EP2744455A1 - Instrumentation chirurgicale spécifique d'un patient pour la préparation du genou dudit patient - Google Patents

Instrumentation chirurgicale spécifique d'un patient pour la préparation du genou dudit patient

Info

Publication number
EP2744455A1
EP2744455A1 EP12751485.9A EP12751485A EP2744455A1 EP 2744455 A1 EP2744455 A1 EP 2744455A1 EP 12751485 A EP12751485 A EP 12751485A EP 2744455 A1 EP2744455 A1 EP 2744455A1
Authority
EP
European Patent Office
Prior art keywords
femoral
tibial
patient
femur
tibia
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP12751485.9A
Other languages
German (de)
English (en)
Inventor
Toufik ZAKARIA
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Corin Ltd
Original Assignee
Tornier SAS
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tornier SAS filed Critical Tornier SAS
Publication of EP2744455A1 publication Critical patent/EP2744455A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564—Methods for bone or joint treatment
    • A61B2017/565—Methods for bone or joint treatment for surgical correction of axial deviation, e.g. hallux valgus or genu valgus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/067—Measuring instruments not otherwise provided for for measuring angles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4658—Measuring instruments used for implanting artificial joints for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4668—Measuring instruments used for implanting artificial joints for measuring angles

Definitions

  • the present invention relates to patient-specific surgical instrumentation for preparing said patient's knee, typically with a view to implanting a prosthesis therein.
  • the invention relates to femoral and tibial instrumentation, also described as "custom-made” or personalised, linked with a specific patient, on whom the instrumentation is exclusively intended to be used.
  • This type of patient-specific instrumentation is opposed to standard instrumentations, which are used without discrimination on various patients, reused a plurality of successive times if applicable, being cleaned and sterilised between each use.
  • preoperative data used are typically obtained from scan images or, more generally, from any bone mapping data record advantageously obtained non-invasively. These data are processed by computer to control the production of custom-made surgical instruments, once the surgeon has decided details of the surgical procedure to be monitored step- by-step in future surgery.
  • the invention relates more specifically to custom-made surgical instrumentations for preparing both the lower end of the femur and the upper end of the tibia in a patient, typically for the purposes of implanting the femoral and tibial components of a knee prosthesis, noting that said prosthesis may also equally be a custom-made prosthesis, i.e. specifically personalised for the patient to undergo surgery, or a "catalogue" knee prosthesis, i.e. a standard, mass-produced, prosthesis, broken down into size-based ranges if applicable.
  • the use of patient-specific instrumentation offers a genuine benefit, due to the complexity of the knee joint and the need to prepare the femur and the tibia with maximum precision, in that this preparation determines, directly and significantly, the implantation positioning of the prosthetic components on the femur and on the tibia: it is thus understood that the subsequent mechanical performances of the implanted prosthesis are directly associated with the best possible implantation in terms of the positioning of the prosthetic components with respect to the femur and tibia.
  • current custom-made instrumentations generally consist of two monolithic blocks which, as explained above, have been produced using preoperative bone mapping data, relating to the specific patient to undergo surgery, and specifically used by the surgeon on that patient: after positioning the femoral block on the lower end of the femur and positioning the tibial block on the upper end of the tibia, according to a unique predetermined configuration, associated with the engagement based on complementary shapes between a bearing surface, defined by each of the two blocks, and the end of the corresponding bone, the surgeon uses these blocks to control the application of one or a plurality of bone preparation tools, such as a drill bit or an anchoring pin.
  • bone preparation tools such as a drill bit or an anchoring pin.
  • This or these tool(s) thus enable(s) the surgeon to prepare the ends of the femur and the tibia, particularly for resecting these ends along one or a plurality of very specific geometric planes, these cutting planes being particularly designed to form corresponding plane bearing surfaces for fixing prosthetic components.
  • these guide blocks specific to the patient to undergo surgery, do not allow the surgeon any scope for adjustment in respect of the application of the abovementioned bone preparation tools: indeed, the use of such custom-made guide blocks is specifically intended to ensure easier and safer surgical procedures, conducted, during surgery, according to a surgical plan predetermined by the surgeon, particularly on the basis of preoperative bone mapping data. In principle, this one-way, constrained approach ensures an optimal implantation result.
  • the aim of the present invention is that of providing custom-made instrumentation for preparing a patient's femur and tibia, enabling the surgeon, when the instrumentation is already in position on the femur and tibia during the actual surgical procedure, to account for any modification of the relative positioning between the femur and the tibia.
  • the invention relates to patient-specific surgical instrumentation, for preparing the patient's knee, comprising:
  • a patient-specific femoral block defining a fixed bearing surface on the patient's femur, shaped in a manner specifically fitted to the femur, and
  • a patient-specific tibial block defining a fixed bearing surface on the patient's tibia, shaped in a manner specifically fitted to the tibia,
