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WO2005110249A1 - Dispositif de chirurgie orthopedique - Google Patents

Dispositif de chirurgie orthopedique Download PDF

Info

Publication number
WO2005110249A1
WO2005110249A1 PCT/GB2005/001896 GB2005001896W WO2005110249A1 WO 2005110249 A1 WO2005110249 A1 WO 2005110249A1 GB 2005001896 W GB2005001896 W GB 2005001896W WO 2005110249 A1 WO2005110249 A1 WO 2005110249A1
Authority
WO
WIPO (PCT)
Prior art keywords
jig
kit
bone
parts according
cutting
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.)
Ceased
Application number
PCT/GB2005/001896
Other languages
English (en)
Inventor
Kenneth P. Davis
David L. Mollon
Timothy S. Drew
David W. Paterson
David I. Rowley
Roy Smith
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.)
IMP Ltd
Original Assignee
IMP Ltd
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 claimed from GB0410965A external-priority patent/GB0410965D0/en
Priority claimed from GB0410978A external-priority patent/GB0410978D0/en
Application filed by IMP Ltd filed Critical IMP Ltd
Publication of WO2005110249A1 publication Critical patent/WO2005110249A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor
    • A61B17/154—Guides therefor for preparing bone for knee prosthesis
    • A61B17/158—Cutting patella
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor
    • A61B17/154—Guides therefor for preparing bone for knee prosthesis
    • A61B17/157—Cutting tibia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
    • A61B17/1767—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee for the patella
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/0084—Material properties low friction

