Instrumentation for preparing an ankle joint and methods of using the same

Abstract

The present disclosure relates to an instrumentation system for implanting an ankle prosthesis. In various embodiments, the system includes a cutting assembly including a reaming tool for preparing a cavity within an intramedullary canal of a patient. In further embodiments, the system includes a guide block configured to fasten to a tibia of the patient and couple to the cutting assembly, the tibia having a proximal end and a distal end, wherein the guide block includes one or more alignment guides for guiding the cutting assembly to the intramedullary canal on the distal end for preparing the cavity without affecting a calcaneus or the proximal end of the tibia. In some embodiments, the system includes a distractor for separating the distal tibia from a talus to facilitate preparing the cavity and inserting an ankle prosthesis into the cavity.

Description

INSTRUMENTATION FOR PREPARING AN ANKLE JOINT AND METHODS OFUSING THE SAMECROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to and the benefit of U.S. Provisional Patent Application No. 63 / 552,491, filed on February 12, 2024, which is hereby incorporated by reference in its entirety.FIELD

[0002] This disclosure relates to a device, system, and method for instrumentation for implanting an ankle prosthesis. More specifically, this disclosure relates to a device, system, and method for preparing a cavity within an intramedullary canal within the tibia of a patient without affecting the calcaneus or the proximal end of the tibia in the patient.SUMMARY

[0003] In one aspect, an instrument system for implanting an ankle prosthesis is provided. The instrument system includes a cutting assembly including a reaming tool for preparing a cavity within an intramedullary canal of a patient, a guide block configured to fasten to a tibia of the patient and couple to the cutting assembly, the tibia having a proximal end and a distal end, wherein the guide block includes one or more alignment guides for guiding the cutting assembly to the intramedullary canal on the distal end for preparing the cavity without affecting a calcaneus or the proximal end of the tibia, and a distractor for separating the distal end from a talus to facilitate preparing the cavity and inserting an ankle prosthesis into the cavity, wherein the cutting assembly is configured to articulate in a sagittal or coronal plane and the reaming tool is configured to rotate in a transverse plane, and wherein motion of the cutting assembly in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane. In some aspects, the motion of the cutting assembly in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane using a worm gear assembly. In some aspects, the motion of the cutting assembly and the distractor in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane using a hole and peg configuration. In some aspects, a depth of the cavity is manually controlled using the distractor. In some aspects, the guide block further comprises one or more depth pins for controlling a depth of the cavity. In some aspects, one or more dimensions of the one or more depth pins are selected based on an anatomy of the patient. In some aspects, one or moredimensions of the one or more depth pins are selected based on dimensions of the guide block and the dimensions of the tibia and the talus. In some aspects, one or more dimensions of the one or more depth pins are selected without consideration of the one or more dimensions of the calcaneus or the proximal end. In some aspects, the instrument system also includes a driving attachment configured to connect the reaming tool with a power tool. In some aspects, the instrument system is used to implant an ankle prosthesis.

[0004] In another aspect, a system for implanting an ankle prosthesis is provided. The system includes an ankle prosthesis, an instrument assembly for implanting the ankle prosthesis, and a power tool. The instrument assembly includes a cutting assembly comprising a reaming tool for preparing a cavity within an intramedullary canal of a patient, a guide block configured to fasten to a tibia of the patient and couple to the cutting assembly, and a distractor for separating the distal end from a talus to facilitate preparing the cavity and inserting an ankle prosthesis into the cavity. The power tool is configured for attachment to the reaming tool, and the cutting assembly is configured to articulate in a sagittal or coronal plane and the reaming tool is configured to rotate in a transverse plane, where motion of the cutting assembly in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane. In some aspects, the guide block comprises one or more alignment guides for guiding the cutting assembly to the intramedullary canal on the distal end for preparing the cavity without affecting a calcaneus or the proximal end of the tibia. In some embodiments, the power tool is a drill. In some embodiments, the depth of the cavity is manually controlled using the distractor. In some embodiments, the guide block further comprises one or more depth pins for controlling a depth of the cavity. In some embodiments, the power tool is operatively connected to the instrument assembly by a driving attachment.

