PATIENT-SPECIFIC AUGMENTS

• US 20170333194A1
• Filed: 08/09/2017
• Published: 11/23/2017
• Est. Priority Date: 02/27/2006
• Status: Active Grant

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Pierce, Andrew L., Metzger, Robert
• Granted Patent: US 10,603,179 B2
• Time in Patent Office: Days
• 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: A61F 2/30734 Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
• 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: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30433 using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30736 Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
• CPC Class Codes: A61F 2002/3092 having an open-celled or open-pored structure

Abstract

A patient-specific augment can be attached to an implant component for a bone of a joint of a patient. The patient-specific augment has first and second surfaces. The first surface is a three-dimensional patient-specific surface that closely matches and can mate to a substantially unaltered and unresected surface of a bone defect of the specific patient only in one position. The second surface is designed to engage a non-custom surface of the implant.

Claims

1-21. -21. (canceled)

22. A method of preparing a knee joint for an implant component:

preparing a bone end of the knee joint of the patient with standard resections configured to match a non-custom bone-engaging surface of the implant component without resecting a three-dimensional surface of a defect in the bone;

attaching a first implant-engaging surface of a patient-specific augment to a portion of the bone-engaging surface of the implant component;

nestingly mating a second patient-specific three-dimensional surface of the augment to the three-dimensional surface of the defect; and

attaching the implant component to the bone.

23. The method of claim 22, further comprising mating a third patient-specific peripheral surface of the augment to at least a portion of a complementary surface of the bone.

24. The method of claim 22, further comprising:

reconstructing an image of the bone with the defect from a medical scan of the bone during a preoperative plan for the patient;

selecting the implant component for the specific patient; and

manufacturing the patient-specific augment from the image of the bone of the specific patient and the implant component.

25. The method of claim 24, wherein manufacturing the augment includes providing the augment with a patient-specific and variable depth between the first implant-engaging surface and the second patient-specific three-dimensional surface.

26. The method of claim 25, wherein providing the augment with the patient-specific and variable depth includes providing the variable depth of the augment has a patient-specific step discontinuity.

27. The method of claim 24, further comprising:

performing an initial virtual fitting of virtual representations the augment and the implant component in a virtual knee joint created from the image of the bone; and

incrementally manipulating a position of the virtual representations of the augment and the implant component in the virtual knee joint.

28. The method of claim 27, further comprising one or more of:

selecting or modifying resection plans in the virtual knee joint;

selecting or modifying the virtual representations of the augment and/or implant component to simulate various types of augments and/or implant components; and

selecting or modifying an orientation of the virtual representations of the augment and/or implant component upon insertion into the virtual knee joint.

29. The method of claim 22, wherein the first implant-engaging surface is one of entirely planar or comprises a plurality of planar segments.

30. The method of claim 22, wherein the second patient-specific three-dimensional surface includes at least one of:

a porous coating and is has a continuously curvature;

convex and concave portions; and

a step discontinuity.

31. The method of claim 22, wherein the augment is one of a femoral augment engageable to the femoral implant and to a distal femur of the knee joint or a tibial augment engageable to a tibial implant of a proximal tibia of the knee joint.

32. The method of claim 22, wherein the medical scan is from one of magnetic resonance imaging, computer tomography, ultrasound, x-ray or other three- or two-dimensional medical scans of anatomy of the patient.

33. A method of preparing a knee joint for an implant component:

preparing a bone end of the knee joint of the patient with standard resections configured to match a non-custom bone-engaging surface of the implant component without resecting a three-dimensional surface of a defect in the bone;

attaching a first implant-engaging surface of a patient-specific augment to a portion of the bone-engaging surface of the implant component;

nestingly mating a second patient-specific three-dimensional surface of the augment to the three-dimensional surface of the defect;

mating a third patient-specific peripheral surface of the augment to at least a portion of a complementary surface of the bone; and

attaching the implant component to the bone.

34. The method of claim 33, further comprising:

reconstructing an image of the bone with the defect from a medical scan of the bone during a preoperative plan for the patient;

selecting the implant component for the specific patient; and

manufacturing the patient-specific augment from the image of the bone of the specific patient and the implant component.

35. The method of claim 34, wherein manufacturing the augment includes providing the augment with a patient-specific and variable depth between the first implant-engaging surface and the second patient-specific three-dimensional surface.

36. The method of claim 35, wherein providing the augment with the patient-specific and variable depth includes providing the variable depth of the augment has a patient-specific step discontinuity.

37. The method of claim 34, further comprising:

performing an initial virtual fitting of virtual representations the augment and the implant component in a virtual knee joint created from the image of the bone; and

incrementally manipulating a position of the virtual representations of the augment and the implant component in the virtual knee joint.

38. A method of preparing a knee joint for an implant component:

reconstructing an image of a bone with a defect from a medical scan of the bone during a preoperative plan for a patient;

selecting an implant component for the specific patient;

manufacturing a patient-specific augment from the image of the bone of the specific patient and the implant component;

preparing a bone end of the knee joint of the patient with standard resections configured to match a non-custom bone-engaging surface of the implant component without resecting a three-dimensional surface of a defect in the bone;

attaching a first implant-engaging surface of the patient-specific augment to a portion of the bone-engaging surface of the implant component;

nestingly mating a second patient-specific three-dimensional surface of the augment to the three-dimensional surface of the defect; and

attaching the implant component to the bone.

39. The method of claim 38, further comprising mating a third patient-specific peripheral surface of the augment to at least a portion of a complementary surface of the bone.

40. The method of claim 38, wherein manufacturing the augment includes providing the augment with a patient-specific and variable depth between the first implant-engaging surface and the second patient-specific three-dimensional surface.

41. The method of claim 38, further comprising:

performing an initial virtual fitting of virtual representations the augment and the implant component in a virtual knee joint created from the image of the bone; and

incrementally manipulating a position of the virtual representations of the augment and the implant component in the virtual knee joint.

42. The method of claim 41, further comprising one or more of:

selecting or modifying resection plans in the virtual knee joint;

selecting or modifying the virtual representations of the augment and/or implant component to simulate various types of augments and/or implant components; and

selecting or modifying an orientation of the virtual representations of the augment and/or implant component upon insertion into the virtual knee joint.