CA2236376A1 - Bone cutting guides for use in the implantation of prosthetic joint components - Google Patents
Bone cutting guides for use in the implantation of prosthetic joint components Download PDFInfo
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- CA2236376A1 CA2236376A1 CA002236376A CA2236376A CA2236376A1 CA 2236376 A1 CA2236376 A1 CA 2236376A1 CA 002236376 A CA002236376 A CA 002236376A CA 2236376 A CA2236376 A CA 2236376A CA 2236376 A1 CA2236376 A1 CA 2236376A1
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- bone
- guide
- trial
- cutting
- implant
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
- A61B17/154—Guides therefor for preparing bone for knee prosthesis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
- A61B17/154—Guides therefor for preparing bone for knee prosthesis
- A61B17/155—Cutting femur
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4684—Trial or dummy prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
- A61B17/154—Guides therefor for preparing bone for knee prosthesis
- A61B17/157—Cutting tibia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00902—Material properties transparent or translucent
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3859—Femoral components
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/3009—Transparent or translucent
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
- A61F2/30771—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth applied in original prostheses, e.g. holes or grooves
- A61F2002/30772—Apertures or holes, e.g. of circular cross section
- A61F2002/30777—Oblong apertures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0091—Additional features; Implant or prostheses properties not otherwise provided for transparent or translucent
Abstract
Improved bone cutting guides enable a surgeon to better gauge required resection characteristics. In one embodiment at least a portion of the guide (204) is transparent (208, 210), thereby enabling the user to optimize cut estimates and to visualize the resection as it is being performed. In another embodiment, at least a portion of the outer surface of the body (404) is shaped to interact with another bone or prosthetic element associated with a joint, thereby enabling the device to function both as a trial and as a cutting guide. In this embodiment (404) as well the guide may be at least partially transparent to improve visualization. Although primarily intended for use in femoral-side knee arthroplasty, the invention is applicable to any procedure which might benefit from improved bone-cutting accuracy.
Description
BONE CUTTING GUIDES FOR USE IN THE
IMPLANTATION OF PROSTHETIC JOINT COMPONENTS
F;el~ of the Tnv~nt;o~
This invention concerns arthroplasty, and, more particularly, resides in improved cutting guides having features to better assist a surgeon in preparing a bone, for example, to receive an implant.
R~ckgrol~n~ of the ~nv~nt;on Whether for primary or revision arthroplasty, cutting guides are typically employed to ensure that the bone saw performs resections corresponding to mating surfaces of the prosthetic component. For example, in a femoral knee replacement, cutting guides or blocks are temporarily secured to the distal end of the femoral shaft, and include slots into which the blade of an oscillating saw is inserted to shape the end of the bone in accordance with corresponding surfaces of the prosthetic element.
In the case of a revision, the procedure is usually more elaborate due to deterioration of the previously prepared surfaces resulting from decomposition of the bone/prosthesis interface, necrosis, and other factors. Cutting blocks are also typically used in revision procedures, though bone deficiency often renders stabilization of the block impossible. In addition, if the cutting block includes a stem, the positioning of the stemmed implant can alter the fit of the final prothesis relative to the bone. More recently introduced techniques attempt to base the cuts on an intramedullary guide to which additional cutting blocks are mounted. Though such approaches improve bone cutting accuracy, there remains an unacceptable margin o~ error, the correction of which in some cases requiring a ~reehand shaping o~ the bone.
Sllmm~ry o~ the Inv~nt;o~
The present invention accordingly provides improved cutting guides which enable one per~orming a resection to better predict and execute required cut characteristics. Broadly, at least a portion o~ the body comprising the cutting guide is transparent, thereby enabling the practitioner to better estimate cut depth and/or visualize the resection as it is being per~ormed.
Pre~erably one or more slots are used to guide a cutting saw, with the volume o~ the body surrounding the slots being transparent.
In one embodiment, at least a portion o~ the outer sur~ace o~ the body is ~urther shaped to interact with another bone or prosthetic element as part of a joint, thereby enabling the device to ~unction both as a trial and as a cutting guide. For example, i~ adapted ~or use in ~emoral knee arthroplasty, the outer shape o~ the body may include condylar protrusions which cooperate with corresponding tibial sur~aces or prosthetic inserts. In this combination trial/cutting-guide embodiment the device may likewise advantageously be at least partially transparent to assist in estimating cut orientation or depth, and to visualize a particular resection in progress.
Although primarily intended ~or use in conjunction with preparing a bone sur~ace to receive a prosthetic component, the invention is applicable to any bone-cutting procedure which might bene~it ~rom improved accuracy.
W O 97/16129 PCTAJS96/17691 ~
Rr; ef Descr;pt;on of the Dr~w;ngs FIGURE 1 is an oblique drawing of the distal end of a femur, showing some of the resections typically used in conjunction with prosthetic implantation;
FIGURE 2 is an oblique drawing of a cutting guide adapted for primary femoral knee arthroplasty which, according to the invention, is constructed of transparent material;
FIGURE 3 is an oblique drawing of an existing prosthetic component adapted for mounting on the distal end of the femoral shaft including an intercondylar box structure;
FIGURE 4 is an improved cutting guide according to the invention, which includes outer surfaces appropriate to trial testing combined with cutting guides to facilitate efficient resection;
FIGURE 5 illustrates from an oblique perspective an alternative embodiment of the invention which facilitates box cuts if not already present;
FIGURE 6 is a top view of yet a further alternative embodiment of the invention involving the use of a box-cutting implement which may be L~llloved from an implanted stem onto which a combination trial and cutting guide may subse~uently be installed;
FIGURE 7 is a top view drawing of the combination trial/cutting guide referenced above with regard to Figure 6, now in position on the implanted stem; and FIGURE 8 is yet a further alternative embodiment of the invention including a stem configuration which facilitates at least partial box cut formation along with guides for other resections in a femoral knee application.
W O 97/16129 PCT~US96/17691 ~
Det~;le~ Descr;pt;on of the Preferre~ ~mhotl;m.onts In Figure 1 there is depicted a distal end portion 104 of a femur 102, which t~rm;n~tes in two bulbous protrusions 105 termed the medial and lateral condyles, which mate and engage with corresponding surfaces in the proximal end of the tibia. As a result of disease or injury, these mating surfaces, ordinarily smooth and cushioned by an intervening cartilage layer, disintegrate and/or become misshapen, resulting in restricted movement and pain.
To ameliorate these conditions, the orthopedic surgeon removes the llnh~lthy bone stock and replaces it with one or more metallic components which adhere to appropriately prepared bone sur~aces and approximate the outer, cortical layer of a healthy bone. To prepare the existing damaged or diseased bone to accept the implant components, various resections are made in a predetermined manner in correspondence with the inner surfaces of the implant. Using the ~emoral example of Figure 1, a saw guide is used to form resected sur~aces resulting ~rom an anterior chamfer cut 106, distal femoral articular surface cut 108, posterior chamfer cut 110, posterior-articular surface cut 112, and/or anterior articular surface CUt, which is typically performed prior to the articular chamfer cut. Although these cuts represent resections made in conjunction with a standard implant technique, more, fewer or different surfaces may be required, depending upon the level of deterioration or other circumstances.
Depending upon the saw guide used, either the cuts associated with only one of the condyles may be resected, or, alternatively, a guide having a dual set o~
slots may be utilized to trim both condyles simultaneously.
A singular type fixture is shown, ~or example, in U.S.
Patent No. 5,122,144, whereas guides having double sets of slots are shown in U.S. Patent Nos. 5,129,909 and 5,364,401. Numerous other examples are evident in the prior art, some of which are in commercial usage. The cuts associated with revision arthroplasty o~ the ~emoral component in a knee replacement are similar to those depicted in Figure 1, though now additional bone stock must be removed, and additional cuts closer to the central axis of the bone are typically made to accommodate a one-piece replacement unit having a intercondylar strengthening structure and posts extending there~rom for intramedullary implantation. Such a revision knee prosthesis is shown, for example, in U.S. Patent No. 4,936,847.
Whether ~or primary or revision arthroplasty, the saw guides involved are without exception now constructed o~ metal, and they are there~ore visually opaque. This results in a substantial piece of hardware which may be washed, sterilized and used repeatedly in numerous procedures, but, being opaque, the orthopedic surgeon is simply unable to see what he or she is doing while making the various bony cuts. As a result, it is often standard practice to make one or more cuts with the guide in place, then move the guide aside in order to view the interface, to ensure that sufficient bone has been removed to facilitate the most ideal cement interface between the resected bone and implant component. This trial-and-error process not only consumes valuable time during the operation, but may lead to the removal of more bone stock than necessary to achieve fixation.
During revision arthroplasty, such trial-and-error is that much more complicated and arduous, owing to the increased number of resected surfaced involved, and the need to ensure that these surfaces and the medullary stem are all properly aligned during the testing of trial implants and the attachment of the final prosthetic device.
In the event of a misalignment, the surgeon may choose to use a final implant having a smaller than optimal diameter stem, for example, to take up the slack upon discovering a slight misalignment with respect to the stem and the resected surfaces. This, in turn, may lead to an undesirable "play" between the stem of the prosthesis and the reamed medullary canal, and/or the need for medullary cementation which might otherwise be unnecessary.
According to this invention, then, improved cutting guides are provided to better assist the surgeon in performing accurate resections in an efficient manner. For example, guides adapted for use with primary arthroplasty have transparent features according to this invention, at least in the vicinity of the saw-receiving slots, thus enabling the surgeon to visualize the way in which the existing bone makes contact with the inner surfaces o$ the guide, and therefore facilitates a much more exacting initial set of cuts, in most cases, ideally eliminating trial-and-error entirely. In the case of revision work, the cuttiny guide itsel~ contains condylar and other outer surfaces enabling it to function both as a cutting guide and as a trial. Accordingly, once an initial trial procedure is carried out, the various resections may be performed, with a greater likelihood that they will be properly located, thereby increasing accuracy. Although a W O 97/16129 ~ PCT~US96/17691 -revision guide according to this invention need not be transparent, the combination o~ a combined trial/cutting guide constructed o~ a transparent material is pre~erred to realize the advantages set ~orth above.
Figure 2 illustrates one version o~ a cutting block constructed in accordance with the invention, in this case a guide for use in making initial articular sur~ace and cham~er cuts. Positioning o~ the block assumes the surgeon has ~irst made a distal ~emoral articular sur~ace cut against which the backside (not shown) o~ block 204 is seated while making these ~urther resections, the cham~er cuts being angular with respect thereto. This block 204 may be held against the bone through any attachment or stabilization means, including screws, pins, braces or other ~ixtures so long as the guide is appropriately secured. Importantly, and unlike all existing guides o~ this type, at least the right and le~t portions 208 and 210 are composed o~ a transparent material, and, pre~erably, the entire unit is clear and constructed o~ acrylic, polycarbonate or any other plastic or material substantial enough to withstand the oscillations o~ a bone saw or other cutting tool, yet su~iciently transparent to enable a surgeon to visualize the sur~aces to be resected in conjunction with a particular procedure. Pre~erably, this unit and others to be described o~ a cast plastic material such as acrylic or Lucite, having polished sur~aces, where necessary, to improve visualization.
In the case o~ primary arthroplasty, a cutting guide according to the invention need not assume the characteristics o~ that shown in Figure 2, but may assume CA 02236376 l998-04-30 W O 97/16129 PCT~US96/17691 -any suitable ~orm and may be used ~or any bone-forming purpose, whether or not resulting ~rom trauma. For example, the unit may resemble that shown in Figure 20 o~
Patent No. 5,234,433, which ~urther includes a guide slot to accommodate not only the cuts just described, but, in addition, the distal femoral articular surface cut creating surface 108 in Figure 1. For that matter, the broad principles o~ this invention are applicable to any type o~
cutting ~ixture, whether slotted or otherwise, adapted ~or use ~or prosthetic resection which might bene~it ~rom having any transparent portions or panels to assist the surgeon in better visualizing the bone preparation process.
This embodiment and those discussed below may also be adapted for use with cutting tools other than saw blades, including osteotomes, router bits, etc.
Re~erence will now be made to Figures 3-8, which represent embodiments o~ the invention more suitable to revision arthroplasty. Be~ore discussing the improved devices and methods made possible through the invention, however, existing approaches will first be discussed with particular regard to ~emoral knee surgery. In preparing the ~emur ~or a revision implant, the procedure may typically first include a drilling and reaming o~ the medullary canal to accept a sleeve and rod which extends outward and past the distal tip of the ~emoral shaft, and onto which various components are temporarily secured and stabilized to facilitate the various resections. For example, to perform the distal revision resection, an outrigger may be secured to the protruding stem and onto this placed a revision distal ~emoral cutting block, typically ~urther secured with pins, screws, or other means W O 97/16129 PCT~US96/17691 -engaged with the anterior cortex. Such a distal cutting guide typically includes various slots on either side to accommodate the lateral and medial resections at di~erent depths according to the level o~ bone loss on either side.
Having prepared the distal surfaces, this ~irst cutting block is removed and an anterior/posterior cutting block is installed onto the stem along with spacers in the event o~ di~erent depths o~ the lateral and medial distal resections. With the anterior/posterior cutting block secured in place, again with pins or screws, the anterior and posterolateral lateral cuts are made. Although the anterior cut is typically easily visualized as this region o~ the ~emoral sha~t is ~ully exposed during the procedure, as with the lateral resection(s), the posterolateral and posteromedial cuts are almost entirely hidden ~rom view.
Once the anterior and posterior resections are carried out, the cutting guide associated therewith is typically removed, and onto the medullary stem there is placed yet another guide used to per~orm notch and cham~er resections.
