Surgical cutting guide

Tools or other instruments can be used by a surgeon to complete an orthopedic procedure. One tool can include a resection tower and a valgus guide. The resection tower can include a cutting block and a dial coupled with the cutting block. The resection tower can be configured such that rotational movement of the dial, about an axis, effectuates movement of the cutting block along a plane substantially parallel with the axis. The dial, when rotated in a first direction, can move between a first position, which corresponds to a minimum cutting depth of the cutting block, and a second position, which corresponds to a maximum cutting depth of the cutting block. The valgus guide can be coupled with the resection tower and includes a rotatable member. The rotatable member can include an angular surface with one or more variable depth splines providing varus/valgus angle adjustment of the cutting block.

BACKGROUND

Tools or other instruments can be used by a surgeon to complete an orthopedic procedure. For example, a surgical cutting guide can be used during an orthopedic procedure to prepare a bone for a prosthetic implant.

SUMMARY

The present disclosure is directed to surgical cutting guide systems and methods for the placement of a cutting block on a bone during an orthopedic procedure. Using the surgical cutting guide systems and methods, a surgeon can quickly and easily position the cutting block at a particular depth and at a particular varus/valgus angle during the orthopedic procedure.

The present inventors have recognized, among other things, that existing systems and methods for adjusting a depth or a varus/valgus angle of a cutting block fail to provide a surgeon with certain speed and ease of use features, such as fast return depth adjustment and minimal rotation to reach maximum varus/valgus angles. The present inventors have further recognized that cutting block adjustment systems and methods can be made more efficient by leveraging a previously positioned intramedullary rod or nail for placement purposes.

The present systems and methods provide or use a resection tower and a valgus guide. The resection tower can include a cutting block and a dial coupled with the cutting block. The resection tower can be configured such that rotational movement of the dial about an axis, effectuates movement of the cutting block along a plane substantially parallel with the axis. The dial, when rotated in a first direction, can move between a first position, which corresponds to a minimum cutting depth of the cutting block, and a second position, which corresponds to a maximum cutting depth of the cutting block. The dial, when rotated in the first direction past the second position, causes the cutting block to return directly to the minimum cutting depth.

The valgus guide can be coupled with the resection tower and includes a rotatable member and a collet lock. The rotatable member can include an angular surface with one or more variable depth splines providing varus/valgus angle adjustment of the cutting block. The variable depth splines are configured such that rotation of the rotatable member less than 90 degrees can effectuate adjustment of the cutting block to a maximum varus/valgus angle. The collet lock is configured to couple the valgus guide to an intramedullary rod or nail and thereby, advantageously provides a surgeon with an intramedullary securement means, instead of pinning, for accurate placement of the cutting block. An amount of time to secure the valgus guide to the intramedullary rod or nail via the collet lock can be less than an amount of time to pin the valgus guide to a bone.

To better illustrate the surgical cutting guide systems and methods disclosed herein, a non-limiting list of examples is provided here:

In Example 1, a system comprises a resection tower including a cutting block, having a slot for guiding a cutting tool, and a dial, coupled with the cutting block such that rotational movement of the dial about an axis effectuates movement of the cutting block along a plane substantially parallel with the axis. The dial, when rotated in a first direction, is configured to move between a first position, corresponding to a minimum cutting depth of the slot, and a second position, corresponding to a maximum cutting depth of the slot. The dial, when rotated in the first direction past the second position, is configured to cause the slot to return directly to the minimum cutting depth.

In Example 2, the system of Example 1 is optionally configured such that the dial includes a first side, a second side, and an internal surface defining a bore extending about the axis between the first and second sides. The internal surface includes a helical groove extending from a first point, adjacent to the first side, to a second point, adjacent to the second side.

In Example 3, the system of Example 2 is optionally configured such that an axial distance between the first point and the second point along the internal surface substantially corresponds to a distance between the minimum cutting depth of the slot and the maximum cutting depth of the slot.

In Example 4, the system of any one or any combination of Examples 2 or 3 is optionally configured such that the helical groove extends less than 360 degrees around the internal surface.

In Example 5, the system of any one or any combination of Examples 2-4 is optionally configured such that the internal surface includes a substantially straight groove extending from the first point to the second point.

In Example 6, the system of any one or any combination of Examples 2-5 is optionally configured such that the resection tower further includes a pin longitudinally disposed in a direction substantially parallel to the axis. The pin includes a first end portion extending through the bore and a second end portion releasably coupled with the cutting block.

In Example 7, the system of Example 6 is optionally configured such that the pin includes a projection extending from the first end portion at an angle relative to the longitudinal disposition of the pin. The projection is configured to move along the helical groove from the first point to the second point as the dial is rotated in the first direction from the first position to the second position, respectively.

