Systems and methods for preparing a patient's femur during orthopedic joint replacement surgery

Abstract

An orthopedic joint replacement system is shown and described. The system includes a plurality of prosthetic components configured to be implanted into a patient's knee joint. The system also includes a plurality of surgical instruments configured to prepare bone of the patient's knee joint to receive the implant. A method or technique for preparing bone using the surgical instruments is also disclosed.

Description

[0001] This application claims priority under 35 U.S.C. §119 to U.S. patent application serial number 62 / 338,276, filed on May 18, 2016, entitled “SYSTEM AND METHOD FOR PREPARING A PATIENT'S SFEMUR IN AN ORTHOPAEDIC JOINT REPLACEMENT PROCEDURE,” which is incorporated herein by reference in its entirety.

[0002] CROSS-REFERENCE TO RELATED APPLICATIONS

[0003] Cross-reference is made to co-pending U.S. patent application serial number 62 / 338,284, entitled “SYSTEM AND METHOD FOR PREPARING A PATIENT'S TIBIA IN AN ORTHOPAEDIC JOINT REPLACEMENT PROCEDURE”; and co-pending U.S. patent application serial number 62 / 338,468, entitled “SYSTEM AND METHOD FOR PREPARING A PATIENT'S BONE TO RECEIVE A PROSTHETIC COMPONENT”, each assigned to the same assignee as the present application, each filed concurrently with the present application, and each incorporated herein by reference. Technical Field

[0004] The present disclosure relates generally to orthopaedic prosthetic systems, including prosthetic components and instruments for use in performing orthopaedic joint replacement procedures, and more particularly to orthopaedic prosthetic components and surgical instruments for use in performing knee replacement procedures. Background Art

[0005] Arthroplasty is a well-known surgical procedure, and can replace diseased and / or damaged natural joints with prosthetic joints through arthroplasty.For example, in total knee arthroplasty, the natural knee joint of the patient is partially or completely replaced with a prosthetic knee joint or a knee joint prosthesis.Typical knee joint prosthesis comprises a tibial tray, a femoral component and a polymer insert or a bearing positioned between the tibial tray and the femoral component.The tibial tray generally comprises a plate with a rod extending distally therefrom, and the femoral component generally comprises a pair of condylar elements spaced apart, and the condylar element comprises a surface articulated with a corresponding surface of the polymer bearing.The rod of the tibial tray is configured to be implanted in the surgically prepared medullary canal of the patient's tibia, and the femoral component is configured to be connected to the surgically prepared distal end of the patient's femur.

[0006] From time to time, it may be necessary to perform revision knee surgery on a patient. In such revision knee surgery, a previously implanted knee prosthesis (sometimes referred to as a "primary knee prosthesis") is surgically removed and a replacement or revised knee prosthesis is implanted. In some revision knee surgeries, all components of the original knee prosthesis, including, for example, the tibial tray, femoral component, and polymer bearing, may be surgically removed and replaced with revision prosthetic components. In other revision knee surgeries, only a portion of the previously implanted knee prosthesis may be removed and replaced.

[0007] During revision knee surgery, orthopaedic surgeons typically use a variety of different orthopaedic instruments, such as, for example, cutting blocks, surgical reamer drills, drill guides, prosthesis trial devices, and other surgical instruments to prepare the patient's bone to receive a knee prosthesis. Other orthopaedic instruments (e.g., trial components) may be used to size and select components of the knee prosthesis that will replace the patient's natural joint. Trial components may include a femoral trial device that can be used to size and select a prosthetic femoral component, a tibial tray trial device that can be used to size and select a prosthetic tibial tray, and a rod trial device that can be used to size and select a prosthetic rod component. Summary of the invention

[0008] An orthopedic joint replacement system is shown and described. The system includes a plurality of prosthetic components configured to be implanted into a patient's knee joint. The system also includes a plurality of surgical instruments configured to prepare bone of the patient's knee joint to receive an implant. A method or technique for preparing bone using the surgical instruments is also disclosed.

[0009] According to one aspect of the present disclosure, an orthopaedic system includes a first surgical reamer including a distal end including a plurality of cutting grooves, a first elongated shaft extending away from the distal end, and a handle configured to be coupled to a surgical reamer. The first elongated shaft has a first diameter. A second surgical reamer includes a distal end including a plurality of cutting grooves, a second elongated shaft extending away from the distal end, and a handle configured to be coupled to a surgical reamer. The second elongated shaft has a second diameter greater than the first diameter. A depth stop includes a central opening having a third diameter equal to the second diameter. The depth stop is configured to be coupled to one of the first elongated shaft and the second elongated shaft individually. The depth stop includes a plurality of alignment tabs extending into the central opening. Each pair of opposing alignment tabs defines a width less than the first diameter of the first surgical reamer. A plurality of longitudinal slots are defined in each of the first elongated shaft and the second elongated shaft, and each longitudinal slot is dimensioned to receive one of the alignment tabs of the depth stop.

[0010] In some embodiments, the first elongated shaft of the first surgical reamer may have a plurality of openings positioned at different distances from the distal end along the longitudinal axis of the first elongated shaft. The depth stop may have a movable plate operable to engage each opening respectively to fix the depth stop in place along the first elongated shaft. In some embodiments, the second elongated shaft of the second surgical reamer may have a plurality of openings positioned at different distances from the distal end along the longitudinal axis of the second elongated shaft. The movable plate of the depth stop may be operable to engage each opening respectively to fix the depth stop in place along the second elongated shaft. In some embodiments, the movable plate may have a pin sized to be received in each opening. The pin may be configured to extend orthogonally to the longitudinal axis of the first elongated shaft and the second elongated shaft. In some embodiments, the pin may extend parallel to a pair of alignment tabs of the depth stop. In some embodiments, each of the first elongated shaft and the second elongated shaft may have a plurality of annular slots. Each annular slot may be associated with one of the apertures and may correspond to a predetermined distance from the distal end.

[0011] In some embodiments, the alignment tabs of the depth stop may have a first pair of opposing alignment tabs. The second pair of opposing alignment tabs may extend orthogonally to the first pair of alignment tabs and may cooperate with the first pair of opposing alignment tabs to define an alignment opening in the depth stop. In some embodiments, the depth stop may have a first flat surface and a second flat surface positioned opposite the first flat surface. The central opening may extend through the first flat surface and the second flat surface. The first pair of opposing alignment tabs and the second pair of opposing alignment tabs may extend inwardly from the first flat surface. In some embodiments, the alignment tabs of the depth stop may have a third pair of opposing alignment tabs extending inwardly from the second flat surface. The fourth pair of opposing alignment tabs may extend orthogonally to the third pair of alignment tabs. The fourth pair of opposing alignment tabs may extend inwardly from the second flat surface.

[0012] In some embodiments, each longitudinal slot of the first elongated shaft may extend inwardly from an elongated opening defined in the first elongated shaft to a base surface. A first distance may be defined between each opposing base surface of the first elongated shaft. Each longitudinal slot of the second elongated shaft may extend inwardly from an elongated opening defined in the second elongated shaft to a base surface. A second distance may be defined between each opposing base surface of the second elongated shaft. The second distance may be equal to the first distance and less than the width of the depth stop. In some embodiments, the guide body may have a passageway sized to receive the first elongated shaft. The depth stop may be configured to engage an outer end of the guide body.

[0013] According to another aspect of the present disclosure, an orthopaedic system includes a surgical reamer including a distal end including a plurality of cutting grooves, an elongated shaft extending away from the distal end, and a handle configured to be coupled to the surgical reamer. The elongated shaft includes a plurality of longitudinal slots and a plurality of openings defined in a base surface of one of the plurality of longitudinal slots. A depth stop includes a central opening sized to receive the elongated shaft, a movable plate operable to respectively engage each opening to secure the depth stop in position along the elongated shaft, and a plurality of alignment tabs extending into the central opening and positioned to be received in the plurality of elongated slots of the surgical reamer.

[0014] In some embodiments, the movable plate may have a pin sized to be received in each aperture. The pin may be configured to extend orthogonally to the longitudinal axis of the elongated shaft. In some embodiments, the pin may extend parallel to a pair of alignment tabs of the depth stop. In some embodiments, the elongated shaft may have a plurality of annular slots. Each annular slot may be associated with one of the apertures and may correspond to a predetermined distance from the distal end of the surgical reamer. In some embodiments, the alignment tabs of the depth stop may have a first pair of opposing alignment tabs. A second pair of opposing alignment tabs may extend orthogonally to the first pair of alignment tabs and may cooperate with the first pair of opposing alignment tabs to define an alignment opening in the depth stop. In some embodiments, the depth stop may have a biasing element operable to bias the pin into engagement with the aperture.

[0015] According to another aspect of the present disclosure, a method for performing an orthopedic surgical procedure includes aligning a central opening of a depth stop with an elongated shaft of a first surgical reamer. The method also includes advancing the depth stop on the elongated shaft to position a plurality of alignment tabs of the depth stop into a plurality of longitudinal slots defined in the elongated shaft. The method also includes securing the depth stop in position along the elongated shaft. The method also includes advancing the first surgical reamer into a guide body to engage the depth stop with the guide body and define an opening in a patient's bone.