Definitions

  • 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. When preparing for total knee arthroplasty, it is necessary to resection both the tibia and the femur. Separate instruments are utilised for resectioning these two bones.
  • the present invention provides a kit of parts for use in resectioning an end of a bone during orthopaedic surgery comprising an alignment jig and a cutting jig, the alignment jig including means for positioning pins at a preselected location on the bone to be resectioned, and the cutting jig being a block of molded material having apertures for receiving the positioning pins, further apertures for receiving means for fixing the cutting jig to the bone, and at least one slot for receiving a cutting tool for resectioning the end of the bone.
  • Fig 1 shows an alignment jig according to the present invention
  • Fig 2 shows a perspective view of a cutting jig for use with the present invention
  • Fig 3 shows a tool for use in resectioning the patella
  • Fig 4 shows a further tool for use in resectioning the patella.
  • the alignment jig consists principally of a main member generally indicated by the reference numeral 1 which comprises a first portion la which telescopically receives a second portion lb so as to enable the length of the main member 1 to be altered to suit the size of the tibia to be resectioned.
  • a leg engaging member in the form of a clip 4 which is arranged to hold in position the bottom of the main portion la of the jig near the patient's ankle.
  • An adjustment means in the form of a grub screw arrangement 5 operating on a stem 6 projecting from the clip 4 permits the main portion la to be moved forwards and away from the clip so as to ensure that the main portion la lies parallel to the tibia.
  • the telescopic portion lb of the main member is provided with a stylus 10 that extends transverse to the axis of the portion 2 and is arranged to contact the end of the tibia to be resectioned.
  • the stylus 10 is elongate and the ends are provided with two different sized projections 10a, 10b depending in whether the surgeon wishes to resection based on the highest point of the end of the femur or the lowest point on the femur.
  • the stylus 10 is rotatably mounted in the end of the portion lb.
  • the portion lb is also provided with a location plate 12 having two through holes 12a which enable two holes to be drilled in the tibia to permit two threaded, headless pins to be accurately placed in the tibia for the reception and accurate location of the tibial cutting jig.
  • the plate 12 is shown as being positioned to one side of the portion lb which means that the headless locating ins will be off axis. This is because the cutting jigs are either left or right handed to cause the resectioning cut to be at the correct angle.
  • the alignment jig is formed with a separate, adjustable spacer plate 14 so as to ensure that the jig will be set at the correct distance from the tibia. It is rendered adjustable in view of the fact that it is moveable in a slot 15 in the portion lb which permits the correct placement of the plate 14 against the tibia but still permits the overall length adjustment to be achieved. It is to be noted that relative rotation between the two sections la and lb of the main member 1 is prevented. In this case this is achieved by utilising rectangular sectioned members but could be achieved in any other convenient fashion as desired. In operation, the alignment jig is manipulated in much the same manner as is the conventional alignment tool.
  • a tibial cutting jig 20 which comprises a mounting portion 21 and a head portion 22 formed with a slot 23 which forms a guide for a cutting saw.
  • the cutting jig is either a left or right handed jig but is always medially biased.
  • the jig is made of a single piece of moulded construction and if not made of metal may be made of plastic in which case the slot should be lined with a metal insert.
  • the mounting portion of the cutting jig 20 is provided with a pair of holes 24 so that the cutting jig can be mounted on the headless locating pins that have previously been inserted into the tibia.
  • One or more further pairs of holes such as those indicated by the reference numeral 25 can be provided to allow for repositioning of the height of the jig.
  • the jig is in position on the locating pins, it is fixed in position by driving two fixing pins into the tibia through the fixing holes 27. Once securely located on the tibia, cutting can be commenced and it will be noted that the lateral end of the slot is open to allow for optimum saw blade movement.
  • the knee joint also includes the patella and although it can be replaced, more often than not it is simply resurfaced.
  • a problem when carrying out resurfacing of the patella is that it is difficult to grip and maintain in a fixed position so as to be able to locate a drill guide onto it.
  • a kit of instruments for operating on the patella comprises a gripper and a drill jig.
  • the patella gripper comprises a tool arranged so as to provide a continual compressive force on the periphery of the patella and is provided with handles to enable the surgeon to hold or manipulate the patella at will.
  • the arrangement shown in the drawing is such that the tool is made of two plastics parts 30,31 which are hinged together at one end 32.
  • Each of the parts 30,31 adjacent the end 32 is either formed with or faced with metal.
  • An interior surface 34 of each metal part is arcuately formed and provided with serrations while the upper and lower metal surfaces 35 are arranged to form a saw guide.
  • the two parts 30,31 are provided with an interlocking arrangement such as that shown by the ratchet 36.
  • the gripper is opened to a degree sufficient to allow the patella to be received between the serrated surfaces 34 and then the parts 30 and 31 are squeezed together until the patella is securely gripped.
  • the parts 30,31 are then held in this position due to the ratchet 36.
  • the plastic parts 30,31 can be arranged so that the handles will deform if too much pressure is applied to the patella.
  • the patella can be adjusted within the jaws 34 so as to expose a desired amount of bone for resectioning.
  • a reciprocating saw is then used to resection the specified portion of the patella utilising the surfaces 35 of the clamp as a saw guide. Once the surface has been resectioned.
  • a drill jig such as that shown in Fig 4 is used.
  • the drill jig comprises a main body portion 40 provided with a jig locating portion
  • patella jig portion 42 which is made of metal and provided with sharp projections 43.
  • the patella is arranged to be received between the jig portion 42 and a clamping member 43. Once the patella is securely held in position on the sharp projections 43, by a clamping member 45, holes can be drilled through guide holes 44 and

Landscapes

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

Abstract

Dispositif de chirurgie orthopédique comprenant des gabarits de coupe, jetables en tout ou en partie, qui s'utilisent pour la restructuration du tibia ainsi qu'un matériel servant à refaçonner la rotule, l'ensemble formant un kit pour chirurgie du genou.
PCT/GB2005/001896 2004-05-17 2005-05-17 Dispositif de chirurgie orthopedique Ceased WO2005110249A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
GB0410965A GB0410965D0 (en) 2004-05-17 2004-05-17 Instruments for use in orthopaedic surgery
GB0410978.1 2004-05-17
GB0410978A GB0410978D0 (en) 2004-05-17 2004-05-17 Apparatus for use in orthopaedic surgery
GB0410965.8 2004-05-17

