Device and method for preparing the proximal surface of the tibia and / or femur and the proximal surface of the posterior femoral condyle for components of an artificial knee joint

Abstract

A device for preparing the proximal surface of the tibia and / or the proximal surface of the distal femur and the posterior femoral condyle for the tibial component and / or femoral component of an artificial knee joint. The device includes an electronic system device that receives or measures data information, and the electronic system can use this information to communicate the control of the blade and / or cutting tool to resect the proximal surface of the tibia and / or the distal femur and / or the posterior femoral condyle to a desired reference plane cut, which can provide balanced angular movement between the femoral component and the tibial component of the artificial knee joint throughout the entire arc of extension, mid-flexion and flexion.

Description

Technical Field

[0001] The present invention relates to an apparatus and method for preparing the proximal surfaces of the distal tibia and / or femur and the posterior femoral condyle for components of an artificial knee joint. More specifically, the present invention relates to an improved manner in which the final bone resection of these surfaces for the tibia and femur can be completed. Background Art

[0002] As disclosed in WO2017181216, the applicant recognized the importance of establishing a "tibia reference plane" which is defined by the orientation of the underside of the joint liner, wherein when replicated as the final bone resection cut of the proximal surface of the tibia, the tibial reference plane provides the necessary surface contour so that when the tibial component of the artificial knee joint is implanted in the patient's knee joint, it will be configured to achieve the desired balance and stability between the tibial component and the femoral component of the artificial knee joint, whether it is a unicompartmental knee replacement or a total knee replacement.

[0003] As further disclosed in WO2017181216, by providing user-operable height extension tabs that help establish a tibial reference surface (by engaging these user-operable height extension tabs with the underside of the joint lining to help establish the tibial reference plane), the mounting device is then used as a device to assist in the cutting process so that the tibial reference plane is replicated as the final bone resection to the proximal surface of the tibia.

[0004] The mounting device in WO2017181216 utilizes a mechanical structural device that includes a mounting joint between a joint lining and a cutting guide.

[0005] The cutting guide includes a slot so that in a first mounted position the slot will be aligned with the established tibial reference plane and then through the vertical support structure this indicator with the slot now aligned with the same orientation of the tibial reference plane can be lowered and best summarized the cutting guide in the second mounted position will be in the correct vertical position for cutting into new bone while the indicator slot of the cutting guide maintains the correct orientation of the established tibial reference plane so that the blade or saw is then guided and oriented through the slot of the cutting guide to make the final bone resection which replicates the necessary contour of the tibial reference plane to the proximal surface of the tibia.

[0006] While it is possible to utilize these structural features of a mounting device including a unique cutting guide having a slot that would be oriented to align with the tibial reference plane to serve as a guide for a blade or saw to complete the resection, thereby replicating the established tibial reference plane to the bone of the tibia, this does require the use of a specific joint liner that is configured so that the mounting device can be partially mounted thereon.

[0007] It would be advantageous if there were a more convenient way to accomplish the cuts to replicate an established tibial reference plane that provides the contour of the proximal surface of the tibia to achieve optimal stability and balance throughout the arc of motion of the artificial knee, as does a normal, healthy knee.

[0008] Through WO2017197462, the applicant is also able to provide a method and device for balancing the femoral side of an artificial knee joint by first providing optimal final bone resection and other femoral osteotomies for the distal femur and posterior femoral condyle to accommodate the femoral component.

[0009] As discussed in wo2017197462, the unique use of a generally L-shaped femoral-tibial stabilization gap alignment jig provides a vertical arm with associated laterally extending tabs responsible for providing the necessary distal femoral reference planes by engaging the anterior plate, and a horizontal arm with associated height extending tabs that make the necessary adjustments to the base plate (and / or separate portions of the base plate) to establish the necessary posterior malleolus reference planes so that the final resection of the distal femur and posterior femoral malleolus that are cut to expose the surface both have the same contours as these reference planes, which then enables the femoral component of the artificial knee joint to function optimally.