[0005] In a further aspect, a method of preparing an ankle for an ankle prosthesis operation. The method includes the steps of forming a parallel cut in a distal tibia and a talus of a patient, sizing and positioning a guide block between the distal tibia and the talus, selecting and positioning a reaming tool within a gap between the distal tibia and the talus, operating the reaming tool to form a cavity within the intramedullary canal of a patient, and implanting the ankle prosthesis at least partially within the intramedullary canal of the patient. In some aspects, the reaming tool is sized relative to a geometry of a cutting guide and an anatomy of the patient to ensure accurate formation of the cavity. In some aspects, the guide block is configured to guide a cutting instrument along the surface of the distal tibia. In some aspects, the method also includes the step of, after positioning the reaming tool, stabilizing the reaming tool within the gap between the distal tibia and the talus using adistractor. In some aspects, the operating the reaming tool to form the cavity within the intramedullary canal does not impact or cause trauma to a calcaneus or proximal tibia.

[0006] In yet another aspect, a method of implanting an ankle prosthesis is provided. The method includes preparing the ankle joint of a patient using an instrument system, and implanting the ankle prosthesis into the prepared ankle joint.BRIEF DESCRIPTION OF THE DRAWINGS

[0007] The detailed description is set forth with reference to the accompanying drawings. The use of the same reference numerals may indicate similar or identical items. Various embodiments may utilize elements and / or components other than those illustrated in the drawings, and some elements and / or components may not be present in various embodiments. Elements and / or components in the figures are not necessarily drawn to scale. Throughout this disclosure, depending on the context, singular or plural terminology may be used interchangeably.

[0008] FIG. 1 is a perspective view of the instrumentation system for implanting an ankle prosthesis, according to one or more embodiments of the present disclosure.

[0009] FIG. 2A is a dotted-line perspective view of the reaming tool of FIG. 1 , according to one or more embodiments of the present disclosure.

[0010] FIG. 2B is front-perspective view of the cutting assembly of FIG. 1 illustrating a reaming tool coupling for operatively coupling the reaming tool of FIGS. 1 and 2A with the cutting assembly, according to one or more embodiments of the present disclosure.

[0011] FIG. 2C is a rear-perspective view of the cutting assembly 200 of FIG. 1 illustrating a reaming tool coupling for operatively coupling the reaming tool of FIGS. 1 and 2A with the cutting assembly 200, according to one or more embodiments of the present disclosure.

[0012] FIG. 3A is a perspective view of the reaming tool of FIG. 1 that is operatively coupled to the guide block, according to one or more embodiments of the present disclosure.

[0013] FIG. 3B is a perspective view of the cutting assembly of FIGS. 1-3A illustrating a guide block receiving surface for receiving the guide block, according to one or more embodiments of the present disclosure.

[0014] FIG. 4 is a perspective view of an alternative embodiment of the cutting assembly of Figure 1 , according to one or more embodiments of the present disclosure.

[0015] FIG. 5 is a section view of the alternative embodiment of the cutting assembly illustrated in FIG. 4, according to one or more embodiments of the present disclosure.

[0016] FIG. 6 is perspective view of the cutting assembly of FIGS. 1-2 further illustrating an interface with a power tool for operating the reaming tool, according to one or more embodiments of the present disclosure.

[0017] FIG. 7 is a flow diagram illustrating a method for preparing the system for implanting an ankle prosthesis for operation, according to one or more embodiments of the present disclosure.

[0018] FIG. 8 is the coronal view of initial tibia and talar cut, including a gap generated between parallel cuts, according to step 610, according to one or more embodiments of the present disclosure.

[0019] FIG. 9 is the sagittal view of the sizing and placement of the guide block relative the tibial cut, according to one or more embodiments of the present disclosure.

[0020] FIG. 10 is a coronal view of a cavity in the interm edullary canal of the tibia formed through the operation of the system in step 650 based on the geometry of the cutting assembly, according to one or more embodiments of the present disclosure.

