Adjustable surgical support base with integral hinge Number:7,520,880 from the United States Patent and Trademark Office (PTO) owispatent

Title: Adjustable surgical support base with integral hinge

Abstract: An apparatus is provided for supporting a surgical component adjacent to a bone during a surgical procedure. The apparatus includes an integral body having a hinge platform, a hinge integral with the hinge platform; and a surgical component mounting portion integral with the hinge for rotation generally about a hinge axis relative to the hinge platform. An adjustment mechanism is operably connected between the hinge platform and the surgical component mounting portion to allow selective incremental rotation of the surgical component mounting portion relative to the hinge platform.

Patent Number: 7,520,880 Issued on 04/21/2009 to Claypool,   et al.

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Inventors:	Claypool; Jody L. (Columbia City, IN), Rangaiah; Chetan (Warsaw, IN), Foreman; Matthew (Warsaw, IN)
Assignee:	Zimmer Technology, Inc. (Warsaw, IN)
Appl. No.:	11/328,011
Filed:	January 9, 2006

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Current U.S. Class:	606/88 ; 606/246
Current International Class:	A61B 17/58 (20060101); A61B 17/70 (20060101)
Field of Search:	606/87,88,86R 16/225,231,232,246,255

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Primary Examiner: Robert; Eduardo C
Assistant Examiner: Rust; Ellen
Attorney, Agent or Firm: Baker & Daniels LLP

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Claims

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What is claimed is:

1. An apparatus for supporting a surgical component adjacent to a bone during a surgical procedure, the apparatus comprising: an integral body comprising: a hinge platform; a first living hinge integral with the hinge platform; a surgical component mounting portion integral with the first hinge for rotation generally about a first axis relative to the hinge platform; and a first adjustment mechanism operably connected between the hinge platform and the surgical component mounting portion to allow selective incremental rotation of the surgical component mounting portion relative to the hinge platform.

2. The apparatus of claim 1 wherein the integral body is formed as a single unitary component.

3. The apparatus of claim 2 wherein the integral body comprises an integrally molded plastic body.

4. The apparatus of claim 1 wherein the integral body is penetrable by x-rays and compatible with magnetic resonance imaging.

5. The apparatus of claim 1 wherein the first hinge comprises a cantilevered wall having a first end and a second end, the wall arising from the hinge platform at the first end and the wall supporting the surgical component mounting portion at the second end.

6. The apparatus of claim 5 wherein the wall further comprises a narrowed portion between the first and second ends, the first hinge bending at the narrowed portion.

7. The apparatus of claim 6 wherein the narrowed portion is defined by opposing radii formed on opposite sides of the wall.

8. The apparatus of claim 1 wherein the first adjustment mechanism comprises an adjustment screw threadably mounted to the hinge platform, the adjustment screw having an end contacting the surgical component mounting portion such that rotating the adjustment screw causes the surgical component mounting portion to rotate about the first hinge.

9. The apparatus of claim 8 wherein the first hinge is resiliently biased against the adjustment screw.

10. The apparatus of claim 8 further comprising an adjustment screw support projecting from the hinge platform, the adjustment screw support defining an adjustment bore having an adjustment axis spaced away from the hinge axis a moment arm distance, the adjustment screw threadably engaging the adjustment bore for translation along the adjustment axis.

11. The apparatus of claim 8 wherein the adjustment screw engages the surgical component mounting portion in bi-directional axial force transmitting relationship.

12. The apparatus of claim 11 wherein the end of the adjustment screw includes a hemispherical ball tip and the surgical component mounting portion defines a hemispherical groove, the ball tip engaging the hemispherical groove for bi-directional axial force transmission.

13. The apparatus of claim 8 wherein the integral body and screw both comprise molded plastic.

14. The apparatus of claim 1 further comprising a second hinge integral with the body, the second hinge supporting rotation generally about a second axis.

15. The apparatus of claim 14 wherein the first axis and second axis are perpendicular to one another.

16. The apparatus of claim 15 further comprising a mounting base and a translational adjustment mechanism operably connected between the mounting base and the integral body, the translational adjustment mechanism being operable to translate the integral body relative to the mounting base.

17. The apparatus of claim 16 wherein the mounting base includes a fixation mechanism operable to secure the mounting base to the bone.

18. The apparatus of claim 16 wherein the translational adjustment mechanism comprises a slide slip-fit within a slot and a screw jack operable to translate the slide within the slot.

