HTO guide with optional guided ACL/PCL tunnels

• US 10,282,488 B2
• Filed: 04/25/2014
• Issued: 05/07/2019
• Est. Priority Date: 04/25/2014
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Eash, Christopher
• Primary Examiner(s): Gibson, Eric S
• Assistant Examiner(s): Shirsat, Marcela I
• Application Number:
  US14/262,105
• Publication Number:
  US 20150305752A1
• Time in Patent Office: 1,838 Days
• Field of Search: 606 79, 606 82, 606 86 R, 606 87- 90, 606 96- 98, 606102, 606104
• CPC Class Codes: A61B 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/58 for osteosynthesis, e.g. bone plates, screws , setting implements or the like A61B17/14, A61B17/16 take precedence
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 17/8886 holding the screw head
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: G06F 30/00 Computer-aided design [CAD]

Abstract

A patient-specific osteotomy guide according to the present disclosure includes a three-dimensional bone-engaging inner surface configured to closely mate and conform to a corresponding portion of a specific patient'"'"'s tibia. A resection slot at a patient-specific position and orientation to guide a cutting tool to perform an osteotomy according to a preoperative plan for the patient. An axial guide at a patient-specific position and orientation to guide a tool to perform an ACL/PCL reconstructive procedure according to a preoperative plan for the patient.

Claims

1. A patient-specific osteotomy guide comprising:

a body comprising a three-dimensional bone-engaging inner surface configured to closely mate and conform to a corresponding portion of a specific patient'"'"'s tibia;

a resection slot extending through the body, the resection slot configured to guide a cutting tool to perform an osteotomy on the tibia; and

an axial guide configured to guide a tool to perform at least one of an ACL reconstructive procedure and a PCL reconstructive procedure on the tibia, wherein (i) the three-dimensional bone-engaging inner surface is designed preoperatively according to a preoperative plan, such that the bone-engaging inner surface conforms only to the portion of the specific patient'"'"'s tibia, (ii) the resection slot is designed preoperatively according to the preoperative plan, such that a cutting axis of the resection slot extends at a pre-defined patient-specific angle β

relative to a reference axis extending through the specific patient'"'"'s tibia, the reference axis comprising an anatomical axis coinciding with a long axis of the patient'"'"'s tibia, and (iii) the axial guide defines first and second apertures extending through the body along first and second fixed axes arranged at pre-defined patient-specific angles θ

₁, θ

₂, respectively, relative to the reference axis, the first fixed axis extending through the specific patient'"'"'s tibia and femur along an ACL tunnel path established preoperatively by way of the preoperative plan, and the second fixed axis extending through specific patient'"'"'s tibia and femur along a PCL tunnel path established preoperatively by way of the preoperative plan.

2. The patient-specific osteotomy guide of claim 1, further comprising an alignment portion having an alignment surface surrounding the resection slot, the alignment surface configured to guide the cutting tool to perform the osteotomy according to the preoperative plan for the patient.

3. The patient-specific osteotomy guide of claim 1, wherein the three-dimensional inner surface, slot, and axial guide are formed in a one-piece, integrated guide.

4. The patient-specific osteotomy guide of claim 1, wherein the resection slot is a single slot for guiding the cutting tool during an open wedge osteotomy procedure.

5. The patient-specific osteotomy guide of claim 1, wherein the resection slot includes a first slot and a second slot for guiding the cutting tool during a closed wedge osteotomy procedure.

6. The patient-specific osteotomy guide of claim 1, wherein the ACL and PCL tunnel path intersects with the cutting axis of the resection slot.

7. A patient-specific osteotomy system comprising:

an osteotomy cutting tool;

an ACL tunnel forming tool and a PCL tunnel forming tool; and

a one-piece, integrated osteotomy guide including;

a body comprising a three-dimensional bone-engaging inner surface configured to closely mate and conform to a corresponding portion of a specific patient'"'"'s tibia;

a resection slot extending through body, the resection slot configured to guide the osteotomy cutting tool to perform an osteotomy on the tibia; and

an axial guide configured to guide the ACL tunnel forming tool and the PCL tunnel forming tool to perform at least one of an ACL reconstructive procedure and a PCL reconstructive procedure, wherein (i) the three-dimensional bone-engaging inner surface is designed preoperatively according to a preoperative plan, such that the bone-engaging inner surface conforms only to the portion of the specific patient'"'"'s tibia, (ii) the resection slot is designed preoperatively according to the preoperative plan, such that a cutting axis of the resection slot extends at a pre-defined patient-specific angle β

relative to a reference axis extending through the specific patient'"'"'s tibia, the reference axis comprising an anatomical axis coinciding with a long axis of the patient'"'"'s tibia, and (iii) the axial guide defines first and second apertures extending through the osteotomy guide along first and second fixed axes arranged at pre-defined patient-specific angles θ

₁, θ

₂, respectively, relative to the reference axis, the first fixed axis extending through the specific patient'"'"'s tibia and femur along an ACL tunnel path established preoperatively by way of the preoperative plan, and the second fixed axis extending through the specific patient'"'"'s tibia and femur along a PCL tunnel path established preoperatively by way of the preoperative plan.

8. The patient-specific osteotomy system of claim 7, further comprising a wedge implant.

9. The patient-specific osteotomy system of claim 8, wherein the wedge implant is designed to conform to the specific patient'"'"'s tibia.

10. The patient-specific osteotomy system of claim 8, wherein the wedge implant defines a tunnel.

11. The patient-specific osteotomy system of claim 7, further comprising a fixation plate.

12. The patient-specific osteotomy system of claim 7, wherein the ACL and PCL tunnel path intersects with the cutting axis of the resection slot.