  • the instrumentation further comprises measurement means for measuring peroperatively, the relative positioning between the femur and the tibia, said measurement means including first and second portions, respectively borne by the femoral block and by the tibial block, and which are suitable for, while the femoral and tibial blocks respectively bear in a fixed manner on the femur and the tibia via the bearing surface thereof, cooperating with each other for measuring at least one geometric characteristic of the relative positioning between the femoral and tibial blocks without affecting this characteristic.
  • One of the underlying ideas of the invention is that of having the femoral and tibial blocks bear additional means for measuring, at the peroperative stage, the relative positioning between these blocks.
  • at least one geometric characteristic of this relative positioning is thus monitored during the actual surgery, particularly after the femoral and tibial blocks have been positioned, in order to, if applicable, detect and quantify the modification thereof by the surgeon.
  • the surgeon is thus free, during surgery, to monitor and, if required, adjust the ligament balance of the operated patient's knee joint, without the risk of having to continue the surgery without knowing the extent of the deviation from the predefined surgical plan.
  • the surgeon is in a position to continue the surgery effectively, accounting for the modification of the relative positioning between the blocks, compared to the initial relative configuration thereof predetermined at the preoperative stage.
  • the surgeon may, if applicable, lock the femoral and distal blocks in the relative configuration selected by the surgeon: advantageously, the instrumentation according to the invention includes ad hoc relative fixing means.
  • the measurement means belonging to this instrumentation do not give rise, in operation, to constraints on the relative positioning between the femoral and tibial blocks of the instrumentation, at the very least on the geometric characteristic measured by these means.
  • the aim of the invention is that of measuring the free fitting of the relative positioning between these femoral and tibial blocks, without interfering with the scope of the fit, at least in respect of the geometric characteristic measured.
  • the geometric characteristic is an angle defined, in projection in a frontal plane with respect to the patient, between a femoral geometric axis, which is associated in a fixed manner with the femur, particularly by joining the centre of the head of the femur and the middle of the knee, and a tibial geometric axis, which is associated in a fixed manner with the tibia, particularly by joining the middle of the knee and the middle of the patient's ankle;
  • the geometric characteristic is a distance, in projection in a frontal plane with respect to the patient, separating a femoral geometric axis, which is associated in a fixed manner with the femur, particularly the axis of the trochlear groove of the femur, and a geometric tibial axis, which is associated in a fixed manner with the tibia, particularly the axis of the anterior femoral tuberosity;
  • the geometric characteristic is an angle defined, in projection in a sagittal plane with respect to the patient, between geometric axes which are respectively associated in a fixed manner with the femur and the tibia along the longitudinal direction thereof;
  • the femoral, or tibial, geometric axis is defined by the femoral, respectively tibial, block, and in that the first, respectively second, portion of the measurement means is borne by the femoral, respectively tibial, block and Is oriented in a fixed manner with respect to the femoral, respectively tibial, geometric axis;
  • the femoral, respectively tibial, geometric axis is defined by the first, respectively second, portion of the measurement means, and the first, respectively second, portion of the measurement means is borne by the femoral, respectively tibial, block and is oriented in a fixed manner with respect to the femoral, respectively tibial, geometric axis;
  • the first and second portions of the measurement means are suitable for cooperating with each other with no mechanical contact;
  • the first and second portions of the measurement means are a laser transmitter and receiver
  • the first and second portion of the measurement means are shafts articulated in respect of each other and borne in a freely sliding manner along the longitudinal direction thereof by the femoral block and by the tibial block, respectively.
  • FIG. 1 and 2 are perspective views, from different respective viewing angles, of instrumentation according to the invention, in use on a patient's knee;
  • figure 3 is an elevation view along the arrow III in figure 1 ;
  • FIG. 4 is a section along the line IV-IV in figure 3;
  • figure 5 is a similar view to figure 3, showing a different configuration of use to that in figures 1 to 4.
  • Figures 1 to 5 show surgical instrumentation 1 comprising a plurality of components which will be detailed in succession, in the course of the description of use of this instrumentation on a patient's knee typically for preparing both the lower end of the patient's femur F to receive the implantation of a femoral component of a knee prosthesis, not shown, and preparing the upper end of the patient's tibia T, to receive the implantation of a tibial component of a knee prosthesis.
  • mapping data are compiled in relation to the femur F and the tibia T of the patient to undergo surgery.
  • these preoperative mapping data may be obtained by various means. For example, scan, X- ray and/or MRI images of the femur F and tibia T are used.
  • the femoral block 10 has a surface 10A which is shaped in a specifically fitted manner with respect to the lower end of the femur F and which, in use, bears in a fixed manner on said end of the femur, moulding the surface thereof by means of shape complementarity. It is understood that, to arrive at such a precise fit between the bearing surface 10A and the lower end of the femur F, the surface 10A is designed using the preoperative mapping data relating to the femur. In this way, the bearing surface 10A has specifically personalised relief features with respect to the operated patient which, by engaging with complementary relief features defined by the surface of the lower end of the femur, only allow one bearing configuration fitted on the femur F, as shown in figures 1 to 5. For example, in the embodiment shown in the figures, the bearing surface 10A covers the anterior and distal areas of the lower end of the femur F, moulding the relief features of these areas in a fitted manner.
