US20040078043A1 - Joint replacement methods and apparatus - Google Patents
Joint replacement methods and apparatus Download PDFInfo
- Publication number
- US20040078043A1 US20040078043A1 US10/685,902 US68590203A US2004078043A1 US 20040078043 A1 US20040078043 A1 US 20040078043A1 US 68590203 A US68590203 A US 68590203A US 2004078043 A1 US2004078043 A1 US 2004078043A1
- Authority
- US
- United States
- Prior art keywords
- resection
- medial
- cutting
- cutting guide
- bone
- 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.)
- Abandoned
Links
Images
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
- A61B17/14—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
- A61B17/157—Cutting tibia
Definitions
- This invention concerns arthroplasty, and, more particularly, resides in improved cutting guides and techniques to better assist a surgeon in preparing a bone, for example, to receive an implant.
- cutting guides are typically employed to ensure that the bone saw performs resections corresponding to mating surfaces of the prosthetic component.
- 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.
- This invention extends and, in certain instances, improves upon, apparatus and methods disclosed and claimed in U.S. Pat. No. 5,716,361, which relates to combination trial/cutting guides, and methods of using the same, in various orthopedic joint situations such as the knee, hip, shoulder, and other areas of the body.
- the present invention is directed toward apparatus and surgical techniques which augment or supplant certain teachings of the '361 patent with respect to alternative cutting fixtures and resection accuracy and stability.
- One embodiment provides stabilizers which are removably attached to a cutting guide so as to temporarily lengthen the surface against which a saw or other cutting device rests.
- Another embodiment provides differently shaped saw blades, having curved distal ends and right-angle bends applicable to box cuts of the type associated with cruciate-sacrifice knee-replacement surgery. Methods are also disclosed whereby the box cuts, distal and posterior augment cuts may be approached from a distal perspective, both laterally and medially.
- a different embodiment provides a trial/cutting guide having flat surfaces as opposed to curved surfaces adapted for articulation within a joint.
- Yet a further alternative embodiment teaches a device for determining the joint line relative to a tibia using the fibula as reference.
- FIG. 1 is a drawing which shows the use of stabilizers removably attached to a cutting guide to temporarily lengthening the surface against which a saw or other cutting device uses as a guide;
- FIG. 2A is a drawing of a curved saw blade according to the invention
- FIG. 2B is a drawing of an alternative saw blade according to the invention, preferably including a right-angle bend;
- FIG. 3A is a drawing which depicts a trial/cutting guide having flat surfaces as opposed to curved surfaces adapted for articulation within a joint;
- FIG. 3B is a drawing which depicts a trial/ cutting guide having truncated surfaces corresponding to chamfer cuts;
- FIG. 3C is a drawing which depicts a trial/ cutting guide having a rounded surface
- FIG. 4A is a drawing which illustrates a method of approaching box cuts from a distal perspective
- FIGS. 4B and 4C depict alternative ways in which distal and posterior augment cuts may be made from the side, whether laterally or medially;
- FIG. 5 shows a device for determining the joint line relative to a tibia using the fibula as reference
- FIG. 6A is a drawing which shows a wedge-shaped defect often encountered in distal femur bone loss.
- FIG. 6B is a drawing which shows a combination trial and cutting guide having “non-parallel” slots and wedges as part of a bone-loss conforming method of resection.
- the present invention extends and, in certain instances, improves upon apparatus and methods disclosed and claimed in U.S. Pat. No. 5,716,361, which issued Feb. 10, 1998, entitled BONE CUTTING GUIDES FOR USE IN THE IMPLANTATION OF PROSTHETIC JOINT COMPONENTS. Accordingly, the entire contents of this patent are incorporated herein by reference.
- the '361 patent relates to combination trial/cutting guides, and methods of using the same, in various orthopedic joint situations such as the knee, hip, shoulder, and other areas of the body.
- the apparatus resides in a shaped body having an inner surface adapted for temporary placement against a bone surface and an outer surface configured to co-act in a joint, for example, as part of a trial reduction.
- the present invention is directed toward apparatus and surgical techniques which augment or supplant certain teachings of the '361 patent with respect to alternative cutting fixtures and resection accuracy and stability.
- the various aspects of the instant disclosure are broadly classified according to broad categories which follow.
- the shaping of the cutting body to co-act in a joint may result in relatively thin thicknesses between the inner and outer surfaces of the body.
- the cutting tool may extend through the body of the device for only a short distance, resulting in a potential instability.
- This aspect of the present invention is accordingly directed toward the lengthening of one or more of the cutting guides through the use of removable stabilizers which are temporarily attached to the body.
- This feature builds upon concepts disclosed in reference to FIG. 6 of the '361 patent, in particular, which teaches the use of an extension block to carry out box cuts.
- FIG. 6 of the '361 patent in particular, which teaches the use of an extension block to carry out box cuts.
- FIG. 6 of the '361 patent which teaches the use of an extension block to carry out box cuts.
- FIG. 6 of the '361 patent which teaches the use of an extension block to carry out box cuts.
- FIG. 6 of the '361 patent which teaches the use of an extension block to carry out box cuts.
- these removable stabilizers are applicable to other bone-cutting situations and, in fact, may be applied to cutting guides even if they are not shaped to function as a trial device.
- stabilizers 12 and 14 are temporarily and removably attached to a cutting guide 10 , thereby effectively lengthening the surface against which a saw or other cutting device uses as a guide with respect to a resection procedure.
- the stabilizers may include a single, extended flat surface such as that provided by block 12 , or may include slots, as shown with respect to block 14 , or both surfaces and slots in combination with additional features.
- the stabilizers may be temporarily affixed to the cutting guide in a number of ways, including removable machine screws or Allen screws, or detachable snaps which use pressure to apply and remove the members.
- a stabilizer such as 16 may include a feature which fits into an adjacent slot to provide temporary positioning.
- the application of the stabilizers according to the invention is not limited to the slots, openings or positions illustrated in the drawing, but may be used in conjunction with any provided cutting surface. Procedurally, the method of use would follow that disclosed in the '361 patent, in that a reduction would be performed and, upon a successful trial, the resections would be carried, as required, with the addition of these slot extensions being used for further tool stabilization as disclosed herein.
- a curved saw blade 22 may be provided such that when the stem 24 is approached from above or below, additional material on either side of the stem will be more effectively removed, thereby forming nearly the entire bottom of the box even with the stem in place.
- a different or supplemental set of slots may be provided to approach the bottom cut from the side of the trial-guide body.
- a saw 26 having a right-angle blade may be provided, such that and with the trial/cutting guide in place and with the knee flexed, any remaining portion(s) of the bottom of the box may be approached from the side.
- a different aspect of this invention is directed toward trial/cutting guides which do not necessarily include articulating outer surfaces to co-act in a joint. That is, in contrast to certain of the devices and techniques disclosed in U.S. Pat. No. 5,716,361 wherein, for example, condylar surfaces are provided to co-act in a joint, so long as both sides of the joint have surfaces which mate to properly determine gaps or distances, such surfaces which conform to human anatomy need not be provided as a prelude to a trial joint reduction.
- trial/cutting guides may be provided having surfaces geometrically indexed to a final implant, as opposed to complex, curved articulating surfaces, and still function to establish a desired orientation as part of a trial joint reduction.
