Patient-specific femoroacetabular impingement instruments and methods

• US 9,386,993 B2
• Filed: 09/26/2012
• Issued: 07/12/2016
• Est. Priority Date: 09/29/2011
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Meridew, Jason D., Scott, Paige, Corten, Kristoff
• Primary Examiner(s): Isabella, David
• Assistant Examiner(s): Nelson, Christine
• Application Number:
  US13/627,626
• Publication Number:
  US 20130085500A1
• Time in Patent Office: 1,385 Days
• Field of Search: 606/89
• 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 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion
• CPC Class Codes: A61B 2017/1602 Mills
• 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 34/00 Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing

Abstract

A device for a patient-specific acetabular and/or femoral guide. The guides can be used in a selected resection of at least one of a femur and an acetabulum to increase a range of motion of the femur relative to the acetabulum. Generally, a natural acetabulum and femoral head are maintained.

Claims

1. A system to resect a selected portion of an anatomy to improve a range of motion of a femur relative to a pelvis in a specific patient, comprising:

a femoral neck resection guide including;

a reamer cap comprising a bone contacting surface that mates with a surface of the femur and a dome-shaped exterior surface opposite the bone contacting surface such that the bone contacting surface is disposed at least partially within the reamer cap;

a pin extending from the exterior surface;

a guide surface defined by at least a portion of the exterior surface; and

a guide arm moveably connected to the pin including a guide arm surface configured to contact the guide surface during movement of the guide arm relative to the exterior surface;

wherein the guide arm includes a mill passage to engage a mill instrument that is configured to resect the selected portion of the femur.

2. The system of claim 1, wherein the guide arm includes a first guide arm portion and a second guide arm portion with an articulation connection between the first guide arm portion and the second guide arm portion;

wherein the second guide arm portion is operable to move relative to the first guide arm portion;

the first guide arm portion is freely rotatable about an entirety of the reamer cap when the second guide arm portion is disengaged from the guide surface; and

the first guide arm portion is rotatable about only a portion of the reamer cap when the second guide arm portion is engaged with the guide surface.

3. The system of claim 2, further comprising:

a milling instrument configured to engage the second guide arm portion via the mill passage;

wherein a movement of the milling instrument is operable to move relative to the pin.

4. The system of claim 3, wherein the guide surface defines an arc having a center at the pin, wherein the milling instrument is operable to move in an arc substantially equivalent to the guide surface arc to mill a portion of the femoral neck.

5. The system of claim 4, wherein the first guide arm portion extends from the pin and the second guide arm portion extends at a non-zero angle relative to the first guide arm portion;

wherein the second guide arm portion defines the guide arm surface.

6. The system of claim 4, wherein the mill instrument is operable to move axially along the mill passage.

7. The system of claim 6, wherein the mill instrument is operable to move in a patient specific milling movement due to the guide surface, the mill passage, and the guide arm surface.

8. The system of claim 1, further comprising:

a greater trochanter guide including an anatomy contacting surface that is a negative of and operable to contact an anatomy of the specific patient in a substantially single position, wherein the greater trochanter guide includes;

a cutting guide slot configured to be positioned at a patient specific location relative to the femur of the patient; and

a drill guide portion operable to orient a drill guide passage at a specific location relative to the femur of the patient.

9. The system of claim 1,

wherein the bone contacting surface that mates with a surface of the femur mates with at least one of a femoral head or a greater trochanter.

10. The system of claim 1, further comprising:

a patient specific acetabular cutting guide including an anatomy contacting surface that is a negative of an anatomy of the specific patient and to engage the anatomy of the patient in a substantially single position, the patient specific acetabular cutting guide having an outer surface that is the anatomy contacting surface to engage an acetabulum of the patient and an upper rim to define a cutting guide surface to resect a portion of the acetabulum in which the patient specific acetabular cutting guide is placed.

11. The system of claim 1, further comprising:

a patient specific tissue removal template having a template region shaped to an inverse of a predetermined region of tissue to be removed.

12. The system of claim 11, wherein the patient specific tissue removal template has the template region shaped to match a portion of a determined resection shape at a femoral neck of the anatomy.

13. The system of claim 11, wherein the patient specific tissue removal template further includes femur contacting tangs to align the template region relative to the femur of the anatomy.