Method for preparing a patient's tibia in an orthopaedic joint replacement procedure

Patent metadata

Field	Value
Publication number	US-10470899-B2
Application number	US-201715598626-A
Country	US
Kind code	B2
Filing date	May 18, 2017
Priority date	May 18, 2016
Publication date	Nov 12, 2019
Grant date	Nov 12, 2019

Abstract

An orthopaedic joint replacement system is shown and described. The system includes a number of prosthetic components configured to be implanted into a patient's knee. The system also includes a number of surgical instruments configured for use in preparing the bones of the patient's knee to receive the implants. A method or technique for using the surgical instruments to prepare the bones is also disclosed.

First claim

The invention claimed is:

1. A method of preparing a patient's tibia for a tibial prosthetic component, the method comprising:
inserting a surgical reamer into a cavity formed in a proximal end of a patient's tibia,
coupling an attachment device to an elongated shaft of the reamer such that the elongated shaft extends through a bore of a locking knob and a bore of a housing of the attachment device,
rotating the locking knob about the elongated shaft such that a section of the housing compresses and engages the elongated shaft of the reamer,
coupling a mounting frame to a rail extending from a fixed end at the housing at an orthogonal angle with respect to the longitudinal axis to a free end,
coupling a cutting block to the mounting frame,
advancing a saw blade through a cutting guide formed in the cutting block to cut the proximal end of the patient's tibia,
removing the attachment device, the mounting frame, and the cutting block from the patient's tibia,
positioning a tibial base plate on the proximal end of the patient's tibia, and
determining an offset orientation of a tibial prosthetic component based on the orientation of the tibial plate relative to the proximal end of the patient's tibia.

2. The method claim 1 , wherein rotating the locking knob includes advancing a bottom surface of the locking knob toward a shoulder surface of the housing.

3. The method claim 1 , wherein rotating the locking knob includes advancing a plurality of beams of the housing into engagement with the elongated shaft of the surgical reamer.

4. The method claim 3 , wherein rotating the locking knob includes advancing an annular rib of the locking knob into engagement with a ramped upper surface of each of the plurality of beams to advance the plurality of beams of the housing into engagement with the elongated shaft of the surgical reamer.

5. The method claim 4 , wherein rotating the locking knob includes engaging a threaded inner surface of the locking knob with a threaded outer surface of each of the plurality of beams.

6. The method claim 1 , wherein rotating the locking knob includes gripping an angled outer surface of the locking knob.

7. The method claim 1 , further comprising operating a locking mechanism to selectively secure the mounting frame to the rail.

8. The method claim 7 , further comprising inserting the rail into a bore extending through the mounting frame such that the mounting frame moves longitudinally on the rail to position the cutting block relative the patient's tibia.

9. The method claim 8 , further comprising engaging a planar outer surface of the rail with a planar inner surface of the bore of the mounting frame to prevent the mounting frame from rotating about the rail.

10. The method of claim 1 , further comprising:
positioning the tibial base plate on the proximal end of the patient's tibia such that the elongated shaft of the surgical reamer extends through a central opening of the tibial base plate,
advancing an end of the elongated shaft into a bore defined in an offset guide, the bore extending along a longitudinal axis that is spaced apart from a longitudinal axis of the central opening,
positioning the offset guide within the central opening of the tibial plate, and
rotating the offset guide to rotate the tibial plate relative a proximal end of the patient's tibia.

11. The method of claim 10 , further comprising:
removing the offset guide and the surgical reamer from the patient's tibia,
positioning a reamer guide body on the tibial base plate,
inserting a second surgical reamer into the reamer guide body, the second surgical reamer including a plurality of cutting flutes that define (i) a distal frustoconical cutting section, (ii) a proximal cutting section having a first diameter, and (iii) a cylindrical middle cutting section having a second diameter smaller than the first diameter.

12. The method of claim 11 , further comprising:
advancing a drill stop along an elongated shaft of the second surgical reamer,
wherein inserting the second surgical reamer into the reamer guide body includes advancing the second surgical reamer into the patient's tibia and using the drill stop to determine a maximum reaming depth.

13. The method of claim 10 , further comprising:
removing the offset guide from the surgical reamer, the offset guide is a first offset guide of a plurality of offset guides,
selecting a second offset guide of the plurality of offset, the second offset guide having a second bore,
advancing an end of the elongated shaft into the second bore of the second offset guide, the second bore extending along a second longitudinal axis that is spaced apart from the longitudinal axis of the central opening by an amount different from longitudinal axis of the first offset guide, and
rotating the second offset guide to rotate the tibial plate relative a proximal end of the patient's tibia to determine the offset orientation.

14. A method of preparing a patient's tibia for a tibial prosthetic component, the method comprising:
inserting a first surgical reamer into a cavity formed in a proximal end of a patient's tibia,
positioning a tibial base plate on the proximal end of the patient's tibia such that the elongated shaft of the first surgical reamer extends through a central opening of the tibial base plate,
advancing an end of the elongated shaft into a bore defined in an offset guide, the bore extending along a longitudinal axis that is spaced apart from a longitudinal axis of the central opening,
positioning the offset guide within the central opening of the tibial plate,
rotating the offset guide to rotate the tibial base plate relative a proximal end of the patient's tibia,
determining an offset orientation of a tibial prosthetic component based on the orientation of the tibial plate relative to the proximal end of the patient's tibia,
removing the offset guide and the first surgical reamer from the patient's tibia,
positioning a reamer guide body on the tibial base plate, and
inserting a second surgical reamer into the reamer guide body, the second surgical reamer including a plurality of cutting flutes that define (i) a distal frustoconical cutting section, (ii) a proximal cutting section having a first diameter, and (iii) a cylindrical middle cutting section having a second diameter smaller than the first diameter.

15. The method of claim 14 , further comprising:
positioning a depth stop on the elongated shaft of the second surgical reamer, the depth stop including a moveable flange sized to be separately received in an aperture defined in the elongated shaft of the second surgical reamer, and
actuating a user-operated button of the depth stop to engage the flange with the annular slot.

16. The method of claim 14 , further comprising:
removing the offset guide from the surgical reamer, the offset guide is a first offset guide of a plurality of offset guides,
selecting a second offset guide of the plurality of offset, the second offset guide having a second bore,
advancing an end of the elongated shaft into the second bore of the second offset guide, the second bore extending along a second longitudinal axis that is spaced apart from the longitudinal axis of the central opening by an amount different from longitudinal axis of the first offset guide, and
rotating the second offset guide to rotate the tibial plate relative a proximal end of the patient's tibia to determine the offset orientation.

Assignees

• Depuy Ireland Ultd Co

Inventors

• Wolfson David R
• Barnett James E
• Penninger Charles L
• Flakne Kyle R
• Hathaway Tyler S
• Carver Adam
• Reeve Michael R
• Robertson Lisa M
• Miltner Nicholas A
• Wogoman Thomas E

Classifications

• A61F2/4603

  for insertion or extraction of endoprosthetic joints or of accessories thereof · CPC title

• A61F2/389

  Tibial components (A61F2/3868 takes precedence) · CPC title

• A61F2002/30555

  along two perpendicular axes · CPC title

• A61F2/461 Primary

  of knees · CPC title

• A61B17/1604

  Chisels; Rongeurs; Punches; Stamps · CPC title