Revision knee arthroplasty methods and instruments

Abstract

Revision knee arthroplasty methods and instruments are disclosed. In particular, a provisional system for knee arthroplasty is disclosed. The system can include any one or combination of a first provisional component (212), a second provisional component (154), a stem provisional assembly (124), and a fastener (214). The first provisional component can be configured to be disposed on a resected bone surface. The second provisional component can be configured to be disposed in a first recess beneath the resected surface of the bone. The stem provisional assembly can be configured to be disposed in a second recess, the stem provisional assembly configured to be engageable in vivo to position the first provisional component on the resected surface of the bone. The fastener can be configured to couple the first provisional component, the second provisional component, and the stem provisional assembly together as an assembly.

Description

[0001] This application is a divisional application of Chinese invention patent application No. 201880066636.2, filed on October 10, 2018, entitled "Method and apparatus for revision knee replacement surgery".

[0002] Priority Statement

[0003] This application claims the benefit of U.S. Provisional Patent Application No. 62 / 572,210, filed October 13, 2017, and claims priority to that U.S. Provisional Patent Application, the entire contents of which are incorporated herein by reference. Technical Field

[0004] This subject matter relates to orthopedic instruments, systems, methods, and techniques. More specifically, this application relates to instruments, systems, methods, and techniques that can be used in revision knee arthroplasty. Background Technology

[0005] Orthopedic surgery and prostheses are commonly used to repair and / or replace damaged bone and tissue in the human body. For example, knee replacement surgery can be used to restore natural knee function by repairing damaged or diseased joint surfaces of the femur and / or tibia. An incision is made in the knee joint to expose the bone including the joint. Cutting guides and other instruments are used to guide the removal of the joint surfaces to be replaced. A prosthesis is used to replicate the joint surfaces. A knee prosthesis may include a femoral component implanted at the distal end of the femur, articulated with a tibial support component and a tibial component implanted at the proximal end of the tibia, to replicate the function of a healthy, natural knee joint. Various types of joint replacement surgery are known, including total knee replacement (where all joint cavities are repaired with prosthetic components) and revision knee replacement (where a surgeon removes a previously implanted knee prosthesis and replaces it with a new one). Summary of the Invention

[0006] This disclosure generally relates to surgical instruments, systems, methods, and techniques for knee replacement surgery (such as revision knee replacement). The inventors of this invention have recognized temporary components, instrument designs, systems, and processes (among others) that simplify knee surgery, reduce the cost of knee surgery, and / or improve the effectiveness of knee surgery. For example, this application discloses temporary systems that can be coupled together in vivo and adjusted in position to better fit the patient's anatomy. More specifically, a rod temporary assembly is disclosed that can be configured to move in vivo to position the rod temporary assembly within a bone recess.

[0007] To reduce cost and the number of components, a temporary rod assembly may include a system comprising multiple adapters and multiple rod extensions. Each of the multiple adapters may have a longitudinal axis extending between a proximal end and a distal end. The multiple adapters include at least one first adapter with no bias on the longitudinal axis and at least one second adapter with a bias on the longitudinal axis. Each of the multiple rod extensions may be configured to be interchangeably coupled to the multiple adapters. Each of the multiple rod extensions may have a different longitudinal range between the proximal end and the distal end.

[0008] On the other hand, which can save time, reduce costs, and simplify procedures, a system is disclosed for temporary components that can be assembled and then removed in vivo. More specifically, after in vivo assembly, the component can then be removed from the patient while maintaining the position of each component relative to each other. This allows for easier and more timely creation of permanent implants based on temporary components, since the positions of the individual temporary components do not need to be documented or otherwise detailed. Instead, the entire temporary component can be maintained in a desired relative position to the other components for easy reference. These and other aspects of this application will be discussed in further detail below. It will be apparent to those skilled in the art that this application includes various other inventive concepts that can simplify knee surgery, reduce the cost of knee surgery, and improve the effectiveness of knee surgery.

[0009] To further illustrate the apparatus, systems, and methods disclosed herein, the following non-limiting examples are provided:

[0010] In Example 1, a temporary system for knee replacement surgery is disclosed. The system may include a first temporary component having a proximal surface and a distal surface opposite the proximal surface, one of which is configured to be disposed on a resection surface of the bone. The system may include a second temporary component configured to be disposed in a first recess below the resection surface of the bone, wherein the second temporary component is configured to mimic the shape of at least one of a sleeve component, a conical component, or a keel component of an implant. The system may include a rod temporary assembly configured to be disposed in a second recess, the rod temporary assembly being configured to engage in vivo to position the first temporary component on the resection surface of the bone. The system may include fasteners configured to connect the first temporary component, the second temporary component, and the rod temporary assembly together as a component, wherein the fasteners include channels allowing access to the rod temporary assembly from an adjacent first temporary component.

[0011] In Example 2, the system according to Example 1 may optionally further include a handle configured to temporarily engage the second temporary component with the rod temporary assembly, wherein, when temporarily engaged with the handle, the second temporary component and the rod temporary assembly can be inserted into the first groove and the second groove of the bone, respectively.

[0012] In Example 3, the system described according to any one or any combination of Examples 1-2 may optionally further include one or more drivers configured to perform at least one of the following operations: engaging the fastener to screw the fastener into a threaded groove of the rod temporary assembly; and engaging the rod temporary assembly through a channel in the fastener, wherein the engagement between the driver and the rod temporary assembly causes the rod temporary assembly to rotate within the body and positions the first temporary component on the cut surface.

[0013] In Example 4, in the system described according to any one or any combination of Examples 1-3, wherein the first temporary component may optionally include a first taper and a second taper, the second temporary component includes a third taper and a fourth taper, and the rod temporary assembly all include a fifth taper, wherein when the fastener connects the first temporary component, the second temporary component and the rod temporary assembly together as an assembly, the first taper is configured to engage with the third taper, the second taper is configured to engage with the fifth taper, and the fourth taper is configured to engage with the fifth taper.

[0014] In Example 5, according to the system described in Example 4, the first taper and the fifth taper may optionally include an outer taper, while the second taper, the third taper and the fourth taper include an inner taper.

[0015] In Example 6, the system according to any one or any combination of Examples 1-5, wherein the fastener, the first temporary component, the second temporary component, and the rod temporary assembly may optionally be removed from the skeleton as a whole while maintaining the position of each component relative to each other.

[0016] In Example 7, the system according to any one or any combination of Examples 1-6, wherein the temporary rod assembly may optionally be a system comprising: a plurality of adapters, each adapter having a longitudinal axis extending between a proximal end and a distal end, wherein the plurality of adapters includes at least one first adapter with no bias on the longitudinal axis and at least one second adapter with a bias on the longitudinal axis; and a plurality of rod extensions, each rod extension being configured to interchangeably engage with the plurality of adapters, wherein each of the plurality of rod extensions has a different longitudinal extent between the proximal end and the distal end.

[0017] In Example 8, according to the system described in Example 7, the at least one second adapter may optionally include two adapters, one adapter having a first bias and the other adapter having a second bias, the second bias being different from the first bias.

[0018] In Example 9, the system according to any one or any combination of Examples 1-6, wherein the temporary rod assembly may optionally be a subsystem comprising a plurality of integral single-piece assemblies, and wherein each of the plurality of integral single-piece assemblies comprises an adapter portion and a rod extension portion.

[0019] In Example 10, the system according to any one or any combination of Examples 1-9, wherein the first temporary component may optionally include a femoral component having an elongated slot configured to receive a pin therein, wherein the elongated slot is configured to allow the femoral component to move proximally-distally relative to the pin.

[0020] In Example 11, according to the system described in any one or any combination of Examples 1-10, the second temporary component may optionally include a puller configured to remove bone to create the first groove.

[0021] In Example 12, a temporary tibial or femoral system for knee replacement surgery is disclosed. The system may include a first temporary component having a proximal surface and a distal surface opposite the proximal surface, one of the proximal or distal surfaces being configured to be disposed on a resection surface of bone, including the tibia or femur. The system may include a second temporary component configured to be disposed in a first groove below the resection surface, wherein the second temporary component is a temporary piece shaped to mimic at least one of a sleeve component, a conical component, or a keel component of an implant. The system may include a rod temporary assembly configured to be disposed in a second groove in the tibia or femur, the rod temporary assembly being configured to engage in vivo to reposition the first temporary component on the resection surface. The system may include fasteners configured to connect the first temporary component, the second temporary component, and the rod temporary assembly together as an assembly.

[0022] In Example 13, according to the system described in Example 12, the fastener may optionally include a channel for allowing access to engage the temporary rod assembly.

[0023] In Example 14, the system according to Example 12 may optionally further include one or more drivers configured to perform at least one of the following operations: engaging the fastener to screw the fastener into a threaded groove of the rod temporary assembly; and engaging the rod temporary assembly through a channel in the fastener, wherein the engagement between the driver and the rod temporary assembly causes the rod temporary assembly to rotate within the body.

[0024] In Example 15, according to the system described in any one or any combination of Examples 12-14, the fastener, the first temporary component, the second temporary component, and the rod temporary assembly may optionally be removed together as an assembly from the tibia while maintaining the position of each part relative to each other.

[0025] In Example 16, according to any one or any combination of Examples 12-15, the temporary rod assembly may optionally include a system comprising: a plurality of adapters, each adapter having a longitudinal axis extending between a proximal end and a distal end, wherein the plurality of adapters includes at least one first adapter with no bias on the longitudinal axis and at least one second adapter with a bias on the longitudinal axis; and a plurality of rod extensions, each rod extension configured to interchangeably engage with the plurality of adapters, wherein the plurality of rod extensions each have a different longitudinal extent between the proximal end and the distal end.

[0026] In Example 17, according to any one or any combination of Examples 12-15, the temporary rod assembly may optionally be a subsystem comprising a plurality of integral single-piece assemblies, and each of the plurality of integral single-piece assemblies includes an adapter portion and a rod extension portion.