In Example 8, the system of Example 7 is optionally configured such that the projection is configured to move along a substantially straight groove extending from the first point to the second point as the dial is rotated in the first direction from the second position, respectively.

In Example 9, the system of any one or any combination of Examples 6-8 is optionally configured such that the resection tower further includes a base, to which the dial and the pin are coupled, and a locking mechanism configured to releasable couple the second end portion of the pin to the cutting block. The locking mechanism includes a locking lever, a plunger, and a locking ball. The locking lever is movable between a locked position and an unlocked position and is coupled with the first end portion of the pin. The plunger extends within the pin and includes a locking ramped surface located near the second end portion of the pin. The locking ball is configured to be engageable with the locking ramped surface and secures engagement between the pin and the cutting block when the locking lever is in the locked position.

In Example 10, the system of Example 9 optionally further includes a resilient member extending around the plunger from a first end to a second end. The resilient member is configured to transition from a compressed state to an uncompressed state as the dial is rotated from the second position to the first position.

In Example 11, the system of any one or any combination of Examples 1-10 optionally further includes a valgus guide, coupled with the resection tower, including a rotatable member having an angular surface with one or more variable depth splines.

In Example 12, the system of Example 11 is optionally configured such that the valgus guide further includes a valgus alignment guide and one or more spherical contacts. The valgus alignment guide couples the valgus guide with the resection tower and includes one or more depressions. The one or more spherical contacts are positioned partially within the one or more depressions and configured to engage with the one or more variable depth splines.

In Example 13, the system of any one or any combination of Examples 11 or 12 is optionally configured such that the rotatable member, when rotated, effectuates adjustment of a varus/valgus angle of the cutting block. The valgus guide is configured such that a maximum varus/valgus angle is reached when the rotatable member is rotated less than 90 degrees.

In Example 14, the system of Example 13 is optionally configured such that the rotatable member includes a plurality of angle reference marks corresponding to a plurality of varus/valgus angles. The plurality of angle reference marks include at least a center reference mark, corresponding to a minimum varus/valgus angle, a right maximum reference mark, corresponding to a maximum right varus/valgus angle, and a left maximum reference mark, corresponding to a maximum left varus/valgus angle.

In Example 15, the system of Example 14 is optionally configured such that a space between each of the plurality of angle reference marks is identical.

In Example 16, the system of any one or any combination of Examples 11-15 is optionally configured such that a thickness of the rotatable member is greatest at a first point on the circumference of the angular surface and is smallest at a second point, diametrically opposite the first point, on the circumference of the angular surface.

In Example 17, the system of Example 16 is optionally configured such that the angular surface comprises a first variable depth spline and a second variable depth spline. The first and second variable depth splines are positioned equidistant from a center line connecting the first and second points on the circumference of the angular surface.

In Example 18, the system of any one or any combination of Examples 16 or 17 is optionally configured such that the one or more variable depth splines taper in width from a first end, near the first point on the circumference, to a second end, near the second point on the circumference. The one or more variable depth splines can form an arc between the first and second ends.

In Example 19, the system of Example 18 is optionally configured such that the one or more variable depth splines have a first depth at the first end and have a second depth at the second end. The first depth is greater than the second depth.

In Example 20, the system of any one or any combination of Examples 11-19 is optionally configured such that the angular surface forms an angle relative to a plane perpendicular to an axis of the rotatable member. The angle can correspond to a maximum right varus/valgus angle of the cutting block and to a maximum left varus/valgus angle of the cutting block.

In Example 21, the system of any one or any combination of Examples 11-20 is optionally configured such that the valgus guide includes a collet lock configured to couple to an intramedullary rod or nail.

In Example 22, a method comprises sliding a system including a resection tower, having a cutting block and a dial, and a valgus guide, having a rotatable member, over an intramedullary rod or nail; turning the rotatable member to adjust a varus/valgus angle of the cutting block, including engaging one or more spherical contacts with one or more variable depth splines on an angular surface of the rotatable member; and turning the dial to adjust a cutting depth of the cutting block.

In Example 23, the method of Example 22 is optionally configured such that turning the dial includes turning the dial in a first direction from a first position, corresponding to a minimum cutting depth of the cutting block, to a second position, corresponding to a maximum cutting depth of the cutting block.

In Example 24, the method of any one or any combination of Examples 22 or 23 is optionally configured such that turning the dial in the first direction further includes turning the dial past the second position, thereby directly returning the cutting block to the minimum cutting depth of the cutting block.

