Patient selectable 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 surgical instrument for use in repairing a joint of a patient, comprising:
a first portion having a patient-specific surface and a second portion having a guide to direct or accommodate a surgical tool;
wherein the patient-specific surface is substantially a negative of a corresponding surface of the joint of the patient; and
wherein the guide has a position or orientation relative to the patient-specific surface to define a predetermined path for the surgical tool that is aligned through a portion of tissue associated with the joint of the patient, when the patient-specific surface is placed against and aligned with the corresponding surface,
wherein the joint of the patient is a shoulder joint of the patient,
wherein the predetermined path for the surgical tool determines the resultant anteversion, retroversion, rotation, or orientation of at least one glenoid or humeral implant component for repairing the shoulder joint.
2. The surgical instrument of claim 1 , wherein the surgical tool is used for reaming a glenoid cup.
3. The surgical instrument of claim 1 , wherein the surgical tool is used for cutting a humeral neck.
4. The surgical instrument of claim 1 , wherein the surgical tool is used for reaming a humeral shaft.
5. The surgical instrument of claim 1 , wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a humeral neck of a proximal humerus of the shoulder joint.
6. The surgical instrument of claim 1 , wherein the portion of the patient-specific surface is a first portion and the patient-specific surface further comprises at least a second portion that is substantially a negative of a corresponding cortical bone surface of a proximal humerus of the shoulder joint, wherein the second portion is configured to align with the cortical bone surface when the first portion is placed against and aligned with the corresponding surface.
7. The surgical instrument of claim 6 , wherein the corresponding surface is located near a humeral neck of the shoulder joint.
8. The surgical instrument of claim 7 , wherein the cortical bone surface is located on a humeral neck of the shoulder joint.
9. The surgical instrument of claim 6 , wherein the corresponding surface is located on a humeral head of the shoulder joint.
10. The surgical instrument of claim 9 , wherein the cortical bone surface is located adjacent to a humeral head of the shoulder joint.
11. The surgical instrument of claim 9 , wherein the corresponding surface is located at or near a junction of the humeral head and humeral neck of the shoulder joint.
12. The surgical instrument of claim 11 , wherein the cortical bone surface is located at or near a junction of the humeral head and humeral neck of the shoulder joint.
13. The surgical instrument of claim 9 , wherein the corresponding surface extends from a humeral neck to a humeral head of a proximal humerus associated with the shoulder joint.
14. The surgical instrument of claim 1 , wherein the corresponding surface is located in a glenoid associated with the shoulder joint.
15. The surgical instrument of claim 1 , wherein the portion of the patient-specific surface is a first portion and the patient-specific surface further comprises at least a second portion that is substantially a negative of a corresponding cortical bone surface of an iliac bone of the shoulder joint, wherein the second portion is configured to align with the cortical bone surface when the first portion is placed against and aligned with the corresponding surface.
16. The surgical instrument of claim 15 , wherein the cortical bone surface is located on a glenoid rim associated with the shoulder joint.
17. The surgical instrument of claim 15 , wherein the corresponding surface is located on an iliac bone associated with the shoulder joint.
18. The surgical instrument of claim 1 , wherein the portion of the patient-specific surface is a first portion and the patient-specific surface further comprises at least a second portion that is substantially a negative of a corresponding cartilage surface of a proximal humerus of the shoulder joint, wherein the second portion is configured to align with the cartilage surface when the first portion is placed against and aligned with the corresponding surface.
19. The surgical instrument of claim 18 , wherein the cartilage surface is located on a humeral head of the shoulder joint.
20. The surgical instrument of claim 18 , wherein the corresponding surface is located on an iliac bone associated with the shoulder joint.
21. The surgical instrument of claim 1 , wherein the portion of the patient-specific surface is a first portion and the patient-specific surface further comprises at least a second portion that is substantially a negative of a corresponding cartilage surface of an glenoid of the shoulder joint, wherein the second portion is configured to align with the cartilage surface when the first portion is placed against and aligned with the corresponding surface.
22. The surgical instrument of claim 21 , wherein the corresponding surface is located on an iliac bone associated with the shoulder joint.