  • the tibial block 20 has a surface 20A which is shaped in a specifically fitted manner with respect to the upper end of the tibia T and which, in use, bears in a fixed manner on said end of the tibia, moulding the surface thereof by means of shape complementarity. Similar technical considerations to those developed above for the bearing surface 10A are applicable to the bearing surface 20A.
  • the bearing surface 20A covers the anterior and distal areas of the upper end of the tibia T, moulding the relief features of these areas in a fitted manner.
  • the femoral block 10 bears in a fixed manner, via the surface 10A thereof, on the lower end of the femur F
  • the tibial block 20 bears in a fixed manner, via the surface 20A thereof, on the upper end of the tibia T.
  • this fixation is, for example, produced by means of bone anchoring pins inserted into through holes defined by the blocks 10 and 20 and opening onto the surface 10A and 20A thereof, until they are set and thus locked in the bone substance of the femur F and tibia T.
  • the blocks 10 and 20 are then as shown in figures 1 to 4: it is understood that, for initial relative positioning between the femur F and the tibia T, the blocks 10 and 20 are positioned with respect to each other in a predefined initial configuration, wherein the geometric characteristics are known in advance, based on the preoperative mapping data.
  • the relative angular positioning between the blocks 10 and 20 along the longitudinal direction of the patient's leg is predefined: more specifically, the relative angular positioning between the blocks 10 and 20 may be characterised by the angle HKA, i.e.
  • a relative angle HKA i.e. an angle defined between the axes HK and KA, equal to 180 °.
  • the femoral 10 and tibial 20 blocks are, at the preoperative stage, designed to guide the peroperative application, on the femur F and tibia T respectively, of at least one bone preparation tool, such as a drill bit, anchoring pin or cutting blade: during the custom design of the blocks 10 and 20, specific arrangements of these blocks, such as through holes and/or slots, are incorporated in these blocks to guide, in a non-adjustable manner, i.e.
  • the positioning of means for subsequently cutting the femur and the tibia such as a cutting block, so as to resect the ends of the femur and tibia along one or a plurality of resection planes designed to subsequently act as corresponding plane bearing surfaces for fixing prosthetic components, on the femur and tibia respectively, of a knee prosthesis.
  • the positioning between the preparation of the femur F, guided by the block 10, and the preparation of the tibia T, guided by the block 20, is based on predetermined knowledge of the relative positioning configuration between the blocks 10 and 20 after these blocks have been positioned and borne in a fixed manner on the femur and tibia while the latter are in a predefined original configuration, on the basis of the preoperative mapping data obtained prior to the actual surgery.
  • the preparation of the femur F with the block 10 and the preparation of the tibia T with the block 20 are designed to be carried out while the blocks 10 and 20 are positioned with respect to each other with an angle HKA of 180°, as mentioned above.
  • this value of 180° for the angle HKA is not limiting for the instrumentation 1 , in that, even if this value of 180° is frequently an optimal value, a slightly different value may be sought by the surgeon or required by the surgeon in view of the operated patient.
  • the measurement means 30 include two main components, i.e., in the example of an embodiment shown in the figures, a laser transmitter 31 and a laser receiver 32, which are respectively borne in a fixed manner by the femoral block 10 and the tibial block 20.
  • This transmitter 31 and this receiver 32 are based on a technology known per se: a laser beam 31 A, transmitted by the transmitter 31 , is envisaged to strike a detection surface 32A defined by the receiver 32 such that, based on the specific portion of the surface 32A touched by the beam 31 A, signal processing means, connected to the transmitter 31 and to the receiver 32, are capable of reverting, by calculation, to the inclination of the beam 31 A with respect to the surface 32A.
  • the transmitter 31 and receiver 32 cooperate with each other so as to measure, during the surgery, the angle HKA between the femoral 10 and tibial 20 blocks
  • the transmitter 31 is fixedly mounted on the block 10 such that the beam 31 A thereof extends along the axis HK
  • the receiver 32 is fixedly mounted on the tibial block such that a median axis of the detection surface 32A thereof extends along the axis KA.
  • two embodiment options may be envisaged.
  • a first option consists of the femoral block 10 being designed by defining the axis HK, the transmitter 31 in this case being mounted and fixed on the block 10 oriented in a fixed and predefined manner with respect to the axis HK defined by the block 10: for this purpose, as in the example of an embodiment shown in the figures, the transmitter 31 is mounted on the block 10 while being received in a fitted housing, defined by the block 10, particularly the face thereof opposite the bearing surface 10A.
  • the transmitter 31 is designed to define the axis HK, the orientation of the beam 31 A thereof being for example adjustable with respect to the rest of the transmitter 31 : in this case, the transmitter 31 is mounted on the block 10 such that the block is oriented in a fixed and predefined manner with respect to the axis HK defined by the preset beam 31 A in the transmitter 31 .
  • the above considerations in respect of the definition of the axis HK by either the block 10 or the transmitter 31 may be transposed to the definition of the axis KA by either the tibial block 20 or the receiver 32.