In Example 25, the method of any one or any combination of Examples 22-24 is optionally configured such that turning the rotatable member includes turning the rotatable member less than 90 degrees and positioning the cutting block at a maximum varus/valgus angle.

In Example 26, the surgical cutting guide system or method of any one or any combination of Examples 1-25 is optionally configured such that all elements or options recited are available to use or select from.

These and other examples and features of the present surgical cutting guide systems and methods will be set forth in part in the following Detail Description. This Summary is intended to provide an overview of the present subject matter—it is not intended to provide an exclusive or exhaustive explanation. The Detailed Description is included to provide further information about the present surgical cutting guide systems and methods.

DETAILED DESCRIPTION

FIG. 1illustrates a perspective view of a system10including a resection tower12and a valgus guide14, in accordance with at least one example of the present disclosure. The system10, according to the present disclosure, can be used to position a cutting block2at a particular depth and at a particular varus/valgus angle on a bone during an orthopedic procedure. For example, the system10can be used to prepare a distal end of a femur or a proximal end of a tibia for a knee arthroplasty procedure, a proximal end of a femur for a hip arthroplasty procedure, or a proximal end of a humerus for a shoulder arthroplasty procedure.

The resection tower12can include a cutting block2having a slot4to guide one or more cuts to be made by a cutting instrument, such as a saw, to remove a portion of a bone. The resection tower12can include a dial6operatively coupled with the cutting block2. Rotational movement of the dial6, in a first direction, can effectuate movement of the cutting block2and adjust a depth of the slot4with respect to the bone. The dial6can include a plurality of rotatable positions corresponding to a plurality of cutting depths of the slot4. For example, a first position of the dial6can correspond to a minimum cutting depth of the slot4, and a second position of the dial6can correspond to a maximum cutting depth of the slot4. As the dial6is rotated, in the first direction, past the second position, the slot4can return directly to the minimum cutting depth. Returning directly to the minimum cutting depth can provide a surgeon with fast return depth adjustment capabilities, which can reduce the amount of time spent adjusting the depth of the cutting block2, relative to the bone, during an orthopedic procedure. The resection tower12can further include one or more longitudinal posts11configured to couple the resection tower12with the valgus guide14.

The valgus guide14can adjust the varus/valgus angle of the cutting block2. The valgus guide14can include a valgus alignment guide16, a rotatable member18, and a collet lock20. The valgus alignment guide16can have one or more lumens to receive the one or more longitudinal posts11of the resection tower12, thereby allowing the resection tower12to couple to the valgus guide14. The rotatable member18can include an angular surface with one or more variable depth splines, such as those illustrated as reference numerals182,184inFIGS. 11 and 12, below. The splines can enable a maximum varus/valgus angle to be reached by rotating the rotatable member18less than 90 degrees. In an example, the maximum varus/valgus angle can be reached by rotating the rotatable member18between 50 and 60 degrees, such as about 56 degrees. The collet lock20can couple the valgus guide14to a previously positioned intramedullary rod or nail (not shown) to secure the valgus guide14to a bone and provide for accurate placement of the cutting block2. The collet lock20can increase operating room efficiency by enabling the valgus guide14to be secured to the intramedullary rod or nail, instead of pinning the valgus guide14, to a distal end of a femur, for example.

FIG. 2illustrates an exploded view of a portion of the resection tower12ofFIG. 1, in accordance with at least one example of the present disclosure. The portion of the resection tower12illustrated inFIG. 2excludes the cutting block2(which is illustrated inFIG. 1). As illustrated inFIG. 2, the resection tower12can include the dial6, a pin54, a base32, a plunger90, and a resilient member84. The dial6can include a first side22, a second side26, and an internal surface24defining a bore100extending along an axis25between the first side22and the second side26. The internal surface24can include a helical groove extending from a first point, adjacent to the first side22, to a second point, adjacent to the second side26. Additionally, the dial6can include a substantially straight groove extending from the first point to the second point.

The pin54can be longitudinally disposed in a direction substantially parallel to the axis25. The pin54can include a first end portion60and a second end portion58, the latter of which is releasable coupled with the cutting block2. The pin54can include a projection62extending from the first end portion60at an angle relative to the longitudinal disposition of the pin54. The projection62can be configured to move along the helical groove as the dial6is rotated from a first position associated with the first point, which corresponds to the minimum cutting depth of the slot4, to a second position associated with the second point, which corresponds to the maximum cutting depth of the slot4. The projection62can also be configured to move along the substantially straight groove as the dial6is rotated, in the first direction, past the second positioned to return the slot4directly to the minimum cutting depth.