[0010] Therefore, although the applicant has previously been able to recognize unique ways and means of establishing reference planes by employing the devices discussed in each of patents WO2017181216 and WO2017197462, it is particularly advantageous to provide an improved manner in which these reference planes of the tibia and femur can be more effectively and conveniently translated to the final bone resection contour cut required for the proximal surface of the tibia and / or the distal femur and posterior condyle.

[0011] It is therefore an object of the present invention to provide an improved device and means to facilitate final resection incisions for the proximal surface of the tibia and / or the distal femur and posterior condyle.

[0012] Although throughout this specification, references to the femur relate in part to improved devices and means to facilitate final resection cuts to the distal femur and posterior femoral condyle, such same improved devices and means may also facilitate other femoral cuts to accommodate femoral components as desired. Summary of the invention

[0013] Thus, in one form of the invention, there is provided a device for preparing the proximal surface of a tibia for use in a tibial component of an artificial knee joint, the device comprising:

[0014] a tibial and femoral stabilization gap preparation plate adapted to be placed on a proximal surface of a tibia, the tibial and femoral stabilization gap preparation plate further comprising an upper side having a plurality of user-operable height-adjustable extension tabs, wherein each user-operable height-adjustable extension tab is adapted to engage an underside of an articulated liner, wherein the articulated liner includes an upper articulated surface to engage a femoral component of a knee joint, such that height adjustment of the plurality of user-operable height-adjustable extension tabs defines a measurement in each of extension, mid-flexion, and flexion, wherein the measurement corresponds to a tibial reference plane defined on the underside of the articulated liner, wherein a final bone resection of the proximal surface of the tibia in accordance with the tibial reference plane provides balanced angular motion between the tibial and femoral components of the artificial knee joint throughout the arc of motion of extension, mid-flexion, and flexion;

[0015] An electronic system device, comprising a measured or received input signal, wherein the measured or received input signal of the electronic system device provides tibial reference plane measurement data information, wherein the tibial reference plane measurement data information includes a spatial orientation, angle and / or position of a tibial reference plane defined by an underside of a joint liner;

[0016] The electronic system device is configured to transmit electrical energy in the form of an output action in response to a measurement or received input signal of the tibial reference plane measurement data information, thereby aligning the blade and / or cutting tool at a certain angle so that, under the alignment of the blade and / or cutting tool provided by the tibial reference plane measurement data information, a tibial resection across the proximal surface of the tibia at or below the proximal surface of the tibia replicates the tibial reference plane on the proximal surface of the final resected tibia.

[0017] In another form of the invention, there is provided a device for providing a femoral component of an artificial knee joint with the proximal surface of the distal femur and the posterior condyle of the femur, the device comprising:

[0018] a generally L-shaped femoral-tibial stabilization gap alignment jig mountable to the femur such that a vertical arm of the generally L-shaped femoral-tibial gap alignment jig is adapted to abut and / or align with the distal end of the femur and such that a horizontal arm of the generally L-shaped femoral-tibial gap alignment jig is adapted to abut and / or align with the posterior condyle of the femur;

[0019] said vertical arm of the generally L-shaped femoral-tibial stabilization gap alignment jig includes a user-operable laterally adjustable extension tab, wherein each user-operable laterally adjustable extension tab is adapted to engage an anterior plate such that lateral adjustment of the anterior plate by said plurality of user-operable laterally adjustable extension tabs provides a distal femoral reference plane defined by an anterior surface of the anterior plate, wherein a final bone resection of the distal femur having a contour of the distal femoral reference plane provides balanced angular motion between the tibial component and the femoral component of the prosthetic knee joint throughout an arc of motion of postoperative extension, midflexion and flexion;

[0020] The horizontal arm of the generally L-shaped femoral-tibial stabilization gap alignment jig includes a user-operable height-adjustable extension tab adapted to adjust the vertical height of a base plate relative to the horizontal arm of the generally L-shaped femoral-tibial stabilization gap alignment jig, such that vertical height adjustment of the base plate by the plurality of user-operable height-adjustable extension tabs defines a posterior femoral condyle reference plane, wherein final bone resection of the posterior femoral condyle of the femur utilizing the posterior femoral condyle reference plane provides balanced angular motion between the femoral component and the tibial component of the artificial knee joint throughout the entire arc of motion of extension, mid-flexion and flexion; and