[0016] In some embodiments, fixing the depth stop may require positioning the pin in an aperture defined in the elongated shaft. In some embodiments, the method may require pressing a button to disengage the pin from the aperture.

[0017] According to one aspect of the present disclosure, an orthopedic system includes a femoral trial component configured to be coupled to a surgically prepared distal end of a patient's femur. The femoral trial component includes an anterior flange and a pair of curved arms extending away from the anterior flange. Each arm includes a distal surface facing the bone. A plurality of reinforcement trial components are provided. Each reinforcement trial component is sized to be positioned on the distal surface facing the bone and includes a mounting post and a magnet. Each curved arm includes a slot defined in its distal surface facing the bone, the slot extending inward from an outer edge. The slot is sized to receive a mounting post of one of the plurality of reinforcement trial components.

[0018] In some embodiments, each reinforcement test component may have a different thickness. The curved arm of the femoral test component may have a plurality of distal cutting slots. Each distal cutting slot may be spaced apart from the distal surface facing the bone by a distance equal to the thickness of one of the reinforcement test components. In some embodiments, each curved arm may have a channel, which may be defined in its distal surface facing the bone and extending inward from the outer edge parallel to the slot. Each reinforcement test component may have a post sized to be received in the channel. In some embodiments, the channel may be partially defined by a tapered surface configured to engage the post of each reinforcement test component. In some embodiments, each curved arm may have an opening, which may be defined in its distal surface facing the bone and spaced apart from the channel. Each opening may be sized to receive the post of each reinforcement test component. In some embodiments, each reinforcement test component may have a flat base surface, which is configured to engage the distal surface of each curved arm facing the bone. The mounting posts and posts may extend outward from the base surface.

[0019] In some embodiments, a plurality of posterior reinforcement test components may be provided. Each reinforcement test component may have a mounting post and a magnet. Each arm may have a posterior surface facing the bone and a posterior slot defined in its posterior surface facing the bone, the posterior slot extending inwardly from the outer edge. The posterior slot may be sized to receive a mounting post of one of the plurality of posterior reinforcement test components. In some embodiments, each posterior reinforcement test component may have a different thickness. The curved arm of the femoral test component may have a plurality of posterior cutting slots. Each posterior cutting slot may be spaced from the posterior surface facing the bone by a distance equal to the thickness of one of the posterior reinforcement test components.

[0020] In some embodiments, the femoral trial insert component can be configured to be fixed to the femoral trial component. The femoral trial insert component can have a body sized to be positioned between the pair of curved arms. In some embodiments, the size of the tibial baseplate can be sized to be positioned on the proximal surface of the patient's tibia. The insert trial device can be configured to be attached to the tibial baseplate. The insert trial device can have a pair of proximal curved surfaces that are configured to articulate with the femoral trial component and the curved arms of the femoral trial insert component.

[0021] In some embodiments, the mounting post may have a pin operable to retain the mounting post in the slot of the flexure arm.

[0022] According to another aspect of the present disclosure, an orthopedic system includes a femoral trial component configured to be coupled to a surgically prepared distal end of a patient's femur. The femoral trial component includes an anterior flange and a pair of curved arms extending away from the anterior flange. A plurality of reinforcement trial components are provided. Each reinforcement trial component includes a post and a magnet. Each curved arm includes an opening defined in a bone-facing surface that is sized to receive a post of one of the plurality of reinforcement trial components.

[0023] In some embodiments, the surface facing the bone may be a distal surface facing the bone. In some embodiments, the surface facing the bone may be a posterior surface facing the bone.

[0024] In some embodiments, each curved arm may have a channel that may be defined in its bone-facing surface. The channel may extend inwardly from the outer edge of the curved arm and be spaced apart from the opening. The channel may be sized to receive the post of each reinforcement test component. In some embodiments, each reinforcement test component may have a mounting post. Each curved arm may have a slot defined in its bone-facing surface, the slot extending inwardly from the outer edge. The slot may be sized to receive the mounting post of one of the plurality of reinforcement test components.

[0025] In some embodiments, each reinforcement trial component may have a different thickness. The curved arm of the femoral trial component may have a plurality of cutting slots. Each cutting slot may be spaced from the bone-facing surface by a distance equal to the thickness of one of the reinforcement trial components.

[0026] According to another aspect of the present disclosure, an orthopedic system includes a femoral trial component configured to be coupled to a surgically prepared distal end of a patient's femur. The femoral trial component includes an anterior flange and a pair of curved arms extending away from the anterior flange. A plurality of reinforcement trial components are provided. Each reinforcement trial component includes a mounting post and a magnet. Each curved arm includes a slot defined in a bone-facing surface that extends inwardly from an outer edge. The slot is sized to receive a mounting post of one of the plurality of reinforcement trial components.

[0027] In some embodiments, the bone-facing surface may have a distal surface facing the bone. In some embodiments, the bone-facing surface may have a posterior surface facing the bone.

[0028] According to one aspect of the present disclosure, an orthopedic system includes a femoral trial component configured to be coupled to a surgically prepared distal end of a patient's femur. The femoral trial component includes an anterior flange. A pair of curved arms extend away from the anterior flange. A posterior flange extends between the pair of curved arms. A cutting block is configured to be coupled to the anterior flange of the femoral trial component. The cutting block includes a cutting guide surface. When the cutting block is coupled to the anterior flange of the femoral trial component, the cutting guide surface is positioned coplanar with the distal surface of the anterior flange of the femoral trial component, and the posterior flange of the femoral trial component is aligned with the cutting guide surface of the cutting block to prevent further rearward movement of the cutting saw blade.

[0029] In some embodiments, the anterior flange of the femoral trial component can have an aperture.The cutting block can have a body having a cutting guide surface and a post extending from the body, the post can be sized to be received in the aperture.

[0030] In some embodiments, the cutting block may have a locking mechanism that is operable to fix the cutting block to the femoral trial component. In some embodiments, the front flange of the femoral trial component may have a slot. The locking mechanism may have a movable locking tab that extends outward from the body and is sized to be received in the slot. The locking tab may be movable between a first position and a second position, in which the locking tab may be configured to engage the front flange to fix the cutting block to the femoral trial component, and in the second position, the locking tab may be configured to be spaced apart from the front flange. In some embodiments, the locking mechanism may have a user-operated button positioned relative to the cutting guide surface. The user-operated button is operable to actuate the locking tab. In some embodiments, the locking mechanism may have a biasing element to bias the locking tab in the first position.

[0031] In some embodiments, the rear plate may have a groove that is coplanar with the distal surface of the front flange. In some embodiments, the rear plate may have a visual indicator that may be coplanar with the distal surface of the front flange.

[0032] In some embodiments, the flexure arm of the femoral trialing component may include a plurality of distal cutting slots extending parallel to the distal surface of the anterior flange. In some embodiments, the flexure arm of the femoral trialing component may have a plurality of posterior cutting slots extending orthogonal to the distal cutting slots.

[0033] In some embodiments, the tibial baseplate may be sized to be positioned on a proximal surface of a patient's tibia. The insert trial device may be configured to be attached to the tibial baseplate. The insert trial device may have a pair of proximal curved surfaces configured to articulate with the curved arms of the femoral trial component.

[0034] According to another aspect of the present disclosure, an orthopedic system includes a femoral trial component configured to be coupled to a surgically prepared distal end of a patient's femur. The femoral trial component includes an anterior flange. A pair of curved arms extend away from the anterior flange. A posterior flange extends between the pair of curved arms. A central passage is defined between the anterior flange, the curved arms, and the posterior flange. A femoral trial insert component is configured to be fixed to the femoral trial component. The femoral trial insert component includes a body that is sized to be positioned in the central passage of the femoral trial component. A cutting block is configured to be coupled to the anterior flange of the femoral trial component. The cutting block includes a cutting guide surface. When the cutting block is coupled to the anterior flange of the femoral trial component, the cutting guide surface is positioned to be coplanar with the distal surface of the anterior flange of the femoral trial component.

[0035] In some embodiments, the body of the femoral trial insert component may have a curved surface that may be shaped to match the patellar surface of the prosthetic femoral component. In some embodiments, the posterior flange of the femoral trial component may be aligned with the cutting guide surface of the cutting block to prevent further posterior movement of the cutting saw blade.

[0036] According to another aspect of the present disclosure, a method includes coupling a femoral trial component to a surgically prepared distal end of a patient's femur. The method also includes coupling a cutting block to an anterior flange of the femoral trial component such that a cutting guide of the cutting block is positioned coplanar with a distal surface of the anterior flange. The method also includes advancing a saw blade along the cutting guide of the cutting block and the distal surface of the anterior flange to contact the patient's femur to cut the patient's femur. The method also includes advancing the saw blade rearwardly to engage the saw blade with a posterior flange of the femoral trial component.

[0037] In some embodiments, the method may entail cutting the distal end of the patient's femur along the inner surface of each of the medial arm and the lateral arm.