Figure 3 illustrates a typical prior-art revision implant, and additionally shows the orientation o~ the notch or "box" cuts to accommodate the intercondylar structure 302, which includes a transverse sur~ace 304 and side sur~aces 306 and 308 (not visible). The structure is box-shaped so that ~lat saw blades may be used to resect the bone and provide a more intimate and stable inter~ace.
~ As discussed above, this box-like structure 302 provides strength~n~ng between the two condylar halves, and allows room for superior post protrusion in posterior-stabilized 30 designs. The structure 302 also supports the stem 310, which is threadingly or compress-~it thereinto. A notch and chamfer cutting guide is typically used for the chamfer cuts and the cuts associated with the sides 306 and 308 of the intercondylar box, although the stem is typically removed to per~orm prox;m~l anterior chamfer resections.
The stem of the ~ixture must also be removed in order to make the transverse cut corresponding to the sur~ace 304.
Once all such guides or their equivalents have been used for the various cuts, the orthopedic surgeon typically must further progress through a trial reduction procedure which has matching inner surfaces, but varying thicknesses between the inner sur~aces and the outer joint surfaces, which are each tested, in turn, to ensure a correct joint line and femur-to-tibia orientation. Trial polyethylene inserts are also selected to provide m~; mllm range of motion and stability, at which point the femoral component may be implanted, in some cases utilizing spacers to accommodate the depth of cut determined as a ~unction of bone loss. Such spacers typically clip into place, as shown in Figures 1 through 4 of U.S. Patent 4,936,847.
It should be evident from the steps just described, that numerous guides must be resorted to as part of a lengthy trial-and-error procedure which, even when carried out in a comprehensive m~nn~, may lead to slight or even gross misalignments upon fixation of the ~inal implant components. The present invention solves many of these problems by providing cutting guides having transparent sections enabling the surgeon to visualize the underlying bone stock before, during and after each resection. In the case o~ the revision situation, or as part o~ a primary procedure wherein cutting blocks have been used, the invention ~urther ~1 ;m; n~tes the need ~or a W O 97/16129 PCT~US96/17691 -protracted trial reduction procedure by providing a cutting guide in the shape of the final implant component, thereby ensuring that once the guide is removed, the final implant component will inherently match the executed resections, thereby saving considerable time while improving accuracy.
One version of a cutting block according to the invention for femoral knee revision work is depicted in Figure 4. In this particular embodiment, a combination trial and cutting guide is provided under the assumption that box cuts have previously been made to accept the intercondylar structure 404. Broadly, in this case, the device includes one or more inner surfaces which are configured ~or correspondence with the resections carried out during the primary procedure, but, according to the invention, the device also includes outer surfaces which approximate the trial prosthesis or final implant shape, including outer condyle surface protrusions, only one side of which is partially visible as 404 in the figure. The device also includes a femoral stem 450, which may be detachable, as well as means for temporarily securing the device to the distal end of the ~emoral shaft, such as thum~b screws 408, which are adapted for engagement with anterior cortical regions, or, as an alternative, stabilization pin holes 410 associated with securing the device laterally or posteriorly. Any type of temporary securement means may be substituted for this optional feature, including tightening bands, outriggers, braces, or any combination of m~nll~lly operated fasteners or pin-receiving holes or guides, so long as the unit is held in position throughout the procedure.
To simultaneously function as a cutting guide, W O 97/16129 PCTrUS96/17691 -the device of Figure 4 also includes one or more slots such as 412 into which a conventional, oscillating saw blade may be inserted to perform a required resection. In the embo~;mPnt depicted in Figure 4, the device is preferably somewhat wider than the final implant, by an amount depicted as '~W'~ shown in the figure, to provide additional material beyond the slotted areas ~or greater structural stability. Inner surfaces of the device are proportioned, where necessary, by an amount "d" representative of the thickness of the cutting tool used to ensure that, once the combination trial/cutting guide is le",ov~d, the final implant mates accurately against the sur~aces resected.
Preferably the device accommodates sufficient slots and/or surfaces to perform all of the cuts necessary before the installation of a conventional revision prosthetic component, though alternative embodiments may include more or ~ewer such slots to accommodate a particular or specialized procedure. Depending upon the particular resection to be performed, multiple slots may also be provided to shape a particular surface, the depth of the slot finally relied upon being a function o~ bone deterioration in a particular region. For example, Figure 4 shows a set of two slots 416 for the distal condylar cuts and two slots 418 associated with trimming the bottom of the box resections. Preferably, such multiple slots, which may be two or more, are separated by an amount related to existing spacers, for example, 4 mm.
It should already be apparent that the invention is suitable to ~emoral knee revision arthroplasty whether or not box cuts have been provided as part o~ a primary procedure. I~ provided, the device o~ Figure 4 may be used CA 02236376 l998-04-30 directlyi if not, the device of Figures 5-8 may alternatively be used. The structure shown in Figure 5 iS
quite similar to that depicted in Figure 4, except the box structure 404 has been replaced with a passageway 506. The device still includes outer condylar surfaces, however, enabling the device to be used as both a trial and a cutting guide. This figure also shows an oscillating saw blade being placed in different slots or against different surfaces to provide the requisite cuts. For example, saw 10 blades 514 and 515 inserted through slots 512 or 513, may be used to form transverse intercondyle cuts, whereas, blades in positions 520 and 522 may be inserted for the chamfer cuts, and so on. In addition, although slots are not shown, by placing the blade against the surfaces 530 15 (not visible) and 532, cuts corresponding to the sides of the box structure may be performed. Blades in positions 540 and 542 may be used to make the bottom cuts associated with the box. In the case of position 540, the blade could rest against a surface (not shown) provided on the device, 20 whereas a slot 543 may be provided for a deeper box bottom cut using blade 542.
Figures 6 and 7 illustrate a further alternative embodiment for accurately providing box cuts in the event that such cuts were not performed previously. In Figure 6, 25 there is shown a block 604 removably attached to an implanted intermedullar stem 602. Once in place, a saw blade at position 608 may be moved along the left surface of the block 604 to make a side box cut 606, and a blade in position 610 may be moved along a right surface of the 30 block 604 to make a box cut 612. As an alternative to the use of outer surfaces of a cutting block such as 604, a guide with slots may also be lellwvdbly attached to the stem 602. To make the bottom cut of the box, a blade may be moved straight down into the page, riding against a rearward surface 618.
Now making reference to Figure 7, a device similar to that depicted in Figure 5 is shown generally at 702. Instead of providing a passageway 506 against which a ~lat saw may be placed to provide the box cuts, separate slots 705 are provided specifically for this purpose. This particular device may include a stem 706, but since the box cuts are not yet available, a trial is carried out in conjunction with a specialized tibial spacer 710 not having superior post protrusions should the joint configuration be stabilized in this m~nn~r Once the cuts 705 are performed, the overall device may be removed from the stem 706, and, assuming the stem connection is su~ficiently deep in the bone, the cut corresponding to the bottom of the box may be completed. Then a device such as that shown in Figure 4 may be inserted, as required, to carry out any necessary subse~uent resections.
Figure 8 shows yet another ~urther alternative embodiment of the invention. In this particular design, a stem 804 is provided, which is removably attachable to the bulk of the trial/cutting guide assembly 810 at an interface 812. As a compromise between the passageway 506 shown in Figure 5 and the complete box structure 404 shown in Figure 4, the stem 804 connects to a smaller box-shaped element 820, enabling a saw to be placed on either side to per~orm the side box cuts, as shown in phantom at 824 ~or the one side, or used ~rom above to ~orm the botto~ sur~ace of the box with a saw shown at position 830. ~aving W O 97/16129 PCTnJS96/17691 -carried out at least this partial bottom surface cut, the bulk of the element may be removed from the stem 804 at interface 812 and the saw in position 830 extending downwardly to finish off the bottom box surface cut. With the box cuts having been performed and with the stem 804 r~m~;n;ng in place, a device such as that shown in Figure 4, with the stem 450 being removable from the box 404 at the interface 460, may then be installed and the r~m~;n;ng resections performed.
In use, then, the invention affords a procedure which, in at least one respect, is essentially opposite to steps now being performed. That is, rather than making the various cuts (including the use of different saw guides), then performing a trial reduction, by using the present invention, in essence, a trial reduction is performed first with a trial having saw guide slots or surfaces. Once the various cuts have been made, the inventive combined trial/
saw guide is removed, at which point the surgeon realizes precisely which final implant to choose for permanent affixation. Not only will the surgeon know which final prosthetic component to select, but he or she will also know which spacers to use based upon the depth of slot used for the cut, and, since the combined trial/saw guide of this invention may be constructed with prior knowledge of the final implant configuration, misalignments of the type discussed earlier with regard to the implant stem are - m;n;m;zed. Due to the fact that a single guide may be used to perform numerous, accurate cuts, the invention should save considerable time while increasing the precision o~
both primary and revision arthroplasty in a wide variety of joint replacement and other orthopaedic situations including the tibial side o~ a knee replacement.
Having thus described my invention, I claim:
IMPLANTATION OF PROSTHETIC JOINT COMPONENTS
F;el~ of the Tnv~nt;o~
This invention concerns arthroplasty, and, more particularly, resides in improved cutting guides having features to better assist a surgeon in preparing a bone, for example, to receive an implant.
R~ckgrol~n~ of the ~nv~nt;on Whether for primary or revision arthroplasty, cutting guides are typically employed to ensure that the bone saw performs resections corresponding to mating surfaces of the prosthetic component. For example, in a femoral knee replacement, cutting guides or blocks are temporarily secured to the distal end of the femoral shaft, and include slots into which the blade of an oscillating saw is inserted to shape the end of the bone in accordance with corresponding surfaces of the prosthetic element.
In the case of a revision, the procedure is usually more elaborate due to deterioration of the previously prepared surfaces resulting from decomposition of the bone/prosthesis interface, necrosis, and other factors. Cutting blocks are also typically used in revision procedures, though bone deficiency often renders stabilization of the block impossible. In addition, if the cutting block includes a stem, the positioning of the stemmed implant can alter the fit of the final prothesis relative to the bone. More recently introduced techniques attempt to base the cuts on an intramedullary guide to which additional cutting blocks are mounted. Though such approaches improve bone cutting accuracy, there remains an unacceptable margin o~ error, the correction of which in some cases requiring a ~reehand shaping o~ the bone.
Sllmm~ry o~ the Inv~nt;o~
The present invention accordingly provides improved cutting guides which enable one per~orming a resection to better predict and execute required cut characteristics. Broadly, at least a portion o~ the body comprising the cutting guide is transparent, thereby enabling the practitioner to better estimate cut depth and/or visualize the resection as it is being per~ormed.
Pre~erably one or more slots are used to guide a cutting saw, with the volume o~ the body surrounding the slots being transparent.
In one embodiment, at least a portion o~ the outer sur~ace o~ the body is ~urther shaped to interact with another bone or prosthetic element as part of a joint, thereby enabling the device to ~unction both as a trial and as a cutting guide. For example, i~ adapted ~or use in ~emoral knee arthroplasty, the outer shape o~ the body may include condylar protrusions which cooperate with corresponding tibial sur~aces or prosthetic inserts. In this combination trial/cutting-guide embodiment the device may likewise advantageously be at least partially transparent to assist in estimating cut orientation or depth, and to visualize a particular resection in progress.
Although primarily intended ~or use in conjunction with preparing a bone sur~ace to receive a prosthetic component, the invention is applicable to any bone-cutting procedure which might bene~it ~rom improved accuracy.
W O 97/16129 PCTAJS96/17691 ~
Rr; ef Descr;pt;on of the Dr~w;ngs FIGURE 1 is an oblique drawing of the distal end of a femur, showing some of the resections typically used in conjunction with prosthetic implantation;
FIGURE 2 is an oblique drawing of a cutting guide adapted for primary femoral knee arthroplasty which, according to the invention, is constructed of transparent material;
FIGURE 3 is an oblique drawing of an existing prosthetic component adapted for mounting on the distal end of the femoral shaft including an intercondylar box structure;
FIGURE 4 is an improved cutting guide according to the invention, which includes outer surfaces appropriate to trial testing combined with cutting guides to facilitate efficient resection;
FIGURE 5 illustrates from an oblique perspective an alternative embodiment of the invention which facilitates box cuts if not already present;
FIGURE 6 is a top view of yet a further alternative embodiment of the invention involving the use of a box-cutting implement which may be L~llloved from an implanted stem onto which a combination trial and cutting guide may subse~uently be installed;
FIGURE 7 is a top view drawing of the combination trial/cutting guide referenced above with regard to Figure 6, now in position on the implanted stem; and FIGURE 8 is yet a further alternative embodiment of the invention including a stem configuration which facilitates at least partial box cut formation along with guides for other resections in a femoral knee application.
W O 97/16129 PCT~US96/17691 ~
Det~;le~ Descr;pt;on of the Preferre~ ~mhotl;m.onts In Figure 1 there is depicted a distal end portion 104 of a femur 102, which t~rm;n~tes in two bulbous protrusions 105 termed the medial and lateral condyles, which mate and engage with corresponding surfaces in the proximal end of the tibia. As a result of disease or injury, these mating surfaces, ordinarily smooth and cushioned by an intervening cartilage layer, disintegrate and/or become misshapen, resulting in restricted movement and pain.
To ameliorate these conditions, the orthopedic surgeon removes the llnh~lthy bone stock and replaces it with one or more metallic components which adhere to appropriately prepared bone sur~aces and approximate the outer, cortical layer of a healthy bone. To prepare the existing damaged or diseased bone to accept the implant components, various resections are made in a predetermined manner in correspondence with the inner surfaces of the implant. Using the ~emoral example of Figure 1, a saw guide is used to form resected sur~aces resulting ~rom an anterior chamfer cut 106, distal femoral articular surface cut 108, posterior chamfer cut 110, posterior-articular surface cut 112, and/or anterior articular surface CUt, which is typically performed prior to the articular chamfer cut. Although these cuts represent resections made in conjunction with a standard implant technique, more, fewer or different surfaces may be required, depending upon the level of deterioration or other circumstances.