19. The apparatus of claim 1 further comprising a cut guide mounted to the surgical component mounting portion.

20. An apparatus for supporting a cut guide adjacent to the knee joint during knee joint replacement surgery, the knee joint comprising a tibia and a femur and having a medial/lateral axis, an anterior/posterior axis, and a proximal/distal axis, rotation about the medial/lateral axis corresponding to extension plane rotation, and rotation about the anterior/posterior axis corresponding to varus/valgus rotation, the apparatus comprising: a mounting base mountable to a bone; an integral body mounted to the mounting base, the integral body comprising: a first living hinge generally defining a first hinge axis; a surgical component mounting portion integral with the first hinge for rotation generally about the first hinge axis relative to the mounting base; a second hinge integral with the first hinge, the second hinge generally defining a second hinge axis oriented generally transverse to the first hinge axis, the surgical component mounting portion being rotatable generally about the second hinge axis relative to the mounting base; a first rotational adjustment mechanism operably connected to the integral body, the first rotational adjustment mechanism being operable to effect selective incremental rotation of the surgical component mounting portion about the first hinge axis relative to the mounting base; a second rotational adjustment mechanism operably connected to the integral body, the second rotational adjustment mechanism being operable to effect selective incremental rotation of the surgical component mounting portion about the second hinge axis relative to the mounting base; and a cut guide mounted to the surgical component mounting portion, the cut guide defining a cut plane.

21. The apparatus of claim 20 further comprising a translational adjustment mechanism operably connected between the integral body and the mounting base, the translational adjustment mechanism being operable to effect selective incremental translation of the integral body relative to the mounting base along a translation axis, the translation axis being oriented generally transverse to both the first and second hinge axes.

22. The apparatus of claim 21 wherein the mounting base is mountable on a bone relative to the knee joint to simultaneously align the first rotational axis parallel to the medial/lateral axis of the knee, the second rotational axis parallel to the anterior/posterior axis of the knee, and the translation axis parallel to the proximal/distal axis of the knee such that operating the first rotational adjustment mechanism moves the cut plane in extension plane rotation, operating the second rotational adjustment mechanism moves the cut plane in varus/valgus rotation, and operating the translation adjustment mechanism translates the cut plane parallel to the proximal/distal axis.

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Description

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FIELD OF THE INVENTION

The present invention relates to instruments for use in surgical procedures. More particularly, the present invention relates to an adjustable support base for supporting a surgical component adjacent to a bone during a surgical procedure.

BACKGROUND

Degenerative and/or traumatic damage to skeletal joints or other locations within a patient's body may require surgical intervention. During such surgical intervention, it is often necessary to position and/or support a surgical component at a desired location relative to the surgical site. Surgical components may include implants, trial implants, drills, burrs, saws, lasers, thermal ablators, electrical ablators, retractors, clamps, cameras, microscopes, guides, and other surgical components. Surgical sites may include a hip joint, knee joint, vertebral joint, shoulder joint, elbow joint, ankle joint, digital joint of the hand or foot, jaw, fracture site, tumor site, and other suitable surgical sites. For example, damage to the articular cartilage of a skeletal joint can result in pain and restricted motion. Prosthetic joint replacement is frequently utilized to alleviate the pain and restore joint function. In this procedure, the damaged parts of the joint are cut away and replaced with prosthetic components. Typically a resection guide is used to guide a cutter such as a saw blade or burr to cut a desired portion of the bone to prepare a seating surface for a prosthetic component. The resection guide must be carefully positioned to guide the cut at the appropriate location. Prior art resection guides and related instruments are made of metal for durability and precision.

For example, during knee replacement surgery, an incision is made into the knee joint to expose the joint. Cutting guides are used to guide the removal of portions of the articular surfaces of the tibia and femur. Artificial joint components are positioned to replace the resected portions of the tibia and femur in order to establish the desired alignment and mechanics of the joint. In a total knee replacement, all of the articulating compartments of the joint are repaired with prosthetic components. However, often only one compartment of the knee joint, typically the medial compartment, is impaired. Thus, in a unicondylar knee replacement, only the damaged compartment is repaired with prosthetic bearing components.

