Joint spacer systems and methods
In some examples, a method for preparing one or more bones involves inserting a spacer into a space defined between a first bone and a second bone, such as a joint space between a first metatarsal and medial cuneiform. A bone preparation guide can be aligned with opposed ends of the first bone and the second bone using the spacer as an alignment reference. For example, the bone preparation guide may include an opening such that the guide can be installed across the joint space with the spacer received in the opening. A clinician may use the bone preparation guide to guide a tissue removing instrument to cut or otherwise prepare the ends of the first bone portion and second bone portion.
1. A method for preparing a tarsometatarsal joint for fusion, the method comprising:
inserting a spacer into a joint space defined between a metatarsal and an opposed cuneiform;
engaging a bone preparation guide with the spacer inserted into the joint space;
aligning at least one of a first guide surface of the bone preparation guide with a portion of the metatarsal and a second guide surface of the bone preparation guide with a portion of the opposed cuneiform, while the spacer is inserted into the joint space; and
guiding a tissue removing instrument using the at least one of the first guide surface and the second guide surface of the bone preparation guide to remove at least one of the portion of the metatarsal and the portion of the opposed cuneiform.
2. The method of claim 1 , wherein:
the bone preparation guide defines an opening between the first guide surface and the second guide surface, the opening being configured to receive the spacer, and
engaging the bone preparation guide with the spacer comprises receiving the spacer within opening.
3. The method of claim 1 , wherein aligning at least one of the first guide surface of the bone preparation guide with the portion of the metatarsal and the second guide surface of the bone preparation guide with the portion of the opposed cuneiform comprises aligning the first guide surface of the bone preparation guide with the portion of the metatarsal and the second guide surface of the bone preparation guide with the portion of the opposed cuneiform.
4. The method of claim 1 , wherein the first guide surface defines a first preparing plane and the second guide surface defines a second preparing plane.
5. The method of claim 4 , wherein the second plane is parallel to the first plane.
6. The method of claim 1 , wherein:
the bone preparation guide further comprises a first facing surface spaced from the first guide surface to define a first preparing slot and a second facing surface spaced from the second guide surface to define a second preparing slot, and
aligning at least one of a first guide surface and the second guide surface comprises aligning at least one of the first preparing slot with the portion of the metatarsal and the second preparing slot with the portion of the opposed cuneiform.
7. The method of claim 1 , further comprising engaging a tissue removal location check member comprising a first portion and a second portion with the bone preparation guide, wherein engaging the tissue removal location check member comprises inserting the first portion in an opening of the bone preparation guide toward at least one of the metatarsal and opposed cuneiform with the second portion projecting out from the bone preparation guide.
8. The method of claim 7 , further comprising rotating the tissue removal location check member about the metatarsal or opposed cuneiform while engaged with the bone preparation guide.
9. The method of claim 1 , wherein inserting the spacer comprises inserting the spacer such that the spacer contacts at least a lateral edge of an end face of the metatarsal and a lateral edge of an end face of the opposed cuneiform.
10. The method of claim 1 , wherein inserting the spacer comprises inserting the spacer such that the spacer contacts at least a lateral third of an end face of the metatarsal and a lateral third of an end face of the opposed cuneiform.
11. The method of claim 1 , wherein inserting the spacer includes positioning a first portion of the spacer within the joint space such that a central longitudinal axis of the first portion is spaced laterally from a central longitudinal axis of a second portion of the spacer.
12. The method of claim 1 , wherein the metatarsal has an end face, the opposed cuneiform has an end face, and inserting the spacer comprises inserting the spacer such that the spacer contacts a lateral half of the end face of the metatarsal and a lateral half of the end face of the opposed cuneiform without contacting a medial half of the end faces of the metatarsal and the opposed cuneiform.
13. The method of claim 1 , wherein the metatarsal is a first metatarsal and the opposed cuneiform is a medial cuneiform.
14. The method of claim 1 , further comprising, subsequent to inserting the spacer and prior to engaging the bone preparation guide, moving the metatarsal to reduce an intermetatarsal angle between the metatarsal and an adjacent metatarsal.
15. The method of claim 1 , wherein the spacer tapers in thickness across its width.
16. The method of claim 1 , wherein the spacer comprises:
a first portion configured to extend into the joint space,
a second portion, opposite the first portion, configured to extend above the joint space, and
an intermediate portion disposed between the first portion and the second portion.
17. The method of claim 16 , wherein the intermediate portion has a thickness and the first portion has a thickness, the thickness of the intermediate portion being different than the thickness of the first portion.
18. The method of claim 16 , wherein a central longitudinal axis of the first portion is spaced from a central longitudinal axis of the second portion.
19. The method of claim 16 , wherein engaging the bone preparation guide with the spacer comprises engaging the intermediate portion of the spacer with the bone preparation guide.
20. The spacer of claim 16 , wherein:
the first, second, and intermediate portions are integral; and
at least the first portion tapers in thickness across its width.