Depending upon the saw guide used, either the cuts associated with only one of the condyles may be resected, or, alternatively, a guide having a dual set o~
slots may be utilized to trim both condyles simultaneously.
A singular type fixture is shown, ~or example, in U.S.
Patent No. 5,122,144, whereas guides having double sets of slots are shown in U.S. Patent Nos. 5,129,909 and 5,364,401. Numerous other examples are evident in the prior art, some of which are in commercial usage. The cuts associated with revision arthroplasty o~ the ~emoral component in a knee replacement are similar to those depicted in Figure 1, though now additional bone stock must be removed, and additional cuts closer to the central axis of the bone are typically made to accommodate a one-piece replacement unit having a intercondylar strengthening structure and posts extending there~rom for intramedullary implantation. Such a revision knee prosthesis is shown, for example, in U.S. Patent No. 4,936,847.
Whether ~or primary or revision arthroplasty, the saw guides involved are without exception now constructed o~ metal, and they are there~ore visually opaque. This results in a substantial piece of hardware which may be washed, sterilized and used repeatedly in numerous procedures, but, being opaque, the orthopedic surgeon is simply unable to see what he or she is doing while making the various bony cuts. As a result, it is often standard practice to make one or more cuts with the guide in place, then move the guide aside in order to view the interface, to ensure that sufficient bone has been removed to facilitate the most ideal cement interface between the resected bone and implant component. This trial-and-error process not only consumes valuable time during the operation, but may lead to the removal of more bone stock than necessary to achieve fixation.
During revision arthroplasty, such trial-and-error is that much more complicated and arduous, owing to the increased number of resected surfaced involved, and the need to ensure that these surfaces and the medullary stem are all properly aligned during the testing of trial implants and the attachment of the final prosthetic device.
In the event of a misalignment, the surgeon may choose to use a final implant having a smaller than optimal diameter stem, for example, to take up the slack upon discovering a slight misalignment with respect to the stem and the resected surfaces. This, in turn, may lead to an undesirable "play" between the stem of the prosthesis and the reamed medullary canal, and/or the need for medullary cementation which might otherwise be unnecessary.
According to this invention, then, improved cutting guides are provided to better assist the surgeon in performing accurate resections in an efficient manner. For example, guides adapted for use with primary arthroplasty have transparent features according to this invention, at least in the vicinity of the saw-receiving slots, thus enabling the surgeon to visualize the way in which the existing bone makes contact with the inner surfaces o$ the guide, and therefore facilitates a much more exacting initial set of cuts, in most cases, ideally eliminating trial-and-error entirely. In the case of revision work, the cuttiny guide itsel~ contains condylar and other outer surfaces enabling it to function both as a cutting guide and as a trial. Accordingly, once an initial trial procedure is carried out, the various resections may be performed, with a greater likelihood that they will be properly located, thereby increasing accuracy. Although a W O 97/16129 ~ PCT~US96/17691 -revision guide according to this invention need not be transparent, the combination o~ a combined trial/cutting guide constructed o~ a transparent material is pre~erred to realize the advantages set ~orth above.
Figure 2 illustrates one version o~ a cutting block constructed in accordance with the invention, in this case a guide for use in making initial articular sur~ace and cham~er cuts. Positioning o~ the block assumes the surgeon has ~irst made a distal ~emoral articular sur~ace cut against which the backside (not shown) o~ block 204 is seated while making these ~urther resections, the cham~er cuts being angular with respect thereto. This block 204 may be held against the bone through any attachment or stabilization means, including screws, pins, braces or other ~ixtures so long as the guide is appropriately secured. Importantly, and unlike all existing guides o~ this type, at least the right and le~t portions 208 and 210 are composed o~ a transparent material, and, pre~erably, the entire unit is clear and constructed o~ acrylic, polycarbonate or any other plastic or material substantial enough to withstand the oscillations o~ a bone saw or other cutting tool, yet su~iciently transparent to enable a surgeon to visualize the sur~aces to be resected in conjunction with a particular procedure. Pre~erably, this unit and others to be described o~ a cast plastic material such as acrylic or Lucite, having polished sur~aces, where necessary, to improve visualization.
In the case o~ primary arthroplasty, a cutting guide according to the invention need not assume the characteristics o~ that shown in Figure 2, but may assume CA 02236376 l998-04-30 W O 97/16129 PCT~US96/17691 -any suitable ~orm and may be used ~or any bone-forming purpose, whether or not resulting ~rom trauma. For example, the unit may resemble that shown in Figure 20 o~
Patent No. 5,234,433, which ~urther includes a guide slot to accommodate not only the cuts just described, but, in addition, the distal femoral articular surface cut creating surface 108 in Figure 1. For that matter, the broad principles o~ this invention are applicable to any type o~
cutting ~ixture, whether slotted or otherwise, adapted ~or use ~or prosthetic resection which might bene~it ~rom having any transparent portions or panels to assist the surgeon in better visualizing the bone preparation process.
This embodiment and those discussed below may also be adapted for use with cutting tools other than saw blades, including osteotomes, router bits, etc.
Re~erence will now be made to Figures 3-8, which represent embodiments o~ the invention more suitable to revision arthroplasty. Be~ore discussing the improved devices and methods made possible through the invention, however, existing approaches will first be discussed with particular regard to ~emoral knee surgery. In preparing the ~emur ~or a revision implant, the procedure may typically first include a drilling and reaming o~ the medullary canal to accept a sleeve and rod which extends outward and past the distal tip of the ~emoral shaft, and onto which various components are temporarily secured and stabilized to facilitate the various resections. For example, to perform the distal revision resection, an outrigger may be secured to the protruding stem and onto this placed a revision distal ~emoral cutting block, typically ~urther secured with pins, screws, or other means W O 97/16129 PCT~US96/17691 -engaged with the anterior cortex. Such a distal cutting guide typically includes various slots on either side to accommodate the lateral and medial resections at di~erent depths according to the level o~ bone loss on either side.
Having prepared the distal surfaces, this ~irst cutting block is removed and an anterior/posterior cutting block is installed onto the stem along with spacers in the event o~ di~erent depths o~ the lateral and medial distal resections. With the anterior/posterior cutting block secured in place, again with pins or screws, the anterior and posterolateral lateral cuts are made. Although the anterior cut is typically easily visualized as this region o~ the ~emoral sha~t is ~ully exposed during the procedure, as with the lateral resection(s), the posterolateral and posteromedial cuts are almost entirely hidden ~rom view.
Once the anterior and posterior resections are carried out, the cutting guide associated therewith is typically removed, and onto the medullary stem there is placed yet another guide used to per~orm notch and cham~er resections.
Figure 3 illustrates a typical prior-art revision implant, and additionally shows the orientation o~ the notch or "box" cuts to accommodate the intercondylar structure 302, which includes a transverse sur~ace 304 and side sur~aces 306 and 308 (not visible). The structure is box-shaped so that ~lat saw blades may be used to resect the bone and provide a more intimate and stable inter~ace.
~ As discussed above, this box-like structure 302 provides strength~n~ng between the two condylar halves, and allows room for superior post protrusion in posterior-stabilized 30 designs. The structure 302 also supports the stem 310, which is threadingly or compress-~it thereinto. A notch and chamfer cutting guide is typically used for the chamfer cuts and the cuts associated with the sides 306 and 308 of the intercondylar box, although the stem is typically removed to per~orm prox;m~l anterior chamfer resections.
The stem of the ~ixture must also be removed in order to make the transverse cut corresponding to the sur~ace 304.
Once all such guides or their equivalents have been used for the various cuts, the orthopedic surgeon typically must further progress through a trial reduction procedure which has matching inner surfaces, but varying thicknesses between the inner sur~aces and the outer joint surfaces, which are each tested, in turn, to ensure a correct joint line and femur-to-tibia orientation. Trial polyethylene inserts are also selected to provide m~; mllm range of motion and stability, at which point the femoral component may be implanted, in some cases utilizing spacers to accommodate the depth of cut determined as a ~unction of bone loss. Such spacers typically clip into place, as shown in Figures 1 through 4 of U.S. Patent 4,936,847.
It should be evident from the steps just described, that numerous guides must be resorted to as part of a lengthy trial-and-error procedure which, even when carried out in a comprehensive m~nn~, may lead to slight or even gross misalignments upon fixation of the ~inal implant components. The present invention solves many of these problems by providing cutting guides having transparent sections enabling the surgeon to visualize the underlying bone stock before, during and after each resection. In the case o~ the revision situation, or as part o~ a primary procedure wherein cutting blocks have been used, the invention ~urther ~1 ;m; n~tes the need ~or a W O 97/16129 PCT~US96/17691 -protracted trial reduction procedure by providing a cutting guide in the shape of the final implant component, thereby ensuring that once the guide is removed, the final implant component will inherently match the executed resections, thereby saving considerable time while improving accuracy.
One version of a cutting block according to the invention for femoral knee revision work is depicted in Figure 4. In this particular embodiment, a combination trial and cutting guide is provided under the assumption that box cuts have previously been made to accept the intercondylar structure 404. Broadly, in this case, the device includes one or more inner surfaces which are configured ~or correspondence with the resections carried out during the primary procedure, but, according to the invention, the device also includes outer surfaces which approximate the trial prosthesis or final implant shape, including outer condyle surface protrusions, only one side of which is partially visible as 404 in the figure. The device also includes a femoral stem 450, which may be detachable, as well as means for temporarily securing the device to the distal end of the ~emoral shaft, such as thum~b screws 408, which are adapted for engagement with anterior cortical regions, or, as an alternative, stabilization pin holes 410 associated with securing the device laterally or posteriorly. Any type of temporary securement means may be substituted for this optional feature, including tightening bands, outriggers, braces, or any combination of m~nll~lly operated fasteners or pin-receiving holes or guides, so long as the unit is held in position throughout the procedure.
To simultaneously function as a cutting guide, W O 97/16129 PCTrUS96/17691 -the device of Figure 4 also includes one or more slots such as 412 into which a conventional, oscillating saw blade may be inserted to perform a required resection. In the embo~;mPnt depicted in Figure 4, the device is preferably somewhat wider than the final implant, by an amount depicted as '~W'~ shown in the figure, to provide additional material beyond the slotted areas ~or greater structural stability. Inner surfaces of the device are proportioned, where necessary, by an amount "d" representative of the thickness of the cutting tool used to ensure that, once the combination trial/cutting guide is le",ov~d, the final implant mates accurately against the sur~aces resected.
Preferably the device accommodates sufficient slots and/or surfaces to perform all of the cuts necessary before the installation of a conventional revision prosthetic component, though alternative embodiments may include more or ~ewer such slots to accommodate a particular or specialized procedure. Depending upon the particular resection to be performed, multiple slots may also be provided to shape a particular surface, the depth of the slot finally relied upon being a function o~ bone deterioration in a particular region. For example, Figure 4 shows a set of two slots 416 for the distal condylar cuts and two slots 418 associated with trimming the bottom of the box resections. Preferably, such multiple slots, which may be two or more, are separated by an amount related to existing spacers, for example, 4 mm.
It should already be apparent that the invention is suitable to ~emoral knee revision arthroplasty whether or not box cuts have been provided as part o~ a primary procedure. I~ provided, the device o~ Figure 4 may be used CA 02236376 l998-04-30 directlyi if not, the device of Figures 5-8 may alternatively be used. The structure shown in Figure 5 iS
quite similar to that depicted in Figure 4, except the box structure 404 has been replaced with a passageway 506. The device still includes outer condylar surfaces, however, enabling the device to be used as both a trial and a cutting guide. This figure also shows an oscillating saw blade being placed in different slots or against different surfaces to provide the requisite cuts. For example, saw 10 blades 514 and 515 inserted through slots 512 or 513, may be used to form transverse intercondyle cuts, whereas, blades in positions 520 and 522 may be inserted for the chamfer cuts, and so on. In addition, although slots are not shown, by placing the blade against the surfaces 530 15 (not visible) and 532, cuts corresponding to the sides of the box structure may be performed. Blades in positions 540 and 542 may be used to make the bottom cuts associated with the box. In the case of position 540, the blade could rest against a surface (not shown) provided on the device, 20 whereas a slot 543 may be provided for a deeper box bottom cut using blade 542.
Figures 6 and 7 illustrate a further alternative embodiment for accurately providing box cuts in the event that such cuts were not performed previously. In Figure 6, 25 there is shown a block 604 removably attached to an implanted intermedullar stem 602. Once in place, a saw blade at position 608 may be moved along the left surface of the block 604 to make a side box cut 606, and a blade in position 610 may be moved along a right surface of the 30 block 604 to make a box cut 612. As an alternative to the use of outer surfaces of a cutting block such as 604, a guide with slots may also be lellwvdbly attached to the stem 602. To make the bottom cut of the box, a blade may be moved straight down into the page, riding against a rearward surface 618.
Now making reference to Figure 7, a device similar to that depicted in Figure 5 is shown generally at 702. Instead of providing a passageway 506 against which a ~lat saw may be placed to provide the box cuts, separate slots 705 are provided specifically for this purpose. This particular device may include a stem 706, but since the box cuts are not yet available, a trial is carried out in conjunction with a specialized tibial spacer 710 not having superior post protrusions should the joint configuration be stabilized in this m~nn~r Once the cuts 705 are performed, the overall device may be removed from the stem 706, and, assuming the stem connection is su~ficiently deep in the bone, the cut corresponding to the bottom of the box may be completed. Then a device such as that shown in Figure 4 may be inserted, as required, to carry out any necessary subse~uent resections.
