Surgical apparatus for implantation of a partial of total knee prosthesis

• US 20060235538A1
• Filed: 04/11/2006
• Published: 10/19/2006
• Est. Priority Date: 04/13/2005
• Status: Active Grant

• Current Assignee: Corin Limited (Corin Medical Ltd. /Management/)
• Original Assignee: Tornier Incorporated
• Inventors: Tornier, Alain, Ratron, Yves-Alain, Rochetin, Olivier
• Granted Patent: US 8,282,685 B2
• Time in Patent Office: Days
• US Class Current: 623/20.190
• CPC Class Codes: A61B 17/158 Cutting patella
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• 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: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/3877 Patellae or trochleae
• CPC Class Codes: A61F 2/461 of knees
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/4632 using computer-controlled surgery, e.g. robotic surgery

Abstract

This surgical apparatus comprises, on the one hand, means for spatial marking-out of the kneecap and femur of a patient to be operated on, and, on the other hand, means for simultaneous and relative representation of this kneecap provided virtually with a patellar implant of the prosthesis, and of this femur provided virtually with a femoral implant of the prosthesis, in a sagittal plane passing both through the kneecap and through the trochlea of the aforementioned femoral implant. Using this apparatus, the surgeon can easily and quickly check the antero-posterior size of the prosthesis in order to reduce the risks of subsequent dislocations of the kneecap fitted with the prosthesis.

Claims

1. Surgical apparatus for implantation of a total or partial knee prosthesis comprising at least a patellar implant and a femoral implant, said apparatus having:

means for peroperative spatial marking-out of the bones of the kneecap and femur to be fitted with the prosthesis,

means for peroperative representation that are designed to show, in a sagittal plane passing both through the kneecap and through an intercondylar trochlea of the femoral implant, a simultaneous and relative representation of the kneecap which is to be fitted with the prosthesis and is provided virtually with the patellar implant, and of the lower part of the femur which is to be fitted with the prosthesis and is provided virtually with the femoral implant.

2. Apparatus according to claim 1, wherein the sagittal plane in which the kneecap and the femur are represented by the representation means passes substantially through the base line of the intercondylar trochlea.

3. Apparatus according to claim 1, wherein the apparatus includes a memory containing data relating to a preferential predetermined positioning of the patellar implant relative to the femoral implant for all the anatomically allowable configurations of flexion-extension of the knee, and wherein the representation means are designed to represent, in the sagittal plane and in a simultaneous and relative manner, both the kneecap fitted virtually with the prosthesis, the femur fitted virtually with the prosthesis, and a line which helps the surgeon and represents the trajectory of a point of the patellar implant during a flexion-extension movement of the knee, this line being positioned relative to the virtual femoral implant as a function of the data on preferential positioning that are contained in the memory.

4. Apparatus according to claim 1, wherein the representation means are designed to represent the kneecap fitted virtually with the prosthesis, the femur fitted virtually with the prosthesis and, if appropriate, the line for helping the surgeon obtain different configurations of flexion-extension of the knee, the sagittal plane in which these elements are represented by these means being fixed relative to the femur.

5. Apparatus according to claim 4, wherein the representation means are designed to represent said elements over a continuous course of flexion-extension of the knee, in particular over the course of maximum flexion-extension that is anatomically allowable.

6. Apparatus according to claim 1, wherein the apparatus comprises adjustment means for adjusting the virtual implantation of the patellar implant on the kneecap.

7. Apparatus according to claim 6, wherein, in the case where the patellar implant is to be fitted level with a posterior cutting of the kneecap, the adjustment means are designed to modify the distance between a predetermined point of the anterior face of the kneecap and the patellar sectioning line in the sagittal plane, the angle value of the patellar sectioning line relative to a predetermined direction, and/or the position of the patellar implant along the patellar sectioning line.

8. Apparatus according to claim 6, wherein, in the case where a set of several patellar implants of different respective sizes is provided, the adjustment means are designed to change the size of the implant shown.

9. Apparatus according to claim 6, wherein the apparatus comprises:

means for selecting and memorizing at least one configuration of implantation of the patellar implant set by the adjustment means,

an ancillary used for resurfacing the anterior face of the kneecap and equipped with spatial marking means, and

means for comparing the resurfacing action effected by this ancillary with the data from the selecting and memorizing means.

11. Surgical method for implantation of a partial or total knee prosthesis comprising at least a patellar implant and a femoral implant, wherein the following steps are carried out in succession in a peroperative period:

the bones of the kneecap and femur of a patient to be treated are spatially marked out,

the kneecap which is to be fitted with the prosthesis and is provided virtually with the patellar implant and the lower part of the femur which is to be fitted with the prosthesis and is provided virtually with the femoral implant are represented in a simultaneous and relative representation, this representation being effected in a sagittal plane passing both through the kneecap and also through an intercondylar trochlea of the femoral implant,

the virtual implantation of the patellar implant on the kneecap and, if appropriate, the virtual implantation of the femoral implant on the femur is adjusted such that the antero-posterior size of the femoral and patellar implants corresponds substantially to the anatomical size in the patient being operated on,

the configuration of implantation of the patellar implant obtained according to the adjustment is selected and memorized, and

the real patellar implant is implanted on the kneecap of the patient according to the configuration of implantation that has been selected and memorized.

10. Apparatus according to claim 11, wherein the apparatus additionally comprises other means for simultaneous and relative representation of the kneecap which is to be fitted with the prosthesis and is provided virtually with the patellar implant, and of the lower part of the femur which is to be fitted with the prosthesis and is provided virtually with the femoral implant, in a transverse plane passing both through the kneecap and the trochlea of the femoral implant.

12. Method according to claim 11, wherein:

in relation to the femoral implant virtually implanted on the spatially marked-out femur, the position of the representation of a point of the patellar implant virtually implanted on the spatially marked-out kneecap is compared with a predetermined line representing the preferred trajectory of the aforementioned point during a flexion-extension movement of the knee, and

the virtual implantation of the patellar implant on the kneecap is adjusted in such a way that the representation of its aforementioned point is substantially placed on the predetermined line.