Surgical instrumentation assembly for positioning an ankle prosthesis

Patent metadata

Field	Value
Publication number	US-9539115-B2
Application number	US-201213669321-A
Country	US
Kind code	B2
Filing date	Nov 5, 2012
Priority date	Nov 4, 2011
Publication date	Jan 10, 2017
Grant date	Jan 10, 2017

Abstract

In order to position an ankle prosthesis including a tibial implant and a talus implant provided with a talo-calcaneal anchoring keel, the invention proposes a surgical instrumentation assembly including: a tibial phantom ( 60 ) of the tibial implant, adapted so as to be attached to the tibia (T) of a patient, and an aiming guide ( 80 ) adapted for setting into place an instrumentation element ( 90 ) through the talus (A) and the calcaneus (C) of the patient, along an axis (Z-Z) for implanting the talo-calcaneal anchoring keel, the tibial phantom and the aiming guide mechanically cooperating with each other to restrict movement of the tibial phantom and the aiming guide relative to each other along vertical and medio-lateral directions, wherein the aiming guide is configured to guide placement of the instrumentation element.

First claim

What is claimed is:

1. A surgical instrumentation assembly for positioning an ankle prosthesis, the ankle prosthesis including a tibia implant and a talus implant provided with a talo-calcaneal anchoring keel, the instrumentation assembly comprising: a tibial phantom adapted for attachment to the tibia of a patient, and an aiming guide, adapted for setting into place an instrumentation element through the talus and the calcaneus of the patient along an axis for implanting the talo-calcaneal anchoring keel, wherein the tibial phantom and the aiming guide mechanically engage with each other to allow movement of the aiming guide with respect to the tibial phantom along an antero-posterior direction and restrict movement of the tibial phantom and the aiming guide relative to each other along vertical and medio-lateral directions, wherein the aiming guide is configured to guide placement of the instrumentation element, wherein the aiming guide defines a through-passage for receiving the instrumentation element, the through-passage positioned to clear the aiming guide with respect to the tibial phantom attached to the tibia while leaving the instrumentation element in place through the talus and the calcaneus, and wherein the aiming guide comprises: a main body, which defines the through-passage, and a piercing barrel removably attached to the main body while opening into the through-passage, the piercing barrel adapted for guiding the instrumentation element along the axis for implanting the talo-calcaneal anchoring keel.

2. The surgical instrumentation assembly of claim 1 , wherein the through-passage is a slot which opens onto two opposing faces of the main body along a longitudinal direction of the instrumentation element and onto at least one other face of the main body, so as to permit disengagement of the aiming guide from the tibial phantom while leaving the instrumentation element in place.

3. The surgical instrumentation assembly of claim 1 , wherein the tibial phantom and the aiming guide mechanically engage with each other in a manner permitting reversible assembly via sliding along the antero-posterior direction.

4. The surgical instrumentation assembly of claim 3 , further comprising an abutment mechanism configured to stop the sliding along the antero-posterior direction of the aiming guide with respect to the tibial phantom.

5. The surgical instrumentation assembly of claim 1 , wherein the aiming guide comprises a visual indicator configured to facilitate positioning of the aiming guide relative to a specific anatomic location of the talus.

6. The surgical instrumentation of claim 5 , wherein the specific anatomic location of the talus is the talonavicular joint.

7. The surgical instrumentation assembly of claim 1 , further comprising a talus phantom, which, while the instrumentation element extends through the talus and the calcaneus, is adapted for being engaged on the instrumentation element up to a position at which the talus phantom bears against the talus, a position in which the talus phantom is adapted so as to form an abutment, along the axis for implanting the talo-calcaneal anchoring keel, for a tool for forming, into the talus and the calcaneus, a housing for receiving the talo-calcaneal anchoring keel, centered on the implantation axis.

8. The surgical instrumentation assembly of claim 7 , further comprising a centering device which is adapted so as to be added around the instrumentation element, while being radially interposed between the instrumentation element, in place through the talus and the calcaneus, and the talus phantom in its position bearing against the talus.

9. The surgical instrumentation assembly of claim 1 , further comprising a mechanism for resecting a lower end of the tibia, the mechanism being adapted for adjusting a position with respect to the tibia of a corresponding tibial sectional plane.

10. The surgical instrumentation assembly of claim 9 , wherein the mechanism is a first mechanism, the surgical instrumentation assembly further comprising a second mechanism for setting into place and attaching the tibial phantom on the tibia, the second mechanism adapted for flattening at least one dedicated portion of the tibial phantom against the tibial sectional plane.

11. A surgical method comprising:
attaching a tibial phantom to a tibia of a patient;
mechanically attaching an aiming guide to the tibial phantom;
adjusting an antero-posterior position of the aiming guide with respect to the tibial phantom, movement of the aiming guide with respect to the tibial phantom being substantially restricted along vertical and medio-lateral directions;
placing an instrumentation element through the aiming guide and into a talus and calcaneus of the patient.

12. The surgical method of claim 11 , wherein mechanically attaching the aiming guide to the tibial phantom comprises attaching the aiming guide to the tibial phantom in a manner permitting sliding of the aiming guide with respect to the tibial phantom, and wherein adjusting the antero-posterior position of the aiming guide with respect to the tibial phantom comprises sliding the aiming guide along the antero-posterior direction with respect to the tibial phantom.

13. The surgical method of claim 12 , wherein the aiming guide comprises a slot, the method further comprising:
sliding the aiming guide away from the tibial phantom while the aiming guide clears the implanted instrumentation element at the slot; and
removing the aiming guide from the tibial phantom without removing the instrumentation element from the talus and the calcaneus.

14. The surgical method of claim 13 , further comprising inserting a talus phantom onto the talus, wherein the talus phantom comprises a hole, and wherein inserting the talus phantom onto the talus comprises inserting the instrumentation element through the hole, such that the talus phantom is inserted onto the talus without removal of the instrumentation element from the talus and the calcaneus.

15. The surgical method of claim 14 , further comprising inserting a centering device over the instrumentation element and into engagement with the talus phantom.

16. The surgical method of claim 11 , wherein the aiming guide defines a through-passage, and wherein placing the instrumentation element through the aiming guide comprises inserting the instrumentation element through the through-passage.

17. The surgical method of claim 16 , wherein the aiming guide further comprises a piercing barrel which at least partially opens into the through-passage, and wherein placing the instrumentation element through the through-passage further comprises placing the instrumentation element through the piercing barrel.

Assignees

• Integra Lifesciences Corp

Inventors

• Coulange Vincent
• Genna Sophie
• Brunnarius Yann
• Lizee Emmanuel
• Perineau Christophe
• Bonnin Michel
• Coetzee Christiaan
• Colombier Jean-Alain
• Judet Thierry
• Myerson Mark

Classifications

• A61F2/4684 Primary

  Trial or dummy prostheses · CPC title

• A61B17/1739

  specially adapted for particular parts of the body · CPC title

• A61B17/15

  Guides therefor · CPC title

• A61F2002/4207

  Talar components · CPC title

• A61F2002/4205

  Tibial components · CPC title