# US 8,540,717 B2 · System and method for joint resurface repair

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- Number: US 8,540,717 B2
- Document ID: US8540717B2
- Status: Granted
- Kind: B2
- Application number: 12/725,181
- Filed: 2010-03-16
- Published: 2010-08-12
- Granted: 2013-09-24
- Earliest claimed: 2000-05-01
- Assignees: Arthrosurface Incorporated
- Applicants: Steven J. Tallarida; Steven W. Ek
- Inventors: Steven J. Tallarida; Steven W. Ek
- Web page: https://patentgrep.com/patent/US8540717B2

## CPC

- A61B 17/1675: {for the knee}
- A61B 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)}
- A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material}
- A61B 17/1642: {for producing a curved bore}
- A61B 17/1764: {for the knee}
- A61B 17/8615: {at the central region of the screw head}
- A61B 17/888: {the driver bit acting on the central region of the screw head}
- A61B 90/06: {Measuring instruments not otherwise provided for}
- A61F 2/30756: {Cartilage endoprostheses (A61F2/3603 takes precedence)}
- A61F 2/30942: {for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques}
- A61F 2/3859: {Femoral components}
- A61F 2/4618: {of cartilage}
- A61F 2/4657: {Measuring instruments used for implanting artificial joints (for surgical instruments A61B90/06)}
- A61B 5/4528: {Joints (A61B5/4533, A61B5/4538 take precedence)}
- A61B 17/0487: {Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks (suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122)}
- A61B 17/06166: {Sutures (suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M)}
- A61B 17/1635: {for grafts, harvesting or transplants}
- A61B 17/1637: {Hollow drills or saws producing a curved cut, e.g. cylindrical (A61B10/025, A61B17/1695 take precedence)}
- A61B 17/7098: {wherein the implant is permeable or has openings, e.g. fenestrated screw (hollow surgical screws A61B17/864)}
- A61B 17/8625: {Shanks, i.e. parts contacting bone tissue}
- A61B 17/863: {with thread interrupted or changing its form along shank, other than constant taper}
- A61B 17/8695: {Washers (surrounding screw head in plate hole A61B17/8047, between bone plate and bone A61B17/8028)}
- A61B 17/8894: {holding the implant into or through which the screw is to be inserted (A61B17/7082, A61B17/7091 take precedence)}
- A61B 2017/00238: {Type of minimally invasive operation (A61B2017/00805 takes precedence)}
- A61B 2017/00464: {for use with different instruments}
- A61B 2017/0404: {Buttons}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/044: {with a threaded shaft, e.g. screws}
- A61B 2017/0445: {cannulated, e.g. with a longitudinal through-hole for passage of an instrument}
- A61B 2017/0448: {Additional elements on or within the anchor}
- A61B 2017/045: {snug fit within the anchor}
- A61B 2090/061: {for measuring dimensions, e.g. length}
- A61F 2/30767: {Special external or bone-contacting surface, e.g. coating for improving bone ingrowth}
- A61F 2/38: for elbows or knees
- A61F 2/4603: {for insertion or extraction of endoprosthetic joints or of accessories thereof}
- A61F 2002/30065: {thermoplastic, i.e. softening or fusing when heated, and hardening and becoming rigid again when cooled}
- A61F 2002/30069: {elastomeric}
- A61F 2002/30113: {circular}
- A61F 2002/30143: {hexagonal}
- A61F 2002/30225: {Flat cylinders, i.e. discs}
- A61F 2002/30299: {umbrella-shaped or mushroom-shaped}
- A61F 2002/30324: {differing in thickness}
- A61F 2002/30332: {Conically- or frustoconically-shaped protrusion and recess}
- A61F 2002/30354: {Cylindrically-shaped protrusion and recess, e.g. cylinder of circular basis}
- A61F 2002/30433: {using additional screws, bolts, dowels, rivets or washers e.g. connecting screws}
- A61F 2002/30448: {using adhesives}
- A61F 2002/30451: {soldered or brazed or welded}
- A61F 2002/30563: {having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers}
- A61F 2002/30604: {modular}
- A61F 2002/30719: {Means for cleaning prostheses}
- A61F 2002/30772: {Apertures or holes, e.g. of circular cross section}
- A61F 2002/30831: {perpendicular with respect to each other}
- A61F 2002/30858: {Threads interrupted by grooves or sidewalls, e.g. flat sidewalls}
- A61F 2002/30871: {Trapezoidal threads}
- A61F 2002/30873: {Threadings machined on non-cylindrical external surfaces}
- A61F 2002/30878: {with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts}
- A61F 2002/30879: {Ribs}
- A61F 2002/30892: {parallel}
- A61F 2002/30896: {perpendicular with respect to each other}
- A61F 2002/30943: {using mathematical models}
- A61F 2002/30948: {using computerized tomography, i.e. CT scans}
- A61F 2002/30952: {using CAD-CAM techniques or NC-techniques}
- A61F 2002/30957: {using a positive or a negative model, e.g. moulds}
- A61F 2002/4635: {using minimally invasive surgery}
- A61F 2002/4658: {for measuring dimensions, e.g. length}
- A61F 2002/4661: {for measuring thickness}
- A61F 2002/4662: {for measuring penetration depth}
- A61F 2002/4663: {for measuring volumes or other three-dimensional shapes}
- A61F 2002/4681: {by applying mechanical shocks, e.g. by hammering}
- A61F 2210/0071: thermoplastic
- A61F 2220/0033: made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
- A61F 2220/0041: using additional screws, bolts, dowels or rivets, e.g. connecting screws
- A61F 2220/005: using adhesives
- A61F 2220/0058: soldered or brazed or welded
- A61F 2230/0006: circular
- A61F 2230/0017: Angular shapes
- A61F 2230/0069: cylindrical
- A61F 2230/0093: Umbrella-shaped, e.g. mushroom-shaped
- A61F 2250/0036: differing in thickness
- A61F 2250/0092: Means for cleaning prostheses
- A61F 2310/00017: Iron- or Fe-based alloys, e.g. stainless steel
- A61F 2310/00023: Titanium or titanium-based alloys, e.g. Ti-Ni alloys
- A61F 2310/00029: Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
- A61F 2310/00059: Chromium or Cr-based alloys
- A61F 2310/00089: Zirconium or Zr-based alloys
- A61F 2310/00095: Niobium or Nb-based alloys
- A61F 2310/00203: containing alumina or aluminium oxide
- A61F 2310/00239: containing zirconia or zirconium oxide ZrO2
- A61F 2310/00796: Coating or prosthesis-covering structure made of a phosphorus-containing compound, e.g. hydroxy(l)apatite
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)