[0021] FIG. 11 is a coronal view of the implant inserted into the tibial canal, according to one or more embodiments of the present disclosure.DETAILED DESCRIPTION

[0022] The disclosure will be described more fully hereinafter with reference to the accompanying drawings, in which example embodiments of the disclosure are shown. This disclosure may, however, be embodied in many different forms and should not be constructed as limited to the embodiments set forth herein.

[0023] Certain terminology is used in the following description for convenience only and is not limiting. The words “front,” “upper” and “lower” designate directions in the drawings to which reference is made. A reference to a list of items that are cited as “at least one of a, b, or c” (where a, b, and c represent the items being listed) means any single one of the items a, b, or c, or combinations thereof.

[0024] The coronal, sagittal, and axial planes are referenced throughout this disclosure. These directional terms are used according to their generally accepted definitions as used in the medical field unless explicitly clarified herein. The terms superior / inferior, medial / lateral, and posterior / anterior, distal / proximal are similarly used according to the generally accepted definitions as used in the medical field, unless explicitly clarified herein. The drawings include further clarifications regarding these directions and planes to the extent it is believednecessary. The terms top / bottom are sometimes used interchangeably with superior / inferior, and the term side is sometimes used interchangeably with medial / lateral.

[0025] Total ankle replacement is a procedure that is used for patients with, for example, osteoarthritis, post-traumatic arthritis or rheumatoid arthritis. Depending on the implant and geometries of the tibia, the intramedullary canal must be prepared prior to performing the total ankle replacement surgery (i.e., a cavity must be drilled to provide space for an ankle prosthesis to be implanted). In some embodiments, the intramedullary canal is prepared along the anatomical axis of the tibia to allow for insertion of the prosthesis in the tibial canal.

[0026] Generally, current ankle replacement procedures prepare the tibial intramedullary canal by reaming through the calcaneus, talus, and proximal tibia shaft of the patient, or by punching a cavity within the distal tibia. These procedures have some disadvantages. In certain examples, affecting areas other than distal tibia and talus, as seen in preparation through calcaneus or proximal tibia, may cause unnecessary trauma to the patient, damaging or modifying non-diseased anatomy and thus hindering their recovery process or quality of life. In other examples, punching a cavity within the distal tibia may cause bone damage by exerting excessive force on the distal tibia or undesired movement of instruments during the surgical procedure. It is desirable to limit trauma to the patient during total ankle replacement procedures.

[0027] The present disclosure allows for preparation of the intramedullary canal at the distal tibia without impacting the calcaneus or proximal tibia. Furthermore, the present disclosure allows for the preparation of the intramedullary canal in a controlled manner to minimize any damage caused by excessive force during impaction.

[0028] Furthermore, the present disclosure allows for transmission of motion from standard power tools in sagittal / coronal plane to motion of the cutting assembly in a transverse plane. Torque created by a cutting tip is combined with perpendicular displacement relative to a tibial cut to increase the depth of the cavity in the tibial canal.

[0029] In embodiments, as shown in FIG. 1, an instrumentation system 100 for implanting an ankle prosthesis is provided. The instrumentation system 100 may include a cutting assembly 200 positioned at a first end 102 of the instrumentation system 102 and a distractor 300 for separating a proximal end of a tibia from a talus of the patient to facilitate preparing the cavity and inserting an ankle prosthesis into the cavity positioned at a second end 104 of the instrumentation system 100 opposite the cutting assembly. In embodiments, the cutting assembly includes a reaming tool attachment 202 connecting a reaming tool 204 to the body 106 of the instrumentation system 100. The reaming tool 204 may be used toprepare a cavity 1000, as shown in FIG. 10, within an intramedullary canal of a patient. In some embodiments, the reaming tool 204 is positioned on a distal end 202a of the reaming tool attachment 202, extending in an upward direction therefrom. The cutting assembly 200 is described in greater detail with respect to FIGS. 2A-4B.

[0030] In embodiments, the cutting assembly 200 also includes a driving attachment 206 attached to a proximal end 202b of the reaming tool attachment 202 adjacent to the body 106 of the instrument system 100. The driving attachment 206 may receive articulating motion along the sagittal and / or coronal planes, translating this motion to the rest of the cutting assembly 200. In some embodiments, the driving attachment 206 connects the cutting assembly 200 to a power tool 700, as shown in FIG. 6. In said embodiments, the driving attachment 206 and the power tool 700 conjunctively provide an articulating motion to the cutting assembly 200 in the sagittal and / or coronal planes. The driving attachment 206 and power tool 700 are described in greater detail with respect to FIG. 6. In some embodiments, the power tool 700 is omitted and the driving attachment 206 is articulated manually by a surgeon.