The base32can include one or more longitudinal posts11, a first holding block36, and a second holding block38. The one or more longitudinal posts11can couple the resection tower12to the valgus guide14. The first holding block36and the second holding block38can be separated by a space34. The space34can be configured to receive a portion of the dial6such that the dial6can rotate about the axis25within the space34. The first holding block36and the second holding block38can each include an opening50extending from a first surface42,46of the first and second holding blocks36,38, to a second surface44,48of the first and second holding blocks36,38. When assembled, the first portion60of the pin54can extend through the opening50in the second holding block38, the bore100of the dial6, and the opening50in the first holding block36. The second portion60of the pin54can be movable along the axis25with respect to the dial6and the base32to adjust the cutting depth of the slot4.

The dial6can be coupled to the base32via locking pegs30. The dial6can include a plurality of positions corresponding to a plurality of cutting depths of the slot4. The locking pegs30are configured such that each position of the plurality of positions aligns at least one of the locking pegs30with one of the openings31in the first holding block36to maintain the dial6at a particular position. For example, when the at least one locking peg30is aligned with one of the openings31, the at least one locking peg30can partially extend into the opening31.

The plunger90can be part of a locking mechanism configured to releasable couple the second end portion58of the pin54to the cutting block2. The locking mechanism can also include a locking lever8and a locking ball66. The plunger90can include a ramped surface96and can extend within a bore54of the pin54. The ramped surface96can be positioned, when assembled, near the second end portion58of the pin54such that the ramped surface96can engage with the locking ball66. The locking ball66can secure the engagement between the pin54and the cutting block2when the locking lever8is in a locked position. The ramped surface96can interact with the locking ball66as the locking lever8is transitioned from an unlocked position to the locked positioned to couple the cutting block2to the pin54. For example, when the locking lever8is in the locked position, the ramped surface96and the locking ball66interact such that the locking ball66partially extends through a locking hole57positioned toward a second end76of the pin54. While in the locked position, the locking ball66can partially extend into a corresponding hole in the cutting block2to couple the cutting block2to the pin54.

The pin54can be coupled to the locking lever8via openings78positioned towards a first end74of the pin54. The openings78can receive a locking rod98that extends through the locking lever8. As the locking lever8moves between the locked positioned and the unlocked position, the relationship between the ramped surface96and the locking ball66changes such that the locking66ball is substantially positioned within a bore56of the pin54and uncouples the cutting block2from the pin54.

The pin54and the plunger90can be coupled to the base32. For example, the pin54can include first and second slots64extending along the first portion60of the pin54. The first and second slots64are positioned directly across from each other and extend in a direction parallel to the axis25. Additionally, the plunger90can include a slot92that extends in a direction parallel to the axis25. A base rod80can extend through the first and second slots64of the pin54, the slot92of the plunger90, and wall openings82in the second holding block38to moveably couple the pin54and the plunger90to the base32. When the pin54and the plunger90are coupled to the cutting block2, the pin54, the plunger90, and the cutting block2can move along axis25as an integral unit, with respect to the base32, to adjust the cutting depth of the slot4.

The resilient member84includes a first end86and a second end88. When assembled, the resilient member84can be positioned around the plunger90and within the first portion60of the pin54(as illustrated inFIG. 6). The first end86of the resilient member84can be positioned between a foot portion94of the plunger and the base rod80. The resilient member84can be configured to be in an uncompressed state when the dial6is at the first position, corresponding to the minimum cutting depth of the slot4, and can be configured to be in a compressed state when the dial6is at the second position, corresponding to the maximum cutting depth of the slot4. For example, as the dial6is rotated, in the first direction, from the first position to the second position, the projection62can move within the helical groove of the dial6and compress the resilient member84between the foot portion94and the base rod80. As the dial6is further rotated, in the first direction, past the second position, the projection62can become aligned with the substantially straight groove of the dial and the resilient member84can transition from the compressed state to the uncompressed state. As the resilient member84transitions from the compressed state to the uncompressed state, the projection62can move along the substantially straight groove and return the slot4directly to the first position, which corresponds to the minimum cutting depth of the slot4.

FIG. 3illustrates a front view of a dial6, in accordance with at least one example of the present disclosure. An external surface40of the dial6can define a plurality of knobs106A-106E (hereinafter generically referred to “knob106” or collectively as “knobs106”). Each knob106can represent a position of the dial6, which in turn can represent a cutting depth of the slot4. In the example ofFIG. 3, the dial6includes five knobs106; however, the dial6may include more or less than five knobs106. The knob106A can represent a minimum cutting depth that, when positioned at an upper-most dial location, corresponds to the minimum cutting depth of the slot4. The knob106E can represent a maximum cutting depth that, when positioned at the upper-most dial location, corresponds to the maximum cutting depth of the slot4. The cutting depth of the slot4corresponding to each knob106, when positioned at the upper-most dial location, can increase from knob106A to knob106E.

