[go: up one dir, main page]

WO2011064473A1 - System for assisting in creation of femoral and tibial cuts - Google Patents

System for assisting in creation of femoral and tibial cuts Download PDF

Info

Publication number
WO2011064473A1
WO2011064473A1 PCT/FR2010/000781 FR2010000781W WO2011064473A1 WO 2011064473 A1 WO2011064473 A1 WO 2011064473A1 FR 2010000781 W FR2010000781 W FR 2010000781W WO 2011064473 A1 WO2011064473 A1 WO 2011064473A1
Authority
WO
WIPO (PCT)
Prior art keywords
block
plane
femoral
tibial
knee
Prior art date
Application number
PCT/FR2010/000781
Other languages
French (fr)
Inventor
Patrick Hechard
Original Assignee
Patrick Hechard
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
Application filed by Patrick Hechard filed Critical Patrick Hechard
Publication of WO2011064473A1 publication Critical patent/WO2011064473A1/en

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
    • A61B17/155—Cutting femur
    • 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
    • A61B17/02—Surgical instruments, devices or methods for holding wounds open, e.g. retractors; Tractors
    • A61B17/025—Joint distractors
    • A61B2017/0268—Joint distractors for the knee

Definitions

  • the invention relates to a surgical system for assisting the realization of femoral and tibial cuts for the placement of a knee prosthesis when the latter is in its so-called "extended" position.
  • the positioning of the two parts of a total knee prosthesis depends on the quality of realization of the bone cuts allowing the adjustment of the implants.
  • the surgeon has a material of assistance to the pose dedicated to a particular type of prosthesis.
  • the positioning of the cutting guides allowing it to embed each prosthesis depends on the orientation given to the respective sections. He must therefore know perfectly the characteristics of each material. To secure the orientation of the cuts, it can for this purpose make use of a computer assistance whose effectiveness is not proven and which remains a very high cost.
  • the object of the present invention is thus to provide a system which overcomes the aforementioned drawbacks of the systems of the prior art, in particular to secure the femoral and tibial cuts, to obtain a saving in operating time and to substantially reduce the manufacturing cost of the device.
  • the present invention relates to a system for assisting the realization of femoral and tibial cuts for the fitting of a joint prosthesis of a knee of a human being when this prosthesis comprises a femoral component and a tibial component and when the knee is in position called "in extension", as defined in claim 1 appended to this description.
  • FIG. 1 is a perspective view of part of the system according to the invention for an aid in the production of femoral and tibial sections for the fitting of a joint prosthesis of a knee, and
  • Figure 2 is a sectional and side view of the system according to the invention shown in cooperation with the knee joint.
  • the present invention relates to a system for assisting the production of femoral and tibial cuts 12 for the fitting of a joint prosthesis of a knee 13 of a human being when this prosthesis comprises a part femoral and a tibial piece and when the knee is in the unfolded position, that is to say "in extension" according to the terminology of the skilled person.
  • the system comprises at least two spacing sheets 21, 22 able to be positioned between the femur Fe and the tibia Ti before the cutting is made, and a block 30 in one piece, this block comprising a support face 32, preferably flat, adapted to be positioned against the Fe femur and tibia Ti at the knee joint.
  • This block 30 comprises at least two orifices 33, 34, 35 passing therethrough, these orifices having a cross-section respectively complementary to the cross-section of the two spacing cards 21, 22. Moreover, the axes of these orifices are located in the same plane 36 substantially perpendicular to the bearing face 32.
  • the block 30 further comprises at least a first slot 40 adapted to guide a saw blade Isc.
  • This first slot 40 is made in the block so as to pass through it and to be located at a predetermined distance from the plane 36 containing the axes of the orifices 33-35, and so that its length is substantially parallel to this plane 36.
  • Block 30 also has a plurality of second slots 51, 52, 53 each adapted to guide a saw blade Isc. These second slots are made so as to cross the block 30 while being all parallel to each other and located in the portion 55 of the block 30 delimited by the plane 36 defined above and which does not contain the first slot 40, and so that their lengths are substantially parallel to this plane 36.
  • the interlacing cards 21, 22 it is possible for the interlacing cards 21, 22 to have different cross-sections and for the block to have more than two through-holes 33, 34, 35 of sections respectively adapted to those of the cards which are intended to be used. to cooperate with them, which allows to better adjust the position of the block 30 relative to the joint.
  • the system according to the invention further comprises a plurality of positioning pins 60 and the block 30 further comprises a plurality of through-holes 61, 62, 63, each of these through-holes being adapted to receive a positioning pin to fix the block 30 at least on the Fe femur or tibia Ti, and advantageously on both.
  • system further comprises reference means 70 made on the block 30 and defining a rectilinear direction substantially perpendicular to the plane 36 defined above, for locating the femoral-tibial axis.
  • these reference means 70 are constituted by at least one of the following elements: a line 71 materialized on the face 37 of the block opposite to the bearing face 32, a rod 72 plugged into the block 30 and at least one end emerges from the block 30, advantageously both emerging on either side of the block, a slide mounted in cooperation with the block, a telescopic rod plugged into the block, etc.
  • the block 30 is made of radiolucent material, for example polyethylene or any other resistant resin, in order to be able to in particular to check the good implantation of the plugs and / or the pins, as well as the realization of the cuts.
  • radiolucent material for example polyethylene or any other resistant resin
  • the slots 40, 51, 52, 53 are all the same width, which makes it possible to use the same saw blades Isc, and thus to have the same thickness of cut on the two bones.
  • the block 30 has the shape of substantially a parallelepiped, preferably rectangle.
  • the present invention therefore relates to a system for the introduction of total knee prostheses. More particularly, the system makes it possible to perform the femoral-distal and tibial-proximal sections in a very short time thanks to an integrated system for automatically locating the axes of the Fe femur and the tibia Ti. In addition, it offers the possibility of ensuring its attachment to the skeleton so as to allow to saw the bone, safely and with the maximum of precision.
  • the present system makes it possible to perform the two sections linked, perpendicularly to the femorotibial axis previously determined on X-ray or CT documents, or even magnetic resonance, with the parallelepiped-shaped block 30 having a first upper slot 40 in which A saw blade Isc can be inserted for the lower end of the femur and several seconds lower slots 51-53 to perform the tibial cut according to the appropriate level.
  • the block 30 comprises a horizontal row of several orifices 33-35, for example 3mm in diameter, materializing, by the introduction of pins 21, 22, as rods, the femoral-tibial spacing and automatically adjusting the slope of the cuts. in the sagittal plane.
  • Some orifices, so also interligne cards that are intended to cooperate with them, may be of greater diameter to compensate for greater wear of the knee condyles.
  • the block 30 is perforated, for example at its corners, with pins 60 to allow the stabilization of the bones and the system during the cutting of the bones which generally generates vibrations.
  • the block 30 may be made of a metallic material, but advantageously in a transparent radio-resistant material in order to allow intraoperative radioscopic checks to check the level and orientation of the cuts before they are made.
  • the validation of the orientation can be carried out on the block itself which comprises, according to one possible embodiment, a vertical gutter in which can be placed a rod 72 of suitable dimensions and of sufficient length to project on the tibial crest and achieve the level of the ankle.
  • the cuts in question can be made safely by automatically adjusting their thickness, orientation and level.

