Cutting guide system and method

Abstract

A cutting guide system for adjusting and stabilizing a cutting instrument is disclosed. An exemplary cutting guide system may be used in orthopedic surgery. In some embodiments, the cutting guide system includes a support mount, a joint, and a cutting tool support, where the joint allows the cutting tool support to be adjusted relative to the support mount. The joint allows the cutting tool support to be rotated about at least two axes. The cutting tool may be rotatable and / or longitudinally movable relative to the cutting tool support. In some embodiments, the cutting guide system includes a track, where the cutting tool support is coupled to the track in a manner that allows the cutting tool support to move along a path. Methods of using the cutting guide system are also disclosed.

Description

Technical Field

[0001] The present disclosure (the present invention) relates to a cutting guide system, a method of fabricating and assembling a cutting guide system, and a method of using a cutting guide system.

[0002] [Citation of Related Applications] This application claims priority to U.S. Provisional Patent Application No. 63 / 154,367, filed on February 26, 2021 (invention title: Cutting Guide Systems), and U.S. Provisional Patent Application No. 63 / 195,994, filed on June 2, 2021 (invention title: Cutting Guide Systems and Methods). These applications are hereby incorporated by reference in their entireties and made a part of this specification.

[0003] This application also relates to U.S. Provisional Patent Application No. 63 / 058,216 (Title of Invention: Thin Single Width Chain Saw), filed on 29 July 2020; U.S. Provisional Patent Application No. 63 / 085,290 (Title of Invention: Thin Single Width Chain Saw), filed on 30 September 2020; U.S. Provisional Patent Application No. 63 / 147,033 (Title of Invention: Chain Saws and Components for Chain Saws), filed on 8 February 2021; U.S. Provisional Patent Application No. 63 / 154,379 (Title of Invention: Systems and Methods for Manufacturing Saws and Saw Components), filed on 26 February 2021; and U.S. Provisional Patent Application No. 63 / 209,525 (Title of Invention: Devices for Maintaining Tension in Chain Saws), filed on 11 June 2021. This invention relates to U.S. Patent Provisional Application No. 63 / 209,540 (Title: Systems for Robotic Surgery), filed on 11 June 2021; U.S. Patent Non-Provisional Application No. 17 / 443,646 (Title: Chain Saws, Components for Chain Saws, and Systems for Operating Saws), filed on 27 July 2021; and International Application PCT / US2021 / 043433 (Title: Chain Saws, Components for Chain Saws, and Systems for Operating Saws), filed on 28 July 2021. These patent documents are incorporated herein by reference, and their entire contents are incorporated as part of this specification. [Background technology]

[0004] Many people suffer from orthopedic conditions that require or are deemed effective to involve cutting bone or other tissue. For example, many people have serious joint problems that require surgical intervention or procedures to implant artificial joints. Every year, doctors implant millions of artificial joints, but such implantation procedures require reshaping the patient's bone to accommodate the implant. The most common joint surgery is knee replacement. Bone repair in knee replacement involves making a series of uniform cuts or incisions at the ends of two major adjacent long bones that will be joined by the implant. Ideally, these cuts are made to be precisely complementary in shape to the implant. When the flat surface of healthy bone faces the peripheral surface of the implant, the result is the strongest possible healing state at the joint with less risk of complications or implant failure.

[0005] The requirements for sawing bone or other tissue during surgical procedures exceed those for other sawing applications. Specifically, in surgical procedures, the saw must be sterile, the sober must be easy for the surgeon to control, and vibration and noise must be minimized. In addition, among other considerations, the saw must cut in a manner that does not generate excessive heat, no metal particles or other contaminants must adhere to the surgical field during the procedure, and the surgical procedure must result in cutting hard bone or other tissue while minimizing trauma to adjacent soft tissue.