[0027] In Example 18, a method for revision knee replacement surgery may optionally include: shaping the patient's bone to create one or more grooves therein; selecting a temporary rod member; arranging the temporary rod member within the one or more grooves; and assembling the temporary rod member in vivo with a first temporary member configured to mimic one of a tibial support implant or a femoral implant and a second temporary member configured to mimic at least one of a sleeve member, a conical member, or a keel member of the implant.

[0028] In Example 19, the method according to Example 18 may optionally further include: temporarily connecting the second temporary component and the rod temporary assembly together via a handle configured to be inserted above the support extension; and inserting the rod temporary assembly and the second temporary component together into the one or more recesses.

[0029] In Example 20, the method described according to any one or any combination of Examples 18-19 may optionally further include: identifying the axis of the bone; and determining whether an offset configuration is needed for the temporary rod assembly.

[0030] In Example 21, according to the method of any one or any combination of Examples 18-20, the selection of the temporary rod member may optionally include: selecting an integral temporary rod member having an adapter portion and a rod extension portion; or, selecting an adapter from a plurality of adapters, each of the plurality of adapters having a longitudinal axis extending between a proximal end and a distal end, wherein the plurality of adapters includes at least one first adapter with no bias in the longitudinal axis and at least one second adapter with a bias in the longitudinal axis; and selecting a rod extension from a plurality of rod extensions, each rod extension being configured to engage with the plurality of adapters, wherein each of the plurality of rod extensions has a different longitudinal extent between a proximal end and a distal end.

[0031] In Example 22, according to the method of any one or any combination of Examples 18-21, the step of assembling the rod temporary assembly in vivo with a first temporary component configured to mimic the shape of one of the tibial support implant or the femoral implant and a second temporary component configured to mimic at least one of the sleeve component or keel component of the implant may optionally include one or both of the following: engaging a fastener to screw the fastener into a threaded groove in the rod temporary assembly; and passing a tool through a channel in the fastener to engage the rod temporary assembly distal to the threaded groove.

[0032] In Example 23, the method according to any one or any combination of Examples 18-22 may optionally further include: engaging the temporary rod assembly in vivo to position the first temporary component at a desired location on the resected surface of the bone.

[0033] In Example 24, the method according to any one or any combination of Examples 18-23 may optionally further include: removing the first temporary component, the second temporary component, and the rod temporary assembly from the bone and the one or more grooves together while maintaining the position of each part relative to each other.

[0034] In Example 25, the method according to Example 24 may optionally further include: constructing an implant assembly based on the positions of the first temporary component, the second temporary component, and the rod temporary assembly.

[0035] In Example 26, the system described according to any one or any combination of Examples 1-17 may optionally also include a multi-function handle configured to engage with one or more of the second temporary component and the biasing broach, wherein the multi-function handle has a hollow shaft and includes a hammer configured to be movable along the axis of the handle and to be secured thereto.

[0036] In Example 27, according to the system described in Example 26, the biasing broach may optionally have a cutting surface only along its first side, and its second side opposite the first side is configured to receive and engage with a reamer, wherein the biasing broach is configured to bias the first groove relative to the second groove.

[0037] In Example 28, the method described according to any one or any combination of Examples 18-25 may optionally further include: attaching a multi-function handle to one or more of the second temporary component and the biased broach; and removing the biased broach from the bone using the movement of the hammer of the multi-function handle.

[0038] In Example 29, according to the method of Example 28, the biasing broach has a cutting surface only along its first side, and its second side opposite the first side is configured to receive and engage with a reamer, wherein the biasing broach is configured to bias a first portion of the one or more grooves relative to a second portion of the one or more grooves.

[0039] In Example 30, the system described according to any one or any combination of Examples 1-17 and 26-27 may optionally also include a drill guide configured to be mounted to the rod temporary assembly and configured to pre-drill the skeleton before broaching the sleeve component or the conical component.

[0040] In Example 31, according to the method of any one or any combination of Examples 18-25 and 28-29, wherein shaping the patient’s bone to create one or more grooves therein may optionally include: coupling a drill guide to the temporary rod assembly having a plurality of orifices configured to receive and guide a drill bit into the bone; and shaving the bone.

[0041] In Example 32, the system described according to any one or any combination of Examples 1-17, 26-27 and 30 may optionally also include an inclined reamer having a distal nose-shaped portion and a cut portion with a rearwardly angled taper, the diameter of which decreases when measured along the longitudinal axis of the inclined reamer from distal to proximal.

[0042] In Example 33, the method according to any one or any combination of Examples 18-25, 28-29 and 31, wherein shaping the patient’s bone to create one or more grooves therein may optionally include: enlarging the bone using a tilting reamer having a distal nasal portion and a tapered cut portion with a rearward angle, the diameter of the cut portion decreasing when measured along the longitudinal axis of the tilting reamer from distal to proximal.

[0043] In Example 34, the system described according to any one or any combination of Examples 1-17, 26-27, 30 and 32 may optionally further include a tibial cutting guide assembly configured to guide a resection forming the resection surface, wherein the tibial cutting guide assembly has a boom and a body connected to the boom via a collar, wherein the collar includes an opening configured to allow removal of the boom from the collar without changing the position of the body relative to the bone.

[0044] The method described according to any one or any combination of Examples 18-25, 28-29, 31 and 33 may optionally also include removing bone via a tibial cutting guide assembly to form a cutting surface, wherein the cutting includes: positioning the body of the tibial cutting guide assembly adjacent to a proximal portion of the tibia via a boom; securing the body to the proximal portion by pins; and removing the boom without removing the body from the position secured to the proximal portion by pins.

[0045] In Example 36, the system described according to any one or any combination of Examples 1-17, 26-27, 30, 32 and 34 may optionally also include a rod implant having one or more slots configured along its distal portion to allow the rod implant to bend in any direction.

[0046] In Example 37, the component may optionally include: a fastener having a threaded portion and a head portion; and a component having a drilled hole, the drilled hole optionally including: a corresponding threaded portion configured to engage with the threaded portion of the fastener; a pouch-like portion adjacent to the corresponding threaded portion within the drilled hole, wherein the pouch-like portion is configured to receive the fastener when the threaded portion of the fastener is separated from the corresponding threaded portion; and a limiting portion arranged adjacent to the pouch-like portion, wherein the limiting portion is configured to have a diameter substantially equal to or smaller than the diameter of the head portion, so as to retain the fastener within the pouch-like portion when the threaded portion of the fastener is separated from the corresponding threaded portion.

[0047] In Example 38, according to the component described in Example 37, the diameter of the bag-shaped portion may optionally be larger than the diameter of the head portion.

[0048] In Example 39, the component according to any one or any combination of Examples 37 and 38, wherein one or more of the limiting portion and the head portion of the fastener may optionally have a chamfered surface configured to serve as a bevel to facilitate insertion of the head portion beyond the limiting portion.

[0049] In Example 40, the apparatus, system, and method described according to any one or any combination of Examples 1 to 39 may optionally be configured such that all the referenced elements or options are available for use or can be selected from.

[0050] These and other examples and features of this apparatus and system will be set forth in part in the detailed description below. This overview is intended to provide non-limiting examples of the subject matter and is not intended to provide an exclusive or exhaustive explanation. The following detailed description is included to provide further information about the apparatus and method. Attached Figure Description

[0051] In accompanying drawings that are not necessarily drawn to scale, similar reference numerals can describe similar parts in different views. Similar reference numerals with different letter suffixes can indicate different instances of similar parts. The accompanying drawings generally illustrate the various examples discussed herein by way of example rather than limitation.

[0052] Figure 1 A cross-sectional view of a reamer inserted into a bone such as the tibia, according to an example of this application, is shown.

[0053] Figure 2 A perspective view of a reamer having a tibial caliper and a connector, according to an example of this application, is shown.

[0054] Figure 3 Examples according to this application are shown. Figure 2 A top view of the reamer and tibial caliper, but it has an offset connector assembly for positioning the tibial caliper relative to the reamer.

[0055] Figure 3A Examples according to this application are shown. Figure 3 Perspective view of the reamer, tibia caliper and offset connector assembly.

[0056] Figure 4 A perspective view of a multi-functional handle according to an example of this application is shown.

[0057] Figure 5 An example of connection with a bias broach according to this specification is shown. Figure 4 A perspective view of the multi-functional handle.

[0058] Figure 5A , Figure 6A and Figure 6B An example of a multi-functional handle and biased broach according to this application is shown, arranged longitudinally along the axis of the reamer to the tibia, and bone is removed from the tibia to create a groove.

[0059] Figure 7A This is a perspective view of an example of a tilting reamer according to this application, which has a tapered cutting section that removes bone from the tibia to create a groove.

[0060] Figure 7B Based on the example in this application Figure 7A A cross-sectional view of a tilting reamer inserted into the tibia and removing bone from the tibia to create a groove.

[0061] Figure 7C yes Figure 7A and Figure 7B Plan view of the inclined reamer.

[0062] Figures 8A-8C An example of a hollow expander according to this application is shown, which removes bone from the tibia to create a groove. The hollow expander can be inserted above a post that is attached to a first rod temporary assembly.

[0063] Figure 9A and Figure 9B An example of a drill guide and drill bit according to this application is shown, which can be used to remove bone from the tibia to create a groove.

[0064] Figures 10A-10E Examples according to this application are shown. Figure 5-6B The multi-functional handle and the second temporary component constructed to simulate a cone.

[0065] Figure 11A and Figure 11B Examples according to this application are shown. Figures 10A-10E A cross-sectional view of a multi-functional handle that engages with a second temporary component, a support, and a first temporary rod assembly.

[0066] Figure 11C-11E This is a perspective view showing an example of a handle for inserting a second temporary component, a support, and a first temporary rod assembly into one or more grooves in the proximal tibia, according to an example of this application.

[0067] Figure 12 Alternative components for the second temporary component, the support post, and the second pole temporary assembly, as shown in the examples of this application, are illustrated.

[0068] Figure 13 An example cutting tool according to this application is shown, which uses a first surface of a second temporary component as a reference to set a cutting plane to cut off the end portion of the bone.

[0069] Figures 14A-14C An example of a booting method according to this application is shown. Figure 13 A perspective view of the cutting guide used to remove the end portion of the bone using cutting tools.