Publications (1)

Publication Number Publication Date
WO2005110249A1 true WO2005110249A1 (fr) 2005-11-24

Family

ID=34969164

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2005/001896 Ceased WO2005110249A1 (fr) 2004-05-17 2005-05-17 Dispositif de chirurgie orthopedique

Country Status (1)

Country Link
WO (1) WO2005110249A1 (fr)

Cited By (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009037470A1 (fr) * 2007-09-21 2009-03-26 Depuy International Ltd Fixation d'instrument chirurgical
EP2039304A3 (fr) * 2007-09-20 2009-04-22 Depuy Products, Inc. Guide chirurgical de coupe
EP2540239A1 (fr) * 2011-06-30 2013-01-02 DePuy Products, Inc. Assemblage de guidage et de serrage d'une rotule
US8821501B2 (en) 2010-09-24 2014-09-02 Depuy (Ireland) Patella resectioning guide and assembly
US8951262B2 (en) 2011-06-30 2015-02-10 Depuy (Ireland) Patella clamp and drill guide surgical instrument
WO2015021140A1 (fr) * 2013-08-06 2015-02-12 Dgimed Ortho, Inc. Adaptateur d'indexage d'agrafage
US8968321B2 (en) 2011-06-30 2015-03-03 Depuy (Ireland) Patella resection guide with locating features and method of using the same
US8979854B2 (en) 2011-06-30 2015-03-17 Depuy (Ireland) Patella orthopaedic surgical instrument assembly
US8986306B2 (en) 2011-06-30 2015-03-24 Depuy (Ireland) Patella orthopaedic surgical method
US8998912B2 (en) 2011-09-28 2015-04-07 Depuy (Ireland) Clamping patella drill guide
US9078772B2 (en) 2011-09-28 2015-07-14 Depuy (Ireland) Rotatable patella drill guide
US9078676B2 (en) 2011-09-28 2015-07-14 Depuy (Ireland) Patella drilling system
US9078674B2 (en) 2007-09-21 2015-07-14 Depuy (Ireland) Adjustable surgical instrument
US9554813B2 (en) 2012-09-28 2017-01-31 Depuy Ireland Unlimited Company Patella drill guide and trial surgical instrument
US10085758B2 (en) 2012-09-28 2018-10-02 Depuy Ireland Unlimited Company Patella drill guide and trial surgical instrument having an alignment bore formed therein and method of using the same
US10278714B2 (en) 2015-03-27 2019-05-07 Depuy Ireland Unlimted Company Orthopaedic surgical instrument system for implanting a prosthetic patella component and method of use
US10335163B2 (en) 2013-03-05 2019-07-02 Depuy Ireland Unlimited Company Polymer 4-in-2 femoral cutting instrument having separable A/P and chamfer cutting blocks
WO2021209496A3 (fr) * 2020-04-15 2021-12-09 Aesculap Ag Dispositif d'alignement servant à effectuer une résection du tibia
US11751883B2 (en) 2018-11-28 2023-09-12 Aesculap Ag Fixing system and aligning device
US20230404604A1 (en) * 2022-06-20 2023-12-21 Aesculap Ag Surgical device
US12042157B2 (en) 2019-02-15 2024-07-23 Aesculap Ag Fixing clamp and aligning device
US12076025B2 (en) 2022-05-11 2024-09-03 DePuy Synthes Products, Inc. Polymer cutting block

