# US 8,551,102 B2 · Joint arthroplasty devices and surgical tools

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- Number: US 8,551,102 B2
- Document ID: US8551102B2
- Status: Granted
- Kind: B2
- Application number: 13/625,702
- Filed: 2012-09-24
- Published: 2013-01-24
- Granted: 2013-10-08
- Earliest claimed: 2001-05-25
- Assignees: ConforMIS, Inc.
- Applicants: ConforMIS, Inc.
- Inventors: Wolfgang Fitz; Philipp Lang; Daniel Steines
- Web page: https://patentgrep.com/patent/US8551102B2

## CPC

- A61F 2/30942: {for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques}
- A61B 5/4528: {Joints (A61B5/4533, A61B5/4538 take precedence)}
- A61B 17/15: Guides therefor
- A61B 17/154: {for preparing bone for knee prosthesis}
- A61B 17/155: {Cutting femur}
- A61B 17/157: {Cutting tibia}
- A61B 17/158: {Cutting patella}
- A61B 17/16: Instruments for performing osteoclasis; Drills or chisels for bones; Trepans {(arthroscopic bone cutters A61B17/320016)}
- A61B 17/1666: {for the acetabulum}
- A61B 17/1668: {for the upper femur (A61B17/164 takes precedence)}
- A61B 17/1671: {for the spine}
- A61B 17/1675: {for the knee}
- A61B 17/1739: {specially adapted for particular parts of the body}
- A61B 17/1764: {for the knee}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61F 2/30756: {Cartilage endoprostheses (A61F2/3603 takes precedence)}
- A61F 2/30771: {applied in original prostheses, e.g. holes or grooves}
- A61F 2/36: Femoral heads {; Femoral endoprostheses}
- A61F 2/3859: {Femoral components}
- A61F 2/4657: {Measuring instruments used for implanting artificial joints (for surgical instruments A61B90/06)}
- B23Q 17/00: Arrangements for {observing,} indicating or measuring on machine tools (for automatic control or regulation of feed movement, cutting velocity or position of tool or work B23Q15/00)
- A61B 5/4504: {Bones (A61B5/4547 takes precedence)}
- A61B 5/4514: {Cartilage}
- A61B 6/508: {for non-human patients}
- A61B 17/7098: {wherein the implant is permeable or has openings, e.g. fenestrated screw (hollow surgical screws A61B17/864)}
- A61B 17/8805: {for introducing fluid filler into bone or extracting it (A61B17/7097, A61B17/8833 take precedence)}
- A61B 2034/102: {Modelling of surgical devices, implants or prosthesis}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/108: {Computer aided selection or customisation of medical implants or cutting guides}
- A61B 2034/256: {having a database of accessory information, e.g. including context sensitive help or scientific articles}
- 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 2002/30062: {(bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive}
- A61F 2002/30677: {Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body}
- A61F 2002/30787: {inclined obliquely with respect to each other}
- A61F 2002/30841: {Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes}
- A61F 2002/30894: {inclined obliquely with respect to each other}
- A61F 2002/3092: {having an open-celled or open-pored structure}
- A61F 2002/30948: {using computerized tomography, i.e. CT scans}
- A61F 2002/30957: {using a positive or a negative model, e.g. moulds}
- A61F 2002/30962: {using stereolithography}
- A61F 2002/3097: {using laser}
- A61F 2002/4631: {the prosthesis being specially adapted for being cemented}
- A61F 2210/0004: bioabsorbable
- A61F 2310/00011: Metals or alloys
- 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 2310/00047: Aluminium or Al-based alloys
- A61F 2310/00065: Manganese or Mn-based alloys
- A61F 2310/00071: Nickel or Ni-based alloys
- A61F 2310/00077: Copper or Cu-based alloys
- A61F 2310/00083: Zinc or Zn-based alloys
- A61F 2310/00107: Palladium or Pd-based alloys
- A61F 2310/00113: Silver or Ag-based alloys
- A61F 2310/00119: Tin or Sn-based alloys
- A61F 2310/00131: Tantalum or Ta-based alloys
- A61F 2310/00143: Iridium or Ir-based alloys
- A61F 2310/00149: Platinum or Pt-based alloys
- A61F 2310/00155: Gold or Au-based alloys
- A61F 2310/00293: containing a phosphorus-containing compound, e.g. apatite
- A61F 2310/00383: Gelatin
- A61F 2310/00395: Coating or prosthesis-covering structure made of metals or of alloys
- A61F 2310/00592: Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds
- B33Y 80/00: Products made by additive manufacturing
- Y10T 29/49: Method of mechanical manufacture
- Y10T 29/49764: with testing or indicating
- Y10T 29/49778: with aligning, guiding, or instruction
- 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)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- B23Q: DETAILS, COMPONENTS, OR ACCESSORIES FOR MACHINE TOOLS, e.g. ARRANGEMENTS FOR COPYING OR CONTROLLING (tools of the kind used in lathes or boring machines B23B27/00); MACHINE TOOLS IN GENERAL CHARACTERISED BY THE CONSTRUCTION OF PARTICULAR DETAILS OR COMPONENTS; COMBINATIONS OR ASSOCIATIONS OF METAL-WORKING MACHINES, NOT DIRECTED TO A PARTICULAR RESULT
- B33Y: ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- Y10T: TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION

## Abstract

Disclosed herein are methods, compositions and tools for repairing articular surfaces repair materials and for repairing an articular surface. The articular surface repairs are customizable or highly selectable by patient and geared toward providing optimal fit and function. The surgical tools are designed to be customizable or highly selectable by patient to increase the speed, accuracy and simplicity of performing total or partial arthroplasty.

## Claims

### Claim 1

A patient-specific surgical tool for use in surgically repairing a diseased or damaged joint of a patient, comprising:
a mold and a guide;
the mold including a patient-specific surface that approximates at least a portion of an articular surface of the joint, the patient-specific surface including shape information of subchondral bone of the joint and cartilage information associated with the articular surface of the joint, wherein the shape information is derived from electronic image data of the joint; and
the guide including an aperture sized to accommodate a cutting or drilling tool and defining a cutting or drilling path having a predetermined position and orientation relative to the patient-specific surface and extending through at least a portion of a tissue of the joint when the patient-specific surface is aligned with and placed against the corresponding portion of the articular surface of the joint.

### Claim 2 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is information of cartilage thickness associated with the joint.

### Claim 3 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is information of cartilage shape associated with the joint.

### Claim 4 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is a standard cartilage thickness associated with the joint.

### Claim 5 (depends on 2)

The patient specific surgical tool of claim 2, wherein the cartilage thickness is based on information about the patient.

### Claim 6 (depends on 2)

The patient specific surgical tool of claim 2, wherein the cartilage thickness varies along the patient-specific surface.

### Claim 7 (depends on 1)

The patient specific surgical tool of claim 1, wherein the articular surface of the joint is a surface of a femoral condyle of a knee joint of the patient and the patient-specific surface includes an anterior zone portion and a weight-bearing zone portion corresponding respectively to an anterior articular surface of the condyle and a central weight bearing surface of the condyle.

### Claim 8 (depends on 2)

The patient specific surgical tool of claim 2, wherein the articular surface of the joint is a surface of a femoral condyle of a knee joint of the patient and the patient-specific surface includes a posterior zone portion and a weight-bearing zone portion corresponding respectively to a posterior articular surface of the condyle and a central weight bearing surface of the condyle, and wherein the cartilage thickness is larger in the posterior portion than in the central weight bearing portion.

### Claim 9 (depends on 2)

The patient specific surgical tool of claim 2, wherein the articular surface of the joint is a surface of a femoral condyle of a knee joint of the patient and the patient-specific surface includes an anterior zone portion, a central weight-bearing zone portion, and a posterior zone portion corresponding respectively to an anterior articular surface of the condyle, a central weight bearing surface of the condyle, and a posterior articular surface of the condyle, and wherein the cartilage thickness is smaller in the central weight-bearing portion of the patient-specific surface than in the anterior or posterior portions of the patient specific surface.

### Claim 10 (depends on 2)

The patient specific surgical tool of claim 2, wherein the articular surface of the joint is a surface of a femoral condyle of a knee joint of the patient and the patient-specific surface includes an anterior zone portion and a weight-bearing zone portion corresponding respectively to an anterior articular surface of the condyle and a central weight bearing surface of the condyle, and wherein the cartilage thickness varies from the anterior zone portion to the central weight bearing zone portion of the patient-specific surface.

### Claim 11 (depends on 2)

The patient specific surgical tool of claim 2, wherein the articular surface of the joint is a surface of a femoral condyle of a knee joint of the patient and the patient-specific surface includes a posterior zone portion and a weight-bearing zone portion corresponding respectively to a posterior articular surface of the condyle and a central weight bearing surface of the condyle, and wherein the cartilage thickness varies from the posterior zone portion to central weight bearing zone portion of the patient-specific surface.

### Claim 12 (depends on 2)

The patient specific surgical tool of claim 2, wherein the articular surface of the joint is a surface of a femoral condyle of a knee joint of the patient and the patient-specific surface includes an anterior zone portion, a central weight-bearing zone portion, and a posterior zone portion corresponding respectively to an anterior articular surface of the condyle, a central weight bearing surface of the condyle, and a posterior articular surface of the condyle, and wherein the cartilage thickness varies from the anterior zone portion to the central weight-bearing zone portion of the patient-specific surface and from the central weight-bearing zone portion to the posterior zone portion of the patient-specific surface.

