Patient selectable joint arthroplasty devices and surgical tools

• US 9,375,222 B2
• Filed: 01/25/2011
• Issued: 06/28/2016
• 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:
  US13/013,195
• Publication Number:
  US 20110218539A1
• Time in Patent Office: 1,981 Days
• Field of Search: 606/102, 606/91, 606/86.R, 606/87, 606/88, 606/89, 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, 703/1, 703/11, 703/7, 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 system including a surgical tool for use in surgically implanting an acetabular component of a hip implant of the system in a hip joint of a patient, comprising:

a jig having a patient specific surface and a guide to direct or accommodate a surgical instrument;

wherein at least a portion of the patient specific surface has a shape that substantially matches a shape of a corresponding surface of the hip joint;

wherein the guide is configured relative to the patient specific surface to provide a predefined path for the surgical instrument when the patient specific surface is placed against and aligned with the corresponding surface of the hip joint; and

wherein the path for the surgical instrument has a predefined position and/or orientation based on a desired position and/or orientation of the acetabular component of the hip implant when the patient specific surface is placed against and aligned with the corresponding surface of the hip joint,

wherein the shape of the corresponding surface of the hip joint and the desired position and/or orientation of the acetabular component are derived from electronic image data of the hip joint of the patient, wherein the corresponding surface of the hip joint is an acetabular surface of the hip joint selected from the group consisting of;

an acetabular fossa, an acetabular rim, an acetabular wall, and any combination thereof.

2. The system of claim 1, wherein the desired position and/or orientation includes a predefined anteversion or retroversion of the acetabular component.

3. The system of claim 1, wherein the desired position and/or orientation includes a predefined tilting of the acetabular component.

4. The system of claim 1, wherein the desired position and/or orientation includes a predefined rotational position of the acetabular component.

5. The system of claim 1, wherein the acetabular component is an acetabular cup.

6. The system of claim 1, wherein the acetabular surface includes at least portions of an acetabular fossa of the hip.

7. The system of claim 1, wherein the acetabular surface includes at least portions of an acetabular rim of the hip.

8. The system of claim 1, wherein the acetabular surface includes at least portions of an acetabular wall of the hip.

9. The system of claim 1, wherein the acetabular surface includes a cartilage surface.

10. The system of claim 1, wherein the acetabular surface includes a normal cartilage surface.

11. The system of claim 1, wherein the acetabular surface includes a diseased cartilage surface.

12. The system of claim 1, wherein the acetabular surface includes a normal cartilage surface and a diseased cartilage surface.

13. The system of claim 1, wherein the acetabular surface includes a subchondral bone surface.

14. The system of claim 1, wherein the acetabular surface includes a cortical bone surface.

15. The system of claim 1, wherein the acetabular surface includes the surface of at least one osteophyte.

16. The system of claim 1, wherein the hip implant includes the acetabular component and a femoral component.

17. The system of claim 1, wherein the corresponding surface of the hip includes a normal cartilage surface.

18. The system of claim 1, wherein the corresponding surface of the hip includes a diseased cartilage surface.

19. The system of claim 1, wherein the corresponding surface of the hip includes a normal cartilage surface and a diseased cartilage surface.

20. The system of claim 1, wherein the corresponding surface of the hip includes a subchondral bone surface.

21. The system of claim 1, wherein the corresponding surface of the hip includes a cortical bone surface.

22. The system of claim 1, wherein the corresponding surface of the hip includes the surface of at least one osteophyte.

23. The system of claim 1, wherein surgical instrument is a reaming device.

24. The system of claim 1, wherein surgical instrument is a drill.

25. The system of claim 1, wherein surgical instrument is a saw.

26. The system of claim 1, wherein surgical instrument is a trial implant.

27. A surgical instrument for use in surgically implanting a femoral component of a hip implant for replacing or resurfacing a hip joint of a patient, comprising:

a jig having a patient specific surface and a guide to direct or accommodate a surgical tool;

wherein at least a portion of the patient specific surface has a shape that substantially matches a shape of a corresponding femoral surface portion of the hip joint;

wherein the guide is configured relative to the patient-specific surface to provide a predefined path for the surgical tool when the patient specific surface is placed against and aligned with the corresponding femoral surface of the hip joint; and

wherein the path for the surgical tool has a predefined position and/or orientation based on a desired position and/or orientation of the femoral component of the hip implant when the patient specific surface is placed against and aligned with the corresponding femoral surface of the hip joint,

wherein the shape of the corresponding femoral surface portion of the hip joint and the desired position and/or orientation of the femoral component are derived from electronic image data of the hip joint of the patient.

