System and method for assisting with attachment of a stock implant to a patient tissue

Patent metadata

Field	Value
Publication number	US-10258352-B2
Application number	US-201715847206-A
Country	US
Kind code	B2
Filing date	Dec 19, 2017
Priority date	Oct 29, 2010
Publication date	Apr 16, 2019
Grant date	Apr 16, 2019

Abstract

A guide for assisting with attachment of a stock prosthetic implant to a patient tissue includes a lower guide surface configured to contact an upper implant surface of the stock prosthetic implant when a lower implant surface of the stock prosthetic implant contacts the patient tissue. An upper guide surface is accessible to a user when the lower guide surface is in contact with the upper implant surface. At least one guiding aperture extends through the guide body between the upper and lower guide surfaces at a predetermined aperture location with respect to the guide body and defines a predetermined target trajectory through the guide body. At least one of the target trajectory and the aperture location of each guiding aperture is preselected responsive to preoperative imaging of the patient tissue. A method of assisting with attachment of a stock prosthetic implant to a patient tissue is also provided.

First claim

Having described the invention, we claim:

1. A method of attaching a stock prosthetic implant to a patient tissue, the stock prosthetic implant including a plurality of fastener apertures extending therethrough, the method comprising the steps of:
placing a lower implant surface of the stock prosthetic implant into contact with the patient tissue in a predetermined implant orientation;
providing a guide having a lower guide surface contoured to substantially mate with at least a portion of an upper implant surface of the stock prosthetic implant, an upper guide surface spaced longitudinally apart from the lower guide surface by a guide body, at least one guiding aperture extending through the guide body between the upper and lower guide surfaces at a predetermined aperture location with respect to the guide body, and two or more locating protrusions extending from the lower guide surface toward the upper implant surface for engaging the upper implant surface, the two or more locating protrusions being spaced apart from the at least one guiding aperture;
defining a target trajectory through the guide body using the at least one guiding aperture, the target trajectory and the predetermined aperture location of the at least one guiding aperture being preselected responsive to preoperative imaging of the patient tissue;
placing the lower guide surface into mating contact with the at least a portion of the upper implant surface in a selected one of a plurality of possible orientations of the guide relative to the stock prosthetic implant, the selected one of the plurality of possible orientations being a predetermined relative guide/implant orientation;
placing a chosen one of the at least one guiding aperture of the guide into a collinear relationship with a chosen one of the plurality of fastener apertures of the stock implant, and nesting the two or more locating protrusions of the guide into preselected ones of the plurality of fastener apertures of the stock prosthetic implant such that the guide is oriented relative to the stock prosthetic implant in the predetermined relative guide/implant orientation, wherein the guide and the stock prosthetic implant are engaged together in a fixed rotational orientation relationship when the two or more locating protrusions are nested with the preselected ones of the plurality of fastener apertures, such that relative rotation between the guide and the stock prosthetic implant is prevented in the fixed rotational relationship; and
at least one step selected from the group of steps consisting of: a step of guiding a surgical tool through the chosen guiding aperture and the chosen one of the plurality of fastener apertures, and a step of inserting the surgical tool into the patient tissue along the target trajectory to create a fastener cavity in the patient tissue; and
guiding a fastener through the chosen one of the plurality of fastener apertures and into the patient tissue along the target trajectory.

2. The method of claim 1 , including the steps of:
removing the surgical tool from the guide;
removing the guide from the stock prosthetic implant;
placing at least one fastener through the chosen fastener aperture and inserting the fastener into the corresponding fastener cavity without placing the at least one fastener through the guiding aperture; and
securing the fastener within the fastener cavity to maintain the stock prosthetic implant in the predetermined implant orientation.

3. The method of claim 1 , including the step of limiting a depth of insertion into the patient tissue of at least one item selected from the group of items consisting of:
the surgical tool and the fastener.

4. The method of claim 1 , wherein the step of providing a guide includes at least one step selected from the group of steps consisting of:
custom-manufacturing the guide responsive to at least one of preoperative imaging of the patient tissue and preoperative selection of the stock prosthetic implant; and
modifying a stock guide responsive to at least one of preoperative imaging of the patient tissue and preoperative selection of the stock prosthetic implant.

5. The method of claim 1 , including the step of preselecting each target trajectory and each aperture location to facilitate placement of the fastener into the stock prosthetic implant and the underlying patient tissue at a preselected fastener location and a preselected fastener trajectory after removal of the guide from the stock prosthetic implant.

6. The method of claim 1 , including the steps of:
affixing at least one landmark to the patient tissue at a predetermined landmark location chosen responsive to preoperative imaging of the patient tissue; and
using the at least one landmark to assist with at least one step selected from the group of steps consisting of: a step of placing a lower implant surface of the stock prosthetic implant into contact with the patient tissue, placing the lower guide surface into mating contact with at least a portion of the upper implant surface; and a step of placing the chosen guiding aperture into a collinear relationship with a chosen one of the fastener apertures.

7. The method of claim 1 , wherein the step of placing a lower implant surface of the stock prosthetic implant into contact with the patient tissue in a predetermined implant orientation includes the steps of:
providing an orienting feature on the guide;
affixing at least one landmark to the patient tissue at a location spaced from a location of implantation of the stock prosthetic implant;
placing the lower guide surface into mating contact with at least a portion of the upper implant surface; and
repositioning the guide and mated implant to bring the orienting feature into a predetermined orienting relationship with the landmark.

8. The method of claim 7 , wherein the orienting feature includes an orienting indicator, and the step of repositioning the guide and mated implant to bring the orienting feature into a predetermined orienting relationship with the landmark includes the step of repositioning the guide and mated implant to achieve a predetermined signaling relationship between the landmark and the orienting indicator.

9. The method of claim 7 , wherein the step of repositioning the guide and mated implant to bring the orienting feature into a predetermined orienting relationship with the landmark includes the step of moving the stock prosthetic implant and the guide concurrently to move both the stock prosthetic implant into the predetermined implant orientation and the guide into the predetermined guide orientation.

10. A method of attaching a stock prosthetic implant to a patient tissue using a guide, the stock prosthetic implant including a lower implant surface, an upper implant surface, and a plurality of fastener apertures extending between the lower and upper implant surfaces, the guide including a lower guide surface contoured to at least partially mate with the upper implant surface of the stock prosthetic implant, an upper guide surface spaced longitudinally apart from the lower guide surface by a guide body, and at least one guiding aperture extending through the guide body between the upper and lower guide surfaces, the method comprising the steps of:
providing the guide with two or more locating protrusions extending from the lower guide surface toward the upper implant surface for engaging the upper implant surface, the two or more locating protrusions being spaced apart from the at least one guiding aperture, including custom-manufacturing the guide responsive to at least one item selected from the group of items consisting of: preoperative imaging of the patient tissue, and preoperative selection of t

Assignees

• Cleveland Clinic Found

Inventors

• Iannotti Joseph P
• Barsoum Wael K
• Bryan Jason A

Classifications

• A61B17/1778

  for the shoulder · CPC title

• A61F2002/3403

  Polar aperture · CPC title

• A61B17/1753

  for fixing pins through femoral hip prostheses · CPC title

• A61B2017/568

  produced with shape and dimensions specific for an individual patient · CPC title

• A61B2017/00526

  Methods of manufacturing · CPC title