Landscapes

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

Abstract

The present invention relates to systems for assisting in the creation of femoral cuts 11 and tibial cuts 12 so as to place a prosthetic knee joint 13 when said prosthesis comprises a femoral part and a tibial part and the knee is in an unbent position. The system according to the invention is essentially characterized in that it comprises: two spacing cards 21, 22 that are positioned between the femur Fe and the tibia Ti; a one-piece block 30 that includes a bearing surface 32; two through-openings 33, 34, 35 for receiving both cards 21, 22, the axes of said openings being located within a plane 36; a groove 40 that passes through the block 30 in order to guide a saw blade lsc and has a length substantially parallel to the plane 36; and a plurality of grooves 51, 52, 53 that pass through the block 30 in order to guide a saw blade lsc, said grooves all being parallel therebetween, having the lengths thereof substantially parallel to the plane 36, and being located within the portion 55 of the block 30 that is defined by the plane 36 and does not include the groove 40.

Description

SYSTEME D'AIDE A LA REALISATION  ASSISTING SYSTEM FOR THE PRODUCTION
DE COUPES FEMORALE ET TIBIALE  OF FEMORAL AND TIBIAL CUTS
L'invention concerne un système chirurgical d'aide à la réalisation de coupes fémorale et tibiale pour la mise en place d'une prothèse de genou lorsque ce dernier est dans sa position dite "en extension". The invention relates to a surgical system for assisting the realization of femoral and tibial cuts for the placement of a knee prosthesis when the latter is in its so-called "extended" position.
Le positionnement des deux pièces d'une prothèse totale de genou dépend de la qualité de réalisation des coupes osseuses permettant l'ajustement des implants.  The positioning of the two parts of a total knee prosthesis depends on the quality of realization of the bone cuts allowing the adjustment of the implants.
Pour optimiser ce positionnement, gage de la réussite biomécanique de l'intervention et de sa pérennisation, il est nécessaire de remplir certaines conditions: hauteur de l'interligne articulaire, orientation des pièces prothétiques dans les trois plans de l'espace notamment. A cet effet, des viseurs guidés par un navigateur électronique ont été proposés.  To optimize this positioning, a guarantee of the biomechanical success of the intervention and its sustainability, it is necessary to fulfill certain conditions: height of joint space, orientation of prosthetic parts in the three planes of space in particular. For this purpose, viewers guided by an electronic browser have been proposed.
L'utilisation des viseurs connus actuellement, comme ceux décrits dans les documents antérieurs US-A-2005/149037 et US-A-2005/085920, permet de sécuriser les poses, mais rallonge le temps opératoire et surtout entraîne un coût élevé de l'intervention dans son ensemble.  The use of visors currently known, such as those described in the previous documents US-A-2005/149037 and US-A-2005/085920, makes it possible to secure the poses, but lengthens the operating time and, above all, entails a high cost of intervention as a whole.
Habituellement, le chirurgien dispose d'un matériel d'aide à la pose dédié à un type de prothèse particulier. Le positionnement des guides de coupe lui permettant d'encastrer chaque prothèse dépend de l'orientation donnée aux coupes respectives. Il doit donc connaître parfaitement les caractéristiques de chaque matériel. Pour sécuriser l'orientation des coupes, il peut à cet effet faire usage d'une assistance par ordinateur dont l'efficacité n'est pas prouvée et qui reste d'un prix de revient très élevé.  Usually, the surgeon has a material of assistance to the pose dedicated to a particular type of prosthesis. The positioning of the cutting guides allowing it to embed each prosthesis depends on the orientation given to the respective sections. He must therefore know perfectly the characteristics of each material. To secure the orientation of the cuts, it can for this purpose make use of a computer assistance whose effectiveness is not proven and which remains a very high cost.
Dans tous les cas, les coupes effectuées sur le fémur et le tibia le sont séparément, le genou étant maintenu en flexion, ce qui implique deux systèmes compliqués, et par là même deux sources possibles d'erreur.  In all cases, the cuts made on the femur and the tibia are separately, the knee being maintained in flexion, which implies two complicated systems, and thus two possible sources of error.