[0038] In some embodiments, the method may require positioning a locking tab extending from the cutting block within a corresponding opening formed in an anterior flange of the femoral trial component to secure the cutting block to the femoral trial component. In some embodiments, the method may require actuating a user-operated button formed on the cutting block to actuate the locking tab. In some embodiments, the method may require coupling a femoral trial insert component to the femoral trial component such that the body of the insert may be positioned in a central passage defined between the medial and lateral arms of the femoral trial component and between the anterior and posterior flanges of the femoral trial component. In some embodiments, the method may require articulating the patient's leg between extension and flexion, wherein the femoral trial component engages an insert trial component located on the patient's tibia.

[0039] According to one aspect of the present disclosure, an orthopedic system includes a tibial baseplate that is sized to be positioned on the proximal surface of a patient's tibia. An insert trial component is configured to be attached to the tibial baseplate. The insert trial component includes a pair of proximally curved concave surfaces. The femoral trial component is configured to be coupled to the distal end of the patient's femur. The femoral trial component includes an anterior flange. A pair of curved arms extend away from the anterior flange. Each arm includes a curved condylar surface and a plurality of cutting guide slots. The femoral trial insert component includes a central body that is sized to be positioned between a pair of curved arms and a pair of mounting flanges that extend outwardly from the central body. Each mounting flange includes a distal surface and a fastener retained in each mounting flange to fix the mounting flange to the femoral trial component. The femoral trial component includes a pair of slots in the curved arms that are sized to receive the mounting flanges of the femoral trial insert component. The distal surface and the curved condylar surface are configured to engage and articulate on a proximal curved concave surface of the insert trial component when the femoral trial insert component is secured to the femoral trial component.

[0040] In some embodiments, the femoral trial insert component may have a tab extending outward from a first flange of a pair of mounting flanges. The femoral trial component may have a groove defined in a first mounting flexure arm of the pair of flexure arms. The groove may be connected to the first slot of the pair of slots and may be sized to receive the tab of the femoral trial insert component so that the femoral trial insert component is oriented relative to the femoral trial component. In some embodiments, the pair of flexure arms may have a second flexure arm that does not have any groove leading to another slot of the pair of slots. In some embodiments, the femoral trial insert component may have a second tab extending outward from the first mounting flange. The femoral trial component may have a second groove defined in the first flexure arm. The second groove may be connected to the first slot and may be sized to receive the second tab of the femoral trial insert component so that the femoral trial insert component is oriented relative to the femoral trial component.

[0041] In some embodiments, each fastener may have an elongated threaded shaft sized to engage a threaded bore defined in one of the mounting flanges of the femoral trial component. The head may be connected to the elongated threaded shaft. The socket may be defined in the head. The annular flange may extend radially outward from the head to engage the mounting flange of the femoral trial component. In some embodiments, each mounting flange may have an opening defined in the distal surface of the mounting flange. The inner wall may extend inward from the opening to define a cavity in the mounting flange. The inner wall may have a distal segment defining a first diameter. The annular flange of the fastener may have a second diameter greater than the first diameter. In some embodiments, the annular flange of the fastener may have a beveled proximal edge.

[0042] In some embodiments, the central body of the femoral trial insert component may have an anterior flange. A pair of arms may extend from the anterior flange. Each arm may have one of the mounting flanges. A proximal wall may extend between the pair of arms. The proximal wall may cooperate with the pair of arms and the anterior flange to define a recess that is sized to receive the spine of the insert trial component. A rear cam may extend from the proximal wall and may be configured to articulate with the spine of the insert trial component within a range of flexion.

[0043] In some embodiments, the femoral trial insert component may be a first femoral trial component. The orthopedic system may have a second femoral trial component, which may have an anterior flange. A pair of arms may extend from the anterior flange. Each arm of the second femoral trial component may have a mounting flange having a distal surface and a fastener retained in the mounting flange to secure the mounting flange to the femoral trial component. An open channel may be defined between the pair of arms.

[0044] In some embodiments, the femoral trial insert component can have a post sized to receive a stem trial device including an elongated shaft. In some embodiments, the femoral trial insert component can have an anterior surface shaped to match a patellar surface of a corresponding femoral prosthetic component.

[0045] According to another aspect of the present disclosure, an orthopedic system includes a rod trial device, which includes a threaded distal end and an elongated shaft extending from the threaded distal end. The femoral trial component is configured to be connected to the distal end of the patient's femur. The femoral trial component includes an anterior flange. A pair of curved arms extend away from the anterior flange. Each arm includes a curved condylar surface and a plurality of cutting guide slots. The femoral box trial component includes a central body that is sized to be positioned between the pair of curved arms. The pillar is sized to receive the threaded distal end of the rod trial device separately. A pair of mounting flanges extend outwardly from the central body. Each mounting flange includes a distal surface and a fastener retained in each mounting flange to fix the femoral box trial component to the femoral trial component. The femoral intramedullary component includes a pillar sized to receive the threaded distal end of the rod trial device separately. Each of the pair of mounting flanges includes a distal surface and a fastener retained in each mounting flange to fix the femoral box trial component to the femoral trial component. The femoral trial component includes a pair of slots in the flexure arm that are sized to receive mounting flanges of the femoral box trial component and the femoral intramedullary component, respectively.

[0046] In some embodiments, the insert trial component may have a pair of proximal curved concave surfaces configured to articulate with the curved condylar surfaces of the femoral trial component. In some embodiments, the central body may have a posterior cam configured to engage the ridges of the insert trial component. In some embodiments, when secured to the femoral trial component, the distal surfaces of the femoral box trial component and the femoral intramedullary component articulate on the proximal curved concave surfaces of the insert trial component.

[0047] According to another aspect of the present disclosure, an orthopedic system includes a femoral trial component configured to be coupled to a distal end of a patient's femur. The femoral trial component includes an anterior flange. A pair of curved arms extend away from the anterior flange. Each arm includes a curved condyle surface and a plurality of cutting guide slots. A femoral trial insert component includes (i) a pair of mounting flanges extending outwardly from a central body, each mounting flange including a distal surface and a fastener retained therein to secure the mounting flange to the femoral trial component, and a tab extending outwardly from a first flange of the pair of mounting flanges. The femoral trial component includes: a pair of slots in the curved arms, the pair of slots being sized to receive the mounting flanges of the femoral trial insert component; and a groove defined in the first mounting curved arm of the pair of curved arms, the groove being connected to the first slot of the pair of slots and being sized to receive the tab of the femoral trial insert component to orient the femoral trial insert component relative to the femoral trial component.

[0048] In some embodiments, the pair of flexure arms may have a second flexure arm that lacks any groove leading to another slot of the pair of slots. In some embodiments, the femoral trial insert component may have a second tab extending outwardly from the first mounting flange. The femoral trial component may have a second groove defined in the first flexure arm. The second groove may be connected to the first slot and be sized to receive the second tab of the femoral trial insert component to orient the femoral trial insert component relative to the femoral trial component.

[0049] In some embodiments, each fastener may have an elongated threaded shaft sized to engage a threaded bore defined in one of the mounting flanges of the femoral trial component. The head may be connected to the elongated threaded shaft. The socket may be defined in the head. The annular flange may extend radially outward from the head to engage the mounting flange of the femoral trial component. In some embodiments, each mounting flange may have an opening defined in a distal surface of the mounting flange. The inner wall may extend inward from the opening to define a cavity in the mounting flange. The inner wall may have a distal segment defining a first diameter. The annular flange of the fastener may have a second diameter greater than the first diameter.

[0050] According to another aspect, a method for performing an orthopedic surgical procedure includes positioning a femoral trial component on a distal end of a patient's femur, advancing a cutting saw blade through a cutting guide slot defined in the femoral trial component to remove a portion of the patient's femur, attaching the femoral trial insert component to the femoral trial component via a pair of fasteners retained on the femoral trial insert component, and engaging the femoral trial component and surfaces of the femoral trial insert component with a pair of concave curved surfaces of the tibial insert trial component within a range of flexion from extension to flexion.

[0051] In some embodiments, attaching the femoral trial insert component may include securing the femoral trial insert component to the femoral trial component while the femoral trial component is positioned on the distal end of the patient's femur.

[0052] In some embodiments, the method may further include attaching the augmentation trial device to the bone-facing surface of the femoral trial component. Additionally, in some embodiments, attaching the augmentation trial device to the bone-facing surface of the femoral trial component may include advancing a mounting post of the augmentation trial into a slot extending inwardly from an outer edge of the femoral trial component. In some embodiments, attaching the augmentation trial device to the bone-facing surface of the femoral trial component may include engaging a post of the augmentation trial device with a tapered surface of a channel defined in the bone-facing surface of the femoral trial component to tilt the augmentation trial device relative to the bone-facing surface.

[0053] In some embodiments, attaching the femoral trial insert component may include advancing a pair of flanges into openings defined in a pair of curved arms of the femoral trial component. The fastener may be retained on the pair of flanges. Additionally, in some embodiments, advancing the pair of flanges into openings defined in a pair of curved arms of the femoral trial component includes advancing an alignment tab extending from a first flange of the pair of flanges into an alignment groove defined in a first curved arm of the pair of curved arms. The second curved arm of the pair of curved arms may not have any alignment grooves.