[0006] The cut surface created by a bone saw is ideally uniform when viewed in the plane of the saw, and ideally straight at the cut boundary. This is necessary to enable optimal healing when two bone surfaces face each other or when one bone surface faces the implant surface. Surfaces that are not coplanar, i.e., uneven surfaces, may take a long time to heal or may form gaps where healing is impossible. Some saws tend to produce an undesirable drift called skiving, where the saw moves away from its intended plane. Also, some saws have cutting elements that tend to create a gripping effect, resulting in undesirable, unguided movement of the saw.

[0007] In surgical procedures, the bone saw is operated by the surgeon within the operating room environment. It is desirable that the vibrations generated by the saw be minimized and therefore easily controllable by the surgeon. This is important for several reasons. Bone is usually located next to important and sensitive soft tissues, such as blood vessels and nerves, and if movement is not controlled, damage to these tissues may result. Furthermore, if movement is not controlled, the desirability of the cut may be reduced.

[0008] Historically, in relation to knee arthroplasty, when highly simplified surface reconstruction (articular surface reconstruction) of the articular surfaces of the distal femur, proximal tibia, and even the patella was performed (more than 40 years ago), the cuts were made freehand in an iterative process of cutting and sizing the bone to fit and align these implants. Finally, after orientation and positioning relative to the natural anatomical markers for the cut depth, after flexion / extension, and after varus / valgus positioning, a cutting block fixed to the bone was used. The cutting block guides the saw blade to create the cut for the knee joint implant. This type of cutting block system is still used today, with tens of thousands of orthopedic devices in use worldwide. Generally, cutting blocks have specific sizes for different sizes of knee joint implants, just as people's shoe sizes differ from one another.

[0009] While chainsaws have long been used for applications such as cutting wood, to date, such chainsaws have not been successfully developed for general surgical applications. This is due to the numerous technical challenges that chainsaws face for the specific requirements of bone or other surgeries. U.S. Patent No. 9,616,512, granted to Viola, discloses a chainsaw for cutting bone. U.S. Patent No. 9,616,512 is incorporated herein by reference in its entirety.U.S. Patent Provisional Application No. 63 / 058,216 (Title of Invention: Thin Single Width Chain Saw), filed on July 29, 2020; U.S. Patent Provisional Application No. 63 / 085,290 (Title of Invention: Thin Single Width Chain Saw), filed on September 30, 2020; U.S. Patent Provisional Application No. 63 / 147,033 (Title of Invention: Chain Saws and Components for Chain Saws), filed on February 8, 2021; U.S. Patent Provisional Application No. 63 / 154,379 (Title of Invention: Systems and Methods for Manufacturing Saws and Saw Components), filed on February 26, 2021; U.S. Patent Provisional Application No. 63 / 209,525 (Title of Invention: Devices for Maintaining Tension in Chain Saws), filed on June 11, 2021. U.S. Patent Provisional Application No. 63 / 209,540 (Title: Systems for Robotic Surgery), filed June 11, 2021, U.S. Patent Non-Provisional Application No. 17 / 443,646 (Title: Chain Saws, Components for Chain Saws, and Systems for Operating Saws), filed July 27, 2021, and International Application PCT / US2021 / 043433 (Title: Chain Saws, Components for Chain Saws, and Systems for Operating Saws) disclose chainsaws, components for chainsaws, methods for manufacturing chainsaws and components, and methods for using chainsaws and components. These patent documents are incorporated herein by reference and their entire contents are incorporated as part of this specification. [Prior art documents] [Patent Documents]

[0010] [Patent Document 1] U.S. Patent No. 9,616,512 [Patent Document 2] U.S. Patent Provisional Application No. 63 / 058,216 [Patent Document 3] U.S. Patent Provisional Application No. 63 / 085,290 [Patent Document 4] U.S. Patent Provisional Application No. 63 / 147,033 [Patent Document 5] U.S. Patent Provisional Application No. 63 / 154,379 [Patent Document 6] U.S. Patent Provisional Application No. 63 / 209,525 [Patent Document 7] U.S. Patent Provisional Application No. 63 / 209,540 [Patent Document 8] U.S. Patent Application No. 17 / 443,646 [Patent Document 9] International application PCT / US2021 / 043433 specification [Overview of the project] [Problems that the invention aims to solve]