FIGS. 1-3 illustrate several aspects of the surgical anatomy of the knee joint. FIG. 1 illustrates various axes of the lower limb in the frontal plane. Axes can be defined for each segment of the lower limb. For example, the femur 1 has an anatomic axis 2 coinciding generally with its intramedullary canal. It also has a mechanical axis 4, or load axis, running from the center of the femoral head to the center of the knee. The angle 6 between these two axes 2, 4 in the frontal plane varies within the patient population but is on the order of 4-9.degree. . The two axes 2, 4 are approximately superimposed in the sagittal plane (FIG. 2). Likewise, the tibia 3 has a mechanical axis 5 coinciding generally with its intramedullary canal. The mechanical axis 5 of the tibia runs from the center of the knee to the center of the ankle. The transverse axis, or joint line 8, about which the knee flexes, is parallel to a line through the medial and lateral femoral condyles and parallel to the tibial plateau. Typically, the distal femur and proximal tibia are resected to be parallel to the joint line 8, and thus perpendicular to the mechanical axes 4, 5 as indicated at 10 and 12. The intersection of the femoral and tibial mechanical axes 4, 5 may subtend a small angle relative to one another. However, the angle is small such that the axes 4, 5 are approximately collinear and may be treated as collinear for most purposes.

FIG. 2 illustrates the knee joint from the side or sagittal view and various bone cuts that may be made to align implant components. The distal femoral cut 10 is typically made perpendicular to the femoral axes 2, 4 in the sagittal plane. The proximal tibial resection 12 is typically cut to match the natural posterior slope, or rotation, 16 of the proximal tibia relative to the mechanical axes 4, 5. The amount of posterior slope 16 relative to a reference line 18 perpendicular to the mechanical axes 4, 5 varies in the patient population but is on the order of 7.degree.. The distance between the distal femoral cut 10 and proximal tibial cut 12 along the mechanical axes 4,5 is the extension gap. Other cuts may be made depending on the components that are to be implanted. These include an anterior femoral cut 20, anterior femoral chamfer cut 22, posterior femoral chamfer cut 24, and posterior femoral cut 26. The patella 7 may also be cut 28 to allow for replacement of the patellar articular surface. In a unicondylar knee replacement, only the medial or lateral side of the knee joint is resurfaced. Furthermore, the trochlear, or patellar bearing, surface of the femur is typically left intact in a unicondylar procedure. Unicondylar implant designs vary, but typically only the distal femoral cut 10, posterior femoral chamfer cut 24, and posterior femoral cut 26 are needed to accommodate the unicondylar femoral implant.

FIG. 3 depicts six aspects of component positioning relative to a coordinate system in which the x-axis 30 corresponds approximately to the joint line 8, the z-axis 34 corresponds approximately to the mechanical axes 4 and 5, and the y-axis 32 is normal to the other two. Position along each of these axes is depicted by arrows. Position along the x, y, and z axes determines the medial/lateral (dx) 36, anterior/posterior (dy) 38, and proximal/distal (dz) 40 positioning of components respectively. Rotation about each of these axes is also depicted by arrows. Rotation about the z-axis (rz) 42 corresponds anatomically to external rotation of the femoral component, rotation about the x-axis (rx) 44 corresponds to extension plane rotation, and rotation about the y-axis (ry) 46 corresponds to varus/valgus rotation.

Many surgical procedures are now performed with surgical navigation systems in which sensors detect tracking elements attached in known relationship to an object in the surgical suite such as a surgical instrument, implant, or patient body part. The sensor information is fed to a computer that then triangulates the three dimensional position of the tracking elements within the surgical navigation system coordinate system. Thus, the computer can resolve the position and orientation of the object and provide position and orientation feedback for surgeon guidance. For example, the position and orientation can be shown superimposed on an image of the patient's anatomy obtained via X-ray, CT scan, ultrasound, or other imaging technology.

SUMMARY

The present invention provides an apparatus for supporting a surgical component adjacent to a bone during a surgical procedure. The apparatus includes an integral body having a hinge platform, a hinge integral with the hinge platform; and a surgical component mounting portion integral with the hinge for rotation generally about a hinge axis relative to the hinge platform. An adjustment mechanism is operably connected between the hinge platform and the surgical component mounting portion to allow selective incremental rotation of the surgical component mounting portion relative to the hinge platform.

BRIEF DESCRIPTION OF THE DRAWINGS

Various examples of the present invention will be discussed with reference to the appended drawings. These drawings depict only illustrative examples of the invention and are not to be considered limiting of its scope.

FIG. 1 is a front elevation view of a tibia and a femur showing axes of the knee joint;

FIG. 2 is a side section view of a knee joint showing typical bone cuts used in replacing the joint surfaces;

FIG. 3 is a perspective view of knee joint showing aspects of component positioning;

FIG.