## Abstract

A system for repairing a defect on a patient's articular surface comprising a guide, a guide pin, a reamer, and an implant. The guide is configured to be disposed about the defect and includes a passageway configured to establish a reference axis extending generally outwardly from the articular surface. The guide pin is configured to be received through the guide passageway along the reference axis and into bone beneath the articular surface. The reamer comprises a cannulated shaft configured to be advanced over the guide pin along the reference axis and further comprises a cutting surface configured to be rotated about the guide pin to form an excision site. The implant comprises a bone facing surface configured to be received in the excision site and a load bearing surface having a contour approximating a contour of the patient's articular surface.

## Claims

### Claim 1

A system for repairing a defect on a patient's articular surface, said system comprising:
a guide configured to be disposed about said defect, said guide comprising a passageway configured to establish a reference axis extending generally outwardly from said articular surface proximate to said defect;
a guide pin configured to be received through said passageway of said guide along said reference axis and into bone beneath said articular surface;
a reamer comprising a cannulated shaft configured to be advanced over said guide pin along said reference axis, said reamer further comprising a cutting surface configured to be rotated about said guide pin to form an excision site; and
an implant comprising a bone facing surface configured to be received in said excision site and a load bearing surface having a contour approximating a contour of said patient's articular surface.

### Claim 2 (depends on 1)

The system of claim 1, wherein said reamer defines a generally circular excision path as said reamer is rotated about said guide pin to form a generally circular excision site.

### Claim 3 (depends on 2)

The system of claim 2, wherein said reamer includes a radius extending from said reference axis to a cutting surface, said radius corresponding to a diameter of the implant.

### Claim 4 (depends on 1)

The system of claim 1, further comprising a bone scoring instrument configured to create a matching fit between the bone surfaces of said implant site and said bone facing surface of the implant.

### Claim 5 (depends on 4)

The system of claim 4, wherein said bone scoring instrument comprises a cannulated handle configured to be advanced over said guide pin.

### Claim 6 (depends on 1)

The system of claim 1, wherein said guide comprises a biaxial guide comprising a cannulated shaft configured to receive said guide pin.

### Claim 7 (depends on 1)

The system of claim 1, wherein said guide comprises a gauge having predefined surfaces configured to be disposed against said articular surface.

### Claim 8 (depends on 7)

The system of claim 7, wherein said gauge further comprises a handling tab for holding said gauge.

### Claim 9 (depends on 8)

The system of claim 8, wherein said passageway extending through said guide is not coaxial with said handling tab.

### Claim 10 (depends on 7)

The system of claim 7, wherein guide has an oval cross-section.

### Claim 11 (depends on 7)

The system of claim 7, wherein guide has a circular cross-section.

### Claim 12 (depends on 7)

The system of claim 7, wherein said guide comprises a contact surface having a plurality of points to surround said defect.

### Claim 13 (depends on 7)

The system of claim 7, wherein said gauge comprises a plurality of cutaway areas.

### Claim 14 (depends on 12)

The system of claim 12, wherein said plurality of points lie in the same plane.

### Claim 15 (depends on 12)

The system of claim 12, wherein said plurality of points do not lie in the same plane.

### Claim 16 (depends on 1)

The system of claim 1, wherein said reference axis is normal to said articular surface.

### Claim 17 (depends on 1)

The system of claim 1, wherein said reference axis is non-normal to said articular surface.

### Claim 18 (depends on 1)

The system of claim 1, further comprising a measuring device configured to configured to measure at least one point on said patient's articular surface proximate to said defect, wherein said measurement corresponds to said contour of said load bearing surface of said implant.

### Claim 19 (depends on 18)

The system of claim 18, wherein said measuring device further comprises:
a cannulated shaft configured to be advanced over said guide pin; and
an outrigger extending generally radially outwardly, said outrigger configured to be rotated about said reference axis and to contact said articular surface at said at least one point on said articular surface;
wherein said measurement corresponds to an axial displacement of said outrigger with respect to a point of origin defined by said guide pin.

### Claim 20 (depends on 1)

The system of claim 1, wherein said system is configured to establish multiple reference axes extending outwardly from said articular surface.