[0011] Technical improvements in cutting bone and other objects, including those in other fields (e.g., architecture), are desired. It would be advantageous to achieve one or more of the following benefits: lower cost, easier to use, more accurate alignment, more precise cuts, shorter cutting time, shorter procedure time, shorter recovery time, and / or better results. [Means for solving the problem]

[0012] The present invention relates to a cutting guide system for adjusting and stabilizing cutting instruments. Certain embodiments of the cutting guide system disclosed herein can be used to adjust and stabilize cutting instruments in orthopedic surgery, such as orthopedic knee joint surgery, spinal surgery, or other orthopedic surgery. Certain embodiments of the cutting guide system disclosed herein can be used to adjust and stabilize bone or tissue cutting instruments, such as chainsaws and other types of bone or tissue cutting saws. Certain embodiments of the cutting guide system disclosed herein can be used to adjust and stabilize cutting instruments in other fields, such as reconstruction. Certain embodiments of the cutting guide system disclosed herein can be used to adjust and stabilize instruments for cutting wood, drywall, plastic, and other materials, such as chainsaws and other types of cutting tools.

[0013] In some embodiments, a cutting guide system for stabilizing a cutting tool includes a support mount that can be attached in a fixed relationship to an object to be cut by the cutting tool, a joint, and a cutting tool support, wherein the joint is configured to allow adjustment of the cutting tool support relative to the support mount. The joint is preferably configured to allow rotation of the cutting tool support about at least two axes.

[0014] In some embodiments, the joint is preferably of the ball-socket type. The ball and socket are preferably lockable to each other. The cutting tool support is preferably having a stem connected to the ball or socket.

[0015] In some embodiments, the joint may have a first hinge having a first rod and a first opening, the first rod being positioned within the first opening to allow relative rotational motion between the first rod and the first opening, thereby allowing the first adjustment guide to rotate around a first axis relative to a support mount. The first adjustment guide and the support mount may be lockable relative to each other. The cutting guide system may further include a first transducer which is configured to detect the amount of rotation of the first adjustment guide around the first axis.

[0016] In some embodiments, the joint may further include a second hinge having a second rod and a second opening, the second rod being positioned within the second opening to allow relative rotational motion between the second rod and the second opening, thereby allowing the first adjustment guide to rotate around a second axis relative to the support mount. The second adjustment guide and the first adjustment guide may be lockable relative to each other. The cutting guide system may further include a second transducer which is configured to detect the amount of rotation of the second adjustment guide around the second axis.

[0017] In some embodiments, the cutting tool support is preferably configured to support the cutting tool so that the cutting tool can rotate relative to the cutting tool support. In some embodiments, the cutting tool support is preferably configured to support the cutting tool so that the cutting tool can move longitudinally back and forth relative to the cutting tool support.

[0018] In some embodiments, the cutting tool support may have a stem. The cutting tool support may further have a first saw clamp and a second saw clamp. The position of the cutting tool along the longitudinal axis of the stem may be adjustable. The position of the cutting tool along the longitudinal axis of the stem may be fixed.

[0019] In some embodiments, the cutting tool support preferably has a saw mount, and the position of the saw mount relative to the adjustment guide is adjustable. The position of the saw mount relative to the adjustment guide is preferably fixable.

[0020] In some embodiments, the stem passes through a slot provided in the cutting tool, and the cutting tool is rotatable relative to the stem and is longitudinally movable back and forth relative to the stem.

[0021] In some embodiments, the cutting tool preferably includes a saw. The cutting tool preferably includes a chainsaw.

[0022] In some embodiments, the cutting guide system preferably further includes a guide mount for positioning the cutting mount block, and the position of the guide mount relative to the adjustment guide is longitudinally adjustable. The cutting mount block is preferably adapted to be fastened to an object to be cut by the cutting tool. The cutting guide system preferably further includes an adapter for attaching the cutting tool to the cutting mount block.

