Patient-specific convertible guides

Patent metadata

Field	Value
Publication number	US-9474539-B2
Application number	US-201414200990-A
Country	US
Kind code	B2
Filing date	Mar 7, 2014
Priority date	Apr 29, 2011
Publication date	Oct 25, 2016
Grant date	Oct 25, 2016

Abstract

A method of intraoperatively selecting between a partial knee arthroplasty and total knee arthroplasty includes mounting a patient-specific three-dimensional surface of a convertible patient-specific guide in a unique position mating to a corresponding surface of a distal femoral bone. The convertible patient-specific guide includes an anterior portion and a distal portion a patellofemoral guide. One of a total knee arthroplasty and a partial knee arthroplasty is selected intraoperatively. If total knee arthroplasty is selected, first and second covers are removed from corresponding first and second distal guiding bore. First and second distal pins through the first and second distal guiding bores are registered on the bone. If partial knee arthroplasty is selected, the anterior portion is severed and removed along a frangible groove and the distal portion is used as a patellofemoral guide.

First claim

What is claimed is:

1. A method of intraoperatively selecting between a partial knee arthroplasty and total knee arthroplasty comprising:
mounting a patient-specific three-dimensional surface of a convertible patient-specific guide in a unique position mating to a corresponding surface of a distal femoral bone, the patient-specific guide including an anterior portion and a distal portion with a patellofemoral guide portion;
selecting intraoperatively one of a total knee arthroplasty and a partial knee arthroplasty;
if total knee arthroplasty is selected, removing first and second covers from corresponding first and second distal guiding bores and registering first and second distal pins through the first and second distal guiding bores; and
if partial knee arthroplasty is selected, removing the anterior portion along a frangible groove and using the patellofemoral guide portion.

2. The method of claim 1 , further comprising registering first and second anterior pins through first and second anterior guiding bores of the anterior portion.

3. The method of claim 1 , further comprising supporting a femoral resection block on the patellofemoral guide portion.

4. The method of claim 3 , further comprising slidably inserting first and second legs of the femoral resection block into first and second slots of the patellofemoral guide portion.

5. The method of claim 1 , wherein the frangible groove has reduced thickness relative to the anterior and distal portions.

6. A method of intraoperatively selecting between a partial knee arthroplasty and total knee arthroplasty comprising:
providing a convertible patient-specific guide including an anterior portion and a distal portion having a score line of reduced thickness therebetween, the patient-specific guide having a patient-specific three-dimensional undersurface designed preoperatively based on images of a patient's knee joint, the patient-specific three-dimensional undersurface closely mateable in only one position relative to the knee such that the patient-specific three-dimensional undersurface nestingly fits about and within surface portions of a corresponding surface of the knee joint of the patient in a single position;
selecting intraoperatively one of a total knee arthroplasty and a partial knee arthroplasty;
if total knee arthroplasty is selected, mounting the convertible patient-specific guide on the distal femoral bone; and
if partial knee arthroplasty is selected, severing and removing the anterior portion along the score line and using the distal portion as a patellofemoral guide.

7. The method of claim 6 , wherein the anterior portion is severed and removed before mounting the convertible patient-specific guide on the knee joint.

8. The method of claim 6 , wherein the anterior portion is severed and removed after mounting the convertible patient-specific guide on the knee joint.

9. The method of claim 6 , further comprising registering anterior and distal pins through corresponding anterior and distal guiding bores and removing covers from the distal guiding bores.

10. The method of claim 6 , further comprising:
mounting an anterior femoral resection block on the distal portion; and
making an anterior femoral resection.

11. The method of claim 10 , wherein mounting an anterior femoral resection block on the distal portion includes sliding first and second legs of the anterior femoral resection block into corresponding first and second slots of a support extending from the distal portion.

12. A method of intraoperatively selecting between a partial knee arthroplasty and total knee arthroplasty comprising:
providing a convertible patient-specific guide having a first body portion and a second body portion, wherein:
the first body portion has a first patient-specific three-dimensional undersurface custom-made to match an anterior femoral knee joint surface of a specific patient such that the first patient-specific three dimensional-undersurface nestingly fits about and within surface portions of the joint surface in a first position relative to the knee joint;
the second body portion has a second patient-specific three-dimensional undersurface custom-made to match a distal femoral surface of the patient such that the second patient-specific three dimensional-undersurface nestingly fits about and within surface portions of the joint surface in a second position relative to the knee joint;
the first and second patient-specific three-dimensional undersurfaces are constructed from images of the patient's knee joint; and
the second body portion is connected to the first body portion along a frangible line of reduced thickness relative to the first and second body portions;
selecting intraoperatively one of a total knee arthroplasty and a partial knee arthroplasty;
if total knee arthroplasty is selected, mounting the convertible patient-specific guide on the distal femoral bone; and
if partial knee arthroplasty is selected, severing and removing the first body portion along the frangible line and using the second portion as a patellofemoral guide.

13. The method of claim 12 , wherein the first body portion is severed and removed before mounting the convertible patient-specific guide on the knee joint.

14. The method of claim 12 , wherein the first body portion is severed and removed after mounting the convertible patient-specific guide on the knee joint.

15. The method of claim 12 , further comprising registering anterior and distal pins through corresponding anterior and distal guiding bores and removing covers from the distal guiding bores.

16. The method of claim 12 , further comprising:
mounting an anterior femoral resection block on the second body portion; and
making an anterior femoral resection.

17. The method of claim 16 , wherein mounting an anterior femoral resection block on the second body portion includes sliding first and second legs of the anterior femoral resection block into corresponding first and second slots of a support extending from the second body portion.

18. The method of claim 12 , wherein the frangible line is a score line.

19. The method of claim 12 , wherein the frangible line is a groove.

20. The method of claim 12 , wherein the frangible line is designed preoperatively from the images of the knee joint to correlate the frangible line to a structure of the patient's knee.

Assignees

• Biomet Mfg Llc

Inventors

• Catanzarite Joshua B
• Schoenefeld Ryan J

Classifications

• A61B17/1764 Primary

  for the knee · CPC title

• B33Y80/00

  Products made by additive manufacturing · CPC title

• A61B17/155 Primary

  Cutting femur · CPC title

• A61B2017/568

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