### Claim 13 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is thickness and/or shape information of articular cartilage of the joint of the patient.

### Claim 14 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is information characterizing diseased or damaged articular cartilage of the joint of the patient.

### Claim 15 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is information characterizing the curvature of articular cartilage of the joint of the patient.

### Claim 16 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is information characterizing articular cartilage of the joint of the patient in a weight-bearing position.

### Claim 17 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is information characterizing articular cartilage of the joint of the patient in a non-weight-bearing position.

### Claim 18 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is information characterizing articular cartilage of the joint of the patient in motion.

### Claim 19 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is information characterizing articular cartilage of the joint of the patient in a combination of a weight-bearing position and in motion.

### Claim 20 (depends on 1)

The patient specific surgical tool of claim 1, wherein the cartilage information is information characterizing articular cartilage of the joint of the patient in a combination of a weight-bearing position and a stationary position.

### Claim 21 (depends on 1)

The patient specific surgical tool of claim 1, wherein the joint is a knee joint and the patient-specific surface is a first patient specific surface corresponding to at least a portion of a medial condyle of the knee joint, and further including a second patient-specific surface corresponding to at least a portion of a lateral condyle of the knee joint.

### Claim 22 (depends on 1)

The patient specific surgical tool of claim 1, wherein the joint is a knee joint and the patient-specific surface corresponds to a tibial plateau of the knee joint.

### Claim 23 (depends on 21)

The patient specific surgical tool of claim 21, wherein the second patient-specific surface approximates an articular surface of the lateral condyle of the joint, the second patient-specific surface including shape information of subchondral bone of the lateral condyle and cartilage information associated with the lateral condyle.

### Claim 24 (depends on 23)

The patient specific surgical tool of claim 23, wherein the cartilage information of the first patient specific surface and the cartilage information of the second patient-specific surfaces includes cartilage thickness information of the medial and lateral respectively.

### Claim 25 (depends on 24)

The patient specific surgical tool of claim 24, wherein the cartilage thickness information of the medial condyle is different than the cartilage thickness information of the lateral condyle.

### Claim 26 (depends on 1)

The patient specific surgical tool of claim 1, wherein the position or orientation of the guide aperture is predetermined based on the cartilage information.

### Claim 27 (depends on 1)

The patient specific surgical tool of claim 1, wherein said cartilage information includes information about residual cartilage on the subchondral bone of the joint.

### Claim 28

A patient-specific surgical tool for use in surgically repairing a joint of a patient, comprising:
a block having a patient-specific surface and a guide;
the patient-specific surface having at least a portion that is substantially a negative of a corresponding portion of a diseased or damaged surface of the joint, wherein the patient specific surface includes information regarding cartilage thickness of the joint of the patient to estimate residual cartilage on the damaged or diseased surface of the joint, wherein the information is derived from electronic image data of the joint, and
the guide having a predetermined position and orientation relative to the corresponding portion, wherein the guide includes one or more apertures for drilling or cutting, the apertures having predetermined positions and orientations relative to the patient-specific surface and each having an axis that extends through a portion of the joint when the patient-specific surface is fit to the corresponding portion of the diseased of damaged articular surface of the joint.

### Claim 29

A patient-specific surgical tool for use in surgically repairing a diseased or damaged joint of a patient, comprising:
a mold and a guide;
the mold including a patient-specific surface that approximates an articular cartilage surface of the joint, the patient-specific surface including shape information of subchondral bone of the joint and an estimation of cartilage thickness based on information about the patient, wherein the shape information is derived from electronic image data of the joint; and
the guide including an aperture sized to accommodate a cutting or drilling tool and defining a cutting or drilling path having a predetermined position and orientation relative to the patient-specific surface and extending through at least a portion of the tissue of the joint when the patient-specific surface is aligned with and placed against a corresponding portion of the diseased or damaged articular surface of the joint.

### Claim 30

A patient-specific surgical tool for use in surgically repairing a diseased or damaged joint of a patient, comprising:
a mold and a guide;
the mold including a first patient-specific surface that approximates an articular cartilage surface of the joint, the patient-specific surface including shape information of subchondral bone of the joint and an estimation of cartilage thickness based on information about the patient, wherein the shape information is derived from electronic image data of the joint, and further including a second patient specific surface that substantially conforms to a corresponding surface portion of the joint of the patient; and
the guide including an aperture sized to accommodate a cutting or drilling tool and defining a cutting or drilling path having a predetermined position and orientation relative to the first and second patient-specific surfaces and extending through at least a portion of the tissue of the joint when the first and second patient-specific surfaces are aligned with and placed against corresponding portions of the surface of the joint.