[0031] In embodiments, the cutting assembly 200 is adjustable in length along the sagittal and / or coronal plane. In these embodiments, the cutting assembly 200 includes an adjustment mechanism 208 to allow a user to adjust the length of the cutting assembly 200. In some embodiments, the length of the cutting assembly 200 can be adjusted manually using the adjustment mechanism 208. The adjustment mechanism 208 may be a rotating knob, or other similar fixture as would be apparent to those of ordinary skill in the art.

[0032] In other embodiments, the length of the cutting assembly 200 can be adjusted automatically. For example, an internal cutting piece 602 and external cutting piece 604, as shown in FIGS. 4-5, may be used to automatically adjust the length of the cutting assembly 200. The internal cutting piece 602 may internally rotate and cut into a surface until its thread length L is reached, whereupon the external cutting piece 604 then rotates to further cut into the surface at a greater depth.

[0033] In embodiments, the cutting assembly 200 also includes a lower arm 210 for securing the distractor 300 at a predetermined height. The lower arm 210 is disposed below the reaming tool attachment 202, defining a gap 212 therebetween. The distractor 300, positioned at the second end 104 of the instrument system 100, may also include a height adjuster 302 for adjusting the separation distance between the proximal end of the tibia and the talus during surgery. The distractor 300 may be used to temporarily separate the bones of the ankle joint (i.e. , the talus and the distal tibia), allowing the surgeon better access to thejoint and facilitating the insertion of surgical instruments and implants. The distractor 300 may help maintain optimal visibility and maneuverability during the procedure. In some embodiments, the distractor 300 is a parallel distractor 300 that maintains a parallel alignment between the cutting assembly 200 and various surfaces within the ankle joint to be distracted.

[0034] Referring now to FIGS. 2A-2B, the reaming tool 204 and reaming tool attachment 202 are shown in greater detail. In embodiments, the reaming tool 204 is a cutting tool used to prepare a bone surface for receiving prosthetic components. As will be understood by those skilled in the art, in total ankle replacement surgery, reamers are used to remove damaged or diseased bone tissue from the joint surface and create a cavity for the implant. Reaming tools may come in various sizes to match the dimensions of the prosthetic components and ensure a proper fit within a unique geometry of the patient. In some embodiments, the reaming tool 204 prepares the distal tibia and talus for implantation of a prosthetic device and promotes stability and integration of the prosthetic device.

[0035] FIG. 2A illustrates an exemplary reaming tool 204 having coupling pegs 214, 216 that couple to reaming tool 204 to the reaming tool attachment 202. The reaming tool attachment 202 includes attachment locations 218, 220 configured to receive one or more of the coupling pegs 214, 216 therein. The engagement of the coupling pegs 214, 216 within the attachment locations 218, 220 provide a secure connection between the reaming tool 204 and the reaming tool attachment 202 that allows the reaming tool 204 to rotate about the transverse plane while providing a stable connection to the instrument system 100.

[0036] For example, as shown in FIG. 2B, the attachment location 218 may be positioned on a top side 219 of the reaming tool attachment 202 that mates with the coupling peg 214 of the reaming tool 204. As shown in FIG. 2C, the attachment location 220 may be located on a bottom side 221 of the reaming tool attachment 202 that mates with the coupling peg 216 of the reaming tool 204.

[0037] In embodiments, as shown in FIG. 3A, a guide block 400 may be operatively coupled to the reaming tool 204 and the cutting assembly 200. The guide block 400 may ensure accurate placement of the instrumentation system 100 during the ankle prosthesis procedure. In some embodiments, the guide block 400 ensures proper alignment and fit for ankle prosthesis implants, which improves the success and longevity of the implant.