La présente invention a ainsi pour but de réaliser un système qui pallie les inconvénients mentionnés ci-dessus des systèmes de l'art antérieur, notamment pour sécuriser les coupes fémorale et tibiale, obtenir un gain de temps opératoire et diminuer substantiellement le coût de fabrication du matériel ancillaire nécessaire à la pose des prothèses totales de genou. La présente invention a pour objet un système d'aide à la réalisation de coupes fémorale et tibiale pour la pose d'une prothèse articulaire d'un genou d'un être humain lorsque cette prothèse comporte une pièce fémorale et une pièce tibiale et lorsque le genou est en position dite "en extension", tel que défini dans la revendication 1 annexée à la présente description. The object of the present invention is thus to provide a system which overcomes the aforementioned drawbacks of the systems of the prior art, in particular to secure the femoral and tibial cuts, to obtain a saving in operating time and to substantially reduce the manufacturing cost of the device. ancillary equipment necessary for the installation of total knee prostheses. The present invention relates to a system for assisting the realization of femoral and tibial cuts for the fitting of a joint prosthesis of a knee of a human being when this prosthesis comprises a femoral component and a tibial component and when the knee is in position called "in extension", as defined in claim 1 appended to this description.
D'autres caractéristiques et avantages de la présente invention apparaîtront au cours de la description suivante donnée en regard des dessins annexés à titre illustratif mais nullement limitatif, dans lesquels :  Other features and advantages of the present invention will become apparent from the following description given with reference to the accompanying drawings, by way of illustration but in no way limiting, in which:
La figure 1 est une vue en perspective d'une partie du système selon l'invention pour une aide à la réalisation de coupes fémorale et tibiale pour la pose d'une prothèse articulaire d'un genou, et  FIG. 1 is a perspective view of part of the system according to the invention for an aid in the production of femoral and tibial sections for the fitting of a joint prosthesis of a knee, and
La figure 2 est une vue en coupe et de côté du système selon l'invention représenté en coopération avec l'articulation d'un genou.  Figure 2 is a sectional and side view of the system according to the invention shown in cooperation with the knee joint.
En référence aux deux figures annexées, la présente invention concerne un système d'aide à la réalisation de coupes fémorale 11 et tibiale 12 pour la pose d'une prothèse articulaire d'un genou 13 d'un être humain lorsque cette prothèse comporte une pièce fémorale et une pièce tibiale et lorsque le genou est en position non pliée, c'est-à-dire "en extension" selon la terminologie des personnes du métier.  With reference to the two appended figures, the present invention relates to a system for assisting the production of femoral and tibial cuts 12 for the fitting of a joint prosthesis of a knee 13 of a human being when this prosthesis comprises a part femoral and a tibial piece and when the knee is in the unfolded position, that is to say "in extension" according to the terminology of the skilled person.
Selon l'invention, le système comporte au moins deux fiches d'interligne 21 , 22 aptes à être positionnées entre le fémur Fe et le tibia Ti avant la réalisation des coupes, et un bloc 30 d'une seule pièce, ce bloc comprenant une face d'appui 32, avantageusement plane, apte à être positionnée contre le fémur Fe et le tibia Ti au niveau de l'articulation du genou.  According to the invention, the system comprises at least two spacing sheets 21, 22 able to be positioned between the femur Fe and the tibia Ti before the cutting is made, and a block 30 in one piece, this block comprising a support face 32, preferably flat, adapted to be positioned against the Fe femur and tibia Ti at the knee joint.
Ce bloc 30 comporte au moins deux orifices 33, 34, 35 le traversant, ces orifices ayant une section respectivement complémentaire de la section transversale des deux fiches d'interligne 21 , 22. De plus, les axes de ces orifices sont situés dans un même plan 36 sensiblement perpendiculaire à la face d'appui 32.  This block 30 comprises at least two orifices 33, 34, 35 passing therethrough, these orifices having a cross-section respectively complementary to the cross-section of the two spacing cards 21, 22. Moreover, the axes of these orifices are located in the same plane 36 substantially perpendicular to the bearing face 32.
Le bloc 30 comporte en outre au moins une première fente 40 apte à guider une lame de scie Isc. Cette première fente 40 est réalisée dans le bloc de façon à le traverser et à être située à une distance déterminée du plan 36 contenant les axes des orifices 33-35, et de façon que sa longueur soit sensiblement parallèle à ce plan 36. The block 30 further comprises at least a first slot 40 adapted to guide a saw blade Isc. This first slot 40 is made in the block so as to pass through it and to be located at a predetermined distance from the plane 36 containing the axes of the orifices 33-35, and so that its length is substantially parallel to this plane 36.
