PATIENT SELECTABLE JOINT ARTHROPLASTY DEVICES AND SURGICAL TOOLS

• US 20140066936A1
• Filed: 11/05/2013
• Published: 03/06/2014
• Est. Priority Date: 05/25/2001
• Status: Active Grant

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Fitz, Wolfgang, Lang, Philipp, Steines, Daniel
• Granted Patent: US 8,951,259 B2
• Time in Patent Office: Days
• US Class Current: 606/87
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/154 for preparing bone for knee prosthesis
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/158 Cutting patella
• CPC Class Codes: A61B 17/1666 for the acetabulum
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1677 for the patella
• CPC Class Codes: A61B 17/1682 for the foot or ankle
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/1746 for the acetabulum
• CPC Class Codes: A61B 17/1767 for the patella
• CPC Class Codes: A61B 2017/568 produced with shape and dimensions specific for an individual patient
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• 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 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4523 : Tendons
• CPC Class Codes: A61B 5/4528 : Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4533 : Ligaments
• CPC Class Codes: A61F 2/30756 : Cartilage endoprostheses A61F2/3603 takes precedence
• 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: B33Y 80/00 : Products made by additive manufacturing
• CPC Class Codes: G06F 30/00 : Computer-aided design [CAD]
• CPC Class Codes: G06F 30/10 : Geometric CAD
• CPC Class Codes: Y10T 29/49 : Method of mechanical manufacture

Abstract

Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

Claims

1. A patient-specific surgical tool for use in surgery on an ankle joint of a patient, comprising:

a block having a patient-specific surface and a surgical instrument guide;

the patient-specific surface being substantially a negative of a corresponding surface portion of the ankle joint that includes an osteophyte;

the surgical instrument guide being sized to accommodate a surgical tool and have a position and orientation relative to the patient-specific surface to provide a predetermined cutting or drilling path for the cutting or drilling tool that is aligned through a portion of tissue of the ankle joint.

2. The surgical tool of claim 1, wherein the surgical tool is configured such that the patient specific surface substantially does not engage a second osteophyte when the patient specific surface is engaged and aligned with the corresponding surface portion.

3. The surgical tool of claim 2, wherein the patient specific surgical tool is configured such that the patient specific surface extends over but does not engage the second osteophyte when the patient specific surface is engaged and aligned with the corresponding surface portion.

4. The surgical tool of claim 1, wherein the patient specific surface substantially engages an entire osteophyte.

5. The surgical tool of claim 1, wherein the patient specific surface substantially engages an entire portion of a surface of an osteophyte.

6. The surgical tool of claim 1, wherein the patient specific surface engages multiple osteophytes.

7. The surgical tool of claim 1, wherein the cutting tool is a drill.

8. The surgical tool of claim 1, wherein the cutting tool is a saw.

9. The surgical tool of claim 1, further comprising an attachment mechanism.

10. The surgical tool of claim 9, further comprising a surgical device for use with the cutting block and connectable to the cutting or drilling block by the attachment mechanism.

11. The surgical tool of claim 1, wherein the tool is comprised of multiple components.

12. The surgical tool of claim 1, wherein the cutting block containing the patient-specific surface and the surgical instrument guide is a single component.

13. The surgical tool of claim 1, wherein the surface of the joint is a tibial surface of the ankle joint of the patient and the surgical instrument guide is configured to define a path through a tibial surface when the patient specific surface is engaged and aligned with the corresponding surface.

14. The surgical tool of claim 1, wherein the surgical instrument guide defines a path having a predetermined orientation relative to the distal portion of the tibial of the ankle joint.

15. The surgical tool of claim 1, further comprising a plurality of surgical instrument guide apertures.

16. The surgical tool of claim 1, wherein the when tool is configured to resist movement when the patient specific surface is placed against a surface of the joint.

17. The surgical tool of claim 1, wherein the when tool is configured to resist rotation in at least one axis when the patient specific surface is placed against a surface of the joint.

18. The surgical tool of claim 1, wherein the surgical instrument guide defines a predetermined path oriented along a biomechanical axis of the ankle joint when the patient specific surface is placed against and aligned with the corresponding surface portion of the ankle joint.