[0070] Figure 15 A perspective view is shown of an example of a tibia according to this application, including a proximal end portion having a cut surface and a groove, a second temporary component positioned in the groove, a tibial support temporary component, and a fastener configured to be connected to the second temporary component.

[0071] Figure 16 A perspective view of an example driver tool according to this application is shown.

[0072] Figure 17 Examples according to this application are shown. Figure 16 The drive tool that is inserted and engaged Figure 15 Fasteners are used to engage the fasteners to attach the second temporary component to the tibial support temporary component, thereby forming part of the temporary tibial assembly.

[0073] Figure 18 An example of connecting the tibial support temporary component and the second temporary component to fasteners according to this application is shown. Figure 17 It is part of a temporary tibial assembly.

[0074] Figure 19 Examples of this application are shown, including Figure 17 and Figure 18 The diagram shows a cross-sectional view of a portion of the entire temporary tibial assembly, which includes a tibial support temporary component, fasteners, and also includes a second temporary component and a rod temporary assembly.

[0075] Figure 20 A perspective view of the entire temporary tibial assembly, as shown in the example of this application, is removed from the tibia and placed in a workspace for constructing a first tibial implant assembly.

[0076] Figure 21 A perspective view is shown of an alternative temporary tibial assembly, with a second temporary component configured to mimic a keel, which is removed from the tibia and placed in a workspace for constructing a second tibial implant assembly, according to an example of this application.

[0077] Figure 22A and Figure 22BThe process of positioning a temporary rod assembly using a driver tool according to an example of this application is shown, wherein the tibial support temporary component and the second temporary component are not shown, to further illustrate the engagement between the driver and the temporary rod assembly.

[0078] Figure 23A and Figure 23B An example according to this application is shown in top view. Figure 22A and Figure 22B The process is illustrated, and a positioning process that can be performed in vivo is shown, in which the positioning of the temporary tibial support component can alter the positioning of the temporary tibial support component on the proximal surface of the tibial resection.

[0079] Figure 24 An example system according to this application is shown, which can be used to construct temporary rod assemblies of various configurations as needed.

[0080] Figure 25 A perspective view is shown of a femur in which a reamer is inserted, and an offset connector assembly for positioning a cutting guide on the distal end of the femur, according to an example of this application.

[0081] Figure 26 and Figure 26A An example of a femoral temporary assembly according to this application is shown, which includes a femoral temporary component, a second temporary component, and a rod temporary assembly.

[0082] Figure 27 and Figure 28 Examples according to this application are shown. Figure 26 and Figure 26A The femoral temporary component may include an elongated slot that allows the position of the femoral temporary component to be adjusted proximally-distally relative to the distal portion of the femur as needed.

[0083] Figure 29-32 Various alternative constructions of a rod extension that can be used with a rod temporary assembly, according to examples of this application, are shown.

[0084] Figure 33 A method for revision knee replacement surgery according to an example of this application is shown.

[0085] Figure 34 Examples shown in this application can be used as Figure 33 A method that is part of the method.

[0086] Figure 35A and Figure 35B A cross-section of an assembly of a fastener and component according to an example of this application is shown. The component has a pocket-like portion and a limiting portion for retaining the fastener, such that once the fastener is received in the pocket-like portion, it cannot be removed from the component.

[0087] Figure 36A and Figure 36B Examples of this application are shown in conjunction with Figure 35A and Figure 35B Another example component is constructed in a similar manner to the component in the cross section, but it includes pathways.

[0088] Figure 37A and Figure 37B Two driver tools, examples of those according to this application, are shown that can replace... Figure 16 Use the driver tools.

[0089] Figure 38 A system for an integral rod temporary assembly according to an example of this application is shown, which can replace... Figure 24 The system is used. Detailed Implementation

[0090] This application relates to temporary prostheses, tools, systems, and methods.

[0091] As stated above, temporary prostheses, instruments, systems, and methods can simplify knee surgery, reduce its cost, and / or improve its effectiveness. It is important to note that all instruments, components, systems, methods, and techniques described herein are applicable to both the femur and tibia and are equally suitable for both.

[0092] As used herein, the terms “proximal” and “distal” should be given their usual anatomical interpretation. The term “proximal” refers to the direction generally towards the patient’s trunk, while “distal” refers to the opposite direction, i.e., away from the patient’s trunk. It should be understood that the use of the terms “proximal” and “distal” should be interpreted as the patient standing with their knee in extension. The purpose is to distinguish the terms “proximal” and “distal” from the terms “anterior” and “posterior.” As used herein, the terms “anterior” and “posterior” should be given their usual anatomical interpretation. Therefore, “posterior” refers to the back of the patient, such as the back of the knee joint. Similarly, “anterior” refers to the front of the patient, such as the front of the knee joint. Therefore, “posterior” refers to the opposite direction of “anterior.” The terms “medial” and “lateral” should be given their usual anatomical interpretation. Therefore, “medial” refers to the opposite direction of “lateral.”

[0093] Figure 1 A cross-sectional view of the tibia 10 and the reamer 14 is shown. Figure 1Only the proximal portion 12 of the tibia 10 is shown. A reamer 14 has been inserted into the tibia 10 and can be configured with grooves or sharp edges to remove bone and create a recess 16 therein. This recess 16 can, in some cases, be at least partially formed by the patient's existing anatomical structures (e.g., the intramedullary canal). In some cases, it is desirable to create the recess 16 and / or insert the reamer to track the intramedullary canal so that temporary parts and implant components are aligned relative to the mechanical and anatomical axes of the tibia 10. The tibia 10 can be the object of revision knee replacement surgery. Therefore, in Figure 1 Prior to the enlargement shown, the tibia 10 may have a removed tibial implant component as part of a revision knee replacement. As will be discussed and shown in further detail later, the proximal portion 12 may be diseased or otherwise become undesirable bone, and this bone may need to be removed as part of a revision knee replacement before a new implant is placed on the proximal portion 12.

[0094] Figure 2 A perspective view of the reamer 14, the tibial caliper 18, and the connector 20 is shown. The connector 20 can engage the tibial caliper 18 and can be configured to receive the reamer 14. Thus, the tibial caliper 18 can be connected to the reamer 14 via the connector 20. Figure 2 The embodiments illustrate that the connector 20 can be configured such that the tibial caliper 18 provides no bias relative to the reamer 14. The reamer 14, via the connector 20, can position the tibial caliper 18 on the proximal surface 22 of the tibia 10. An appropriately sized tibial caliper 18 can be selected, resulting in a desired amount of coverage of the proximal surface 22 with little or no overhang. A non-biased assembly of the tibial caliper 18 may be required if it is satisfactorily positioned on top of the proximal surface 22 and substantially aligned with the mechanical and anatomical axes of the tibia 10 as indicated by the reamer 14. Once the appropriate size and position are determined, any desired marking of the proximal tibia can be made, and the tibial caliper 18 and connector 20 can be removed, leaving the reamer 14 in the tibia 10.

[0095] Figure 3 and Figure 3A Alternative components for the reamer 14, tibial caliper 18, and bias connector 24 are shown. The bias connector 24 may include a distal portion 26 and a proximal portion 28.

[0096] The distal portion 26 can be with Figure 2The connector 20 engages with the tibial caliper 18 in a similar manner. However, the proximal portion 28 can be configured as a turntable so that it is movable relative to the distal portion 26. Since the position of the reamer 14 is fixed relative to the tibia 10, while the tibial caliper 18 is not fixed relative to the tibia 10, movement of the proximal portion 28 relative to the distal portion 26 allows the position of the tibial caliper 18 to be moved on the proximal surface 22 of the tibia 10. The proximal portion 28 can be rotated relative to the distal portion 26 until the desired position of the tibial caliper 18 is achieved. Markings 29A and 29B can be placed on the distal portion 26 and the proximal portion 28, respectively. Markings 29A and 29B can be used to indicate the position of the tibial caliper 18 relative to the reamer 14.

[0097] As in Figure 3 As best illustrated in the example, the proximal portion 28 may have a plurality of through holes 30A, 30B configured to receive the reamer 14. The plurality of through holes 30A, 30B may include a first through hole 30A and a second through hole 30B. More specifically, the plurality of through holes 30A and 30B may have parallel longitudinal axes and may communicate with each other. The through holes 30A and 30B may be configured to provide different degrees of offset relative to the reamer 14 for the bias connector 24 and the tibial caliper 18. For example, the first through hole 30A may provide a 3 mm offset relative to the reamer 14 for the bias connector 24 and the tibial caliper 18, while the second through hole 30B may provide a 6 mm offset relative to the reamer 14 for the bias connector 24 and the tibial caliper 18.

[0098] Figure 4-6B A multi-functional handle 50 is shown. The handle 50 can also be used with... Figure 10A-11D The apparatus, system, and method are used in combination. For example... Figure 4 As shown, tool 50 may include a distal end 52, a pin 54, a collar 56, a shaft 58, a proximal end portion 60, and a hammer 62.

[0099] A handle 50 may extend along the longitudinal axis L from a distal end 52 to a proximal end portion 60. The distal end 52 may be connected to a shaft 58. The shaft 58 may be connected to the proximal end portion 60. In fact, the shaft 58 may form the proximal end portion 60. A pin 54 may be arranged along the shaft 58 and may be connected to a collar 56. The collar 56 may be arranged around the shaft 58 and may move proximally-distally (along the longitudinal axis L) relative to the shaft 58. A hammer 62 may be movably connected to the proximal end portion 60. The hammer 62 may be configured to be gripped by a user and moved proximally-distally (along the longitudinal axis L and along the shaft 58).

[0100] The distal end 52 may be constructed with one or more features 64. Figure 4 ), such as being constructed as with such Figure 5 The protrusions engage with various other devices of the biased broach 66. The pin 54 is movable substantially along the longitudinal axis L of the tool 50 (extendable and retractable). In the extended position, the pin 54 can engage with devices mounted to the distal end 52 (such as…). Figure 5 The offset puller) engages. Pin 54 can be engaged via a spring ( Figure 4 Not shown in, but in Figure 10A-10D and Figure 11B (as shown in the image) or otherwise biased to Figure 4 The extended position is shown. The collar 56 can be coupled to the pin 54 and can be used as a mechanism to retract the pin 54 if needed.