Le bloc 30 comporte aussi une pluralité de secondes fentes 51, 52, 53 aptes chacune à guider une lame de scie Isc. Ces secondes fentes sont réalisées de façon à traverser le bloc 30 en étant toutes parallèles entre elles et situées dans la partie 55 du bloc 30 délimitée par le plan 36 défini ci-dessus et qui ne contient pas la première fente 40, et de façon que leurs longueurs soient sensiblement parallèles à ce plan 36.  Block 30 also has a plurality of second slots 51, 52, 53 each adapted to guide a saw blade Isc. These second slots are made so as to cross the block 30 while being all parallel to each other and located in the portion 55 of the block 30 delimited by the plane 36 defined above and which does not contain the first slot 40, and so that their lengths are substantially parallel to this plane 36.
Selon un mode de réalisation avantageux, il est possible que les fiches d'interligne 21, 22 aient des sections transversales différentes et que le bloc comporte plus de deux orifices traversants 33, 34, 35 de sections respectivement adaptées à celles des fiches qui sont destinées à coopérer avec eux, ce qui permet de mieux ajuster la position du bloc 30 par rapport à l'articulation.  According to an advantageous embodiment, it is possible for the interlacing cards 21, 22 to have different cross-sections and for the block to have more than two through-holes 33, 34, 35 of sections respectively adapted to those of the cards which are intended to be used. to cooperate with them, which allows to better adjust the position of the block 30 relative to the joint.
Selon un autre mode de réalisation avantageux, le système selon l'invention comprend en outre une pluralité de broches de positionnement 60 et le bloc 30 comporte en outre une pluralité des percées traversantes 61 , 62, 63, chacune de ces percées traversantes étant apte à recevoir une broche de positionnement pour fixer le bloc 30 au moins sur le fémur Fe ou sur le tibia Ti, et avantageusement sur les deux.  According to another advantageous embodiment, the system according to the invention further comprises a plurality of positioning pins 60 and the block 30 further comprises a plurality of through-holes 61, 62, 63, each of these through-holes being adapted to receive a positioning pin to fix the block 30 at least on the Fe femur or tibia Ti, and advantageously on both.
Selon un autre mode de réalisation avantageux, le système comprend en outre des moyens de repère 70 réalisés sur le bloc 30 et définissant une direction rectiligne sensiblement perpendiculaire au plan 36 défini ci-avant, pour repérer l'axe fémoral-tibial.  According to another advantageous embodiment, the system further comprises reference means 70 made on the block 30 and defining a rectilinear direction substantially perpendicular to the plane 36 defined above, for locating the femoral-tibial axis.
Selon une réalisation possible, ces moyens de repère 70 sont constitués par au moins l'un des éléments suivants : un trait 71 matérialisé sur la face 37 du bloc opposée à la face d'appui 32, une tige 72 enfichée dans le bloc 30 et dont au moins une extrémité émerge du bloc 30, avantageusement les deux émergeant de part et d'autre du bloc, une glissière montée en coopération avec le bloc, une tige télescopique enfichée dans le bloc, etc.  According to one possible embodiment, these reference means 70 are constituted by at least one of the following elements: a line 71 materialized on the face 37 of the block opposite to the bearing face 32, a rod 72 plugged into the block 30 and at least one end emerges from the block 30, advantageously both emerging on either side of the block, a slide mounted in cooperation with the block, a telescopic rod plugged into the block, etc.
De façon très préférentielle, le bloc 30 est en matériau radio-transparent, par exemple du polyéthylène ou toute autre résine résistante, pour pouvoir notamment vérifier la bonne implantation des fiches et/ou des broches, ainsi que la réalisation des coupes. In a very preferential manner, the block 30 is made of radiolucent material, for example polyethylene or any other resistant resin, in order to be able to in particular to check the good implantation of the plugs and / or the pins, as well as the realization of the cuts.
Selon une réalisation préférentielle, les fentes 40, 51, 52, 53 ont toutes la même largeur, ce qui permet d'utiliser les mêmes lames de scie Isc, et d'avoir donc une même épaisseur de coupe sur les deux os. De plus, pour une facilité de réalisation et donc un moindre coût de production, le bloc 30 présente la forme sensiblement d'un parallélépipède, avantageusement rectangle.  According to a preferred embodiment, the slots 40, 51, 52, 53 are all the same width, which makes it possible to use the same saw blades Isc, and thus to have the same thickness of cut on the two bones. In addition, for ease of implementation and therefore a lower production cost, the block 30 has the shape of substantially a parallelepiped, preferably rectangle.