23. The surgical instrument of claim 1 , wherein the portion of the patient-specific surface is a first portion and the patient-specific surface further comprises:
at least a second portion that is substantially a negative of a corresponding cortical bone surface of a proximal humerus of the shoulder joint; and
at least a third portion that is substantially a negative of a corresponding cartilage surface of a proximal humerus of the shoulder joint,
wherein the second portion is configured to align with the cortical bone surface and the third portion is configured to align with the cartilage surface when the first portion is placed against and aligned with the corresponding surface.
24. The surgical instrument of claim 1 , wherein the portion of the patient-specific surface is a first portion and the patient-specific surface further comprises:
at least a second portion that is substantially a negative of a corresponding cortical bone surface of an glenoid of the shoulder joint; and
at least a third portion that is substantially a negative of a corresponding cartilage surface of an glenoid of the shoulder joint, wherein the second portion is configured to align with the cortical bone surface and the third portion is configured to align with the cartilage surface when the first portion is placed against and aligned with the corresponding surface.
25. The surgical instrument of claim 1 , wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a glenoid of a shoulder joint.
26. The surgical instrument of claim 1 , wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a glenoid rim of a shoulder joint.
27. The surgical instrument of claim 1 , wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone of a glenoid of the shoulder joint.
28. The surgical instrument of claim 1 , wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a humeral head of a proximal humerus of the associated shoulder joint.
29. The surgical instrument of claim 1 , wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of subchondral bone of a humeral head of a proximal humerus of the shoulder joint.
30. The surgical instrument of claim 1 , wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a humeral neck of a proximal humerus of the shoulder joint.
31. The surgical instrument of claim 1 , wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of a junction of a humeral head and humeral neck of a proximal humerus of the shoulder joint.
32. The surgical instrument of claim 1 , wherein the component and the guide are formed in two separate pieces that can be linked to each other.
33. The surgical instrument of claim 1 , wherein the patient-specific surface has at least a portion that is substantially a negative of a corresponding portion of an iliac bone of the shoulder joint.
34. The surgical instrument of claim 1 , wherein the surgical instrument is stabilized against at least one of an iliac bone, an glenoid, an glenoid rim, a humeral head, neck or shaft using at least one of a wire, a screw, an anchor, or a drill bit.
35. The surgical instrument of claim 1 , wherein the surgical instrument is stabilized against at least one of an iliac bone, an glenoid, an glenoid rim, a humeral head, neck or shaft using at least one or more convexities and one or more concavities on a subchondral bone surface.
36. The surgical instrument of claim 1 , wherein the surgical instrument is stabilized against at least one of an iliac bone, an glenoid, an glenoid rim, a humeral head, neck or shaft using at least one or more convexities and one or more concavities on a cortical surface.
37. The surgical instrument of claim 1 , wherein the surgical instrument is stabilized against at least one of an iliac bone, an glenoid, an glenoid rim, a humeral head, neck or shaft using at least one or more convexities and one or more concavities on a cartilage surface.
38. The surgical instrument of claim 1 , wherein the corresponding surface includes normal or diseased subchondral bone.
39. The surgical instrument of claim 38 , wherein the surgical instrument is stabilized against at least one of an iliac bone, an glenoid or a humeral head by positioning it on or over an interface between normal and diseased subchondral bone.
40. The surgical instrument of claim 1 , wherein the surgical instrument is stabilized against at least one of an iliac bone, a glenoid or a humeral head by positioning it on or over an anatomic feature.
41. The surgical instrument of claim 40 , wherein said anatomic features is at least one of a fovea capities, a tri-radiate subchondral bone, an glenoid fossa, an glenoid wall or an glenoid rim.
42. The surgical instrument of claim 1 , wherein the position of the guide can be adjusted intraoperatively in order to optimize ligament tension in one or more joint positions.
43. The surgical instrument of claim 42 , wherein the position of the guide can be adjusted using at least one or more adjustment mechanisms selected from the group consisting of: a spacer like device, a ratchet like device, a pin like device, and any combination thereof.
44. The surgical instrument of claim 43 , wherein said one or more adjustment mechanisms are configured to achieve a desired anteversion, retroversion, rotation, or orientation of the at least one glenoid or humeral implant component.
45. The surgical instrument of claim 1 , further comprising a first third portion having a second guide to direct or accommodate a surgical tool, wherein the third portion includes a linkage mechanism to the second portion.
46. The surgical instrument of claim 1 , wherein the first and second portions form a single component.
47. The surgical instrument of claim 1 , further comprising a first component including the first portion and a second component including the second portion.