Patient-adapted and improved articular implants, designs and related guide tools

• US 9,603,711 B2
• Filed: 04/28/2010
• Issued: 03/28/2017
• Est. Priority Date: 05/25/2001
• Status: Active Grant

• Current Assignee: Conformis Incorporated
• Original Assignee: Conformis Incorporated
• Inventors: Bojarski, Raymond A., Chao, Nam T., Slamin, John, Lang, Philipp, Fitz, Wolfgang, Steines, Daniel, Minas, Thomas
• Primary Examiner(s): Willse, David H.
• Assistant Examiner(s): BLANCO, JAVIER G
• Application Number:
  US12/799,641
• Publication Number:
  US 20110087332A1
• Time in Patent Office: 2,526 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 17/155 Cutting femur
• CPC Class Codes: A61B 17/157 Cutting tibia
• CPC Class Codes: A61B 17/1742 for the hip
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/1778 for the shoulder
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take 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 2/3886 for stabilising knees against anterior or lateral dislocations
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2002/30324 differing in thickness
• CPC Class Codes: A61F 2002/30327 differing in diameter
• CPC Class Codes: A61F 2002/30952 using CAD-CAM techniques or NC-techniques
• CPC Class Codes: A61F 2250/0036 differing in thickness
• CPC Class Codes: A61F 2250/0039 differing in diameter
• CPC Class Codes: Y10T 29/49 Method of mechanical manufacture

Abstract

Methods and devices are disclosed relating improved articular models, implant components, and related guide tools and procedures. In addition, methods and devices are disclosed relating articular models, implant components, and/or related guide tools and procedures that include one or more features derived from patient-data, for example, images of the patient'"'"'s joint. The data can be used to create a model for analyzing a patient'"'"'s joint and to devise and evaluate a course of corrective action. The data also can be used to create patient-adapted implant components and related tools and procedures.

Claims

1. A method for implanting a knee implant in a patient'"'"'s knee joint, the method comprising the steps of:

(a) preparing, using a tibial resection guide tool, a proximal end of a tibia of the patient'"'"'s knee joint to receive a tibia implant, wherein the tibial resection guide tool includes a patient-specific bone-facing surface configured to substantially mate and conform with at least a portion of the proximal end of the tibia, wherein said preparing includes resecting said proximal end of the tibia of the patient'"'"'s knee joint;

(b) inserting at least one tibial implant onto the prepared proximal end of the tibia such that a first tibial articular surface of the at least one tibial implant engages a first femoral articular surface of a femoral implant and a second tibial articular surface of the at least one tibial implant engages a second femoral articular surface of the femoral implant;

wherein the first tibial articular surface has a different height than the second tibial articular surface relative to an anatomical axis of the tibia, wherein the tibial implant is configured to maximize coverage and extend to cortical margins of the prepared proximal end of the tibia, and further configured to avoid impingement on a popliteus tendon associated with the patient'"'"'s knee joint, and

(c) adjusting and optimizing alignment of the tibia and the corresponding femur of the patient'"'"'s knee joint,

wherein the tibial implant includes a perimeter profile configured to achieve greater than 90% coverage of cortical bone of the resected surface of the proximal end of the tibia of the patient'"'"'s knee joint, wherein the 90% coverage is preoperatively determined using a three-dimensional representation of the resected surface of the proximal end of the tibia of the patient'"'"'s knee joint derived from electronic image data of the patient'"'"'s knee joint,

wherein the height difference between the first and second tibial articular surfaces is derived from the electronic image data of the patient'"'"'s knee joint,

wherein the perimeter profile of the tibial implant substantially matches the perimeter of the resected surface of the proximal end of the tibia of the patient'"'"'s knee joint,

wherein each of the first and second tibial articular surfaces, and each of the first and second femoral articular surfaces, comprises patient-adapted sagittal radii or curvature.

2. The method of claim 1, wherein the at least one tibial implant comprises a single tibial implant tray.

3. The method of claim 1, further comprising assessing the alignment of the patient'"'"'s knee joint.

4. The method of claim 1, further comprising adjusting alignment of the patient'"'"'s knee joint.

5. The method of claim 1, further comprising adjusting rotational alignment of the patient'"'"'s knee joint.

6. The method of claim 1, further comprising adjusting linear alignment of the patient'"'"'s joint.

7. The method of claim 1, further comprising adjusting a biomechanical axis of the patient'"'"'s knee joint.

8. The method of claim 1, further comprising adjusting an anatomical axis of the patient'"'"'s knee joint.

9. The method of claim 1, further comprising balancing a patient'"'"'s knee joint.

10. The method of claim 9, further comprising assessing the balance of the patient'"'"'s knee joint.

11. The method of claim 9, further comprising adjusting the balance of the patient'"'"'s knee joint.

12. The method of claim 9, wherein balancing of the patient'"'"'s joint comprises balancing of the patient'"'"'s knee joint in extension.

13. The method of claim 9, wherein balancing of the patient'"'"'s joint comprises balancing of the patient'"'"'s knee joint in flexion.