La présente invention concerne donc un système permettant la mise en place de prothèses totales de genou. Plus particulièrement, le système permet de réaliser les coupes fémorale-distale et tibiale-proximale en un temps très court grâce à un système intégré de repérage automatique 70 des axes du fémur Fe et du tibia Ti. De plus, il offre la possibilité d'assurer sa fixation au squelette de façon à permettre de scier les os, en toute sécurité et avec le maximum de précision.  The present invention therefore relates to a system for the introduction of total knee prostheses. More particularly, the system makes it possible to perform the femoral-distal and tibial-proximal sections in a very short time thanks to an integrated system for automatically locating the axes of the Fe femur and the tibia Ti. In addition, it offers the possibility of ensuring its attachment to the skeleton so as to allow to saw the bone, safely and with the maximum of precision.
Le présent système permet de pratiquer les deux coupes liées, perpendiculairement à l'axe fémoro-tibial préalablement déterminé sur des documents radiographiques ou tomodensitométriques, voire de résonance magnétique, avec le bloc 30 de forme parallélépipédique disposant d'une première fente supérieure 40 dans laquelle peut s'immiscer une lame de scie Isc pour l'extrémité inférieure du fémur et de plusieurs secondes fentes inférieures 51-53 pour effectuer la coupe tibiale selon le niveau adéquat.  The present system makes it possible to perform the two sections linked, perpendicularly to the femorotibial axis previously determined on X-ray or CT documents, or even magnetic resonance, with the parallelepiped-shaped block 30 having a first upper slot 40 in which A saw blade Isc can be inserted for the lower end of the femur and several seconds lower slots 51-53 to perform the tibial cut according to the appropriate level.
Le bloc 30 comprend une rangée horizontale de plusieurs orifices 33-35, par exemple de 3mm de diamètre, matérialisant, par l'introduction de fiches 21 , 22, comme des tiges, l'interligne fémoro-tibial et réglant automatiquement la pente des coupes dans le plan sagittal. Certains orifices, donc aussi les fiches d'interligne qui sont destinées à coopérer avec eux, peuvent être de diamètre supérieur pour permettre de compenser une usure plus importante des condyles du genou.  The block 30 comprises a horizontal row of several orifices 33-35, for example 3mm in diameter, materializing, by the introduction of pins 21, 22, as rods, the femoral-tibial spacing and automatically adjusting the slope of the cuts. in the sagittal plane. Some orifices, so also interligne cards that are intended to cooperate with them, may be of greater diameter to compensate for greater wear of the knee condyles.
Compte tenu de ces éléments, il a été mis au point le système selon l'invention décrit ci-dessus qui constitue en outre un guide de coupe simplifié permettant de pratiquer en un seul temps les sections osseuses principales fémorale distale et tibiale proximale, et cela de façon coordonnée afin d'assurer l'équilibre ligamentaire du genou quand le genou est en position d'extension. In view of these elements, it has been developed the system according to the invention described above which further constitutes a simplified cutting guide for practicing in one step the main bone sections femoral distal and proximal tibial, and this in a coordinated manner to ensure the ligament balance of the knee when the knee is in the extended position.
Le bloc 30 est perforé, par exemple à ses angles, avec des broches 60 pour permettre la stabilisation des os et du système lors de la coupe des os qui généralement engendre des vibrations.  The block 30 is perforated, for example at its corners, with pins 60 to allow the stabilization of the bones and the system during the cutting of the bones which generally generates vibrations.
Le bloc 30 peut être réalisé dans un matériau métallique, mais avantageusement dans une matière résistante radio transparente afin de permettre des contrôles radioscopiques per opératoires pour vérifier le niveau et l'orientation des coupes avant leur réalisation.  The block 30 may be made of a metallic material, but advantageously in a transparent radio-resistant material in order to allow intraoperative radioscopic checks to check the level and orientation of the cuts before they are made.
La validation de l'orientation peut être effectuée sur le bloc lui-même qui comporte, selon une réalisation possible, une gouttière verticale dans laquelle peut être placée une tige 72 de dimensions adaptées et de longueur suffisante pour se projeter sur la crête tibiale et atteindre le niveau de la cheville.  The validation of the orientation can be carried out on the block itself which comprises, according to one possible embodiment, a vertical gutter in which can be placed a rod 72 of suitable dimensions and of sufficient length to project on the tibial crest and achieve the level of the ankle.
Dès lors, les coupes en question peuvent être réalisées en toute sécurité en réglant automatiquement leur épaisseur, leur orientation et leur niveau.  Therefore, the cuts in question can be made safely by automatically adjusting their thickness, orientation and level.

