Tibial tubercule osteotomy

• US 11,026,699 B2
• Filed: 05/29/2019
• Issued: 06/08/2021
• Est. Priority Date: 09/29/2014
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Maxson, William
• Primary Examiner(s): Gibson, Eric S
• Application Number:
  US16/425,572
• Publication Number:
  US 20190314038A1
• Time in Patent Office: 741 Days
• CPC Class Codes: A61B 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/152 for removing a wedge-shaped piece of bone
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61F 2002/2892 Tibia

Abstract

Patient-specific guides for a tibial tubercle osteotomy are provided. The guides include a guide body defining a portion with a bone-engaging surface that conforms as a negative surface to a corresponding surface of a specific patient'"'"'s tibia, and a guide portion that guides a surgical instrument to a specific location on the specific patient'"'"'s tibia, wherein the bone-engaging surface and guide portion are configured during a pre-operative planning stage. Methods for performing a tibial tubercle osteotomy with the patient-specific guides are also provided.

Claims

1. A method for performing a tibial tubercle osteotomy on a patient'"'"'s tibia, comprising:

positioning a patient-specific guide on the patient'"'"'s tibia, wherein the guide comprises a guide body defining a bone-engaging portion with a bone-engaging surface configured during a pre-operative planning stage of a tibial osteotomy to conform as a negative surface to a corresponding surface of the patient'"'"'s tibia at, around or near the tubercle of the patient'"'"'s tibia, and a plurality of apertures;

resecting the tibia in three intersecting planes with a saw to generate a tubercle flap, wherein the patient-specific guide provides visual indicia for resecting; and

repositioning the tubercle flap in an anterior direction or in both anterior and medial-lateral directions to form a gap between the tubercle flap and the resected surface of the tibia.

2. The method according to claim 1, further comprising implanting a wedge in the gap, wherein the wedge has a predetermined shape configured during the pre-operative planning stage and wherein the wedge is composed of a material that promotes bone in-growth.

3. The method according to claim 2, further comprising securing the tubercle flap relative to a resected surface of the tibia by driving a screw through the tubercle flap and the wedge, and into the tibia through the resected surface.

4. The method according to claim 1, wherein the plurality of apertures are positioned along three intersecting lines that define three predetermined angles relative to a proximal-distal axis of the patient'"'"'s tibia that are selected during the pre-operative planning stage of the tibial osteotomy, and wherein the method further comprises:

inserting a plurality of pins through the apertures, the pins having a diameter smaller than a diameter of the apertures; and

removing the patient specific guide,

wherein the pins provide the visual indicia for resecting.

5. The method according to claim 1, wherein the guide body further defines a first planar slot oriented at a first predetermined angle and at a first predetermined position relative to a proximal-distal axis of the patient'"'"'s tibia that is selected during the pre-operative planning stage of the tibial osteotomy, wherein the first planar slot defined by the guide body has a distal end and a proximal end, the guide body further defining a circular slot in communication with the first distal end, and wherein the method further comprises:

anchoring the guide to the patient'"'"'s tibia near the tubercle by inserting pins through the apertures and into the tibia;

inserting a drill bit through the circular slot and drilling a hole through the tibia;

resecting a first plane through the tibia by inserting a saw blade through the first slot;

resecting a second plane through the tibia by inserting a saw blade through a second slot;

removing the pins and the guide;

further resecting the tibia to connect the first plane and the second plane; and

resecting a third plane through the tibia to connect the second plane to an anterior surface of the tibia to form the tubercle flap.

6. The method according to claim 1, wherein the guide body further defines a soft tissue-clearing portion comprising an outer convex surface and an inner concave surface, and wherein positioning the patient-specific guide on the patient'"'"'s tibia further comprises nesting the bone-engaging surface of the guide onto a corresponding surface on the tibia, wherein the inner concave surface of the soft tissue-clearing portion provides a recess for accommodating the patient'"'"'s medial collateral ligament, lateral cruciate ligament, or patellar tendon.