Modified bone plate for tibial osteotomy

Abstract

The invention pertains to a bone plate (10) designed for tibial Osteotomy, offering enhanced correction capabilities for genu varus deformity of the knee joint. The bone plate comprises an upper portion (12), a middle portion (14), and a lower portion (16), each equipped with a plurality of holes for secure attachment to the tibia at various locations. The middle portion (14) is pivotal in achieving correction at the osteotomy site, utilizing blocks (22) with threaded holes for fixation via locking screws (24) to achieve a valgus overcorrection of 2 to 6 degrees. The bone plate features three locking holes (18) in the upper portion and locking holes (20) with diameters less than 5 mm in the middle portion.

Description

[0001] TITLE OF THE INVENTION

[0002] MODIFIED BONE PLATE FOR TIBIAL OSTEOTOMY

[0003] FIELD OF INVENTION

[0004] This invention discloses relates to a new type of bone plate designed for realignment of the tibia, specifically for correcting a bowlegged condition (genu varus) in the knee joint with blocks.

[0005] BACKGROUND OF THE INVENTION

[0006] Genu varus, commonly known as bowleggedness, presents with inward angulation of the tibia relative to the femur, causing outward knee alignment (tibiofemoral malalignment).

[0007] Ideal tibiofemoral alignment is 180 degrees. Minor deviations may be asymptomatic for years. Untreated varus knee can lead to: Joint pain, particularly during weight-bearing activities (walking); Uneven cartilage wear and tear in the knee, progressing to osteoarthritis.

[0008] Osteoarthritis Progression: Early osteoarthritis presents mild symptoms. Advanced stages (stage 3 / 4) may necessitate surgery. Progressive cartilage damage and narrowing of the joint space are evident on X-rays in later stages. Symptoms include pain, discomfort during daily activities (walking, kneeling), and early joint inflammation.

[0009] Further cartilage degradation leads to crepitus (grinding) during knee movement. Bone thickening (osteophytes) and synovial inflammation occur, potentially leading to joint effusion (fluid buildup). US10709457B2 discloses A cutting block for use in a bone osteotomy procedure is disclosed, and includes a first cutting guide surface, a second cutting guide surface, and a third cutting guide surface. The first, second, and third cutting guide surfaces are adapted to be temporarily affixed to a bone having a first side and a second side such that the first cutting guide surface is disposed on the first side of the bone, and such that the second cutting guide surface and third cutting guide surface are disposed on the second side of the bone forming an angle therebetween.

[0010] RU2340296C2 discloses device contains the case and carving bars with the hinge, thus the last have bracing possibility in Ilizarov apparatus support. The case has excision possibility. The device also has an oseotome, fixing perosseous elements, sliding bars with a through cut for placing of carving bars and lock screws for an oseotome, fixing perosseous elements, sliding bars and carving bars with the hinge. The case is executed in the form of a guide-arch with a through cut for an oseotome and with the through apertures placed in parallel to the cut for introduction of fixing elements. The grooves for sliding bars are created on the guide-arch extremities.

[0011] US8353914B2 discloses Alignment guides, cutting guides, cutting tools and soft tissue management techniques for profile-based resection (PBR) arthroplasty facilitate intraoperative and postoperative efficacy and ease of use. In one embodiment, a manual alignment guide is provided that permits less invasive incisions by providing soft tissue accommodating contours or reliefs. In another embodiment, a single medial drill guide plate is used for the PBR arthroplasty.

[0012] High Tibial Osteotomy (HTO) is a surgical procedure for realigning the knee joint in knee arthritis patients. It aims to delay or prevent the need for knee replacements by preserving damaged joint tissue. The procedure involves: Determining the desired correction angle. Making an oblique incision on the lateral upper tibia, creating a wedge-shaped opening of 45°. Realigning the lower tibia by opening the wedge and securing it with an L-shaped bracket screwed into the tibia.

[0013] Requires shortening of the tibia and fibula, potentially leading to ankle pain. Additional incisions might be needed due to difficulty in precise bone removal estimation.

[0014] Hybrid HTO combines benefits of open wedge techniques. While suitable for advanced osteoarthritis, it's a complex procedure with a dedicated bone plate. None of the prior art indicate above either alone or in combination with one another disclose what the present invention has disclosed. The present invention addresses the need for a bone plate optimized for the corrected tibial anatomy resulting from hybrid HTO with different size of metal block to maintain osteotomy gap and it helps in weight bearing.