[0038] In embodiments, the guide block 400 includes one or more depth pins 402 for controlling a depth of the cavity to be formed within the intermedullary canal of the patient. The one or more depth pins 402 may be positioned on a proximal end 400a of the guide block 400 opposite the reaming tool 204. In some embodiments, the one or more depth pins 402 areselected based on the anatomy of the patient to consider the size and positioning of the distal tibia and talus. In other embodiments, one or more dimensions of the one or more depth pins 402 can be selected based on the dimensions of the guide block 400 in conjunction with the dimensions of the distal tibia and the talus. In further embodiments, one or more dimensions of the one or more depth pins 402 can be selected without consideration of the dimensions of the calcaneus or the proximal end of the tibia.

[0039] In embodiments, the guide block 400 also includes one or more alignment guides 404 for guiding the cutting assembly 200 to a surgical site for preparing the cavity without negatively affecting the calcaneus or proximal end of the tibia. The one or more alignment guides 404 may be positioned adjacent to the one or more depth pins 402, towards the distal end 400b of the guide block 400. The distal end 400b of the guide block includes a cutout 406 sized and shaped to receive the reaming tool 204 therethrough.

[0040] In embodiments, as shown in FIG. 3B, the cutting assembly 200, more specifically, the reaming tool attachment 202, includes a guide block receiving surface 408 for receiving the guide block 400 thereon. In embodiments, the guide block receiving surface 408 includes one or more recesses 410 for mating with the guide block 400. In some embodiments, the guide block receiving surface 400 includes one or more slots or holes 412 for receiving the one or more depth pins 402.

[0041] Referring now to FIG. 4, the cutting assembly 200 may also include a cover 500 to be placed around the reaming tool attachment 202 and the reaming tool 204. The cover 500 may include an opening 502 for receiving the reaming tool 204 therein. The cover 500 may also include an adjustable slot 504 for receiving the distractor 300 and adjusting the height thereof.

[0042] In embodiments, as shown in FIG. 5, the reaming tool 204 is a reaming tool assembly 600. The reaming tool assembly 600 may include an internal cutting piece 602 and an external cutting piece 064. In some embodiments, the motion of the cutting assembly 200 in the sagittal or coronal plane via rotation of a gear 606 is transmitted to the reaming assembly 600 in the transverse plane. In some embodiments, the gear 606 is a worm gear assembly, where the gear 606 is a worm gear. In some embodiments, rotation of the gear 606 may be caused by a power tool, such as that described with respect to FIG. 6.

[0043] In some embodiments, the motion of the cutting assembly 200 and the distractor 300 in the sagittal or coronal plane is transmitted to the reaming assembly 600 in the transverse plane using a hole and peg configuration.

[0044] In other embodiments, as the rotational motion of the cutting piece begins, the internal cutting piece 602 rotates and progresses into the bone with a constant feed rate. After reaching a predetermined depth according to the thread height of the internal cutting piece 602, the internal cutting piece 602 may drive the rotation of the external cutting piece 604 to further define the cavity within the tibia.

[0045] In embodiments, as shown in FIG. 6, a power tool 700 for operating the reaming tool 204. The power tool 700 may be any number of power tools that are operable to control the use of a reaming tool 204 as recognized by a person of ordinary skill in the art. In some embodiments, these include orthopedic surgical drills, electrical surgical drills, pneumatic surgical drills, battery-powered surgical drills, and a reciprocating saw. The power tool 700 operably couples with the driving attachment 206 to articulate the cutting assembly 200 along the sagittal and / or coronal planes. As the driving attachment 206 articulates, the motion of the cutting assembly 200 along the sagittal or coronal plane is transferred to the reaming tool 204 in the transverse plane via the arrangement of coupling pegs 214, 316 and cutting assembly attachment locations 218, 220.

[0046] The instrument system 100 as described herein may be used to implant an ankle prosthesis, as shown in FIG. 7. The method 800 may include the step of forming a parallel cut in the distal tibia and the talus of a patient (810). The guide block 400 may be used to guide a surgical saw or other cutting instrument along the surface of the tibia and talus to ensure accuracy of the cuts. The method 800 may subsequently include the step of sizing and positioning the guide block 400 (820). In some embodiments, this is achieved by fastening the guide block 400 to the patient at a first end of the guide block, as illustrated and described in further detail with respect to FIG. 8, at a first side and the cutting assembly 200 at a second side. In some embodiments, the distractor 300 is set to a predetermined height considering the anatomy of the patient and the geometry of the guide block 400. As will be understood, the guide block 400 is used to ensure the accurate alignment of cuts during surgery.

