System and method for side insertion of a bicondylar mini knee implant
A bicondylar knee implants with improved fixation means for resurfacing only the weight-bearing surface of the femoral medial and lateral condyles, while preserving the cruciate ligaments and avoids displacing the patella. The inventive device includes metallic convex articular surfaces for resurfacing the medial and lateral femoral condyles, and concave multifacial non-articular surfaces to be affixed to the resected distal surfaces of the femur. The prosthesis provides claws situated at the anterior and posterior ends of the medial and lateral metallic condyles, which will firmly attach the implant against the resected femoral condyle. The prosthesis is designed to be implanted through a direct lateral approach and does not resurface the femoropatellar joint. Furthermore, a minirobot or electromechanical actuator is used to perform the femoral and tibial bone cuts using electromagnetic bone chipper.
1. A method of forming a joint between a patient's femur and tibia, comprising the steps of:
placing a patient on their side on an operating table and placing an operated leg on a platform generally horizontally placed between the patient's legs and firmly attached to side rails of the operating table;
establishing an approach to a retropatellar region of the patient's knee joint;
establishing locations of surfaces to be resected on the femur utilizing a hand held femoral template guide and a femoral cutting block;
resecting a surface of the femur;
resecting a surface of the tibia;
inserting an implantable bicondylar femoral prosthesis having a curved articular portion that includes a medial condyle, a lateral condyle, and intercondylar anterior connection, the femoral prosthesis having inner retaining claws, such that when the femoral prosthesis is implanted on the femur, no portion of an outer surface of the femoral prosthesis resurfaces any area of the patello-femoral joint;
inserting an implantable tibial prosthesis including a tibial platform having a bottom surface, which includes retaining ridges placed anteriorly and posteriorly onto said tibial platform, and a top surface, which includes anterior and posterior retaining ridges for retaining a polyethylene insert; and
inserting the polyethylene insert having a bottom surface, which includes anterior and posterior grooves, by sliding said polyethylene insert into the retaining ridges of the top surface of the tibial platform.
2. The method of claim 1 , wherein the operated leg is wrapped with surgical stockinet and firmly secured to an upper surface of the platform by heavy hook and loop fastener or a vacuum bean bag or a vise.
3. The method of claim 1 , wherein the resection of the femur and the tibia is performed using an electromagnetic bone cutter.
4. The method of claim 3 , wherein the electromagnetic bone cutter comprises an inverted T shaped rail running longitudinally along a bottom of said electromagnetic bone cutter, whereby movement of said electromagnetic bone cutter is thereby guided.
5. The method of claim 3 , wherein the electromagnetic bone cutter is guided by the femoral cutting block having two or more T grooves adapted to slidably accept the inverted T shaped rail running longitudinally along the bottom of said electromagnetic bone cutter, whereby movement of said electromagnetic bone cutter is thereby guided during the resection, the femoral cutting block being removably affixed to a lateral surface of the femur and secured in position using at least two fixation pins, wherein the fixation pins pass through the femoral cutting block and into said femur, positions of the fixation pins relative to the femur being established by the hand held femoral template guide.
6. The method in claim 5 , wherein the femoral cutting block is a template for the electromagnetic bone cutter, and establishes resection planes for removal of weight bearing articular surfaces of medial and lateral condyles of the femur, the femoral cutting block comprising three flat surfaces which correspond to three flat surfaces of non-articular surfaces of the femoral prosthesis.
7. The method of claim 5 , wherein the hand held femoral template guide; comprises a handle, two arcuate and curved medial and lateral condylar templates connected by a sliding connecting rod, and a bracket having apertures for receiving the fixation pins, wherein, in use, the arcuate and curved medial and lateral condylar templates are positioned against medial and lateral condyles of the femur, fixation pins are inserted through the apertures, ends of the fixation pins are removably affixed to the femur, subsequently the hand held femoral template guide is disengaged from the fixation pins, and thereafter the femoral cutting block is engaged upon the fixation pins.