[0015] SUMMARY OF THE INVENTION

[0016] This summary is provided to introduce a selection of concepts, in a simplified format, that are further described in the detailed description of the invention.

[0017] This summary is neither intended to identify key or essential inventive concepts of the invention and nor is it intended for determining the scope of the invention.

[0018] Present invention describes a novel bone plate designed to address the challenges of treating Genu varus (bowleggedness) in the knee joint, particularly in patients with advanced osteoarthritis grade 3. Unlike traditional bone plates used in High Tibial Osteotomy (HTO) procedures, this invention offers several advantages.

[0019] Firstly, the plate features separate upper and lower sections that secure to the tibia, with a central portion specifically designed to attach to the bone at the osteotomy site. This central section utilizes biocompatible blocks that come in various widths. These customizable blocks cater to the unique gap created during the osteotomy procedure, which can vary depending on the severity of the patient's condition.

[0020] Secondly, the bone plate boasts versatility. Unlike existing solutions that might require specific plates for different degrees of deformity, this single, "universal" plate can be adapted to various scenarios. By utilizing the different sized biocompatible blocks, surgeons can address a wider range of patient needs, including those with varying degrees of bowleggedness and osteotomy gap widths. This adaptability simplifies surgical procedures and potentially reduces the need for additional specialized equipment.

[0021] Overall, this modified bone plate with its customizable block system offers a more adaptable and potentially more efficient solution for correcting Genu varus deformity in patients with advanced knee osteoarthritis, the blocks are fitted in the same angle as osteotomy done.

[0022] To further clarify advantages and features of the present invention, a more particular description of the invention will be rendered by reference to specific embodiments thereof, which is illustrated in the appended drawings. It is appreciated that these drawings depict only typical embodiments of the invention and are therefore not to be considered limiting of its scope. The invention will be described and explained with additional specificity and detail with the accompanying drawings.

[0023] BRIEF DESCRIPTION OF THE DRAWINGS

[0024] The foregoing detailed description of embodiments is better understood when read in conjunction with the appended drawings. For the purpose of illustrating of the present subject matter, an example of construction of the present subject matter is provided as figures; however, the invention is not limited to the specific method and system disclosed in the document and the figures. The present subject matter is described in detail with reference to the accompanying figures. In the figures, the left-most digit(s) of a reference number identifies the figure in which the reference number first appears. The same numbers are used throughout the drawings to refer various features of the present subject matter.

[0025] Fig. 1 is a perspective view of a modified bone plate according to one embodiment of the present invention.

[0026] Fig. 2 is a side view of a modified bone plate illustrated in Fig. 1.

[0027] Fig. 3 is Back view of the modified bone plate illustrated in Fig. 1.

[0028] Figure 3 is Front view of the modified bone plate illustrated in Fig. 1.

[0029] DETAILED DESCRIPTION

[0030] The detailed description of various exemplary embodiments of the disclosure is described herein with reference to the accompanying drawings. It should be noted that the embodiments are described herein in such details as to clearly communicate the disclosure. However, the amount of details provided herein is not intended to limit the anticipated variations of embodiments; on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the scope of the present disclosure as defined by the appended claims.

[0031] It is also to be understood that various arrangements may be devised that, although not explicitly described or shown herein, embody the principles of the present disclosure. Moreover, all statements herein reciting principles, aspects, and embodiments of the present disclosure, as well as specific examples, are intended to encompass equivalents thereof. The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of example embodiments. As used herein, the singular forms “a",” “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises,” “comprising,” “includes” and / or “including,” when used herein, specify the presence of stated features, integers, steps, operations, elements and / or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components and / or groups thereof.

[0032] It should also be noted that in some alternative implementations, the functions / acts noted may occur out of the order noted in the figures. For example, two figures shown in succession may, in fact, be executed concurrently or may sometimes be executed in the reverse order, depending upon the functionality / acts involved.

[0033] In addition, the descriptions of "first", "second", “third”, and the like in the present invention are used for the purpose of description only, and are not to be construed as indicating or implying their relative importance or implicitly indicating the number of technical features indicated. Thus, features defining "first" and "second" may include at least one of the features, either explicitly or implicitly.

