CA2546023A1 - Adjustable surgical cutting systems - Google Patents

Adjustable surgical cutting systems Download PDF

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Publication number
CA2546023A1
CA2546023A1 CA002546023A CA2546023A CA2546023A1 CA 2546023 A1 CA2546023 A1 CA 2546023A1 CA 002546023 A CA002546023 A CA 002546023A CA 2546023 A CA2546023 A CA 2546023A CA 2546023 A1 CA2546023 A1 CA 2546023A1
Authority
CA
Canada
Prior art keywords
cutting guide
adjustor
bone
anterior
cutting
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002546023A
Other languages
French (fr)
Other versions
CA2546023C (en
Inventor
Brian J. Mcginley
Daniel Mccombs
Chester Paul Wheeler
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Smith and Nephew Inc
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of CA2546023A1 publication Critical patent/CA2546023A1/en
Application granted granted Critical
Publication of CA2546023C publication Critical patent/CA2546023C/en
Expired - Fee Related legal-status Critical Current
Anticipated expiration legal-status Critical

Links

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
    • A61B17/155—Cutting femur
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • 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
    • A61B17/32—Surgical cutting instruments
    • A61B2017/320052—Guides for cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3983—Reference marker arrangements for use with image guided surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
    • A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints

Abstract

Adjustable and modular systems, devices and methods for accurately cutting or resecting bones during surgery, particularly in preparation for installing joint implants during arthroplasties, including, but not limited to, preparation of femur (1) or tibia (321) during knee arthroplasties, such as total knee arthroplasty. The embodiments of the present invention provide solutions for adjusting a position of the cutting guides (13, 101, 203, 301), or structures for guiding or directing the implements for resecting a patient~s bone tissue, such as saws. The systems and devices comprise an adjustor for adjusting the cutting guide~s position at the patient~s bone in at least one degree of rotational freedom and in at least one degree of translational freedom.

Claims (25)

1. A system for positioning a cutting guide for preparation of a bone of a patient during total knee arthroplasty, comprising:

an adjustor for adjusting said cutting guide at the bone;

structures operatively associated with the adjustor for adjusting the position of the cutting guide in at least one degree of rotational freedom and at least one degree of translational freedom;

structures for stabilizing the adjustor at the bone; and structures for engaging the cutting guide.
2. The system of Claim 1, further comprising the cutting guide.
3. The system of Claim 2, wherein the cutting guide is a femoral cutting guide or a tibial cutting guide.
4. The system of Claim 1, further comprising a femoral cutting guide for performing one or more of distal, axially directed anterior, axially directed posterior, anterior chamfer, or posterior chamfer cuts, or a combination thereof.
5. The system of Claim 4, wherein the adjustor comprises one or more structures for the adjustment of the cutting guide with respect to the femur in at least one of superior/inferior, medial/lateral, or anterior/posterior translations.
6. The system of Claim 4, wherein the adjustor comprises one or more structures for the adjustment of the cutting guide with respect to the femur in at least one of varus/valgus angle, flexion/extension angle, or axial rotation.
7. The system of Claim 4, wherein the adjustor comprises one or more structures for the adjustment of the cutting guide with respect to the femur in at least one of vargus/valgus angle, flexion/extension angle, or proximal/distal translation.
8. The system of Claim 4, wherein the adjustor comprises a ball-and-socket structure for adjusting the cutting guide in at least two degrees of rotational freedom, comprising:

a plate operably connected to the cutting guide and comprising a first, a second, and a third sockets;

a first member comprising a first ball member inserted into the first socket;

a second member, comprising a second ball member inserted into the second socket, a first opening, and a second opening, wherein the first member is inserted into and is retractable through the first opening in the second member;

a third member; and a fourth member comprising a third ball member inserted into the third socket and a third opening, wherein the third member is inserted into and is retractable through the second opening in the second member and the third opening in the third member;