28. The surgical instrument of claim 27, wherein the desired position and/or orientation includes a predefined anteversion or retroversion of the femoral component.

29. The surgical instrument of claim 27, wherein the desired position and/or orientation includes a predefined tilting of the femoral component.

30. The surgical instrument of claim 27, wherein the desired position and/or orientation includes a predefined rotational position of the femoral component.

31. The surgical instrument of claim 27, wherein the femoral component is a femoral head component.

32. The surgical instrument of claim 27, wherein the corresponding femoral surface of the hip is at least a portion of a femoral neck surface of the hip.

33. The surgical instrument of claim 27, wherein the corresponding femoral surface of the hip is at least a portion of a femoral head surface of the hip.

34. The surgical instrument of claim 27, wherein the corresponding femoral surface of the hip is at least a portion of a junction of the femoral head and femoral neck surface of the hip.

35. The surgical instrument of claim 27, wherein the corresponding femoral surface includes a cartilage surface.

36. The surgical instrument of claim 27, wherein the corresponding femoral surface of the hip includes a normal cartilage surface.

37. The surgical instrument of claim 27, wherein the corresponding femoral surface of the hip includes a diseased cartilage surface.

38. The surgical instrument of claim 27, wherein the corresponding femoral surface of the hip includes a normal cartilage surface and a diseased cartilage surface.

39. The surgical instrument of claim 27, wherein the corresponding femoral surface of the hip includes a subchondral bone surface.

40. The surgical instrument of claim 27, wherein the corresponding femoral surface of the hip includes a cortical bone surface.

41. The surgical instrument of claim 27, wherein the corresponding femoral surface of the hip includes the surface of at least one osteophyte.

42. The surgical instrument of claim 27, wherein surgical tool is a reaming device.

43. The surgical instrument of claim 27, wherein surgical tool is a drill.

44. The surgical instrument of claim 27, wherein surgical tool is a saw.

45. The surgical instrument of claim 27, wherein surgical tool is a trial implant.

46. A surgical instrument for use in surgically implanting an acetabular component of a hip implant in a hip joint of a patient, comprising:

a jig having a patient-specific surface and a guide to direct or accommodate a surgical tool;

wherein at least a portion of the patient-specific surface has a shape that is substantially a negative of a corresponding acetabular surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface based on a desired position and/or orientation of the acetabular component of the hip implant when the patient specific surface is placed against and aligned with the corresponding acetabular surface of the hip joint,

wherein the corresponding acetabular surface of the hip joint is selected from the group consisting of;

an acetabular fossa, an acetabular rim, an acetabular wall, and any combination thereof.

47. The surgical instrument of claim 46, wherein the desired position and/or orientation includes a predefined anteversion or retroversion of the acetabular component.

48. The surgical instrument of claim 46, wherein the desired position and/or orientation includes a predefined tilting of the acetabular component.

49. The surgical instrument of claim 46, wherein the desired position and/or orientation includes a predefined rotational position of the acetabular component.

50. The surgical instrument of claim 46, wherein the jig is a single component.

51. The surgical instrument of claim 46, wherein the jig includes multiple components.

52. A surgical instrument for use in surgically implanting a femoral component of a hip implant in a hip joint of a patient, comprising:

a jig having a patient specific surface and a guide to direct or accommodate a surgical tool;

wherein at least of a portion of the patient specific surface has a shape that is substantially a negative of a corresponding femoral surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface based on a desired position and/or orientation of the femoral component of the hip implant when the patient specific surface is placed against and aligned with the corresponding femoral surface of the hip joint.

53. The surgical instrument of claim 52, wherein the desired position and/or orientation includes a predefined anteversion or retroversion of the femoral component.

54. The surgical instrument of claim 52, wherein the desired position and/or orientation includes a predefined tilting of the femoral component.