[0101] Figure 5 A bias baffle 66 is shown, which is mounted at a proximal portion 67 to a distal end 52. The proximal portion 67 of the bias baffle 66 can be engaged in this position by a pin 54 to lock the bias baffle 66 in this position. The bias baffle 66 includes a distal portion 68, which is configured as a cutting surface 69 only along one of its surfaces 70. The cutting surface 69 may be tapered, having teeth or other types of cutting edges and / or surfaces.

[0102] like Figure 5A As shown, the bias broach 66 and handle 50 can be hollow to accommodate the reamer 14. More specifically, the handle 50 can be positioned along the longitudinal axis L ( Figure 4 ) is hollow, such that the distal end 52, shaft 58 and / or proximal end portion 60 ( Figure 4 At least a portion of it is hollow. Similarly, the offset broach 66 can be hollow between its distal portion 68 and proximal portion 67. For example... Figure 5A As shown, this hollow construction allows the handle 60 and the biased broach 66 to be inserted downwards onto the reamer 14 in a proximal-to-distal manner. Once positioned and received by the reamer 14, the biased broach 66 can be moved distally to contact the proximal end 12 of the tibia 10 to remove bone. This can create grooves (such as...) Figure 5A (groove 72).

[0103] Figure 6A and Figure 6B A cross-section of the handle 50, the bias broach 66, and the reamer 14 is shown. The reamer 14 is received within the hollow handle 50 and the bias broach 66. Figure 6B The hammer 62 is shown from Figure 6A The position moves along axis 58 and the proximal end portion 60. The movement of the hammer 62 can be along the longitudinal axis L ( Figure 4 A generally controlled movement from proximal to distal, the longitudinal axis L can be substantially aligned with the longitudinal axis of the reamer 14. For example... Figure 6B As shown, the hammer 62 can be configured to strike the enlarged surface 74 of the shaft 58 proximal to the collar 56. This striking action provides a proximal-to-distal force along the shaft 58 through the distal end 52 to the biased baffle 66. This force can also cause the cutting surface 69 of the biased baffle 66 to contact the bone to create a groove 72. Additionally or alternatively, the hammer 62 can be configured to remove the biased baffle 66 from the bone. In some examples, the biased baffle 66 can be driven into the bone via the handle 50 by striking the proximal end portion 60 with a tool, instead of using the impact via the hammer 62. In some examples, the hammer 62 can be configured to lock to the proximal end portion 60 or alternatively lock against the enlarged surface 74 to restrict movement of the hammer 62 along the proximal end portion 60 and the shaft 58. As described above, the hammer 62 can be released when movement is required.

[0104] As described above, since the hammer 62 is coupled to the shaft 58 and the proximal end portion 60, the movement of the hammer 62 and the resulting force are along the longitudinal axis L of the handle 50. Because the handle 50 and the biased broach 66 can be hollow to receive the reamer 14, common alignment between the longitudinal axis L of the handle 50 and the longitudinal axis of the reamer 14 is facilitated. The force generated by the hammer 62 striking can act as a guide to direct the reamer 14 in the desired direction (e.g., from proximal to distal) to create the groove 72. Eccentric striking forces in a direction tangential to the longitudinal axis can be avoided or minimized, thus protecting the preparation of the bone.

[0105] Figure 7A and Figure 7B An inclined reamer 100 is shown, which can be attached to or replace the bias broach 66. Figure 5-6B )use. Figure 7A An inclined reamer 100 is shown for use in removing bone from the proximal portion 12 of the tibia 10 to create a groove 72. The inclined reamer 100 may have a rearwardly angled tapered portion to minimize the risk of over-reaming the bone. Figure 7B A cross-section of the inclined reamer 100 in the tibia 10 is shown. Figure 7B and Figure 7C As shown, the tilting reamer 100 may include a distal nose-shaped portion 102, a cutting portion 104, and a proximal shaft portion 106. The cutting portion 104 may include a first tapered section 108 and a second tapered section 110.

[0106] The distal nasal portion 102 may extend longitudinally to the cutting portion 104. The distal nasal portion 102 may be configured as a groove 16 referencing the tibia 10. The groove 16 may be an intramedullary canal of the tibia 10 and / or may be a groove formed by the reamer 14. The distal nasal portion 102 may include a rounded, blunt end 114. The longitudinal length of the distal nasal portion 102 may vary depending on the embodiment.

[0107] The cut portion 104 may have an increased diameter relative to the distal nose-shaped portion 102 and the proximal axial portion 106. The first tapered segment 108 may be disposed distal to the second tapered segment 110 and may connect to the distal nose-shaped portion 102. Measured from the rounded blunt end 114 to the starting point of the first tapered segment 108, the length of the nose-shaped portion 104 may be between approximately 15 mm and approximately 70 mm. According to various examples, the diameter of the rounded blunt end 114 may be between approximately 6 mm and approximately 16 mm, and its radius may be 5 mm.

[0108] During surgical applications, the conical segment 108 can be the leading portion and the second conical segment 110 can be the trailing portion. For example... Figure 7C As shown, the first tapered segment 108 may have a first tapered angle α (also called a leading angle) between approximately 10 degrees and 40 degrees measured from the surface of the tapered segment 108 to the longitudinal axis A. The length of the first tapered segment 108 along the longitudinal axis A may be between approximately 11 mm and approximately 24 mm. The second tapered segment 110 may have an angle between approximately 4 degrees and approximately 16 degrees measured from the surface of the tapered segment 108 to the longitudinal axis A. The length of the second tapered segment 110 along the longitudinal axis A may be between approximately 20 mm and approximately 60 mm.

[0109] When measured from the longitudinal axis A, the first cone angle α may differ from the second cone angle β of the second cone segment 110. The second cone angle β may be reversed relative to the first cone angle α in the measurement direction. In other words, the second cone segment 110 may have a rearward taper relative to the first cone segment 108. In some examples, the longitudinal length of the first cone segment 108 is different from the longitudinal length of the second cone segment 110.

[0110] In other examples, the inclined reamer 100 may be configured to have only a second tapered section 110 instead of a first tapered section 108. The second tapered section 110 may be positioned proximal to the first tapered section 108 and may be connected to the proximal shaft portion 106. For example... Figure 7B and Figure 7C As shown in both examples, in some instances, the second tapered segment 110 can be separated from the first tapered segment 108 by region 109. Region 109 may include a region having the maximum cross-sectional diameter for the inclined reamer 100, and may be substantially flat (i.e., having a diameter similar to that of the first tapered segment 108). Figure 7C The surface parallel to the longitudinal axis A). In some examples, the region 109 may include a sharp transition (e.g., a ridge) between the first tapered segment 108 and the second tapered segment 110. In examples where the region 109 is flat, the region 109 is parallel to the longitudinal axis A (the surface parallel to the longitudinal axis A). Figure 7C The length of the region can be several millimeters in other examples. Region 109 can have a diameter between approximately 16 mm and approximately 60 mm.

[0111] The second tapered section 110 may have a longitudinal axis A extending from region 109 to the proximal axis portion 106. Figure 7C The diameter decreases from the distal to the proximal side. Conversely, the first tapered segment 108 may have an increased diameter from the nose-shaped portion 102 to the region 109 along the longitudinal axis A from the distal to the proximal side.

[0112] Figure 8A , Figure 8B and Figure 8C A hollow expander 120 is shown, which can be used to prepare the tibia or femur into a temporary rod receiving portion and / or remove the initial bone to receive a conical / sleeve broach or a tibial keel broach. Figure 8A A hollow expander 120 is shown that can be used to remove bone from the proximal portion 12 of the tibia 10 to create a groove 72. Figure 8B and Figure 8C A cross-section of a hollow expander 120 in the tibia 10 is shown. The hollow expander 120 may include a cutting portion 122 and a shaft portion 123. Figure 8B and Figure 8C Also shown is a temporary rod assembly 124 disposed in recesses 72 and 16 of the tibia 10. The temporary rod assembly 124 may include a strut extension 126, an adapter 128, and a rod extension 130. According to other examples, the temporary rod assembly 124 may include the strut extension 126 and an integral temporary rod member (shown later).

[0113] like Figure 8B and Figure 8C As shown, channel 132 can be formed by a cutting portion 122 and a shaft portion 123. Channel 132 can be configured as a support extension 126 of a receiving rod temporary assembly 124. Support extension 126 can be configured to guide the cutting portion 122 of the hollow expander 120 into the tibia 10 to form a groove 72.

[0114] The support extension 126 can be partially disposed within the groove 72 and can extend proximally to a position above the tibia 10, such as... Figure 8C As shown. For example in Figure 8CIn this configuration, the support extension 126 can be removably connected to the adapter 128 via threads 133. The hollow expander 120 can also be positioned above the proximal portion 134 of the adapter 128 in the recess 72.

[0115] The adapter 128 can be positioned in the recess 72 and can have a distal portion 136 arranged on the proximal side of the proximal portion 134 and the distal side of the support extension 126. Figure 8B and Figure 8C The temporary rod assembly 124 is shown to have an offset O provided by the adapter 128. More specifically, the proximal portion 134 of the strut extension 126 and the adapter 128 can define a first longitudinal axis L1, the distance between which is the offset O and a second longitudinal axis L2 defined by the distal portion 136 of the strut extension 130 and the adapter 128. The offset O measured between axes L1 and L2 can be in one or more directions (e.g., proximal, distal, medial, and lateral directions).

[0116] The rod extension 128 can be positioned in the recess 16, and can be, for example, via the thread 137 ( Figure 8C It is removably connected to the distal portion 136 of the adapter 128. The rod extension 128 may extend along the groove 16 on the distal side of the adapter 126.

