Customized patient-specific orthopaedic pin guides
View Patent ↗Customized patient-specific orthopaedic surgical instruments are disclosed. Methods for fabricating and using such instruments are also disclosed.
1. A method of performing an orthopaedic surgical procedure on a femur of a patient, comprising:
assembling a customized patient-specific femoral pin guide assembly by (i) locking a first removable drill bushing into a first hole of a customized patient-specific femoral pin guide, (ii) locking a second removable drill bushing into a second hole of the customized patient-specific femoral pin guide, (iii) locking a third removable drill bushing into a third hole of the customized patient-specific femoral pin guide, and (iv) locking a fourth removable drill bushing into a fourth hole of the customized patient-specific femoral pin guide,
positioning the assembled customized patient-specific femoral pin guide assembly in contact with the femur of the patient,
inserting a pair of guide pins into the anterior surface of the femur of the patient by (i) advancing a first guide pin of the pair of guide pins through the first removable drill bushing, and (ii) advancing a second guide pin of the pair of guide pins through the second removable drill bushing,
drilling a pair of holes into the distal surface of the femur of the patient by (i) advancing a drill bit through the third removable drill bushing and into the distal surface of the femur of the patient, and (ii) advancing the drill bit through the fourth removable drill bushing and into the distal surface of the femur of the patient,
removing the customized patient-specific femoral pin guide assembly and the pair of guide pins from the femur of the patient,
positioning a patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins, and
making a distal cut in the femur of the patient with the patient-universal distal cutting block.
2. The method of claim 1 , wherein removing the customized patient-specific femoral pin guide assembly and the pair of guide pins from the femur of the patient comprises removing the customized patient-specific pin guide assembly from the femur of the patient subsequent to removal of the pair of guide pins from the femur of the patient.
3. The method of claim 1 , wherein positioning a patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins comprises:
positioning a pair of spikes of an anterior fixed reference guide into a pair of locating holes defined in the patient-universal distal cutting block, and
positioning the pair of spikes of the anterior fixed reference guide into a pair of holes formed in the anterior surface of the femur of the patient as a result of removal of the pair of guide pins.
4. The method of claim 3 , wherein positioning the patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins further comprises coupling the anterior fixed reference guide to a handle assembly prior to positioning the spikes of the anterior fixed reference guide into the pair of locating holes defined in the patient-universal distal cutting block.
5. The method of claim 3 , wherein making the distal cut in the femur of the patient with the patient-universal distal cutting block comprises making the distal cut in the femur of the patient with the patient-universal distal cutting block with the pair of spikes of an anterior fixed reference guide positioned in both the pair of locating holes defined in the patient-universal distal cutting block and the pair of holes formed in the anterior surface of the femur.
6. The method of claim 3 , wherein:
positioning the patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins further comprises coupling the anterior fixed reference guide to a handle assembly prior to positioning the spikes of the anterior fixed reference guide into the pair of locating holes defined in the patient-universal distal cutting block, and
making the distal cut in the femur of the patient with the patient-universal distal cutting block comprises decoupling the anterior fixed reference guide from the handle assembly and making the distal cut in the femur of the patient with the patient-universal distal cutting block with the pair of spikes of the anterior fixed reference guide positioned in both the pair of locating holes defined in the patient-universal distal cutting block and the pair of holes formed in the anterior surface of the femur.
7. The method of claim 3 , wherein positioning the patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins comprises:
removing the patient-universal distal cutting block from the femur of the patient prior to making the cut in the femur of the patient, and
repositioning the anterior fixed reference guide such that the pair of spikes is positioned into a second, different pair of locating holes defined in the patient-universal distal cutting block prior to making the cut in the femur of the patient.
8. The method of claim 7 , wherein repositioning the patient-universal distal cutting block into contact with the femur of the patient comprises:
determining an amount of bone to be removed from the femur of the patient subsequent to positioning the patient-universal distal cutting block into contact with the femur of the patient,
selecting the pair of second, different locating holes which corresponds to the amount of bone to be removed from the femur of the patient from a plurality of pairs of locating holes, and
repositioning the anterior fixed reference guide such that the pair of spikes is received into the selected second, different pair of locating holes defined in the patient-universal distal cutting block prior to making the cut in the femur of the patient.
9. The method of claim 1 , further comprising:
securing a patient-universal A/P chamfer cutting block to the femur of the patient, and
making an anterior cut in the femur of the patient with the patient-universal A/P chamfer cutting block.
10. The method of claim 9 , wherein securing the patient-universal A/P chamfer cutting block to the femur of the patient comprises:
positioning a pair of spikes of a distal fixed reference guide into a pair of locating holes defined in the patient-universal A/P chamfer cutting block, and
positioning the pair of spikes of the distal fixed reference guide into the pair of holes drilled in the distal surface of the femur of the patient.