[0021] An electronic system device including a measured or received input signal, wherein the measured or received input signal entering the electronic system device provides distal femoral reference plane measurement data information and / or posterior femoral condyle reference plane measurement data information;

[0022] The electronic system device is configured to respond to the measurement or received input signal of the distal femoral reference plane measurement data information and / or the posterior femoral condyle reference plane measurement data information to transmit electrical energy in the form of an output action to align the blade and / or cutting tool at a certain angle and / or multiple angles to resect the distal femur and / or posterior femoral condyle using a contour or multiple contours that replicate the distal femoral reference plane and / or the posterior femoral condyle reference plane.

[0023] In yet another form of the invention, there is provided an apparatus for preparing a proximal surface of a tibia for a tibial component of an artificial knee joint, the apparatus comprising:

[0024] a joint liner, wherein the joint liner includes an upper articulating surface that engages a femoral component of a knee joint, the joint liner including a plurality of user-operable height-adjustable extension tabs on an underside, wherein each user-operable height-adjustable extension tab is adapted to engage a proximal surface of a tibia and / or a plate, platform or other generally flat object on a tibial surface such that height adjustment of the plurality of user-operable height-adjustable extension tabs defines a measurement taken in each of extension, midflexion and flexion, wherein the measurement corresponds to a tibial reference plane defined within and / or beneath the joint liner, wherein a final bone resection of the proximal surface of the tibia coincident with the tibial reference plane provides balanced angular motion between the tibial component and the femoral component of the artificial knee joint throughout the arc of motion of extension, midflexion and flexion;

[0025] An electronic system device including a measured or received input signal, wherein the measured or received input signal into the electronic system device provides tibial reference plane measurement data information, wherein the tibial reference plane measurement data information includes a spatial orientation, angle and / or position of a tibial reference plane defined within and / or beneath a joint liner;

[0026] The electronic system device is configured to transmit electrical energy in the form of an output action in response to a measurement of the tibial reference plane measurement data information or a received input signal to align the blade and / or cutting tool at a certain angle so that under the alignment of the blade and / or cutting tool provided by the tibial reference plane measurement data information, the resection of bone at or below the proximal surface of the tibia across the tibial reference plane will replicate the tibial reference plane on the proximal surface of the final resected tibia.

[0027] In yet another form of the invention, there is provided a device for providing a femoral component of an artificial knee joint with the proximal surface of the distal femur and the posterior condyle of the femur, the device comprising:

[0028] a generally L-shaped femoral-tibial stabilization gap alignment device adapted to be positioned to the femur such that the vertical arm of the generally L-shaped femoral-tibial gap alignment fixture is adapted to be aligned with the distal end of the femur and the horizontal arm of the generally L-shaped femoral-tibial gap alignment device is adapted to be aligned with the posterior condyle of the femur;

[0029] said vertical arm of the generally L-shaped femoral-tibial stabilization gap alignment device including user-operable laterally adjustable extension tabs, wherein each user-operable laterally adjustable extension tab is adapted to engage a distal femur or a device mounted on the distal femur, such that lateral adjustment by said plurality of user-operable laterally adjustable extension tabs provides a distal femoral reference plane defined by an anterior surface of the L-shaped femoral-tibial stabilization gap alignment device, wherein a final bone resection of the distal femur having a contour of the distal femoral reference plane provides balanced angular motion between the tibial component and the femoral component of the artificial knee joint throughout the entire arc of motion of extension, mid-flexion and flexion post-operatively;

[0030] The horizontal arm of the generally L-shaped femoral-tibial stabilization gap alignment device includes a plurality of user-operable height-adjustable extension tabs, such that vertical height adjustment of the plurality of user-operable height-adjustable extension tabs on the posterior femoral condyle or a device positioned on the posterior femoral condyle provides a posterior femoral condyle reference plane defined on the underside of the horizontal arm, wherein final bone resection of the posterior femoral condyle of the femur utilizing the posterior femoral condyle reference plane provides balanced angular motion between the femoral component and the tibial component of the artificial knee joint throughout the entire arc of motion of extension, mid-flexion and flexion; and

[0031] An electronic system device including a measured or received input signal, wherein the measured or received input signal into the electronic system device provides distal femoral reference plane measurement data information and / or posterior femoral condyle reference plane measurement data information;

[0032] The electronic system device is configured to transmit electrical energy in the form of an output action in response to the measurement of the distal femoral reference plane measurement data information and / or the posterior femoral condyle reference plane measurement data information or the received input signal, so as to align the blade and / or the cutting tool at a certain angle and / or multiple angles to resect the distal femur and / or the posterior femoral condyle using a contour or multiple contours that replicate the distal femoral reference plane and / or the posterior femoral condyle reference plane.