[0047] In embodiments, the method 800 also includes sizing (e.g., selecting) and positioning the reaming tool 204 (830). In some embodiments, the reaming tool 204 is sized relative to the geometry of the cutting guide and the anatomy of the patient to ensure an accurate placement and depth of the cavity. In some embodiments, the reaming tool 204 is attached to the cutting assembly 200 and operatively controlled by the driving attachment 206. In some embodiments, the method 800 also includes attaching the driving attachment 206 to the power tool 700 (840).

[0048] The method 800 subsequently includes the step of operating the instrumentation system 100 without affecting the calcaneus or proximal tibia (850). As previously described, it is desirable to affect only the talus and distal tibia without affecting the calcaneus or proximal tibia to limit unnecessary trauma to the patient that may hinder their recovery process. In particular embodiments, the reaming tool 204 is positioned within the gap generated between the tibia and talus while aligning the reaming tool 204 with the guide block 400. The distractor 300 may expand until the reaming tool 204 is stable between the gap.

[0049] Referring now to FIG. 8, the surgical site 900 includes the distal tibia 910, the talus 920, and the gap 930 generated between the parallel cuts thereof. In some embodiments, the gap 930 is formed using the distractor 300. As shown in FIG. 9, the cutting assembly 200 and the guide block 400 may be placed at the surgical site 700 within the gap 930 between the distal tibia 910 and the talus 920. In some embodiments, the guide block 400 is strategically positioned to guide the surgeon in creating the cavity 1000, as shown in FIG. 10, within the intermedullary canal of the distal tibia. In embodiments, as shown in FIG. 10, an implant 1010 may be positioned within the cavity 1000 of the distal tibia 910. EMBODIMENTS

[0050] Some embodiments of the present disclosure can be described in view of one or more of the following:

[0051] Embodiment 1. An instrument system for implanting an ankle prosthesis comprising a cutting assembly including a reaming tool for preparing a cavity within an intramedullary canal of a patient ;a guide block configured to fasten to a tibia of the patient and couple to the cutting assembly, the tibia having a proximal end and a distal end, wherein the guide block includes one or more alignment guides for guiding the cutting assembly to the intramedullary canal on the distal end for preparing the cavity without affecting a calcaneus or the proximal end of the tibia; and a distractor for separating the distal end from a talus to facilitate preparing the cavity and inserting an ankle prosthesis into the cavity, wherein the cutting assembly is configured to articulate in a sagittal or coronal plane and the reaming tool is configured to rotate in a transverse plane, and wherein motion of the cutting assembly in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane.

[0052] Embodiment 2. The instrument system of Embodiment 1, wherein the motion of the cutting assembly in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane using a worm gear assembly.

[0053] Embodiment 3. The instrument system of Embodiment 1 or 2, wherein the motion of the cutting assembly and the distractor in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane using a hole and peg configuration.

[0054] Embodiment 4. The instrument system of any one of Embodiments 1 to 3, wherein a depth of the cavity is manually controlled using the distractor.

[0055] Embodiment 5. The instrument system of any one of Embodiments 1 to 4, wherein the guide block further comprises one or more depth pins for controlling a depth of the cavity.

[0056] Embodiment 6. The instrument system of any one of Embodiments 1 to 5, wherein one or more dimensions of the one or more depth pins are selected based on an anatomy of the patient.

[0057] Embodiment 7. The instrument system of any one of Embodiments 1 to 6, wherein one or more dimensions of the one or more depth pins are selected based on dimensions of the guide block and the dimensions of the tibia and the talus.

[0058] Embodiment 8. The instrument system of any one of Embodiments 1 to 7, wherein one or more dimensions of the one or more depth pins are selected without consideration of the one or more dimensions of the calcaneus or the proximal end.

