Method and apparatus for femoral resection alignment

Abstract

The apparatus of the present invention includes a number of components including tibial and femoral alignment guides, tibial and femoral cutting guides and tibial and femoral implants for total knee arthroplasty procedures.

1 - 20 . (canceled) 
     
     
         21 . A system for primary total knee arthroplasty on a diseased knee joint of a human patient, comprising 
       a femoral alignment guide configured to be placed on a femur of the patient in simultaneous contact with at least five points on the femur including one point on a non-resected anterior cortex of the femur and four points on non-resected articular surfaces of the femur, including two points on a non-resected lateral femoral condyle and two points on a non-resected medial femoral condyle, wherein the femoral alignment guide includes at least four cannulae configured to enable passing of one or more elongate fixation elements through the alignment guide to create at least four holes in the femur;
 a distal femoral cutting block configured to mechanically reference a plurality of the holes created in the femur by the one or more elongate fixation elements after removal of the femoral alignment guide, the distal femoral cutting block configured to guide an oscillating sawblade to make a planar distal resected surface on the femur; 
 a second femoral cutting block configured to be placed into contact with the planar distal resected surface and to mechanically reference a plurality of the holes created in the femur by the one or more elongate fixation elements, the second femoral cutting block configured to guide the oscillating sawblade to make planar anterior chamfer and posterior chamfer resected surfaces on the femur; 
 a tibial alignment guide configured to be placed an a proximal end of a tibia of to patient in simultaneous contact with at least five points on the tibia including one point on a non-resected anterior cortex of the tibia and four points on non-resected articular surfaces of the tibia, including two points on a non-resected lateral tibial condyle and two points on a non-resected medial tibial condyle, wherein the tibial alignment guide includes a plurality of apertures configured to enable passing of one or more elongate fixation elements through the tibial alignment guide to create a plurality of holes in the tibia; 
 a proximal tibial cutting block configured to mechanically reference the holes created in the tibia after removal of the tibial alignment guide to position the proximal tibial cutting block substantially along a medial half of the anterior cortex of the tibia such that a lateral most end of the proximal tibial cutting block is located medially of a lateral most point of contact between the tibial alignment guide and the non-resected articular surfaces of the tibia, the proximal tibial cutting block configured to guide an oscillating sawblade to make a planar proximal resected surface on the tibia without being mechanically interconnected to any other cutting blocks while guiding the oscillating sawblade; 
 a femoral total knee arthroplasty implant with fixation surfaces configured to face the planar distal resected surface and the planar anterior chamfer and posterior chamfer resected surfaces on the femur; and 
 a tibial total knee arthroplasty implant with a fixation surface configured to face the planar proximal resected surface on the tibia, 
 wherein, while the holes are creating in the femur and the tibia using the femoral alignment guide and the tibial alignment guide, neither the femoral alignment guide nor the tibial alignment guide is mechanically interconnected to an intramedullary rod and the femoral alignment guide is not mechanically interconnected to a tibial referencing tensor linkage. 
 
     
     
         22 . The system of  claim 21 , wherein the femoral alignment guide does not have an oscillating saw blade guide surface configured to be aligned coplanar with the planar distal femoral resected surface to be created while the holes are being created in the femur and the tibial alignment guide does not have an oscillating saw blade guide surface configured to be aligned coplanar with the planar proximal resected surface to be created while the holes are being created in the tibia. 
     
     
         23 . The system of  claim 22 , wherein the distal femoral cutting block is configured to be positioned such that a lateral most end of the distal femoral cutting block is located medially of a lateral most point of contact between the femoral alignment guide and the non-resected articular surfaces of the femur. 
     
     
         24 . The system of  claim 22 , wherein the elongate fixation elements are selected from the group consisting of: screws, cannulated screws, drills, nails and pins. 
     
     
         25 . The system of  claim 22 , the at least four cannulae in the femoral alignment guide are positioned such that the holes in the femur are configured to be created in the femoral cortex. 
     
     
         26 . The system of  claim 22 , wherein the plurality of apertures in the tibial alignment guide are positioned such that the holes in the tibia are configured to be created in the tibial cortex. 
     
     
         27 . The system of  claim 22 , wherein a location and orientation of the holes in the tibia are mechanically referenced to determine a location and orientation of the tibial total knee arthroplasty implant in to plurality of degrees of freedom including anterior-posterior location, medial-lateral location and internal-external rotational orientation. 
     
     
         28 . The system of  claim 22 , wherein the second femoral cutting block is further configured to guide the oscillating sawblade to create an anterior resected surface and a posterior resected surface on the femur. 
     
     
         29 . The system of  claim 22 , wherein the at least four cannulae in the femoral alignment guide are configured to enable creation of two pairs of holes in the femur. 
     
     
         30 . The system of  claim 22 , wherein the plurality of apertures in the tibial alignment guide are configured to enable creation of two pairs of holes in the tibia. 
     
     
         31 . The system of  claim 22 , further comprising a pin guide in at least two of the at least four cannulae in the femoral alignment guide. 
     
     
         32 . The system of  claim 31 , wherein the pin guides are at least one of fixed within the cannulae or configured to be extended through the cannulae. 
     
     
         33 . The system of  claim 21 , further comprising a pin guide positioned in the apertures in the tibial alignment guide. 
     