[0034] Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which example embodiments belong. It will be further understood that terms, e.g., those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein. The modified bone plate designed for correcting genu varus deformity of the knee joint consists of three main portions interconnected to address specific requirements of the surgical procedure. The upper portion features a series of locking holes, typically three, enabling fixation to the upper part of the tibia post-osteotomy. This upper fixation is crucial for stability and alignment. The middle portion of the plate contains holes to secure it to the tibia at the osteotomy site, where blocks of various widths, depending on the gap required for correction, are utilized. The Blocks are of 6 sizes. If starting size Block is placed Horizontally it gives 8 mm opening & when placed Vertically it corrects 10 mm of Osteotomy which maintains the Osteotomy size & gives support in weight bearing. The same way the Osteotomy size up to 20 mm can be corrected for high degree of Genu Varus (Bow Leg) with Weight bearing with different sized blocks. These blocks have threaded holes on one face to accommodate locking screws, ensuring secure attachment of the plate during the healing process. Additionally, the lower portion of the plate includes holes for securing it to the tibia below the osteotomy site, providing further support and stability. The entire assembly, including the plate, blocks, locking screws, and other securing screws, is constructed from biocompatible materials such as titanium alloy, cobalt chromium alloy, or stainless steel (316 L), ensuring compatibility with the body's tissues and minimizing the risk of adverse reactions. The interconnected design of the bone plate facilitates precise correction of the deformity while promoting proper healing and functional recovery of the knee joint.

[0035] This embodiment of the invention introduces a novel bone plate (10), specifically a locking compression plate, designed to address Genu varus deformity in the knee joint. This plate offers several improvements over traditional options. Firstly, the plate features a unique three-part design: an upper portion (12), a middle portion (14), and a lower portion (16). Each section is specifically intended for secure attachment to the tibia, with details on their fixation methods provided later in the document.

[0036] Secondly, the plate boasts a curved profile (10) that closely resembles the three-dimensional shape of the tibia. This contoured design offers a significant advantage by conforming more naturally to the bone's anatomy. This improved fit can potentially enhance stability and potentially lead to a more successful surgical outcome. Further, the plate 10 may be installed temporarily in young patients and permanently in older patients. The proximal tibial osteotomy is an accepted and commonly used treatment for younger and active patients with medial unit compartmental osteoarthritis of the knee and varus deformity. The aim is to achieve 2 to 6 degrees of valgus over correction and to achieve good long-term outcomes.

[0037] High Tibial Osteotomy (HTO) aims to realign the leg by shifting the mechanical axis from the medial side (inside) to a slightly lateral position (outside) of the knee joint. This reduces pressure on the damaged joint surfaces, potentially delaying the progression of osteoarthritis. Present invention discloses a novel bone plate (10) designed to address Genu varus deformity (bowleggedness) in the knee joint, particularly during High Tibial Osteotomy (HTO) procedures for advanced osteoarthritis. This innovative plate offers several advancements over traditional solutions.

[0038] In another embodiment, the plate features a three-part design, each section specifically tailored for optimal fixation to the tibia. The upper portion (12) boasts a T-shaped configuration, providing a robust anchor for the upper tibia after osteotomy. This section includes a "first plurality of locking holes" (18) that accommodate screws of varying sizes (based on the upper tibial contour). This customizable screw selection ensures a more secure and individualized fit, potentially improving stability and potentially reducing the risk of implant loosening.

[0039] In further embodiment, the middle portion (14) plays a pivotal role in correcting the deformity at the osteotomy site. This section integrates a "second plurality of holes" (20) that facilitate secure attachment of the plate to the tibia. Notably, a dedicated block (22) with threaded holes on one face plays a key role in gap correction. This block attaches to the plate using "locking screws" (24). The ingenious aspect lies in the availability of the block in various predetermined widths (e.g., 5mm x 6mm, 6mm x 8mm, etc.). This allows surgeons to select the most appropriate block size based on the unique gap created during the osteotomy procedure. This degree of adjustability caters to a wider range of patient anatomies and potentially simplifies surgical planning. The hole above the block hole, the plate (10) has a 45-degree angled hole which fixes the proximal part of tibia and gives the support to bear weight as beam in the column since the plate works as a column.

[0040] The lower portion (16) of the plate features a "third plurality of holes" (26). These holes, with consistent threading, facilitate firm fixation of the plate to the lower tibia using screws. This three- point fixation strategy (upper, middle, and lower) aims to provide a robust and stable construct essential for successful bone healing and deformity correction.

