and each having a cross-section substantially corresponding to a cross-section of the shaft of at least one of said reamers, said at least one opening to receive the cutting head of one or more of said reamers in a first and a second position between said guide body and said articular surface when said exterior surface of said body engages against said articular surface and the shaft of said one or more reamers is received in said first and said second passageway, respectively;

wherein said first and said second passageways are to align said one or more reamers such that the shaft is centered along said first and said second axis and said cutting head is disposed in said first and said second positions of said at least one opening corresponding to a first and a second portion of an excision site, respectively, extending through said articular surface and only partially into said bone beneath said articular surface, and

wherein said guide block and said one or more reamers are configured to control a depth of the excision site as said shaft is advanced within said guide block.

2. The system of claim 1, wherein said guide block is further configured to be secured to articular surface of said bone.

3. The system of claim 1, further comprising an implant configured to be received in said excision site.

4. The system of claim 1, wherein said guide block is configured to receive a guide bushing, said guide bushing defining said first passageway and to align a longitudinal axis of said shaft of said at least one reamer at a predetermined angle relative to said articular surface along said first working axis.

5. The system of claim 4, wherein said guide block is includes a cavity configured to receive said guide bushing.

6. The system of claim 5, wherein said guide block and said guide bushing are configured to be threadably coupled.

7. The system of claim 5, wherein said guide block and said guide bushing forms an interference connection with said cavity.

8. The system of claim 1, wherein said cutting head includes a plurality of cutting surfaces.

9. The system of claim 5, wherein said cutting head of said reamer is configured to be disposed between a distal end of said guide bushing and said articular surface when said guide bushing is received in said cavity.

10. The system of claim 1, wherein said shaft of said one or more reamers includes indicia to control said depth of said excision site formed by said reamer in said articular surface.

11. The system of claim 10, wherein said indicia includes a laser mark.

12. The system of claim 10, wherein said indicia includes an opening.

13. The system of claim 1, wherein at least a portion of said exterior surface of said body engages said articular surface and has a contour that is substantially the inverse of said articular surface.

14. The system of claim 1, wherein at least a portion of said exterior surface is configured to engage with saddle portion and ridge portions of said patient'"'"'s trochlear region.

15. The system of claim 1, wherein said guide block further comprises a protrusion extending generally from said body and configured to be received in a first bore formed in said articular surface along a reference axis.

16. The system of claim 1, wherein said first passageway extends through said body of said guide block along a said first working axis.

17. The system of claim 1, further comprising one or more guide bushings configured to be secured in at least one cavity formed in said body, said one or more guide bushings including at least one of said first or said second passageways and configured to receive said shaft of at least one of said reamers and align a longitudinal axis of said reamer along one of said first or second working axes.

18. The system of claim 17,

wherein said at least one opening is defined by said body and said one or more bushings.

19. The system of claim 1, wherein said one or more reamers includes a first and a second reamer, and said first reamer configured to be received in a first of said plurality of openings and said second reamer configured to be received in a second of said plurality of openings.

20. The system of claim 1, wherein said one or more openings includes a first and a second opening corresponding said first and said second positions, respectively, and wherein said first and said second passageways extend from said first and said second openings, respectively.

23. The system of claim 1, wherein a portion of said reamer is aligned with a portion of said body to control said depth of said excision site formed by said reamer in said articular surface.

24. The system of claim 1, wherein said body further defines at least one of said plurality of openings, said at least one opening configured to be disposed adjacent to said articular surface when said body engages against said articular surface and to receive said cutting head of said reamer as said reamer is advanced within said passageway to form said excision site in said articular surface.

21. A method for preparing an implant site in a bone, comprising:

advancing a guide block against an articular surface of said bone; and

advancing a portion of a shaft of a first reamer through a first passageway of a guide block along a first working axis defined by said first passageway to cause a cutting head of said first reamer to be advanced from at least one opening of said guide block into said articular surface to form a first portion of an excision site centered along said first working axis and extending through said articular surface and only partially into said bone beneath said articular surface;

advancing a portion of the shaft of the first reamer or a shaft of a second reamer through a second passageway of a guide block along a second working axis defined by said second passageway to cause a cutting head of said reamer to be advanced from said at least one opening of said guide block into said articular surface to form a second portion of said excision site centered along said second working axis and extending through said articular surface and only partially into said bone beneath said articular surface;

wherein said body and said reamer control a depth of said excision site; and

wherein said first and said second passageway each have a cross-section that substantially corresponding to a cross-section of the shaft of at least one of said first or said second reamers and is less than a cross-section of the cutting head of at least one of said first or said second reamers.

22. The method of claim 21, further comprising securing an implant to said excision site.

25. A system for repairing a defect on a patient'"'"'s articular surface of a bone, said system comprising:

one or more reamers, each of which comprises a shaft and a cutting head extending radially outward beyond said shaft; and

a guide block comprising;

a first bushing having a first passageway extending therethrough along a first working axis, said first bushing having a cross-section substantially corresponding to a cross-section of the shaft of one of said reamers and smaller than a cross-section of said cutting head;

a second bushing having a second passageway extending therethrough along a second working axis, said second bushing having a cross-section substantially corresponding to a cross-section of the shaft of one of said reamers and smaller than a cross-section of said cutting head; and

a body having an exterior surface configured to engage against said articular surface of said bone, said body further including at least one cavity extending therethrough, said at least one cavity configured to receive said first and said second bushing;

said first and said second bushing and said body defining at least one opening configured to receive the cutting head of least one of said reamers in a first position along said first working axis between said articular surface and said first bushing and in a second position along said second working axis between said articular surface and said second bushing when said body engages against said articular surface;

wherein a portion of the shaft of one of said reamers is configured to be advanced within said first passageway along said first working axis to form a first portion of an excision site in said articular surface corresponding to said first position;

wherein a portion of said shaft of one of said reamers is configured to be advanced within said second passageway along said second working axis to from a second portion of said excision site corresponding to said second position; and

wherein said guide block and said reamer are configured to control a depth of said excision site.