[0033] Preferably, the electronic system device includes a sensor device, wherein the sensor device includes an accelerometer, a gyroscope, a position sensor, an inductive sensor, a capacitive displacement sensor, a laser sensor, an optical sensor, a pressure sensor, a magnetic sensor and a magnetic inductor sensor, a confocal sensor and / or a wire sensor and / or computer navigation to help provide reference plane measurement data.

[0034] Preferably, the sensor assembly comprises a pressure sensor assembly coupled to a joint liner, a tibial and femoral stabilization gap preparation plate or a generally L-shaped femoral tibial stabilization gap alignment jig.

[0035] Preferably, the device further comprises a robotic arm to which the blade and / or cutting tool is attached.

[0036] Preferably, the robotic arm is under the control of an electronic system device.

[0037] Preferably, in one embodiment, the electronic system device is configured to control the movement of the robotic arm so that it is placed in a position where the final bone cut is completed by the blade and / or cutting tool, at which point the electronic system device has oriented the blade and / or cutting tool to a certain angle to complete the cutting of the predetermined reference plane contour.

[0038] Preferably, the electronic system device comprises a microcontroller.

[0039] Preferably, the electronic system device comprises a display screen and / or communicates with a display screen to display measured information and / or actions performed under the control of the electronic system device.

[0040] Preferably, the electronic system device is configured and operative to control a user-operable height-adjustable extension tab of the joint liner or a height-adjustable tibial and femoral stabilization gap preparation plate for said multiple user-operable height-adjustable extension tabs to perform measurements at each of extension, mid-flexion and flexion, wherein said measurements at each of extension, mid-flexion and flexion performed by the electronic system device correspond to a tibial reference plane.

[0041] Preferably, the electronic system device is configured and operative to control a user-operable laterally adjustable extension tab and a user-operable height adjustable extension tab of a generally L-shaped femoral-tibial stability gap alignment fixture to adjust the user-operable laterally adjustable extension tab and the user-operable height adjustable extension tab for measurements corresponding to a femoral reference plane and a femoral condyle reference plane.

[0042] Advantageously, the present invention provides an improved manner in which reference planes established by an apparatus for preparing the proximal surface of the tibia, the distal femur, and the proximal surface of the posterior condyle of the femur may be utilized.

[0043] The electronic system device is configured to have the ability to identify, measure and / or record relevant reference planes, and then utilize further inherent functions of the electronic system device to communicate the identified, measured and / or recorded reference planes to control the blade and / or cutting tool responsible for the final resection cut of the bone.

[0044] In other preferred embodiments of the present invention, the electronic system device will be suitable for controlling structural features such as robotic arms to effectively and conveniently drive the blade and / or cutting tool that has been oriented to the correct angle to copy the relevant reference plane to the knee joint to complete the cutting on the bone to be finally resected, with or without the guidance of the surgeon. BRIEF DESCRIPTION OF THE DRAWINGS

[0045] Figure 1 is a rear perspective view of a generally L-shaped femoral tibia stabilization gap alignment jig and anterior plate assembly in a preferred embodiment of the present invention.

[0046] Figure 2 is a front perspective view of a generally L-shaped femoral tibia stabilization gap alignment jig and anterior plate assembly in a preferred embodiment of the present invention.

[0047] Figures 3a to 3h is a schematic diagram of a method by which the apparatus may be utilized to prepare and perform final bone resection of the distal femur and posterior femoral condyle in a preferred embodiment of the present invention.