[0023] In some embodiments, the cutting guide system for stabilizing the cutting tool includes a track defining a path and a cutting tool support, and the cutting tool support is connected to the track in a manner that stabilizes the cutting tool support relative to the track while allowing the cutting tool support to move in the direction of the path of the track.

[0024] In some embodiments, one of the track and the cutting tool support preferably consists of a channel, and the other of the track and the cutting tool support preferably consists of a protrusion that fits into the channel, thereby preventing separation of the cutting tool support from the track while allowing the cutting tool support to move in the direction of the path of the track.

[0025] In some embodiments, the cutting tool support comprises a stem, a first saw clamp, and a second saw clamp. The position of the cutting tool along the longitudinal axis of the stem is preferably adjustable and fixed. The stem is preferably configured to pass through a slot provided in the cutting tool, and the cutting tool is rotatable relative to the stem and can move longitudinally back and forth relative to the stem.

[0026] In some embodiments, a method for stabilizing a cutting tool includes the steps of (i) attaching a support mount of a cutting guide system to an object to be cut by the cutting tool in a fixed relationship, wherein the cutting guide system further includes a joint and a cutting tool support, and (ii) adjusting the position of the cutting tool support relative to the support mount by moving the cutting guide system at the joint. The method may further include the step of fixing the position of the cutting tool support relative to the support mount after adjusting the position of the cutting tool support relative to the support mount by moving the cutting guide system at the joint. The joint may be of the ball-socket type. The joint may (i) have a first hinge having a first rod and a first opening, the first rod being positioned within the first opening so as to be rotatable relative to the first rod and the first opening, thereby allowing the first adjustment guide to rotate around a first axis relative to the support mount; and (ii) have a second hinge having a second rod and a second opening, the second rod being positioned within the second opening so as to be rotatable relative to the second rod and the second opening, thereby allowing the second adjustment guide to rotate around a second axis relative to the first adjustment guide. The cutting tool may be rotatable relative to the cutting tool support and be able to move longitudinally back and forth relative to the cutting tool support.

[0027] Further embodiments and features of the present invention are evident from the drawings and the detailed description.

[0028] The accompanying drawings illustrate the apparatus, components, and methods disclosed herein and, together with the text, are useful in illustrating the principles of the present invention. [Brief explanation of the drawing]

