Bone implants and cutting apparatuses and methods
Implant devices and cutting clamp apparatuses and methods for creating the implants for insertion into a patient's joint to restore anatomic length and assist in final positioning of the bones following removal of cartilage and/or bone in preparation for fusion. A first implant is a biplanar implant having a shape to mimic the normal anatomical shape of the bones the implant is configured to mate with. The first implant may be cut using a cutting clamp and jig having the anatomical shape of the bones the implant will be inserted within or between. A second implant is a cylindrical piece of bone having a convex end and a concave end for mating with bones reamed to have the opposite mating surfaces. The second implant is created using cup and cone reamers having dimensions corresponding to the size of the patient's bones. Surgical methods for inserting the implants within a patient.
1. A surgical method for implanting a metatarsal-phalangeal implant into a metatarsal-phalangeal joint, the method comprising:
providing a monolithic metatarsal-phalangeal implant comprising a first end and an opposite second end;
surgically exposing the metatarsal-phalangeal joint of a patient;
separating a metatarsal bone from a proximal phalanx bone;
obtaining a cone reamer;
reaming the metatarsal bone with the cone reamer to form a convex end on the metatarsal bone for engaging the first end of the implant, the first end of the implant comprising a surface complementary to the convex end of the metatarsal bone;
obtaining a cup reamer;
reaming the proximal phalanx bone with the cup reamer to form a concave end on the proximal phalanx bone for engaging the second end of the implant, the second end of the implant comprising a surface complementary to the concave end of the proximal phalanx;
inserting the metatarsal-phalangeal implant between the metatarsal bone and the proximal phalanx bone, wherein the first end of the implant is configured to mate with the convex end of the metatarsal bone and the second end of the implant is configured to mate with the concave end of the proximal phalanx bone, and
securing the implant to the metatarsal bone and the proximal phalanx bone by positioning an external fixation device over the implant and attaching the fixation device to the metatarsal bone and the proximal phalanx bone,
wherein the cone reamer comprises:
a shank; and
a cutting portion coupled to a distal end of the shank with a plurality of cutting edges having a concave cutting surface; and
wherein the cup reamer comprises:
a shank; and
a cutting portion coupled to a distal end of the shank with a plurality of cutting edges having a convex cutting surface;
wherein the metatarsal-phalangeal implant is monolithically formed from a cylindrical piece of bone having a desired length and desired circumference, wherein said first end of the implant comprises a concave end created using the cup reamer, and wherein said second end of the implant comprises a convex end created using the cone reamer.
2. The method of claim 1 , wherein the proximal phalanx is reamed first and the metatarsal is reamed second.
3. The method of claim 1 , wherein the cup reamer further comprises: a backstop removably coupled on the shank and positioned over the cutting portion to protect surrounding soft tissue from the cutting edges.
4. The method of claim 1 , wherein the cone shaped reamer further comprises: a backstop removably coupled on the shank and positioned over the cutting portion to protect surrounding soft tissue form the cutting edges.
5. The method of claim 1 , wherein the metatarsal is reamed first and the proximal phalanx is reamed second.