WO2005084558A1 - Apparatus for use in orthopaedic surgery - Google Patents

Apparatus for use in orthopaedic surgery Download PDF

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Publication number
WO2005084558A1
WO2005084558A1 PCT/GB2005/000901 GB2005000901W WO2005084558A1 WO 2005084558 A1 WO2005084558 A1 WO 2005084558A1 GB 2005000901 W GB2005000901 W GB 2005000901W WO 2005084558 A1 WO2005084558 A1 WO 2005084558A1
Authority
WO
WIPO (PCT)
Prior art keywords
alignment
member
bone
cutting jig
block
Prior art date
Application number
PCT/GB2005/000901
Other languages
French (fr)
Inventor
Kenneth P. Davis
David L. Mollon
Timothy S. Drew
David W. Paterson
David I. Rowley
Roy Smith
Original Assignee
Imp (Holdings) Limited
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
Priority to GB0405294.0 priority Critical
Priority to GB0405294A priority patent/GB0405294D0/en
Application filed by Imp (Holdings) Limited filed Critical Imp (Holdings) Limited
Publication of WO2005084558A1 publication Critical patent/WO2005084558A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/14Surgical saws ; Accessories therefor
    • A61B17/15Guides therefor
    • A61B17/154Guides therefor for preparing bone for knee prosthesis
    • A61B17/155Cutting femur
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0023Surgical instruments, devices or methods, e.g. tourniquets disposable

Abstract

A kit of parts for use in resectioning an end of a bone during orthopaedic surgery, comprising a cutting jig (12) and a alignment tool (10, 11), the cutting jig comprising a generally parallel pipedal member having a top face (20a) a bottom face and four side faces(20b, 20c), the bottom face being recessed in order to receive the end of the bone to be resectioned, means defining a plurality of slots (24, 25, 27, 29, 30) through the member (12) for receiving a cutting implement, a generally medial opening (33) extending from the. bottom face for receiving the alignment tool (10, 11) and having a shaped cross section whereby to mate with the alignment tool (10, 11) in a predetermined orientation, and a plurality of firing elements (31) in at least two side walls (20b) arranged to enable fixing the cutting jig (12) to the bone. The alignment tool comprises an elongate metal rod (10) and a separate alignment member (11) arranged to have a bore for receiving the rod and a flange (11a) provided on the main member and extending in opposite directions therefrom to facilitate fixing of the alignment member to the end of the bone to be resectioned. Preferably, the cutting jig is of plastics material in which case the slots are lined with metal.

