Joint arthroplasty devices and surgical tools
View Patent ↗Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.
1. A patient-specific instrument system for surgery of a diseased or damaged knee joint of a patient, the instrument system comprising:
a patient-specific surface for engaging at least a portion of a substantially uncut joint surface of the diseased or damaged knee joint of the patient, the patient-specific surface including cartilage information derived from image data of the diseased or damaged knee joint of the patient; and
a guide for directing a surgical instrument, wherein the guide has a predetermined position relative to the patient-specific surface and relative to from at least one of an anatomical axis and a biomechanical axis associated with said knee joint; wherein the guide defines a drilling path through at least a portion of the knee joint, the drilling path having a position based on a predetermined internal rotation angle or external rotation angle of an orthopedic implant.
2. The instrument system of claim 1 , wherein the patient-specific surface and the guide are included in an integrally formed body.
3. The instrument system of claim 1 , wherein the patient-specific surface is included in a first body having a linkage mechanism and the guide is included in a second body having a complimentary linkage mechanism for connecting the first and second bodies.
4. The instrument system of claim 1 , wherein the patient-specific surface has a convex portion.
5. The instrument system of claim 1 , wherein the instrument system has a plurality of guides therein.
6. The instrument system of claim 5 , wherein a first guide of the plurality of guides is configured at an angle to a second guide of the plurality of guides.
7. The instrument system of claim 1 having a first guide and a second guide, wherein the first guide is configured at an angle to the second guide.
8. The instrument system of claim 1 having a second guide, wherein the second guide is configured for drilling.
9. The instrument system of claim 1 , wherein the patient-specific surface is configured to prevent at least one movement selected from the group consisting of axial, lateral and rotational.
10. The instrument system of claim 1 , wherein the instrument system is configured to position the orthopedic implant, wherein the orthopedic implant is a femoral component of a knee implant.
11. The instrument system of claim 1 , wherein the instrument system is configured to position the orthopedic implant, wherein the orthopedic implant is a tibial component of a knee implant.
12. The instrument system of claim 8 , wherein the first guide is configured for drilling on a medial tibial plateau of the knee joint.
13. The instrument system of claim 8 , wherein the second guide is configured for drilling on a lateral tibial plateau of the knee joint.
14. The instrument system of claim 8 , wherein the first guide is configured for drilling on a medial femoral condyle of the knee joint.
15. The instrument system of claim 8 , wherein the second guide is configured for drilling on a lateral femoral condyle of the knee joint.
16. The instrument system of claim 1 , wherein the substantially uncut joint surface includes normal or diseased cartilage.
17. The instrument system of claim 1 , wherein the substantially uncut joint surface includes subchondral bone.
18. The instrument system of claim 1 , wherein the predetermined internal rotation angle or external rotation angle of the orthopedic implant is selected by an operator.
19. The instrument system of claim 18 , wherein the operator is a surgeon.
20. The instrument system of claim 1 , wherein the substantially uncut surface portion of the knee joint includes at least a portion of a femoral condyle.
21. The instrument system of claim 1 , wherein the substantially uncut surface portion of the knee joint includes at least a portion of a tibial plateau.
22. The instrument system of claim 1 , wherein the patient-specific surface is, at least in part, derived by estimating cartilage loss for at least a portion of the knee joint of the patient.
23. A patient-specific instrument system for surgery of a knee joint of a patient, the instrument system comprising:
a patient-specific surface for engaging at least a portion of a substantially uncut joint surface of a tibia of the knee joint of the patient, the patient-specific surface including cartilage information derived from image data of the knee joint of the patient; and
a guide for directing a surgical instrument, wherein the guide has a predetermined position relative to the patient-specific surface and has a predetermined orientation relative to at least one of an anatomical axis and a biomechanical axis associated with said knee joint; and wherein the guide defines a cutting or drilling path through at least a portion of the tibia of the knee joint, the cutting or drilling pat having a position based on
a predetermined internal rotation angle or external rotation angle of a tibial component of an orthopedic implant.
24. The instrument system of claim 23 , wherein the patient-specific surface and the guide are included in an integrally formed body.
