Patient-specific tools and implants

• US 9,445,907 B2
• Filed: 09/16/2013
• Issued: 09/20/2016
• Est. Priority Date: 03/07/2011
• 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., White, John R., Metzger, Robert
• Primary Examiner(s): SNOW, BRUCE EDWARD
• Application Number:
  US14/027,340
• Publication Number:
  US 20140018934A1
• Time in Patent Office: 1,100 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1624 Drive mechanisms therefor
• CPC Class Codes: A61B 17/164 intramedullary
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• 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: 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 2/3601 for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices non-prosthetic internal fixation devices for the femoral head or neck A61B17/74
• CPC Class Codes: A61F 2/3609 Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts A61F2/3601 takes precedence
• CPC Class Codes: A61F 2002/30574 with an integral complete or partial collar or flange
• CPC Class Codes: A61F 2002/30593 hollow
• CPC Class Codes: A61F 2002/30617 Visible markings for adjusting, locating or measuring
• CPC Class Codes: A61F 2250/0097 Visible markings, e.g. indicia
• CPC Class Codes: B33Y 70/00 Materials specially adapted for additive manufacturing
• CPC Class Codes: B33Y 80/00 Products made by additive manufacturing
• CPC Class Codes: Y10T 29/49826 Assembling or joining

Abstract

A method for preparing a femoral neck for receiving a neck implant includes resecting a femoral head from a femoral neck of a patient according to a pre-operative patient-specific plan. The method also includes removing only cancellous bone from the femoral neck and proximal femoral bone of the patient using a patient-specific broach. The patient-specific broach has a three-dimensional cutting surface matching as a negative mold a cortical/cancellous bone interface surface of the femoral neck of the patient.

Claims

1. method of preparing a femoral neck for receiving a femoral neck implant comprising:

obtaining image data of a proximal femoral bone and the femoral neck of a specific patient using a medical imaging modality;

constructing a three-dimensional image model of the proximal femoral bone and neck of the specific patient using the image data;

identifying a three-dimensional cortical boundary surface at an interface between cortical bone and cancellous bone of the femoral neck of the specific patient using the three-dimensional image model;

resecting a femoral head from the femoral neck of a patient according to a pre-operative patient-specific plan;

removing only cancellous bone from the femoral neck and proximal femoral bone of the patient using a patient-specific broach having a three-dimensional cutting surface matching as a negative mold the cortical boundary surface of the femoral neck;

selecting a patient-specific neck implant having a patient-specific length determined from the three-dimensional image model of the specific patient; and

implanting the patient-specific neck implant having a three-dimensional outer surface matching as a negative mold the cortical boundary surface of the femoral neck of the patient after the cancellous bone is removed.

2. The method of claim 1, further comprising:

coupling a driver tool to the patient-specific broach; and

inserting the broach into the femoral neck of the patient.

3. The method of claim 2, further comprising:

inserting a protrusion extending from a proximal surface of the broach into a bore of a distal surface of the driver tool; and

inserting a distal portion of a retractable rod of the driver tool into a bore defined through the proximal surface of the broach to secure the broach to the driver tool.

4. The method of claim 1, further comprising engaging a proximal flange of the neck implant with a resected surface of the femoral neck.

5. The method of claim 4, further comprising coupling a femoral head implant to a neck portion of the neck implant.

6. The method of claim 1, further comprising coupling a femoral head implant to a neck portion of the neck implant.

7. A method of preparing a femoral neck for receiving a femoral neck implant comprising:

identifying a three-dimensional cortical boundary surface at an interface between cortical bone and cancellous bone of the femoral neck of the specific patient using a three-dimensional model derived from image data gathered about a specific patient;

coupling a driver tool to a patient-specific broach having a three-dimensional cutting surface matching as a negative mold the three-dimensional cortical boundary surface at the femoral neck;

using the driver to insert the broach into a resected portion of the femoral neck of the patient;

removing only cancellous bone from the femoral neck and proximal femoral bone of the patient using the patient-specific broach; and

exposing the three-dimensional cortical boundary surface by removing only the cancellous bone using the patient-specific broach

selecting a patient-specific neck implant having a patient-specific length determined from the three-dimensional model of the specific patient, the patient-specific length configured such that the neck implant does not extend beyond the femora neck into an intramedullary canal; and

implanting the patient-specific neck implant having a three-dimensional outer surface matching as a negative mold the cortical boundary surface of the femoral neck of the patient after the cancellous bone is removed.

8. The method of claim 7, further comprising:

directing bone chips away from a cavity created by the broach.

9. A method of preparing a femoral neck for receiving a femoral neck implant comprising:

identifying a three-dimensional cortical boundary surface at an interface between cortical bone and cancellous bone of the femoral neck of the specific patient using a three-dimensional model derived from image data gathered about a specific patient;

resecting a femoral head from the femoral neck of the specific patient to expose a corresponding resected surface of the femoral neck;

inserting a patient-specific broach into the femoral neck of the patient through the exposed corresponding resected surface of the femoral neck, the patient-specific broach having a three-dimensional cutting surface matching as a negative mold the three-dimensional cortical boundary surface of the specific patient;

removing only cancellous bone from the femoral neck of the patient using the patient-specific broach at least by inserting the patient-specific broach;

exposing the three-dimensional cortical boundary surface by removing only the cancellous bone using the patient-specific broach;

selecting a patient-specific neck implant having a patient-specific length determined from the three-dimensional model of the specific patient, the patient-specific length configured such that the neck implant does not extend beyond the femoral neck into an intramedullary canal; and

implanting the patient-specific neck implant having a three-dimensional outer surface matching as a negative mold the cortical boundary surface of the femoral neck of the patient after the cancellous bone is removed.

10. The method of claim 9, further comprising:

directing bone chips away from a cavity created by the broach.

11. The method of claim 9, further comprising:

coupling a driver tool to the patient-specific broach.

12. The method of claim 11, further comprising securing the driver tool to the broach.

13. The method of claim 11, further comprising inserting a protrusion extending from a proximal surface of the broach into a bore of a distal surface of the driver tool.

14. The method of claim 11, further comprising inserting a distal portion of a retractable rod of the driver tool into a bore defined through the proximal surface of the broach.

15. The method of claim 11, further comprising engaging a proximal flange of the neck implant to the resected surface of the femoral neck.

16. The method of claim 15, further comprising coupling a femoral head implant to a neck portion of the neck implant.