[0048] Figure 4a and 4b A stereoscopic view of a tibial and femoral stabilization gap preparation plate in a preferred embodiment of the present invention is shown, wherein: Figure 4a The user-operable extension tab is shown in a lowered position, wherein Figure 4b The user-operable extension tab is shown in an adjusted, raised position.

[0049] Figure 5a to Figure 5f is a schematic diagram of a method in a preferred embodiment of the present invention by which the device may be utilized to prepare and cut a final bone resection of the proximal surface of the tibia.

[0050] The illustrations need to be placed in the context of the intended results achieved by using the apparatus and methods provided in the present invention. DETAILED DESCRIPTION

[0051] During surgery, the orthopedic surgeon aims to provide balanced, unimpeded movement of the knee components to achieve a complete arc of motion from extension, midflexion, and flexion to retroflexion.

[0052] Therefore, the final bone resections of the proximal surfaces of the tibia and the distal femur and posterior femoral condyle need to be correctly cut to present appropriate contours for the tibial and femoral prosthetic components positioned in the knee replacement (whether a total knee surgery or a unicompartmental knee surgery).

[0053] The establishment of a reference plane, described below, helps achieve this result.

[0054] Figure 1 to Figure 3h The method for preparing Figure 3e The distal femoral reference plane 70 shown by the dashed line in FIG. Figure 3fThe device (10) for the posterior condyle reference plane 74 shown by the dotted line in the figure inputs the information discussed in more detail below into the electronic system device shown as 72, for pictorial reference only, wherein, in a preferred embodiment, the electronic system device 72 is responsible for controlling the robotic arm 78 and cutting blade 79 for the final bone resection of the distal femur 39 and the posterior condyle 80.

[0055] The device (10) includes a generally L-shaped femoral-tibial stabilization gap alignment fixture (11).

[0056] In a preferred embodiment, the anterior plate (12) is a separate piece from the generally L-shaped femoral tibia stabilization gap alignment jig (11). The outer surface of the anterior plate (12) is referenced as (28).

[0057] The size of the front plate (12) corresponds to the size and shape of the distal end of the femur, such as Figure 3a Best shown.

[0058] In a preferred embodiment, the bottom of the front plate (12) includes separate portions (7a) and (7b), wherein each portion (7a) and (7b) of the bottom of the front plate (12) engages below with a corresponding user-operable height-adjustable tab (17a) and (17b) on a corresponding portion (43a) and (43b) of a horizontal arm (16) of a generally L-shaped femoral-tibial stabilization gap alignment fixture (11).

[0059] In other embodiments not shown, the front plate (12) and bottom plates (7a) and (7b) may be integrated into a single component with the generally L-shaped femoral-tibial stabilizing gap alignment fixture (11).

[0060] like Figure 1 and Figure 2 As best shown, the front plate (12) and the bottom plate portions (7a) and (7b) are all a single piece, wherein the single piece forms a generally L-shaped configuration that replicates the shape of the femoral component corresponding to the configuration of the generally L-shaped femoral tibial stabilization gap alignment fixture (11).

[0061] The horizontal arm (16) of the generally L-shaped femoral-tibial stabilization gap alignment fixture (11) described above is actually two parts (43a) and (43b), so that the horizontal arm (16) is constructed to basically conform to the posterior femoral condyle (80) located at the distal end of the femur 32.

[0062] The vertical arm (14) of the generally L-shaped femoral-tibial stabilization gap alignment clamp (11) includes user-operable laterally adjustable tabs (15a) and (15b) that are adapted to engage with the inner side (30) of the front plate (12) when the front plate (12) is mounted or connected to the generally L-shaped femoral-tibial stabilization gap alignment clamp (11).

[0063] exist Figure 1 and Figure 2 In the preferred embodiment shown, there are two user operable height adjustment tabs (17a) and (17b) and two user operable side adjustable tabs (15a) and (15b).

[0064] Nonetheless, the number and / or orientation of the user-operable height adjustable extension tabs and the user-operable side adjustable extension tabs are not limited to the present invention.

[0065] As will be discussed in more detail later below, the scope of the present invention is merely to provide a plurality of user-operable lateral extension tabs on the vertical arm (14) of a generally L-shaped femoral-tibial stabilization gap alignment clamp (11) and a plurality of height-adjustable extension tabs on the underside of a horizontal arm (16).

