Methods and apparatus for pivotable guide surfaces for arthroplasty
Cutting guides, cutting tools, and soft tissue management techniques permit the use of pivoting guide surfaces to facilitate in controlling the sweep or arc of a cutting tool used in connection with resection and arthroplasty procedures. In accordance with one embodiment, a guide structure is provided with one or more guide pivot aperture(s) and one or more guide pivot reference surface(s) that mate with a bushing assembly controlling a cutting tool. The bushing assembly possesses a bushing reference plan which mates with the pivot reference surface(s) of the guide structure and a bushing pivot pin which mates with the guide pivot aperture(s) of the guide structure. In one embodiment, a bushing guide lumen is operably coupled to the guide structure for articulated and/or axial guidance of the cutting tool.
1 . A method for implanting an orthopedic prosthesis during arthroplasty surgery comprising:
providing a guide pivot reference surface in a predetermined orientation to a resected surface to be created in a bone, the guide pivot reference surface including at least one guide pivot aperture defined therein;
providing a bushing assembly having a bushing reference plane, a bushing pivot pin and a guide structure having a guide lumen defined therein with a long axis of the guide lumen corresponding to a long axis of a cutting instrument;
operably mating the bushing reference plane with the guide pivot surface such that the bushing pivot pin engages one of the at least one guide pivot apertures;
utilizing the cutting instrument to create at least a portion of the resected surface by inserting the cutting instrument into and beyond the guide lumen of the guide structure and sweeping the cutting instrument across at least a portion of the resected surface by pivoting the bushing assembly on an axis defined by the bushing pivot pin engaged with the one of the at least one guide pivot apertures; and
operably attaching a corresponding surface of the orthopedic prosthesis to the resected surface.
2 . The method of claim 1 , wherein the guide pivot reference surface is defined on a sweeping guide body having fixation features and the method further comprises operably securing the fixture features relative to the bone to be resected such that the guide pivot reference surface is positioned in the predetermined orientation.
3 . The method of claim 1 , where the guide pivot reference surface is defined on the bone to be resected and the method further comprises creating the guide pivot reference surface on the bone to be resected and drilling the at least one guide pivot aperture in the guide pivot reference surface.
4 . An apparatus for guiding a cutting tool to create a resected surface in a bone during an arthroplasty procedure, the apparatus comprising:
a sweeping guide body having fixation features adapted to operably securing the sweeping guide body relative to the bone, the sweeping guide body have a guide pivot reference surface that includes at least one guide pivot aperture defined therein; and
a bushing assembly having a bushing reference plane, a bushing pivot pin and a guide structure with a guide lumen defined therein with a long axis corresponding to a long axis of a cutting tool,
such that, when the fixture features are operably secured to the bone and the bushing assembly operably coacts with the sweeping guide body whereby the bushing reference plane operably mates with the guide pivot surface and the bushing pivot pin operably engages with one of the at least one guide pivot apertures, the apparatus provides articulated and axial guidance of the cutting tool as the cutting tool creates at least a portion of the resected surface by inserting the cutting tool into and beyond the guide lumen of the guide structure and sweeping the cutting tool across at least a portion of the resected surface by pivoting the bushing assembly on an axis defined by the bushing pivot pin engaged with the one of the at least one guide pivot apertures.
5 . The apparatus of claim 4 , wherein the guide lumen has an internal cross-section along the long axis of the guide lumen generally corresponding to a cross section of the cutting tool along the long axis of the cutting tool and the cutting tool is selected from the set consisting of: a sagital saw, a milling bit, and an ultrasonic blade.