[0029] [Figure 1] This figure shows one embodiment of the cutting guide system of the present invention. [Figure 2] Figure 1 is an exploded view of the cutting guide system. [Figure 3] This figure shows another embodiment of the cutting guide system of the present invention. [Figure 4A] Figure 3 shows the cutting guide system, illustrating the state where the saw starts cutting from the right side. [Figure 4B] Figure 3 shows the cutting guide system, illustrating the state in which the saw is advancing from the position shown in Figure 4A. [Figure 4C] Figure 3 shows the cutting guide system, illustrating the state where the saw is directed towards the middle of the bone to be cut. [Figure 4D] Figure 3 shows the cutting guide system, illustrating the state in which the saw is advancing from the position shown in Figure 4C. [Figure 4E] Figure 3 shows the cutting guide system, illustrating the state where the saw starts cutting from the left side. [Figure 4F] Figure 3 shows the cutting guide system, illustrating the state in which the saw is advancing from the position shown in Figure 4E. [Figure 5A] This figure shows another embodiment of the cutting guide system of the present invention. [Figure 5B] This is another diagram of the cutting guide system shown in Figure 5A. [Figure 5C] This is another diagram of the cutting guide system shown in Figure 5A. [Figure 6] This figure shows another embodiment of the cutting guide system of the present invention. [Figure 7] This is another diagram of the cutting guide system shown in Figure 6. [Figure 8] This is another diagram of the cutting guide system shown in Figure 6. [Figure 9] This is another diagram of the cutting guide system shown in Figure 6. [Figure 10] Figure 6 shows the cutting guide system, and depicts the state in which the first adjustment guide is rotated in a first direction around the axis of the first rod. [Figure 11] Figure 6 shows the cutting guide system, and depicts the state in which the first adjustment guide is rotated in a second direction around the first rod axis. [Figure 12] Figure 6 shows the cutting guide system, and depicts the state in which the second adjustment guide is rotated in the first direction around the axis of the second rod. [Figure 13] Figure 6 shows the cutting guide system, and depicts the state in which the second adjustment guide is rotated in a second direction around the axis of the second rod. [Figure 14A] This is a schematic diagram of one embodiment of a hinge, showing a state in which the rod is positioned within the opening, enabling relative rotational movement between the rod and the opening. [Figure 14B] This figure shows an exemplary transducer that can be incorporated as part of the cutting guide system of the present invention, for example, as shown in Figure 6. [Figure 15] This figure shows the cutting guide system provided for cutting bone, as shown in Figure 6. [Figure 16] This diagram shows several typical osteotomies made in the femur for knee joint replacement surgery. [Figure 17] This figure shows one embodiment of a support mount for the cutting guide system of the present invention. [Figure 18] This figure shows an assembly of components (including the support mount in Figure 17) of another embodiment of the cutting guide system of the present invention. [Figure 19] Figure 18 shows the assembly, with the alignment rod attached to it. [Figure 20]This is another diagram of the assembly shown in Figure 18, illustrating the state in which the alignment rod is attached to this assembly. [Figure 21] Figure 18 shows the assembly, with the alignment rod attached to it and the first adjustment guide rotated in a first direction around the axis of the first rod. [Figure 22] Figure 18 shows the assembly, with the alignment rod attached to it and the first adjustment guide rotated in a second direction around the axis of the first rod. [Figure 23] This is another diagram of the assembly shown in Figure 18, illustrating the state in which the alignment rod is attached to this assembly. [Figure 24] This is another diagram of the assembly shown in Figure 18, illustrating the state in which the alignment rod is attached to this assembly. [Figure 25] This figure shows one embodiment of the cutting guide system of the present invention, and illustrates the state in which the saw mount is connected to the assembly of components shown in Figure 18. [Figure 26] Figure 25 shows the cutting guide system, and illustrates another step in connecting the saw mount to the component assembly shown in Figure 18. [Figure 27] Figure 25 shows the cutting guide system used to fix the saw in order to create the distal femoral cutting section. [Figure 28] Another diagram of the cutting guide system shown in Figure 25, which secures the saw used to create the distal femoral section. [Figure 29] Figure 25 shows a cutting guide system, which is a diagram showing a guide mount connected to the component assembly shown in Figure 18 for positioning the cutting mount block. [Figure 30] Figure 25 shows the cutting guide system, illustrating another step in connecting the guide mount to the component assembly shown in Figure 18 in order to position the cutting mount block. [Figure 31]Figure 25 shows the cutting guide system, which is a diagram illustrating the mechanism for adjusting the front-to-rear (front-to-rear) position of the cutting mount block. [Figure 32] Figure 25 shows the cutting guide system, illustrating the angular position of the cutting mount block adjusted in the first direction. [Figure 33] Figure 25 shows the cutting guide system, illustrating the angular position of the cutting mount block being adjusted in the second direction. [Figure 34] Figure 25 is another diagram of the cutting guide system, showing the position of the cutting mount block. [Figure 35] Figures 29-34 show the cutting mount blocks attached to the bone. [Figure 36] This figure shows the first adapter configured to be coupled to the cutting mount block shown in Figures 29 to 35. [Figure 37] This is another diagram of the first adapter shown in Figure 36. [Figure 38] This figure shows the first adapter in Figure 36 positioned over the cutting mount blocks in Figures 29 to 35. [Figure 39] This figure shows the saw mounted on the front surface of the first adapter in Figure 36, which secures the saw for making the anterior femoral cutting section, while the first adapter in Figure 36 covers and positions the cutting mount block in Figures 29-35. [Figure 40] Another view of the saw mounted on the front surface of the first adapter in Figure 36, which secures the saw for making the anterior femoral cut section, while the first adapter in Figure 36 covers and positions the cutting mount block in Figures 29-35. [Figure 41] Figure 36 shows the saw mounted on the posterior surface of the first adapter, which secures the saw for creating the posterior femoral cutting section, while the first adapter in Figure 36 covers and positions the cutting mount block in Figures 29-35. [Figure 42]Another view of the saw mounted on the posterior surface of the first adapter in Figure 36, which secures the saw for making the posterior femoral cut, while the first adapter in Figure 36 covers and positions the cutting mount block in Figures 29-35. [Figure 43] This figure shows a second adapter positioned over the cutting mount block shown in Figures 29-35, which holds the saw for creating the front chamfered cutting section. [Figure 44] Another diagram of the second adapter positioned over the cutting mount block shown in Figures 29-35, which holds the saw for creating the front chamfered cut section. [Figure 45] This figure shows a second adapter positioned over the cutting mount block shown in Figures 29-35, which holds the saw for creating the rear chamfered cut section. [Modes for carrying out the invention]