     
         34 . The system of  claim 33 , wherein the pin guides are at least one of fixed within the apertures or configured to be extended through the apertures. 
     
     
         35 . A system for primary total knee arthroplasty on a diseased knee joint of a human patient, comprising:
 a femoral alignment guide configured to be placed on a femur of the patient in simultaneous contact with at least five points on the femur including one point on a non-resected anterior cortex of the femur and four points on non-resected articular surfaces of the femur, including two points on a non-resected lateral femoral condyle and two points on a non-resected medial femoral condyle, wherein the femoral alignment guide includes at least four cannulae configured to enable passing of one or more elongate fixation elements through the alignment guide to create at least four holes in the femur;   a pin guide positioned in at least two of the at least four cannulae in the femoral alignment guide such that passing one or more of the elongate fixation elements through the at least two of the at least four cannulae passes the one or more of the elongate fixation elements through the pin guides;   a distal femoral cutting block configured to mechanically reference a plurality of the holes created in the femur by the one or more elongate fixation elements after removal of the femoral alignment guide, the distal femoral cutting block configured to guide an oscillating sawblade to make a planar distal resected surface on the femur;   a second femoral cutting block configured to be placed into contact with the planar distal resected surface and to mechanically reference a plurality of the holes created in the femur by the one or more elongate fixation elements, the second femoral cutting block, configured to guide the oscillating sawblade to make planar anterior chamfer and posterior chamfer resected surfaces on the femur;   a tibial alignment guide configured to be placed on a proximal end of a tibia of a patient in simultaneous contact with at least five points on the tibia including one point on a non-resected anterior cortex of the tibia and four points on non-resected articular surfaces of the tibia, including two points on a non-resected lateral tibial condyle and two points on a non-resected medial tibial condyle, wherein the tibial alignment guide includes a plurality of apertures configured to enable passing of one or more elongate fixation elements through the tibial alignment guide to create a plurality of holes in the tibia;   a pin guide positioned within each of the apertures in the tibial alignment guide such that passing one or more elongate fixation elements through the tibial alignment guide includes passing the one or more elongate fixation elements through the pin guides;   a proximal tibial cutting block configured to mechanically reference the holes created in the tibia after removal of the tibial alignment guide to position the proximal tibial cutting block substantially along a medial half of the anterior cortex of the tibia such that a lateral most end of the proximal tibial cutting block is located medially of as lateral most point of contact between the tibial alignment guide and the non-resected articular surfaces of the tibia, the proximal tibial cutting block configured to guide an oscillating sawblade to make a planar proximal resected surface on the tibia without being mechanically interconnected, to any other cutting blocks while guiding the oscillating sawblade;   a femoral total knee arthroplasty implant with fixation surfaces configured to face the planar distal resected surface and the planar anterior chamfer and posterior chamfer resected surfaces on the femur; and   a tibial total knee arthroplasty implant with a fixation surface configured to face the planar proximal resected surface on the tibia,   wherein, while the holes are creating in the femur and the tibia using the femoral alignment guide and the tibial alignment guide, neither the femoral alignment guide nor the tibial alignment guide is mechanically interconnected to an intramedullary rod and the femoral alignment guide is not mechanically interconnected to a tibial referencing tensor linkage.   
     
     
         36 . New The system of  claim 35 , wherein the femoral alignment guide does not have an oscillating saw blade guide surface configured to be aligned coplanar with the planar distal femoral resected surface to be created while the holes are being created in the femur and the tibial alignment guide does not have an oscillating saw blade guide surface configured to be aligned coplanar with the planar proximal resected surface to be created while the holes are being created in the tibia. 
     
     
         37 . The system of  claim 36 , wherein the distal femoral cutting block is configured to be positioned such that a lateral most end of the distal femoral cutting block is located medially of a lateral most point of contact between the femoral alignment guide and the non-resected articular surfaces of the femur. 
     
     
         38 . The system of  claim 36 , wherein the elongate fixation elements are selected from the group consisting of: screws, cannulated screws, drills, nails and pins. 
     
     
         39 . The system of  claim 36 , the at least four cannulae in the femoral alignment guide are positioned such that the holes in the femur are configured to be created in the femoral cortex. 
     
     
         40 . The system of  claim 36 , wherein the plurality of apertures in the tibial alignment guide are positioned such that the holes in the tibia are configured to be created in the tibial cortex. 
     
     
         41 . The system of  claim 36 , wherein a location and orientation of the holes in the tibia are mechanically referenced to determine a location and orientation of the tibial total knee arthroplasty implant in a plurality of degrees of freedom including anterior-posterior location, medial-lateral location and internal-external rotational orientation. 
     
     
         42 . The system of  claim 36 , wherein the second femoral cutting block is further configured to guide the oscillating sawblade to create an anterior resected surface and a posterior resected surface on the femur. 
     
     
         43 . The system of  claim 36 , wherein the at least four cannulae in the femoral alignment guide are configured to enable creation of two pairs of holes in the femur. 
     
     
         44 . The system of  claim 36 , wherein the plurality of apertures in the tibial alignment guide are configured to enable creation of two pairs of holes in the tibia. 
     
     
         45 . The system of  claim 36 , wherein the pin guides are at least one of fixed within the cannulae and apertures or configured to be extended through the cannulae and apertures.