Method of Preparing an Ankle Joint for Replacement, Joint Prosthesis, and Cutting Alignment Apparatus for Use in Performing an Arthroplasty Procedure

Abstract

A method prepares an ankle joint of a patient for replacement. The patient includes a tibia ( 20 ) having a medial portion ( 22 ), a talus ( 40 ), and an ankle ( 10 ) having a medial portion. The method employs a cutting alignment apparatus ( 50 ) including a first portion external to the patient and a second portion, and surgically prepares and exposes the medial portion of the ankle for replacement. The second portion of the cutting alignment apparatus is coupled to the tibia, and a cutting guide ( 90 ) is disposed with respect to the cutting alignment apparatus. The medial portion of the tibia is detached, a portion of the tibia proximate the talus is cut, and a portion of the talus proximate the tibia is cut. An ankle prosthesis ( 100 ) is installed to the ankle, and the medial portion of the tibia is reattached.

1 - 30 . (canceled) 
     
     
         31 . A cutting alignment apparatus for arthroplasty procedures, comprising:
 a first positioning member extending along a first longitudinal axis and including a first alignment element extending laterally therefrom to determine a location of a tibia, the first position member including an opening extending laterally therethrough substantially parallel to the first alignment extension to receive a bone fixation element configured to fix the first positioning member to the tibia; and   a cutting guide coupled to the first positioning member such that when the first member is fixed to the tibia, the cutting guide is positioned along a medial portion of the tibia and a talus, the cutting guide including a first cutting slot extending therethrough to guide a blade to resect a desired portion of the tibia and a second cutting slot extending therethrough to guide a cutting blade to resect a desired portion of the tibia.   
     
     
         32 . The apparatus according to  claim 31 , wherein the first positioning member includes an alignment channel extending longitudinally therethrough and a second alignment element sized and shaped for insertion through the alignment aperture to determine a desired alignment of the first positioning member with the tibia. 
     
     
         33 . The apparatus according to  claim 31 , wherein the first positioning member includes first rods extending laterally therefrom substantially perpendicularly of the first alignment extension rod, the apparatus further comprising:
 a second positioning member extending along a longitudinal axis and including first openings extending therethrough to receive the first rods therein such that the second positioning member is movable relative to the first positioning member along the first rods and the longitudinal axes of the first and second positioning members are substantially parallel to one another, the second positioning member including second rods extending laterally therefrom such that the second rods are substantially perpendicular to the first rods;   a third positioning member extending along a longitudinal axis and including second openings extending therethrough to receive the second rods therein such that the third positioning members movable relative to the second positioning member along the second rods and the longitudinal axes of the second and third positioning members are substantially parallel to one another, the cutting guide coupled to the third positioning member such that the cutting guide is longitudinally movable relative to the third positioning member to position the cutting guide along the medial portion of the tibia and talus.   
     
     
         34 . The apparatus of  claim 33 , wherein the cutting guide is coupled to the third positioning member such that the cutting guide is rotatable relative to the third positioning member. 
     
     
         35 . The apparatus of  claim 33 , further comprising a locking mechanism to fix the cutting guide in a desired position relative to the third positioning member. 
     
     
         36 . The apparatus of  claim 31 , wherein the cutting guide includes a first mounting aperture extending therethrough to guide a cutting tool along a portion of the tibia corresponding to a first mounting projection of a joint prosthesis and a second mounting aperture extending therethrough to guide a cutting tool along a portion of the talus corresponding to a second mounting projection of a joint prosthesis. 
     
     
         37 . The apparatus of  claim 36 , wherein the first mounting aperture is open to the first cutting slot and the second mounting aperture is open to the second cutting slot. 
     
     
         38 . The apparatus of  claim 31 , wherein the cutting guide includes a locking hole extending therethrough and configured to receive a locking element therethrough to fix the cutting guide to the medial portion of one of the tibia and the talus. 
     
     
         39 . A method for preparing an ankle for ankle joint replacement, comprising:
 positioning a first positioning member of a cutting alignment apparatus along a tibia of a patient using a first alignment element extending laterally therefrom, the first positioning member extending substantially perpendicularly to a longitudinal axis of the first positioning member;   fixing the first positioning member to the tibia by inserting a bone fixation element through an opening extending transversely through the first positioning member;   exposing a medial portion of the tibia and a talus to which a joint prosthesis is to be implanted; and   coupling a cutting guide to the first positioning member such that the cutting guide extends along the medial portion of the tibia and the talus.   
     
     
         40 . The method of  claim 39 , wherein positioning the first member along the tibia includes aligning the first positioning member along the tibia using a second alignment element extending longitudinally through the first positioning member. 
     
     
         41 . The method of  claim 39 , wherein the cutting guide is coupled to the first positioning member via second and third positioning member connected to one another, the second positioning member extending along a longitudinal axis and including first openings extending therethrough to receive first rods extending from the first positioning member therein such that longitudinal axes of the first and second positioning members are substantially parallel to one another, the third positioning member extending along a longitudinal axis and including second openings extending therethrough to receive the second rods extending from the second positioning member therein such that longitudinal axes of the second and third positioning members are substantially parallel to one another, the third positioning member extending along a medial portion of the tibia. 
     
     
         42 . The method of  claim 41 , adjusting the cutting guide alignment apparatus to the patient by moving the second positioning member relative to the first positioning member along the second rods and moving the third positioning member relative to the second positioning member along the second rods, 
     
     
         43 . The method of  claim 39 , further comprising adjusting the cutting guide to a desired configuration relative to medial portion tibia and the talus. 
     
     
         44 . The method of  claim 43 , wherein adjusting the cutting guide includes rotating the cutting guide relative to the first positioning member. 
     
     
         45 . The method of  claim 43 , wherein adjusting the cutting guide includes moving the cutting guide longitudinally relative to the first positioning member. 
     
     
         46 . The method of  claim 43 , further comprising locking the cutting in the desired configuration. 
     
     
         47 . The method of  claim 39 , further comprising resecting a desired portion of the tibia and the talus using a blade inserted through first and second cutting slots extending through the cutting guide. 
     
     
         48 . The method of  claim 47 , further comprising inserting a cutting tool through a first mounting aperture extending through the cutting guide to form a first recess in the tibia corresponding to a first mounting projection of a joint prosthesis and through a second mounting aperture extending through the cutting guide to form a second recess corresponding to a second mounting projection of a joint prosthesis. 
     
     
         49 . The method of  claim 48 , sliding the first mounting projection of the joint prosthesis through the first recess and sliding the second mounting projection of the joint prosthesis through the second recess to implant the joint prosthesis. 
     
     
         50 . The method of  claim 39 , further comprising fixing the cutting guide to the medial portion of one of the tibia and the talus by inserting a locking element through a locking hole extending through the cutting guide.