Description

APPARATUS FOR USE IN ORTHOPAEDIC SURGERY

The present invention relates to apparatus for use in orthopaedic surgery and more particularly to apparatus for use in preparing bones for the fitting of artificial joints. It has become well known to replace worn or damaged human joints by artificial joints and one such joint is the knee. Successful total knee arthroplasty is directly dependent on re-establishment of normal lower extremity alignment, proper orientation of the artificial joint and secure fixation. Instruments and techniques to assist the surgeon in achieving the above factors already exist but are currently made of metal so that they can be sterilised by autoclaving after use. Unfortunately, autoclaving does not necessarily result in the instruments being automatically suitable for reuse and there exists a need for a single-use alternative to the current instruments. It is an object of the present invention to provide a disposable cutting jig for use in orthopaedic surgery. Preferably the jig is in the form of a single unitary block which provides guides for all the necessary cuts to one of the bones. Alternatively, two jigs may be provided. In this case, the first jig provides for an initial cut while the second jig provides for all the remaining cuts. In order that the present invention be more readily understood, embodiments thereof will now be described by way of example with reference to the accompanying drawings in which: Fig 1 shows a perspective view of an assembled kit of parts for a disposable cutting jig; Fig 2 is a diagrammatic cross-sectional view of the jig shown in Fig 1 in position on a femur; Fig 3 is a perspective view of a part of the kit used to locate guide pins in position; Fig 4 shows a perspective view of a modification to the embodiment shown in Fig 1; Fig 5 shows a perspective view of one part of a two part jig embodiment; and Fig 6 shows a perspective view of the other part of the two part cutting jig. The embodiments of the present invention are all made of plastics mouldings and are designed to be supplied as a kit of parts in a sterile pack. Once the surgeon has finished, the kit of parts is disposed with. All the embodiments are designed to explain how the femur is prepared ready to accept an artificial knee joint. It is, of course, necessary to also prepare the tibia but it will be appreciated that a similar procedure will be followed to that which will be described later and also appropriate jigs will be provided which will again be made of plastic mouldings so that they may be disposed of after use. In preparing for total knee arthroplasty, it is already known that there is a "5 in 1" procedure as well as a "4 in 1" procedure. The first embodiment to be described relates to a 5 in 1 procedure which permits five cuts to be made utilising one cutting jig. Turning now to Figs 1 and 2, the apparatus of the present invention consists of a kit of parts formed by an alignment rod 10 made of metal, a detachable handle (not shown) for attachment to one end of the alignment rod, a rotation guide member, an alignment block 11 arranged to be fitted on to the alignment rod and a cutting jig assembly 12 provided with a stylus 13. The cutting jig assembly 12 is made from a suitable material which can be moulded into a rigid form. Most, if not all the parts may be made from a plastics material but some or parts of some of the kit may be metal. All are disposable. The cutting jig assembly 12 comprises a main body member 20 which is generally box shaped with a top surface 20a, end surfaces 20b and a sloping front surface 20c at the bottom of which is located the stylus 13. The bottom of the main body member is recessed in order to receive the end of the bone, in this case the femur, which is to be cut to shape. The top surface 20a is provided with an opening 21 (see Fig 2), the upper portion of which is generally V-shaped and which extends into the recess in the main member 20. This opening 21 receives a generally V-shaped member 22 which is held in position on the top surface 20a so as to form two angled slots 24 and 25 of a width to permit a tool such as a reciprocating saw to project through the slots for cutting a bone in the recess of the main member. The top surface 20a is also provided with a slot 26 which extends normal to the top surface 20a and is again of a width to receive a tool for cutting a bone with recess of the main member. The sloping front surface 20c is also provided with an opening 27 which forms two walls 27a and 27b at right angles to each other as is best seen in Fig 2. A generally V-shaped member 28 is received in the opening 27 and is held in position on the front surface 20c so as to form two slots 29 and 30 at right angles to each other which extend in the recess in the main member. The slots 29 and 30 are each of a width to receive a tool for cutting a base in the recess. The slots 24, 25, 26, 