Claims

R E V E N D I C A T I O N S
1. Système d'aide à la réalisation de coupes fémorale (11) et tibiale (12) pour la pose d'une prothèse articulaire d'un genou (13) d'un être humain lorsque cette prothèse comporte une pièce fémorale et une pièce tibiale et lorsque le genou est en position dite "en extension", caractérisé par le fait qu'il comporte : 1. Support system for the realization of femoral (11) and tibial (12) cuts for the fitting of a joint prosthesis of a knee (13) of a human being when this prosthesis comprises a femoral component and a workpiece tibial and when the knee is in position called "in extension", characterized in that it comprises:
• au moins deux fiches d'interligne (21 , 22) aptes à être positionnées entre le fémur (Fe) et le tibia (Ti) avant la réalisation des coupes,  At least two spacing cards (21, 22) capable of being positioned between the femur (Fe) and the tibia (Ti) before the cutting is made,
· un bloc (30) d'une seule pièce, ledit bloc comprenant une face d'appui A block (30) in one piece, said block comprising a bearing face
(32) apte à être positionnée contre le fémur (Fe) et le tibia (Ti) au niveau de l'articulation du genou, ledit bloc (30) comportant : (32) adapted to be positioned against the femur (Fe) and the tibia (Ti) at the knee joint, said block (30) comprising:
* au moins deux orifices (33, 34, 35) le traversant et d'une section respectivement complémentaire de la section transversale des deux fiches d'interligne (21 , 22), les axes des dits orifices étant situés dans un même plan (36) sensiblement perpendiculaire à ladite face d'appui (32),  at least two orifices (33, 34, 35) passing therethrough and of a section respectively complementary to the cross section of the two interline cards (21, 22), the axes of said orifices being situated in the same plane (36 ) substantially perpendicular to said bearing face (32),
* au moins une première fente (40) le traversant et apte à guider une lame de scie (Isc), ladite première fente (40) étant réalisée dans ledit bloc (30) de façon que sa longueur soit sensiblement parallèle au dit plan (36) et de façon qu'elle soit à une distance déterminée du dit plan, et * At least one first slot (40) extending therethrough and adapted to guide a saw blade (Isc), said first slot (40) being formed in said block (30) so that its length is substantially parallel to said plane (36 ) and so that it is at a fixed distance from said plane, and
* une pluralité de secondes fentes (51 , 52, 53) le traversant, chaque seconde fente étant apte à guider une lame de scie (Isc), lesdites secondes fentes étant réalisées dans ledit bloc (30) de façon qu'elles soient toutes parallèles entre elles et que leurs longueurs soient sensiblement parallèles au dit plan (36), et de façon qu'elles soient situées dans la partie (55) du bloc (30) délimitée par ledit plan (36) qui ne contient pas la première fente (40).  a plurality of second slots (51, 52, 53) passing therethrough, each second slot being able to guide a saw blade (Isc), said second slots being made in said block (30) so that they are all parallel between them and that their lengths are substantially parallel to said plane (36), and so that they are located in the portion (55) of the block (30) delimited by said plane (36) which does not contain the first slot ( 40).
2. Système selon la revendication 1, caractérisé par le fait que, lesdites fiches d'interligne (21 , 22) ont des sections transversales différentes et que le bloc comporte plus de deux orifices traversants (33, 34, 35). 2. System according to claim 1, characterized in that said spacing cards (21, 22) have different cross sections and the block has more than two through holes (33, 34, 35).
3. Système selon l'une des revendications 1 et 2, caractérisé par le fait qu'il comprend en outre une pluralité de broches de positionnement (60) et que le bloc (30) comporte en outre une pluralité des percées traversantes (61, 62, 63), chacune de ces percées traversantes étant apte à recevoir une broche de positionnement pour fixer le bloc (30) au moins sur le fémur (Fe) ou sur le tibia (Ti). 3. System according to one of claims 1 and 2, characterized in that it further comprises a plurality of positioning pins (60) and the block (30) further comprises a plurality of through-holes (61, 62, 63), each of these through-holes being adapted to receive a positioning pin for fixing the block (30) at least on the femur (Fe) or on the tibia (Ti).
4. Système selon l'une des revendications précédentes, caractérisé par le fait qu'il comprend en outre des moyens de repère (70) réalisés sur le bloc (30) et définissant une direction rectiligne sensiblement perpendiculaire au dit plan (36). 4. System according to one of the preceding claims, characterized in that it further comprises reference means (70) made on the block (30) and defining a rectilinear direction substantially perpendicular to said plane (36).
5. Système selon la revendication 4, caractérisé par le fait que les moyens de repère (70) sont constitués par au moins l'un des éléments suivants : un trait (71) matérialisé sur la face (37) du bloc opposée à la face d'appui (32), une tige (72) enfichée dans le bloc (30) et dont au moins une extrémité émerge du dit bloc, une glissière montée en coopération avec le bloc (30), une tige télescopique enfichée dans ledit bloc. 5. System according to claim 4, characterized in that the marking means (70) consist of at least one of the following elements: a line (71) materialized on the face (37) of the block opposite the face support (32), a rod (72) plugged into the block (30) and at least one end emerges from said block, a slide mounted in cooperation with the block (30), a telescopic rod plugged into said block.
6. Système selon l'une des revendications précédentes, caractérisé par le fait que le bloc (30) est en matériau radio-transparent. 6. System according to one of the preceding claims, characterized in that the block (30) is made of radiolucent material.
7. Système selon la revendication 6, caractérisé par le fait que ledit matériau radio-transparent est choisi parmi les produits suivants : polyéthylène, résine. 7. System according to claim 6, characterized in that said radiolucent material is selected from the following products: polyethylene, resin.
8. Système selon l'une des revendications précédentes, caractérisé par le fait que lesdites fentes (40, 51 , 52, 53) ont toutes la même largeur. 8. System according to one of the preceding claims, characterized in that said slots (40, 51, 52, 53) all have the same width.
9. Système selon l'une des revendications précédentes, caractérisé par le fait que ledit bloc (10) présente la forme sensiblement d'un parallélépipède rectangle. 9. System according to one of the preceding claims, characterized in that said block (10) has the shape substantially of a rectangular parallelepiped.
PCT/FR2010/000781 2009-11-27 2010-11-25 System for assisting in creation of femoral and tibial cuts WO2011064473A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR0905699A FR2953120B1 (en) 2009-11-27 2009-11-27 SYSTEM FOR ASSISTING FEMORAL AND TIBIAL CUTS
FR0905699 2009-11-27