25. The instrument system of claim 23 , wherein the patient-specific surface is included in a first body having a linkage mechanism and the guide is included in a second body having a complimentary linkage mechanism for connecting the first and second bodies.
26. The instrument system of claim 23 , wherein the patient-specific surface has a convex portion.
27. The instrument system of claim 23 further including a plurality of guides therein.
28. The instrument system of claim 27 , wherein a first guide of the plurality of guides is configured at an angle to a second guide of the plurality of guides.
29. The instrument system of claim 23 having a first guide and a second guide, wherein the first guide is configured at an angle to the second guide.
30. The instrument system of claim 23 , having a second guide, wherein the first is configured for drilling and the first guide is configured for drilling and the second guide is configured for drilling.
31. The instrument system of claim 23 , wherein the patient-specific surface is configured to prevent at least one movement selected from the group consisting of axial, lateral and rotational.
32. The instrument system of claim 23 , wherein the cartilage information includes information about a cartilage surface of the knee joint of the patient.
33. The instrument system of claim 23 , wherein the instrument system is configured to position the tibial component of a the orthopedic implant.
34. The instrument system of claim 23 , wherein the cartilage information includes information about a cartilage shape of the substantially uncut joint surface.
35. The instrument system of claim 23 , wherein the cartilage information includes information about normal and diseased cartilage of the knee joint.
36. The instrument system of claim 30 , wherein the first guide is configured for drilling a hole on a medial plateau of the tibia of the knee joint of the patient.
37. The instrument system of claim 30 , wherein the second guide is configured for drilling a hole on a lateral plateau of the tibia of the knee joint of the patient.
38. The instrument system of claim 23 , wherein the substantially uncut joint surface includes normal or diseased cartilage.
39. The instrument system of claim 23 , wherein the patient-specific surface includes information about subchondral bone.
40. The instrument system of claim 23 , wherein the predetermined internal rotation angle or external rotation angle of an orthopedic implant is selected by an operator.
41. The instrument system of claim 40 , wherein the operator is a surgeon.
42. The instrument system of claim 23 , wherein the substantially uncut joint surface portion of the knee joint includes at least a portion of a tibial plateau.
43. The instrument system of claim 23 , wherein the patient-specific surface is, at least in part, derived by estimating cartilage loss for at least a portion of the knee joint of the patient.
44. A patient-specific instrument system for surgery of a knee joint of a patient, the instrument system comprising:
a patient-specific surface for engaging at least a portion of a substantially uncut joint surface of a femoral condyle of the knee joint of the patient, the patient-specific surface including cartilage information derived from image data of the knee joint of the patient; and
a guide for directing a surgical instrument, wherein the guide has a predetermined position relative to the patient-specific surface and is fixed at a predetermined orientation from at least one of an anatomical axis and a biomechanical axis associated with said knee joint; and wherein the guide defines a cutting or drilling path through at least a portion of the femoral condyle of the knee joint, the cutting or drilling path having a position based on a predetermined internal rotation angle or external rotation angle of a femoral component of an orthopedic implant.
45. The instrument system of claim 44 , wherein the patient-specific surface and the guide are included in an integrally formed body.
46. The instrument system of claim 44 , wherein the patient-specific surface is included in a first body having a linkage mechanism and the guide is included in a second body having a complimentary linkage mechanism for connecting the first and second bodies.
47. The instrument system of claim 44 , wherein the patient-specific surface has a convex portion.
48. The instrument system of claim 44 , wherein the instrument system has a plurality of guides therein.
49. The instrument system of claim 48 , wherein a first guide of the plurality of guides is configured at an angle to a second guide of the plurality of guides.
50. The instrument system of claim 44 , having a first guide and a second guide, wherein the first guide is configured at an angle to the second guide.
51. The instrument system of claim 44 having a second guide, wherein the second guide is configured for drilling.
52. The instrument system of claim 44 , wherein the patient-specific surface is configured to prevent at least one movement selected from the group consisting of axial, lateral and rotational.
53. The instrument system of claim 44 , wherein the instrument system is configured to position the femoral component of the orthopedic implant.
54. The instrument system of claim 51 , wherein the first guide is configured for drilling a hole on a medial femoral condyle of the knee joint of the patient.