- the surgeon may reduce this assembly into the joint to test for proper joint action, including extension/flexion gaps in the case of knee-replacement surgery.
- the trial/cutting guide With the trial/cutting guide is in position, it may be moved around so as to mate with the corresponding joint surface and then pinned into place once a desired orientation has been established. After flexing, the cuts associated with the joint may be made with the cutting guide and, in the event that augments are required, these may be provided in conjunction with a trial or a final, as appropriate.
- FIG. 3A shows a primary distal flat section which is connected to a stem and an anterior section
- the apparatus may include a posterior section as depicted with the arrow.
- this posterior piece may rest against the tibial portion to stabilize the entire assembly for resection as shown in the small inset drawing.
- the test surfaces need to be flat or joined at right angles.
- the outer surface 38 may be truncated in a manner corresponding to the “chamfer” cuts or, alternatively, as shown in FIG.
- the outer surface 39 may be rounded off without having to form complex condylar surfaces, for example, so long as a geometric index is established with respect to the prosthesis ultimately installed in terms of joint line, flection/extension gaps, degree of varus/vulgus, or some combination of these or other criteria.
- One advantage of these alternative configurations is that joint geometry and movement may be tested for accuracy, but the apparatus may be much more easy to manufacture with the flat surfaces as opposed to highly complex surfaces used to provide natural joint features.
- box cuts are used to accommodate an intercondylar protrusion.
- slots may be provided from anterior to posterior, as shown in U.S. Pat. No. 5,716,361.
- slots may be provided as shown in FIG. 4A to approach these cuts distally.
- FIGS. 4B and 4C depict alternative ways in which the distal and posterior augment cuts may be made from the side, whether laterally or medially.
- FIG. 4B shows how a standard trial may be employed with or without other slots or cutting guides.
- a removable attachment guide may be temporarily attached to the side of the trial, as shown, to perform the distal cuts.
- the removable attachment guide may be located at different positions, depending upon the augments that will be used on the final.
- indicators may be provided along various edges or other points of the cutting guide body itself, enabling the surgeon to mark the bone, whether or not as part of a trial reduction, remove the cutting guide body, and perform the cuts in a conventional manner (i.e., with standard cutting guides).
- the advantage here is that with the trial in place these markings would indicate precisely where the final implant will be fixed to the bone, whether augments are required or not.
- FIG. 4C illustrates a similar concept, except for the posterior cuts, in the sense that a standard trial could be used but again facilities could be provided whereby either a saw guide could be clipped on or the bone could be marked for the posterior and anterior cuts in the manner just described for the distal cut.
- FIG. 5 depicts a different aspect of the invention, including a device for determining the joint line relative to the tibia, using the fibula as reference.
- the device labeled ‘A’, contacts the head or proximal portion of the fibula.
- the device preferably includes a transverse extending rod which is used to estimate where the joint line should be recreated relative to a deficient tibial surface.
- the vertical portion labeled ‘X’ may be adjustable or fixed. Adjustability allows the joint line to be estimated and adjusted relative to a different sized individual. This could be estimated from an x-ray or other means.
- transverse bar ‘Y’ an element may be provided on the transverse bar ‘Y’, to assure a transverse positioning, such as a bubble within a fluid as commonly provided with a level, this of course would be more involved than just a simple transverse bar or any other such configuration would be appropriate as well.
- FIG. 6A it is often the case that bone loss occurs primarily with respect to a central portion of the bone, leaving outer edges with a greater volume of bone stock remaining intact. As shown in FIG. 6A, such is typically the case with the distal femur, resulting in a defect which is often wedge-shaped, as shown. With traditional cutting guides that produce transversely-aligned surfaces, it is often the case that this abundance of medial and lateral remaining bone is simply resected and lost for the sake of geometric simplicity.
- a different aspect of this invention is the provision of nonparallel slots and corresponding wedges, which may be used to retain at least some of this outer remaining bone material. That is, instead of making the traditional straight across distal cut 62 , as shown in FIG. 6A, the cutting guide of FIG. 6B is instead used to make the cuts along lines 64 and 66 thereby retaining the tips of the outer portions of the bone. In the event that wedges are required to fill the gaps between the prosthetic element and the surfaces created through these non-parallel slots, the wedges, too, are also wedge-shaped, as shown in FIG. 6B.
Abstract
Apparatus and surgical techniques provide alternative cutting fixtures and other features to improve bone resection accuracy and joint stability. According to one embodiment, stabilizers are removably attached to a cutting guide to temporarily lengthen the surface against which a saw or other cutting device rests. Another embodiment provides differently shaped saw blades, having curved distal ends and right-angle bends applicable to box cuts of the type associated with cruciate sacrifice knee-replacement surgery. Methods are also disclosed whereby the box cuts, distal and posterior augment cuts may be approached from a distal perspective, both laterally and medially. A different embodiment provides a trial/cutting guide having flat surfaces as opposed to curved surfaces adapted for articulation within a joint. Yet a further alternative embodiment teaches a device for determining the joint line relative to a tibia using the fibula as reference.
Description
- This application is a continuation of U.S. patent application Ser. No. 10/308,046, filed Dec. 2, 2002; which is a divisional of U.S. patent application Ser. No. 09/159,168, filed Sep. 23, 1998, now U.S. Pat. No. 6,488,687; which claims priority of U.S. provisional patent application Serial No. 60/059,804, filed Sep. 23, 1997. U.S. patent application Ser. No. 10/308,046 is also a continuation-in-part of U.S. patent application Ser. No. 09/300,665, filed Apr. 27, 1999, now U.S. Pat. No. 6,602,259, which is a continuation of U.S. patent application Ser. No. 08/937,216, filed Sep. 18, 1997, now U.S. Pat. No. 5,897,559, the entire content of all of which are incorporated herein by reference.
- This invention concerns arthroplasty, and, more particularly, resides in improved cutting guides and techniques to better assist a surgeon in preparing a bone, for example, to receive an implant.
- 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 prosthesis 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 of error, the correction of which in some cases requiring a freehand shaping of the bone.
- This invention extends and, in certain instances, improves upon, apparatus and methods disclosed and claimed in U.S. Pat. No. 5,716,361, which relates to combination trial/cutting guides, and methods of using the same, in various orthopedic joint situations such as the knee, hip, shoulder, and other areas of the body. The present invention is directed toward apparatus and surgical techniques which augment or supplant certain teachings of the '361 patent with respect to alternative cutting fixtures and resection accuracy and stability.
- One embodiment provides stabilizers which are removably attached to a cutting guide so as to temporarily lengthen the surface against which a saw or other cutting device rests. Another embodiment provides differently shaped saw blades, having curved distal ends and right-angle bends applicable to box cuts of the type associated with cruciate-sacrifice knee-replacement surgery. Methods are also disclosed whereby the box cuts, distal and posterior augment cuts may be approached from a distal perspective, both laterally and medially. A different embodiment provides a trial/cutting guide having flat surfaces as opposed to curved surfaces adapted for articulation within a joint. Yet a further alternative embodiment teaches a device for determining the joint line relative to a tibia using the fibula as reference.