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994014366A2 (fr) * 1992-12-28 1994-07-07 Synvasive Technology, Inc. Bloc de coupe chirurgicale et son procede d'utilisation
US5704941A (en) * 1995-11-03 1998-01-06 Osteonics Corp. Tibial preparation apparatus and method
FR2776176A1 (fr) * 1998-03-20 1999-09-24 Aesculap Sa Systeme de positionnement d'un guide de coupe osseuse pour la preparation a la pose d'une prothese de genou
US6059831A (en) * 1999-03-31 2000-05-09 Biomet, Inc. Method of implanting a uni-condylar knee prosthesis
WO2000071035A1 (fr) * 1999-05-20 2000-11-30 Depuy International Limited Guide de resection osseuse
WO2001000096A1 (fr) * 1999-06-29 2001-01-04 Howmedica Osteonics Corp. Guide de resection du plateau tibial
US20030100907A1 (en) * 2001-11-28 2003-05-29 Rosa Richard A. Instrumentation for minimally invasive unicompartmental knee replacement
FR2847453A1 (fr) * 2002-11-22 2004-05-28 Jean Francois Biegun Ancillaires, notamment rape ou bloc de coupe, a usage unique, kit comportant des ancillaires et procede de fabrication
WO2005000901A2 (fr) 2003-05-09 2005-01-06 Duke University Anticorps specifiques de cd20 et leurs methodes d'utilisation

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1994014366A2 (fr) * 1992-12-28 1994-07-07 Synvasive Technology, Inc. Bloc de coupe chirurgicale et son procede d'utilisation
US5704941A (en) * 1995-11-03 1998-01-06 Osteonics Corp. Tibial preparation apparatus and method
FR2776176A1 (fr) * 1998-03-20 1999-09-24 Aesculap Sa Systeme de positionnement d'un guide de coupe osseuse pour la preparation a la pose d'une prothese de genou
US6059831A (en) * 1999-03-31 2000-05-09 Biomet, Inc. Method of implanting a uni-condylar knee prosthesis
WO2000071035A1 (fr) * 1999-05-20 2000-11-30 Depuy International Limited Guide de resection osseuse
WO2001000096A1 (fr) * 1999-06-29 2001-01-04 Howmedica Osteonics Corp. Guide de resection du plateau tibial
US20030100907A1 (en) * 2001-11-28 2003-05-29 Rosa Richard A. Instrumentation for minimally invasive unicompartmental knee replacement
FR2847453A1 (fr) * 2002-11-22 2004-05-28 Jean Francois Biegun Ancillaires, notamment rape ou bloc de coupe, a usage unique, kit comportant des ancillaires et procede de fabrication
WO2005000901A2 (fr) 2003-05-09 2005-01-06 Duke University Anticorps specifiques de cd20 et leurs methodes d'utilisation