[0117] Figure 9A and Figure 9B A drill bit guide 140 is shown, which can be attached to a hollow reamer 120. Figures 8A-8C This is used in preparation for broaching conical or sleeve implants. More specifically, the drill guide 140 can be configured to pre-drill the bone in the desired shape and area before broaching the sleeve or conical component. Pre-drilling the bone using the drill guide 140 can reduce the risk of fracture during broaching. Figure 9A The installation onto the temporary rod assembly 124 is shown. Figure 9B The support extension 126 guides one or more drill bits 142 to remove bone from the proximal portion 12 of the tibia 10 to create a groove 72 (this groove may be larger than the groove created by the hollow reamer 120 and may be close to the one created by the bias broach 66). Figure 4-6B ) and / or tilting expander 100 ( Figure 7A and Figure 7B The drill guide 140 creates the groove. The drill guide 140 can be used to guide one or more drill bits 142 along a desired path to break the bone along the periphery or a specified area to create the groove 72.

[0118] The drill bit guide 140 may include a connector 144 and a body 146. The body 146 may include a plurality of orifices 148 configured to receive one or more drill bits 142. Figure 9A ). Figure 9B A cross-section of the drill guide 140 is shown, along with a portion of the body 146 having two orifices 148 and a connector 144. The connector 144 has orifices and is configured to receive and rest on the strut extension 126. The connector 144 can be connected to the body 146 and can hold the body 146 above the tibia 10.

[0119] Figure 9B A drill guide 140 is shown mounted proximally to the strut extension 126 on the tibia 10 and groove 72. (See diagram.) Figure 9B As shown, the drill guide 140 can be configured to guide one or more drill bits 142 distally into the tibia 10 on the anterior, posterior, medial, and / or lateral sides of the temporary rod assembly 124. The ends of the one or more drill bits 142 may be arranged adjacent to, but spaced apart from, the adapter 128. Each of the one or more drill bits 142 may be provided with an enlarged diameter section 150 to limit the distal travel of the one or more drill bits 142, thereby avoiding contact with the adapter 128.

[0120] Figures 10A-10E The previous reference is shown again. Figure 4-6B The multi-functional handle 50 is shown and described. Therefore, the details of the handle 50 will not be discussed again. Figures 10A-10E The features previously discussed, including the distal end 52 and the pin 54, are shown. Figure 10A-10D Additionally, a biasing element 152 is shown, which is configured to position the pin 54 in the extended position. Figures 10A-10B One or more features 64 (e.g., protrusions) are also shown, which are configured to resemble, for example, Figure 5 The bias broach 66 and Figures 10A-10E The second temporary component 154 engages with various other devices.

[0121] Figure 10A and Figure 10B The handle 50 is shown detached from the second temporary component 154, while Figure 10C-10E A handle 50 is shown engaging with the second temporary component 154.

[0122] like Figure 10A and Figure 10B As shown, the second temporary component 154 includes a groove 156 and a proximal surface 157. Figure 10A ) and the outer side surface 158. (e.g.) Figure 10AAs shown, the groove 156 may include a channel 160 configured to allow one or more features 64 to pass through. The second temporary component 154 may additionally include one or more lips 162 partially formed by the proximal surface 157, which are designed to capture the one or more features 64 when the handle 50 is rotated about the longitudinal axis L (e.g., a quarter turn).

[0123] like Figure 10C-10D As shown, when one or more features 64 are captured below one or more lips 162, the pin 54 can extend distally into the second recess 164. This arrangement secures the second temporary member 154 to the handle 50 because the pin 54 constrains the second temporary member 154 about the longitudinal axis L. Figure 10A ) rotation.

[0124] The second temporary component 154 can be constructed (e.g., sized and shaped along the outer lateral surface 158) into the shape of at least one of a sleeve component or a conical component simulating an implant. More specifically, the second temporary component 154 can be constructed (shaped and sized) into the shape and size of a sleeve component simulating an implant. Figure 21 Another example is provided in the subsequent discussion, which shows a temporary component constructed as a keel part of a simulated implant.

[0125] As will be discussed and shown later, the recess 156 may include a portion extending from the proximal surface 157 to the distal surface 166. Figures 10A-10C The side outer surface 158 can extend from the proximal surface 157 to the distal surface 166. According to one example, the second temporary member 154 can be configured as a broach. Therefore, the side outer surface 158 can include a plurality of cutting edges 168. Figure 10C and Figure 10D It can be used with handle 50 to create a groove in the tibia at least partially.

[0126] According to one example, one or more of the side outer surface 158 and a portion of the groove 156 may be tapered along their longitudinal length. Therefore, the cross-sectional area of ​​the distal portion of the second temporary member 154 may differ from and / or change from the cross-sectional area of ​​the proximal portion.

[0127] Figure 11A An assembly 170 of a handle 50 having a second temporary component 154 and a rod temporary assembly 124 is shown. Figure 11B An enlarged view of a portion of component 170 is shown, including a handle 50 and a portion of the temporary rod assembly 124.

[0128] Figure 11A and Figure 11BA second temporary member 154 is shown that engages with the handle 50. The second temporary member 154 may be configured to receive a portion of the rod temporary assembly 124 therein. More specifically, a portion of the support extension 126 and the adapter 128 may be disposed in a recess 156 of the second temporary member 154. The adapter 128 may extend distally from the second temporary member 154. The support extension 126 may extend proximally from the second temporary member 154 and may be received by the handle 50. More specifically, the handle 50 may be hollow to receive the support extension 126 therein.

[0129] Best as Figure 11B As shown, the grooved support extension 126 may have a flared section 172 with an outer surface 174 tapered in such a way that when the support extension 126 is screwed into and secured to the adapter 128, the outer surface 174 engages with and rests against a first tapered inner surface 176 of a portion of the groove 156 forming the second temporary member 154. Additionally, the adapter 128 may include a tapered outer surface 178 configured such that when the support extension 126 is screwed into and secured to the adapter 128, the tapered outer surface 178 engages with and rests against a second tapered inner surface 180 of a portion of the groove 156 forming the second temporary member 154. According to some examples, the taper utilized in one or more of the support extension 126, the second temporary member 154, and the rod temporary assembly 124 may be self-holding (e.g., a Morse taper, etc.). According to other examples, the taper utilized in one or more of the strut extension 126, the second temporary component 154, and the temporary rod assembly 124 may be self-releasing.

[0130] Figure 11C-11E Method 184 is shown, through which method 184, Figure 11A and Figure 11B Component 170 is disposed in the tibia 10. Specifically, component 170 is positioned via a reference... Figure 10A-11B The process described is used to create it. Method 184 may include attaching a second temporary component 154 to the handle 50, and may further include via a reference Figure 11B The tapered surface discussed, as well as the threaded connection between the strut extension and the adapter, will connect the temporary rod assembly 124 ( Figure 11C and Figure 11D It is connected to the second temporary component 154. The connection of the component according to method 184 to form component 170 can be performed inside or outside the knee joint.

[0131] like Figure 11C-11D As shown, method 184 may include inserting the temporary rod assembly 124 and the second temporary component 154 into one or more recesses (e.g., Figure 8B and Figure 8C In the grooves 72 and 16). This allows the rod extension 130 to run along the groove 16 ( Figure 8B and Figure 8C ) extends, and allows the second temporary component 154 to be inserted into the groove 72 ( Figure 8B and Figure 8C In the process of ), the handle 50 can be configured to facilitate the insertion of the temporary rod assembly 124 and the second temporary component 154.

[0132] Figure 12 The second component 186 is shown, which includes the strut extension 126, the second temporary component 154, and the rod extension 130 as described above. Figure 12 A second adapter 188 is also shown, which is substantially unbiased along its longitudinal length. Thus, the second adapter 188 has a longitudinal axis extending over its entire length.

[0133] Figure 13 A cutting instrument 190, such as a saw, is shown, used to remove a portion of bone during a resection to create a resection surface including the proximal surface 22 of the tibia 10. Figure 13 As shown, the proximal surface 157 of the second temporary component 154 can be used to set the resection height of the proximal surface 22. More specifically, the tibia 12 can be removed substantially flush with the proximal surface 157, such that the blade of the cutting instrument 190 is placed on top of the proximal surface 157, and the proximal surface 157 guides the removal of the bone.

[0134] Figures 14A-14C It shows that it can be used with cutting instrument 190 ( Figure 13 The cutting guide component 192 is used together with the cutting guide component. The cutting guide component 192 can be attached to or replace the cutting guide component. Figure 13 The excision method is used. For example... Figure 14B As shown, the cutting guide assembly 192 may include a first collar 194, a first arm 196, a second collar 198, a second arm 200, and a body 202.

[0135] like Figure 14BAs shown, the cutting guide assembly 192 can be assembled proximal to the second temporary component 154. The first collar 194 may include a boom that can be configured to engage with the strut extension 126 or the reamer 14. The first collar 194 can be releasably locked to the strut extension 126 or the reamer 14, for example, by turning a knob 204. A first arm 196 can be engaged with the first collar 194 and can protrude from the first collar 194 (including protruding in a lateral direction). A second collar 198 can be configured to receive the first arm 196. The second collar 198 can move along the length of the first arm 196 and can be releasably locked onto the first arm 196, for example, by turning a second knob 206. Figure 14C As shown, the second collar 198 may have an opening 199 along a portion thereof. The opening 199 can facilitate the removal of components of the cutting guide assembly 192, including the first collar 194 and the first arm 196 (and the reamer 14), without having to loosen the body 202 from the skeleton. Specifically, the opening 199 may be designed to allow the first arm 196 to pass through it when it is not engaged with the second knob 206. Therefore, the first arm 196 and the first collar 194 can be removed without changing the position of the body 202 relative to the skeleton.

[0136] Refer again Figure 14B The second arm 200 can be connected to the second collar 198 and extends generally distally to connect to the body 202. The body 202 can be positioned anterior to and adjacent to the anterior portion of the proximal portion 12 of the tibia 10. The body 202 can be positioned relative to the tibia 10 using the first collar 194 and the second collar 198. The body 202 can be configured with a plurality of slots 208 and pin holes. When performing a resection to remove bone to create the proximal surface 22, the surgeon can select one or more of the plurality of slots 208 to guide the cutting instrument 190 ( Figure 13 In some examples, multiple slots 208 can be placed at predetermined intervals (e.g., in 5 mm increments).