As further illustrated inFIG. 3, the internal surface26of the dial6can include the helical groove102and the substantially straight groove104. As the dial6is rotated in the first direction108from the first position, associated with the knob106A positioned at the upper-most dial location, to the second position, associated with the knob106E positioned at the upper-most dial location, the cutting block2moves from the minimum cutting depth to the maximum cutting depth. The substantially straight groove104is positioned between helical groove positions associated with the knobs106A and106E, such that when the dial6is rotated past the second position, in the first direction108, the cutting block2can return directly to the minimum cutting depth.

FIG. 4illustrates a partial cross-sectional view of the dial6ofFIG. 3, such as along line4-4. The internal surface26of the dial includes the helical groove102. The helical groove can be in the form of a depression (e.g., an internal thread), as shown inFIG. 6, or the helical groove can be in the form of a projection (e.g., an external thread), as shown inFIG. 4. In either form, the helical groove102can be configured to engage the projection62of the pin54.

In the example ofFIG. 4, the helical groove102is an external thread that can interact with the projection62of the pin54. The helical groove102can extend from a first point110, adjacent to the first side22of the dial6, to a second point112, adjacent to the second side26of the dial6. An axial distance114between the first point110and the second point112can substantially correspond to a distance between the minimum cutting depth and the maximum cutting depth of the slot4. The helical groove102can extend less than 360 degrees around the internal surface26. The substantially straight groove104can extend from the first point110to the second point112and is positioned between the first and second positions of the dial6. That is, the substantially straight groove104is positioned between knob106A, representing the minimum cutting depth of the slot4, and knob106E, representing the maximum cutting depth of the slot4.

As the dial6is rotated in the first direction108, from the first position to the second position, the projection62can move along the helical groove102from the first position110to the second position112. As the projection62moves along the helical groove102, the cutting depth of the slot4can be adjusted from the minimum cutting depth to the maximum cutting depth. As the dial6is rotated in the first direction106, past the second position, the projection62can move along the substantially straight groove104from the second position112to the first position110. As the projection62moves along the substantially straight groove104, the cutting depth of the slot4can be adjusted from the maximum cutting depth directly to the minimum cutting depth. The resilient member84, while the dial6is at the second position, can be configured to be in a compressed state such that when the projection62aligns with the substantially straight groove104, the resilient member84transitions from the compressed state to the uncompressed state returning the slot4directly to the minimum cutting depth associated with the first position of the dial6.

FIG. 5illustrates a side view of the portion of the resection tower12ofFIG. 2, in accordance with at least one example of the present disclosure. InFIG. 5, the dial6is shown in the first position (e.g., the knob106A is positioned at an upper-most dial location), corresponding to the minimum cutting depth of the slot2. The pin54can include a plate portion68that is positioned between the first portion60and the second portion58of the pin54. The plate portion68can include a first surface70and a second surface72. The first surface70is configured to face the second surface44of the second holding block38. As the dial6is rotated in the first direction, from the first position to the second position, a distance45between the first surface70of the plate68and the second surface48of the second holding block28can increase. As the dial6is rotated in the first direction, past the second position to the first position, the distance45between the first surface70of the plate68and the second surface48of the second holding block38can decrease.

FIG. 6illustrates a cross-sectional view of the portion of the resection tower12ofFIG. 5, such as along line6-6. The locking lever8is shown in a locked position and the locking ball66extends through the locking hole57of the pin54. The ramped surface96can interact with the locking ball66and when the locking lever8is in the locked position, the locking ball66can move along the ramped surface96and extend through the locking hole57. When the locking lever8is transitioned to an unlocked positioned, such as by rotating the locking lever8about locking rod98, the plunger90can move with respect to the pin54and the locking ball66can move along the ramped surface97and be positioned substantially within the bore56of the pin54. In the unlocked position, the locking ball66does not engage the corresponding hole in the cutting block2and the pin54and the cutting block2can be separated.

In the example ofFIG. 6, the projection62is positioned within a helical groove102, in the form of an internal thread, and the resilient member84is positioned between the base rod80and the foot portion93of the plunger90. As shown, the projection62extends from a bottom surface of the pin54. However, the projection62can also extend from the top surface of the pin54.

As the dial6is rotated in the first direction from the first position to the second position, the projection62can move along the helical groove120causing the pin54and plunger90to move linearly with respect to the base32and the dial6. When the pin54and the plunger90are coupled to the cutting block2, the pin54, the plunger90, and the cutting block2can move along axis25as an integral unit with respect to the base32to adjust the cutting depth of the slot4.