[0054] In some embodiments, the method may further include attaching the post trial insert component to the femoral trial component via a pair of fasteners retained on the femoral trial insert component, engaging surfaces of the post trial component and the femoral trial insert component with a pair of concave curved surfaces of the tibial insert trial component in a flexion range from extension to flexion, and removing the post trial insert component from the femoral trial component. The femoral trial insert component may be a femoral box trial component, and attaching the femoral trial insert component to the femoral trial component may include attaching the femoral box trial component after removing the post trial insert component from the femoral trial component.

[0055] In some embodiments, the method may further include coupling the cutting block to the anterior flange of the femoral trial component such that the cutting guide of the cutting block is coplanarly positioned with the distal surface of the anterior flange, advancing the saw blade along the cutting guide of the cutting block and the distal surface of the anterior flange into contact with the patient's femur to cut the patient's femur, and advancing the saw blade rearwardly to engage the saw blade with the posterior flange of the femoral trial component. Additionally, in some embodiments, attaching the femoral trial insert component includes attaching the femoral trial insert component to the femoral trial component after advancing the saw blade rearwardly to engage the saw blade with the posterior flange of the femoral trial component.

[0056] In some embodiments, the method may further include attaching the drill guide body to the femoral trial component via a pair of retaining screws, and advancing the surgical reamer through the drill guide body to define an opening in the patient's femur. Additionally, in some embodiments, the method may further include securing a depth stop in position along the elongated shaft of the surgical reamer, and advancing the surgical reamer into the guide body to engage the depth stop with the guide body.

[0057] In some embodiments, this may also include securing a stem trial device to the femoral trial insert component.

[0058] According to another aspect, a method of performing an orthopaedic surgical procedure includes attaching a first femoral trial insert component to a femoral trial component, positioning the first femoral trial insert component and the femoral trial component on a distal end of a patient's femur, and engaging surfaces of the femoral trial component and the first femoral trial insert component with a pair of concave curved surfaces of a tibial insert trial component in a range of flexion from extension to flexion. The method also includes advancing a cutting saw blade through a cutting guide slot defined in the femoral trial component to remove a portion of the patient's femur, advancing an augmentation trial device medially into a slot defined in the femoral trial component to position a body of the augmentation trial device between a bone-facing surface of the femoral trial component and the patient's femur, and removing the first femoral trial insert component from the femoral trial component. The method also includes coupling a cutting block to an anterior flange of a femoral trial component, advancing a saw blade along a cutting guide and a distal surface of the anterior flange of the cutting block into contact with the patient's femur to cut the patient's femur, attaching a second femoral trial insert component to the femoral trial component, and engaging surfaces of the femoral trial component and the second femoral trial insert component with a pair of concave curved surfaces of the tibial insert trial component over a range of flexion from extension to flexion.

[0059] In some embodiments, the method may further include advancing the saw blade rearwardly to engage the saw blade with the posterior flange of the femoral trial component.

[0060] In some embodiments, advancing the cutting saw blade through the cutting guide slot may include selecting a cutting guide slot that is positioned a distance from the bone-facing surface of the femoral trial component that is equal to the thickness of the reinforcement trial component.

[0061] In some embodiments, the method may further include attaching the drill guide body to the femoral trial component via a pair of retaining screws, and advancing a surgical reamer through the drill guide body to define an opening in the patient's femur.

[0062] In some embodiments, the method may further include securing a stem trial device to the first femoral trial insert component prior to attaching the first femoral trial insert component to the femoral trial component.

[0063] According to another aspect, a method for performing an orthopedic surgical procedure includes positioning a femoral trial component on a distal end of a patient's femur, selecting a cutting guide slot positioned a distance from a bone-facing surface of the femoral trial component that is equal to the thickness of the augmentation trial component, advancing a cutting saw blade through the cutting guide slot defined in the femoral trial component to remove a portion of the patient's femur, and advancing a mounting post of the augmentation trial device into a slot extending inward from an outer edge of the femoral trial component.

[0064] In some embodiments, advancing the mounting post of the augmentation trial device into the slot may include positioning the body of the augmentation trial device between the bone-facing surface of the femoral trial component and the patient's femur. BRIEF DESCRIPTION OF THE DRAWINGS

[0065] The detailed description is made with reference to the following drawings, in which:

[0066] Figure 1 is an exploded perspective view of prosthetic components of an orthopedic joint replacement system;

[0067] Figure 2 is an exploded perspective view of surgical instruments for an orthopedic joint replacement system for use in preparing a patient's femur;

[0068] Figure 2A is along Figure 2 A cross-sectional side elevation view taken along line 2-2 in FIG.

[0069] Figure 3 yes Figure 2 A distal plan view of a femoral cutting guide of a surgical instrument;

[0070] Figure 4 yes Figures 2 to 3 Anterior view of a femoral cutting guide;

[0071] Figure 5 yes Figures 2 to 4 A side elevation view of a femoral cutting guide;

[0072] Figure 6 to Figure 7 The steps of an orthopedic surgical procedure using an orthopedic joint replacement system are shown;

[0073] Figure 8 is a perspective view of a pair of surgical instruments of an orthopedic joint replacement system;

[0074] Fig. 8A yes Figure 8 Along the instrument Figure 8 A cross-sectional plan view taken along line 8-8 in FIG.

[0075] Figures 9 to 19 Other steps of an orthopedic surgical procedure using an orthopedic joint replacement system are shown;

[0076] Fig. 20 yes Figure 9 to Figure 5 A proximal perspective view of a femoral cutting guide;

[0077] Fig.21 yes Fig.14 A perspective view of the femoral augmentation trial shown in;

[0078] Fig. 22 yes Fig.21 A side view of a femoral augmentation test device; and

[0079] Fig.23 is a further illustration of the steps of an orthopedic surgical procedure using an orthopedic joint replacement system. DETAILED DESCRIPTION

[0080] Although the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific exemplary embodiments thereof have been shown by way of example in the accompanying drawings and will be described in detail herein. However, it should be understood that the concepts of the present disclosure are not intended to be limited to the specific forms disclosed, but on the contrary, it is intended to cover all modifications, equivalents and alternative forms within the spirit and scope of the present invention as defined by the appended claims.

[0081] Throughout the specification, when referring to the orthopaedic implants and orthopaedic devices described herein and the natural anatomy of the patient, terms indicating anatomical references may be used, such as anterior, posterior, medial, lateral, superior, inferior, etc. These terms have well-known meanings in the field of anatomical research and orthopaedics. Unless otherwise specified, these anatomical reference terms used in the written detailed description and claims are intended to be consistent with their well-known meanings.

[0082] The exemplary embodiments of the present invention described below and shown cover knee joint prosthesis and knee joint component, and implant and the method for reconstructing knee joint.It will also be apparent to those of ordinary skill in the art that the preferred embodiments discussed below are exemplary in nature, and can be reconstructed without departing from the scope and essence of the present invention.However, for clarity and accuracy, the exemplary embodiments described below may include optional steps, methods and features, and those of ordinary skill should recognize them as not to meet the required requirements of the scope of the present invention.

[0083] See now Figure 1 The orthopedic joint replacement system 10 includes a plurality of orthopedic prosthetic components 12 and a plurality of orthopedic instruments 14 (see, e.g. Figure 2 ) for use in preparing the bone to receive one or more of the prosthetic components 12. The term "orthopaedic surgical instrument" or "orthopaedic surgical instrument system" is used herein to refer to surgical tools used by surgeons when performing orthopaedic surgery. Therefore, it should be understood that as used herein, the terms "orthopaedic surgical instrument" and "orthopaedic surgical instruments" are different from orthopaedic prosthetic components or implants, such as Figure 1 Those shown in .

[0084] The prosthetic components 12 of the system 10 include a prosthetic femoral component 20 configured to be fixed to the surgically prepared distal end of the patient's femur and a prosthetic tibial component 22 configured to be fixed to the surgically prepared proximal end of the patient's tibia. In an exemplary embodiment, the tibial component 22 includes a tibial tray 24 and a prosthetic insert 26 configured to engage the femoral component 20 after implantation in the patient's knee. It should be understood that the system 10 may include multiple components 12 corresponding to patients with bones of different sizes. In this way, the surgeon will be able to select the components and other instruments that most closely match the patient's bone anatomy.

[0085] like Figure 1 As shown, the femoral component 20 includes an anterior flange 30 and a pair of condyles 32 extending away from the flange 30. A recess 34, commonly referred to as an intracondylar recess, is defined between the condyles 32. The condyles 32 define an articulation surface 36 that is configured to engage a corresponding articulation surface 70 of the insert 26. The femoral component 20 also includes an elongated stem strut 40 that extends upwardly away from a posterior surface 42 thereof. As described in more detail below, the femoral stem strut 40 is configured to receive one of a plurality of different stem components 44. In an exemplary embodiment, a threaded bore 48 is defined in the stem strut 40 that is sized to receive a corresponding threaded shaft 50 of the stem component 44.