[0137] Figure 15 An exploded view of a portion of component 210 is shown, which may include a tibial support temporary component 212, a fastener 214, a second temporary component 154, and a rod temporary component 124 (e.g., Figure 11A-11E ). Figure 18 Component 210 is shown, in which a temporary tibial support component 212 is mounted on top of the proximal surface 22 of the tibia 10. Figure 18 In this case, fastener 214 can be screwed into the temporary assembly 124 of the rod (e.g., Figure 11A-11E ) to join the tibial support temporary component 212 and the second temporary component 154 ( Figure 15) and temporary rod assembly 124 (e.g., Figure 11A-11E They are connected together.

[0138] Figure 15 The tibial support temporary component 212 and fastener 214, detached from the second temporary component 154, are shown. The tibial support temporary component may have an opening 216 configured to receive the fastener 214, and may have an opening 216 configured for subsequent reference. Figure 19 The distal extension protrusion 218 is shown in a manner connected to the second temporary component 154.

[0139] Figure 16 A driver 220 is shown, which can be configured to work with component 210 ( Figure 15 and Figure 18 The various components of the joint include fastener 214 and rod temporary assembly 124 (e.g., Figure 11A-11E The driver 220 includes a first head 222, a handle 223, and a second head 224.

[0140] The first head 222 of the driver 220 can be configured to connect and engage with the fastener 214, causing the fastener 214 to rotate and screw into the adapter 128 (e.g., Figure 11A-11E The fasteners 214 and adapter 128 are engaged, thereby screwing the fasteners 214 and adapter 128 together, as shown. Figure 17 As shown. The second head 224 may be arranged opposite to the first head 222 relative to the handle 223, and may be designed to be different in size relative to the first head 222. More specifically, the second head 224 may be smaller than the first head 222 so as to be configured as a distal portion of those parts of the adapter 128 that engage with the first head 222, as will be discussed and shown subsequently with reference to 19.

[0141] Figure 19 A cross-sectional view of component 210 is shown. Component 210 may include a tibial support temporary component 212, a fastener 214, a second temporary component 154, and a rod temporary assembly 124, as previously shown and described. Rod temporary assembly 124 may include an adapter 128 and a rod extension 130. (Reference) Figure 26 and Figure 26A A similar component, but for the femur, is shown.

[0142] like Figure 19As shown, fastener 214 may extend through orifice 216 and may be at least partially received in distal extension protrusion 218 of tibial support temporary member 212. Fastener 214 may extend into threaded hole 225 of adapter 128 and may have threads configured to engage with threaded hole 225. Second temporary member 154 may be arranged around distal extension protrusion 218 of tibial support temporary member 212. Proximal portion 134 of adapter 128 may be received in recess 156 of second temporary member 154. Adapter 128 and rod extension 130 may extend distally to tibial support temporary member 212 and second temporary member 154. Adapter 128 may be configured to provide bias along its longitudinal length, as previously referenced. Figure 8B and Figure 8C As described.

[0143] Fastener 214 can be screwed into the proximal portion 134 of adapter 128 in the threaded hole 225. The distal extension 218 of the tibial support temporary member 212 may have an outer conical surface 226 that is conical in such a way that, when fastener 214 is screwed into and secured to adapter 128, the outer conical surface 226 engages with and rests against a first conical inner surface 176 forming a portion of the groove 156 of the second temporary member 154. Additionally, adapter 128 may include a conical outer surface 178 configured such that, when fastener 214 is screwed into and secured to adapter 128, the outer conical surface 178 engages with and rests against a second conical inner surface 180 forming a portion of the groove 156 of the second temporary member 154. According to some examples, the taper utilized by one or more of the distal extension protrusion 218, the second temporary member 154, and the rod temporary assembly 124 may be self-holding (e.g., a Morse taper, etc.). According to other examples, the taper utilized by the distal extension protrusion 218, the second temporary member 154, and the rod temporary assembly 124 may be self-releasing.

[0144] like Figure 19 As shown, fastener 214 may include a channel 228. Channel 228 may extend along the entire longitudinal length of fastener 214 and may include a through-hole, and channel 228 may be defined by a proximal portion 230, a central portion 232, and a distal portion 234. The central portion 232 defining channel 228 of fastener 214 may include a first engagement feature 236. Proximal portion 232 may be threaded along channel 228 (and therefore may have internal threads) for engagement with a second fastener to lock the tibia support member (not shown) downward. Distal portion 234 may include external threads 238 configured for engagement with threaded drill hole 225.

[0145] The first engagement feature 236 can be configured to be formed by the first head 222 of the actuator 220. Figure 16 Engagement. This engagement facilitates rotation of the fastener 214 to engage or disengage the fastener 214 from the adapter 128 via a threaded connection.

[0146] Additionally, adapter 128 may include a second engagement feature 240 disposed within adapter 128, distal to but in communication with the threaded bore 225. The second engagement feature 240 may be configured to be formed by the second head 224 of the actuator 220. Figure 16 ( ) Engagement. When it is desired to change the position of the temporary tibial support component 212, this engagement can facilitate movement of the temporary tibial support component 212, such as... Figure 23A and Figure 23B As shown. This allows for the temporary tibial support component 212 or Figure 26A The femoral temporary component 268 is better matched as Figure 23A and Figure 23B The periphery of the tibia shown (or, in the case of a temporary femoral piece), better matches as... Figure 27 and Figure 28 (The periphery of the femur is shown). The temporary rod assembly 124 engages with the actuator 220 in... Figure 22A and Figure 22B As shown in the diagram. This engagement allows the temporary rod assembly 124 to rotate within the body, and this rotation occurs... Figure 22A and Figure 22B It is displayed in the middle.

[0147] The actuator 220 can access the second engagement feature 240 because the dimensions of the shaft and the second head 224 can be designed to be small enough to pass through the channel 228 and threaded hole 225 of the first engagement feature 236, which includes the fastener 214, thereby accessing the second engagement feature 240. Therefore, the actuator 220 can be positioned proximal to the tibial support temporary component 212 (i.e., Figure 17 In one of the positions shown, the positioning of the temporary tibial support component 212 is completed via a threaded connection and / or the engagement of the fastener 214 with or without the adapter 128 is facilitated.

[0148] refer to Figure 17-23B This illustrates engagement via a threaded connection that facilitates positioning and / or fastener 214 engaging or disengaging with adapter 128. This can be performed endoscopically, with a temporary tibial support component 212 positioned atop the proximal surface 22 of the resected tibia 10, and a second temporary component 154 and a temporary rod assembly 124 positioned in one or more recesses, such as... Figure 17 , Figure 23A and Figure 23B As shown. In the case of the femur, the femoral temporary component 268 ( Figure 26A It can be positioned in the body, wherein the femoral temporary component 268 is disposed on top of the distal surface of the resected femur, and the second temporary component 154 and the rod temporary assembly 124 are disposed in one or more grooves of the femur.

[0149] It should be noted that, such as Figure 23A and Figure 23B As shown, via the actuation driver 220 (by... Figure 23A Arrow A2 in the diagram indicates the position of engaging and rotating the temporary assembly 124 (as shown in the diagram). Figure 22A and Figure 22B As shown), the position of the tibial support temporary assembly 212 on top of the proximal surface 22 of the resected tibia 10 can be changed (e.g., Figure 23A (Indicated by arrow A1 in the diagram). This allows for alteration of the positioning of the tibial support temporary component 212 on the resected proximal surface 22 and relative to the rod temporary component 124 after implantation of the second temporary component 154 and the rod temporary assembly 124. The use of the actuator and the rod temporary assembly 124 to adjust the femoral temporary component 268 on the femur is also anticipated. Figure 26-28 ) and / or the femoral calibrating cutting guide 262 on the femur ( Figure 25 ).

[0150] Figure 20 This illustrates that once the desired relative positions of the individual components of component 210 are achieved, component 210 can be removed from the patient together and placed on the working surface 211. More specifically, after being assembled and positioned in vivo, component 210 can then be removed from the patient while maintaining the position of each component relative to each other. This allows for easier and more timely creation of permanent implants based on temporary components, as the positions of the individual temporary components do not need to be documented or otherwise detailed. Instead, the entire temporary component can be maintained with each part in a desired relative position to the others for easy reference.

[0151] Figure 21 Alternative component 213 is shown, which can be assembled and positioned within the body as previously described, and then removed together and placed on the working surface 211. Figure 21 Examples include a second temporary component 215, which is designed to mimic the construction of a keel implant.

[0152] Figure 24 A system 250 is shown that can be assembled to include components such as rod temporary assembly 124 or another rod temporary assembly. Alternatively, as Figure 38 As shown, a system can be provided that has an integral temporary rod assembly (a single-piece adapter portion and a rod extension portion).

[0153] like Figure 24 As shown in the example, system 250 may include a plurality of adapters 252 and a plurality of rod extensions 254. The plurality of adapters 252 may include a first adapter 128, a second adapter 188, and a third adapter 256. The plurality of rod extensions 254 may include a rod extension 130 and a second rod extension 258.

[0154] Multiple adapters 252 can be used interchangeably with multiple rod extensions 254 to provide different amounts of bias in the longitudinal direction. For example, adapter 128 can provide a first bias amount O1. A second adapter 188 can provide essentially no bias. A third adapter 256 can provide a third bias amount O3, which can differ from the bias O1 and no bias provided by the first adapter 128 and the second adapter 188. According to one example, the first bias amount O1 includes 3 mm, and the bias amount O3 includes 6 mm.

[0155] Multiple rod extensions 254 provide different longitudinal lengths. For example, rod extension 130 may have a longitudinal length of 135 mm, while rod extension 258 may have a longitudinal length of 175 mm. As part of system 250, each of the multiple rod extensions 254 may be provided with various diameters.

[0156] System 250 can be used interchangeably with either the tibial or femoral temporary component as a kit to reduce the total number of components, thereby reducing the cost and weight of the temporary system shown herein. According to other examples, System 250 can differ, for example, by providing other adapters with different biases. According to some examples, unlike modular systems, an integrated rod temporary assembly with rod extensions and adapters, as a single component, is provided. Figure 38 As shown.