Figure 8 shows yet another ~urther alternative embodiment of the invention. In this particular design, a stem 804 is provided, which is removably attachable to the bulk of the trial/cutting guide assembly 810 at an interface 812. As a compromise between the passageway 506 shown in Figure 5 and the complete box structure 404 shown in Figure 4, the stem 804 connects to a smaller box-shaped element 820, enabling a saw to be placed on either side to per~orm the side box cuts, as shown in phantom at 824 ~or the one side, or used ~rom above to ~orm the botto~ sur~ace of the box with a saw shown at position 830. ~aving W O 97/16129 PCTnJS96/17691 -carried out at least this partial bottom surface cut, the bulk of the element may be removed from the stem 804 at interface 812 and the saw in position 830 extending downwardly to finish off the bottom box surface cut. With the box cuts having been performed and with the stem 804 r~m~;n;ng in place, a device such as that shown in Figure 4, with the stem 450 being removable from the box 404 at the interface 460, may then be installed and the r~m~;n;ng resections performed.
In use, then, the invention affords a procedure which, in at least one respect, is essentially opposite to steps now being performed. That is, rather than making the various cuts (including the use of different saw guides), then performing a trial reduction, by using the present invention, in essence, a trial reduction is performed first with a trial having saw guide slots or surfaces. Once the various cuts have been made, the inventive combined trial/
saw guide is removed, at which point the surgeon realizes precisely which final implant to choose for permanent affixation. Not only will the surgeon know which final prosthetic component to select, but he or she will also know which spacers to use based upon the depth of slot used for the cut, and, since the combined trial/saw guide of this invention may be constructed with prior knowledge of the final implant configuration, misalignments of the type discussed earlier with regard to the implant stem are - m;n;m;zed. Due to the fact that a single guide may be used to perform numerous, accurate cuts, the invention should save considerable time while increasing the precision o~
both primary and revision arthroplasty in a wide variety of joint replacement and other orthopaedic situations including the tibial side o~ a knee replacement.
Having thus described my invention, I claim:
Claims (20)
1. A bone cutting guide, comprising:
a shaped body including means for guiding a bone-cutting tool, at least a portion of the body being transparent, thereby enabling a user to visualize a bone resection as it is being performed with the tool.
a shaped body including means for guiding a bone-cutting tool, at least a portion of the body being transparent, thereby enabling a user to visualize a bone resection as it is being performed with the tool.
2. The guide of claim 1, wherein the means for guiding a bone-cutting tool includes one or more slots formed through the body to guide a bone cutting saw.
3. The guide of claim 1, wherein the shape of the body is configured to co-act in a joint, thereby enabling the body to function as a trial as well as a cutting guide.
4. The guide of claim 3, the shape of the body including outer, condylar protrusions configured for use in femoral knee arthroplasty.
5. The guide of claim 1, further including means to hold the guide in place relative to the bone to be resected.
6. The guide of claim 5, the means to hold the guide in place to the bone to be resected including a projection which enters into the bone.
7. A combination trial and bone cutting guide adapted for use with a cutting tool exhibiting a cutting thickness and a prosthetic component having an inner, bone-contacting surface and an outer joint co-acting surface, the thickness between the inner and outer surfaces of the component defining a thickness T, the trial/cutting guide comprising:
a shaped body having an inner surface configured to mate with one or more resections made to the bone, and an outer surface configured to interact within a joint, the body further including one or more guides enabling additional resections to be performed with the cutting tool, and wherein at least a portion of the thickness between the inner and outer surfaces of the trial/cutting guide is less than T by an amount equal to the cutting thickness.
a shaped body having an inner surface configured to mate with one or more resections made to the bone, and an outer surface configured to interact within a joint, the body further including one or more guides enabling additional resections to be performed with the cutting tool, and wherein at least a portion of the thickness between the inner and outer surfaces of the trial/cutting guide is less than T by an amount equal to the cutting thickness.
8. The combination trial and bone cutting guide of claim 7, wherein the additional resections are associated with the implantation of the prosthetic component.
9. The cutting guide of claim 8, wherein the prosthetic component is associated with femoral knee arthroplasty.
10. The cutting guide of claim 7, wherein the cutting tool is a saw and the guides are in the form of slots.
11. The cutting guide of claim 7, wherein the least a portion of the combination trial and bone cutting guide is transparent, thereby enabling a user to visualize the additional bone resection as it is being performed.
12. The method of resecting a bone to receive a joint-related implant, comprising the steps of:
providing a combination trial and cutting guide;
installing the combination trial and cutting guide onto the end of the bone destined to receive the implant;
reducing the bone with the guide installed to test the joint; and upon a satisfactory reduction, resecting the end of the bone using the cutting guide as installed.
providing a combination trial and cutting guide;
installing the combination trial and cutting guide onto the end of the bone destined to receive the implant;
reducing the bone with the guide installed to test the joint; and upon a satisfactory reduction, resecting the end of the bone using the cutting guide as installed.
13. The method of claim 12, wherein the step of providing a combination trial and cutting guide includes the step of providing such d guide which is at least partially transparent.
14. In revision knee arthroplasty, wherein a final implant having outer condylar surfaces and an intercondylar box structure is to be installed onto the distal end of a femur, the method of preparing the femur to receive the final implant, comprising the steps of:
performing a series of box cuts into the end of the femur sufficient to receive the box structure;
providing a trial implant having outer condylar surfaces and a box structure which correspond to those of the final implant, the trial implant further including a plurality of bone-modification guides sufficient to perform all anterior, posterior, angled, and axial resections necessary to receive the final implant;
installing and securing the trial implant to the distal end of the femur;
performing a trial reduction with the trial implant in place; and in the event of a successful trial reduction, performing all required resections using the bone-modification guides, removing the trial implant, and installing the final implant.
performing a series of box cuts into the end of the femur sufficient to receive the box structure;
providing a trial implant having outer condylar surfaces and a box structure which correspond to those of the final implant, the trial implant further including a plurality of bone-modification guides sufficient to perform all anterior, posterior, angled, and axial resections necessary to receive the final implant;
installing and securing the trial implant to the distal end of the femur;
performing a trial reduction with the trial implant in place; and in the event of a successful trial reduction, performing all required resections using the bone-modification guides, removing the trial implant, and installing the final implant.
15. The method of claim 14, wherein the trial implant includes bone-modification guides capable of performing:
a distal cut, and both anterior and posterior chamfer cuts.
a distal cut, and both anterior and posterior chamfer cuts.
16. The method of claim 14, including the step of providing a trial implant having one or more guides to perform one or more of the box cuts.
17. The method of claim 14, wherein the step of performing a series of box cuts into the end of the femur further includes the steps of:
installing an intermedullary guide post;
installing, onto the guide post, a rectangular structure having surfaces which correspond to the box cuts;
and performing the box cuts using the surfaces of the rectangular structure as references.
installing an intermedullary guide post;
installing, onto the guide post, a rectangular structure having surfaces which correspond to the box cuts;
and performing the box cuts using the surfaces of the rectangular structure as references.
18. A trial implant for femoral revision knee arthroplasty including a cutting guide for performing box cuts associated with a certain class of final implants, the trial comprising:
a solid body having an outer condylar surface and a plurality of inner surfaces which correspond to resected surfaces on the distal end of a femur; and a rectangular aperture formed through a central region of the body, the aperture having one or more side surfaces which may be used as references to perform the box cuts.
a solid body having an outer condylar surface and a plurality of inner surfaces which correspond to resected surfaces on the distal end of a femur; and a rectangular aperture formed through a central region of the body, the aperture having one or more side surfaces which may be used as references to perform the box cuts.
19. The trial of claim 18, further including one or more slots into which a saw blade may be inserted to trim one of the resected surfaces.
20. The trial of claim 18, wherein the spacing between the outer condylar surface and that of at least one of the inner surfaces is slightly less than the corresponding thickness of the final implant to account for the thickness of the saw blade.
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US08/556,812 US5716361A (en) | 1995-11-02 | 1995-11-02 | Bone cutting guides for use in the implantation of prosthetic joint components |
US08/556,812 | 1995-11-02 |
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Families Citing this family (341)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5718717A (en) | 1996-08-19 | 1998-02-17 | Bonutti; Peter M. | Suture anchor |
US8545569B2 (en) | 2001-05-25 | 2013-10-01 | Conformis, Inc. | Patient selectable knee arthroplasty devices |
US20090222103A1 (en) * | 2001-05-25 | 2009-09-03 | Conformis, Inc. | Articular Implants Providing Lower Adjacent Cartilage Wear |
US8617242B2 (en) * | 2001-05-25 | 2013-12-31 | Conformis, Inc. | Implant device and method for manufacture |
US8771365B2 (en) * | 2009-02-25 | 2014-07-08 | Conformis, Inc. | Patient-adapted and improved orthopedic implants, designs, and related tools |
US7534263B2 (en) | 2001-05-25 | 2009-05-19 | Conformis, Inc. | Surgical tools facilitating increased accuracy, speed and simplicity in performing joint arthroplasty |
US8556983B2 (en) | 2001-05-25 | 2013-10-15 | Conformis, Inc. | Patient-adapted and improved orthopedic implants, designs and related tools |
US8480754B2 (en) | 2001-05-25 | 2013-07-09 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
US8735773B2 (en) | 2007-02-14 | 2014-05-27 | Conformis, Inc. | Implant device and method for manufacture |
US20110071645A1 (en) * | 2009-02-25 | 2011-03-24 | Ray Bojarski | Patient-adapted and improved articular implants, designs and related guide tools |
US9603711B2 (en) * | 2001-05-25 | 2017-03-28 | Conformis, Inc. | Patient-adapted and improved articular implants, designs and related guide tools |
US7468075B2 (en) | 2001-05-25 | 2008-12-23 | Conformis, Inc. | Methods and compositions for articular repair |
