Source: https://patents.justia.com/patent/9566076
Timestamp: 2020-05-24 23:28:03
Document Index: 639936973

Matched Legal Cases: ['Application No. 61', 'Application No. 61', 'Application No. 2015', 'Application No. 201410652267', 'Application No. 201410652267', 'Application No. 2015202216', 'Application No. 09716515', 'Application No. 2010', 'Application No. 2009221920', 'Application No. 200990108374', 'Application No. 09716515', 'Application No. 2010', 'Application No. 2010', 'Application No. 2015']

US Patent for Low profile patient specific cutting blocks for a knee joint Patent (Patent # 9,566,076 issued February 14, 2017) - Justia Patents Search
Justia Patents Reamer Or DrillUS Patent for Low profile patient specific cutting blocks for a knee joint Patent (Patent # 9,566,076)
Aug 9, 2016 - Smith & Nephew, Inc.
This application is a continuation of U.S. patent application Ser. No. 14/642,116 filed Mar. 9, 2015 and now issued as U.S. Pat. No. 9,408,619, which is a continuation of U.S. patent application Ser. No. 12/920,645 filed Jan. 5, 2011 and now issued as U.S. Pat. No. 9,033,991, which is a U.S. national phase filing of International Application No. PCT/US2009/035935 filed Mar. 3, 2009, which claims the benefit of U.S. Provisional Application No. 61/033,419 filed Mar. 3, 2008 and which further claims the benefit of U.S. Provisional Application No. 61/089,373 filed Aug. 15, 2008. The disclosure of each of these applications is incorporated by reference in its entirety.
Yet another embodiment, the bone interfacing portions are generally oriented in the middle of the low profile patient specific cutting block in an anterior portion of the low profile patient specific cutting block and are oriented medially and laterally at a posterior portion of the low profile patient specific cutting block.
Referring to the accompanying drawings in which like reference numbers indicate like elements, FIG. 1 illustrates a view of a knee joint with a femoral patient specific cutting block 10 and a tibial patient specific block 14. The femoral patient specific cutting block 10 is attached to a femur 12. The tibial patient specific cutting block 14 is attached to a tibia 16. The patient specific cutting blocks 10 and 14 ace configured to engage portions of bone and cartilage on the femur 12 and tibia 16 to align cutting surfaces within the patient specific cutting blocks so that a distal cut (on the femur) and a proximal cut (on the tibia) may be made without using either intramedullary or extramedullary guides.
The pin holes 40 and 48 are oriented on anterior face of the patient specific cutting block 10. The pin holes 40 and 48 may have bosses (as shown with reference to pin holes 40) or may be flush with the surface (as shown in pin hole 48). The bosses may be used to direct the pins, for example, away from the edges of the bone. The low profile of the patient specific cutting block 10 would allow a pin hole without a boss to allow a pin to extend in a wide variety of angular directions. By extending bosses a thickness greater than the diameter of the aperture through the boss, the bosses may orient the pins by adding a guide through the patient specific cutting block 10 so that the pins are directed as they are impacted or drilled into the bone.
In addition to the MR and X-ray information, surgeon preferences are used to place the cutting slot 46 on the patient specific cutting block 10. The cutting slot 46 may be oriented relative to the mechanical axis in a varus or valgus orientation (according to surgeon preference based upon the X-ray data). The flexible gap may be adjusted by adjusting the angle of the cutting slot 46 relative to the patient specific cutting block 10. The depth of the resection cut is also determined by the placement of the cutting slot 46 and is determined from the distal points on the condyles.
The guide bosses 42 are also placed on the patient specific cutting block 10 according to MR data, X-ray data and surgeon preference. The guide bosses 42 may set the rotation of the implant by adjusting the posterior bosses 42 relative to one another. The relative placement of the bosses 42 allows for pins to be placed so that the pins guide a further cutting guide over the distal cut of the femur in order to make the anterior and posterior cuts and any chamfer cuts required by the bone interfacing surfaces of the implant. Internal/external rotation is directed by moving the depth of the one of the posterior bosses relative to the other posterior boss. A-P placement of the implant is adjusted by moving both of the posterior bosses 42 together in the A-P direction.