  • the surgeon is immediately warned by the measurement means 30: indeed, in this case, the laser beam 31 A points towards a portion of the surface 32A thereof, different to that through which the axis KA passes.
  • the angular variation applied to the angle HKA is quantified and communicated to the surgeon, particularly by an ad hoc display, not shown in the figures.
  • a first option consists of the surgeon readjusting the ligament balance to reposition the blocks 10 and 20 according to the initial configuration thereof, particular to restore a relative angular positioning such that the angle HKA thereof is again equal to 180°: in this case, subsequent surgical procedures may be carried out in compliance with the initial plan decided at the preoperative stage, as explained above.
  • a further solution in principle more respectful of the natural ligament environment of the knee joint, consists of accounting for the measurement of the relative positioning between the femur F and the tibia T, obtained in figure 5, to modify the subsequent application on the femur and/or on the tibia of the bone preparation tool(s) accordingly, noting that, in this case, the tool(s) can no longer, at least for one of the bones of the femur and tibia, be guided by the corresponding femoral 10 or tibial 20 block: in other words, the surgeon then clears at least one of the blocks 10 and 20, in favour of a further ancillary, for example a standard ancillary, whereby the surgeon will be able to account for the value measured for the angle HKA in the configuration presented by the femur F and tibia T to receive the femoral and tibial components of the knee prosthesis.
  • a further ancillary for example a standard ancillary
  • a further solution consists of continuing the surgery with the blocks 10 and 20 while the femur F and tibia T are in the configuration not initially envisaged in figure 5 but, in this case, the components of the subsequently implanted prosthesis would be adjusted to compensate for the variation in the angle HKA.
  • an insert generally present between the femoral and tibial prosthetic components of such a knee prosthesis, would be selected as dissymmetrical with respect to the internal and external condyles, to accommodate the variation in the angle HKA.
  • the measurement, by the means 30, of any alteration of the relative positioning between the femoral block 10 and the tibial block 20, particularly that of the angle HKA between same as explained above, is carried out without said measurement means 30 interfering between the free relative positioning of the blocks 10 and 20.
  • the measurement means 30 are not designed to adjust or constrain the relative positioning of the blocks 10 and 20, but merely to measure this positioning, more specifically any change of this position during the subsequent actual surgery.
  • this aspect of the invention is obvious in that the cooperation between the transmitter 31 and the receiver 32 is optical in nature, associated with the interaction between the laser beam 31 A and the detection surface 32A.
  • the measurement means 30 have other embodiments, preference will be given to the embodiments wherein the portion of these means, borne by the femoral block 10, does not create any mechanical interaction with the part of these means, borne by the tibial block 20.
  • the measurement means 30 may take the form of an ad hoc mechanism, physically connecting the femoral 10 and tibial 20 blocks.
  • the block 10 is provided with a rigid shaft, extending lengthwise along the axis HK, while being mounted on this blockl O in a freely sliding manner along this axis
  • the tibial block 20 is also provided with a rigid shaft extending lengthwise along the axis KA, while being free to slide along this axis KA, both shafts mentioned above being articulated with respect to each other with a pivot connection substantially centred on K, about a joint axis perpendicular to both the axis HK and the axis KA.
  • the measurement means 30 may be borne by custom femoral or tibial blocks designed to bear on the femur and tibia after the ends thereof have at least partly been resected; in this case, the corresponding instrumentation is used to check, retrospectively, that the relative positioning between these femoral and tibial blocks, particularly the angular positioning thereof along the angle HKA, continues to meet the specifications of the surgical plan decided in advance.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Transplantation (AREA)
  • Cardiology (AREA)
  • Biomedical Technology (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne une instrumentation chirurgicale (1), conçue « sur mesure » pour un patient donné, qui comprend un bloc fémoral spécifique du patient (10), définissant une surface d'appui fixe (10A) sur le fémur du patient (F), conformée de manière spécifiquement ajustée au fémur, et un bloc tibial spécifique du patient (20), définissant une surface d'appui fixe (20A) sur le tibia du patient (T), conformée de manière spécifiquement ajustée au tibia. Selon l'invention, l'instrumentation comprend en outre un moyen (30) de mesure peropératoire de la position relative entre le fémur (F) et le tibia (T), ledit moyen de mesure comprenant des première et seconde parties (31, 32), respectivement portées par le bloc fémoral et par le bloc tibial, et qui sont adaptées, alors que les blocs fémoral et tibial appuient respectivement de manière fixe sur le fémur et le tibia via leur surface d'appui, à coopérer l'une avec l'autre pour mesurer au moins une caractéristique géométrique, particulièrement l'angle HKA, du positionnement relatif entre les bloc fémoral et tibial sans affecter cette caractéristique.
EP12751485.9A 2011-08-19 2012-08-17 Instrumentation chirurgicale spécifique d'un patient pour la préparation du genou dudit patient Withdrawn EP2744455A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR1157415A FR2979056A1 (fr) 2011-08-19 2011-08-19 Instrumentation chirurgicale specifique a un patient pour la preparation du genou de ce patient
US201161528005P 2011-08-26 2011-08-26
PCT/EP2012/066070 WO2013026786A1 (fr) 2011-08-19 2012-08-17 Instrumentation chirurgicale spécifique d'un patient pour la préparation du genou dudit patient