- FIG. 1 is a drawing which shows the use of stabilizers removably attached to a cutting guide to temporarily lengthening the surface against which a saw or other cutting device uses as a guide;
- FIG. 2A is a drawing of a curved saw blade according to the invention
- FIG. 2B is a drawing of an alternative saw blade according to the invention, preferably including a right-angle bend;
- FIG. 3A is a drawing which depicts a trial/cutting guide having flat surfaces as opposed to curved surfaces adapted for articulation within a joint;
- FIG. 3B is a drawing which depicts a trial/ cutting guide having truncated surfaces corresponding to chamfer cuts;
- FIG. 3C is a drawing which depicts a trial/ cutting guide having a rounded surface;
- FIG. 4A is a drawing which illustrates a method of approaching box cuts from a distal perspective;
- FIGS. 4B and 4C depict alternative ways in which distal and posterior augment cuts may be made from the side, whether laterally or medially;
- FIG. 5 shows a device for determining the joint line relative to a tibia using the fibula as reference;
- FIG. 6A is a drawing which shows a wedge-shaped defect often encountered in distal femur bone loss; and
- FIG. 6B is a drawing which shows a combination trial and cutting guide having “non-parallel” slots and wedges as part of a bone-loss conforming method of resection.
- The present invention extends and, in certain instances, improves upon apparatus and methods disclosed and claimed in U.S. Pat. No. 5,716,361, which issued Feb. 10, 1998, entitled BONE CUTTING GUIDES FOR USE IN THE IMPLANTATION OF PROSTHETIC JOINT COMPONENTS. Accordingly, the entire contents of this patent are incorporated herein by reference. Broadly, the '361 patent relates to combination trial/cutting guides, and methods of using the same, in various orthopedic joint situations such as the knee, hip, shoulder, and other areas of the body. The apparatus resides in a shaped body having an inner surface adapted for temporary placement against a bone surface and an outer surface configured to co-act in a joint, for example, as part of a trial reduction. The present invention is directed toward apparatus and surgical techniques which augment or supplant certain teachings of the '361 patent with respect to alternative cutting fixtures and resection accuracy and stability. The various aspects of the instant disclosure are broadly classified according to broad categories which follow.
- In some instances, including those associated with femoral knee arthroplasty, the shaping of the cutting body to co-act in a joint may result in relatively thin thicknesses between the inner and outer surfaces of the body. As such, if surfaces or slots are provided for a particular resection, the cutting tool may extend through the body of the device for only a short distance, resulting in a potential instability.
- This aspect of the present invention is accordingly directed toward the lengthening of one or more of the cutting guides through the use of removable stabilizers which are temporarily attached to the body. This feature builds upon concepts disclosed in reference to FIG. 6 of the '361 patent, in particular, which teaches the use of an extension block to carry out box cuts. However, although the following discussion and drawings reference a combination trial and cutting guide of the type disclosed in this issued patent, it should be understood that these removable stabilizers are applicable to other bone-cutting situations and, in fact, may be applied to cutting guides even if they are not shaped to function as a trial device.
- As illustrated in FIG. 1,
stabilizers guide 10, thereby effectively lengthening the surface against which a saw or other cutting device uses as a guide with respect to a resection procedure. The stabilizers may include a single, extended flat surface such as that provided byblock 12, or may include slots, as shown with respect to block 14, or both surfaces and slots in combination with additional features. - The stabilizers may be temporarily affixed to the cutting guide in a number of ways, including removable machine screws or Allen screws, or detachable snaps which use pressure to apply and remove the members. As a further alternative, a stabilizer such as16 may include a feature which fits into an adjacent slot to provide temporary positioning. The application of the stabilizers according to the invention is not limited to the slots, openings or positions illustrated in the drawing, but may be used in conjunction with any provided cutting surface. Procedurally, the method of use would follow that disclosed in the '361 patent, in that a reduction would be performed and, upon a successful trial, the resections would be carried, as required, with the addition of these slot extensions being used for further tool stabilization as disclosed herein.
- In U.S. Pat. No. 5,716,361, slots and surfaces are provided to perform box cuts of the type associated with a cruciate-sacrificing procedure. Apparatus and methods are shown whereby even the bottom of the box could be at least partially formed by a slot or surface provided for such purpose. Although the end of the saw blade may eventually reach the surface of an intramedullary stem, if so provided, upon removal of interfering portion later in the procedure, the beginning of the cut could simply be extended, using the cut itself as a guide for the remaining portion of the resection.
- As shown in FIG. 2A, a
curved saw blade 22 may be provided such that when thestem 24 is approached from above or below, additional material on either side of the stem will be more effectively removed, thereby forming nearly the entire bottom of the box even with the stem in place. As an alternative to posterior-anterior slot orientation, a different or supplemental set of slots may be provided to approach the bottom cut from the side of the trial-guide body. As shown in FIG. 2B, asaw 26 having a right-angle blade may be provided, such that and with the trial/cutting guide in place and with the knee flexed, any remaining portion(s) of the bottom of the box may be approached from the side. - A different aspect of this invention is directed toward trial/cutting guides which do not necessarily include articulating outer surfaces to co-act in a joint. That is, in contrast to certain of the devices and techniques disclosed in U.S. Pat. No. 5,716,361 wherein, for example, condylar surfaces are provided to co-act in a joint, so long as both sides of the joint have surfaces which mate to properly determine gaps or distances, such surfaces which conform to human anatomy need not be provided as a prelude to a trial joint reduction.
- As shown in FIGS.3A-3C, trial/cutting guides may be provided having surfaces geometrically indexed to a final implant, as opposed to complex, curved articulating surfaces, and still function to establish a desired orientation as part of a trial joint reduction. As long as the opposite side of the joint is configured to mate with these flat surface, the surgeon may reduce this assembly into the joint to test for proper joint action, including extension/flexion gaps in the case of knee-replacement surgery. With the trial/cutting guide is in position, it may be moved around so as to mate with the corresponding joint surface and then pinned into place once a desired orientation has been established. After flexing, the cuts associated with the joint may be made with the cutting guide and, in the event that augments are required, these may be provided in conjunction with a trial or a final, as appropriate.
- Although FIG. 3A shows a primary distal flat section which is connected to a stem and an anterior section, the apparatus may include a posterior section as depicted with the arrow. In such a case, when the joint is flexed, this posterior piece may rest against the tibial portion to stabilize the entire assembly for resection as shown in the small inset drawing. Nor do the test surfaces need to be flat or joined at right angles. As shown in FIG. 3B, the outer surface38 may be truncated in a manner corresponding to the “chamfer” cuts or, alternatively, as shown in FIG. 3C, the outer surface 39 may be rounded off without having to form complex condylar surfaces, for example, so long as a geometric index is established with respect to the prosthesis ultimately installed in terms of joint line, flection/extension gaps, degree of varus/vulgus, or some combination of these or other criteria. One advantage of these alternative configurations is that joint geometry and movement may be tested for accuracy, but the apparatus may be much more easy to manufacture with the flat surfaces as opposed to highly complex surfaces used to provide natural joint features.
- In performing cruciate sacrificing knee-replacement surgery, so-called box cuts are used to accommodate an intercondylar protrusion. To make the sides of the box cuts, slots may be provided from anterior to posterior, as shown in U.S. Pat. No. 5,716,361. As an alternative, however, slots may be provided as shown in FIG. 4A to approach these cuts distally. Although such a capability is disclosed in the form of an aperture in the '361 patent, slots may alternatively be provided, as shown.