[0041] The screws employed in this system are specifically designed to withstand vertical loads, minimizing the risk of screw breakage. Additionally, the screw diameters are deliberately chosen to be smaller, aiming to minimize potential adverse effects caused by screw holes in the cancellous bone (spongy bone) of the tibia. This focus on minimizing bone disruption during screw placement and removal can contribute to a faster and potentially less complicated recovery process. The plate 10, the block 22, the locking screws 24 and the screws to secure the upper portion 12 and the lower portion 16 of the plate 10 with the tibia are formed of a biocompatible material so as to impart a relatively high safety to the human body. The material can be, including but not limited to, titanium alloy, cobalt chromium alloy or stainless steel (316 L).

[0042] Furthermore, the length of the plate 10 in longitudinal direction may range from 80 mm to 120 mm depending on the degree of correction required and the length of tibia which in turn can be attributed to different built-up of the human body. In other words, the bone plate 10 is universal in nature as it can be used with blocks of varying sizes for correcting Genu varus in osteoarthritis in all types of patients with different degrees of deformities and different width of Osteotomy.

[0043] According to one embodiment of the present invention, the upper portion 12 of the plate 10 is set at an offset amount ranging from 10 mm to 20 mm relative to the middle portion 14 and the lower portion 16 of the plate 10. This will ensure that the plate 10 follows the contour of the tibia and the fitting is proper and firm.

[0044] Therefore, with the plate fixation, the weight bearing will be early and there will be full correction of deformity. If total knee replacement is needed in future then the mechanical axis of joint will be same as needed.

[0045] The bone plate (10), block (22), locking screws (24), and screws used for fixation (upper and lower portions) are all crafted from biocompatible materials. This material selection prioritizes patient safety by minimizing the risk of adverse reactions within the human body. Common materials employed include titanium alloy, cobalt chromium alloy, or 316L stainless steel.

[0046] The plate boasts a "universal" design, adaptable to a wide range of patients with varying degrees of Genu varus deformity. This adaptability stems from two key features: • Adjustable Plate Length: The plate's longitudinal length can be tailored from 80mm to 120mm. This adjustability allows surgeons to select the optimal size based on the severity of the correction needed and the patient's individual tibial bone length, which can vary depending on body size.

[0047] • Customizable Block System: As previously mentioned, the block (22) comes in various predetermined widths. This allows surgeons to address the unique gap created during osteotomy for each patient.

[0048] Technical Advancement and Best Method of working:

[0049] In this embodiment, the upper portion (12) of the plate is strategically offset by 10mm to 20mm relative to the middle and lower portions (14 and 16). This offset design serves two purposes:

[0050] The offset mimics the natural curvature of the tibia, promoting a more secure and comfortable fit of the plate to the bone. This potentially reduces the risk of implant loosening or migration.

[0051] The improved fit potentially allows for earlier weight-bearing post-surgery, which can contribute to a faster recovery process.

[0052] The new bone plate (Fig. 1) utilizes a block (22) with various width options (to accommodate the gap created during osteotomy) that attaches to the middle portion via screws (24). This enables surgeons to customize the correction based on the individual patient's needs. The bone plate in the image likely doesn't have this adjustable gap correction feature. It may require using a bone graft of a specific size or performing additional bone trimming procedures.

[0053] The present invention describes the screws used with the new bone plate (Fig. 1) as specifically designed to absorb vertical load, minimize breakage, and have a small diameter for reduced bone disruption. The offset upper portion (12) mentioned in the present invention could further enhance the new plate's fit to the tibia's curvature. The length of the new bone plate (Fig. 1) is adjusted (80mm to 120mm) to accommodate different tibial bone lengths. It's difficult to determine the adjustability of the older bone plate.

[0054] Overall, the new bone plate (Fig. 1) in the patent appears to offer a more modular design with adjustable gap correction and potentially improved screw design, potentially leading to a more customized fit, improved stability, and potentially faster healing for the patient. However, for a more definitive comparison, more information about the older bone plate's design and functionalities would be necessary.