Publications (1)

Publication Number Publication Date
WO2011064473A1 true WO2011064473A1 (en) 2011-06-03

Family

ID=42083904

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/FR2010/000781 WO2011064473A1 (en) 2009-11-27 2010-11-25 System for assisting in creation of femoral and tibial cuts

Country Status (2)

Country Link
FR (1) FR2953120B1 (en)
WO (1) WO2011064473A1 (en)

Families Citing this family (30)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20160015426A1 (en) 2014-07-15 2016-01-21 Treace Medical Concepts, Inc. Bone positioning and cutting system and method
US9687250B2 (en) 2015-01-07 2017-06-27 Treace Medical Concepts, Inc. Bone cutting guide systems and methods
WO2016134154A1 (en) 2015-02-18 2016-08-25 Treace Medical Concepts, Inc. Pivotable bone cutting guide useful for bone realignment and compression techniques
US9622805B2 (en) 2015-08-14 2017-04-18 Treace Medical Concepts, Inc. Bone positioning and preparing guide systems and methods
US10849663B2 (en) 2015-07-14 2020-12-01 Treace Medical Concepts, Inc. Bone cutting guide systems and methods
CA2991424A1 (en) 2015-07-14 2017-01-19 Treace Medical Concepts, Inc. Bone positioning guide
CA2998727A1 (en) 2015-08-14 2017-02-23 Treace Medical Concepts, Inc. Tarsal-metatarsal joint procedure utilizing fulcrum
EP4494582A3 (en) 2015-08-14 2025-04-16 Treace Medical Concepts, Inc. Tarsal-metatarsal joint procedure utilizing fulcrum
CA2998481C (en) 2015-09-18 2024-05-14 Treace Medical Concepts, Inc. Joint spacer systems and methods
US10512470B1 (en) 2016-08-26 2019-12-24 Treace Medical Concepts, Inc. Osteotomy procedure for correcting bone misalignment
US10524808B1 (en) 2016-11-11 2020-01-07 Treace Medical Concepts, Inc. Devices and techniques for performing an osteotomy procedure on a first metatarsal to correct a bone misalignment
AU2019302676B2 (en) 2018-07-11 2025-03-06 Treace Medical Concepts, Inc. Compressor-distractor for angularly realigning bone portions
US11583323B2 (en) 2018-07-12 2023-02-21 Treace Medical Concepts, Inc. Multi-diameter bone pin for installing and aligning bone fixation plate while minimizing bone damage
US11607250B2 (en) 2019-02-13 2023-03-21 Treace Medical Concepts, Inc. Tarsal-metatarsal joint procedure utilizing compressor-distractor and instrument providing sliding surface
US11627954B2 (en) 2019-08-07 2023-04-18 Treace Medical Concepts, Inc. Bi-planar instrument for bone cutting and joint realignment procedure
US11889998B1 (en) 2019-09-12 2024-02-06 Treace Medical Concepts, Inc. Surgical pin positioning lock
US11890039B1 (en) 2019-09-13 2024-02-06 Treace Medical Concepts, Inc. Multi-diameter K-wire for orthopedic applications
US11986251B2 (en) 2019-09-13 2024-05-21 Treace Medical Concepts, Inc. Patient-specific osteotomy instrumentation
WO2021155269A1 (en) 2020-01-31 2021-08-05 Treace Medical Concepts, Inc. Metatarsophalangeal joint preparation and metatarsal realignment for fusion
WO2021236838A1 (en) 2020-05-19 2021-11-25 Treace Medical Concepts, Inc. Devices and techniques for treating metatarsus adductus
US12161371B2 (en) 2021-01-18 2024-12-10 Treace Medical Concepts, Inc. Contoured bone plate with locking screw for bone compression, particularly across a tarsometatarsal joint
US12310603B2 (en) 2021-02-18 2025-05-27 Treace Medical Concepts, Inc. System and technique for metatarsal realignment with reduced incision length
AU2022276540A1 (en) 2021-05-20 2023-11-30 Treace Medical Concepts, Inc. Cut guide with integrated joint realignment features
USD1079011S1 (en) 2022-02-23 2025-06-10 Treace Medical Concepts, Inc. Metatarsal cut guide with parallel cut faces
USD1051382S1 (en) 2022-02-23 2024-11-12 Treace Medical Concepts, Inc. Lesser metatarsal cut guide
USD1011524S1 (en) 2022-02-23 2024-01-16 Treace Medical Concepts, Inc. Compressor-distractor for the foot
USD1075012S1 (en) 2022-02-23 2025-05-13 Treace Medical Concepts, Inc. Metatarsal lateral release instrument
USD1057155S1 (en) 2022-02-23 2025-01-07 Treace Medical Concepts, Inc. Lesser metatarsal cut guide with parallel cut faces
USD1068078S1 (en) 2023-02-08 2025-03-25 Treace Medical Concepts, Inc. Handle for an orthopedic instrument
USD1068077S1 (en) 2023-02-08 2025-03-25 Treace Medical Concepts, Inc. Orthopedic rasp for preparing an intercuneiform joint