US20110071802A1 (en) * | 2009-02-25 | 2011-03-24 | Ray Bojarski | Patient-adapted and improved articular implants, designs and related guide tools |
US20070233269A1 (en) * | 2001-05-25 | 2007-10-04 | Conformis, Inc. | Interpositional Joint Implant |
US8882847B2 (en) * | 2001-05-25 | 2014-11-11 | Conformis, Inc. | Patient selectable knee joint arthroplasty devices |
US8083745B2 (en) * | 2001-05-25 | 2011-12-27 | Conformis, Inc. | Surgical tools for arthroplasty |
US7618451B2 (en) * | 2001-05-25 | 2009-11-17 | Conformis, Inc. | Patient selectable joint arthroplasty devices and surgical tools facilitating increased accuracy, speed and simplicity in performing total and partial joint arthroplasty |
WO1998032384A1 (en) | 1997-01-28 | 1998-07-30 | New York Society For The Relief Of The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Method and apparatus for femoral resection |
US6488687B1 (en) * | 1997-09-18 | 2002-12-03 | Medidea, Llc | Joint replacement method and apparatus |
US7419491B2 (en) * | 1997-09-18 | 2008-09-02 | Medidea, Llc | Bone-conserving orthopedic instrumentation and appliances |
FR2768922B1 (en) * | 1997-10-01 | 2000-01-14 | Tornier Sa | PROSTHESIS FOR BEING ANCHORED IN A LONG BONE |
FR2770393B1 (en) * | 1997-10-31 | 1999-12-31 | Protek Sa | FEMORAL CUTTING DEVICE FOR PLACING A TOTAL RECOVERY KNEE PROSTHESIS |
US5941881A (en) * | 1998-01-09 | 1999-08-24 | Medidea, Llc | Bone fastening apparatus and related procedures |
US6045551A (en) | 1998-02-06 | 2000-04-04 | Bonutti; Peter M. | Bone suture |
US6494913B1 (en) | 1998-03-17 | 2002-12-17 | Acumed, Inc. | Shoulder prosthesis |
US6258095B1 (en) * | 1998-03-28 | 2001-07-10 | Stryker Technologies Corporation | Methods and tools for femoral intermedullary revision surgery |
US7410482B2 (en) | 1998-09-04 | 2008-08-12 | Boston Scientific-Scimed, Inc. | Detachable aneurysm neck bridge |
US7239908B1 (en) * | 1998-09-14 | 2007-07-03 | The Board Of Trustees Of The Leland Stanford Junior University | Assessing the condition of a joint and devising treatment |
US7184814B2 (en) * | 1998-09-14 | 2007-02-27 | The Board Of Trustees Of The Leland Stanford Junior University | Assessing the condition of a joint and assessing cartilage loss |
ATE439806T1 (en) * | 1998-09-14 | 2009-09-15 | Univ Leland Stanford Junior | DETERMINING THE CONDITION OF A JOINT AND PREVENTING DAMAGE |
US20020198529A1 (en) * | 1999-02-16 | 2002-12-26 | Michael A. Masini | Optimizing patellar femoral mechanics through alternative depth referencing |
US6447516B1 (en) | 1999-08-09 | 2002-09-10 | Peter M. Bonutti | Method of securing tissue |
US6368343B1 (en) | 2000-03-13 | 2002-04-09 | Peter M. Bonutti | Method of using ultrasonic vibration to secure body tissue |
US7635390B1 (en) * | 2000-01-14 | 2009-12-22 | Marctec, Llc | Joint replacement component having a modular articulating surface |
US6702821B2 (en) | 2000-01-14 | 2004-03-09 | The Bonutti 2003 Trust A | Instrumentation for minimally invasive joint replacement and methods for using same |
US7104996B2 (en) * | 2000-01-14 | 2006-09-12 | Marctec. Llc | Method of performing surgery |
US6635073B2 (en) | 2000-05-03 | 2003-10-21 | Peter M. Bonutti | Method of securing body tissue |
IT1317747B1 (en) * | 2000-01-31 | 2003-07-15 | Medacta Sa | ANCILLARY EQUIPMENT FOR KNEE PROSTHESIS. |
JP5026651B2 (en) | 2000-03-10 | 2012-09-12 | スミス アンド ネフュー インコーポレーテッド | Device used for knee arthroplasty |
US6712856B1 (en) * | 2000-03-17 | 2004-03-30 | Kinamed, Inc. | Custom replacement device for resurfacing a femur and method of making the same |
ATE426357T1 (en) | 2000-09-14 | 2009-04-15 | Univ Leland Stanford Junior | ASSESSING THE CONDITION OF A JOINT AND PLANNING TREATMENT |
JP5127089B2 (en) | 2000-10-17 | 2013-01-23 | キヤノン株式会社 | Display device, projection display device, light modulation device driving device, and light modulation device driving method |
US7547307B2 (en) * | 2001-02-27 | 2009-06-16 | Smith & Nephew, Inc. | Computer assisted knee arthroplasty instrumentation, systems, and processes |
US20050113846A1 (en) * | 2001-02-27 | 2005-05-26 | Carson Christopher P. | Surgical navigation systems and processes for unicompartmental knee arthroplasty |
WO2002067784A2 (en) * | 2001-02-27 | 2002-09-06 | Smith & Nephew, Inc. | Surgical navigation systems and processes for unicompartmental knee |
JP2005504563A (en) * | 2001-05-25 | 2005-02-17 | イメージング セラピューティクス,インコーポレーテッド | Methods and compositions for resurfacing joints |
US8951260B2 (en) * | 2001-05-25 | 2015-02-10 | Conformis, Inc. | Surgical cutting guide |
US8439926B2 (en) | 2001-05-25 | 2013-05-14 | Conformis, Inc. | Patient selectable joint arthroplasty devices and surgical tools |
US6723102B2 (en) * | 2001-06-14 | 2004-04-20 | Alexandria Research Technologies, Llc | Apparatus and method for minimally invasive total joint replacement |
US7708741B1 (en) | 2001-08-28 | 2010-05-04 | Marctec, Llc | Method of preparing bones for knee replacement surgery |
US6719765B2 (en) | 2001-12-03 | 2004-04-13 | Bonutti 2003 Trust-A | Magnetic suturing system and method |
AU2003205311A1 (en) * | 2002-01-25 | 2003-09-02 | Depuy Products, Inc. | Extramedullary fluoroscopic alignment guide |
AU2003217389B2 (en) * | 2002-02-11 | 2008-10-30 | Smith & Nephew, Inc. | Image-guided fracture reduction |
US7172596B2 (en) * | 2002-03-05 | 2007-02-06 | Coon Thomas M | Minimally invasive total knee arthroplasty method and instrumentation |
US8801720B2 (en) * | 2002-05-15 | 2014-08-12 | Otismed Corporation | Total joint arthroplasty system |
US6962593B2 (en) * | 2002-06-04 | 2005-11-08 | Zimmer Technology, Inc. | Two-piece cut block for minimally invasive surgical procedure |
DE10233808B3 (en) * | 2002-07-25 | 2004-04-15 | Richard Wolf Gmbh | Bone-cutter for correcting ostetomy has bearing parts each containing a duct, slots meeting at acute angle and holding p iece of bone |
US7699851B2 (en) * | 2002-08-19 | 2010-04-20 | Dalton Brian E | Bone cutting jig system for spinal implant |
EP1555962B1 (en) * | 2002-10-07 | 2011-02-09 | Conformis, Inc. | Minimally invasive joint implant with 3-dimensional geometry matching the articular surfaces |
AU2003287190A1 (en) * | 2002-10-23 | 2004-05-13 | Alastair J. T. Clemow | Modular femoral component for a total knee joint replacement for minimally invasive implantation |
JP2006505366A (en) * | 2002-11-07 | 2006-02-16 | コンフォーミス・インコーポレイテッド | Method of determining meniscus size and shape and devised treatment |
FR2847453B1 (en) * | 2002-11-22 | 2005-09-23 | Jean Francois Biegun | ANCILLARIES, ESPECIALLY RAPE OR CUTTING BLOCK, FOR SINGLE USE, KIT COMPRISING ANCILLARIES AND METHOD OF MANUFACTURE |
US7094241B2 (en) | 2002-11-27 | 2006-08-22 | Zimmer Technology, Inc. | Method and apparatus for achieving correct limb alignment in unicondylar knee arthroplasty |
US7029477B2 (en) * | 2002-12-20 | 2006-04-18 | Zimmer Technology, Inc. | Surgical instrument and positioning method |
US7789885B2 (en) | 2003-01-15 | 2010-09-07 | Biomet Manufacturing Corp. | Instrumentation for knee resection |
US8551100B2 (en) | 2003-01-15 | 2013-10-08 | Biomet Manufacturing, Llc | Instrumentation for knee resection |
US7837690B2 (en) | 2003-01-15 | 2010-11-23 | Biomet Manufacturing Corp. | Method and apparatus for less invasive knee resection |
US7887542B2 (en) | 2003-01-15 | 2011-02-15 | Biomet Manufacturing Corp. | Method and apparatus for less invasive knee resection |
US7172597B2 (en) * | 2003-02-04 | 2007-02-06 | Zimmer Technology, Inc. | Provisional orthopedic implant and recutting instrument guide |
US7111401B2 (en) * | 2003-02-04 | 2006-09-26 | Eveready Battery Company, Inc. | Razor head having skin controlling means |
US7112204B2 (en) * | 2003-02-06 | 2006-09-26 | Medicinelodge, Inc. | Tibial tubercle osteotomy for total knee arthroplasty and instruments and implants therefor |
US8545506B2 (en) * | 2003-03-31 | 2013-10-01 | DePuy Synthes Products, LLC | Cutting guide for use with an extended articulation orthopaedic implant |
US8366713B2 (en) | 2003-03-31 | 2013-02-05 | Depuy Products, Inc. | Arthroplasty instruments and associated method |
US20040193278A1 (en) * | 2003-03-31 | 2004-09-30 | Maroney Brian J. | Articulating surface replacement prosthesis |
US7338498B2 (en) * | 2003-03-31 | 2008-03-04 | Depuy Products, Inc. | Prosthetic implant, trial and associated method |
US8105327B2 (en) | 2003-03-31 | 2012-01-31 | Depuy Products, Inc. | Punch, implant and associated method |
US7527631B2 (en) * | 2003-03-31 | 2009-05-05 | Depuy Products, Inc. | Arthroplasty sizing gauge |
US7517364B2 (en) | 2003-03-31 | 2009-04-14 | Depuy Products, Inc. | Extended articulation orthopaedic implant and associated method |
ATE327715T1 (en) * | 2003-04-25 | 2006-06-15 | Zimmer Gmbh | DEVICE FOR PREPARING A FEMURAL CONDYLE |
US7985225B2 (en) * | 2003-05-05 | 2011-07-26 | Alexandria Research Technologies, Llc | Apparatus and method for sculpting the surface of a joint |
US20050021037A1 (en) * | 2003-05-29 | 2005-01-27 | Mccombs Daniel L. | Image-guided navigated precision reamers |
US7559931B2 (en) * | 2003-06-09 | 2009-07-14 | OrthAlign, Inc. | Surgical orientation system and method |
US7104997B2 (en) * | 2003-06-19 | 2006-09-12 | Lionberger Jr David R | Cutting guide apparatus and surgical method for use in knee arthroplasty |
US7306607B2 (en) * | 2003-07-28 | 2007-12-11 | Biomet Manufacturing Corp. | Method and apparatus for minimally invasive distal femoral resection |
DE50300339D1 (en) | 2003-09-15 | 2005-04-07 | Zimmer Gmbh Winterthur | adjustment |
US7547327B2 (en) * | 2003-10-03 | 2009-06-16 | Howmedica Osteonics Corp. | Expandable augment trial |
US7862570B2 (en) | 2003-10-03 | 2011-01-04 | Smith & Nephew, Inc. | Surgical positioners |
CA2538126A1 (en) * | 2003-10-06 | 2005-05-06 | Smith & Nephew, Inc. | Modular navigated portal |
US7364580B2 (en) * | 2003-10-08 | 2008-04-29 | Biomet Manufacturing Corp. | Bone-cutting apparatus |
US7764985B2 (en) * | 2003-10-20 | 2010-07-27 | Smith & Nephew, Inc. | Surgical navigation system component fault interfaces and related processes |
US20050085822A1 (en) * | 2003-10-20 | 2005-04-21 | Thornberry Robert C. | Surgical navigation system component fault interfaces and related processes |
US7794467B2 (en) | 2003-11-14 | 2010-09-14 | Smith & Nephew, Inc. | Adjustable surgical cutting systems |
DE602004023422D1 (en) * | 2003-11-18 | 2009-11-12 | Smith & Nephew Inc | OPERATIVE TECHNIQUE AND INSTRUMENTS FOR MINIMAL INCISION HIP ARTHOPLASTY SURGERY |
US8657824B2 (en) * | 2003-11-18 | 2014-02-25 | Smith & Nephew, Inc. | Universal double offset surgical instrument |
US20050109855A1 (en) * | 2003-11-25 | 2005-05-26 | Mccombs Daniel | Methods and apparatuses for providing a navigational array |
US20050113659A1 (en) * | 2003-11-26 | 2005-05-26 | Albert Pothier | Device for data input for surgical navigation system |
US7488324B1 (en) | 2003-12-08 | 2009-02-10 | Biomet Manufacturing Corporation | Femoral guide for implanting a femoral knee prosthesis |
US7727281B2 (en) * | 2003-12-08 | 2010-06-01 | Ortho Development Corporation | Modular femoral knee stem extender |
US7641661B2 (en) | 2003-12-26 | 2010-01-05 | Zimmer Technology, Inc. | Adjustable resection guide |
JP2007523696A (en) * | 2004-01-16 | 2007-08-23 | スミス アンド ネフュー インコーポレーテッド | Computer-aided ligament balancing in total knee arthroplasty |
US20050159759A1 (en) * | 2004-01-20 | 2005-07-21 | Mark Harbaugh | Systems and methods for performing minimally invasive incisions |
JP2007518540A (en) * | 2004-01-22 | 2007-07-12 | スミス アンド ネフュー インコーポレーテッド | Method, system and apparatus for providing a surgical navigation sensor attached to a patient |
US7901411B2 (en) * | 2004-02-10 | 2011-03-08 | Smith & Nephew, Inc. | Hip replacement incision locator |
US7879042B2 (en) * | 2004-03-05 | 2011-02-01 | Depuy Products, Inc. | Surface replacement extractor device and associated method |
GB0405294D0 (en) * | 2004-03-09 | 2004-04-21 | Imp Ltd | Apparatus for use in orthopaedic surgery |
US20060089621A1 (en) * | 2004-03-18 | 2006-04-27 | Mike Fard | Bone mill and template |
US7632277B2 (en) * | 2004-03-29 | 2009-12-15 | Woll Bioorthopedics Llc | Orthopedic intramedullary fixation system |
US20050234466A1 (en) * | 2004-03-31 | 2005-10-20 | Jody Stallings | TLS adjustable block |