[0055] Advantages of the Invention Enhanced Correction Capabilities: The bone plate's innovative design, particularly the middle portion featuring blocks with adjustable width options, allows for precise customization of correction. This enables surgeons to address individual patient needs effectively, leading to improved alignment and functional outcomes post-surgery. Optimal Stability: The bone plate's secure attachment to the tibia at various locations, facilitated by the upper, middle, and lower portions equipped with locking holes, ensures optimal stability during the healing process. This stability is crucial for promoting proper bone fusion and minimizing the risk of complications. Valgus Overcorrection: The ability to achieve a valgus overcorrection of 2 to 6 degrees using the locking screws and blocks at the osteotomy site can lead to better long-term outcomes. This intentional overcorrection helps compensate for potential postoperative changes and ensures optimal alignment of the knee joint over time. Minimized Bone Disruption: The bone plate's design, including locking holes with diameters less than 5 mm and blocks with threaded holes for attachment, minimizes bone disruption during surgery. This reduces the risk of damage to surrounding tissues and facilitates smoother recovery for the patient. Versatility and Adaptability: The bone plate's adjustable width options ranging from 5mm to 12mm accommodate variations in the gap present at the osteotomy site. This versatility allows for use in a wide range of patients with different anatomies and degrees of deformity, enhancing its applicability in clinical practice.

[0056] These and other advantages of the present subject matter would be described in greater detail with reference to the following figures. It should be noted that the description merely illustrates the principles of the present subject matter. It will thus be appreciated that those skilled in the art will be able to devise various arrangements that, although not explicitly described herein, embody the principles of the present subject matter and are included within its scope.

Claims

We Claim:1 . A bone plate (10) for tibial Osteotomy, comprising: an upper portion (12) featuring a first plurality of locking holes (18) for fixing the bone plate (10) to the upper part of the tibia post-osteotomy; a middle portion (14) equipped with a second plurality of holes (20) for securing the bone plate (10) to the tibia at the osteotomy site; a lower portion (16) containing a third plurality of holes (26) for securing the bone plate (10) to the tibia below the osteotomy site; wherein the middle portion (14) of the bone plate (10) is secured to the tibia at the osteotomy site by utilizing a block (22) with a locking screw (24) to achieve a valgus over correction of 2 to 6 degrees; wherein the first plurality of locking holes (18) comprises three holes; and the second plurality of locking holes (20) has a diameter less than 5 mm; wherein the bone plate (10), blocks (22), locking screws (24), and screws for securing the upper portion (12), middle portion (14), and lower portion (16) of the bone plate (10) to the tibia are formed of a biocompatible material selected from the group consisting of titanium alloy, cobalt chromium alloy, and stainless steel (316 L); characterized in that each block (22) comprises a threaded hole on one face for attachment to the bone plate (10) using the locking screw (24); and said blocks (22) also having a predetermined width for securing the bone plate ranging from 5mm to 12mm, the selection dependent on the gap present at the osteotomy site; wherein the plate (10) is having a 45-degree angled hole which fixes the proximal part of tibia and gives the support to bear weight as beam in the column since the plate works as a column.

2. The bone plate as claimed in claim 1 , wherein a bone plate (10) featuring a middle portion (14) with a plurality of holes (20) for securing the bone plate (10) to a tibia at an osteotomy site; and a block (22) with adjustable width options, attached to the middle portion (14) via screws (24), facilitating customization of correction based on individual patient needs.

3. The bone plate as claimed in claim 1 , wherein the adjustable width options of the block (22) accommodate the gap created during osteotomy, enabling precise correction without the need for additional bone grafts or trimming procedures.

4. The bone plate as claimed in claim 1 , wherein bone plate (10) featuring screws specifically designed to absorb vertical load, minimize breakage, and possess a small diameter to reduce bone disruption; and the screws ensure secure fixation of the bone plate (10) to the tibia while minimizing adverse effects on the bone.

5. The bone plate as claimed in claim 1 , wherein the upper portion (12) of the bone plate (10) offset relative to the middle portion (14), enhancing the fit of the bone plate (10) to the curvature of the tibia.

6. The bone plate as claimed in claim 1 , wherein the length of the bone plate (10) is adjustable (ranging from 80mm to 120mm) to accommodate different tibial bone lengths, providing versatility in surgical applications.

7. The bone plate as claimed in claim 1 , wherein the upper portion (12) boasts a T- shaped 5 configuration, providing a robust anchor for the upper tibia after osteotomy; and this section includes a "first plurality of locking holes" (18) that accommodate screws of varying sizes (based on the upper tibial contour).

8. The bone plate as claimed in claim 1 , wherein the middle portion (14) integrates a "second plurality of holes" (20) that facilitate secure attachment of the plate to the tibia; and a dedicated block (22) with threaded holes on one face plays a key role in gap correction; wherein the block attaches to the plate using "locking screws" (24); wherein the availability of the block in various predetermined widths (5mm x 6mm, 6mm x 8mm,), allows surgeons to select the most appropriate block size based on the unique gap created during the osteotomy procedure.

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