55. The instrument system of claim 51 , wherein the second guide is configured for drilling a hole on a lateral femoral condyle of the knee joint of the patient.
56. The instrument system of claim 44 , wherein the substantially uncut cartilage surface includes normal or diseased joint.
57. The instrument system of claim 44 , wherein the patient-specific surface includes information about subchondral bone.
58. The instrument system of claim 44 , wherein the predetermined internal rotation angle or external rotation angle of the femoral component of the orthopedic implant is selected by an operator.
59. The instrument system of claim 58 , wherein the operator is a surgeon.
60. The instrument system of claim 44 , wherein the substantially uncut joint surface portion of the femur of the knee joint includes at least a portion of a femoral condyle.
61. The instrument system of claim 44 , wherein the patient-specific surface is, at least in part, derived by estimating cartilage loss for at least a portion of the knee joint of the patient.
62. A patient-specific instrument system for surgery of a knee joint of a patient, the instrument system comprising:
a patient-specific surface for engaging at least a portion of a substantially uncut joint surface of the knee joint of the patient, the patient-specific surface including cartilage information derived from image data of the knee joint of the patient; and
a guide for directing a surgical instrument, wherein the guide has a predetermined position relative to the patient-specific surface and a predetermined orientation relative to at least one of an anatomical axis and a biomechanical axis associated with said knee joint when the patient-specific surface is engaged with the joint surface; and wherein the guide defines a cutting or drilling path through at least a portion of the knee joint the cutting or drilling path having a position based on at least one of a predetermined orientation of an orthopedic implant configured to correct a varus or valgus condition of the knee joint of the patient.
63. The instrument system of claim 62 , wherein the patient-specific surface and the guide are included in an integrally formed body.
64. The instrument system of claim 62 , wherein the patient-specific surface is included in a first body having a linkage mechanism and the guide is included in a second body having a complimentary linkage mechanism for connecting the first and second bodies.
65. The instrument system of claim 62 , wherein the patient-specific surface has a convex portion.
66. The instrument system of claim 62 , wherein the instrument system has a plurality of guides therein.
67. The instrument system of claim 66 , wherein a first guide of the plurality of guides is configured at an angle to a second guide of the plurality of guides.
68. The instrument system of claim 62 having a first guide and a second guide, wherein the first guide is configured at an angle to the second guide.
69. The instrument system of claim 62 having a second guide, wherein the second guide is configured for drilling.
70. The instrument system of claim 62 , wherein the patient-specific surface is configured to prevent at least one movement selected from the group consisting of axial, lateral and rotational.
71. The instrument system of claim 62 , wherein the instrument system is configured to position a femoral component of the orthopedic implant.
72. The instrument system of claim 62 , wherein the instrument system is configured to position a tibial component of the orthopedic implant.
73. The instrument system of claim 69 , wherein the first guide is configured for drilling a hole on a medial plateau of a tibia of the knee joint of the patient.
74. The instrument system of claim 69 , wherein the second guide is configured for drilling a hole on a lateral plateau of a tibia of the knee joint of the patient.
75. The instrument system of claim 69 , wherein the first guide is configured for drilling a hole on a medial femoral condyle of the knee joint of the patient.
76. The instrument system of claim 69 , wherein the second guide is configured for drilling a hole on a lateral femoral condyle of the knee joint of the patient.
77. The instrument system of claim 62 , wherein the substantially uncut cartilage surface includes normal or diseased joint.
78. The instrument system of claim 62 , wherein the patient-specific surface includes information about subchondral bone.
79. The instrument system of claim 62 , wherein the predetermined orientation of the orthopedic implant is selected by an operator.
80. The instrument system of claim 79 , wherein the operator is a surgeon.
81. The instrument system of claim 62 , wherein the substantially uncut joint surface portion of the knee joint includes at least a portion of a femoral condyle.
82. The instrument system of claim 62 , wherein the substantially uncut joint surface portion of the knee joint includes at least a portion of a tibial plateau.
83. The instrument system of claim 62 , wherein the patient-specific surface is, at least in part, derived by estimating cartilage loss for at least a portion of the knee joint of the patient.