Patient-specific bone grafting system and method

• US 11,020,128 B2
• Filed: 03/13/2019
• Issued: 06/01/2021
• Est. Priority Date: 05/28/2015
• Status: Active Grant

• Current Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Guilloux, Sebastien, Boisvert, Olivier, Dupuis, Karine, Neurohr, Anselm, Abiven, Jean-Guillaume
• Primary Examiner(s): Sevilla, Christian A
• Application Number:
  US16/352,285
• Publication Number:
  US 20190209186A1
• Time in Patent Office: 811 Days
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/1635 for grafts, harvesting or transplants
• CPC Class Codes: A61B 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/1684 for the shoulder
• CPC Class Codes: A61B 17/1778 for the shoulder
• 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 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61F 2/4601 for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2/4612 of shoulders
• CPC Class Codes: A61F 2/4644 Preparation of bone graft, bone plugs or bone dowels, e.g. grinding or milling bone material bone material A61F2/28; disintegrating or milling devices B02C

Abstract

A system and method for generating a model of a patient specific cut guide instrument for harvesting a graft comprises a model of a graft defined by an implant interface surface, a bone interface surface, and a spatial geometry therebetween, the model being specific to a patient. A patient-specific instrument generator outputs the model of the patient specific cut guide instrument, the patient-specific instrument generator including a position determination module for orienting and positioning at least a first guide axis, and for positioning an abutment on a model of a donor bone as a function of the spatial geometry, and an instrument body generator module for generating a model of the patient specific cut guide instrument comprising a body supporting a cut guide to perform a depth cut in the donor bone positioned and oriented as a function of a contact of the body with the abutment on the donor bone, and of the model of the graft, a first guide channel for alignment with the first guide axis, and at least one anchor guide for securing the patient specific instrument cut guide on the donor bone as abutted with the abutment and aligned with the first guide axis, whereby the patient specific cut guide instrument is used for harvesting the graft for subsequent implanting without alterations to the spatial geometry of the graft.

Claims

1. A cut guide instrument for harvesting a graft comprising

a base adapted to abut a surface of a bone,

an instrument body having a cut slot adapted to receive a blade for defining a depth cut,

at least one portion spacing the base from the cut slot as a function of a planned geometry of the cut guide instrument,

wherein the planned geometry between the base and the cut slot is defined as a function of a geometry of a patient-specific graft, the geometry of the patient-specific graft having at least an implant interface surface and a bone interface surface and a planned spatial geometry therebetween, and wherein the depth cut forms one of the implant interface surface and the bone interface surface, and wherein the planned geometry corresponds to a Walch glenoid indication.

2. The cut guide instrument according to claim 1, wherein the base has a plate, and wherein the cut slot is oriented for the depth cut to be non parallel to the plate.

3. The cut guide instrument according to claim 1, further comprising pin guides in the instrument body adjacent to opposite ends of the cut slot, the pin guides adapted to receive pins therein configured for securing the instrument body to the bone.

4. The cut guide instrument according to claim 1, wherein the base has a guide bore adapted to receive a guide rod, the guide bore being aligned in the planned geometry with an axis of a cylindrical reamer defining a lateral surface of the patient-specific graft between the implant interface surface and the bone interface surface.

5. The cut guide instrument according to claim 4, wherein the guide bore is positioned in the base as a function of a location of a peg hole of the geometry of the patient-specific graft.

6. A system for graft arthroplasty comprising:

a model file of a geometry of a patient-specific graft, the geometry of the patient-specific graft having at least an implant interface surface and a bone interface surface and a planned spatial geometry therebetween; and

a cut guide instrument for harvesting a graft comprising a base adapted to abut a surface of a bone, an instrument body having a cut slot adapted to receive a blade for defining a depth cut, at least one portion spacing the base from the cut slot as a function of a planned geometry of the cut guide instrument, wherein the planned geometry between the base and the cut slot is defined as a function of the geometry of the patient-specific graft, and wherein the depth cut is one of the implant interface surface and the bone interface surface.

7. The system according to claim 6, wherein the base has a plate, and wherein the cut slot is oriented for the depth cut to be non parallel to the plate.

8. The system according to claim 6, further comprising pins, and pin guides in the instrument body adjacent to opposite ends of the cut slot, the pin guides receiving the pins therein configured for securing the instrument body to the bone.

9. The system according to claim 6, further comprising a guide rod and a cylindrical reamer, wherein the base has a guide bore to receive the guide rod, the guide bore being in the planned geometry with an axis of the cylindrical reamer defining a lateral surface of the patient-specific graft between the implant interface surface and the bone interface surface.

10. The system according to claim 9, further comprising an implant with a peg, and wherein the guide bore is positioned in the base as a function of location of a peg hole of the geometry of the patient-specific graft.

11. The system according to claim 6, wherein the base has a first guide and a second guide.

12. The system according to claim 11, further comprising a hemispherical reamer, and wherein the first guide is aligned in the planned geometry with an axis of the hemispherical reamer defining the bone interface surface of the patient-specific graft.

13. The system according to claim 12, further comprising a cylindrical reamer, and wherein the second guide is aligned in the planned geometry with an axis of the cylindrical reamer defining a lateral surface of the patient-specific graft between the implant interface surface and the bone interface surface.

14. The system according to claim 10, wherein the implant is a reverse shoulder glenoid implant adapted to be interfaced to a glenoid with the patient-specific graft.

15. A cut guide instrument for harvesting a graft comprising

a base adapted to abut a surface of a bone, the base having a first guide and a second guide,

an instrument body having a cut slot adapted to receive a blade for defining a depth cut, and

at least one portion spacing the base from the cut slot as a function of a planned geometry of the cut guide instrument, the planned geometry corresponding to a Favard glenoid indication,

wherein the planned geometry between the base and the cut slot is defined as a function of a geometry of a patient-specific graft, the geometry of the patient-specific graft having at least an implant interface surface and a bone interface surface and a planned spatial geometry therebetween, and wherein the depth cut forms one of the implant interface surface and the bone interface surface,

wherein the first guide is aligned in the planned geometry with an axis of a hemispherical reamer defining the bone interface surface of the patient-specific graft, wherein the second guide is aligned in the planned geometry with an axis of a cylindrical reamer defining a lateral surface of the patient-specific graft between the implant interface surface and the bone interface surface.

16. The cut guide instrument according to claim 15, further including pin guides in the instrument body adjacent to opposite ends of the cut slot, the pin guides adapted to receive pins therein configured for securing the instrument body to the bone.