Kinematic alignment and novel femoral and tibial prosthetics

{
  "publication_number": "US9901463B2",
  "country": "US",
  "kind": "B2",
  "title": "Kinematic alignment and novel femoral and tibial prosthetics",
  "abstract": "A tibial component placement guide for use in a knee arthroplasty procedure involving a knee joint comprising a tibia, a patella, and a femur, the guide comprising an overlay configured to be overlaid a resected tibia, the overlay including at least one of an indicia and an opening indicative of at least one of an orientation and a position of at least one of a first axis of the femur, a second axis of the femur, and a first axis of the patella.",
  "claims": [
    "1. A method of using a tibial component placement guide for use in a knee arthroplasty procedure involving a knee joint comprising a tibia, a patella, and a femur, the method comprising: applying an overlay to a resected tibia, the overlay including at least one of an indicia and an opening indicative of at least one of an orientation and a position of a projected axis comprising at least one of a posterior condylar femoral axis, a spherical femoral axis, a cylindrical femoral axis, a flexion axis of the femur about the tibia, and a helical axis of the femur relative to the tibia; marking the resected tibia with at least one mark using the overlay to denote at least one of an orientation and a position of the projected axis; and, orienting and attaching at least one of an orthopedic tibial tray trial and an orthopedic tibial tray to the resected tibia using the mark.",
    "2. The method of claim 1, wherein the step of applying the overlay includes aligning a peripheral shape of the overlay with a peripheral shape of the resected tibia and placing the overlay on top of the resected tibia.",
    "3. The method of claim 1, wherein the overlay includes an opening indicative of the orientation of the projected axis.",
    "4. The method of claim 3, wherein the opening comprises a through hole.",
    "5. The method of claim 4, wherein: the through hole outlines a T-shape; a horizontal aspect of the T-shape is indicative of orientation of the projected axis; and, a vertical aspect of the T-shape is indicative of orientation of the projected axis.",
    "6. The method of claim 4, wherein: the through hole outlines a + shape; a horizontal aspect of the + shape is indicative of orientation of the projected axis; and, a vertical aspect of the + shape is indicative of orientation of the projected axis.",
    "7. The method of claim 3, wherein: the opening comprises a first through hole and a second through hole; the first through hole is indicative of the projected axis; and, the second through hole is indicative of orientation of the projected axis.",
    "8. The method of claim 3, wherein: the opening comprises a first cutout and a second cutout; the first cutout is indicative of the projected axis; and, the second cutout is indicative of orientation of the projected axis.",
    "9. The method of claim 1, wherein the projected axis comprises the posterior condylar femoral axis.",
    "10. The method of claim 1, wherein the projected axis comprises the helical axis of the femur relative to the tibia.",
    "11. The method of claim 1, wherein the overlay has a contour outline that is aligned with the resected tibia.",
    "12. The method of claim 11, wherein the contour outline is patient-specific.",
    "13. The method of claim 1, further comprising at least one of an indicia and an opening indicative of at least two of a medial guide, a lateral guide, a size of the guide, and a particular patient.",
    "14. The method of claim 1, wherein the guide is fabricated from at least one of titanium, a titanium alloy, stainless steel, and a stainless steel alloy.",
    "15. The method of claim 1, wherein the guide includes a through aperture configured to align a through fastener mounted to the resected tibia.",
    "16. The method of claim 15, wherein the through fastener comprises a pin.",
    "17. The method of claim 16, wherein: the through aperture comprises a plurality of through apertures; each of the plurality of apertures is configured to receive a pin.",
    "18. The method of claim 1, wherein the overlay comprises a base plate.",
    "19. The method of claim 18, wherein the base plate includes a flange along a periphery of the base plate.",
    "20. The method of claim 1, wherein the overlay further comprises at least one of an indicia and an opening indicative of the orientation of a third axis of the femur, the third axis being parallel to the projected axis.",
    "21. The method of claim 1, wherein: the at least one mark comprises an indentation formed into the resected tibia; and, the step of marking the resected tibia includes using a punch to form the indentation into the resected tibia.",
    "22. The method of claim 1, wherein: the at least one mark comprises a representation formed into the resected tibia; and, the step of marking the resected tibia includes writing the representation onto the resected tibia.",
    "23. The method of claim 1, wherein the orienting and attaching step includes orienting and attaching an orthopedic tibial tray to the resected tibia using the mark.",
    "24. The method of claim 1, further comprising removing the overlay prior to orienting and attaching at least one of the orthopedic tibial tray trial and the orthopedic tibial tray to the resected tibia using the mark.",
    "25. The method of claim 1, wherein the overlay includes a contour on a posterior side accounting for retention of the posterior cruciate ligament."
  ],
  "description_excerpt": "The present disclosure is directed to knee kinematics as well as techniques, surgical guides, and orthopedic prosthetics to enhance knee arthroplasty.\n\nKnee arthritis causes debilitating pain affecting activities of daily living. When pain is not well controlled by non-operative treatments and the failure in managing disease′ symptoms (pain, stiffness, swelling, and/or bony spurs), Total Knee Arthroplasty (TKA) is recommended if the patient is medically fit for the surgery and has no active infection.\n\nOne common objective in TKA is to restore normal kinematics. However, what are normal kinematics? Is it the relationship between ligaments menisci and articular surfaces of femur, tibia and patella or the distribution of contact stresses across the articulating joint as symmetrically as possible, avoiding overloading of the one compartment? Although trying to achieve the same goal, these two philosophies require different surgical techniques - one to provide a restoration to normal anatomy (in the case of osteoarthritis), second is to correct defective anatomy (i.e. varus/valgus).\n\nThe former philosophy is a measured resection technique where bone and cartilage are replaced by implants that are of generally the same thickness. The latter philosophy is a balanced flexion gap technique that may require altering the patient's pre-arthritic anatomy. The major assumption underlying this philosophy is many patients who develop medial compartment arthritis of the knee are bowlegged, or walk with a varus thrust, since childhood.",
  "cpc": [
    "A61F 2/461",
    "A61B 17/157",
    "A61B 17/1764",
    "A61B 17/90",
    "A61B 2017/568",
    "A61B 2017/90",
    "A61F 2/30942",
    "A61F 2/3859",
    "A61F 2/389",
    "A61F 2/4684",
    "A61F 2002/4633",
    "A61F 2002/4687"
  ],
  "ipc": [
    "A61F 2/46",
    "A61B 17/15"
  ],
  "inventors": [
    "Mohamed R. Mahfouz"
  ],
  "filing_date": "2015-04-14",
  "publication_date": "2018-02-27",
  "grant_date": "2018-02-27",
  "priority_date": "2014-04-14",
  "application_number": "US-201514686685-A",
  "family_id": "54324513",
  "cited_by_count": 37,
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}