[0066] The height adjustability of the height adjustable extension tabs (17a) and (17b) as indicated by arrows (21a) and (21b) and the lateral adjustability of the user operable lateral extension tabs (15a) and (15b) as indicated by arrows (19a) and (19b) will establish Figure 3e The necessary distal femoral reference plane 70 is shown and prepared Figure 3f The posterior malleolus reference plane 74 is shown.

[0067] The preferred embodiment shows a series of slots (18) into which the necessary tools can be engaged to adjust the laterally extending tabs (15a), (15b) and / or the height adjustable extension tabs (17a) and (17b) laterally and vertically again in the directions indicated by the arrows shown as (19a), (19b) or (21a) and (21b).

[0068] Positioning and operation of the slot (18) is not essential to the present invention and may be accomplished through a variety of design choices and tooling operations to drive the laterally extending tabs (15a), (15b) and / or the height-adjustable extension tabs (17a) and (17b), including mechanically, hydraulically, electrically, electronically and / or through computer-guided, robotic or pneumatically driven action devices.

[0069] The slots (18) are merely indicative of the fact that the associated laterally adjustable extension tabs (15a) and (15b) and the height adjustable extension tabs (17a) and (17b) may be manipulated accordingly to orient the front plate 12 and the bottom plate portions (7a) and (7b) relative to the generally L-shaped femoral-tibial stabilizing gap alignment fixture (11) so that the necessary alignment may be established. Figure 3e The distal femoral reference plane 70 is shown and Figure 3fThe posterior condyle reference plane 74 is shown in FIG. 1 , and again referring to the above and as will be described below, this information is input into the electronic system device 72 to control the robotic arm 78 and cutting blade 79 responsible for the final bone resection of the distal femur and posterior condyle.

[0070] First, refer to the distal femoral reference plane (70) shown in Figure 3(e).

[0071] As described above, the surgeon's adjustment of the laterally extending tabs (15a) and (15b) has oriented the anterior plate (12) to present the distal femoral reference plane (70).

[0072] However, what is important to the present invention is how the distal femoral reference plane (70) is established and the manner in which the distal femoral reference plane (70) is replicated on the surface of the distal femur when the final bone resection is completed.

[0073] In a preferred embodiment of the present invention, the electronic system device (72) is adapted to respond to an input signal, wherein the input signal entering the electronic system device (72) has identified, measured and / or allowed to record information of the distal femoral reference plane (70) so that the electronic system device (72) can use the information to control the robotic arm (78) and the cutting blade (79) connected to the robotic arm (78).

[0074] In the illustration, the electronic system device (72) is not intended to indicate its relative position with respect to the knee joint being operated on.

[0075] The electronic system device (72) is shown for illustrative purposes only to understand its use in the present invention, as in certain preferred embodiments, the electronic system device (72) can be at least partially incorporated into a component used by a surgeon or the electronic system device (72) can remain a stand-alone unit used within a computer or other electronically operable device.

[0076] However, the essence of the present invention is that once the surgeon establishes the distal femoral reference plane (70) and / or the posterior malleolus reference plane (74), the electronic system device (72) is inherently adapted to be capable of receiving a signal providing information of the established distal femoral reference plane (70) shown in Figure 3, with the input signal being shown as (71) and in the case of the posterior malleolus reference plane (74) in Figure 3(f), the input being signal (75).

[0077] Again for illustration purposes, in Figures 3(e) and 3(g), the electronic system device (72) receives an input signal (71) providing information of a distal femoral reference plane (70), wherein the electronic system device (72), again illustrated as (73), sends a control signal to a robotic arm (78) to enable the robotic arm (78) to position and orient the cutting blade (79) so that bone resection at or below the distal femur, once completed, will replicate the same established distal femoral reference plane (70) shown in Figure 3(e).

[0078] In the cases of Figures 3(f) and 3(h), the established posterior malleolus reference plane (74) is input into the electronic system device (72) as an appropriate signal (75), wherein the electronic system device (72) sends a control signal (77) to the robotic arm (78) and the corresponding cutting blade (79) so that the cutting blade (79) used for the final resection cut can provide the same contour surface as the posterior malleolus reference plane (74) referenced in Figure 3(f), as shown in Figure 3(h).