[0059] Embodiment 9. The instrument system of any one of Embodiments 1 to 8, further comprising a driving attachment configured to connect the reaming tool with a power tool.

[0060] Embodiment 10. The instrument system of any one of Embodiments 1 to 9, wherein the instrument system is used to implant an ankle prosthesis in a patient.

[0061] Embodiment 11. A system for implanting an ankle prosthesis comprising an ankle prosthesis, an instrument assembly for implanting the ankle prosthesis, the instrument assembly comprising a cutting assembly comprising a reaming tool for preparing a cavity within an intramedullary canal of a patient, a guide block configured to fasten to a tibia of the patient and couple to the cutting assembly, and a distractor for separating the distal end from a talus to facilitate preparing the cavity and inserting an ankle prosthesis into the cavity, a power tool configured for attachment to the reaming tool, wherein the cutting assembly is configured to articulate in a sagittal or coronal plane and the reaming tool is configured to rotate in a transverse plane, and wherein motion of the cutting assembly in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane.

[0062] Embodiment 12. The system of Embodiment 11, wherein the guide block comprises one or more alignment guides for guiding the cutting assembly to theintramedullary canal on the distal end for preparing the cavity without affecting a calcaneus or the proximal end of the tibia.

[0063] Embodiment 13. The system of Embodiment 11 or 12, wherein the power tool is a drill.

[0064] Embodiment 14. The system of any one of Embodiments 11 to 13, wherein the depth of the cavity is manually controlled using the distractor.

[0065] Embodiment 15. The system of any one of Embodiments 11 to 14, wherein the guide block further comprises one or more depth pins for controlling a depth of the cavity.

[0066] Embodiment 16. The system of any one of Embodiments 11 to 15, wherein the power tool is operatively connected to the instrument assembly by a driving attachment.

[0067] Embodiment 17. A method of preparing an ankle for an ankle prosthesis operation, the method comprising forming a parallel cut in a distal tibia and a talus of a patient, sizing and positioning a guide block between the distal tibia and the talus, selecting and positioning a reaming tool within a gap between the distal tibia and the talus, operating the reaming tool to form a cavity within the intramedullary canal of a patient, and implanting an ankle prothesis at least partially within the intramedullary canal of the patient.

[0068] Embodiment 18. The method of Embodiment 17, wherein the reaming tool is sized relative to a geometry of a cutting guide and an anatomy of the patient to ensure accurate formation of the cavity.

[0069] Embodiment 19. The method of Embodiment 17 or 18, wherein the guide block is configured to guide a cutting instrument along the surface of the distal tibia.

[0070] Embodiment 20. The method of any one Embodiments 17 to 19, further comprising the step of, after positioning the reaming tool, stabilizing the reaming tool within the gap between the distal tibia and the talus using a distractor.

[0071] Embodiment 21. The method of any one of Embodiments 17 to 20, wherein the operating the reaming tool to form the cavity within the intramedullary canal does not impact or cause trauma to a calcaneus or proximal tibia.

[0072] Embodiment 22. A method of implanting an ankle prosthesis in a patient, the method comprising preparing an ankle joint of a patient using the instrument system of any one of claims 1 to 15, and implanting the ankle prosthesis into the prepared ankle joint.

[0073] Having thus described the present systems and methods in detail, it is to be appreciated and will be apparent to those skilled in the art that many physical changes, only a few of which are exemplified in the detailed description of the invention, could be made without altering the concepts and principles embodied therein.

[0074] It is also to be appreciated that numerous embodiments incorporating only part of the embodiments discussed herein are possible which do not alter, with respect to those parts, the concepts and principles embodied therein.

[0075] The present embodiments and optional configurations are therefore to be considered in all respects as exemplary and / or illustrative and not restrictive, the scope of the systems and methods being indicated by the appended claims rather than by the foregoing description, and all alternate embodiments and changes to this embodiment which come within the meaning and range of equivalency of said claims are therefore to be embraced therein.