The tibial patient specific cutting block 14 includes an anterior femoral portion 300, a medial femoral paddle 32 and a lateral femoral paddle 34. These portions overlie portions of the anterior face, media plateau and lateral plateau of the tibia 16, respectively. Because the portions 20, 22, and 24 only overlie portions of the tibia 16 instead of an entire conforming overlay of the end of the tibia 16, the patient specific cutting block 14 may have a lower profile, both in the medio-lateral and anterior-posterior direction.
The planar proximal surface may match the distal femur resection plane from the femoral patient specific cutting block. This feature may allow intraoperative flexion/extension testing when the tibial patient specific cutting block is secured to the tibia.
Bone interfacing, surfaces 90, 92, and 94 are shown in FIG. 5. The anterior bone interfacing portion 90 overlies a portion of the anterior surface of cartilage and bone. The medial bone interlacing portion 92 and the lateral bone interfacing portion 84 overlie the medial and lateral portions of the tibia, respectively. The bone interfacing portions 92 and 94 align to the proximal faces of the tibial plateaus (thus orienting the patient specific cutting block proximally) while the anterior bone interfacing portion 90 orients the block medio-laterally and in the AP direction. By using relatively small portions of the surfaces, the profile of the patient specific cutting block may be lowered. Additionally, the fit may be better as smaller portions may result in few osteotomes on the bone surface (which may cause poor fit of the patient specific cutting block to the bone. The paddles 32 and 34 may also be relatively thin posteriorly and may be elevated from the tibial plateau surface anteriorly to avoid poor placement. This further minimizes the profile of the patient specific cutting block.
The MR data and X-ray data may be taken by known means. As an example, the following protocols may be used. Different MR protocols may be executed on different patients. To minimize scan time, a fast spin echo imaging technique may be used for any protocol, essentially producing a proton density (PD) weighted image. One protocol may use the spoiled gradient echo technique with a low repetition time (TR) and low echo time (TE) and a flip angle of 30 degrees combined with a fat saturation technique. A second protocol and third protocol may use a high TR and a low TE combined with a fat saturation technique. The only difference between the second protocol and third protocol is that the second protocol has lower TE than the third protocol, which in turn offers more TI and less PD properties. The increased TI relaxation time may help to increase the image contrast within the different tissues in the MR image.
It view of the foregoing, it will be seen that the several advantages of the invention are achieved and attained.
The embodiments were chosen nod described in order to best explain the principles of the invention and its practical application to thereby enable others skilled in the ad to best utilize the invention in various embodiments and with various modifications as are suited to the particular use contemplated.
As various modifications could be made in the constructions and methods having described and illustrated without departing from the scope of the invention, it is intended that all matter contained in the foregoing description or shown in the accompanying drawings shall be interpreted as illustrative rather than limiting. Thus, the breadth and scope of the present invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims appended hereto and their equivalents.
a cutting guide oriented in a fixed position relative to the bone interfacing portions to guide a cutting tool at a fixed angle relative to the bone interfacing portions; and
wherein the cutting guide is medially offset relative to an anterior portion of the bone and is oriented entirely along a medial portion of the patient specific cutting block and does not extend along a lateral portion of the patient specific cutting block.
2. The low profile patient specific cutting block of claim 1, wherein the cutting guide opens in a direction facing the lateral portion of the patient specific cutting block.
3. The low profile patient specific cutting block of claim 1, wherein the first of the bone interfacing portions comprises a medial paddle and a lateral paddle, the medial paddle configured to overlie a medial portion of the bone, the lateral paddle configured to overlie a lateral portion of the bone; and
4. The low profile patient specific cutting block of claim 1, wherein the first of the bone interfacing portions extends generally perpendicular to the second of the bone interfacing portions.
5. The low profile patient specific cutting block of claim 1, wherein the bone interfacing portions each have a surface that is generally a negative of the portion of the bone that the bone interfacing portion is configured to overlie, wherein the first of the bone interfacing portions is configured to overlie an anterior portion of the bone extending in a first direction, and wherein the second of the bone interfacing portions is configured to overlie another portion of the bone extending in a second direction generally perpendicular to the first direction.