US20050234465A1 (en) * | 2004-03-31 | 2005-10-20 | Mccombs Daniel L | Guided saw with pins |
AU2005231404B9 (en) * | 2004-03-31 | 2012-04-26 | Smith & Nephew, Inc. | Methods and apparatuses for providing a reference array input device |
US7621919B2 (en) * | 2004-04-08 | 2009-11-24 | Howmedica Osteonics Corp. | Orthopedic cutting block |
US20050228404A1 (en) * | 2004-04-12 | 2005-10-13 | Dirk Vandevelde | Surgical navigation system component automated imaging navigation and related processes |
US20070287910A1 (en) * | 2004-04-15 | 2007-12-13 | Jody Stallings | Quick Disconnect and Repositionable Reference Frame for Computer Assisted Surgery |
WO2005104978A1 (en) * | 2004-04-21 | 2005-11-10 | Smith & Nephew, Inc. | Computer-aided methods, systems, and apparatuses for shoulder arthroplasty |
US7666187B2 (en) * | 2004-04-22 | 2010-02-23 | Howmedica Osteonics Corp. | Bone shaped cutting block |
US20050279368A1 (en) * | 2004-06-16 | 2005-12-22 | Mccombs Daniel L | Computer assisted surgery input/output systems and processes |
US20060025775A1 (en) * | 2004-07-28 | 2006-02-02 | Howmedica Osteonics Corp. | Femoral neck resection guide and method |
US8167888B2 (en) * | 2004-08-06 | 2012-05-01 | Zimmer Technology, Inc. | Tibial spacer blocks and femoral cutting guide |
DE102004063977A1 (en) * | 2004-10-19 | 2006-06-22 | Mathys Ag Bettlach | Ligament Tension Device, Cutting Guide and Osteotomy Technique |
EP1835967A1 (en) * | 2004-12-02 | 2007-09-26 | Smith and Nephew, Inc. | Systems for providing a reference plane for mounting an acetabular cup |
US20060200025A1 (en) * | 2004-12-02 | 2006-09-07 | Scott Elliott | Systems, methods, and apparatus for automatic software flow using instrument detection during computer-aided surgery |
US7056156B1 (en) * | 2004-12-06 | 2006-06-06 | Jds Uniphase Corporation | Vertically offset EMI projections |
CA2591977C (en) * | 2004-12-21 | 2013-07-30 | Smith & Nephew, Inc. | Distal femoral trial with removable cutting guide |
AU2006200152B2 (en) * | 2005-01-14 | 2012-06-07 | Smith & Nephew, Inc. | Hip replacement incision locator |
US20060161051A1 (en) * | 2005-01-18 | 2006-07-20 | Lauralan Terrill-Grisoni | Method of computer-assisted ligament balancing and component placement in total knee arthroplasty |
JP2008531091A (en) | 2005-02-22 | 2008-08-14 | スミス アンド ネフュー インコーポレーテッド | In-line milling system |
US20060217734A1 (en) * | 2005-03-09 | 2006-09-28 | Zimmer Technology, Inc. | Femoral resection guide apparatus and method |
US7628794B2 (en) * | 2005-04-06 | 2009-12-08 | Trigon Inc. | Prosthetic revision knee system |
US7695479B1 (en) | 2005-04-12 | 2010-04-13 | Biomet Manufacturing Corp. | Femoral sizer |
GB0510194D0 (en) * | 2005-05-19 | 2005-06-22 | Mcminn Derek J W | Knee prosthesis |
US7983777B2 (en) * | 2005-08-19 | 2011-07-19 | Mark Melton | System for biomedical implant creation and procurement |
WO2007035713A2 (en) * | 2005-09-16 | 2007-03-29 | Small Bone Innovations, Inc. | Condylar plate |
EP1928359A4 (en) * | 2005-09-30 | 2010-10-13 | Conformis Inc | Joint arthroplasty devices |
US20070118055A1 (en) * | 2005-11-04 | 2007-05-24 | Smith & Nephew, Inc. | Systems and methods for facilitating surgical procedures involving custom medical implants |
US7618422B2 (en) | 2005-11-07 | 2009-11-17 | Howmedica Osteonics Corp. | Tibial augmentation guide |
EP1951158A4 (en) * | 2005-11-21 | 2010-03-31 | Vertegen Inc | Devices and methods for treating facet joints, uncovertebral joints, costovertebral joints and other joints |
US7780671B2 (en) | 2006-01-23 | 2010-08-24 | Zimmer Technology, Inc. | Bone resection apparatus and method for knee surgery |
US8623026B2 (en) | 2006-02-06 | 2014-01-07 | Conformis, Inc. | Patient selectable joint arthroplasty devices and surgical tools incorporating anatomical relief |
WO2007092841A2 (en) * | 2006-02-06 | 2007-08-16 | Conformis, Inc. | Patient selectable joint arthroplasty devices and surgical tools |
EP2007291A2 (en) * | 2006-02-15 | 2008-12-31 | Otismed Corp. | Arthroplasty jigs and related methods |
US9808262B2 (en) | 2006-02-15 | 2017-11-07 | Howmedica Osteonics Corporation | Arthroplasty devices and related methods |
US9907659B2 (en) * | 2007-04-17 | 2018-03-06 | Biomet Manufacturing, Llc | Method and apparatus for manufacturing an implant |
US9289253B2 (en) | 2006-02-27 | 2016-03-22 | Biomet Manufacturing, Llc | Patient-specific shoulder guide |
US8603180B2 (en) | 2006-02-27 | 2013-12-10 | Biomet Manufacturing, Llc | Patient-specific acetabular alignment guides |
US8133234B2 (en) * | 2006-02-27 | 2012-03-13 | Biomet Manufacturing Corp. | Patient specific acetabular guide and method |
US8298237B2 (en) * | 2006-06-09 | 2012-10-30 | Biomet Manufacturing Corp. | Patient-specific alignment guide for multiple incisions |
US20110190899A1 (en) * | 2006-02-27 | 2011-08-04 | Biomet Manufacturing Corp. | Patient-specific augments |
US9918740B2 (en) | 2006-02-27 | 2018-03-20 | Biomet Manufacturing, Llc | Backup surgical instrument system and method |
US9113971B2 (en) | 2006-02-27 | 2015-08-25 | Biomet Manufacturing, Llc | Femoral acetabular impingement guide |
US20150335438A1 (en) | 2006-02-27 | 2015-11-26 | Biomet Manufacturing, Llc. | Patient-specific augments |
US20110172672A1 (en) * | 2006-02-27 | 2011-07-14 | Biomet Manufacturing Corp. | Instrument with transparent portion for use with patient-specific alignment guide |
US8864769B2 (en) * | 2006-02-27 | 2014-10-21 | Biomet Manufacturing, Llc | Alignment guides with patient-specific anchoring elements |
US8568487B2 (en) | 2006-02-27 | 2013-10-29 | Biomet Manufacturing, Llc | Patient-specific hip joint devices |
US8608749B2 (en) | 2006-02-27 | 2013-12-17 | Biomet Manufacturing, Llc | Patient-specific acetabular guides and associated instruments |
US7967868B2 (en) | 2007-04-17 | 2011-06-28 | Biomet Manufacturing Corp. | Patient-modified implant and associated method |
US7780672B2 (en) | 2006-02-27 | 2010-08-24 | Biomet Manufacturing Corp. | Femoral adjustment device and associated method |
US8070752B2 (en) | 2006-02-27 | 2011-12-06 | Biomet Manufacturing Corp. | Patient specific alignment guide and inter-operative adjustment |
US9345548B2 (en) * | 2006-02-27 | 2016-05-24 | Biomet Manufacturing, Llc | Patient-specific pre-operative planning |
US8858561B2 (en) * | 2006-06-09 | 2014-10-14 | Blomet Manufacturing, LLC | Patient-specific alignment guide |
US9339278B2 (en) | 2006-02-27 | 2016-05-17 | Biomet Manufacturing, Llc | Patient-specific acetabular guides and associated instruments |
US8535387B2 (en) | 2006-02-27 | 2013-09-17 | Biomet Manufacturing, Llc | Patient-specific tools and implants |
US8377066B2 (en) * | 2006-02-27 | 2013-02-19 | Biomet Manufacturing Corp. | Patient-specific elbow guides and associated methods |
US8591516B2 (en) | 2006-02-27 | 2013-11-26 | Biomet Manufacturing, Llc | Patient-specific orthopedic instruments |
US9173661B2 (en) | 2006-02-27 | 2015-11-03 | Biomet Manufacturing, Llc | Patient specific alignment guide with cutting surface and laser indicator |
US8473305B2 (en) * | 2007-04-17 | 2013-06-25 | Biomet Manufacturing Corp. | Method and apparatus for manufacturing an implant |
US8608748B2 (en) * | 2006-02-27 | 2013-12-17 | Biomet Manufacturing, Llc | Patient specific guides |
US8241293B2 (en) * | 2006-02-27 | 2012-08-14 | Biomet Manufacturing Corp. | Patient specific high tibia osteotomy |
US8407067B2 (en) | 2007-04-17 | 2013-03-26 | Biomet Manufacturing Corp. | Method and apparatus for manufacturing an implant |
US10278711B2 (en) * | 2006-02-27 | 2019-05-07 | Biomet Manufacturing, Llc | Patient-specific femoral guide |
US20080257363A1 (en) * | 2007-04-17 | 2008-10-23 | Biomet Manufacturing Corp. | Method And Apparatus For Manufacturing An Implant |
US8282646B2 (en) | 2006-02-27 | 2012-10-09 | Biomet Manufacturing Corp. | Patient specific knee alignment guide and associated method |
US8092465B2 (en) | 2006-06-09 | 2012-01-10 | Biomet Manufacturing Corp. | Patient specific knee alignment guide and associated method |
US7704253B2 (en) * | 2006-03-06 | 2010-04-27 | Howmedica Osteonics Corp. | Single use resection guide |
US7967824B2 (en) * | 2006-05-19 | 2011-06-28 | Greatbatch Medical S.A. | Bone cutting fixture assembly with guide appendages |
US7695520B2 (en) | 2006-05-31 | 2010-04-13 | Biomet Manufacturing Corp. | Prosthesis and implementation system |
US9795399B2 (en) | 2006-06-09 | 2017-10-24 | Biomet Manufacturing, Llc | Patient-specific knee alignment guide and associated method |
US8021369B2 (en) * | 2006-06-12 | 2011-09-20 | Howmedica Osteonics Corp. | Navigated femoral neck resection guide and method |
US7678115B2 (en) * | 2006-06-21 | 2010-03-16 | Howmedia Osteonics Corp. | Unicondylar knee implants and insertion methods therefor |
US20080015602A1 (en) * | 2006-06-22 | 2008-01-17 | Howmedica Osteonics Corp. | Cutting block for bone resection |
US8372078B2 (en) | 2006-06-30 | 2013-02-12 | Howmedica Osteonics Corp. | Method for performing a high tibial osteotomy |
EP2083713B1 (en) | 2006-10-31 | 2016-07-27 | Smith & Nephew, Inc. | Trial femoral prosthesis and its use |
US8460302B2 (en) | 2006-12-18 | 2013-06-11 | Otismed Corporation | Arthroplasty devices and related methods |
US8016833B2 (en) * | 2006-12-20 | 2011-09-13 | Howmedica Osteonics Corp. | Femoral cutting block |
US8821500B2 (en) * | 2006-12-20 | 2014-09-02 | Howmedica Osteonics Corp. | Femoral cutting block |
US8328873B2 (en) | 2007-01-10 | 2012-12-11 | Biomet Manufacturing Corp. | Knee joint prosthesis system and method for implantation |
US8163028B2 (en) | 2007-01-10 | 2012-04-24 | Biomet Manufacturing Corp. | Knee joint prosthesis system and method for implantation |
US8157869B2 (en) | 2007-01-10 | 2012-04-17 | Biomet Manufacturing Corp. | Knee joint prosthesis system and method for implantation |
US8562616B2 (en) | 2007-10-10 | 2013-10-22 | Biomet Manufacturing, Llc | Knee joint prosthesis system and method for implantation |
US8187280B2 (en) | 2007-10-10 | 2012-05-29 | Biomet Manufacturing Corp. | Knee joint prosthesis system and method for implantation |
US8282644B2 (en) * | 2007-01-17 | 2012-10-09 | Edwards Scott G | System and method for bone shortening |
US8628560B2 (en) * | 2007-03-08 | 2014-01-14 | DePuy Synthes Products, LLC | Orthopaedic instrumentation with integral load-bearing members |
US8142510B2 (en) * | 2007-03-30 | 2012-03-27 | Depuy Products, Inc. | Mobile bearing assembly having a non-planar interface |
US8147557B2 (en) * | 2007-03-30 | 2012-04-03 | Depuy Products, Inc. | Mobile bearing insert having offset dwell point |
US8764841B2 (en) * | 2007-03-30 | 2014-07-01 | DePuy Synthes Products, LLC | Mobile bearing assembly having a closed track |
US8328874B2 (en) * | 2007-03-30 | 2012-12-11 | Depuy Products, Inc. | Mobile bearing assembly |
US8147558B2 (en) * | 2007-03-30 | 2012-04-03 | Depuy Products, Inc. | Mobile bearing assembly having multiple articulation interfaces |
US8926618B2 (en) * | 2007-04-19 | 2015-01-06 | Howmedica Osteonics Corp. | Cutting guide with internal distraction |
US20090062928A1 (en) * | 2007-09-05 | 2009-03-05 | Mark Pitkin | In-bone implantable shaft for prosthetic joints or for direct skeletal attachment of external limb prostheses and method of its installation |
US8197486B2 (en) * | 2007-09-20 | 2012-06-12 | Depuy Products, Inc. | Surgical cutting guide |
US8265949B2 (en) | 2007-09-27 | 2012-09-11 | Depuy Products, Inc. | Customized patient surgical plan |
US8038681B2 (en) * | 2007-09-30 | 2011-10-18 | Depuy Products, Inc. | Modular femoral orthopaedic surgical instrument |
CN102670275B (en) | 2007-09-30 | 2016-01-20 | 德普伊产品公司 | The patient-specific orthopaedic surgical instrumentation of customization |
WO2011106430A1 (en) | 2010-02-25 | 2011-09-01 | Depuy Products, Inc | Customized patient-specific bone cutting blocks |
US9173662B2 (en) | 2007-09-30 | 2015-11-03 | DePuy Synthes Products, Inc. | Customized patient-specific tibial cutting blocks |
US8357111B2 (en) | 2007-09-30 | 2013-01-22 | Depuy Products, Inc. | Method and system for designing patient-specific orthopaedic surgical instruments |
USD642263S1 (en) | 2007-10-25 | 2011-07-26 | Otismed Corporation | Arthroplasty jig blank |
US8460303B2 (en) * | 2007-10-25 | 2013-06-11 | Otismed Corporation | Arthroplasty systems and devices, and related methods |