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050085920A1 (en) 2000-06-29 2005-04-21 Williamson Richard V. Instruments and methods for use in performing knee surgery
US20050149037A1 (en) 2003-12-26 2005-07-07 Steffensmeier Scott J. Adjustable cut block

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050085920A1 (en) 2000-06-29 2005-04-21 Williamson Richard V. Instruments and methods for use in performing knee surgery
US20050149037A1 (en) 2003-12-26 2005-07-07 Steffensmeier Scott J. Adjustable cut block

Also Published As

Publication number Publication date
FR2953120A1 (en) 2011-06-03
FR2953120B1 (en) 2012-01-20

Similar Documents

Publication Publication Date Title
WO2011064473A1 (en) System for assisting in creation of femoral and tibial cuts
EP1978894B1 (en) Surgical implant with extracortical support for a ligament transplant
FR3071400B1 (en) ANKLE PROSTHESIS COMPRISING A TALEN IMPLANT, A TIBIAL IMPLANT AND AN INSERT, KIT INCLUDING AT LEAST ONE SUCH PROSTHESIS, AND CUTTING GUIDE FOR THE PLACEMENT OF THE TIBIAL IMPLANT
EP1732448B1 (en) Ancillary assembly for implanting a knee prosthesis
EP1599140B1 (en) Knee distractor
EP2277460A1 (en) Surgical instrumentation for preparing the setting of a knee prosthesis
FR2727003A1 (en) Lumbar-sacral vertebrae anterior stabiliser
EP2589354A1 (en) Surgical instrument assembly for inserting an ankle prosthesis
FR2900814A1 (en) INTERSOMATIC CAGE MAY BE INTERCALE BETWEEN TWO CONSECUTIVE VERTEBRA, AND INSTRUMENT FOR IMPLANTING SUCH AN INTERSOMATIC CAGE BETWEEN TWO CONSECUTIVE VERTEBERS
FR2764183A1 (en) Surgical apparatus for correction of hallux valgus
FR2780636A1 (en) Modular knee prosthesis comprises lower femoral mounting plate and upper tibial plate for total knee prosthesis
EP0687448A1 (en) Femoral-patellar prosthesis and ancillary device for making a trochlear impression for receiving said prosthesis
FR2923155A1 (en) Intervertebral implant for immobilizing vertebrae, has door pivotally mounted on one end of wall, and opening formed on opposite side of implant with respect to connection unit for allowing passage of instrument through opening
WO2010023399A1 (en) Set of ancillaries for implanting a knee prosthesis
FR2635675A1 (en) Accessory instrumentation for implanting a total knee prosthesis and secondarily for axial correction osteotomies
FR2759900A1 (en) Ancillary instrument for fitting components of ankle joint prosthesis
EP1881792B1 (en) Implant for use with an osteotomy plate
WO2006117463A1 (en) Angurlarly adjustable tibial osteotomy case
FR2630639A1 (en) Partial knee prosthesis device
WO2015052431A1 (en) Implantable vertebral arthrodesis device for fusing two overlying and underlying vertebrae
FR2976176A1 (en) Total knee prosthesis, has femoral implant including two bent legs forming lower portion of prosthetic trochlea, where depth of trochlea is less than height of kneecap, and width of trochlea is greater than that of kneecap
FR3071147A1 (en) DEVICE FOR ASSEMBLING KNEE PROSTHESIS, DISTILING TOOL AND BALANCING LIGAMENTARY KNEE SYSTEM
FR2810227A1 (en) System for preparing femoral and tibial sections prior to fitting knee joint prosthesis comprises guide, template, impacter and trial condyle
FR3070257A1 (en) METHOD FOR MANUFACTURING A RANGE OF COMPONENTS OF TOTAL KNEE PROSTHESES, AND RANGE OF COMPONENTS OBTAINED THEREBY
FR2742651A1 (en) Prosthesis for knee joint

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 10801601

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: CONSTATATION DE LA PERTE D UN DROIT CONFORMEMENT A LA REGLE 112(1) CBE (OEB FORM 1205A EN DATE DU 01/10/2012)

122 Ep: pct application non-entry in european phase

Ref document number: 10801601

Country of ref document: EP

Kind code of ref document: A1