6. The low profile patient specific cutting block of claim 5, wherein the first of the bone interfacing portions is configured to overlie an anterior face of the bone, and wherein the second of the bone interfacing portions includes a first portion configured to overlie a medial portion of the bone and a second portion configured to overlie a lateral portion of the bone.
7. The low profile patient specific cutting block of claim 1, wherein the patient specific cutting block further comprises a plurality of bosses each having a thickness and an aperture extending therethrough, the aperture having a diameter sized and configured to direct a pin therethrough, the thickness of the boss being greater than the diameter of the aperture.
8. The low profile patient specific cutting block of claim 1, wherein the bone interfacing portions further include medial and lateral paddles positioned medially and laterally at a posterior portion of the patient specific cutting block, and wherein the medial and lateral paddles each have a raised portion anteriorly oriented on the patient specific cutting block such that the paddles do not touch the tibia on an anterior proximal surface and do touch the tibia on a posterior proximal surface.
9. The low profile patient specific cutting block of claim 1, wherein the bone interfacing portions include an anterior portion generally positioned along the mid-portion of the patient specific cutting block, and wherein the bone interfacing portions further include medial and lateral paddles positioned medially and laterally at a posterior portion of the patient specific cutting block.
10. The low profile patient specific cutting block of claim 1, wherein the cutting guide includes at least one cutting guide surface configured to guide the cutting tool at the fixed angle relative to the bone interfacing portions.
11. The low profile patient specific cutting block of claim 1, wherein the cutting guide includes a pair of cutting guide surfaces facing opposite one another and configured to guide the cutting tool at the fixed angle relative to the bone interfacing portions.
12. The low profile patient specific cutting block of claim 1, wherein the patient specific cutting block comprises a patient specific tibial cutting block.
13. A low profile patient specific cutting block for a knee, comprising:
cutting guide surfaces oriented in a fixed position relative to the bone interfacing portions for guiding a cutting tool at a fixed angle relative to the bone interfacing portions; and
wherein the cutting guide surfaces are medially offset relative to an anterior portion of the bone and is oriented entirely along a medial portion of the patient specific cutting block and do not extend along a lateral portion of the patient specific cutting block.
14. The low profile patient specific cutting block of claim 13, wherein the cutting guide surfaces open in a direction facing the lateral portion of the patient specific cutting block.
15. The low profile patient specific cutting block of claim 13, wherein the first of the bone interfacing portions comprises a medial paddle and a lateral paddle, the medial paddle configured to overlie a medial portion of the bone, the lateral paddle configured to overlie a lateral portion of the bone; and
16. The low profile patient specific cutting block of claim 13, wherein the first of the bone interfacing portions extends in a first direction and the second of the bone interfacing portions extends in a second direction generally perpendicular to the first direction; and
wherein the first of the bone interfacing portions is configured to overlie an anterior face of the bone, and wherein the second of the bone interfacing portions includes a first portion configured to overlie a medial portion of the bone and a second portion configured to overlie a lateral portion of the bone.
17. A low profile patient specific cutting block for a knee, comprising:
wherein the cutting guide is medially offset relative to an anterior portion of the bone and is oriented entirely along a medial portion of the patient specific cutting block and does not extend along a lateral portion of the patient specific cutting block; and
18. The low profile patient specific cutting block of claim 17, wherein the patient specific cutting block comprises a patient specific tibial cutting block.
19. The low profile patient specific cutting block of claim 17, wherein the cutting guide includes at least one cutting guide surface configured to guide the cutting tool at the fixed angle relative to the bone interfacing portions.
20. The low profile patient specific cutting block of claim 17, wherein the cutting guide includes a pair of cutting guide surfaces facing opposite one another and configured to guide the cutting tool at the fixed angle relative to the bone interfacing portions.
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Patent number: 9566076
Patent Publication Number: 20160345982
Application Number: 15/232,407
International Classification: A61B 17/56 (20060101); A61B 17/15 (20060101); A61B 17/17 (20060101);