Patient-specific guide for total prosthetic knee revision

Patent metadata

Field	Value
Publication number	US-2025255622-A1
Application number	US-202519055319-A
Country	US
Kind code	A1
Filing date	Feb 17, 2025
Priority date	Apr 9, 2019
Publication date	Aug 14, 2025
Grant date	—

Abstract

A femoral component and a tibial component are respectively configured to exclusively couple with the distal end of a femur bearing a femoral prosthesis and with the proximal end of a tibia bearing a tibial prosthesis. The femoral component has a distal portion configured to face the distal end of the femur, bearing distal positioning holes facing a distal region of the femoral prosthesis. A frontal portion extends on the continuation of the distal portion and has a first abutment area operating against the femur bone part and a second area facing a frontal region of the femoral prosthesis. The frontal portion has at least two guide holes at the first abutment area, and at least two frontal positioning holes at the second area.

First claim

1 .- 29 . (canceled)

30 . A surgical method for prosthetic knee revision, comprising:
exclusively coupling a femoral component of a surgical guide against a distal end of a patient's femur bearing a femoral prosthesis attached to a femoral bone part,
wherein the femoral component comprises:
a distal portion configured to face the distal end of the femur, the distal portion defining at least two distal positioning holes configured to face a distal region of the femoral prosthesis when the femoral component is coupled with the distal end of the femur; and
a frontal portion extending on a continuation of the distal portion and displaying a first abutment area configured to act in abutment against the femur bone part in a cortical frontal region of the femur, and a second area configured to face a frontal region of the femoral prosthesis, when the femoral component is coupled with the distal end of the femur,
wherein the frontal portion of the femoral component defines at least two guide holes, extending parallel to each other through the frontal portion at the first abutment area, and defines at least two frontal positioning holes extending through the frontal portion at the second area;
inserting at least two alignment pins into the guide holes of the femoral component and through a front cortical region of the femur; removing the femoral component from the distal end of the femur; removing the femoral prosthesis from the distal end of the femur; engaging said guide holes along the alignment pins to exclusively re-couple the femoral component to the distal end of the femur; preparing attachment holes through the femoral bone part, using a drilling tool guided through the frontal positioning holes and the distal positioning holes of the femoral component; removing the femoral component from the distal end of the femur; engaging frontal and distal positioning pins in the frontal and distal positioning holes, respectively; engaging a distal cutting block on the frontal positioning pins; performing a distal femoral bone resection while the distal cutting block is engaged on the frontal positioning pins; engaging a frontal cutting block on the distal positioning pins; performing a frontal resection of the femoral bone part while the frontal cutting block is engaged on the distal positioning pins; removing the frontal and distal positioning pins; positioning a revision femoral prosthesis on the distal end of the femur.

31 . The method according to claim 30 , further comprising abutting third abutment areas of two lateral abutments of the femoral component against the femoral bone part in epicondylar regions, respectively medial and lateral, of the femur.

32 . The method according to claim 30 , further comprising abutting the second area against the frontal region of the femoral prosthesis.

33 . The method according to claim 30 , further comprising abutting a fourth abutment area of the distal portion against the distal region of the femoral prosthesis.

34 . The method according to claim 30 , further comprising smoothly engaging the guiding holes with the respective alignment pins that are inserted through the frontal cortical region of the femur.

35 . The method according to claim 30 , wherein the alignment pins are inserted through the frontal cortical region of the femur in a direction parallel to the guide holes.

36 . The method according to claim 30 , further comprising:
inserting a drilling tool through the femoral bone part when the femoral component is coupled with the distal end of the femur after removing the femoral prosthesis; and smoothly engaging the drilling tools with the frontal positioning holes.

37 . The method according to claim 30 , further comprising:
inserting a drilling tool through the femoral bone part when the femoral component is coupled with the distal end of the femur after removing the femoral prosthesis; and smoothly engaging the drilling tools with the distal positioning holes.

38 . The method according to claim 37 , wherein inserting the drilling tool is engaged with the distal positioning holes in a direction parallel to a longitudinal extension direction of the femur.

39 . The method according to claim 30 , further comprising inserting a bore cutter along the longitudinal axis of the femur,
wherein the bore cutter is guided by a femoral centring housing of the distal portion.

40 . The method according to claim 30 , further comprising:
exclusively coupling a tibial component of the surgical guide against a proximal end of a tibia bearing a prosthetic dish attached to a tibial bone part, the tibial component comprising:
a front portion having a first contact area configured to act in abutment against a front cortical region of the tibial bone part; and
a proximal portion projecting in cantilever fashion on a continuation of the front portion and having at least one second contact area configured to act in abutment against a working surface of the prosthetic dish surrounded by a peripheral edge of the prosthetic dish itself,
wherein the front portion defines at least one first pair of tibial positioning holes configured to face the front cortical region of the tibia, when the tibial component is coupled with the proximal end of the tibia;
inserting at least two tibial alignment pins into the tibial positioning holes of the tibial component and through the tibia's front cortical region; removing the tibial component from the proximal end of the tibia; removing a tibial prosthesis from the proximal end of the tibia; engaging a tibial resection block on the tibial positioning pins; performing a proximal resection of the tibial bone part while the tibial component is engaged on the tibial positioning pins; removing the tibial alignment pins; and positioning a revision tibial prosthesis on the proximal end of the tibia.

41 . The method according to claim 40 , wherein the tibial alignment pins are inserted in positions spaced apart from an upper portion of the first contact area, wherein the upper portion extends according to an arched extension along the peripheral edge of the prosthetic dish.

42 . The method according to claim 40 , further comprising abutting an additional contact area of the front portion against the prosthetic dish along the peripheral edge thereof,
wherein additional contact area extends according to an arched extension.

43 . The method according to claim 40 , further comprising abutting against working surface terminal portions of two arms of the front portion.

44 . The method according to claim 40 , further comprising inserting a bore cutter along the longitudinal axis of the tibia,
wherein the bore cutter is guided by a tibial centring housing of the proximal portion.

45 . The method according to claim 30 , further comprising, before exclusively coupling the femoral component:
detecting anatomical conformation of the distal end of the patient's femur, wherein said distal end bears the femoral prosthesis; preparing the femoral component of surgical guide based on the detected anatomical conformation.

46 . The method according to claim 40 , further comprising, before exclusively coupling the tibial component:
detecting anatomical conformation of the distal end of the patient's femur, wherein said distal end bears the femoral prosthesis; preparing the femoral component of surgical guide based on the detected anatomical conformation.

47 . A method of manufacturing a surgical guide for prosthetic knee revision, compri

Assignees

• Medacta Int Sa

Inventors

• Siccardi Francesco
• Bernardoni Massimiliano
• Parrinello Andrea
• Gargantini Gianluca

Classifications

• A61B17/1615

  Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material · CPC title

• A61B2017/568

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

• A61B17/1764 Primary

  for the knee · CPC title

• A61B17/157

  Cutting tibia · CPC title

• A61B17/155 Primary

  Cutting femur · CPC title