Patient-specific partial knee guides and other instruments

• US 9,743,940 B2
• Filed: 02/13/2015
• Issued: 08/29/2017
• Est. Priority Date: 04/29/2011
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Catanzarite, Joshua B., Mauch, Thomas J.
• Primary Examiner(s): BATES, DAVID W
• Application Number:
  US14/621,721
• Publication Number:
  US 20150157341A1
• Time in Patent Office: 928 Days
• Field of Search: 606 88
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61F 2002/3895 unicompartimental

Abstract

A patient-specific unicompartmental tibial guide has a patient-specific body with an inner surface. The inner surface is preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a proximal portion of a tibial bone of a specific patient. The tibial guide includes a vertical resection channel having a variable width preoperatively configured for guiding a vertical resection through the proximal portion of the tibial bone.

Claims

1. A surgical system for unicompartmental knee arthroplasty comprising:

a patient-specific unicompartmental tibial guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a proximal portion of a tibial bone of a specific patient, the tibial guide including a proximal-distal resection channel having a first width formed between first and second flanges of the tibial guide, the proximal-distal resection channel being open in a proximal-distal direction; and

a cutting insert having a first plate receivable in the proximal-distal resection channel to occupy a portion of the first width of the resection channel to form a second width smaller than the first width.

2. The surgical system of claim 1, wherein the cutting insert includes an open channel formed between the first plate and a second plate.

3. The surgical system of claim 2, wherein the first and second plates have different thicknesses.

4. The surgical system of claim 1, further comprising additional cutting inserts configured for changing the first width of the resection channel to corresponding different widths.

5. The surgical system of claim 1, wherein the tibial guide includes a drill guide portion preoperatively configured for drilling first and second anterior holes into the tibial bone for guiding a horizontal tibial resection.

6. The surgical system of claim 1, wherein the drill guide portion is unitarily attached to the patient-specific body.

7. The surgical system of claim 1, wherein the proximal-distal resection channel ends in a safety hole formed between the first and second resection flanges, the safety hole configured to receive a stop pin limiting a depth of a proximal-distal resection.

8. The surgical system of claim 1, wherein the patient-specific body includes a proximal portion configured to be engageable with a surface of a proximal plateau of the tibial bone and an anterior portion configured to be engageable with an anterior surface of the tibial bone.

9. The surgical system of claim 8, wherein the patient-specific body defines an elongated window passing through the body.

10. The surgical system of claim 1, further comprising a unitary patient-specific unicompartmental femoral guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a distal portion of a distal femoral bone of the specific patient, the femoral guide including an elongated slot with a tapered inner wall.

11. A surgical system for a unicompartmental knee arthroplasty, comprising:

a patient-specific unicompartmental tibial guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with at least an anterior portion of a tibial bone of a specific patient, the tibial guide including a vertical resection channel having a first width formed between first and second flanges of the tibial guide, the first and second flanges being joined at a posterior end of the vertical resection channel to form a stop surface; and

a plurality of cutting inserts, each cutting insert having a first plate receivable in the vertical resection channel and configured to occupy a portion of the first width of the resection channel to form a second width smaller than the first width, wherein each plate has a different thickness to provide a plurality of different second widths.

12. The surgical system of claim 11, wherein the patient-specific body is further configured to conform and mate in only one position with a proximal portion of the tibial bone of the specific patient.

13. The surgical system of claim 11, wherein the first plate and the second plate of each cutting insert are connected at ends thereof such that each cutting insert is U-shaped to define an open channel formed between the first plate and a second plate.

14. The surgical system of claim 13, wherein the first plate is thicker than the second plate so that when one of the first and second flanges is inserted in the open channel the second width can have one of two different values.

15. The surgical system of claim 11, wherein the vertical resection channel is formed within a resection guide portion extending from the patient-specific body.

16. The surgical system of claim 15, wherein the resection guide portion further includes a drill guide portion preoperatively configured for drilling first and second anterior holes into the tibia bone for use in guiding a horizontal tibial resection.

17. The surgical system of claim 14, wherein each open channel of each cutting insert is configured to be received on either the first or second flange of the tibial guide with the first plate positioned within the vertical resection channel, wherein the first and second flanges define opposed planar surfaces.

18. The surgical system of claim 11, further comprising a unitary patient-specific unicompartmental femoral guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a distal portion of a distal femoral bone of the specific patient, the femoral guide including an elongated slot with a tapered inner wall.

19. A surgical system for a unicompartmental knee arthroplasty, comprising:

a patient-specific unicompartmental tibial guide having a patient-specific body with an inner surface configured to nestingly conform to an anterior portion and a proximal portion of a tibial bone of a specific patient, the tibial guide further including a drill/resection block coupled to the patient-specific body, the drill/resection block defining a vertical resection channel having a first width formed between first and second flanges and defining at least one bore configured for use in drilling at least one hole into the tibial bone; and

a removable cutting insert having a plate receivable in the vertical resection channel to produce a cutting slot between the cutting insert and the tibial guide and configured to occupy a portion of the first width of the resection channel to form a second width smaller than the first width.

20. The surgical system of claim 19, further comprising a unitary patient-specific unicompartmental femoral guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with a distal femoral bone of the specific patient, the femoral guide defining an elongated slot passing through the guide.