- FIGS. 4B and 4C depict alternative ways in which the distal and posterior augment cuts may be made from the side, whether laterally or medially. FIG. 4B shows how a standard trial may be employed with or without other slots or cutting guides. In addition, a removable attachment guide may be temporarily attached to the side of the trial, as shown, to perform the distal cuts. The removable attachment guide may be located at different positions, depending upon the augments that will be used on the final.
- As a further alternative, instead of a guide attachment, indicators may be provided along various edges or other points of the cutting guide body itself, enabling the surgeon to mark the bone, whether or not as part of a trial reduction, remove the cutting guide body, and perform the cuts in a conventional manner (i.e., with standard cutting guides). The advantage here, however, is that with the trial in place these markings would indicate precisely where the final implant will be fixed to the bone, whether augments are required or not. FIG. 4C illustrates a similar concept, except for the posterior cuts, in the sense that a standard trial could be used but again facilities could be provided whereby either a saw guide could be clipped on or the bone could be marked for the posterior and anterior cuts in the manner just described for the distal cut.
- FIG. 5 depicts a different aspect of the invention, including a device for determining the joint line relative to the tibia, using the fibula as reference. The device, labeled ‘A’, contacts the head or proximal portion of the fibula. The device preferably includes a transverse extending rod which is used to estimate where the joint line should be recreated relative to a deficient tibial surface. The vertical portion labeled ‘X’ may be adjustable or fixed. Adjustability allows the joint line to be estimated and adjusted relative to a different sized individual. This could be estimated from an x-ray or other means.
- In addition, an element may be provided on the transverse bar ‘Y’, to assure a transverse positioning, such as a bubble within a fluid as commonly provided with a level, this of course would be more involved than just a simple transverse bar or any other such configuration would be appropriate as well.
- Now making reference to FIG. 6A, it is often the case that bone loss occurs primarily with respect to a central portion of the bone, leaving outer edges with a greater volume of bone stock remaining intact. As shown in FIG. 6A, such is typically the case with the distal femur, resulting in a defect which is often wedge-shaped, as shown. With traditional cutting guides that produce transversely-aligned surfaces, it is often the case that this abundance of medial and lateral remaining bone is simply resected and lost for the sake of geometric simplicity.
- As shown in FIG. 6B, a different aspect of this invention is the provision of nonparallel slots and corresponding wedges, which may be used to retain at least some of this outer remaining bone material. That is, instead of making the traditional straight across
distal cut 62, as shown in FIG. 6A, the cutting guide of FIG. 6B is instead used to make the cuts alonglines
Claims (35)
1. Apparatus for use in conjunction with a cutting tool to resect the end of a bone having a longitudinal axis and medial and lateral sides, the apparatus comprising:
a body adapted for placement relative to one of the medial or lateral sides of the bone,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a resection is made to the bone along a plane generally transverse to the longitudinal axis.
2. The apparatus of claim 1 , wherein the resection is a distal resection.
3. The apparatus of claim 1 , wherein the resection is a posterior resection.
4. The apparatus of claim 1 , wherein the resection is an anterior resection.
5. The apparatus of claim 1 , wherein the resection is a chamfer resection.
6. The apparatus of claim 1 , wherein the cutting guide is a surface against which the cutting tool slides.
7. The apparatus of claim 1 , wherein the cutting guide is in the form of a slot.
8. The apparatus of claim 1 , further including:
a joint trialing device having medial and lateral sides; and
wherein the body is adapted for placement relative to the medial or lateral side of the joint trialing device.
9. The apparatus of claim 1 , further including:
a joint trialing device having cutting guides or surfaces; and
wherein the body is adapted to extend one or more of the cutting guides or surfaces of the joint trialing device.
10. The apparatus of claim 1 , further including a prosthetic component including a surface that contacts the resection when implanted.
11. The apparatus of claim 10 , wherein the prosthetic component forms part of a knee joint.
12. Apparatus for resecting the end of a bone having a longitudinal axis and medial and lateral sides to receive an implant having a generally planar surface associated with fixation, the apparatus comprising:
a body adapted for placement relative to one of the medial or lateral sides of the bone,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a resection is made to contact the generally planar surface of the implant associated with fixation.
13. The apparatus of claim 12 , wherein the resection is a distal resection.
14. The apparatus of claim 12 , wherein the resection is a posterior resection.
15. The apparatus of claim 12 , wherein the resection is an anterior resection.
16. The apparatus of claim 12 , wherein the resection is a chamfer resection.
17. The apparatus of claim 12 , wherein the cutting guide is a surface against which the cutting tool slides.
18. The apparatus of claim 12 , wherein the cutting guide is in the form of a slot.
19. The apparatus of claim 12 , further including:
a trialing device having medial and lateral sides that is temporarily placed on the bode before the implant is installed; and
wherein the body is adapted for placement relative to the medial or lateral side of the joint trialing device.
20. The apparatus of claim 12 , further including:
a trialing device having medial and lateral sides that is temporarily placed on the bode before the implant is installed; and
the body is adapted to extend one or more of the cutting guides or surfaces of the joint trialing device.
21. The apparatus of claim 12 , further including a prosthetic component including a surface that contacts the resection when implanted.
22. A method of resecting the end of a bone having a longitudinal axis and medial and lateral sides, comprising:
providing an implant having a generally planar surface associated with fixation;
positioning a cutting guide relative to one of the medial or lateral sides of the bone; and
resecting the bone using the guide to create a surface that corresponds to the surface of the implant.
23. The method of claim 22 , wherein the resection and implant surface are distal.
24. The method of claim 22 , wherein the resection and implant surface are anterior.
25. The method of claim 22 , wherein the resection and implant surface are posterior.
26. A method of the resecting the end of a bone having a longitudinal axis and medial and lateral sides, comprising:
positioning a cutting guide relative to the medial side of the bone; and
resecting the bone using the guide to create one or more planar surfaces that are generally transverse to the longitudinal axis.
27. A method of the resecting the end of a bone having a longitudinal axis and medial and lateral sides, comprising:
positioning a cutting guide relative the lateral side of the bone; and
resecting the bone using the guide to create one or more planar surfaces that are generally transverse to the longitudinal axis.
28. Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising:
a body adapted for placement relative to the medial side of the distal femur,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a distal resection is performed.
29. Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising:
a body adapted for placement relative to the medial side of the distal femur,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, an anterior resection is performed.
30. Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising:
a body adapted for placement relative to the medial side of the distal femur,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a posterior resection is performed.
31. Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising:
a body adapted for placement relative to the medial side of the distal femur,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a chamfer resection is performed.
32. Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising:
a body adapted for placement relative to the lateral side of the distal femur,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a distal resection is performed.
33. Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising:
a body adapted for placement relative to the lateral side of the distal femur,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, an anterior resection is performed.
34. Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising:
a body adapted for placement relative to the lateral side of the distal femur,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a posterior resection is performed.
35. Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising:
a body adapted for placement relative to the lateral side of the distal femur,
the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a chamfer resection is performed.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/685,902 US20040078043A1 (en) | 1997-09-18 | 2003-10-14 | Joint replacement methods and apparatus |
US11/409,404 US20060195113A1 (en) | 1997-09-18 | 2006-04-21 | Joint replacement methods and apparatus |
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/937,216 US5897559A (en) | 1995-11-02 | 1997-09-18 | Bone cutting guides for use in the implantation of prosthetic joint components |
US5980497P | 1997-09-23 | 1997-09-23 | |
US09/159,168 US6488687B1 (en) | 1997-09-18 | 1998-09-23 | Joint replacement method and apparatus |
US09/300,665 US6602259B1 (en) | 1995-11-02 | 1999-04-27 | Bone cutting guides for use in the implantation of prosthetic joint components |
US10/308,046 US7128745B2 (en) | 1997-09-18 | 2002-12-02 | Joint replacement methods and apparatus |
US10/685,902 US20040078043A1 (en) | 1997-09-18 | 2003-10-14 | Joint replacement methods and apparatus |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/308,046 Continuation US7128745B2 (en) | 1997-09-18 | 2002-12-02 | Joint replacement methods and apparatus |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/409,404 Division US20060195113A1 (en) | 1997-09-18 | 2006-04-21 | Joint replacement methods and apparatus |
Publications (1)
Publication Number | Publication Date |
---|---|
US20040078043A1 true US20040078043A1 (en) | 2004-04-22 |
Family
ID=26739204
Family Applications (4)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/159,168 Expired - Lifetime US6488687B1 (en) | 1997-09-18 | 1998-09-23 | Joint replacement method and apparatus |
US10/308,046 Expired - Fee Related US7128745B2 (en) | 1997-09-18 | 2002-12-02 | Joint replacement methods and apparatus |
US10/685,902 Abandoned US20040078043A1 (en) | 1997-09-18 | 2003-10-14 | Joint replacement methods and apparatus |
US11/409,404 Abandoned US20060195113A1 (en) | 1997-09-18 | 2006-04-21 | Joint replacement methods and apparatus |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/159,168 Expired - Lifetime US6488687B1 (en) | 1997-09-18 | 1998-09-23 | Joint replacement method and apparatus |
US10/308,046 Expired - Fee Related US7128745B2 (en) | 1997-09-18 | 2002-12-02 | Joint replacement methods and apparatus |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/409,404 Abandoned US20060195113A1 (en) | 1997-09-18 | 2006-04-21 | Joint replacement methods and apparatus |
Country Status (1)
Country | Link |
---|---|
US (4) | US6488687B1 (en) |
Cited By (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20060173463A1 (en) * | 2004-12-21 | 2006-08-03 | Dees Roger R Jr | Distal femoral trial with removable cutting guide |
US20070055268A1 (en) * | 2005-08-17 | 2007-03-08 | Aesculap Ag & Co. Kg | Cutting blocks for a surgical procedure and methods for using cutting blocks |
US20110054533A1 (en) * | 2009-08-26 | 2011-03-03 | Binder Lawrence J | Spinous fusion device |
US20140288564A1 (en) * | 2010-03-08 | 2014-09-25 | Zimmer, Inc. | Femoral cut guide |
US9011453B2 (en) | 2010-09-10 | 2015-04-21 | Zimmer, Inc. | Bone preserving intraoperative downsizing system for orthopaedic implants |
US10363147B2 (en) | 2016-05-18 | 2019-07-30 | Depuy Ireland Unlimited Company | System and method for preparing a patient's femur in an orthopaedic joint replacement procedure |
US10470898B2 (en) | 2016-05-18 | 2019-11-12 | Depuy Ireland Unlimited Company | Orthopaedic instrument system for surgically-preparing a patient's tibia |
US10537446B2 (en) | 2017-09-20 | 2020-01-21 | Depuy Ireland Unlimited Company | Method and instruments for assembling an orthopaedic prosthesis |
US10537341B2 (en) | 2017-09-20 | 2020-01-21 | Depuy Ireland Unlimited Company | Orthopaedic system and method for assembling prosthetic components |
US10543001B2 (en) | 2017-09-20 | 2020-01-28 | Depuy Ireland Unlimited Company | Method and instruments for assembling a femoral orthopaedic prosthesis |
US11439409B2 (en) | 2019-09-18 | 2022-09-13 | Depuy Ireland Unlimited Company | Cutting block |
Families Citing this family (45)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
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 |
US7635390B1 (en) | 2000-01-14 | 2009-12-22 | Marctec, Llc | Joint replacement component having a modular articulating surface |
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 |
US7708741B1 (en) | 2001-08-28 | 2010-05-04 | Marctec, Llc | Method of preparing bones for knee replacement surgery |
US8801720B2 (en) | 2002-05-15 | 2014-08-12 | Otismed Corporation | Total joint arthroplasty system |
US8211113B2 (en) * | 2002-06-21 | 2012-07-03 | Depuy Products, Inc. | Prosthesis cutting guide, cutting tool and method |
US20030236522A1 (en) | 2002-06-21 | 2003-12-25 | Jack Long | Prosthesis cavity cutting guide, cutting tool and method |
US7935118B2 (en) | 2002-06-21 | 2011-05-03 | Depuy Products, Inc. | Prosthesis removal cutting guide, cutting tool and method |
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 |
US20040153087A1 (en) * | 2003-02-04 | 2004-08-05 | Sanford Adam H. | Provisional orthopedic implant with removable guide |
US6916324B2 (en) * | 2003-02-04 | 2005-07-12 | Zimmer Technology, Inc. | Provisional orthopedic prosthesis for partially resected bone |
US20050192588A1 (en) * | 2004-02-27 | 2005-09-01 | Garcia Daniel X. | Instrumentation and method for prosthetic knee |
US8303597B2 (en) | 2005-02-08 | 2012-11-06 | Rasmussen G Lynn | Systems and methods for guiding cuts to a femur and tibia during a knee arthroplasty |
US8317797B2 (en) | 2005-02-08 | 2012-11-27 | Rasmussen G Lynn | Arthroplasty systems and methods for optimally aligning and tensioning a knee prosthesis |
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 |
US7678115B2 (en) * | 2006-06-21 | 2010-03-16 | Howmedia Osteonics Corp. | Unicondylar knee implants and insertion methods therefor |
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 |
US8038681B2 (en) * | 2007-09-30 | 2011-10-18 | Depuy Products, Inc. | Modular femoral orthopaedic surgical instrument |
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 |
US8737700B2 (en) | 2007-12-18 | 2014-05-27 | Otismed Corporation | Preoperatively planning an arthroplasty procedure and generating a corresponding patient specific arthroplasty resection guide |
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 |
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 |
US8617171B2 (en) | 2007-12-18 | 2013-12-31 | Otismed Corporation | Preoperatively planning an arthroplasty procedure and generating a corresponding patient specific arthroplasty resection guide |
