Patient-Specific Partial Knee Guides And Other Instruments

• US 20120323246A1
• Filed: 08/29/2012
• Published: 12/20/2012
• Est. Priority Date: 04/29/2011
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Catanzarite, Joshua B., Mauch, Thomas J.
• Granted Patent: US 8,956,364 B2
• Time in Patent Office: Days
• US Class Current: 606/88
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61F 2002/3895 unicompartimental

Abstract

A patient-specific unicompartmental tibial guide has a patient-specific body with an inner surface. The inner surface is preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a proximal portion of a tibial bone of a specific patient. The tibial guide includes a vertical resection channel having a variable width preoperatively configured for guiding a vertical resection through the proximal portion of the tibial bone.

Claims

1. A surgical kit for unicompartmental knee arthroplasty comprising:

a patient-specific unicompartmental tibial guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a proximal portion of a tibial bone of a specific patient, the tibial guide including a vertical resection channel having a variable width preoperatively configured for guiding a vertical resection through the proximal portion of the tibial bone.

2. The surgical kit of claim 1, wherein the variable width varies in a coronal plane relative to the patient.

3. The surgical kit of claim 1, wherein the variable width varies in an axial plane relative to the patient.

4. The surgical kit of claim 1, wherein the variable width varies in a coronal plane and in an axial plane relative to the patient.

5. The surgical kit of claim 1, wherein the vertical resection channel is formed between first and second curved surfaces of corresponding first and second flanges of the tibial guide.

6. The surgical kit of claim 5, wherein the first and second curved surfaces are convex towards one another.

7. The surgical kit of claim 6, wherein the first and second curved surfaces are piecewise convex in a coronal plane relative to the patient.

8. The surgical kit of claim 6, wherein the first and second curved surfaces are piecewise convex in an axial plane relative to the patient.

9. The surgical kit of claim 6, wherein the first and second curved surfaces are piecewise convex in coronal and axial planes relative to the patient.

10. The surgical kit of claim 1, wherein the tibial guide includes a drill guide portion preoperatively configured for drilling first and second anterior holes into the tibial bone for guiding a horizontal tibial resection.

11. The surgical kit of claim 10, wherein the drill guide portion is unitarily attached to the patient-specific body.

12. The surgical kit of claim 1, wherein the vertical resection channel ends in a safety hole formed between first and second resection flanges, the safety hole configured to receive a stop pin limiting a depth of the vertical resection.

13. The surgical kit of claim 1, further comprising a unitary patient-specific unicompartmental femoral guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a distal portion of a distal femoral bone of a specific patient, the femoral guide including an elongated slot with a tapered inner wall.

14. The surgical kit of claim 13, further comprising a femoral drill template having a tapered outer portion configured to be received in the elongated slot and first and second guiding holes configured for drilling holes into the femoral bone to support a resection block.

15. The surgical kit of claim 1, further comprising a knee implant assembly for partial knee arthroplasty.

16. A surgical kit for unicompartmental knee arthroplasty comprising:

a patient-specific unicompartmental tibial guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a proximal portion of a tibial bone of a specific patient, the tibial guide including a vertical resection channel having a first width formed between first and second flanges of the tibial guide; and

a cutting insert having a first plate receivable in the vertical resection channel and changing the first width of the resection channel to a second width smaller than the first width.

19. The surgical kit of claim 16, further comprising additional cutting inserts configured for changing the first width of the resection channel to corresponding and different widths.

20. The surgical kit of claim 16, wherein the tibial guide includes a drill guide portion preoperatively configured for drilling first and second anterior holes into the tibial bone for guiding a horizontal tibial resection.

17. The surgical kit of claim 17, wherein the cutting insert includes an open channel formed between the first plate and a second plate.

18. The surgical kit of claim 17, wherein the first and second plates have different thicknesses.

21. A method for unicompartmental knee arthroplasty comprising:

mounting a patient-specific tibial guide on a tibial bone;

nestingly mating and registering a patient-specific inner surface of the tibial guide onto a corresponding anterior surface of the tibial bone and a corresponding proximal surface of a proximal plateau of the tibial bone; and

making a vertical tibial resection of the proximal plateau through a vertical resection channel of the tibial guide, the vertical resection channel having variable width along an anatomic plane of the patient.

22. The method of claim 21, wherein the anatomic plane is a coronal plane.

23. The method of claim 21, wherein the anatomic plane is an axial plane.

24. A method for unicompartmental knee arthroplasty comprising:

mounting a patient-specific tibial guide on a tibial bone;

nestingly mating and registering a patient-specific inner surface of the tibial guide onto a corresponding anterior surface of the tibial bone and a corresponding proximal surface of a proximal plateau of the tibial bone;

selecting one of a plurality of cutting inserts having different widths;

inserting a plate extending from the selected cutting insert into a vertical resection channel of the tibial guide;

changing the width of the vertical resection channel to a reduced width; and

making a vertical tibial resection of the proximal plateau through the reduced width.

25. A method for unicompartmental knee arthroplasty comprising:

mounting a patient-specific femoral guide on a femoral bone;

nestingly mating and registering a patient-specific inner surface of the femoral guide onto a corresponding anterior surface and a corresponding distal surface of the femoral bone;

coupling a tibial sizing gauge to a distal opening of a guiding formation of the femoral guide;

measuring a tibial gap;

coupling a tibial resection block to the tibial sizing gauge; and

guiding a vertical resection of the tibia at distance determined by the tibial sizing gauge.

26. The method of claim 25, further comprising:

removing the tibial sizing gauge;

inserting a femoral drill template into the guiding formation of the femoral guide; and

drilling locating holes into the femoral bone through the femoral drill guide.

27. The method of claim 26, further comprising:

guiding a horizontal resection of the tibia using the tibial resection block.