55. The surgical instrument of claim 52, wherein the desired position and/or orientation includes a predefined rotational position of the femoral component.

56. A system including a surgical instrument for use in surgically replacing or resurfacing portions of or an entire hip joint of a patient, comprising:

a body having a patient specific surface and a guide to direct or accommodate a surgical tool;

wherein at least a portion of the patient specific surface has a shape that is substantially a negative of a corresponding acetabular or femoral surface of the hip joint, wherein the corresponding acetabular surface of the hip joint is an acetabular surface of the hip selected from the group consisting of;

an acetabular fossa an acetabular rim, an acetabular wall, and any combination thereof;

wherein the guide is configured relative to the patient-specific surface to provide a predefined path for the surgical tool that is aligned through a portion of tissue associated with the hip joint when the patient specific surface is placed against and aligned with the corresponding acetabular or femoral surface; and

wherein the path for the surgical tool is configured to provide a predefined position and/or orientation of at least one acetabular or femoral implant when the patient specific surface is placed against and aligned with the surface.

57. The system of claim 56, wherein the predefined position and/or orientation includes a predefined anteversion or retroversion of at least one acetabular or femoral implant of the system when the patient specific surface is placed against and aligned with the surface.

58. The system of claim 56, wherein the predefined position and/or orientation includes a predefined rotation of at least one acetabular or femoral implant of the system when the patient specific surface is placed against and aligned with the surface.

59. The system of claim 56, wherein the predefined position and/or orientation includes a predefined tilting of at least one acetabular implant when the patient specific surface is placed against and aligned with the surface.

60. A surgical instrument for use in surgically implanting one or more components of a hip implant in a hip joint of a patient, comprising:

a jig having a patient specific surface and a guide to direct or accommodate a surgical tool;

wherein at least a portion of the patient specific surface has a shape that substantially matches a shape of a corresponding cartilage surface of the hip joint;

wherein the guide is configured relative to the patient-specific surface to provide a predefined path for the surgical tool when the patient specific surface is placed against and aligned with the corresponding cartilage surface; and

wherein the path for the surgical tool has a predefined position and/or orientation based on a desired position and/or orientation of at least one component of the hip implant when the patient specific surface is placed against and aligned with the corresponding cartilage surface.

61. The surgical instrument of claim 60, wherein the desired position and/or orientation includes a predefined anteversion or retroversion of the at least one component.

62. The surgical instrument of claim 60, wherein the desired position and/or orientation includes a predefined tilting of the at least one component.

63. The surgical instrument of claim 60, wherein the desired position and/or orientation includes a predefined rotational position of the at least one component.

64. The surgical instrument of claim 60, wherein the at least one component is an acetabular component.

65. The surgical instrument of claim 60, wherein the at least one component is an acetabular cup.

66. The surgical instrument of claim 60, wherein the at least one component is a femoral component.

67. The surgical instrument of claim 60, wherein the at least one component is a femoral head.

68. A surgical instrument for use in surgically replacing or resurfacing portions of or an entire hip joint of a patient, comprising:

a body having a patient specific surface and a guide to direct or accommodate a surgical tool;

wherein at least a portion of the patient specific surface has a shape-that substantially matches a shape of a corresponding subchondral bone surface of the hip joint, wherein the corresponding subchondral bone surface of the hip is a femoral surface of the hip joint or an acetabular surface of the hip joint selected from the group consisting of;

an acetabular fossa, an acetabular rim, an acetabular wall, and any combination thereof;

wherein the guide is configured relative to the patient-specific surface to provide a predefined path for the surgical tool when the patient specific surface is placed against and aligned with the subchondral bone surface; and

wherein the path for the surgical tool is configured to provide a predefined position and/or orientation of at least one acetabular implant when the patient specific surface is placed against and aligned with the surface.

69. The surgical instrument of claim 68, wherein the predefined position and/or orientation includes a predefined anteversion or retroversion of at least one acetabular or femoral implant when the patient specific surface is placed against and aligned with the corresponding subchondral bone surface.

70. The surgical instrument of claim 68, wherein the predefined position and/or orientation includes a predefined rotation and/or tilting of at least one acetabular or femoral implant when the patient specific surface is placed against and aligned with the corresponding subchondral bone surface.