[0157] Figure 25 A femur 260 is shown, comprising a reamer 14, a femoral cutting guide 262, and a bias connector 24. The bias connector 24 may have previously referenced... Figure 3 and Figure 3A The described structure. It is important to note the previous references. Figure 1-24 All instruments, components, systems, methods and techniques described are applicable to and equally applicable to the femur 260 and tibia 10.

[0158] exist Figure 25 In this configuration, the bias connector 24 is connected to the reamer 14 and can also be connected to the femoral cutting guide 262. The bias connector 24 can be referenced previously. Figure 3 and Figure 3AThe described method is used to adjust the position of the femoral cutting guide 262 on the distal end portion 264 of the femur 250 as needed. The femoral cutting guide 262 may include a 4-in-1 cutting guide having a plurality of slots 256 configured to guide the resection of the distal end portion 264 of the femur 250 at various desired angles.

[0159] Figure 26 and Figure 26A Component 266 is shown, which includes a femoral temporary component 268 as previously shown and described, and fasteners 270. Figure 26A The second temporary component 154 and the temporary rod assembly 124. The temporary rod assembly 124 includes an adapter 128 and a rod extension 130.

[0160] Fastener 270 can be used with the previously described fastener 214 ( Figure 19 It can be constructed in a similar manner, but may have a different longitudinal length and proximal end portion, since it is not necessary to attach the support member to the fastener 262. The fastener 262 may include a channel 228 to provide access to the adapter 128, thereby allowing the positioning of the rod temporary assembly 124 to be adjusted in the manner previously described.

[0161] like Figure 27 and Figure 28 As shown, according to some examples, the femoral temporary component 268 may include an elongated slot 272. This elongated slot 272 may be configured to receive a pin 273 therein. The elongated slot 272 may be positioned to allow proximal-distal adjustment of the femoral temporary component 268 on the distal portion 264 of the femur 260, such as... Figure 26 and Figure 27 As shown. More specifically, with the pin 273 in place and received in the elongated slot 272, the medial-lateral movement and internal-external rotation of the femoral temporary component 268 can be restricted. However, due to the shape and orientation of the slot 272, the proximal-distal position of the femoral temporary component 268 can be adjusted. When the desired position of the femoral temporary component 268 is reached, a second pin (not shown) can pass through the orifice 274 into the femur 260. This can hold the femoral temporary component 268 in the desired position.

[0162] The femoral temporary component 268 may include various slots for enhancing cutting and may include an interankular groove configured to engage with an insert for box cutting when needed.

[0163] Figure 29-32A rod extension implant configured to be insensitive to the rod rotation angle is shown. This allows the rod extension implant to buckle in any direction. In contrast, in the prior art, known rod implants with slots are configured to be direction-sensitive and therefore only allow the implant to buckle in a limited number of directions.

[0164] Figure 29 An alternative design for the distal portion of a rod extension implant 275, according to one example, is shown. The rod extension implant 275 may include a helical channel 276 along a portion of its longitudinal length. This configuration can provide the rod extension implant 275 with additional flexibility, independent of specific rotational placement in the bone, when needed.

[0165] Figure 30 An alternative design for the distal portion of the rod extension implant 278 is shown. The rod extension implant 278 may include a plurality of spaced-apart gaps 280 along a portion of the longitudinal length of the rod extension implant 278. These plurality of gaps 280 create spaced-apart segments 282 having a cross-sectional area different from the cross-sectional area cut through the plurality of gaps 280. This configuration can provide the rod extension implant 278 with additional flexibility, independent of specific rotational placement in the bone, when needed.

[0166] Figure 31 and Figure 32 Another alternative design for the distal portion of the rod extension implant 284 is shown. The rod extension implant 284 may include a plurality of slots 286. These slots 286 may extend along a portion of the longitudinal length of the rod extension implant 284 and may extend to its distal end 288. The plurality of slots 286 may divide the rod extension implant 284 into a plurality of segments 290, said segments 290 including a central segment 292 and a plurality of outer segments 294. This configuration may provide additional flexibility to the rod extension implant 284 when needed, while providing increased flexural stiffness through the contact of 294 with the central core (288 or 292).

[0167] It should be noted that, in addition to having three slots 286 as shown in the figure, more or fewer slots may be provided according to other embodiments. For example, in addition to the central segment 292 having a generally triangular shape (when viewed in a cross section perpendicular to the longitudinal axis L) due to the use of three slots 286, the central segment may have a generally square shape if four slots are used.

[0168] Figure 33 Method 300 according to an example is shown. Method 300 can utilize previous references. Figure 1-32The described systems, instruments, and components. According to one example, method 300 may include preoperative steps. This may include imaging the knee joint using medical imaging techniques such as computed tomography (CT), X-ray, or magnetic resonance imaging (MRI) to obtain imaging data representative of the knee joint. According to some examples, imaging data may be acquired or collected during the preoperative planning stage based on two-dimensional or three-dimensional computer images of corresponding anatomical structures reconstructed from image scans of the patient using computer imaging methods. Such imaging may be used to identify lesions of bone and / or tissue in one of the tibia and / or femur that require removal, as well as implants that need to be removed (in the case of revision surgery). Imaging may also be used to identify one or more axes of the knee joint (such as the mechanical or anatomical axes of the tibia and femur). A model of the joint may be presented to the surgeon as part of the preoperative planning. In some examples, the surgeon may view the three-dimensional model and may provide guidance via electronic input.

[0169] In step 304, the joint can be exposed and one or more existing implants can be removed. A preliminary joint assessment 306 can also be performed. The tibial joint revision stage of method 300 can then be implemented. The surgeon can identify the tibial mechanical axis based on image data and / or observation and experience 308. An initiation hole can also be created. The tibial canal (e.g., intramedullary canal, diaphysis, and / or metaphysis) can be prepared 310 using, for example, the reamer 14 previously shown and discussed. The size and position of the tibia can be assessed 312. If a biased temporary rod assembly is required, this temporary rod assembly or another temporary rod assembly can be prepared and inserted 314 into one or more grooves in the tibia. Any desired drilling, broaching, or reaming can be performed using, for example, a reference... Figure 5-10E The instruments and / or techniques discussed are subject to 316. For example, they may be used... Figure 13-14B The instruments and / or techniques used are employed to perform a resection of the proximal tibia at 318. A temporary tibial support at 320 may be attached, and can be performed as described in reference [reference needed]. Figure 15-23B Assemble as discussed. Joint assessment 322 can be performed. In some examples, the tibial component can be removed to create the implant component, as referenced. Figure 20 and Figure 21 As discussed.

[0170] The revision stage of the femoral joint using method 300 can then be implemented. The surgeon can identify the mechanical and / or anatomical axes of the femur based on image data and / or observation and experience 324. An initial hole can also be created. The femoral canal (e.g., intramedullary canal, diaphysis, and / or metaphysis) can be prepared using, for example, the reamer 14 previously shown and discussed 326. Femoral size and position can be assessed 328. If a biased temporary rod assembly is required, this temporary rod assembly or another temporary rod assembly can be prepared and inserted 330 into one or more grooves in the tibia. Any desired drilling, broaching, or reaming can be performed using, for example, a reference... Figure 5-10E The instruments and / or techniques discussed are subject to 332. For example, they may be used... Figure 25-28 Instruments and / or techniques are used to perform the resection of the distal femur at 334. A temporary femoral component at 336 may be attached, and can be referenced as described above. Figure 15-28 Assemble as discussed.

[0171] Method 300 may also include preliminary testing and reduction 338, as well as resection and thoracotomy for femoral reinforcement 340. Method 300 may also include revision and final testing phases 343 of the patella 342, wherein the knee joint can remain stable in flexion and extension. Method 300 may conclude with the insertion of one or more implants 344.

[0172] Figure 34 It shows what can be used as Figure 33Further details of another method 350, a part of method 300. Method 350 may include shaping the patient's bone 352 to create one or more grooves therein. Method 350 may include assembling 354 a temporary rod assembly including adapters and rod extensions, and arranging the temporary rod assembly 356 within the one or more grooves. Method 350 may also include assembling 358 in vivo the temporary rod assembly with a first temporary component configured to mimic the shape of one of a tibial support implant or a femoral implant, and a second temporary component configured to mimic the shape of at least one of a sleeve component or a keel component of the implant. In some examples, the assembly may include: selecting an adapter from a plurality of adapters, each of the plurality of adapters having a longitudinal axis extending between a proximal end and a distal end, wherein the plurality of adapters includes at least one first adapter with no bias in the longitudinal axis and at least one second adapter with a bias in the longitudinal axis; and selecting a rod extension from a plurality of rod extensions, each rod extension being configured to engage with the plurality of adapters, wherein the plurality of rod extensions each have a different longitudinal extent between a proximal end and a distal end. In other examples, the assembly may include one or more of the following steps: engaging a fastener to screw the fastener into a threaded groove in the temporary rod assembly; and passing a tool through a channel in the fastener to engage the temporary rod assembly distal to the threaded groove.

[0173] Method 350 may additionally include: temporarily joining the second temporary component and the rod temporary assembly together via a handle configured to insert over the strut extension; and inserting the rod temporary assembly and the second temporary component together into the one or more recesses. According to one example, method 350 may include: identifying the axis of the bone; and determining whether an offset configuration for the rod temporary assembly is required. According to one example, method 350 may include moving the rod temporary assembly in vivo to position it at a desired location within the one or more recesses, and positioning the first temporary component on the resection surface of the bone. According to one example, method 350 may include removing the tibial support temporary component, the second temporary component, and the rod temporary assembly from the bone and at least together from the one or more recesses while maintaining the position of each component relative to each other. Additionally, method 350 may include constructing the implant assembly based on the position of the tibial support temporary component, the second temporary component, and the rod temporary assembly.

[0174] Figure 35A and Figure 35B Assembly 400 is shown, comprising a set screw 402, a fastener 402, and a component 404. Component 404 may substantially include any orthopedic instrument or device, and may include the instruments and devices described herein (e.g., drill guide 140). Figure 9A and Figure 9B), bias connector 24 and Figure 25 (Femoral cutting guide 262).