19. The surgical tool of claim 1, wherein the surgical instrument guide aperture defines a predetermined path oriented along an anatomical axis of the ankle joint when the patient specific surface is placed against and aligned with the corresponding surface portion of the ankle joint.

20. The surgical tool of claim 1, wherein the surgical instrument guide aperture includes a stop to control the depth of the cutting tool.

21. A surgical tool for use in surgically repairing an ankle joint of a patient, comprising:

a cutting or drilling block having a patient-specific surface and a surgical instrument guide;

the patient-specific surface having a first portion that is substantially a negative of a corresponding portion of a surface associated with the ankle joint and a second portion that is configured to substantially avoid contact with one or more osteophytes of the joint when the first portion is engaged and aligned with the corresponding portion of the surface of the ankle joint;

the surgical instrument guide being sized to accommodate a cutting or drilling tool and have a position and orientation relative to the patient-specific surface to provide a predetermined cutting or drilling path for the cutting or drilling tool that is aligned through a portion of tissue of the joint when the first portion is engaged and aligned with the corresponding portion of the surface of the ankle joint.

22. The surgical tool of claim 21, wherein the patient specific surgical tool is configured such that the patient specific surface does not engage any osteophyte when the patient specific surface is engaged and aligned with the corresponding portion of the surface of the ankle joint.

23. The surgical tool of claim 21, wherein the patient specific surgical tool is configured such that the patient specific surface substantially does not engage any osteophyte when the patient specific surface is engaged and aligned with the corresponding portion of the surface of the ankle joint.

24. The surgical tool of claim 21, wherein the patient specific surgical tool is configured such that the patient specific surface extends over but does not engage an osteophyte when the patient specific surface is engaged and aligned with the corresponding portion of the surface of the ankle joint.

25. The surgical tool of claim 21, wherein the patient specific surgical tool is configured such that the patient specific surface extends over but substantially does not engage an osteophyte when the patient specific surface is engaged and aligned with the corresponding portion of the surface of the ankle joint.

26. The surgical tool of claim 21, wherein the patient specific surgical tool is configured such that the patient specific surface extends around an edge of an osteophyte but does not engage the osteophyte when the patient specific surface is engaged and aligned with the corresponding portion of the surface of the ankle joint.

27. The surgical tool of claim 21, wherein the patient specific surgical tool is configured such that the patient specific surface extends around an edge of an osteophyte but substantially does not engage the osteophyte when the patient specific surface is engaged and aligned with the corresponding portion of the surface of the ankle joint.

28. A surgical tool for use in surgically repairing an ankle joint of a patient, comprising:

a block having a patient-specific surface and a surgical instrument guide sized to accommodate a surgical tool;

the patient-specific surface having at least a portion that is substantially a negative of an ankle joint surface of the patient that includes an osteophyte;

the surgical instrument guide having a position and orientation relative to the patient-specific surface to provide a predetermined path for cutting or drilling when the patient-specific surface is placed against the joint surface of the patient such that the surgical instrument guide has a predetermined alignment relative to an anatomical or biomechanical axis of the patient'"'"'s ankle joint.

29. A surgical tool system for use in surgically repairing an ankle joint of a patient, comprising:

a first tool including a first block having a first patient-specific surface and a first surgical instrument guide sized to accommodate a surgical tool;

the patient-specific surface having at least a portion that is substantially a negative of a first surface of the ankle joint of the patient that includes an osteophyte;

the surgical instrument guide having a position and orientation relative to the patient-specific surface to provide a predetermined path for cutting or drilling when the patient-specific surface is placed against the joint surface of the patient such that the surgical instrument guide has a predetermined alignment relative to an anatomical or biomechanical axis of the patient'"'"'s ankle joint;

a second tool including a second block having a second patient-specific surface and a second surgical instrument guide aperture;

the second patient-specific surface having at least a portion that is substantially a negative of a second surface of the ankle joint of the patient;

the second surgical instrument guide having a position and orientation relative to the second patient-specific surface to provide a second predetermined path for cutting or drilling when the second patient-specific surface is placed against the joint surface of the patient such that the surgical instrument guide aperture has a predetermined alignment relative to an anatomical or biomechanical axis of the patient'"'"'s ankle joint.

30. The surgical tool system of claim 29, wherein the patient specific surface engages multiple osteophytes