Patient-specific augments

• US 10,603,179 B2
• Filed: 08/09/2017
• Issued: 03/31/2020
• Est. Priority Date: 02/27/2006
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Pierce, Andrew L., Metzger, Robert
• Primary Examiner(s): Snow, Bruce E
• Application Number:
  US15/672,724
• Publication Number:
  US 20170333194A1
• Time in Patent Office: 965 Days
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61F 2/30734 Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
• 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: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30433 using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
• CPC Class Codes: A61F 2002/3092 having an open-celled or open-pored structure

Abstract

A patient-specific augment can be attached to an implant component for a bone of a joint of a patient. The patient-specific augment has first and second surfaces. The first surface is a three-dimensional patient-specific surface that closely matches and can mate to a substantially unaltered and unresected surface of a bone defect of the specific patient only in one position. The second surface is designed to engage a non-custom surface of the implant.

Claims

1. A method of preparing a knee joint for a femoral implant component, comprising:

reconstructing an image of a bone of the knee joint with a defect from a medical scan of the bone during a preoperative plan for a specific patient;

incrementally manipulating a position of the virtual representations of an augment and the femoral implant component in the virtual knee joint;

performing an initial virtual fitting of virtual representations of the augment and the femoral implant component in a virtual knee joint created from the image of the bone;

manufacturing the augment, wherein manufacturing the augment includes providing the augment with a patient-specific and variable depth between a first implant-engaging surface and a second patient-specific three-dimensional surface;

selecting the femoral implant component for the specific patient;

preparing a bone end of the bone of the knee joint of the specific patient with standard resections configured to match a non-custom bone-engaging surface of the femoral implant component without resecting a three-dimensional surface of the defect in the bone;

attaching the first implant-engaging surface of the augment to a portion of the bone-engaging surface of the femoral implant component;

nestingly mating the second patient-specific three-dimensional surface of the augment to the three-dimensional surface of the defect, wherein the augment is a femoral augment engageable to the femoral implant component and to a distal femur of the knee joint;

attaching the femoral implant component to the bone.

2. The method of claim 1, further comprising mating a third patient-specific peripheral surface of the augment to at least a portion of a complementary surface of the bone.

3. The method of claim 1, wherein providing the augment with the patient-specific and variable depth includes providing the variable depth of the augment has a patient-specific step discontinuity.

4. The method of claim 1, further comprising:

selecting or modifying resection plans in the virtual knee joint;

selecting or modifying the virtual representations of the augment and/or implant component to simulate various types of augments and/or implant components; and

selecting or modifying an orientation of the virtual representations of the augment and/or implant component upon insertion into the virtual knee joint.

5. The method of claim 1, wherein the first implant-engaging surface is a plurality of planar segments.

6. The method of claim 1, wherein the second patient-specific three-dimensional surface includes a step discontinuity.

7. The method of claim 1, wherein the medical scan is from x-ray scans of anatomy of the patient.

8. A method of preparing a knee joint for a femoral implant component, comprising:

reconstructing an image of a bone of the knee joint with a defect from a medical scan of the bone during a preoperative plan for a specific patient;

incrementally manipulating a position of the virtual representations of an augment and the femoral implant component in the virtual knee joint;

performing an initial virtual fitting of virtual representations of the augment and the femoral implant component in a virtual knee joint created from the image of the bone;

manufacturing the augment, wherein manufacturing the augment includes providing the augment with a patient-specific and variable depth between a first implant-engaging surface and a second patient-specific three-dimensional surface, wherein the variable depth of the augment has a patient-specific step discontinuity;

selecting the femoral implant component for the specific patient;

preparing a bone end of the bone of the knee joint of the specific patient with standard resections configured to match a non-custom bone-engaging surface of the femoral implant component without resecting a three-dimensional surface of the defect in the bone;

attaching the first implant-engaging surface of the augment to a portion of the bone-engaging surface of the femoral implant component;

nestingly mating the second patient-specific three-dimensional surface of the augment to the three-dimensional surface of the defect, wherein the augment is a femoral augment engageable to the femoral implant component and to a distal femur of the knee joint;

mating a third patient-specific peripheral surface of the augment to at least a portion of a complementary surface of the bone; and

attaching the implant component to the bone.