[0079] Although not shown in the drawings, the electronic system device (72) may include a sensor device such as a pressure sensor that will be incorporated into the generally "L" femoral tibia stabilization gap alignment fixture (11), the front plate (12) and / or the bottom of the front plate (12). The information from the pressure sensor can then be sent as a signal to the electronic system device (72) so that the electronic system device (72) can act accordingly.

[0080] Figure 4a , 4b 5a to 5f are schematic representations of a method in a preferred embodiment of the present invention by which the device may be utilized to prepare and cut a final bone resection of the proximal surface of the tibia.

[0081] 4 and 5a to 5f, a tibial and femoral stabilization gap preparation plate is generally indicated at 110 and forms part of an integral device for preparing the proximal surface of the tibia of the tibial component of the artificial knee joint of the present invention.

[0082] In a preferred embodiment, the tibial and femoral stabilization gap preparation plate 110 includes a base plate 112. The base plate 112 is configured to rest appropriately on an initial cutout 135 of the proximal surface of the tibia 127.

[0083] In a preferred embodiment, a top plate or platform 122 is also included. However, the user-operable height-adjustable extension tabs 113, 114 and 115 and associated tips 119, 120 and 121 may also directly engage the underside 143 of the joint liner 137, again as described with reference to Figure 5a to Figure 5fDiscussed in greater detail, in a preferred embodiment, the top plate 122 will engage the underside 143 of the joint liner 137 .

[0084] The user-operable height adjustable extension tabs 113, 114 and 115 are operably engaged with the rotatable knobs 116, 117 and 118. As shown by arrows 145, 146 and 147, the rotation of the rotatable knobs 116, 117 and 118 translates into vertical height adjustment of the tips 119, 120 and 121 of the corresponding user-operable height adjustment extension tabs 113, 114 and 115.

[0085] Figure 4a The tips 119, 120 and 121 of the user-operable extension tabs 113, 114 and 115 are shown in a lowered position and in Figure 4b 1, the rotational movement of the user-engageable knobs 116, 117 and 118 has seen the raised heights of the tips 119, 120 and 121 of the corresponding height-adjustable extension tabs 113, 114 and 115 being raised, indicating their adjustability to establish a height adjustment such as Figure 5e The tibial reference plane 160 is shown as a dotted line in FIG.

[0086] By having three tips 119, 120 and 121, this provides triangulation that establishes an appropriate tibial reference plane on the plate 122, which is then translated into an orientation of the underside 143 of the joint liner 137, to which the plate 122 of the tibial and femoral stabilization gap preparation plate 110 is joined.

[0087] The knee joint is generally shown at 129 .

[0088] The cutter 131 prepares for the initial resection of the proximal surface 135 of the tibia 127. Also shown is the general distal end of the femur 130. The tibial and femoral stabilization gap preparation plate 110, indicated by arrow 134, is inserted onto the initially resected proximal surface 135 of the tibia 127.

[0089] In other preferred embodiments, although not shown in the figures, the tool (131) may be included as part of a robotic arm assembly to complete the initial resection, or in other preferred embodiments, the tool (131) will include and / or be used in conjunction with a hand saw, robot, navigation, patient-specific cutting guides, etc.

[0090] It will be appreciated that the general shape of the tibial and femoral stabilization gap preparation plate 110 is commensurate with the dimensions of the proximal surface 135 of the tibia 127 .

[0091] Figure 5cThe actual positioning of the tibial and femoral stabilization gap preparation plate 110 on the proximal surface 135 of the tibia 127 is shown, and sandwiched between the femoral component 136 and the tibial and femoral stabilization gap preparation plate 110 is the articular liner 137.

[0092] Arrow 138 represents the position where the joint lining 137 will be positioned in the knee joint 129.

[0093] The joint lining 137 has a hinged upper surface 139 to engage the femoral component 136 of the femur 130. 143 represents the underside of the joint lining 137.