The resilient member84can be configured to be in an uncompressed state when the dial6is at the first position, corresponding to the minimum cutting depth of the slot4, as illustrated inFIG. 6. As the dial6is rotated in the first direction from the first position to the second positioned, the projection62can move within the helical groove102can cause the resilient member to transition to a compressed state. For example, the resilient member84is positioned between the base rod80and the foot portion94of the plunger90. As the pin54and plunger90move along axis25with respect to base rod80, the resilient member becomes compressed as a distance between the base rod80and the foot portion94decreases.

When the dial6is rotated in the first direction past the second position, the projection62can become aligned with the substantially straight groove (shown as reference number104inFIGS. 3 and 4) and the resilient member84can transition from the compressed state to the uncompressed state. As the resilient member84transitions from the compressed state to the uncompressed state, the projection62moves along the substantially straight groove and the slot4can return directly to the minimum cutting depth, which corresponds to the first position of the dial6.

FIG. 7illustrates a top view of the portion of the resection tower12ofFIG. 5, in accordance with at least one example of the present disclosure. As shown, the dial6is in the first position corresponding to the minimum cutting depth of the slot2. The knobs106can include markings to indicate a cutting depth associated with each knob106, when positioned at an upper-most dial location. By way of example, knob106A can include a “0” marking indicating that the cutting block2is at the minimum cutting depth (e.g., zero millimeters) and knob106E can include a “4” marking indicating that the cutting block2is at the maximum cutting depth (e.g., 4 millimeters). The substantially straight groove can be positioned between knob106A and106E enabling the slot4to return to the minimum cutting depth when the dial6is rotated in the first direction past the second position. In this example, the second position is associated with knob106E positioned at the upper-most dial location. In an example, the dial6can include an opening120that is in communication with the substantially straight groove.

The pin54can also include a depth gauge118that aligns with reference markings116on the second holding block38to indicate a cutting depth of the slot4. When the dial6is at the first position, corresponding to the minimum cutting depth of the slot4, the depth gauge118can be aligned with the “0” reference marking116indicating that the cutting depth of the slot4is at the minimum cut depth. When the dial6is at the second position, corresponding to the maximum cutting depth of the slot4, (e.g., four millimeters), the depth gauge118can be aligned with the “+4” reference marking116.

FIG. 8illustrates an exploded view of the valgus guide14ofFIG. 1, in accordance with at least one example of the present disclosure. The valgus guide14can include a valgus alignment guide16and a rotatable member18. The valgus alignment guide16can include one or more slots124configured to receive the one or more longitudinal posts11of the resection tower12(as illustrated inFIG. 1) to couple the valgus guide16to the resection tower12. The valgus alignment guide16can include a first surface128and a second surface129, which is opposite the first surface128. The first surface128can be a bone contacting surface and the second surface129can include one or more depressions130. The valgus alignment guide16can further include one or more spherical contacts160positioned partially within the one or more depressions130. The valgus guide16can further include an alignment port126that is configured to receive at least an intramedullary rod or nail and rotate about a rotation axis193to adjust the varus/valgus angle of the cutting block2.

The rotatable member18can include an angular surface136with one or more variable depth splines (illustrated inFIG. 11as reference numbers182and184). The rotatable member18can include a bore140that is configured to receive the intramedullary rod or nail. The intramedullary rod or nail can be configured to extend through the bore140and the alignment port124. The one or more spherical contacts160can engage with the one or more variable depth splines such that, when rotated, the rotatable member18can effectuate adjustment of a varus/valgus angle of the cutting block2by rotating the valgus alignment guide16about the rotation axis192.

The valgus guide14can further include a reference member151having a reference base152, a rotation post148, and a locking post156. The rotation post148can extend from a first side153of the reference base152and the locking post156can extend from a second side157of the reference base152. The reference member151can be coupled to the valgus alignment guide16and the rotatable member18. For example, the rotation post148can extend through the bore140of the rotatable member18and into the adjustment port126of the valgus alignment guide16. The valgus alignment guide16can include rotation holes193that can be aligned with openings150that extend through the rotation post148. When assembled, the rotation holes193and the openings150can be configured to receive rotation pins122such that the valgus alignment guide16can rotate about the rotation axis155. The rotation axis155can extend centrally through the rotation holes193and the openings150and be substantially perpendicular with respect to a longitudinal axis149of the valgus guide14. The valgus guide14can also include a locking hole and a locking pin configured to secure the valgus guide to a distal end of a bone.