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 |
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 |
US8715291B2 (en) | 2007-12-18 | 2014-05-06 | Otismed Corporation | Arthroplasty system and related methods |
US8734455B2 (en) | 2008-02-29 | 2014-05-27 | Otismed Corporation | Hip resurfacing surgical guide tool |
US8617175B2 (en) | 2008-12-16 | 2013-12-31 | Otismed Corporation | Unicompartmental customized arthroplasty cutting jigs and methods of making the same |
JP5302595B2 (en) * | 2008-08-06 | 2013-10-02 | 株式会社日立ハイテクノロジーズ | Inclination observation method and observation apparatus |
US9668748B2 (en) | 2009-05-29 | 2017-06-06 | Smith & Nephew, Inc. | Methods and apparatus for performing knee arthroplasty |
BRPI1014341A2 (en) * | 2009-06-24 | 2016-04-05 | Custom Med Orthopaedics Proprietary Ltd | positioning guide, and, guide system for bone cutting. |
US8403935B2 (en) * | 2009-11-10 | 2013-03-26 | Wright Medical Technology, Inc. | Adjustable revision guide |
US8974459B1 (en) | 2010-05-21 | 2015-03-10 | Howmedica Osteonics Corp. | Natural alignment knee instruments |
CH704563B1 (en) * | 2011-02-21 | 2015-04-30 | Microport Orthopedics Inc | Patient Specific Proberepositionsblock. |
AU2012262079B2 (en) * | 2011-06-01 | 2017-02-23 | Smith And Nephew, Inc. | Patient specific instrument |
US8979847B2 (en) | 2011-06-06 | 2015-03-17 | Biomet Manufacturing, Llc | Method and apparatus for implanting a knee prosthesis |
US10603056B2 (en) | 2012-08-31 | 2020-03-31 | Smith & Nephew, Inc. | Patient specific implant technology |
US9402637B2 (en) | 2012-10-11 | 2016-08-02 | Howmedica Osteonics Corporation | Customized arthroplasty cutting guides and surgical methods using the same |
Citations (45)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3868730A (en) * | 1973-09-24 | 1975-03-04 | Howmedica | Knee or elbow prosthesis |
US4736737A (en) * | 1986-03-31 | 1988-04-12 | William Fargie | Tibial cutting jig |
US4738253A (en) * | 1981-12-31 | 1988-04-19 | Biomedical Engineering Trust | Guides for inclined surgical cuts or resections |
US4893619A (en) * | 1988-02-04 | 1990-01-16 | Intermedics Orthopedics, Inc. | Humeral osteotomy guide |
US4936847A (en) * | 1988-12-27 | 1990-06-26 | Johnson & Johnson Orthopaedics, Inc. | Revision knee prosthesis |
US4938769A (en) * | 1989-05-31 | 1990-07-03 | Shaw James A | Modular tibial prosthesis |
US4944760A (en) * | 1983-10-26 | 1990-07-31 | Pfizer Hospital Products Group, Inc. | Method and instrumentation for the replacement of a knee prosthesis |
US4944757A (en) * | 1988-11-07 | 1990-07-31 | Martinez David M | Modulator knee prosthesis system |
US4979949A (en) * | 1988-04-26 | 1990-12-25 | The Board Of Regents Of The University Of Washington | Robot-aided system for surgery |
US5021056A (en) * | 1989-09-14 | 1991-06-04 | Intermedics Orthopedics, Inc. | Upper tibial osteotomy system |
US5047058A (en) * | 1988-04-08 | 1991-09-10 | Smith & Nephew Richards, Inc. | System of inserts for the tibial component of a knee prosthesis |
US5092869A (en) * | 1991-03-01 | 1992-03-03 | Biomet, Inc. | Oscillating surgical saw guide pins and instrumentation system |
US5122144A (en) * | 1989-09-26 | 1992-06-16 | Kirschner Medical Corporation | Method and instrumentation for unicompartmental total knee arthroplasty |
US5129909A (en) * | 1991-03-13 | 1992-07-14 | Sutherland Charles J | Apparatus and method for making precise bone cuts in total knee replacement |
US5226915A (en) * | 1992-04-03 | 1993-07-13 | Bertin Kim C | Femoral prosthesis component system for knee replacement surgery |
US5234433A (en) * | 1989-09-26 | 1993-08-10 | Kirschner Medical Corporation | Method and instrumentation for unicompartmental total knee arthroplasty |
US5250050A (en) * | 1987-02-07 | 1993-10-05 | Pfizer Hospital Products Group, Inc. | Apparatus for knee prosthesis |
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 |
US5263498A (en) * | 1990-01-08 | 1993-11-23 | Caspari Richard B | Method of arthroscopically preparing an articular bone surface |
US5275603A (en) * | 1992-02-20 | 1994-01-04 | Wright Medical Technology, Inc. | Rotationally and angularly adjustable tibial cutting guide and method of use |
US5282866A (en) * | 1992-02-12 | 1994-02-01 | Osteonics Corp. | Prosthetic knee tibial component with axially ribbed keel and apparatus for effecting implant |
US5364401A (en) * | 1992-10-08 | 1994-11-15 | Wright Medical Technology, Inc. | External alignment system for preparing a femur for an implant |
US5364402A (en) * | 1993-07-29 | 1994-11-15 | Intermedics Orthopedics, Inc. | Tibial spacer saw guide |
US5423827A (en) * | 1994-06-02 | 1995-06-13 | Intermedics Orthopedics, Inc. | Surgical jig for femoral knee prosthesis |
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 |
US5490854A (en) * | 1992-02-20 | 1996-02-13 | Synvasive Technology, Inc. | Surgical cutting block and method of use |
US5514139A (en) * | 1994-09-02 | 1996-05-07 | Hudson Surgical Design, Inc. | Method and apparatus for femoral resection |
US5569259A (en) * | 1992-02-20 | 1996-10-29 | Wright Medical Technology, Inc. | Modular shaping and trial reduction guide for implantation of femoral prosthesis and method of using same |
US5597379A (en) * | 1994-09-02 | 1997-01-28 | Hudson Surgical Design, Inc. | Method and apparatus for femoral resection alignment |
US5601563A (en) * | 1995-08-25 | 1997-02-11 | Zimmer, Inc. | Orthopaedic milling template with attachable cutting guide |
US5643272A (en) * | 1994-09-02 | 1997-07-01 | Hudson Surgical Design, Inc. | Method and apparatus for tibial resection |
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 |
US5683397A (en) * | 1995-02-15 | 1997-11-04 | Smith & Nephew, Inc. | Distal femoral cutting guide apparatus for use in knee joint replacement surgery |
US5688282A (en) * | 1995-08-24 | 1997-11-18 | Benois & Girard & Cie | Distraction apparatus for a knee |
US5702460A (en) * | 1995-02-15 | 1997-12-30 | Smith & Nephew, Inc. | Revision femoral trial prosthesis |
US5709689A (en) * | 1995-09-25 | 1998-01-20 | Wright Medical Technology, Inc. | Distal femur multiple resection guide |
US5716361A (en) * | 1995-11-02 | 1998-02-10 | Masini; Michael A. | Bone cutting guides for use in the implantation of prosthetic joint components |
US5720752A (en) * | 1993-11-08 | 1998-02-24 | Smith & Nephew, Inc. | Distal femoral cutting guide apparatus with anterior or posterior referencing for use in knee joint replacement surgery |
US5722978A (en) * | 1996-03-13 | 1998-03-03 | Jenkins, Jr.; Joseph Robert | Osteotomy system |
US5755803A (en) * | 1994-09-02 | 1998-05-26 | Hudson Surgical Design | Prosthetic implant |
US5810827A (en) * | 1994-09-02 | 1998-09-22 | Hudson Surgical Design, Inc. | Method and apparatus for bony material removal |