[0086] The tibial tray 24 is configured to be implanted in a surgically prepared end of a patient's proximal tibia (not shown). The tibial tray 24 includes a platform 58 having an elongated stem support 60 extending downwardly away from a lower surface 62 thereof. The elongated tibial stem support 60 is configured to receive one of a plurality of different stem components 44. Specifically, as shown in Figure 1 As can be seen in FIG. 6 , a threaded bore 48 is defined in the stem support 60 , which is sized to receive the corresponding threaded shaft 50 of the stem member 44 .

[0087] The insert 26 can be fixed to the tibial tray 24. Specifically, the insert 26 can be snap-fitted to the tibial tray 24. In this way, the insert 26 is fixed relative to the tibial tray 24 (i.e., it cannot rotate or move in the anterior / posterior or medial / lateral directions). Although in other embodiments, the tibial tray can be fixed in a manner that allows it to rotate relative to the tibial tray 24.

[0088] Insert 26 includes lateral and medial articulation surfaces 70. Surfaces 70 are configured to articulate with corresponding articulation surfaces 36 of femoral component 20. Specifically, femoral component 20 is configured to be implanted into a surgically prepared distal end of a patient's femur (not shown) and is configured to mimic the configuration of the patient's natural femoral condyles. Thus, articulation surfaces 36 of femoral component 20 are configured (e.g., curved) in a manner that mimics the condyles of a natural femur.

[0089] like Figure 1 As shown, the rod component 44 of the system 10 includes an elongated rod 80 configured to be attached to either of the components 20, 22. Each elongated rod 80 extends from a threaded shaft 50 at one end to a sharp tip 82 at an opposite end. Each rod also includes a ribbed outer surface 84 extending from the sharp tip 82 toward the threaded shaft 50. A plurality of generally flat surfaces 86 are positioned around the outer circumference of the rod 80 adjacent the shaft 50. The surface 86 is sized and positioned to receive the end of a wrench or other installation tool so that the rod 80 can be rotated into close engagement with one of the threaded bores 48.

[0090] In an exemplary embodiment, the prosthetic component 12 also includes a plurality of offset adapters 90, 92 configured to be attached to the components 20, 22. Figure 1 As shown, the adapter 90 is configured to offset the longitudinal axis of the elongated stem 80 from the longitudinal axis of the stem strut 60 of the tibial tray 24 by a predetermined amount. Similarly, the adapter 92 is configured to offset the longitudinal axis of the elongated stem 80 from the longitudinal axis of the stem strut 40 of the femoral component 20. Each of the adapters 90, 92 includes a threaded shaft 50 configured to be received in the threaded bore 48 of either of the components 20, 22. Each of the adapters 90, 92 also includes a threaded bore 48 at an opposite end thereof that is sized to receive the threaded shaft 50 of one of the elongated stems 80. In an exemplary embodiment, a locking nut 100 is positioned on the threaded shaft 50 of each of the adapters 90, 92. The locking nut 100 can abut against a surface of the stem strut of each component to secure the adapter thereto.

[0091] The parts of knee joint prosthesis 10 that engage with natural bone, such as femoral component 20, tibial tray 24 and rod component 44 can be constructed with implant-grade biocompatible metal, but other materials can also be used. The example of such metal includes cobalt (including cobalt alloys such as cobalt-chromium alloy), titanium (including titanium alloys such as Ti6Al4V alloy) and stainless steel. Such metal parts can also be coated with surface treatment agents (such as hydroxyapatite) to improve biocompatibility. In addition, the surface of the natural bone of the metal parts can be textured, so that these parts are fixed to bone. Such surface can also be porous coated, to promote bone ingrowth with permanent fixation.

[0092] The insert 26 may be constructed of a material, such as a polymer material, that allows for smooth articulation between the insert 26 and the femoral component 20. One such polymer material is polyethylene, such as ultra high molecular weight polyethylene (UHMWPE).

[0093] See now Figure 2 , a plurality of orthopaedic instruments 14 for use in preparing a femur to receive one or more of the prosthetic components 12 are shown. The instrument 14 includes a femoral trial component 410 and a femoral trial insert component 412 configured to be secured to the femoral trial component. The instrument 14 also includes a cutting platform or cutting block 416 configured to couple to a front flange 420 of the femoral trial device 410. It should be understood that the system 10 may include a plurality of components 410, 412 and platforms 416 corresponding to patients having femoral bones of different sizes. In this way, the surgeon will be able to select components and other instruments that most closely match the patient's bone anatomy. As described in more detail below, the surgeon may use the components 410, 412 and platforms 416 to prepare the distal end of the patient's femur to receive the above-described prosthetic components. Figure 1 A femoral prosthetic component is described.

[0094] The femoral trial component 410 is a unitary body formed of a metallic material (such as, for example, a titanium alloy or a cobalt-chromium alloy) or other suitable biocompatible material. The component 410 includes an anterior flange 420 and a pair of curved arms 422, 424 extending distally away from the anterior flange 420. Each of the arms 422, 424 extends to a posterior top 426, and the posterior top 426 is connected by a posterior plate 428. It should be understood that in other embodiments, the posterior plate may be omitted. In an exemplary embodiment, the anterior flange 420, the arms 422, 424 and the posterior plate 428 cooperate to define a central passage 430 extending through the trial component 410.

[0095] like Figures 2 to 5 As shown, the trial component 410 includes a plurality of mounting holes and slots 440 that permit attachment of other surgical instruments, including a femoral trial insert (box trial) component 412 and a platform 416. The mounting holes 440 include a pair of oval openings 442 defined in the anterior flange 420, and a locking slot 444 positioned between the openings 442. In an exemplary embodiment, the oval openings 442 are sized to receive a pair of corresponding flanges 446 of the cutting platform 416, and the locking slots 444 are sized to receive a movable locking arm 448 of the cutting platform 416, as described in more detail below.

[0096] The mounting aperture 440 also includes a pair of openings 450, 452 defined in the arms 422, 424, respectively, which open to the central passage 430. Figures 2 to 3 As shown, the base surface 454 of each of the openings 450, 452 has a through hole 456 defined therein. In an exemplary embodiment, a plurality of threads 458 are aligned with the holes 456, and the threads 458 are sized to receive a corresponding pair of fasteners, such as, for example, a pair of retaining screws 460 of the box test component 412, as described in more detail below.

[0097] like Figures 2 to 3 As shown, openings 450, 452 are defined in the distal surface 470 of each of the arms 422, 424. Each of the arms 422, 424 has a curved anterior surface 472 extending from the distal surface 470 to the anterior flange 420 and a curved posterior surface 474 extending posteriorly away from the distal surface 470 to the posterior tip 426. Surfaces 470, 472, 474 and the anterior surface 476 of the anterior flange 420 are configured to contact the insert trial component 730 to allow the surgeon to evaluate the range of motion before selecting a final set of prosthetic components. In an exemplary embodiment, the contact surface of the femoral trial component 410 is shaped to match the shape of a corresponding surface of a femoral prosthetic component corresponding to the size of the trial component 410.

[0098] The femoral trial component 410 also includes a plurality of cutting slots that are sized and shaped to guide a surgical saw during surgery to ensure that a predetermined amount of bone is removed with each cut. Figure 2 As shown, each of the arms 422, 424 includes a plurality of distal cutting slots 480 defined in the curved anterior surface 472 of the arms 422, 424. Each of the slots 480 corresponds to a different level of distal resection of the femur, with the most distal slot being used to remove the least amount of bone during the cutting operation and the most proximal or anterior slot being used to remove the greatest amount of bone. Figure 3 As shown, each of the arms 422, 424 also includes a plurality of posterior cutting guide slots 482 defined in the curved posterior surface 474 of the arms 422, 424. Each of the slots 482 corresponds to a different level of posterior resection of the femur.

[0099] The test component 410 also includes a plurality of guide holes 484 that are sized to permit passage of retaining pins 486 (see Figure 6 ). Such a fixation pin may be used to temporarily fix the trial component 410 to the patient's femur during surgery.

[0100] See now Figure 5, the trial component 410 also includes a bone-facing side 490 that includes a surface configured to engage the distal end of the patient's femur. The surface includes an anterior fixation surface 492 positioned opposite the anterior surface 476 of the flange 420. A pair of anterior chamfered surfaces 494 (one for each of the arms 422, 424) extend between the anterior fixation surface 492 and a distal fixation surface 496 of the arms 422, 424. Each of the arms 422, 424 also includes a posterior chamfered fixation surface 498 extending between the distal fixation surface 496 and the posterior fixation surface 500. As shown in FIG. Figure 5 As shown, cutting guide slots 480, 482 extend through fixation surfaces 492, 494, 496, 498, 500 to permit the cutting saw to engage the patient's bone.

[0101] In an exemplary embodiment, surfaces 496, 500 also include mounting slots 502, 504, respectively, which are sized to receive mounting pins or posts 908 of a femoral augmentation trial 506 (see FIG. Fig.14 and Figure 21 to Figure 23 ). It should be appreciated that system 10 may include a variety of different sized femoral augment trial devices corresponding to different sized femoral augment prosthetic components.

