Tibial guides, tools, and techniques for resecting the tibial plateau
Various patient-specific tibial guide housings, patient-specific tibial guide boxes, and methods of resecting the tibial plateau are disclosed herein.
1. A system for preparing a tibial plateau of a tibia of a patient, the system comprising: a tibial guide housing, the tibial guide housing comprising: a top side generally opposite a bottom side and a front side generally opposite a back side; a first reference arm having a patient-specific contact surface configured to conform to a first portion of a superior surface of the tibia; a second reference arm having a patient-specific contact surface configured to conform to a second portion of the superior surface of the tibia; and at least one pin hole configured to accommodate insertion of a pin through the tibial guide housing and into the tibia, wherein the back side includes a patient-specific contact surface configured to conform to a portion of the anterior surface of the tibia; one or more tibial cutting guide boxes, each of the one or more tibial cutting guide boxes comprising: a patient-specific contact surface configured to conform to a portion of an anterior surface of the tibia; a guide aperture configured to accommodate a surgical cutting tool and guide the cutting tool along a cutting plane having a predetermined cut depth and angle; and at least one pin hole configured to accommodate a pin passing into the tibia.
2. The system of claim 1 , wherein the one or more tibial cutting guide boxes are each configured for releasable securement within the tibial guide housing.
3. The system of claim 1 , including at least two tibial cutting guide boxes, wherein each of the at least two tibial cutting guide boxes has a different predetermined cut depth.
4. The system of claim 1 , wherein the tibial guide housing further comprises a third reference arm having a patient-specific contact surface configured to conform to a third portion of the superior surface of the tibia.
5. A method of preparing a tibial plateau of a tibia of a knee joint of a patient for implantation of at least one prosthesis, the method comprising: providing a tibial guide housing, the tibial guide housing including: a first reference arm having a patient-specific contact surface configured to conform to a first portion of a superior surface of the tibia; a second reference arm having a patient-specific contact surface configured to conform to a second portion of the superior surface of the tibia; and a back side having a patient-specific contact surface configured to conform to a portion of an anterior surface of the tibia; providing a first tibial cutting guide box, the first tibial cutting guide box including: a patient-specific contact surface configured to conform to a portion of the anterior surface of the tibia; and a guide aperture configured to accommodate a surgical cutting tool and guide the cutting tool along a cutting plane having a predetermined cut depth and angle; positioning the tibial guide housing on the tibia such that each of the patient-specific contact surfaces of the tibial guide housing achieves a conforming fit with the tibia; positioning the first tibial cutting guide box such that the patient-specific contact surface of the first tibial cutting guide box achieves a conforming fit with the tibia; and inserting a cutting device through the guide aperture and cutting a portion of the tibia along the cutting plane.
6. The method of claim 5 , further comprising inserting the first tibial cutting guide box into an opening of the tibial guide housing.
7. The method of claim 5 , further comprising removing the first tibial cutting guide box from the tibial guide housing.
8. The method of claim 5 , further comprising selecting the first tibial cutting guide box from a plurality of tibial cutting guide boxes, each including a guide aperture having a different predetermined cut depth.
9. The method of claim 5 , further comprising: positioning a prosthesis component on a cut surface of the tibia; and checking a state of the knee joint, wherein the state of the knee joint is selected from the group consisting of ligament stability of the knee joint, range of motion of the knee joint, alignment of the knee joint, and combinations thereof.
10. The method of claim 9 , further comprising: selecting a second tibial cutting guide box from a plurality of tibial cutting guide boxes, each including a guide aperture having a different predetermined cut depth, based, at least in part, on the checking a state of the knee joint; and positioning the second tibial cutting guide box such that a patient-specific contact surface of the second tibial cutting guide box achieves a conforming fit with a portion of the anterior surface the tibia.
11. The method of claim 5 , including cutting a medial portion of the tibia or a lateral portion of the tibia.