Cited By (37)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8197486B2 (en) 2007-09-20 2012-06-12 Depuy Products, Inc. Surgical cutting guide
EP2039304A3 (fr) * 2007-09-20 2009-04-22 Depuy Products, Inc. Guide chirurgical de coupe
AU2008300429B2 (en) * 2007-09-21 2013-11-07 Depuy International Ltd Surgical instrument attachment
JP2010540006A (ja) * 2007-09-21 2010-12-24 デピュー インターナショナル リミテッド 外科器具の取り付け
US8496010B2 (en) 2007-09-21 2013-07-30 Depuy International Limited Surgical instrument attachment
US9078674B2 (en) 2007-09-21 2015-07-14 Depuy (Ireland) Adjustable surgical instrument
JP2014023942A (ja) * 2007-09-21 2014-02-06 Depuy Internatl Ltd 外科器具の取り付け
WO2009037470A1 (fr) * 2007-09-21 2009-03-26 Depuy International Ltd Fixation d'instrument chirurgical
US8821501B2 (en) 2010-09-24 2014-09-02 Depuy (Ireland) Patella resectioning guide and assembly
EP2540239A1 (fr) * 2011-06-30 2013-01-02 DePuy Products, Inc. Assemblage de guidage et de serrage d'une rotule
US8951262B2 (en) 2011-06-30 2015-02-10 Depuy (Ireland) Patella clamp and drill guide surgical instrument
US9414851B2 (en) 2011-06-30 2016-08-16 Depuy (Ireland) Patella clamp and drill guide surgical instrument and method of use
US8968321B2 (en) 2011-06-30 2015-03-03 Depuy (Ireland) Patella resection guide with locating features and method of using the same
US8979854B2 (en) 2011-06-30 2015-03-17 Depuy (Ireland) Patella orthopaedic surgical instrument assembly
US8986306B2 (en) 2011-06-30 2015-03-24 Depuy (Ireland) Patella orthopaedic surgical method
US9295483B2 (en) 2011-09-28 2016-03-29 Depuy (Ireland) Rotatable patella drill guide
US9078676B2 (en) 2011-09-28 2015-07-14 Depuy (Ireland) Patella drilling system
US9078772B2 (en) 2011-09-28 2015-07-14 Depuy (Ireland) Rotatable patella drill guide
US8998912B2 (en) 2011-09-28 2015-04-07 Depuy (Ireland) Clamping patella drill guide
US11109873B2 (en) 2012-09-28 2021-09-07 Depuy Ireland Unlimited Company Patella drill guide and trial surgical instrument system and method of using the same
US9554813B2 (en) 2012-09-28 2017-01-31 Depuy Ireland Unlimited Company Patella drill guide and trial surgical instrument
US9700330B2 (en) 2012-09-28 2017-07-11 Depuy Ireland Unlimited Company Method for surgically implanting a prosthetic patella component
US9855065B2 (en) 2012-09-28 2018-01-02 Depuy Ireland Unlimited Company Orthopaedic surgical instrument assembly for implanting a prosthetic patella component
US10085758B2 (en) 2012-09-28 2018-10-02 Depuy Ireland Unlimited Company Patella drill guide and trial surgical instrument having an alignment bore formed therein and method of using the same
US11925365B2 (en) 2012-09-28 2024-03-12 Depuy Ireland Unlimited Company Patella drill guide and trial surgical instrument
US11234711B2 (en) 2013-03-05 2022-02-01 Depuy Ireland Unlimited Company Polymer 4-in-2 femoral cutting instrument having separable A/P and chamfer cutting blocks
US10335163B2 (en) 2013-03-05 2019-07-02 Depuy Ireland Unlimited Company Polymer 4-in-2 femoral cutting instrument having separable A/P and chamfer cutting blocks
WO2015021140A1 (fr) * 2013-08-06 2015-02-12 Dgimed Ortho, Inc. Adaptateur d'indexage d'agrafage
US11304711B2 (en) 2015-03-27 2022-04-19 Depuy Ireland Unlimited Company Orthopaedic surgical instrument system for implanting a prosthetic patella component and method of use
US10278714B2 (en) 2015-03-27 2019-05-07 Depuy Ireland Unlimted Company Orthopaedic surgical instrument system for implanting a prosthetic patella component and method of use
US12156663B2 (en) 2015-03-27 2024-12-03 Depuy Ireland Unlimited Company Orthopaedic surgical instrument system for implanting a prosthetic patella component and method of use
US12167862B2 (en) 2015-03-27 2024-12-17 Depuy Ireland Unlimited Company Orthopaedic surgical instrument system for implanting a prosthetic patella component and method of use
US11751883B2 (en) 2018-11-28 2023-09-12 Aesculap Ag Fixing system and aligning device
US12042157B2 (en) 2019-02-15 2024-07-23 Aesculap Ag Fixing clamp and aligning device
WO2021209496A3 (fr) * 2020-04-15 2021-12-09 Aesculap Ag Dispositif d'alignement servant à effectuer une résection du tibia
US12076025B2 (en) 2022-05-11 2024-09-03 DePuy Synthes Products, Inc. Polymer cutting block
US20230404604A1 (en) * 2022-06-20 2023-12-21 Aesculap Ag Surgical device

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