[0030] The attached drawings can be better understood by referring to the detailed explanation below.

[0031] For the purpose of facilitating an understanding of the principles of this disclosure, examples shown in the drawings will be referenced below, with specific language used to describe these examples and other examples. Nevertheless, it will be understood that the scope of the invention as described in the claims is not intended to be limited by the examples shown in the drawings or described herein. Any modifications of the illustrated or described systems, apparatus, components, or methods, and further modifications thereof, as well as any further applications of the principles of the invention, are fully conceivable as would normally be thought of by those skilled in the art relating to the invention. Specifically, features, components, and / or steps described in relation to one embodiment of the invention may be combined with features, components, and / or steps described in relation to other embodiments of the invention.

[0032] As used herein, the terms “first” and “second” do not indicate or suggest any particular location or other characteristic. Rather, where the terms “first” and “second” are used herein, they are used solely to distinguish one component or part from another. Expressions such as “attached,” “connected,” and “joined” mean, unless direct or indirect attachment, connection, or joining is specified, either directly or indirectly, of one part to another part by one or more other parts. The term “user” means one or more persons using the apparatus, system, and / or method described herein, for example, one or more surgeons, physicians, operators, or other persons using the apparatus, system, and / or method.

[0033] Figure 1 shows a first exemplary embodiment of the cutting guide system 12. Figure 1 shows the cutting guide system 12 attached to the proximal (upper) end of the tibia T, which is oriented vertically overall. Figure 1 shows the cutting guide system 12 being used to guide the saw to create a lateral cut in the tibia T in the horizontal plane of the human body.

[0034] Figure 2 is an exploded view of the cutting guide system 12, showing the individual components of the cutting guide system 12.

[0035] As shown in Figure 1, the cutting guide system 12 includes a support mount 9A that can be attached to a bone, for example, the proximal anterior tibia T. The support mount 9A can be attached to the bone in a conventional manner. For example, the support mount 9A may be attached to the bone by one or more fasteners being inserted into one or more holes 22 provided in the support mount 9A and then penetrating into the bone. The fasteners may be conventional fixing pins, pins with trocar tips, screws, and / or other fasteners. Additionally or alternatively, spikes may be provided on the contact surfaces of the support mount 9A, and driving such spikes into the bone can attach the support mount 9A to the bone and / or help the stability and rigidity of the support mount 9A relative to the bone. The support mount can be attached in a fixed relationship to the bone or other object to be cut by the cutting instrument, either directly or via one or more other components.

