Position adjustable trial systems for prosthetic implants
A trial system for an implantable joint replacement includes a guide assembly having a baseplate and a guide plate, the guide plate rotatable relative to the base plate about a rotation axis extending through the guide plate and the baseplate while directly connected to the baseplate. An adjustment mechanism is actuable to selectively control the rotational juxtaposition of the guide plate relative to the baseplate. The rotation axis may be medially offset from the center of the guide assembly. A single instrument may be used to rotate the guide plate relative to the base plate and lock the plates in the selected juxtaposition. The guide plate provides in situ positionable cutting guidance for implantation of prosthetic joint components. The system may further include an articulating insert trial mounted on the guide assembly to determine preferred joint alignment and/or optimal positioning of the guide plate.
1. A knee joint trial system, the system comprising:
a baseplate trial comprising a flat baseplate body having a baseplate trial superior surface, a baseplate trial inferior surface and a baseplate trial aperture extending between the baseplate trial superior surface and the baseplate trial inferior surface, the baseplate trial aperture comprising a baseplate trial port aligned along a medially-displaced axis, and an elongated baseplate trial opening extending laterally from the baseplate trial port, the baseplate trial inferior surface shaped to be positioned on a resected tibial surface;
a guide plate trial comprising a flat guide plate body having a guide plate trial superior surface, a guide plate trial inferior surface and a guide plate trial aperture extending between the guide plate trial superior surface and the guide plate trial inferior surface, the guide plate trial aperture comprises a guide plate trial port aligned along the medially-displaced axis, and an elongated guide plate trial opening extending laterally from the guide plate trial port, the guide plate trial lying directly on the baseplate trial with the guide plate trial inferior surface overlaying the baseplate trial superior surface;
a femoral implant comprising a cam feature, a pair of condyles and a femur facing surface;
a tibial insert trial comprising guide plate trial facing side, a femoral implant facing side, a lateral articulating surface, and a medial articulating surface, and wherein the guide plate trial facing side defines a boss positioned medially on the guide plate trial facing side that is rotatable within the guide plate trial port to enable a pivotal articulation of the guide plate trial facing side with the guide plate trial superior surface about the medially-displaced axis, wherein each of the medial and lateral articulating surfaces are shaped and positioned to articulate with the pair of condyles;
the tibial insert trial further comprising an arc-shaped channel passing through the guide plate trial facing side of the tibial insert trial, the arc-shaped channel tibial being concave toward the medial articulating surface; and
a post assembled with the tibial insert trial and passing through the arc-shaped channel into the guide plate trial aperture, wherein the pivotal articulation is provided at least partially by contact of an anterior side of the cam feature with a posterior side of the post during articulation of the pair of condyles with the medial and lateral articulating surfaces;
wherein the baseplate trial is rotatable relative to the guide plate trial about the medially-displaced axis to confirm proper contact between the femoral implant and the tibial insert trial.
2. The system of claim 1 , wherein the baseplate trial aperture is larger than the guide plate trial aperture in at least one dimension.
3. The system of claim 2 , wherein the guide plate trial superior and inferior surfaces are planar.
4. The system of claim 3 , wherein the baseplate trial superior and inferior surfaces are planar.
5. The system of claim 1 , wherein the baseplate trial, guide plate trial and tibial insert trial each have an ovoid footprint shape.
6. The system of claim 1 , wherein the baseplate trial includes an outer periphery and the guide plate trial includes an outer periphery, wherein a posterior portion of the baseplate trial outer periphery includes a notch recessed toward a center of the baseplate trial, and wherein a posterior portion of the guide plate trial outer periphery includes a notch recessed toward a center of the guide plate trial, and wherein the guide plate trial notch is wider medial-laterally than the baseplate trial notch.
7. The system of claim 6 , wherein the baseplate trial has a plurality of circular holes extending between the baseplate trial superior surface and the baseplate trial inferior surface, the holes positioned between the baseplate trial aperture and the baseplate trial outer periphery.
8. The system of claim 6 , wherein the guide plate trial has a plurality of circular holes extending between the guide plate trial superior surface and the guide plate trial inferior surface, the holes positioned between the guide plate trial aperture and the guide plate trial outer periphery.
9. The system of claim 1 , wherein at least one of the tibial insert trial, and guide plate trial is available in a variety of dimensions to allow selection of a tibial insert.