29 and 30 are the guides for the five cuts which need to be made to the end of the femur so as to prepare it to receive an artificial knee joint. The main member may be provided with a further slot parallel to slot 29. that can be used as a re-cut if required. The end surfaces 20b are provided with a number of holes 31 to permit locating pins or screws to be used to fix the assembly 12 in position on the femur. In use, the surgeon prepares the femur in basically the same manner as before. Initially, a hole is drilled in the centre of the femur making sure that the hole is parallel to the shaft of the femur in both the anteroposterior and lateral projections. The femur is then sized in order to determine the desired alignment block 1 1 for use with the particular patient, for this purpose a femoral sizing and rotation guide 31 is used to position 2 off headless pints. The guide 31 is removed leaving the headless pins which are then used to set the rotation angle of the subsequent alignment block. A basic design of a rotation guide is shown in Fig 3. Alignment blocks 11 each comprise a base member 11 a adapted to contact the top of the femur and an alignment member consisting of a column 1 lb through which the alignment rod 10 is arranged to pass. The column 1 lb can be at any one of a fixed number of different angles with respect to the base member 11a and the most common angles are 5°, 6° and 7°. The base member 1 la is provided with two slots or holes l ie arranged to receive the two headless pins left in the bone after use of the guide 31 , as best seen in Fig 4. After selection of the appropriate alignment block 11, the cutting jig assembly 12 is then slipped over the alignment rod and also over the columnar part l ib of the locator block 11. The stylus 13 on the cutting jig assembly is brought into engagement with the femur and locating screws are inserted into holes 31 on either end surface 20b of the cutting jig assembly 12 in order to fix the cutting jig assembly 12 in place on the femur, at this stage the alignment rod is removed. Once in position, the jig is used by the surgeon in order to determine the precise position of each of the five cuts which are required in order to prepare the femur to accept the artificial joint. The cuts are made in the normal order as indicated by the broken lines 1 to 5 shown in Fig 2. After use, all the parts are disposed of. Turning now to Fig 4, this also shows a 5 in 1 cutting jig assembly and the same reference numerals are used for the same parts. However, it differs from the jig assembly shown in Figs 1 and 2 in that the jig assembly 12 is inserted onto the alignment block 11 by being slid onto the alignment block 11 in a direction normal to the axis of the alignment rod 10 rather than being slipped axially over the alignment rod 10 and alignment block 11. This is achieved by means of a slot 33 in the main body 20 of the assembly 12 and a corresponding slot 34 in the N- shaped member 22. In order to retain the rigidity of the body 20 and the member 22, it is advantageous to form the main body such that the slots 25 and 26 are each constituted by two aligned portions separated by the slots in the recess 20 and 22. In other respects, the construction and technique are similar to that described in relation to the embodiment shown in Figs 1 and 2. Turning now to Figs 5 and 6, these show the parts necessary for a 4 in 1 procedure. In this case, the kit instead of having a single cutting jig assembly as was the case in the previous embodiments, is provided with two cutting jigs. The first cutting jig provides for the cutting of the distal femur using a separate cutting guide to that for cutting the remaining cuts for preparing the femur. As shown in Fig 5, the alignment rod, sizing and provision of the appropriate alignment block occurs as in the embodiments described above. In this case, however, a cutting block 40 for a single cut is slipped over the columnar portion of the alignment block 11 as in the embodiment described with reference to Fig 4 and the block 40 is fixed in position by means of screws or pins being inserted through appropriate holes 41 in the cutting block so as to engage the femur. The distal cut can then be made utilising a slot 42 as a guide. Slot 42 may be replicated by another slot, 3mm offset but parallel. This is only used should a re-cut be necessary. Holes 1 lc are used to receive 2 off headless pins. Thereafter, the block 40 is removed and a 4 in 1 cutting block 44 as shown in Fig 6 is attached. Cutting block 44 is positioned on the headless pins using the slots 45 shown (Fig 6). This determines the anterior/posterior position and also rotation angle. Mediolateral adjustment is achieved by sliding the block along the pin slots. Cutting block 44 provides a jig for cuts 1 to 4 as indicated in Fig 2. As with the previous embodiments, the cutting jigs are made of any suitable disposable material.