US10582934B2 (en) * | 2007-11-27 | 2020-03-10 | Howmedica Osteonics Corporation | Generating MRI images usable for the creation of 3D bone models employed to make customized arthroplasty jigs |
CN106037872B (en) | 2007-12-06 | 2020-01-07 | 史密夫和内修有限公司 | System and method for determining a mechanical axis of a femur |
US8160345B2 (en) | 2008-04-30 | 2012-04-17 | Otismed Corporation | System and method for image segmentation in generating computer models of a joint to undergo arthroplasty |
US8221430B2 (en) | 2007-12-18 | 2012-07-17 | Otismed Corporation | System and method for manufacturing arthroplasty jigs |
US8777875B2 (en) | 2008-07-23 | 2014-07-15 | Otismed Corporation | System and method for manufacturing arthroplasty jigs having improved mating accuracy |
US8545509B2 (en) | 2007-12-18 | 2013-10-01 | Otismed Corporation | Arthroplasty system and related methods |
US8715291B2 (en) * | 2007-12-18 | 2014-05-06 | Otismed Corporation | Arthroplasty system and related methods |
US8311306B2 (en) * | 2008-04-30 | 2012-11-13 | Otismed Corporation | System and method for image segmentation in generating computer models of a joint to undergo arthroplasty |
US8737700B2 (en) * | 2007-12-18 | 2014-05-27 | Otismed Corporation | Preoperatively planning an arthroplasty procedure and generating a corresponding patient specific arthroplasty resection guide |
US8617171B2 (en) | 2007-12-18 | 2013-12-31 | Otismed Corporation | Preoperatively planning an arthroplasty procedure and generating a corresponding patient specific arthroplasty resection guide |
US8480679B2 (en) | 2008-04-29 | 2013-07-09 | Otismed Corporation | Generation of a computerized bone model representative of a pre-degenerated state and useable in the design and manufacture of arthroplasty devices |
US8734455B2 (en) * | 2008-02-29 | 2014-05-27 | Otismed Corporation | Hip resurfacing surgical guide tool |
WO2009111656A1 (en) * | 2008-03-05 | 2009-09-11 | Conformis, Inc. | Edge-matched articular implant |
US8682052B2 (en) | 2008-03-05 | 2014-03-25 | Conformis, Inc. | Implants for altering wear patterns of articular surfaces |
US8152846B2 (en) * | 2008-03-06 | 2012-04-10 | Musculoskeletal Transplant Foundation | Instrumentation and method for repair of meniscus tissue |
EP2303193A4 (en) * | 2008-05-12 | 2012-03-21 | Conformis Inc | Devices and methods for treatment of facet and other joints |
US8617175B2 (en) * | 2008-12-16 | 2013-12-31 | Otismed Corporation | Unicompartmental customized arthroplasty cutting jigs and methods of making the same |
US8078440B2 (en) | 2008-09-19 | 2011-12-13 | Smith & Nephew, Inc. | Operatively tuning implants for increased performance |
US8192441B2 (en) | 2008-10-03 | 2012-06-05 | Howmedica Osteonics Corp. | High tibial osteotomy instrumentation |
US8170641B2 (en) * | 2009-02-20 | 2012-05-01 | Biomet Manufacturing Corp. | Method of imaging an extremity of a patient |
US8808297B2 (en) | 2009-02-24 | 2014-08-19 | Microport Orthopedics Holdings Inc. | Orthopedic surgical guide |
WO2010099231A2 (en) | 2009-02-24 | 2010-09-02 | Conformis, Inc. | Automated systems for manufacturing patient-specific orthopedic implants and instrumentation |
US9017334B2 (en) | 2009-02-24 | 2015-04-28 | Microport Orthopedics Holdings Inc. | Patient specific surgical guide locator and mount |
US8808303B2 (en) | 2009-02-24 | 2014-08-19 | Microport Orthopedics Holdings Inc. | Orthopedic surgical guide |
SG175229A1 (en) | 2009-04-16 | 2011-11-28 | Conformis Inc | Patient-specific joint arthroplasty devices for ligament repair |
US8794977B2 (en) * | 2009-04-29 | 2014-08-05 | Lifemodeler, Inc. | Implant training system |
DE102009028503B4 (en) | 2009-08-13 | 2013-11-14 | Biomet Manufacturing Corp. | Resection template for the resection of bones, method for producing such a resection template and operation set for performing knee joint surgery |
US8403935B2 (en) * | 2009-11-10 | 2013-03-26 | Wright Medical Technology, Inc. | Adjustable revision guide |
EP2509539B1 (en) * | 2009-12-11 | 2020-07-01 | ConforMIS, Inc. | Patient-specific and patient-engineered orthopedic implants |
JP4995888B2 (en) * | 2009-12-15 | 2012-08-08 | 株式会社神戸製鋼所 | Stainless steel arc welding flux cored wire |
EP2538855A4 (en) | 2010-02-25 | 2016-08-03 | Depuy Products Inc | Customized patient-specific tibial cutting blocks |
WO2011106407A1 (en) | 2010-02-25 | 2011-09-01 | Depuy Products, Inc. | Method of fabricating customized patient-specific bone cutting blocks |
EP2538853A4 (en) | 2010-02-25 | 2016-07-27 | Depuy Products Inc | Customized patient-specific bone cutting blocks |
US8632547B2 (en) * | 2010-02-26 | 2014-01-21 | Biomet Sports Medicine, Llc | Patient-specific osteotomy devices and methods |
US9066727B2 (en) | 2010-03-04 | 2015-06-30 | Materialise Nv | Patient-specific computed tomography guides |
GB201006716D0 (en) * | 2010-04-22 | 2010-06-09 | Depuy Ireland | A composite trial prosthesis |
US9386994B2 (en) | 2010-06-11 | 2016-07-12 | Smith & Nephew, Inc. | Patient-matched instruments |
US9119644B2 (en) * | 2010-08-21 | 2015-09-01 | New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery | Instruments for use in femoroacetabular impingement procedures |
US9011453B2 (en) * | 2010-09-10 | 2015-04-21 | Zimmer, Inc. | Bone preserving intraoperative downsizing system for orthopaedic implants |
US8758356B2 (en) | 2010-09-24 | 2014-06-24 | Arthrex, Inc. | Methods and apparatus for preparing an intercondylar area of a distal femur |
US9271744B2 (en) | 2010-09-29 | 2016-03-01 | Biomet Manufacturing, Llc | Patient-specific guide for partial acetabular socket replacement |
US9492183B2 (en) * | 2010-10-14 | 2016-11-15 | Smith & Nephew, Inc. | Patient-matched instrumentation and methods |
US9968376B2 (en) | 2010-11-29 | 2018-05-15 | Biomet Manufacturing, Llc | Patient-specific orthopedic instruments |
EP2754419B1 (en) | 2011-02-15 | 2024-02-07 | ConforMIS, Inc. | Patient-adapted and improved orthopedic implants |
US9241745B2 (en) | 2011-03-07 | 2016-01-26 | Biomet Manufacturing, Llc | Patient-specific femoral version guide |
US8715289B2 (en) | 2011-04-15 | 2014-05-06 | Biomet Manufacturing, Llc | Patient-specific numerically controlled instrument |
US9675400B2 (en) | 2011-04-19 | 2017-06-13 | Biomet Manufacturing, Llc | Patient-specific fracture fixation instrumentation and method |
US8668700B2 (en) | 2011-04-29 | 2014-03-11 | Biomet Manufacturing, Llc | Patient-specific convertible guides |
US8956364B2 (en) | 2011-04-29 | 2015-02-17 | Biomet Manufacturing, Llc | Patient-specific partial knee guides and other instruments |
US8979847B2 (en) | 2011-06-06 | 2015-03-17 | Biomet Manufacturing, Llc | Method and apparatus for implanting a knee prosthesis |
US8532807B2 (en) | 2011-06-06 | 2013-09-10 | Biomet Manufacturing, Llc | Pre-operative planning and manufacturing method for orthopedic procedure |
US9084618B2 (en) | 2011-06-13 | 2015-07-21 | Biomet Manufacturing, Llc | Drill guides for confirming alignment of patient-specific alignment guides |
JP6121406B2 (en) | 2011-06-16 | 2017-04-26 | スミス アンド ネフュー インコーポレイテッド | Surgical alignment using criteria |
AU2012273645B2 (en) | 2011-06-22 | 2016-11-17 | Medacta International S.A. | Device for patellar resurfacing |
US8968412B2 (en) | 2011-06-30 | 2015-03-03 | Depuy (Ireland) | Trialing system for a knee prosthesis and method of use |
CN103841908B (en) | 2011-06-30 | 2016-08-17 | 德普伊(爱尔兰)有限公司 | Patella fixture and brill guider surgical instruments |
US8641721B2 (en) | 2011-06-30 | 2014-02-04 | DePuy Synthes Products, LLC | Customized patient-specific orthopaedic pin guides |
US8986306B2 (en) | 2011-06-30 | 2015-03-24 | Depuy (Ireland) | Patella orthopaedic surgical method |
US8979854B2 (en) | 2011-06-30 | 2015-03-17 | Depuy (Ireland) | Patella orthopaedic surgical instrument assembly |
US8968321B2 (en) | 2011-06-30 | 2015-03-03 | Depuy (Ireland) | Patella resection guide with locating features and method of using the same |
US8764760B2 (en) | 2011-07-01 | 2014-07-01 | Biomet Manufacturing, Llc | Patient-specific bone-cutting guidance instruments and methods |
US20130001121A1 (en) | 2011-07-01 | 2013-01-03 | Biomet Manufacturing Corp. | Backup kit for a patient-specific arthroplasty kit assembly |
US8597365B2 (en) | 2011-08-04 | 2013-12-03 | Biomet Manufacturing, Llc | Patient-specific pelvic implants for acetabular reconstruction |
EP2561814A1 (en) * | 2011-08-25 | 2013-02-27 | Deru GmbH | Cutting guide for creating an external contour for an articulated endoprosthetic |
US9066734B2 (en) | 2011-08-31 | 2015-06-30 | Biomet Manufacturing, Llc | Patient-specific sacroiliac guides and associated methods |
US9295497B2 (en) | 2011-08-31 | 2016-03-29 | Biomet Manufacturing, Llc | Patient-specific sacroiliac and pedicle guides |
US9386993B2 (en) | 2011-09-29 | 2016-07-12 | Biomet Manufacturing, Llc | Patient-specific femoroacetabular impingement instruments and methods |
EP2770918B1 (en) | 2011-10-27 | 2017-07-19 | Biomet Manufacturing, LLC | Patient-specific glenoid guides |
KR20130046337A (en) | 2011-10-27 | 2013-05-07 | 삼성전자주식회사 | Multi-view device and contol method thereof, display apparatus and contol method thereof, and display system |
US9301812B2 (en) | 2011-10-27 | 2016-04-05 | Biomet Manufacturing, Llc | Methods for patient-specific shoulder arthroplasty |
US9451973B2 (en) | 2011-10-27 | 2016-09-27 | Biomet Manufacturing, Llc | Patient specific glenoid guide |
US9554910B2 (en) | 2011-10-27 | 2017-01-31 | Biomet Manufacturing, Llc | Patient-specific glenoid guide and implants |
FR2986415A1 (en) * | 2012-02-06 | 2013-08-09 | Tornier Sa | SURGICAL INSTRUMENTATION ASSEMBLY FOR POSTING AN ANKLE PROSTHESIS |
US9237950B2 (en) | 2012-02-02 | 2016-01-19 | Biomet Manufacturing, Llc | Implant with patient-specific porous structure |
US9486226B2 (en) | 2012-04-18 | 2016-11-08 | Conformis, Inc. | Tibial guides, tools, and techniques for resecting the tibial plateau |
US9033989B2 (en) * | 2012-06-04 | 2015-05-19 | Depuy (Ireland) | Surgical cutting guide |
US9675471B2 (en) | 2012-06-11 | 2017-06-13 | Conformis, Inc. | Devices, techniques and methods for assessing joint spacing, balancing soft tissues and obtaining desired kinematics for joint implant components |
US20140018813A1 (en) * | 2012-07-15 | 2014-01-16 | Smith & Nephew, Inc. | Patient match instrument |
EP2874550B1 (en) * | 2012-07-23 | 2017-09-27 | Orthosoft, Inc. | Patient-specific instrumentation for implant revision surgery |
AU2013299495B2 (en) * | 2012-08-09 | 2018-03-08 | Smith & Nephew, Inc. | Intra-operatively adjustable cutting guide |
US9700330B2 (en) | 2012-09-28 | 2017-07-11 | Depuy Ireland Unlimited Company | Method for surgically implanting a prosthetic patella component |
US10085758B2 (en) | 2012-09-28 | 2018-10-02 | Depuy Ireland Unlimited Company | Patella drill guide and trial surgical instrument having an alignment bore formed therein and method of using the same |
US9402637B2 (en) | 2012-10-11 | 2016-08-02 | Howmedica Osteonics Corporation | Customized arthroplasty cutting guides and surgical methods using the same |
US9060788B2 (en) | 2012-12-11 | 2015-06-23 | Biomet Manufacturing, Llc | Patient-specific acetabular guide for anterior approach |
US9204977B2 (en) | 2012-12-11 | 2015-12-08 | Biomet Manufacturing, Llc | Patient-specific acetabular guide for anterior approach |
US9480571B2 (en) | 2012-12-27 | 2016-11-01 | Wright Medical Technology, Inc. | Ankle replacement system and method |
US9974588B2 (en) | 2012-12-27 | 2018-05-22 | Wright Medical Technology, Inc. | Ankle replacement system and method |
CA2836651C (en) | 2012-12-27 | 2016-03-22 | Wright Medical Technology, Inc. | Ankle replacement system and method |
US10080573B2 (en) | 2012-12-27 | 2018-09-25 | Wright Medical Technology, Inc. | Ankle replacement system and method |
US9918724B2 (en) | 2012-12-27 | 2018-03-20 | Wright Medical Technology, Inc. | Ankle replacement system and method |
US10335163B2 (en) | 2013-03-05 | 2019-07-02 | Depuy Ireland Unlimited Company | Polymer 4-in-2 femoral cutting instrument having separable A/P and chamfer cutting blocks |
US10022130B2 (en) | 2013-03-05 | 2018-07-17 | Depuy Ireland Unlimited Company | Polymer 4-in-1 femoral cutting block |
