Instrumentation for long stem surgery

A cutting instrumentation system for use in preparing a patient's bone tissue at the patient's knee joint area for a knee prosthesis, and wherein the bone tissue has a proximal bone tissue surface that is generally transverse to the patient's intramedullary canal, comprising;

• a) a plurality of elongated rotary reamers, each having an upper proximal end portion and a lower distal end portion having a rotary cutting element thereon, wherein each respective reamer has a rotary cutting element of a progressively larger cutting diameter for reaming the patient's intramedullary canal;
• b) an instrumentation assembly having means thereon for supporting the assembly during use upon a selected reamer at its upper end portion and in a position externally of the patient's intramedullary canal so that the instrumentation assembly is referenced upon the reamer;
• c) adjustable referencing member means on the instrumentation assembly for adjustably fixing the angle of the cutting block relative to the reamer, said referencing means means including an opening that closely fits the reamer;
• d) the instrumentation assembly surrounding the reamer during use and providing a surface portion that closely fits the patient's proximal bone tissue surface at the knee joint area;
• and
• e) the instrumentation assembly including a cutting block having a cutting guide surface thereon for referencing a cutting blade so that selected bone tissue cuts can be made adjacent the knee joint area of the patient.

A cutting instrumentation apparatus for use in preparing bone tissue at one end of a patient's leg bone at the patient's knee joint area for receiving a knee prosthesis, and wherein the leg bone has and end portion that is generally transverse to the patient's intramedullary canal, comprising:

• a) referencing means that includes at least in part a plurality of reamers of progressively larger diameter, each with a longitudinal axis for tracking and referencing the patient's intramedullary canal by forming a reamed opening in the intramedullary canal of the patient's long bone;
• b) cutting instrumentation means that fits the reamed opening to reference the instrumentation assembly to the reamed opening, the instrumentation means including a cutting block that has cutting guide surfaces thereon, at least one of the surfaces being generally perpendicular to the patient's mechanical axis;
• c) the cutting guide surfaces being positioned to guide surgical cuts of the long bone end portion with at least an anterior cut;
• and
• d) a prosthesis having a stem that fits the reamed opening.

A cutting instrumentation apparatus for use in preparing bone tissue at one end of a patient's leg bone at the patient's knee joint area for receiving a knee prosthesis, and wherein the leg bone has and end portion that is generally transverse to the patient's intramedullary canal, comprising:

• a) referencing means that includes at least in part a plurality of reamers of progressively larger diameter, each with a longitudinal axis for tracking and referencing the patient's intramedullary canal, each of the reamers being sized and shaped to form a reamed opening in the intramedullary canal of the patient's long bone;
• b) cutting instrumentation means that fits the reamed opening during a cutting of the patient's bone tissue for referencing cuts to the reamed opening;
• c) the instrumentation means including a cutting block that has cutting guide surfaces thereon;
• d) at least one of the surfaces being generally perpendicular to the patient's mechanical axis;
• and
• e) the cutting guide surfaces being positioned to guide surgical cuts of the long bone end portion with at least anterior and posterior cuts.

A method of shaping a patients long bone tissue at the knee joint area comprising the steps of:

• a) reaming the intramedullary canal with a plurality of progressively larger diameter elongated reamers to form a reamed opening that defines a reference position;
• b) inserting a guide member in the reamed opening so that the position of the guide member closely fits the reamed opening;
• c) attaching a cutting block with cutting guide surfaces thereon to the guide member so that the cutting guide surfaces have a position that is of known orientation relative to the guide member and reamed opening;
• d) cutting the long bone tissue at the knee joint area using cutting instruments that are aligned during cutting by the guide surfaces;
• e) wherein in step "d" each of the cuts is of a known orientation relative to the reamed opening.