wherein retracting or inserting at least one of the first member through the first opening or the third member through at least one of the second opening or the third opening moves the plate in at least one degree of rotational freedom, causing the cutting guide to move in the at least one degree of rotational freedom.
9. The system of Claim 1, wherein the adjustor further comprises a module for stabilizing the adjustor at the bone.
10. The system of Claim 9, wherein the module for attaching the adjustor to the bone is for attaching the adjustor to a femoral post or to an intramedullary rod.
11. The system of Claim 9, wherein the module for attaching the adjustor to the bone is adjustably connected to the ball-and-socket structures by a translationally adjustable connection.
12. The system of Claim 11, wherein the module for attaching the adjustor to the bone is adjustably connected to the ball and socket structures by the translationally adjustable connection controlled by a lever or a screw.
13. The system of Claim 11, wherein the translationally adjustable connection is adjustable in one or more of superior/inferior, anterior/posterior or medial/lateral translations.
14. The system of Claim 12, wherein the ball and socket structure is connected to the cutting guide by one or more translationally adjustable connections controlled by a lever or a screw.
15. The system of Claim 12, wherein the translationally adjustable connection is adjustable in one or more of superior/anterior, anterior/posterior or medial/lateral translations.
16. The system of Claim 1, wherein the adjustor comprises means for attaching the adjustor to the bone percutaneously.
17. The system of Claim 1, wherein the adjustor is of a size suitable for minimally invasive surgery.
18. The system of Claim 1, further comprising one or more fiducials for computer-assisted surgery.
19. A method for adjusting a position of a cutting block at a bone of a patient, comprising the steps of:
a. attaching an adjustor to the bone;
b. connecting the cutting guide to the adjustor;
c. manipulating the adjustor to adjust the position of the cutting guide in at least one degree of translational freedom and at least one degree of translational freedom;
d. attaching the cutting guide to the bone; and e. cutting the bone with a cutting implement directed by the cutting guide.
20. The method of Claim 19, further comprising disengaging the adjustor device from the cutting guide.
21. The method of Claim 19, wherein the cutting guide is a femoral cutting guide or a tibial cutting guide.
22. The method of Claim 21, further comprising in step a cutting the bone in one or more of distal, axially directed anterior, axially directed posterior, anterior chamfer, or posterior chamfer cuts, or a combination thereof.
23. The method of Claim 19, further comprising in step c adjusting the position of the cutting guide with respect to the femur in at least one of superior/inferior, medial/lateral, or anterior/posterior translations.
24. The method of Claim 19, further comprising in step c adjusting the position cutting guide with respect to the femur in at least one of varus/valgus angle, flexion/extension angle, or axial rotation.
25. The method of Claim 19, further comprising in step c adjusting the position cutting guide with respect to the femur in at least one of varus/valgus angle, flexion/extension angle, or proximal/distal translation.
CA2546023A 2003-11-14 2004-11-15 Adjustable surgical cutting systems Expired - Fee Related CA2546023C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US52009703P 2003-11-14 2003-11-14
US60/520,097 2003-11-14
PCT/US2004/038284 WO2005048851A1 (en) 2003-11-14 2004-11-15 Adjustable surgical cutting systems

Publications (2)

Publication Number Publication Date
CA2546023A1 true CA2546023A1 (en) 2005-06-02
CA2546023C CA2546023C (en) 2012-11-06

Family

ID=34619432

Family Applications (1)

Application Number Title Priority Date Filing Date
CA2546023A Expired - Fee Related CA2546023C (en) 2003-11-14 2004-11-15 Adjustable surgical cutting systems

Country Status (8)

Country Link
US (2) US7794467B2 (en)
EP (1) EP1691692B1 (en)
AT (1) ATE495706T1 (en)
AU (1) AU2004291146B2 (en)
CA (1) CA2546023C (en)
DE (1) DE602004031147D1 (en)
ES (1) ES2362491T3 (en)
WO (1) WO2005048851A1 (en)

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US7794467B2 (en) 2010-09-14
WO2005048851A1 (en) 2005-06-02
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AU2004291146B2 (en) 2011-08-25
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US20100268240A1 (en) 2010-10-21
AU2004291146A1 (en) 2005-06-02

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