US10111673B2 (en) | 2013-03-05 | 2018-10-30 | Depuy Ireland Unlimited Company | Polymer 4-in-1 femoral cutting block including metallic protective bushings |
US9839438B2 (en) | 2013-03-11 | 2017-12-12 | Biomet Manufacturing, Llc | Patient-specific glenoid guide with a reusable guide holder |
US9579107B2 (en) | 2013-03-12 | 2017-02-28 | Biomet Manufacturing, Llc | Multi-point fit for patient specific guide |
US9826981B2 (en) | 2013-03-13 | 2017-11-28 | Biomet Manufacturing, Llc | Tangential fit of patient-specific guides |
US9498233B2 (en) | 2013-03-13 | 2016-11-22 | Biomet Manufacturing, Llc. | Universal acetabular guide and associated hardware |
CN105228541A (en) | 2013-03-14 | 2016-01-06 | 瑞特医疗技术公司 | Ankle replacement system and method |
US9517145B2 (en) | 2013-03-15 | 2016-12-13 | Biomet Manufacturing, Llc | Guide alignment system and method |
WO2014143740A1 (en) | 2013-03-15 | 2014-09-18 | Mako Surgical Corp. | Unicondylar tibial knee implant |
JP6152583B2 (en) * | 2013-03-19 | 2017-06-28 | 京セラ株式会社 | Femoral component trial for knee joint |
DE102013205156B4 (en) | 2013-03-22 | 2015-02-12 | Heraeus Medical Gmbh | Knee spacer for temporary replacement of an artificial knee joint |
US8800158B1 (en) * | 2013-06-24 | 2014-08-12 | John H. Shim | Apparatus for cutting and fabricating allografts |
US20150112349A1 (en) | 2013-10-21 | 2015-04-23 | Biomet Manufacturing, Llc | Ligament Guide Registration |
US10282488B2 (en) | 2014-04-25 | 2019-05-07 | Biomet Manufacturing, Llc | HTO guide with optional guided ACL/PCL tunnels |
US9861491B2 (en) | 2014-04-30 | 2018-01-09 | Depuy Ireland Unlimited Company | Tibial trial system for a knee prosthesis |
US9408616B2 (en) | 2014-05-12 | 2016-08-09 | Biomet Manufacturing, Llc | Humeral cut guide |
AU2015259293B2 (en) | 2014-05-12 | 2019-07-11 | Smith & Nephew Asia Pacific Pte. Limited | Total ankle replacement prosthesis |
US9561040B2 (en) | 2014-06-03 | 2017-02-07 | Biomet Manufacturing, Llc | Patient-specific glenoid depth control |
US9839436B2 (en) | 2014-06-03 | 2017-12-12 | Biomet Manufacturing, Llc | Patient-specific glenoid depth control |
AU2015308660B2 (en) * | 2014-08-28 | 2019-11-14 | Zimmer, Inc. | Proximal bunion resection guides and plates and methods of use |
US9826994B2 (en) | 2014-09-29 | 2017-11-28 | Biomet Manufacturing, Llc | Adjustable glenoid pin insertion guide |
US9833245B2 (en) | 2014-09-29 | 2017-12-05 | Biomet Sports Medicine, Llc | Tibial tubercule osteotomy |
US9820858B2 (en) * | 2015-03-23 | 2017-11-21 | Modal Manufacturing, LLC | Knee implants and instruments |
EP3072462B1 (en) | 2015-03-27 | 2017-10-04 | DePuy Ireland Unlimited Company | Orthopaedic surgical instrument system |
US9820868B2 (en) | 2015-03-30 | 2017-11-21 | Biomet Manufacturing, Llc | Method and apparatus for a pin apparatus |
DE102015107484A1 (en) * | 2015-05-12 | 2016-11-17 | Karl Leibinger Medizintechnik Gmbh & Co. Kg | Orthogonal sawing and positioning implant |
US10226262B2 (en) | 2015-06-25 | 2019-03-12 | Biomet Manufacturing, Llc | Patient-specific humeral guide designs |
US10568647B2 (en) | 2015-06-25 | 2020-02-25 | Biomet Manufacturing, Llc | Patient-specific humeral guide designs |
US9999428B2 (en) * | 2015-06-30 | 2018-06-19 | DePuy Synthes Products, Inc. | Orthopaedic surgical instrument system and method for surgically preparing a patients bone |
US10195056B2 (en) | 2015-10-19 | 2019-02-05 | Depuy Ireland Unlimited Company | Method for preparing a patient's tibia to receive an implant |
US10537445B2 (en) | 2015-10-19 | 2020-01-21 | Depuy Ireland Unlimited Company | Surgical instruments for preparing a patient's tibia to receive an implant |
CN105310741B (en) | 2015-12-07 | 2018-01-23 | 上海昕健医疗技术有限公司 | Total knee replacement digitizes deep guide plate |
JP2019509132A (en) | 2016-03-23 | 2019-04-04 | ライト メディカル テクノロジー インコーポレイテッドWright Medical Technology, Inc. | Fixation device and method for total ankle replacement |
KR20190031281A (en) | 2016-07-15 | 2019-03-25 | 마코 서지컬 코포레이션 | System for robot-assisted orthodontic surgery |
US10709460B2 (en) | 2016-08-01 | 2020-07-14 | Howmedica Osteonics Corp. | Centering guide system for arthroplasty |
AU201711075S (en) * | 2017-02-22 | 2017-03-06 | Orthopaedic surgery cutting block guide | |
US10722310B2 (en) | 2017-03-13 | 2020-07-28 | Zimmer Biomet CMF and Thoracic, LLC | Virtual surgery planning system and method |
EP3595545B1 (en) | 2017-07-28 | 2023-12-27 | Wright Medical Technology, Inc. | Joint osteotomy system |
US10835262B2 (en) | 2017-12-06 | 2020-11-17 | Howmedica Osteonics Corp. | Tibial posterior slope alignment guide |
WO2019213025A1 (en) * | 2018-05-02 | 2019-11-07 | MAP Medical Solutions, LLC | Joint revision surgery apparatus |
US11051829B2 (en) | 2018-06-26 | 2021-07-06 | DePuy Synthes Products, Inc. | Customized patient-specific orthopaedic surgical instrument |
US11376018B2 (en) | 2019-09-14 | 2022-07-05 | Microport Orthopedics Holdings Inc. | Adjustable revision guide with translating stem adaptor |
US11872137B2 (en) | 2021-06-15 | 2024-01-16 | Wright Medical Technology, Inc. | Unicompartmental ankle prosthesis |
Family Cites Families (34)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3868730A (en) * | 1973-09-24 | 1975-03-04 | Howmedica | Knee or elbow prosthesis |
US4567885A (en) * | 1981-11-03 | 1986-02-04 | Androphy Gary W | Triplanar knee resection system |
US4944760A (en) * | 1983-10-26 | 1990-07-31 | Pfizer Hospital Products Group, Inc. | Method and instrumentation for the replacement of a knee prosthesis |
US5250050A (en) * | 1987-02-07 | 1993-10-05 | Pfizer Hospital Products Group, Inc. | Apparatus for knee prosthesis |
US5047058A (en) * | 1988-04-08 | 1991-09-10 | Smith & Nephew Richards, Inc. | System of inserts for the tibial component of a knee prosthesis |
US4979949A (en) * | 1988-04-26 | 1990-12-25 | The Board Of Regents Of The University Of Washington | Robot-aided system for surgery |
US4944757A (en) * | 1988-11-07 | 1990-07-31 | Martinez David M | Modulator knee prosthesis system |
US4936847A (en) * | 1988-12-27 | 1990-06-26 | Johnson & Johnson Orthopaedics, Inc. | Revision knee prosthesis |
US4963847A (en) * | 1989-04-11 | 1990-10-16 | Heinemann Electric Company | Circuit breaker with transparent tube magnetic core holder |
US4938769A (en) * | 1989-05-31 | 1990-07-03 | Shaw James A | Modular tibial prosthesis |
US5021056A (en) * | 1989-09-14 | 1991-06-04 | Intermedics Orthopedics, Inc. | Upper tibial osteotomy system |
US5234433A (en) * | 1989-09-26 | 1993-08-10 | Kirschner Medical Corporation | Method and instrumentation for unicompartmental total knee arthroplasty |
US5122144A (en) * | 1989-09-26 | 1992-06-16 | Kirschner Medical Corporation | Method and instrumentation for unicompartmental total knee arthroplasty |
US5092869A (en) * | 1991-03-01 | 1992-03-03 | Biomet, Inc. | Oscillating surgical saw guide pins and instrumentation system |
US5129909A (en) * | 1991-03-13 | 1992-07-14 | Sutherland Charles J | Apparatus and method for making precise bone cuts in total knee replacement |
GB9202561D0 (en) * | 1992-02-07 | 1992-03-25 | Howmedica | Orthopaedic instrument |
US5282866A (en) * | 1992-02-12 | 1994-02-01 | Osteonics Corp. | Prosthetic knee tibial component with axially ribbed keel and apparatus for effecting implant |
US5176684A (en) * | 1992-02-20 | 1993-01-05 | Dow Corning Wright | Modular shaping and trial reduction guide for implantation of posterior-stabilized femoral prosthesis and method of using same |
DE69319587T2 (en) * | 1992-02-20 | 1999-04-01 | Synvasive Technology Inc | SURGICAL CUTTING BLOCK |
US5275603A (en) * | 1992-02-20 | 1994-01-04 | Wright Medical Technology, Inc. | Rotationally and angularly adjustable tibial cutting guide and method of use |
US5258032A (en) * | 1992-04-03 | 1993-11-02 | Bertin Kim C | Knee prosthesis provisional apparatus and resection guide and method of use in knee replacement surgery |
US5226915A (en) | 1992-04-03 | 1993-07-13 | Bertin Kim C | Femoral prosthesis component system for knee replacement surgery |
US5665090A (en) * | 1992-09-09 | 1997-09-09 | Dupuy Inc. | Bone cutting apparatus and method |
US5364401A (en) * | 1992-10-08 | 1994-11-15 | Wright Medical Technology, Inc. | External alignment system for preparing a femur for an implant |
US5464406A (en) | 1992-12-09 | 1995-11-07 | Ritter; Merrill A. | Instrumentation for revision surgery |
US5474559A (en) * | 1993-07-06 | 1995-12-12 | Zimmer, Inc. | Femoral milling instrumentation for use in total knee arthroplasty with optional cutting guide attachment |
US5364402A (en) * | 1993-07-29 | 1994-11-15 | Intermedics Orthopedics, Inc. | Tibial spacer saw guide |
US5702460A (en) | 1995-02-15 | 1997-12-30 | Smith & Nephew, Inc. | Revision femoral trial prosthesis |
US5683397A (en) * | 1995-02-15 | 1997-11-04 | Smith & Nephew, Inc. | Distal femoral cutting guide apparatus for use in knee joint replacement surgery |
FR2732886B1 (en) * | 1995-04-13 | 1997-10-31 | France Bloc Sa | PATELLAR CUTTING GUIDE FOR PLACEMENT OF THE PROSTHETIC KNEE PROSTHESIS PATELLA |
US5601563A (en) * | 1995-08-25 | 1997-02-11 | Zimmer, Inc. | Orthopaedic milling template with attachable cutting guide |
US5709689A (en) * | 1995-09-25 | 1998-01-20 | Wright Medical Technology, Inc. | Distal femur multiple resection guide |
US5776201A (en) * | 1995-10-02 | 1998-07-07 | Johnson & Johnson Professional, Inc. | Modular femoral trial system |
US5662656A (en) * | 1995-12-08 | 1997-09-02 | Wright Medical Technology, Inc. | Instrumentation and method for distal femoral sizing, and anterior and distal femoral resections |
-
1995
- 1995-11-02 US US08/556,812 patent/US5716361A/en not_active Expired - Lifetime
-
1996
- 1996-11-01 WO PCT/US1996/017691 patent/WO1997016129A1/en active IP Right Grant
- 1996-11-01 AU AU77215/96A patent/AU730146B2/en not_active Ceased
- 1996-11-01 EP EP96940294A patent/EP0874596B1/en not_active Expired - Lifetime
- 1996-11-01 CA CA002236376A patent/CA2236376A1/en not_active Abandoned
- 1996-11-01 DE DE69635956T patent/DE69635956T2/en not_active Expired - Lifetime
- 1996-11-01 AT AT96940294T patent/ATE320764T1/en not_active IP Right Cessation
- 1996-11-01 JP JP9517611A patent/JPH11514906A/en active Pending
-
1997
- 1997-09-17 US US08/932,277 patent/US6187010B1/en not_active Expired - Lifetime
- 1997-09-18 US US08/933,255 patent/US5885296A/en not_active Expired - Lifetime
- 1997-09-18 US US08/937,216 patent/US5897559A/en not_active Expired - Lifetime
-
1998
- 1998-12-23 US US09/220,203 patent/US6068633A/en not_active Expired - Lifetime
- 1998-12-23 US US09/220,151 patent/US5971989A/en not_active Expired - Lifetime
- 1998-12-23 US US09/220,150 patent/US5961523A/en not_active Expired - Lifetime
- 1998-12-23 US US09/220,205 patent/US6077269A/en not_active Expired - Lifetime
- 1998-12-23 US US09/220,079 patent/US5957926A/en not_active Expired - Lifetime
- 1998-12-23 US US09/220,202 patent/US5947973A/en not_active Expired - Fee Related
- 1998-12-23 US US09/220,204 patent/US5944722A/en not_active Expired - Lifetime
- 1998-12-23 US US09/220,152 patent/US6214011B1/en not_active Expired - Lifetime
-
1999
- 1999-04-01 US US09/272,546 patent/US6102916A/en not_active Expired - Lifetime
- 1999-04-27 US US09/300,665 patent/US6602259B1/en not_active Expired - Fee Related
-
2000
- 2000-12-21 US US09/747,087 patent/US6503254B2/en not_active Expired - Lifetime
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US5716361A (en) | 1998-02-10 |
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US6214011B1 (en) | 2001-04-10 |
US20010001120A1 (en) | 2001-05-10 |
AU7721596A (en) | 1997-05-22 |
DE69635956D1 (en) | 2006-05-11 |
EP0874596A1 (en) | 1998-11-04 |
ATE320764T1 (en) | 2006-04-15 |
DE69635956T2 (en) | 2006-12-07 |
US6602259B1 (en) | 2003-08-05 |
US6077269A (en) | 2000-06-20 |
US5897559A (en) | 1999-04-27 |
US5957926A (en) | 1999-09-28 |
JPH11514906A (en) | 1999-12-21 |
US6503254B2 (en) | 2003-01-07 |
US6102916A (en) | 2000-08-15 |
US5944722A (en) | 1999-08-31 |
US6187010B1 (en) | 2001-02-13 |
US5971989A (en) | 1999-10-26 |
AU730146B2 (en) | 2001-03-01 |
US5947973A (en) | 1999-09-07 |
US5961523A (en) | 1999-10-05 |
WO1997016129A1 (en) | 1997-05-09 |
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