Publications (1)

Publication Number Publication Date
EP2744455A1 true EP2744455A1 (fr) 2014-06-25

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP12751485.9A Withdrawn EP2744455A1 (fr) 2011-08-19 2012-08-17 Instrumentation chirurgicale spécifique d'un patient pour la préparation du genou dudit patient

Country Status (3)

Country Link
EP (1) EP2744455A1 (fr)
FR (1) FR2979056A1 (fr)
WO (1) WO2013026786A1 (fr)

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US5376093A (en) * 1992-12-09 1994-12-27 Newman; Michael H. Tibiofemoral alignment guide
GB9611074D0 (en) * 1996-05-28 1996-07-31 Howmedica Surgical apparatus
US6022377A (en) * 1998-01-20 2000-02-08 Sulzer Orthopedics Inc. Instrument for evaluating balance of knee joint
WO2005099636A1 (fr) * 2004-03-31 2005-10-27 Niigata Tlo Corporation Tige intra-médullaire pour assistance dans une opération de remplacement de genou prothétique et méthode pour gérer l'opération à l'aide de cette tige
US8133234B2 (en) * 2006-02-27 2012-03-13 Biomet Manufacturing Corp. Patient specific acetabular guide and method
US20110112639A1 (en) * 2009-11-06 2011-05-12 Moximed, Inc. Positioning Systems and Methods for Implanting an Energy Absorbing System

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Also Published As

Publication number Publication date
FR2979056A1 (fr) 2013-02-22
WO2013026786A1 (fr) 2013-02-28

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