Intraoperative dynamic trialing

Patent metadata

Field	Value
Publication number	US-11045209-B2
Application number	US-201816229665-A
Country	US
Kind code	B2
Filing date	Dec 21, 2018
Priority date	Aug 23, 2013
Publication date	Jun 29, 2021
Grant date	Jun 29, 2021

Abstract

A dynamic trialing method generally allows a surgeon to perform a preliminary bone resection on the distal femur according to a curved or planar resection profile. With the curved resection profile, the distal-posterior femoral condyles may act as a femoral trial component after the preliminary bone resection. This may eliminate the need for a separate femoral trial component, reducing the cost and complexity of surgery. With the planar resection profile, shims or skid-like inserts that correlate to the distal-posterior condyles of the final insert may be attached to the distal femur after the preliminary bone resection to facilitate intraoperative trialing. The method and related components may also provide the ability of a surgeon to perform iterative intraoperative kinematic analysis and gap balancing, providing the surgeon the ability to perform necessary ligament and/or other soft tissue releases and fine tune the final implant positions based on data acquired during the surgery.

First claim

The invention claimed is:

1. An implant trialing method comprising:
creating a bone model of a distal femur of a patient;
determining a preliminary resection profile on the bone model;
determining a final desired resection profile prior to making a preliminary resection, the determined final resection profile being based at least in part on a planned resection of a bone surface;
resecting the distal femur by making the preliminary resection along the preliminary resection profile such that a first area of bone is removed from the distal femur;
coupling a femoral shim system to the preliminarily resected distal femur;
performing trialing while the femoral shim system is coupled to the preliminarily resected distal femur;
after performing trialing, removing the femoral shim system, and then making a subsequent resection according to either (i) the final desired resection profile or (ii) a modified final resection plan; and
coupling a femoral implant to the femur after performing either (i) the final desired resection profile or (ii) the modified final resection plan,
wherein the preliminary resection profile includes a preliminary distal femoral cut plane spaced a first distance from a native distal femoral surface, and the final desired resection profile includes a final distal femoral cut plane parallel to the preliminary distal femoral cut plane and spaced a second distance from the native distal femoral surface, the second distance being greater than the first distance,
wherein the preliminary distal femoral cut plane is intended to receive the femoral shim but is not intended to receive the femoral implant.

2. The method of claim 1 , wherein the preliminary resection profile is determined, at least in part, based on a feature of a final design plan of the femoral implant.

3. The method of claim 2 , wherein the final design plan of the femoral implant includes a femoral implant flexion axis, and the preliminary resection profile is based on the femoral implant flexion axis.

4. The method of claim 3 , wherein the preliminary resection profile includes a flexion axis, the flexion axis of the preliminary resection profile being coaxial with the femoral implant flexion axis.

5. The method of claim 1 , wherein performing trialing includes performing intraoperative kinematic analysis by at least articulating a proximal tibia with respect to the distal femur.

6. The method of claim 1 , wherein performing trialing includes performing intraoperative gap balancing.

7. The method of claim 1 , further comprising: making the subsequent resection of the distal femur such that a second area of bone is removed from the distal femur.

8. The method of claim 7 , wherein the subsequent resection includes making planar bone resections corresponding to mating surfaces on the femoral implant.

9. The method of claim 7 , wherein the subsequent resection is performed according to the final desired resection profile.

10. The method of claim 7 , wherein the subsequent resection is performed according to the modified final resection profile, the modified final resection profile being determined, at least in part, based upon results of the trialing.

11. The method of claim 10 , wherein the medial and lateral shim portions have articulation surfaces that correspond to a shape of the femoral implant.

12. The method of claim 11 , wherein the medial and lateral shim portions have articulation surfaces that correspond to a shape of the femoral implant.

13. The method of claim 1 , wherein the femoral shim system includes a medial shim portion adapted to couple to a medial femoral condylar portion of the preliminarily resected distal femur and a lateral shim portion adapted to couple to a lateral femoral condylar portion of the preliminarily resected distal femur.

14. The method of claim 1 , wherein the preliminary resection profile is a curved resection profile.

15. The method of claim 14 , wherein the femoral shim system includes one or more curved bone-contacting surfaces.

16. The method of claim 1 , wherein the preliminary resection profile is a planar resection profile.

17. The method of claim 16 , wherein the femoral shim system includes one or more planar bone-contacting surface.

18. The method of claim 1 , further comprising coupling a tibial trial to a resected proximal tibia.

19. The method of claim 18 , wherein performing trialing includes
engaging the femoral shim system with the tibial trial.

Assignees

• Howmedica Osteonics Corp

Inventors

• Axelson Jr Stuart L
• Hampp Emily
• Fossez John R

Classifications

• A61B17/025 Primary

  Joint distractors · CPC title

• A61B17/00234

  for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence) · CPC title

• A61B17/154

  for preparing bone for knee prosthesis · CPC title

• A61B2017/00557

  inflatable (A61B2017/22051 takes precedence) · CPC title

• A61B2034/105

  Modelling of the patient, e.g. for ligaments or bones · CPC title