11. The method of claim 10 , wherein securing the patient-universal A/P chamfer cutting block to the femur of the patient further comprises:
inserting a number of fixation pins through a number of pin holes formed in the A/P chamfer cutting block and into the femur of the patient, and
removing the pair of spikes of the distal fixed reference guide from the pair of holes drilled in the distal surface of the femur of the patient and the pair of locating holes defined in the patient-universal A/P chamfer cutting block prior to making the anterior cut in the femur of the patient.
12. A method of performing an orthopaedic surgical procedure on a femur of a patient, comprising:
positioning a customized patient-specific femoral pin guide in contact with the femur of the patient,
inserting a pair of guide pins into the anterior surface of the femur of the patient by (i) advancing a first guide pin of the pair of guide pins through a first removable drill bushing, and (ii) advancing a second guide pin of the pair of guide pins through a second removable drill bushing,
drilling a pair of holes into the distal surface of the femur of the patient by (i) advancing a drill bit through a third removable drill bushing and into the distal surface of the femur of the patient, and (ii) advancing the drill bit through a fourth removable drill bushing and into the distal surface of the femur of the patient,
removing the customized patient-specific femoral pin guide assembly and the pair of guide pins from the femur of the patient,
positioning a patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins, and
making a distal cut in the femur of the patient with the patient-universal distal cutting block.
13. The method of claim 12 , wherein removing the customized patient-specific femoral pin guide assembly and the pair of guide pins from the femur of the patient comprises removing the customized patient-specific pin guide from the femur of the patient subsequent to removal of the pair of guide pins from the femur of the patient.
14. The method of claim 12 , wherein positioning the patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins comprises:
positioning a pair of spikes of an anterior fixed reference guide into a pair of locating holes defined in the patient-universal distal cutting block, and
positioning the pair of spikes of the anterior fixed reference guide into a pair of holes formed in the anterior surface of the femur of the patient as a result of removal of the pair of guide pins.
15. The method of claim 14 , wherein positioning the patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins further comprises coupling the anterior fixed reference guide to a handle assembly prior to positioning the spikes of the anterior fixed reference guide into the pair of locating holes defined in the patient-universal distal cutting block.
16. The method of claim 14 , wherein making the distal cut in the femur of the patient with the patient-universal distal cutting block comprises making the distal cut in the femur of the patient with the patient-universal distal cutting block with the pair of spikes of an anterior fixed reference guide positioned in both the pair of locating holes defined in the patient-universal distal cutting block and the pair of holes formed in the anterior surface of the femur.
17. The method of claim 14 , wherein:
positioning the patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins further comprises coupling the anterior fixed reference guide to a handle assembly prior to positioning the spikes of the anterior fixed reference guide into the pair of locating holes defined in the patient-universal distal cutting block, and
making the distal cut in the femur of the patient with the patient-universal distal cutting block comprises decoupling the anterior fixed reference guide from the handle assembly and making the distal cut in the femur of the patient with the patient-universal distal cutting block with the pair of spikes of an anterior fixed reference guide positioned in both the pair of locating holes defined in the patient-universal distal cutting block and the pair of holes formed in the anterior surface of the femur.
18. The method of claim 14 , wherein positioning the patient-universal distal cutting block into contact with the femur of the patient subsequent to removal of the pair of guide pins comprises:
removing the patient-universal distal cutting block from the femur of the patient prior to making the cut in the femur of the patient, and
repositioning the anterior fixed reference guide such that the pair of spikes is positioned into a second, different pair of locating holes defined in the patient-universal distal cutting block prior to making the cut in the femur of the patient.
19. The method of claim 18 , wherein repositioning the patient-universal distal cutting block into contact with the femur of the patient comprises:
determining an amount of bone to be removed from the femur of the patient subsequent to positioning the patient-universal distal cutting block into contact with the femur of the patient,
selecting the pair of second, different locating holes which corresponds to the amount of bone to be removed from the femur of the patient from a plurality of pairs of locating holes, and
repositioning the anterior fixed reference guide such that the pair of spikes is received into the selected second, different pair of locating holes defined in the patient-universal distal cutting block prior to making the cut in the femur of the patient.
20. The method of claim 12 , further comprising:
securing a patient-universal A/P chamfer cutting block to the femur of the patient, and
making an anterior cut in the femur of the patient with the patient-universal A/P chamfer cutting block.
21. The method of claim 20 , wherein securing the patient-universal A/P chamfer cutting block to the femur of the patient comprises:
positioning a pair of spikes of a distal fixed reference guide into a pair of locating holes defined in the patient-universal A/P chamfer cutting block, and
positioning the pair of spikes of the distal fixed reference guide into the pair of holes drilled in the distal surface of the femur of the patient.
22. The method of claim 21 , wherein securing the patient-universal A/P chamfer cutting block to the femur of the patient further comprises:
inserting a number of fixation pins through a number of pin holes formed in the A/P chamfer cutting block and into the femur of the patient, and
removing the pair of spikes of the distal fixed reference guide from the pair of holes drilled in the distal surface of the femur of the patient and the pair of locating holes defined in the patient-universal A/P chamfer cutting block prior to making the anterior cut in the femur of the patient.