[0102] Return now Figure 2 The apparatus 14 also includes a number of femoral insert trial components, including Figure 2 The box test component 412 and the pillar test component 712 shown in FIG. Fig.16 ), which are configured to be individually attached to the femoral trial component 410. In an exemplary embodiment, the box trial component 412 includes a central body 510 that is sized to be positioned in the central passage 430 of the trial component 410. The body 510 includes an anterior flange 512 having a surface shaped to match the patella surface of a corresponding femoral prosthetic component. The body 510 also includes a pair of arms 514 extending from the flange 512. Each arm 514 also includes a curved surface 516 that is shaped to match the corresponding surface of the femoral prosthetic component. In this way, when the box trial component 412 is fixed to the femoral trial component 410, the components 410, 412 can cooperate to allow the surgeon to evaluate the range of motion and select a set of prosthetic components.

[0103] The cartridge trial component 412 has a pair of mounting flanges 520, 522 extending outwardly from the arms 514. The mounting flanges 520 are sized and shaped to be received in the openings 450, 452 of the femoral trial component 410, as described in more detail below. The proximal wall 524 extends between the pair of arms 514 and cooperates with the arms 514 and the anterior flange 512 to define a recess 526 in the cartridge trial component 412. The recess 526 is sized to receive the ridge 738 of the insert trial component 730 (see Fig.19).like Figure 1 As shown, the cartridge trial component 412 also includes a posterior cam 528 that is configured to articulate with the spine 738 through a range of flexion.

[0104] The box test component 412 also includes a pair of fasteners 460 attached to the flange 520 and configured to be received in the threaded holes 456 of the test component 410 to secure the box test component 412 thereto. Figure 2A As shown, each fastener 460 includes a head 550 and an elongated body 552 extending from the head 550. The elongated body 552 includes a plurality of threads 554 configured to engage a threaded surface 458 of a hole 456 defined in the femoral trial component 410. Each fastener 460 also includes an annular plate 558 extending outwardly from the head 550 to attach the fastener 460 to the flange 520 of the femoral trial insert component 412.

[0105] Each flange 520 of the femoral trial insert component 412 includes a distal surface 560 that is shaped to match the posterior surface 474 of the femoral trial component 410. Each flange 520 also has an opening 562 defined in the distal surface 560, and an inner wall 564 extending inwardly from the opening 562 to define a passage 566 extending through the flange 520. Figure 2A As shown, the fastener 460 is retained in the passage 566. In an exemplary embodiment, the inner wall 564 includes a distal segment 568 and a central segment 570 that is larger than the distal segment 568. The diameter of the distal segment 568 is also smaller than the diameter of the annular plate 558 of the fastener 460 to retain the fastener 460 in the passage 566. The plate 558 also includes a chamfered proximal edge 572 so that during assembly, the assembler can press the chamfered proximal edge 572 into the opening 562 to push the fastener 460 into the passage 566. The flat distal edge 574 of the plate 558 prevents removal of the fastener 460.

[0106] In an exemplary embodiment, the femoral trial component 410 and the box trial component 412 include additional features that prevent the components 410, 412 from being assembled incorrectly. Figure 3 As shown, a pair of notches 530, 532 are defined in the outer perimeter of the opening 450 of the femoral trial component 410. A corresponding pair of tabs 534, 536 extend outwardly from the flange 522 of the box trial component 412, respectively, and are sized to be received in the notches 530, 532. Figure 3As shown, the other opening 452 of the femoral trial component 410 does not have any such notches, so that the surgeon will not be able to assemble the components 410, 412 with the flange 522 in the opening 452. It should be understood that the notches of the femoral trial component and the flanges of the box trial component can be moved to different positions depending on the size of the components. In this way, these features can be used to ensure that only a box trial component with the same size as the femoral trial component can be fixed to the femoral trial component. It should also be understood that other features can be used to prevent incorrect assembly of the components.

[0107] Return to Figure 2 , the instrument 14 also includes a cutting guide platform 416 having a cutting guide surface 576. The platform 416 includes a body 540 including a rear surface 542 that is shaped to engage the front surface 476 of the flange 420 so that the cutting guide surface 417 is positioned coplanar with the distal surface 684 of the front flange 420 and is aligned with the rear plate 428 to prevent the cutting saw blade from moving further rearward as the cutting saw blade is advanced rearwardly along the cutting guide surface 576. In an exemplary embodiment, the rear plate 428 includes a groove 690 that is coplanar with the distal surface 684 of the front flange 420. In some embodiments, the rear plate 428 includes a visual indicator that is coplanar with the distal surface 419 of the front flange 420. As described above, the platform 416 also includes a pair of flanges 446 that extend outwardly from the rear surface 542. The platform 416 also includes a locking mechanism 544 that is configured to secure the cutting platform 416 to the test component 410. In an exemplary embodiment, the locking mechanism 544 includes a locking arm 448 (and its engaging tab) and a user-operated button 546 attached to the body 540. A spring or other biasing element 548 biases the button 546 in the Figure 2 in the position shown.

[0108] When the rear surface 542 of the platform 416 engages the front surface 476 of the component 410, the flange 446 is received in the slot 442 defined in the component 410 and the engagement tab of the locking arm 448 engages the front fixation surface of the flange 420, thereby securing the platform 416 to the component 410. To remove the platform 416 from the component 410, the surgeon may depress the button 546, thereby compressing the spring 548 and rotating the locking arm 448 out of engagement with the fixation surface 492. The surgeon may then withdraw the locking arm 448 and the flange 446 from the component 410 before releasing the button 546.

[0109] As described above, the instrument 14 can be used to surgically prepare a patient's femur to receive one of the prosthetic femoral component 20 and the stem component 44. In an exemplary embodiment, the instrument 14 can be used in a revision surgery where a primary implant has been removed from the distal end of the patient's femur. Figure 6As shown, the distal end 600 of a patient's femur 602 in revision surgery includes a plurality of surfaces 604 that have been previously shaped to receive a primary implant. During revision surgery, the surfaces 604 are resected to prepare the distal end 600 to receive the prosthetic femoral component 20. Figures 6 to 19 and Fig.23 Several exemplary steps are shown for a procedure to surgically prepare the distal end 600 during revision surgery. It should be understood that any surgical procedure may include additional or fewer steps depending on the state of the patient's bone anatomy and the surgeon's preference.

[0110] See now Figure 6 , the surgeon may select a femoral trial component 410 of appropriate size to be positioned on the distal end 600 of the patient's femur 602. When the surgeon has selected the trial component 410, the surgeon may advance the trial component 410 on the distal end 600 so that the fixation surfaces 492, 494, 496, 498, 500 of the trial component 410 engage the distal end 600. The surgeon may then secure the trial component 410 to the patient's femur 602 via one or more fixation pins 486. To do this, the surgeon may align the fixation pin 486 with one of the guide holes 484 and then advance the pin 486 through the guide hole 484 into the patient's femur 602. With the femoral trial component 410 attached to the bone, the surgeon may use it to perform a reaming operation on the patient's femur 602. The surgeon may also use the cutting guide slots 480, 482 of the trial component 410 to perform one or more resections.

[0111] like Figure 7 As shown, the reaming guide 610 can be attached to the test component 410 via the openings 450, 452 in a manner similar to that described above with respect to the box test component 412. The reaming guide 610 includes a cylindrical body 612 and a pair of mounting flanges 520 extending outwardly from one end of the body 612. The mounting flanges 520 are sized and shaped to be positioned within the openings 450, 452 and include a retaining fastener 460 that is configured to be received in the threaded bore 456 of the test component 410. A central cylindrical passage 614 extends through the body 612 to permit passage of a surgical reamer. In an exemplary embodiment, the reaming guide 610 also includes an adapter 620 that is sized to be positioned in the central passage 614. As shown in FIG. Figure 7 As shown, adapter 620 has a central cylindrical passage 622 having a smaller diameter than passage 614. In this manner, reaming guide 610 can be used with reamers of different sizes.

[0112] See now Figure 8, a surgical reamer 630 for use with the reaming guide 610 is shown. The reamer includes an elongated shaft 632 having a plurality of cutting grooves 634 formed at a distal end 636. A tool handle (not shown) is formed at the opposite end and is sized to be fixed to a surgical drill or other rotating surgical instrument. The elongated shaft 632 includes a cylindrical outer surface 640 extending from the cutting grooves 634 to the tool handle. A plurality of spaced-apart annular slots 642 are defined in the outer surface 640. In an exemplary embodiment, the position of each annular slot 642 along the outer surface 640 corresponds to the desired reaming depth of the reamer 630, which in turn corresponds to the desired depth of the rod component 44.

[0113] An outer surface 640 of the shaft 632 defines a diameter 644 of the reamer 630. In an exemplary embodiment, the instrument 14 includes a plurality of different reamers having a similar configuration as the reamer 630 but having a larger diameter.

[0114] The system 10 also includes a removable depth stop 650 that can be attached to the reamer 630 at the annular slot 642 corresponding to the desired depth. In an exemplary embodiment, the depth stop 650 has a central opening 652 and a plurality of alignment tabs 654 extending inwardly into the opening 652. The diameter of the central opening 652 corresponds to the diameter of the central passage 614 of the reamer guide 610, which corresponds to the largest diameter reamer in the system 10. Each reamer, including the reamer 630, includes a plurality of longitudinal slots 660, the number of which corresponds to the number of alignment tabs 654 of the depth stop 650. Each of the longitudinal slots 660 includes an opening or notch 664 formed therein. The notch 664 is offset from the annular slot 642 and corresponds to the annular slot 624 (i.e., the desired reaming depth).