[0175] according to Figure 35A and Figure 35B For example, the component may include a drilled hole 406 having a threaded portion 408, a pocket-shaped portion 410, and a limiting portion 412. The fastener 402 may include a set screw having a head portion 414 and a threaded portion 416.

[0176] The drill hole 406 can be configured such that the threaded portion 408 is arranged adjacent to and communicates with the pocket-shaped portion 410, and the pocket-shaped portion 410 is arranged adjacent to and communicates with the limiting portion 412. According to some examples, the limiting portion 412 may be arranged at or immediately adjacent to the opening 418 of the drill hole 406. However, this arrangement is not present in other examples. The threaded portion 416 of the fastener 402 can be connected to the head portion 414.

[0177] like Figure 35A As shown, fastener 402 can be detached from component 404, such that threaded portion 408 is not engaged with threaded portion 416. Therefore, fastener 402, including threaded portion 416 and head portion 414, can remain within bag-shaped portion 410 with some space 420 around it. More specifically, bag-shaped portion 410 can be designed to receive fastener 402 therein, thus leaving space 420 between the sidewall of bag-shaped portion 410 and a portion of the surface of fastener 402 forming head portion 414 and threaded portion 416. For example, this space 420 can allow disinfectant solution to enter threaded portion 408, bag-shaped portion 410, and fastener 402 through opening 418 and around head portion 414.

[0178] Figure 35A The bag-shaped portion 410 is shown to be designed with a diameter larger than that of the head portion 414 to provide a certain degree of separation. However, the diameter of the restricting portion 412 can be substantially equal to or slightly smaller than the diameter of the head portion 414. Therefore, an interference fit will be formed between the restricting portion 412 and the head portion 414. Figure 35AIn this process, the fastener 402 is inserted into the pouch-like portion 410 via an interference fit. This insertion can be accomplished, for example, by using a flexible material for the component and / or the fastener; applying sufficient force to the fastener 402 to complete the insertion; or applying a temperature difference between the fastener and the component (to cause expansion and / or contraction of the relevant portions). To facilitate this insertion, the head portion 414 may include a chamfered surface 422, which can serve as a bevel to facilitate insertion of the fastener 402 into the restrictor portion 412. Additionally or alternatively, the restrictor portion 412 may include a chamfered surface 424 that can serve as a bevel. In the example utilizing two chamfered surfaces 424 and 422, the chamfered surface 422 may be shaped and positioned to interact first with the chamfered surface 424 during the insertion of the fastener 402 into the pouch-like portion 410.

[0179] Once captured in the pocket portion 410, the limiting portion 410 can be constructed (designed to be sized) relative to the head portion 414 such that the fastener 402 cannot be retracted from the bore 406 beyond the limiting portion 412 due to the interference fit between the limiting portion 412 and the head portion 414. Therefore, the fastener 402 can be non-removable after being inserted into the pocket portion 410 and can be held by the limiting portion 410.

[0180] Figure 35B The fastener 402 is shown after it has engaged at engagement feature 426 in head portion 414 and been rotated to engage threaded portion 416 with threaded portion 408. For example, this threaded engagement can tighten both parts of component 404.

[0181] Figure 36A and Figure 36B It shows the relationship with Figure 35A and Figure 35B Component 400 has an alternative component 430 with a similar construction. Therefore, the specific features of component 430 will not be discussed in detail, as they are included in the previous references. Figure 35A and Figure 35B Characteristics of the discussion. Figure 36A and Figure 36B Examples and Figure 35A and Figure 35B The difference in this example is that passages 432A and 432B are provided to communicate with the bag-shaped portion 410. For example, these passages 432A and 432B may extend substantially transversely to the longitudinal axis of the borehole 406. Passages 432A and 432B may facilitate the passage of disinfectant solution if desired.

[0182] Figure 37A and Figure 37B Two drives, 450A and 450B, are shown, which can be used as replacements. Figure 16 The driver 220 is utilized. Figure 37A The driver 450A can be configured to work with components such as 210 ( Figure 15 and Figure 18 Specifically, this refers to the engagement of various components of the fastener 214. Therefore, the actuator 450A may include the previously described first head 222 and handle 223. The first head 222 of the actuator 450A may be configured to engage and perform actuation on the fastener 214, thereby causing the fastener 214 to rotate and screw into the adapter 128 (e.g., Figure 11A-11E The fasteners 214 and adapter 128 are engaged, thereby screwing the fasteners 214 and adapter 128 together, as shown. Figure 17 As shown. According to Figure 37A For example, the first head 222 may include a hexagonal head with a size of 5 mm.

[0183] Figure 37B The actuator 450B may include a handle 223 and a second head 224. The actuator 450B may be configured to engage with the lever temporary assembly 124, as previously referenced. Figure 11A-11E and Figures 22A-22B As shown and described. The second head 224 can be connected to the first head 222 ( Figure 37A The second head 224 may be designed to be smaller than the first head 222 (e.g., a hexagonal head with a size of 3 mm) so that it can be configured to enter the portion of the adapter 128 distal to those portions that engage with the first head 222, as shown in the reference. Figure 19 As discussed and shown.

[0184] Figure 38 A system 460, consisting of an integral component, is shown that can be assembled to include, for example, a temporary rod assembly. This system 460 can replace... Figure 24 It uses a modular system (separate adapters and rod extensions).

[0185] System 460 can utilize, for example Figure 38 The temporary rod assembly shown is in an integral form (i.e., it comprises a single component having an adapter portion 462A, 462B, 462C and a rod extension portion 464A and 464B).

[0186] At a basic level, system 460 may include a plurality of components 466, 468, 470, 472, 474, and 476. Each of the plurality of components 466, 468, 470, 472, 474, and 476 may have one of a plurality of adapter portions 462A, 462B, and 462C and one of a plurality of rod extension portions 464A and 464B.

[0187] Multiple rod extension portions 464A and 464B can be configured to provide different longitudinal lengths. For example, rod extension portion 464A can have a longitudinal length of 135 mm, while rod extension portion 464B can have a longitudinal length of 175 mm. As part of system 460, each of the multiple rod extension portions 464A and 464B can be provided with various diameters.

[0188] Multiple adapter portions 462B and 462C can be configured to provide different bias amounts in the longitudinal direction. For example, adapter portion 462B can provide a first bias amount O1. Adapter portion 462A can provide essentially no bias. A third adapter portion 462C can provide a third bias amount O3, which can differ from the bias O1 and no bias provided by adapter portions 462A and 462B. According to one example, the first bias amount O1 includes 3 mm, and the bias O3 includes 6 mm.

[0189] Additional Notes

[0190] The above detailed description includes reference to the accompanying drawings, which form part of the detailed description. The drawings illustrate, by way of illustration, specific embodiments in which the invention may be practiced. These embodiments are also referred to herein as “examples.” These examples may include elements other than those shown or described. However, the inventors of this application also contemplate providing examples of only those elements shown or described. Furthermore, the inventors of this application contemplate examples using any combination or arrangement of those elements (or one or more aspects thereof) shown or described with respect to a particular example (or one or more aspects thereof) or with respect to other examples (or one or more aspects thereof) shown or described herein.

[0191] In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more, independent of any other instances or uses of “at least one” or “one or more.” Unless otherwise stated, the term “or” is used herein to indicate non-exclusivity, or to mean that “A or B” includes “A without B,” “B without A,” and “A and B.” In this document, the terms “comprising” and “in which” are used as common English equivalents to the corresponding terms “including” and “wherein.” Furthermore, in the following claims, the terms “comprising” and “including” are open-ended, meaning that a system, device, article, composition, formulation, or process including elements other than those listed after this term in a claim is still considered to fall within the scope of that claim. Additionally, in the following claims, the terms “first,” “second,” and “third,” etc., are used merely as designations and are not intended to impose numerical requirements on their subject matter.

[0192] The above description is intended to be illustrative and not restrictive. For example, the examples above (or one or more aspects thereof) may be used in combination with each other. Other examples may be used, for instance, by someone skilled in the art after reading the above description. An abstract is provided to conform to 37 C. FR § 1.72(b), thereby allowing the reader to quickly ascertain the nature of the disclosure. It is understood at the time of filing that this abstract is not intended to interpret or limit the scope or meaning of the claims. Moreover, in the detailed description above, various features may be combined together to simplify the disclosure. This should not be construed as an intention that any unclaimed disclosed feature is essential to any claim. Rather, the inventive subject matter may lie in fewer than all features of a particular disclosed example. Therefore, the following claims are incorporated herein by way of example or embodiment, wherein each claim is itself an individual example, and these examples may be contemplated to be combined with each other in various combinations or arrangements. The scope of the invention should be determined with reference to the appended claims and the full scope of the equivalents conferred by those claims.

Claims

1. A component for knee replacement surgery, comprising: Fasteners having a threaded portion and a head portion; as well as A component having a drilled hole, the drilled hole comprising: The corresponding threaded portion is configured to connect with the threaded portion of the fastener; A pouch-like portion adjacent to the corresponding threaded portion within the drill hole, wherein the pouch-like portion is configured to receive the fastener when it disengages from the component such that the threaded portion of the fastener is not engaged with the corresponding threaded portion, thereby leaving a space between the sidewall of the pouch-like portion and a portion of the surface of the fastener forming the head portion and the threaded portion, and the space allowing a disinfectant solution to enter the corresponding threaded portion, the pouch-like portion, and the fastener through the opening of the drill hole and around the head portion; and A limiting portion is arranged adjacent to the bag-shaped portion, wherein the limiting portion is configured to have a diameter substantially equal to or smaller than the diameter of the head portion, so as to retain the fastener within the bag-shaped portion when the threaded portion of the fastener disengages from the corresponding threaded portion.

2. The component according to claim 1, wherein, The diameter of the bag-shaped portion is larger than the diameter of the head portion.

3. The component according to claim 1, wherein, One or more of the limiting portion and the head portion of the fastener have chamfered surfaces configured to serve as bevels to facilitate insertion of the head portion beyond the limiting portion.

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