[0094] Figure 5d The knee joint is shown in neutral flexion. Operable knobs 116, 117 and 118 when rotated in the manner of arrows 145, 146 and 147 will adjust the orientation of the underside 143 of the joint liner 137 via the height adjustable extension tabs 113, 114 and 115.

[0095] Although not shown in the diagram, this height adjustability will also be accomplished in extension and then eventually in flexion or 90 degrees.

[0096] Thus, the user-operable height-adjustable extension tabs 113, 114, and 115 create a triangular support for the top plate 122, which then aligns and / or orients the underside 143 of the joint liner 137 accordingly. Figure 5e As shown, a tibial reference plane 160 has now been established on the underside 143 of the joint liner 137 through the height adjustability of the height adjustable extension tabs 113, 114 and 115 from extension, mid-flexion to flexion.

[0097] With the tibial reference plane 160 now established on the inferior side 143 of the articular liner 137 , the final bone resection of the proximal surface of the tibia will require the same contour as this tibial reference plane 160 .

Claims

1. A device for preparing the proximal surface of a tibia for a tibial component of an artificial knee joint, the device comprising: a tibial and femoral stabilization gap preparation plate adapted to be placed on a proximal surface of a tibia, the tibial and femoral stabilization gap preparation plate further comprising an upper side having a plurality of user-operable height-adjustable extension tabs, wherein each user-operable height-adjustable extension tab is adapted to engage an underside of an articulating liner, wherein the articulating liner includes an upper articulating surface to engage a femoral component of a knee joint such that height adjustment of the plurality of user-operable height-adjustable extension tabs in extension, midflexion, and flexion provides a tibial reference plane defined on the underside of the articulating liner; an electronic system device including a measured or received input signal, wherein the measured or received input signal entering the electronic system device provides tibial reference plane measurement data information, wherein the tibial reference plane measurement data information includes an orientation, angle and / or position of a tibial reference plane defined by an underside of an articular liner; The electronic system device is configured to transmit electrical energy in the form of an output action in response to a measurement or input signal of the tibial reference plane measurement data information to align the cutting tool at a certain angle so that bone resection across the proximal surface of the tibia or below it under the alignment of the cutting tool provided by the tibial reference plane measurement data information replicates the tibial reference plane on the proximal surface of the final resected tibia.

2. A device for preparing the proximal surface of a tibia for a tibial component of an artificial knee joint, the device comprising: a joint liner, wherein the joint liner includes an upper articulating surface to engage a femoral component of a knee joint, the joint liner including a plurality of user-operable height-adjustable extension tabs on an underside, wherein each user-operable height-adjustable extension tab is adapted to engage a proximal surface of a tibia or a plate on a tibial surface such that height adjustment of the plurality of user-operable height-adjustable extension tabs in extension, midflexion, and flexion provides a tibial reference plane defined within and / or beneath the joint liner; An electronic system device including a measured or received input signal, wherein the measured or received input signal entering the electronic system device provides tibial reference plane measurement data information, wherein the tibial reference plane measurement data information includes a spatial orientation, angle and / or position of a tibial reference plane defined within and / or beneath a joint liner; The electronic system device is configured to transmit electrical energy in the form of an output action in response to a measurement or input signal of the tibial reference plane measurement data information to align the cutting tool at a certain angle so that bone resection across the proximal surface of the tibia or below it under the alignment of the cutting tool provided by the tibial reference plane measurement data information replicates the tibial reference plane on the proximal surface of the final resected tibia.

3. The device according to claim 1 or 2, wherein the electronic system device comprises a sensor device, wherein the sensor device comprises at least one of an accelerometer, a gyroscope, a position sensor, a laser sensor, a pressure sensor, and a magnetic sensor.

4. An apparatus according to claim 3, wherein the electronic system device is configured and operative to control user-operable height-adjustable extension tabs of a joint liner or a tibial and femoral stabilization gap preparation plate for height adjustment of the multiple user-operable height-adjustable extension tabs for measuring at each of extension, mid-flexion and flexion.

5. The device according to claim 1 or 2, further comprising a robotic arm to which the cutting tool is attached. The device of claim 5 , wherein the robotic arm is under the control of the electronic system device.

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