[0115] like Fig. 8A As shown, the bottom surface 666 of the slot 660 of each reamer (illustratively reamer 630 and another reamer 668 having a larger diameter shown in phantom) is positioned and sized to be received in the alignment opening 662 defined by the top end of the tab 654, so that a single depth stop 650 can be used with any size reamer. In an exemplary embodiment, the opposing bottom surfaces 666 define the same distance 669 for each reamer, so that a single depth stop 650 can be used with all of the reamers.

[0116] In an exemplary embodiment, the depth stop 650 includes a movable plate 670 connected to a pin 674 that can be urged into and out of engagement with one of the notches 664 to secure the depth stop at a desired position indicated by the annular slot 642. The pin 674 extends from a flange 676 that aligns with one of the tabs 654 of the depth stop 650.

[0117] like Fig. 8A As shown, the depth stop 650 includes a body 850 defining a cavity 852. An alignment opening 662 extends through the body 850 and through the cavity 852. A movable plate 670 is positioned within the cavity 852. The movable plate 670 includes a button 854 extending from an actuation side 856 of the depth stop 650. A spring 856 extends between the movable plate 670 and a sidewall 858 formed on a retaining side 860 of the depth stop 650 to bias the movable plate 670 toward the engaged position. A pin in the body 850 received in the opening defined in the movable plate 670 couples the movable plate 670 to the body 850.

[0118] The body 850 of the depth stop 650 includes a pair of flat walls 862 that are configured to engage the guide adapter 620. A plurality of alignment tabs 654 extend from each wall 862. In the exemplary embodiment, the depth stop 650 includes eight alignment tabs arranged orthogonally to one another. Four opposing alignment tabs 654 (located on each side of the plate 670) extend parallel to the pin 674, while the other tabs 654 (also located on each side of the plate 670) extend orthogonally to the pin 674.

[0119] To secure the depth stop 650 to the reamer 630, the depth stop 650 is advanced along the length of the reamer 630 such that the tab 654 is advanced along the longitudinal slot 660. While the depth stop 650 is moved along the length of the reamer 630, the button 854 of the depth stop 650 is pressed to move the movable plate 670 such that the pin 674 is disengaged from the reamer 630. The depth stop 650 is aligned with the annular slot 642 corresponding to the desired depth. After the depth stop 650 is aligned, the button 854 of the depth stop 650 is released such that the spring 856 biases the movable plate 670 to position the pin 674 within the corresponding notch 664 in the longitudinal slot 660 of the reamer 630.

[0120] like Fig. 9As shown, when the depth stop 650 is properly positioned at the desired annular slot 642 of the reamer 630, the reamer can be advanced into the central cylindrical passage 614 of the reamer guide adapter 620 and contact the distal end 600 of the patient's femur 602. The surgeon can continue to advance the reamer 630 deeper into the patient's femur until the depth stop 650 contacts the guide adapter 620, thereby forming a surgically prepared passage 672 in the distal end 600 of the femur 602, as shown in FIG. Fig.10 shown.

[0121] See now Fig.10 , when the surgeon has the desired depth and diameter of the passage 672, the reaming guide 610 can be removed from the trial component 410. The surgeon can then use the surgical saw 682 to perform a "box cut" of the distal end 600 of the patient's femur 602. As described above, the trial component 410 includes a central passage 430 defined by the anterior flange 420, arms 422, 424, and the inner surface of the posterior plate 428 of the component 410. In an exemplary embodiment, the surface 684 defining the central passage 430 is a generally flat surface and serves as a cutting guide surface for the surgical saw 682.

[0122] To provide additional support for the distal resection of the box cut, the surgeon may attach a cutting guide platform 416, such as Fig.11 As shown. The flat surface 686 of the platform 416 is aligned with the surface 684 of the front flange 420 to provide an extended cutting guide surface for resection. Fig.12 As shown, the rear plate 428 of the trial component 410 includes a groove 690 extending between the arms 422, 424. The groove 690 is sized to receive the cutting edge 692 of the surgical saw 682, thereby acting as a catch for the saw 682. In addition, the groove 690 provides a visual indication to the surgeon that the desired resection depth has been achieved. When the resection is complete, the surgeon can remove the femoral trial component 410 from the patient's bone.

[0123] See now Fig.13A and Fig. 13B , the surgeon may attach the box trial component 412 to the femoral trial component 410. To do this, the surgeon may align the box trial component 412 with the central passage 430 of the trial component 410, such as Fig.13AAs shown. The surgeon may then advance the body 510 of the box trial component 412 into the central passage 430 and the mounting flanges 520 into their corresponding apertures 450, 452. As described above, improper alignment of the components 410, 412 is prevented by the combination of the notches 530, 532 and the tabs 534, 536 formed on the components 410, 412, respectively. With the flanges 520 positioned in the apertures 450, 452, the surgeon may advance the fasteners 460 into the threaded holes 456, thereby securing the box trial component 412 to the femoral trial component 410. It should be understood that the box trial component 412 may be attached before the femoral trial component 410 is positioned on the bone or after the component 410c is in place.

[0124] like Fig.14 As shown, the box trial component 412 includes a rod support post 700, which is configured to be secured to a rod trial device 702. It should be understood that the system 10 may include a number of different rod trial devices 702, which have different lengths and different diameters, and are sized to fit bones of different sizes. To secure the rod trial device 702 to the support post 700, one end of the rod trial device 702 is aligned with an opening 704 defined in the rod support post 700 and then advanced into the opening 704. Fig.13A and Fig. 13B As shown, threaded fastener 706 is advanced between arms 514, 516 of box test component 412 and into the passageway of stem support 700. Fastener 706 is threaded into an opening (not shown) defined in the end of stem test device 702 to secure stem test device 702 to test component 412.

[0125] Go to again Fig.14 , the surgeon may optionally attach one or more femoral augmentation trials 506 to the femoral trial component 410. To do so, the surgeon may align a tab (not shown) of the trial device 506 with one of the mounting slots 502 defined in the trial component 410. The surgeon may then advance the trial device 506 into the mounting slot 502, thereby securing the trial components together. The surgeon may introduce the assembly into the surgically prepared distal end 600 of the patient's femur 602 and perform a trial bone reduction to evaluate the range of motion of the femoral trial component 410 attached to the bone. Alternatively, the trial device 506 may be inserted into the slot 502 with the femoral trial component 410 already positioned on the bone.

[0126] refer to Fig. 20, each curved arm 422, 424 includes a mounting slot 502 defined in its distal bone-facing surface 496. The mounting slot 502 extends inwardly from the outer edge 900 of the arm 422, 424. It should be understood that the outer edge can be the medial or lateral edge of the femoral trial component. A channel 902 is defined in the distal bone-facing surface 496 of each arm 422, 424 and extends inwardly from the outer edge 900 parallel to the slot 502. The channel 902 is partially defined by a tapered surface 904. An aperture 906 is defined in the distal bone-facing surface 496 of each arm 422, 424 and is spaced apart from the channel 902.

[0127] In addition, each curved arm 422, 424 includes a mounting slot 502 defined in its bone-facing surface 500. The mounting slot 502 extends inwardly from the outer edge 900 of the arm 422, 424. A channel 902 is defined in the posterior bone-facing surface 500 of each arm 422, 424 and extends inwardly from the outer edge 900 parallel to the slot 502. The channel 902 is partially defined by a tapered surface 904. An aperture 906 is defined in the posterior bone-facing surface 500 of each arm 422, 424 and is spaced apart from the channel 902.

[0128] refer to Fig.21 and Fig. 22 , a plurality of reinforcement trial components 506 are sized to be positioned on one of the distal bone-facing surface 496 or the posterior bone-facing surface 500 of the arms 422, 424. In particular, the reinforcement trial components 506 include a distal reinforcement trial component and a posterior reinforcement trial component. The reinforcement trial component 506 includes at least one magnet and may be made of a magnetic material.

[0129] Each reinforcement trial component 506 has a different thickness 507 defined between a flat base surface 903 and a flat base surface 907. In the distal reinforcement trial component 506, the thickness 507 is equal to the spacing 509 ( 1 / 20 mm) defined between the bone-facing surface 496 of each arm 422, 424 and the distal cutting slot 480. Fig.14 In the posterior reinforcement test component 506, the thickness 507 is equal to the spacing 511 ( Fig.14 903). The flat base surface 903 is configured to engage one of the bone-facing surfaces 496, 500 of the curved arms 422, 424. In the distal augmentation trial component 506, a flange 913 extends from a front portion 915 of the component 506. It should be noted that the posterior augmentation trial component 506 does not include the flange 913. The trial device 506 includes a mounting post 908 and a post 910 extending outwardly from the flat base surface 903. The mounting post 908 has a substantially cylindrical end 915.