The rotatable member18can be coupled to the reference member151. For example, the rotatable member18can be coupled to the reference member151via a primary locking mechanism and a secondary locking mechanism. The primary locking mechanism can include a lock132and a resilient member134. The primary locking mechanism, when locked, can prevent rotation of the rotatable member18. The lock132can include a projection135that is configured to extend into and engage a first indentation positioned on the first side153of the reference body152. In response to an applied force, the lock132can compress the resilient member134and the projection135can disengage from the indentation. Once disengaged, the rotatable member18can rotate about the longitudinal axis149.

The secondary locking mechanism can assist in guiding the rotatable member18to a particular varus/valgus angle. The first side153of the reference base152can include a plurality of second indentations configured to be engaged with pins144of the rotatable member18. The pins144can couple to the rotatable member and include the compressible members146. When the rotatable member18is rotated while the primary locking mechanism is in an unlocked state, the compressible members146can compress into the pins144and enable the rotatable member18to rotate. For each varus/valgus angle, the pins144can align with one or more of the plurality of second indentations to assist in guiding the rotatable member18to a particular varus/valgus angle. That is, the pins144can engage one or more second indentations when the rotatable member18is rotated to each varus/valgus angle.

The rotatable member18can further include the collet lock20. The collet lock20can include the locking post158and a turn knob159. The locking post156can include a plurality of threads158configured to engage corresponding threads along an internal surface of the turn knob159. The locking post156can include a plurality of flexible pegs160. A bore142extending through the reference member151can be configured to receive the intramedullary rod or nail. As the turn knob159is turned in a first direction161, the flexible pegs160can compress onto the intramedullary rod or nail and couple the valgus guide14to the intramedullary rod or nail. When the turn knob159is turned in a second direction162, the flexible pegs160can release the intramedullary rod or nail and uncouple the valgus guide14from the intramedullary rod or nail.

FIG. 9illustrates a perspective view of a portion of the valgus guide14ofFIG. 8, in accordance with at least one example of the present disclosure. As shown inFIG. 9, the rotatable member18can be coupled to the reference member151. A thickness172of the rotatable member18can be greatest at a first point166on the circumference of the angular surface136. A thickness173of the rotatable member18can be smallest at a second point168, diametrically opposite the first point166, on the circumference of the angular surface136. The angled surface136can form an angle170relative to a plane174perpendicular to the longitudinal axis149of the rotatable member. The angle170can correspond to a maximum left varus/valgus angle of the cutting block2and a maximum right varus/valgus angle of the cutting block2.

FIG. 10shows an example of a rotatable member18. The rotatable member18can include a plurality of angle reference marks138corresponding to a plurality of varus/valgus angles. The plurality of angle reference marks138can include a center reference mark176corresponding to a minimum varus/valgus angle, a right maximum reference mark175corresponding to a maximum right varus/valgus angle, and a left maximum reference mark178corresponding to a maximum left varus/valgus angle. A space180between each of the plurality of angle reference marks136can be identical. In an example, each reference mark of the plurality of reference marks136can correspond to a same relative adjustment to the varus/valgus angle. As shown in the example ofFIG. 10, the rotatable member can have a maximum right varus/valgus angle and a maximum left varus/valgus angle of nine degrees. In addition, by turning the rotatable member18one reference mark138, a user can adjust the varus/valgus angle by, for example, one degree.

FIG. 11illustrates a perspective view of a rotatable member, in accordance with at least one example of the present disclosure. The angled surface136of the rotatable member can include a first variable depth spline182and a second variable depth spline184. The first and second variable depth splines182,184can be positioned equidistant from a center line186connecting the first and second points166,168on the circumference of the angular surface136. The first and second variable depth splines182,184can taper in width from a first end188, near the first point166on the circumference, to a second end190, near the second point168on the circumference, as shown inFIGS. 12A-12I. The first and second variable depth splines182,184can form an arc between the first and second ends188,190. The first and second variable depth splines182,184can have a first depth at the first end188and can have a second depth at the second end190, where the first depth is greater than the second depth, as incrementally shown inFIGS. 12A-12I. The first and second variable depth splines182,184enable the spacing180between the reference markings136(as illustrated inFIG. 10) to be identical. Additionally, the variable depth splines182,184enable the maximum right varus/valgus angle and the maximum left varus/valgus angle to be reached by rotating the rotatable member18less than 90 degrees. In an example, the maximum right and left varus/valgus angle can be reached by rotating the rotatable member18plus or minus fifty-six degrees (+/−56°).