Claims

CLAIMS:
1. A cutting jig for use in resectioning an end of a bone during orthopaedic surgery, comprising a generally parallel pipedal member (12) having a top face (20a)a bottom face and four side faces (20a,20b) with, the bottom face being recessed in order to receive the end of the bone to be resectioned, means defining a plurality of slots (24,25,27,29,30) through the member (12) for receiving a cutting implement, a generally medial opening (33) extending from the bottom face for receiving an alignment member and having a shaped cross section whereby to mate with the alignment member in a predetermined orientation, and a plurality of fixing elements (31) in at least two side walls arranged to enable fixing the cutting jig to the bone.
2. A cutting jig according to claim 1 wherein the shape of a cross section of the opening is rectangular.
3. A cutting jig according to claim 1 or 2, wherein the generally pipedal member is a made of moldable material.
4. A cutting jig according to claim 3, wherein the moldable material is plastics.
5. A cutting jig according to claim 4 wherein the plastics material in transparent.
6. A cutting jig according to claim 3 or 4 wherein the slots (24,25,27,29,30) are lined with metal.
7. A cutting jig according to claim 6 wherein the metal is stainless steel.
8. A cutting jig according to any of the preceding claims wherein there are four slots.
9. A cutting jig according to any one of claims 1 to 7 wherein there are five slots.
10. A kit of parts for use in resectioning an end of a bone during orthopaedic surgery, comprising a cutting jig (12) and a alignment tool (10,11), the cutting jig comprising a generally parallel pipedal member having a top face (20a) a bottom face and four side faces(20b,20c), the bottom face being recessed in order to receive the end of the bone to be resectioned, means defining a plurality of slots (24,25,27,29,30) through the member (12) for receiving a cutting implement, a generally medial opening (33) extending from the bottom face for receiving the alignment tool (10,11) and having a shaped cross section whereby to mate with the alignment tool (10,11) in a predetermined orientation, and a plurality of fixing elements (31) in at least two side walls (20b) arranged to enable fixing the cutting jig (12) to the bone.
11. A kit of parts according to claim 10, wherein the alignment tool comprises an elongate metal rod (10) and a separate alignment member (1 1) arranged to have a bore for receiving the rod.
12. A kit of parts according to claim 20 or 11, wherein the alignment member (11) comprises a main portion (l ib) provided with a bore for receiving the rod, and a flange (1 1a) provided on the main member and extending in opposite directions therefrom to facilitate fixing of the alignment member to the end of the bone to be resectioned.
13. A kit of parts according to claim 1 1, wherein the alignment member (11) comprises a main portion (l ib) having a top, bottom and side walls, the bore extending through the member from the top to the bottom at an angle to the direction at right angles to the bottom wall.
14. A kit of parts according to claim 13, wherein the bottom wall of the main portion (l ib) is provided with a flange (1 1a) extending in opposite directions therefrom to facilitate fixing the alignment member to the end of bone to be resectioned.
15. An alignment tool for use with a cutting jig in a kit of parts for resectioning the end of a bone during orthopaedic surgery: the tool comprising an elongate rod (10) and separate alignment block (11) having a top, bottom and side walls with means defining a bore through the block from the top wall to the bottom wall for receiving the separate alignment rod (10), the bore being at an angle to the direction at right angles to the bottom wall.
16. An alignment tool according to claim 15 wherein the bottom wall of the block (l ib) is provided with a flange (11a) which extends from the block in opposite directions and is provided with projections for engagement with the end of the bone to resectioned in order to position the block on the bone.
17. An alignment tool according to claim 15 or 16 wherein the alignment block (1 lb) is of generally rectangular cross-section with four side walls.
18. A kit of parts for use in resectioning an end of bone during orthopaedic surgery comprising an alignment tool (10,11) and a cutting jig (12) having a plurality of slots (24,25,27,29,30) for a cutting tool, the alignment tool comprising an elongate rod (10) and an alignment block (11) having a top, bottom and side walls with means defining a bore through the block from the top wall to the bottom wall for receiving the alignment rod (10), the bore being at an angle to the direction at right angles to the bottom wall.
19. A kit of parts according to claim 18 wherein the bottom wall of the block (l ib) is provided with a flange (11a) which extends from the block in opposite directions and is provided with projections for engagement with the end of the bone to be resectioned in order to position the block on the bone.
20. A kit of parts ccording to claim 18 or 19 wherein the cutting jig (12) has an opening (33) for receiving the alignment block (l ib), which opening has a shape which mates with a corresponding shape of the alignment block whereby the jig adopts a predetermined orientation with respect to the alignment block when the block is in the bore.
21. A kit of parts according to claim 20 wherein the opening in the cutting jig is at least partly of rectangular cross-section.
22. A kit of parts according to any one of claims 18 to 21 wherein the cutting ig has four slots for receiving a cutting tool.
23. A kit of parts according to any one of claims 18 to 21 wherein the cutting jig has five slots for receiving a cutting tool.
PCT/GB2005/000901 2004-03-09 2005-03-09 Apparatus for use in orthopaedic surgery WO2005084558A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
GB0405294.0 2004-03-09
GB0405294A GB0405294D0 (en) 2004-03-09 2004-03-09 Apparatus for use in orthopaedic surgery

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Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1832239A1 (en) * 2006-03-06 2007-09-12 Howmedica Osteonics Corp. Single use resection guide
WO2009045960A1 (en) * 2007-09-30 2009-04-09 Depuy Products, Inc. Customized patient-specific orthopaedic surgical instrumentation
EP2039304A3 (en) * 2007-09-20 2009-04-22 Depuy Products, Inc. Surgical cutting guide
US7967824B2 (en) 2006-05-19 2011-06-28 Greatbatch Medical S.A. Bone cutting fixture assembly with guide appendages
US8265949B2 (en) 2007-09-27 2012-09-11 Depuy Products, Inc. Customized patient surgical plan
US8357111B2 (en) 2007-09-30 2013-01-22 Depuy Products, Inc. Method and system for designing patient-specific orthopaedic surgical instruments
US8641721B2 (en) 2011-06-30 2014-02-04 DePuy Synthes Products, LLC Customized patient-specific orthopaedic pin guides
US8808302B2 (en) 2010-08-12 2014-08-19 DePuy Synthes Products, LLC Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
US8992538B2 (en) 2008-09-30 2015-03-31 DePuy Synthes Products, Inc. Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
US9786022B2 (en) 2007-09-30 2017-10-10 DePuy Synthes Products, Inc. Customized patient-specific bone cutting blocks
WO2018125481A1 (en) * 2016-12-30 2018-07-05 DePuy Synthes Products, Inc. Customized patient-specific surgical instruments and method
US10034753B2 (en) 2015-10-22 2018-07-31 DePuy Synthes Products, Inc. Customized patient-specific orthopaedic instruments for component placement in a total hip arthroplasty

