Minimally invasive total knee arthroplasty method and instrumentation

• US 7,172,596 B2
• Filed: 02/28/2003
• Issued: 02/06/2007
• Est. Priority Date: 03/05/2002
• Status: Active Grant

• Current Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Van Zile, Richard R., Coon, Thomas M., Smucker, Donald M., Tria, Alfred J Jr.
• Primary Examiner(s): Philogene; Pedro
• Application Number:
  US10/377,068
• Publication Number:
  US 20030171757A1
• Time in Patent Office: 1,439 Days
• Field of Search: 606 86-989
• US Class Current: 606/87
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 2090/0801 Prevention of accidental cutting or pricking

Abstract

A method and apparatus for performing total knee arthroplasty which is minimally invasive includes components with guide surfaces and slots for controlling the path of a cutting saw. The instrumentation permits resection of the proximal end of the tibia and distal end of the femur to be performed either medially or laterally with minimal cutting of soft tissue.

Claims

1. A method for resectioning the proximal end of a tibia comprising the steps of

(a) providing a tibial resection guide having

(i) an engagement surface following a contoured path permitting engagement with two spaced apart portions of said tibia, one of said portions being in the vicinity of an anterior cortex and the other of said portions being in the vicinity of either a medial cortex adjacent a medial collateral ligament or a lateral cortex adjacent a lateral collateral ligament;

(ii) an opposed surface spaced from said engagement surface;

(iii) a first end between said engagement surface and said opposed surface;

(iv) a second end between said engagement surface and said opposed surface;

(v) a proximal surface; and

(vi) a slot for receiving and guiding the path of a saw extending therethrough, said slot extending between said opposed surface and said engagement surface and permitting positioning of said saw medially in the vicinity of a medial collateral ligament or laterally in the vicinity of a lateral collateral ligament;

(b) positioning said resection guide with said engagement surface in the area of said tibia proximal end and in contact with said tibia in the area of said anterior cortex and either said medial cortex or said lateral cortex and with said slot being substantially perpendicular to the mechanical axis of said tibia;

(c) displacing said medial collateral ligament or said lateral collateral ligament with said first end; and

(d) resecting said tibia proximal end with a saw extending through said slot.

2. The method according to claim 1 further including the step of displacing a patella tendon with said second end prior to said step of resecting.

3. A tibial resection guide for use in resectioning a proximal end of a tibia while preventing damage to medial collateral ligaments positioned adjacent said tibia proximal end comprising:

(a) an engagement surface following a contoured path permitting engagement with two spaced apart portions of said tibia, one of said portions being in the vicinity of an anterior cortex and the other of said portions being in the vicinity of a medial cortex adjacent a medial collateral ligament;

(b) an opposed surface on an opposite side from said engagement surface, said opposed surface or an extension thereof meeting said engagement surface (i) at a first location to define a first end and (ii) at a second location to define a second end;

(c) a proximal surface adapted for positioning in the vicinity of said tibia proximal end;

(d) a slot for receiving and guiding the path of a saw extending therethrough, said slot extending between said opposed surface and said engagement surface and permitting positioning of said saw medially in the vicinity of said medial collateral ligament;

(e) a medial collateral engagement surface in the vicinity of said first end for displacing said medial collateral ligament while said saw extends through said slot; and

(f) a patella engagement surface in the vicinity of said second end for displacing the patella tendon while said medial collateral engagement surface is displacing said medial collateral ligament.

4. A tibial resection guide for use in resectioning a proximal end of a tibia while preventing damage or lateral collateral ligaments positioned adjacent said tibia proximal end comprising:

(a) an engagement surface following a contoured path permitting engagement with two spaced apart portions of said tibia, one of said portions being in the vicinity of an anterior cortex and the other of said portions being in the vicinity of a lateral cortex adjacent a lateral collateral ligament;

(b) an opposed surface on an opposite side from said engagement surface, said opposed surface or an extension thereof meeting said engagement surface (i) at a first location to define a first end and (ii) at a second location to define a second end;

(c) a proximal surface adapted for positioning in the vicinity of said tibia proximal end;

(d) a slot for receiving and guiding the path of a saw extending therethrough, said slot extending between said opposed surface and said engagement surface and permitting positioning of said saw laterally in the vicinity of said lateral collateral ligament;

(e) a lateral collateral engagement surface in the vicinity of said first end for displacing said lateral collateral ligament while said saw extends through said slot; and

(f) a patella engagement surface in the vicinity of said second end for displacing the patella tendon while said lateral collateral surface is displacing said lateral collateral ligament.

5. A one-piece tibial resection guide for use in resectioning a proximal end of a tibia while preventing damage to medial collateral ligaments positioned adjacent said tibia proximal end comprising:

(a) an engagement surface following a contoured path permitting engagement with two spaced apart portions of said tibia, one of said portions being in the vicinity of an anterior cortex and the other of said portions being in the vicinity of a medial cortex adjacent a medial collateral ligament;

(b) an opposed surface on an opposite side from said engagement surface, said opposed surface or an extension thereof meeting said engagement surface (i) at a first location to define a first end and (ii) at a second location to define a second end;

(c) a proximal surface adapted for positioning in the vicinity of said tibia proximal end;

(d) a slot for receiving and guiding the path of a saw extending therethrough, said slot extending between said opposed surface and said engagement surface and permitting positioning of said saw medially in the vicinity of said medial collateral ligament;

(e) a medial collateral engagement surface in the vicinity of said first end for displacing said medial collateral ligament while said saw extends through said slot; and

(f) a patella engagement surface in the vicinity of said second end for displacing the patella tendon while said medial collateral engagement surface is displacing said medial collateral ligament.

6. A one-piece tibial resection guide for use in resectioning a proximal end of a tibia while preventing damage or lateral collateral ligaments positioned adjacent said tibia proximal end comprising:

(a) an engagement surface following a contoured path permitting engagement with two spaced apart portions of said tibia, one of said portions being in the vicinity of an anterior cortex and the other of said portions being in the vicinity of a lateral cortex adjacent a lateral collateral ligament;

(b) an opposed surface on an opposite side from said engagement surface, said opposed surface or an extension thereof meeting said engagement surface (i) at a first location to define a first end and (ii) at a second location to define a second end;

(c) a proximal surface adapted for positioning in the vicinity of said tibia proximal end;

(d) a slot for receiving and guiding the path of a saw extending therethrough, said slot extending between said opposed surface and said engagement surface and permitting positioning of said saw laterally in the vicinity of said lateral collateral ligament;

(e) a lateral collateral engagement surface in the vicinity of said first end for displacing said lateral collateral ligament while said saw extends through said slot; and

(f) a patella engagement surface in the vicinity of said second end for displacing the patella tendon while said lateral collateral surface is displacing said lateral collateral ligament.