FIGS. 12A-12Iillustrate cross-sectional views of the rotatable member ofFIG. 11, such as along lines A-A to I-I. As illustrated inFIGS. 12A-12I, the depth and width of the first and second variable depth splines182,184can vary from the first end188to the second end190. The depth and width can vary based on the maximum right and left varus/valgus angle and an amount of rotation of the rotatable member18to reach the maximum right and left varus/valgus angle. In the example ofFIGS. 12A-12I, the maximum right and left varus/valgus angle is plus or minus nine degrees (+/−9°) and the amount of rotation to reach the maximum right and left varus/valgus angle is approximately plus or minus fifty-six degrees (+/−56°). The width192of the first variable depth spline182and the width194of the second variable depth spline184vary from the first end188to the second end190of the first and second variable depth splines182,184. The depth196of the first variable depth spline182and the depth198of the second variable depth spline184vary from the first end188to the second end190. The widths192,194and the depths196,198for the first and second variable depth splines182,184, along lines A-A to I-I ofFIG. 11, are provided by way of example in Table 1.

FIG. 13illustrates a top view of a valgus guide14, in accordance with at least one example of the present disclosure. The one or more spherical contacts160can engage with the one or more variable depth splines such that, when rotated, the rotatable member18can effectuate adjustment of a varus/valgus angle of the cutting block2. For example, the valgus alignment guide16can rotate about the rotation axis (aligned with rotation pin122) in a direction of the movement arrows200to adjust a varus/valgus angle of the cutting block2. As shown in the example ofFIG. 13, the reference base152can include an angle gauge154that can indicate the varus/valgus angle of the cutting block2. The valgus guide14of the present disclosure can enable a maximum varus/valgus angle of the cutting block2to be reached by rotating the rotatable member18less than 90 degrees. Additionally, the collet lock20can secure the valgus guide14to an intramedullary rod or nail for accurate placement of the cutting block2instead of pinning the valgus alignment guide16to a distal end of a bone.

FIGS. 14A-Cillustrate perspective views of a valgus guide202, in accordance with at least one example of the present disclosure. The valgus guide202can be coupled with the resection tower12. For example, the valgus guide202can include one or more slots208that can be configured to receive one or more longitudinal posts11of the resection tower12. The valgus guide202can include a bore220(as illustrated inFIG. 14C) that can be configured to receive an intramedullary rod or nail. Depending on the orientation of the valgus guide202with respect to a bone, the valgus guide202can position the cutting block2at either a fixed right varus/valgus angle or a fixed left varus/valgus angle. As illustrated inFIGS. 14Aand B, a bone contacting surface204can form an angle224with respect to a plane214that is perpendicular to a longitudinal axis212of the valgus guide202. The angle224can correspond to the fixed right and left varus/valgus angle.

As illustrated inFIG. 14A, the valgus guide202can include a marking “5°R” indicating that the fixed varus/valgus angle is a five degree right varus/valgus angle. As illustrated inFIG. 14B, the valgus guide202can include a marking “5° L” indicating that the fixed varus/valgus angle is a five degree left varus/valgus angle. The valgus guide202can include a locking hole222and a locking pin216configured to secure the valgus guide202to a distal end of a bone.

FIG. 15illustrates a method300of using a system including a resection tower and a valgus guide, in accordance with at least one example of the present disclosure. At302, the method300can include sliding a system over an intramedullary rod or nail. The system can include a resection tower, having a cutting block and a dial, and a valgus guide, having a rotatable member, over an intramedullary rod or nail.

At304, the method can include turning the rotatable member to adjust a varus/valgus angle of the cutting block. Turning the rotatable member can include engaging one or more spherical contacts with one or more variable depth splines on an angular surface of the rotatable member. In an example, turning the rotatable member less than 90 degrees can include positioning the cutting block at a maximum varus/valgus angle.

At306, the method can include turning the dial to adjust a cutting depth of the cutting block. The dial can be turned in a first direction from a first position, corresponding to a minimum cutting depth of the cutting block, to a second position, corresponding to a maximum cutting depth of the cutting block. The dial, when turned in the first direction past the second position, can directly return the cutting block to the minimum cutting depth.

The above Detailed Description includes references to the accompanying drawings, which form a part of the Detailed Description. The drawings show, by way of illustration, specific embodiments in which the present surgical cutting guide systems and methods can be practiced. These embodiments are also referred to herein as “examples.”

In the event of inconsistent usages between this document and any document so incorporated by reference, the usage in this document controls.

In this document, the terms “a” or “an” are used to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the phrase “varus/valgus angle” is used to refer to a varus angle only, a valgus angle only, or both a varus angle and a valgus angle.

In the appended claims, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” The terms “including” and “comprising” are open-ended, that is, a system or method that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.