US5879393A (en) * | 1997-05-21 | 1999-03-09 | Smith & Nephew, Inc. | Trial femoral prosthesis for use in knee joint replacement surgery |
US5916220A (en) * | 1998-02-02 | 1999-06-29 | Medidea, Llc | Bone cutting guide and method to accommodate different-sized implants |
US6695848B2 (en) * | 1994-09-02 | 2004-02-24 | Hudson Surgical Design, Inc. | Methods for femoral and tibial resection |
Family Cites Families (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5755719A (en) * | 1997-01-15 | 1998-05-26 | Case Medical, Inc. | Acetabular reamer |
US5980526A (en) * | 1997-02-12 | 1999-11-09 | Orthopaedic Innovations, Inc. | Wedge osteotomy device including a guide for controlling osteotomy depth |
EP0919195B1 (en) * | 1997-11-28 | 2006-01-18 | Zimmer GmbH | Tool assembly for a prosthetic knee |
-
1998
- 1998-09-23 US US09/159,168 patent/US6488687B1/en not_active Expired - Lifetime
-
2002
- 2002-12-02 US US10/308,046 patent/US7128745B2/en not_active Expired - Fee Related
-
2003
- 2003-10-14 US US10/685,902 patent/US20040078043A1/en not_active Abandoned
-
2006
- 2006-04-21 US US11/409,404 patent/US20060195113A1/en not_active Abandoned
Patent Citations (54)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3868730A (en) * | 1973-09-24 | 1975-03-04 | Howmedica | Knee or elbow prosthesis |
US4738253A (en) * | 1981-12-31 | 1988-04-19 | Biomedical Engineering Trust | Guides for inclined surgical cuts or resections |
US4944760A (en) * | 1983-10-26 | 1990-07-31 | Pfizer Hospital Products Group, Inc. | Method and instrumentation for the replacement of a knee prosthesis |
US4736737A (en) * | 1986-03-31 | 1988-04-12 | William Fargie | Tibial cutting jig |
US5250050A (en) * | 1987-02-07 | 1993-10-05 | Pfizer Hospital Products Group, Inc. | Apparatus for knee prosthesis |
US4893619A (en) * | 1988-02-04 | 1990-01-16 | Intermedics Orthopedics, Inc. | Humeral osteotomy guide |
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 |
US5236432A (en) * | 1988-04-26 | 1993-08-17 | 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 |
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 |
US5122144A (en) * | 1989-09-26 | 1992-06-16 | Kirschner Medical Corporation | Method and instrumentation for unicompartmental total knee arthroplasty |
US5234433A (en) * | 1989-09-26 | 1993-08-10 | Kirschner Medical Corporation | Method and instrumentation for unicompartmental total knee arthroplasty |
US5263498A (en) * | 1990-01-08 | 1993-11-23 | Caspari Richard B | Method of arthroscopically preparing an articular bone surface |
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 |
US5282866A (en) * | 1992-02-12 | 1994-02-01 | Osteonics Corp. | Prosthetic knee tibial component with axially ribbed keel and apparatus for effecting implant |
US5275603A (en) * | 1992-02-20 | 1994-01-04 | Wright Medical Technology, Inc. | Rotationally and angularly adjustable tibial cutting guide and method of use |
US5342367A (en) * | 1992-02-20 | 1994-08-30 | Wright Medical Technology, Inc. | Rotationally and angularly adjustable tibial cutting guide and method of use |
US5569259A (en) * | 1992-02-20 | 1996-10-29 | Wright Medical Technology, Inc. | Modular shaping and trial reduction guide for implantation of femoral prosthesis and method of using same |
US5490854A (en) * | 1992-02-20 | 1996-02-13 | Synvasive Technology, Inc. | Surgical cutting block and method of use |
US5226915A (en) * | 1992-04-03 | 1993-07-13 | Bertin Kim C | Femoral prosthesis component system for knee replacement surgery |
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 |
US5458645A (en) * | 1992-04-03 | 1995-10-17 | Bertin; Kim C. | Method for resecting the knee using a resection guide and provisional prosthetic component |
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 |
US5720752A (en) * | 1993-11-08 | 1998-02-24 | Smith & Nephew, Inc. | Distal femoral cutting guide apparatus with anterior or posterior referencing for use in knee joint replacement surgery |
US5423827A (en) * | 1994-06-02 | 1995-06-13 | Intermedics Orthopedics, Inc. | Surgical jig for femoral knee prosthesis |
US5879354A (en) * | 1994-09-02 | 1999-03-09 | Hudson Surgical Design, Inc. | Prosthetic implant |
US5597379A (en) * | 1994-09-02 | 1997-01-28 | Hudson Surgical Design, Inc. | Method and apparatus for femoral resection alignment |
US5643272A (en) * | 1994-09-02 | 1997-07-01 | Hudson Surgical Design, Inc. | Method and apparatus for tibial resection |
US6695848B2 (en) * | 1994-09-02 | 2004-02-24 | Hudson Surgical Design, Inc. | Methods for femoral and tibial resection |
US6197064B1 (en) * | 1994-09-02 | 2001-03-06 | Hudson Surgical Design, Inc. | Prosthetic implant |
US5514139A (en) * | 1994-09-02 | 1996-05-07 | Hudson Surgical Design, Inc. | Method and apparatus for femoral resection |
US5810827A (en) * | 1994-09-02 | 1998-09-22 | Hudson Surgical Design, Inc. | Method and apparatus for bony material removal |
US5755803A (en) * | 1994-09-02 | 1998-05-26 | Hudson Surgical Design | Prosthetic implant |
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 |
US5688282A (en) * | 1995-08-24 | 1997-11-18 | Benois & Girard & Cie | Distraction apparatus for a knee |
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 |
US5897559A (en) * | 1995-11-02 | 1999-04-27 | Medidea, Llc | Bone cutting guides for use in the implantation of prosthetic joint components |
US5716361A (en) * | 1995-11-02 | 1998-02-10 | Masini; Michael A. | Bone cutting guides for use in the implantation of prosthetic joint components |
US5947973A (en) * | 1995-11-02 | 1999-09-07 | Medidea, Llc | Bone cutting guides for use in the implantation of prosthetic joint components |
US5957926A (en) * | 1995-11-02 | 1999-09-28 | Medidea, Llc | Combination trial and bone cutting guides for use in establishing the position of a prosthetic joint component |
US6602259B1 (en) * | 1995-11-02 | 2003-08-05 | Medidea, Llc | Bone cutting guides for use in the implantation of prosthetic joint components |
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 |
US5722978A (en) * | 1996-03-13 | 1998-03-03 | Jenkins, Jr.; Joseph Robert | Osteotomy system |
US5879393A (en) * | 1997-05-21 | 1999-03-09 | Smith & Nephew, Inc. | Trial femoral prosthesis for use in knee joint replacement surgery |
US5916220A (en) * | 1998-02-02 | 1999-06-29 | Medidea, Llc | Bone cutting guide and method to accommodate different-sized implants |
Cited By (35)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7963968B2 (en) * | 2004-12-21 | 2011-06-21 | Smith & Nephew, Inc. | Distal femoral trial with removable cutting guide |
US20110213378A1 (en) * | 2004-12-21 | 2011-09-01 | Smith & Nephew, Inc. | Distal femoral trial with removable cutting guide |
US8764759B2 (en) | 2004-12-21 | 2014-07-01 | Smith & Nephew, Inc. | Distal femoral trial with removable cutting guide |