[0130] The slot 502 formed in the arm 422, 424 is sized to receive the mounting post 908 of one of the plurality of test devices 506. In particular, the slot is sized and shaped to receive the cylindrical end 915 of the mounting post 908. The mounting post 908 includes a pin 914 operable to retain the cylindrical end 915 of the mounting post 908 in the slot 502 of the curved arm 422, 424. The post 910 is sized to be received in the channel 902. Specifically, the tapered surface 904 of the channel 902 is configured to engage the post 910 of each test device 506 when the test device 506 is advanced into the arm 422, 424. The aperture 906 is sized to receive the post 910 of each test device 506 when the test device 506 is fully advanced into the slot 502.

[0131] like Fig.23 As shown, after positioning the femoral trial component 410 on the patient's femur, the surgeon can advance the trial device 506 into one of the mounting slots 502 of the component 410. As the trial device 506 is advanced into the mounting slot 502 from the outer edge, either medially or laterally, the post 910 engages the tapered surface 904, thereby tilting the trial device 506 relative to the bone-facing surface of the femoral trial component. The post 910 can exit the channel 902, slide along the bone-facing surface, and then fall into the aperture 906. In this position, the post 910 of the trial device 506 is retained in the aperture 906 component 410 to retain the trial device 506 and prevent the trial device 506 from being retracted through the mounting slot 502. In addition, the trial device 506 is magnetically coupled to the component 410 to further retain the trial device 506.

[0132] return FIG. 15A to FIG. 15B , the femoral trial component 410 can be used with other trial components, including, for example, a post trial component 712. Similar to the box trial component 412, the post trial component 712 includes a front flange 512 and a pair of arms 514 extending from the flange 512. A pair of mounting flanges 520 extend outwardly from the arms 514 and are configured to be received in the openings 450, 452 of the femoral trial component 410. The stem post 700 extends away from the arms 514 of the post trial component 712.

[0133] The system 10 also includes a boss test fixture 714 that is configured to be secured to the rod support 700 via the threaded fastener 706. Fig.16 As shown, the boss test fixture 714 is a threaded bore 716 that is sized to receive a corresponding threaded shaft 718 of a rod test component 720. A driver tool 722 may be used to thread the rod test component 720 onto the boss test fixture 714.

[0134] See now Fig.17 , the assembled trial component 410, post trial component 712, and stem trial component 720 can be advanced onto the distal end 600 of the patient's femur 602. It should be understood that the post trial component 712, like the other femoral trial insert components, can be attached before the femoral trial component 410 is positioned on the bone or after the component 410 is in place. Fig.18 As shown, with the assembly positioned on the distal end 600, the surgeon can use a surgical saw 682 to remove the patient's bone. To do this, the surgeon can position the saw 682 in one of the cutting guide slots 480 to remove the desired amount of bone from the distal end 600. Fig.17 As shown, the surgeon may utilize the cutting guide slot 480 to remove sufficient bone material to permit insertion of the augmentation trial 506, as described above. The surgeon may continue to resect to shape the bone as needed to receive the femoral prosthetic component 20.

[0135] As described above, the femoral trial component 410 and the box trial component 412 and / or the strut trial component 712 may be used to assess range of motion during a trial bone reduction. Fig.19 As shown, the femoral trial component 410 is configured to engage a tibial insert trial component 730 positioned on a tibial base trial component 732, which is attached to the proximal end 734 of the patient's tibia 736. An exemplary description of trial bone reduction and preparation of the patient's tibia is disclosed in the following U.S. patents. U.S. Patent 9,028,501, entitled "TIBIAL ORTHOPAEDIC SURGICALINSTRUMENTS AND METHOD OF USING SAME", published by Kyle B. Thomas et al. on May 12, 2015, is incorporated herein by reference. The tibial insert trial component includes a pair of concave curved surfaces that engage with the surfaces of the femoral trial component 410 and the box trial component 412 and / or the pillar trial component 712 in a flexion range from extension to flexion and perform joint movement to evaluate the range of motion and determine the appropriate size of the prosthesis.

[0136] It should be understood that the surgeon may perform an initial trial bone reduction using the post trial component 712 and the stem trial component 720. The surgeon may then remove the post trial component 712 and the stem trial component 720 while leaving the femoral trial component 410 in place on the patient's femur. The surgeon may then perform the above-described Figure 7 and Fig. 9 The expansion operation described above is performed Figures 10 to 12 The box cutting operation described is then followed by attaching the box trial component 412 before performing additional trial reductions and / or reinforcement resections as described above.

[0137] Although the above exemplary embodiments have been described as having a separable tibial tray and tibial tray insert, it should be appreciated that the tibial tray may include a condyle-receiving device bearing surface that eliminates the need for a separate tibial tray insert.

[0138] After reading the above description and the Abstract of the Invention, one of ordinary skill in the art will recognize that, although the methods and apparatus described herein constitute exemplary embodiments of the invention, the invention contained herein is not limited to that precise embodiment and that modifications may be made to these embodiments without departing from the scope of the invention as defined by the claims. In addition, it should be understood that the invention is defined by the claims and that it is not intended that any limitation or provision describing the exemplary embodiments set forth herein be incorporated into the interpretation of any claim provision unless such limitation or provision is expressly stated. Likewise, it should be understood that compliance with the scope of any claim does not require that any or all of the identified advantages or objectives of the invention disclosed herein must be met, as the invention is defined by the claims and that there may be inherent and / or unforeseen advantages of the invention even though such advantages may not be explicitly discussed herein.

Claims

1. A plastic surgery system, comprising: a femoral trial component configured to couple to a surgically prepared distal end of a patient's femur, the femoral trial component comprising an anterior flange, a pair of curved arms extending away from the anterior flange, and a posterior flange extending between the pair of curved arms, a cutting block configured to couple to the anterior flange of the femoral trial component, the cutting block comprising a cutting guide surface, wherein when the cutting block is coupled to the anterior flange of the femoral trial component, the cutting guide surface is positioned coplanar with a distal surface of the anterior flange of the femoral trial component, and the posterior flange of the femoral trial component is aligned with the cutting guide surface of the cutting block to prevent further rearward movement of the cutting saw blade, and wherein the posterior flange includes a groove coplanar with the distal surface of the anterior flange, the groove being sized to receive a cutting edge of the cutting saw blade.

2. The orthopaedic system of claim 1, wherein: The anterior flange of the femoral trial component includes an opening, and The cutting block includes a body having a cutting guide surface and a post extending from the body, the post being sized to be received in the aperture.

3. The orthopaedic system of claim 2, wherein the cutting block comprises a locking mechanism operable to secure the cutting block to the femoral trial component.

4. The orthopaedic system of claim 3, wherein: The anterior flange of the femoral trial component includes a slot, and The locking mechanism includes a movable locking tab extending outwardly from the body, the locking tab being sized to be received in the slot, the locking tab being movable between a first position and a second position, wherein the locking tab is configured to engage the anterior flange to secure the cutting block to the femoral trial component, and wherein the locking tab is configured to be spaced apart from the anterior flange.

5. The plastic surgery system of claim 4, wherein the locking mechanism comprises a user-operated button positioned relative to the cutting guide surface, the user-operated button operable to actuate the locking tab.

6. The orthopaedic system of claim 5, wherein the locking mechanism further comprises a biasing element to bias the locking tab in the first position.

7. The orthopaedic system of claim 1, wherein the posterior flange comprises a visual indicator coplanar with the distal surface of the anterior flange.

8. The orthopaedic system of claim 1, wherein the flexion arm of the femoral trial component includes a plurality of distal cutting slots extending parallel to the distal surface of the anterior flange.

9. The orthopaedic system of claim 8, wherein the flexion arm of the femoral trial component includes a plurality of posterior cutting slots extending orthogonally to the distal cutting slots.

10. The orthopaedic system of claim 1, further comprising: a tibial baseplate sized to be positioned on a proximal surface of a patient's tibia, and An insert trial device configured to be attached to the tibial baseplate includes a pair of proximal curved surfaces configured to articulate with the flexure arms of the femoral trial component.

11. A plastic surgery system comprising: a femoral trial component configured to couple to a surgically prepared distal end of a patient's femur, the femoral trial component comprising an anterior flange, a pair of curved arms extending away from the anterior flange, a posterior flange extending between the pair of curved arms, and a central passage defined between the anterior flange, the curved arms, and the posterior flange, a femoral trial insert component configured to be secured to the femoral trial component, the femoral trial insert component comprising a body sized to be positioned in the central passage of the femoral trial component, and a cutting block configured to be coupled to the anterior flange of the femoral trial component, the cutting block comprising a cutting guide surface, wherein when the cutting block is coupled to the anterior flange of the femoral trial component, the cutting guide surface is positioned coplanar with a distal surface of the anterior flange of the femoral trial component, and the posterior flange of the femoral trial component is aligned with the cutting guide surface of the cutting block to prevent further rearward movement of the cutting saw blade, and wherein the posterior flange includes a groove coplanar with the distal surface of the anterior flange, the groove being sized to receive a cutting edge of the cutting saw blade.

12. The orthopaedic system of claim 11, wherein the body of the femoral trial insert component includes a curved surface shaped to match a patellar surface of a prosthetic femoral component.

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