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Cited By (28)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1832239A1 (en) * 2006-03-06 2007-09-12 Howmedica Osteonics Corp. Single use resection guide
US7967824B2 (en) 2006-05-19 2011-06-28 Greatbatch Medical S.A. Bone cutting fixture assembly with guide appendages
EP2039304A3 (en) * 2007-09-20 2009-04-22 Depuy Products, Inc. Surgical cutting guide
US8197486B2 (en) 2007-09-20 2012-06-12 Depuy Products, Inc. Surgical cutting guide
US8265949B2 (en) 2007-09-27 2012-09-11 Depuy Products, Inc. Customized patient surgical plan
US9786022B2 (en) 2007-09-30 2017-10-10 DePuy Synthes Products, Inc. Customized patient-specific bone cutting blocks
US8323288B2 (en) 2007-09-30 2012-12-04 Depuy Products, Inc. Customized patient-specific bone cutting blocks
US8343159B2 (en) 2007-09-30 2013-01-01 Depuy Products, Inc. Orthopaedic bone saw and method of use thereof
US8357111B2 (en) 2007-09-30 2013-01-22 Depuy Products, Inc. Method and system for designing patient-specific orthopaedic surgical instruments
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US8377068B2 (en) 2007-09-30 2013-02-19 DePuy Synthes Products, LLC. Customized patient-specific instrumentation for use in orthopaedic surgical procedures
US8398645B2 (en) 2007-09-30 2013-03-19 DePuy Synthes Products, LLC Femoral tibial customized patient-specific orthopaedic surgical instrumentation
US8419740B2 (en) 2007-09-30 2013-04-16 DePuy Synthes Products, LLC. Customized patient-specific bone cutting instrumentation
WO2009045960A1 (en) * 2007-09-30 2009-04-09 Depuy Products, Inc. Customized patient-specific orthopaedic surgical instrumentation
US8425524B2 (en) 2007-09-30 2013-04-23 DePuy Synthes Products, LLC Customized patient-specific multi-cutting blocks
US8594395B2 (en) 2007-09-30 2013-11-26 DePuy Synthes Products, LLC System and method for fabricating a customized patient-specific surgical instrument
US10028750B2 (en) 2007-09-30 2018-07-24 DePuy Synthes Products, Inc. Apparatus and method for fabricating a customized patient-specific orthopaedic instrument
US8425523B2 (en) 2007-09-30 2013-04-23 DePuy Synthes Products, LLC Customized patient-specific instrumentation for use in orthopaedic surgical procedures
US8992538B2 (en) 2008-09-30 2015-03-31 DePuy Synthes Products, Inc. Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
US9492182B2 (en) 2008-09-30 2016-11-15 DePuy Synthes Products, Inc. Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
US9168048B2 (en) 2010-08-12 2015-10-27 DePuy Synthes Products, Inc. Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
US8808302B2 (en) 2010-08-12 2014-08-19 DePuy Synthes Products, LLC Customized patient-specific acetabular orthopaedic surgical instrument and method of use and fabrication
US9095355B2 (en) 2011-06-30 2015-08-04 DePuy Synthes Products, Inc. Customized patient-specific orthopaedic pin guides
US9561039B2 (en) 2011-06-30 2017-02-07 DePuy Synthes Products, Inc. Customized patient-specific orthopaedic pin guides
US8641721B2 (en) 2011-06-30 2014-02-04 DePuy Synthes Products, LLC Customized patient-specific orthopaedic pin guides
US10034753B2 (en) 2015-10-22 2018-07-31 DePuy Synthes Products, Inc. Customized patient-specific orthopaedic instruments for component placement in a total hip arthroplasty
WO2018125481A1 (en) * 2016-12-30 2018-07-05 DePuy Synthes Products, Inc. Customized patient-specific surgical instruments and method

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