US20060173463A1 (en) * | 2004-12-21 | 2006-08-03 | Dees Roger R Jr | Distal femoral trial with removable cutting guide |
US9044249B2 (en) | 2004-12-21 | 2015-06-02 | Smith & Nephew, Inc. | Distal femoral trial with removable cutting guide |
US9649205B2 (en) | 2004-12-21 | 2017-05-16 | Smith & Nephew, Inc. | Distal femoral trial with removable cutting guide |
US20070055268A1 (en) * | 2005-08-17 | 2007-03-08 | Aesculap Ag & Co. Kg | Cutting blocks for a surgical procedure and methods for using cutting blocks |
US20110054533A1 (en) * | 2009-08-26 | 2011-03-03 | Binder Lawrence J | Spinous fusion device |
US9149287B2 (en) * | 2010-03-08 | 2015-10-06 | Zimmer, Inc. | Femoral cut guide |
US20140288564A1 (en) * | 2010-03-08 | 2014-09-25 | Zimmer, Inc. | Femoral cut guide |
US8986310B2 (en) * | 2010-03-08 | 2015-03-24 | Zimmer, Inc. | Femoral cut guide |
US20150157342A1 (en) * | 2010-03-08 | 2015-06-11 | Zimmer, Inc. | Femoral cut guide |
US10166121B2 (en) * | 2010-09-10 | 2019-01-01 | Zimmer, Inc. | Bone preserving intraoperative downsizing system for orthopaedic implants |
US20150182352A1 (en) * | 2010-09-10 | 2015-07-02 | Zimmer, Inc. | Bone preserving intraoperative downsizing system for orthopaedic implants |
US9931228B2 (en) * | 2010-09-10 | 2018-04-03 | Zimmer, Inc. | Bone preserving intraoperative downsizing system for orthopaedic implants |
US20180228625A1 (en) * | 2010-09-10 | 2018-08-16 | Zimmer, Inc. | Bone preserving intraoperative downsizing system for orthopaedic implants |
US9011453B2 (en) | 2010-09-10 | 2015-04-21 | Zimmer, Inc. | Bone preserving intraoperative downsizing system for orthopaedic implants |
US10828176B2 (en) * | 2010-09-10 | 2020-11-10 | Zimmer, Inc. | Bone preserving intraoperative downsizing system for orthopaedic implants |
US10492799B2 (en) | 2016-05-18 | 2019-12-03 | Depuy Ireland Unlimited Company | System for preparing a patient's tibia in an orthopaedic joint replacement procedure |
US10363147B2 (en) | 2016-05-18 | 2019-07-30 | Depuy Ireland Unlimited Company | System and method for preparing a patient's femur in an orthopaedic joint replacement procedure |
US10390965B2 (en) | 2016-05-18 | 2019-08-27 | Depuy Ireland Unlimited Company | System for preparing a patient's femur in an orthopaedic joint replacement procedure |
US10470898B2 (en) | 2016-05-18 | 2019-11-12 | Depuy Ireland Unlimited Company | Orthopaedic instrument system for surgically-preparing a patient's tibia |
US10470899B2 (en) | 2016-05-18 | 2019-11-12 | Depuy Ireland Unlimited Company | Method for preparing a patient's tibia in an orthopaedic joint replacement procedure |
US10363148B2 (en) | 2016-05-18 | 2019-07-30 | Depuy Ireland Unlimited Company | Method for preparing a patient's femur in an orthopaedic joint replacement procedure |
US11517448B2 (en) | 2016-05-18 | 2022-12-06 | Depuy Ireland Unlimited Company | Method for preparing a patient's femur in an orthopaedic joint replacement procedure |
US11504251B2 (en) | 2016-05-18 | 2022-11-22 | Depuy Ireland Unlimited Company | System and method for preparing a patient's femur in an orthopaedic joint replacement procedure |
US11497620B2 (en) | 2016-05-18 | 2022-11-15 | Depuy Ireland Unlimited Company | System for preparing a patient's tibia in an orthopaedic joint replacement procedure |
US10390966B2 (en) | 2016-05-18 | 2019-08-27 | Depuy Ireland Unlimited Company | System including femoral augment trials and method of performing an orthopaedic joint replacement procedure |
US11234841B2 (en) | 2016-05-18 | 2022-02-01 | Depuy Ireland Unlimited Company | System and method of performing a reaming operation on a patient's femur during an orthopaedic joint replacement procedure |
US11337828B2 (en) | 2016-05-18 | 2022-05-24 | Depuy Ireland Unlimited Company | System for preparing a patient's femur in an orthopaedic joint replacement procedure |
US10543001B2 (en) | 2017-09-20 | 2020-01-28 | Depuy Ireland Unlimited Company | Method and instruments for assembling a femoral orthopaedic prosthesis |
US10537341B2 (en) | 2017-09-20 | 2020-01-21 | Depuy Ireland Unlimited Company | Orthopaedic system and method for assembling prosthetic components |
US10537446B2 (en) | 2017-09-20 | 2020-01-21 | Depuy Ireland Unlimited Company | Method and instruments for assembling an orthopaedic prosthesis |
US11672547B2 (en) | 2017-09-20 | 2023-06-13 | Depuy Ireland Unlimited Company | Orthopaedic system and method for assembling prosthetic components |
US11439409B2 (en) | 2019-09-18 | 2022-09-13 | Depuy Ireland Unlimited Company | Cutting block |
Also Published As
Publication number | Publication date |
---|---|
US20030093079A1 (en) | 2003-05-15 |
US6488687B1 (en) | 2002-12-03 |
US20060195113A1 (en) | 2006-08-31 |
US7128745B2 (en) | 2006-10-31 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US7128745B2 (en) | Joint replacement methods and apparatus | |
US6916324B2 (en) | Provisional orthopedic prosthesis for partially resected bone | |
US7344541B2 (en) | Methods and apparatus for femoral and tibial resection | |
US5702460A (en) | Revision femoral trial prosthesis | |
US8062377B2 (en) | Methods and apparatus for knee arthroplasty | |
US8986310B2 (en) | Femoral cut guide | |
US5578037A (en) | Surgical guide for femoral resection | |
EP1862149B1 (en) | Prosthesis and implementation system | |
US6632225B2 (en) | Method and apparatus for resecting a distal femur and a proximal tibia in preparation for implanting a partial knee prosthesis | |
US6558391B2 (en) | Methods and tools for femoral resection in primary knee surgery | |
US5688279A (en) | Alignment guide for a bone cutting block | |
US20040153087A1 (en) | Provisional orthopedic implant with removable guide | |
US20060015113A1 (en) | Optimizing patellar femoral mechanics through alternative depth referencing | |
US20120053591A1 (en) | Apparatuses for femoral and tibial resection | |
US20040039394A1 (en) | Ankle fusion guide and method | |
US7618422B2 (en) | Tibial augmentation guide | |
US7419491B2 (en) | Bone-conserving orthopedic instrumentation and appliances | |
KR101913370B1 (en) | Cutting guide for generating an outer contour for a joint endoprosthesis | |
EP1414356B1 (en) | Guide for locating femur resection plane | |
CA2144337A1 (en) | Method and apparatus for installing a femoral component | |
US20220354508A1 (en) | Cutting block | |
WO1997021389A1 (en) | Distal femoral resection and re-cut instrumentation | |
US11553928B2 (en) | Tibial cutting guide assemblies and associated instrumentation for performing surgical methods | |
AU2002319511B2 (en) | Guide for locating femur resection plane | |
AU2002319511A1 (en) | Guide for locating femur resection plane |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STCB | Information on status: application discontinuation |
Free format text: EXPRESSLY ABANDONED -- DURING EXAMINATION |