Claims

CLAIMSThat which is claimed is:

1. An instrument system for implanting an ankle prosthesis comprising: a cutting assembly including a reaming tool for preparing a cavity within an intramedullary canal of a patient; a guide block configured to fasten to a tibia of the patient and couple to the cutting assembly, the tibia having a proximal end and a distal end, wherein the guide block includes one or more alignment guides for guiding the cutting assembly to the intramedullary canal on the distal end for preparing the cavity without affecting a calcaneus or the proximal end of the tibia; and a distractor for separating the distal end from a talus to facilitate preparing the cavity and inserting an ankle prosthesis into the cavity, wherein the cutting assembly is configured to articulate in a sagittal or coronal plane and the reaming tool is configured to rotate in a transverse plane, and wherein motion of the cutting assembly in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane.

2. The instrument system of claim 1 , wherein the motion of the cutting assembly in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane using a worm gear assembly.

3. The instrument system of claim 1, wherein the motion of the cutting assembly and the distractor in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane using a hole and peg configuration.

4. The instrument system of claim 1 , wherein a depth of the cavity is manually controlled using the distractor.

5. The instrument system of claim 1, wherein the guide block further comprises one or more depth pins for controlling a depth of the cavity.

6. The instrument system of claim 5, wherein one or more dimensions of the one or more depth pins are selected based on an anatomy of the patient.

7. The instrument system of claim 5, wherein one or more dimensions of the one or more depth pins are selected based on dimensions of the guide block and the dimensions of the tibia and the talus.

8. The instrument system of claim 5, wherein one or more dimensions of the one or more depth pins are selected without consideration of the one or more dimensions of the calcaneus or the proximal end.

9. The instrument system of claim 1, further comprising a driving attachment configured to connect the reaming tool with a power tool.

10. The instrument system of claim 1, wherein the instrument system is used to implant an ankle prosthesis in a patient.

11. A system for implanting an ankle prosthesis comprising: an ankle prosthesis; an instrument assembly for implanting the ankle prothesis, the instrument assembly comprising: a cutting assembly comprising a reaming tool for preparing a cavity within an intramedullary canal of a patient; a guide block configured to fasten to a tibia of the patient and couple to the cutting assembly; and a distractor for separating the distal end from a talus to facilitate preparing the cavity and inserting an ankle prosthesis into the cavity; and a power tool configured for attachment to the reaming tool; wherein the cutting assembly is configured to articulate in a sagittal or coronal plane and the reaming tool is configured to rotate in a transverse plane; and wherein motion of the cutting assembly in the sagittal or coronal plane is transmitted to the reaming tool in the transverse plane.

12. The system of claim 11, wherein the guide block comprises one or more alignment guides for guiding the cutting assembly to the intramedullary canal on the distal end for preparing the cavity without affecting a calcaneus or the proximal end of the tibia.

13. The system of claim 11 , wherein the power tool is a drill.

14. The system of claim 11, wherein the depth of the cavity is manually controlled using the distractor.

15. The system of claim 11, wherein the guide block further comprises one or more depth pins for controlling a depth of the cavity.

16. The system of claim 11, wherein the power tool is operatively connected to the instrument assembly by a driving attachment.

17. A method of preparing an ankle for an ankle prosthesis operation, the method comprising: forming a parallel cut in a distal tibia and a talus of a patient; sizing and positioning a guide block between the distal tibia and the talus; selecting and positioning a reaming tool within a gap between the distal tibia and the talus; forming, by the reaming tool, a cavity within the intramedullary canal of a patient; and implanting an ankle prothesis at least partially within the intramedullary canal of the patient.

18. The method of claim 17, wherein the reaming tool is sized relative to a geometry of a cutting guide and an anatomy of the patient to ensure accurate formation of the cavity.

19. The method of claim 17, wherein the guide block is configured to guide a cutting instrument along the surface of the distal tibia.

20. The method of claim 17, further comprising the step of, after positioning the reaming tool, stabilizing the reaming tool within the gap between the distal tibia and the talus using a distractor.

21. The method of claim 17, wherein the forming the cavity within the intramedullary canal does not impact or cause trauma to a calcaneus or proximal tibia.

22. A method of implanting an ankle prosthesis in a patient, the method comprising: preparing an ankle joint of a patient using the instrument system of any one of claims 1 to 9; and implanting the ankle prosthesis into the prepared ankle joint.

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