Ankle replacement system and method
Various surgical devices and methods are disclosed herein. Also disclosed is multi-component prosthesis, which can be used as an ankle prosthesis. One of the disclosed surgical alignment systems includes a guide arm, a ratchet arm frame configured to be coupled slidably to the guide arm, a ratchet arm configured to be coupled to the ratchet arm frame, and a sagittal sizing guide body configured to be coupled to the ratchet arm. The sagittal sizing guide body includes a first radiopaque object disposed at a first position and a second radiopaque object disposed at a second position that is spaced apart from the first position.
1. A method, comprising:
coupling an alignment frame to a first fixture configured to be attached to a first bone;
adjusting the alignment frame to locate a position for a position adjustment guide;
coupling the position adjustment guide to a second fixture, the position adjustment guide comprising a tool holder;
attaching an alignment tool to the position adjustment guide;
performing a fluoroscopic alignment check using the alignment tool;
adjusting a position of the tool holder via adjustment features of the position adjustment guide based on the fluoroscopic alignment check;
attaching a cutting guide to the tool holder;
performing a bone resection using the cutting guide.
2. The method of claim 1 , wherein the alignment frame comprises a length adjustment feature and wherein adjusting the alignment frame comprises adjusting a length of the alignment frame via the telescoping feature.
3. The method of claim 2 , wherein the length adjustment feature comprises a distal alignment frame configured to slide relative to a proximal adjustment frame.
4. The method of claim 3 , wherein the distal alignment frame comprises a channel configured to receive the proximal adjustment frame and the length adjustment feature further comprises a knob configured to be tightened to prevent relative movement between the proximal alignment frame and the distal alignment frame.
5. The method of claim 1 , wherein adjusting the position of the tool holder comprises adjusting the position adjustment guide in at least two directions.
6. The method of claim 5 , wherein the at least two directions comprise a medial-lateral direction and a proximal-distal direction.
7. The method of claim 1 , further comprising placing the second fixture relative to the first bone, wherein the second fixture comprises at least one pin inserted through a hole in the alignment frame.
8. The method of claim 7 , wherein coupling the position adjustment guide to the second fixture comprises inserting the at least one pin into a hole in the position adjustment guide.
9. The method of claim 1 , wherein the first bone is a tibia.
10. A method, comprising:
coupling a position adjustment guide to a first component configured to be attached to a first bone, the position adjustment guide comprising a tool holder, a first adjustment feature for medial-lateral adjustment of the tool holder and a second adjustment feature for proximal-distal adjustment of the tool holder;
attaching an alignment tool to the position adjustment guide;
performing a fluoroscopic alignment check using the alignment tool;
adjusting a position of the tool holder of the position adjustment guide based on the fluoroscopic alignment check using at least one of the first adjustment feature or the second adjustment feature;
placing at least one pin in the first bone based on the adjusted position of the tool holder;
attaching a cutting guide to the tool holder, the cutting guide position defined at least in part by the at least one pin; and
performing a bone resection using the cutting guide.
11. The method of claim 10 , wherein the first component comprises at least one positioning pin inserted into the first bone.
12. The method of claim 11 , wherein the at least one positioning pin comprises two positioning pins and the first bone is a tibia.
13. The method of claim 10 , wherein at least one of the first adjustment feature and the second adjustment feature comprise a knob configured to be turned to adjust a position of the tool holder.
14. The method of claim 13 , further comprising locking the position adjustment guide in the adjusted position by tightening a locking screw.
15. The method of claim 10 , wherein the tool holder comprises a dovetail joint.
16. The method of claim 10 , wherein the at least one pin comprises two pins and the first bone is a tibia.
17. The method of claim 10 , further comprising inserting at least one fixation pin through the cutting guide into a second bone.
18. The method of claim 17 , wherein the first bone is a tibia and the second bone is a talus.
19. The method of claim 10 , wherein performing the bone resection using the cutting guide comprises performing a tibial resection and a talar resection.
20. A method, comprising:
coupling an alignment frame to a first fixture configured to be attached to a first bone;
adjusting the alignment frame to locate a position for a position adjustment guide;
coupling the position adjustment guide to a second fixture, the position adjustment guide comprising a tool holder, a first adjustment feature for medial-lateral adjustment of the tool holder and a second adjustment feature for proximal-distal adjustment of the tool holder;
attaching an alignment tool to the tool holder, the alignment tool comprising a guide having a body defining a first guide hole, a second guide hole, and a radiopaque reference cue having a predetermined positional relationship with the first and second guide holes;
performing a fluoroscopic alignment check using the radiopaque reference cue;
adjusting a position of the tool holder via one or more of the first and second adjustment features of the position adjustment guide based on the fluoroscopic alignment check;
securing a first pin in the first guide hole and a second pin located in the second guide hole based;
removing the alignment tool from the first and second pins;
attaching a cutting guide to the first and second pins; and
performing a bone resection using the cutting guide.