[0036] As will be explained in more detail below, when the support mount 9A is attached to the bone, the specific position is not important as far as the XYZ location and XYZ rotational orientation of the support mount 9A relative to the bone are concerned. Rather than being limited to precise location and alignment, the user can position the support mount 9A on a stable topology of the patient's bone. The proximal anterior tibia has a somewhat irregular shape due to the tibial tuberosity, which is a bony prominence that fixes the quadriceps femoris patellar flexion mechanism. Since the precise positioning of the support mount 9A relative to the bone is not important, the user should position the support mount 9A on a region of bone that facilitates the achievement of stability of the support mount 9A.

[0037] Figure 1 shows the support mount 9A as a translucent body so that its internal features can be seen, including areas of dimensions and shape that receive the components of the ball-stem assembly 8, which in this embodiment consists of parts labeled 8A, 8B, and 8C. The ball-stem assembly 8 includes a stem 8A, a ball 8B, and in this embodiment, a fastener 8C. The stem 8A passes through a hole provided in the ball 8B and is secured by the fastener 8C. In some embodiments, the stem 8A and the fastener 8C are often a single component, such as a headed fastener, the head of which does not fit into the hole that passes through the ball 8B. In some embodiments, the stem 8A and the ball 8B are often manufactured as a single component, and the stem 8A and the ball 8B are connected to each other without the need for a fastener. In its overall appearance, the ball-stem assembly 8 resembles an inverted spherical lollipop when assembled.

[0038] When the cutting guide system 12 is assembled, the ball-stem assembly 8 fits into the socket of the cutting guide system 12. The socket 14 may include recesses provided in the lower block 10 and in the support mount 9A. These recesses may be partially spherical (e.g., hemispherical) or of any other suitable shape. The two recesses form the socket 14 into which the ball 8B fits. The ball 8B acts as a swivel joint with degrees of freedom in all planes in relation to the socket 14 of the cutting guide system 12 that receives the ball 8B. Once positioned within the socket 14, the ball 8B of the ball-stem assembly 8 rotates as a ball joint with all degrees of freedom within the socket 14 of the cutting guide system 12. This allows the stem 8A to be directed and rotated at various angles. As an example of permissible directions of motion, the joint (ball 8B and socket 14) allows the stem 8A to be rotated left and right, rotated around a first axis, rotated toward or away from an object to be cut (e.g., bone), and rotated around a second axis.

[0039] The swivel joint, consisting of a ball 8B and a socket 14, provides the user with ultimate flexibility regarding the positioning of the bone cutting portion. The ball 8B can rotate completely freely within the socket 14, which is formed by recesses in the lower block 10 and the support mount 9A. Eventually, the user can tighten the locking device 11, thereby bringing the lower block 10 closer to the support mount 9A and creating pressure on the ball 8B, which prevents the ball 8B from rotating. The recesses in the lower block 10 and the support mount 9A are preferably dimensioned so that, when the locking device 11 is in place, these recesses clamp the ball 8B between themselves. In this embodiment, the locking device 11 is a bolt that is screwed into a threaded insert 9B that passes through a hole in the block 10 and a hole in the support mount 9A, or, as a variation, a bolt that is screwed into a threaded hole in the support mount 9A. Other mechanisms, such as locking (fastening, clamping, or fixing) mechanisms, can be used for the locking device 11. Once the user has operated the ball-stem assembly 8 to the desired position, the user can then position the locking mechanism 11 to fix the position. If the user wishes to readjust this position, it is best to release the locking mechanism (for example, by turning it in the opposite direction), reposition the ball-stem assembly 8, and then reposition the locking mechanism 11.

[0040] The cutting guide system 12 further includes a lower saw clamp 7 and an upper saw clamp 3 for securing the opposite sides of the saw 4. In this embodiment, the stem 8A (either alone or in association with the lower saw clamp 7 and upper saw clamp 3) forms a cutting tool support for supporting the saw 4 or other cutting tool. The saw clamps 3,7 have through holes for receiving the stem 8A, so that the stem 8A passes through the through holes of both saw clamps 3,7. The positioning of the saw clamps 3,7 along the longitudinal length of the stem 8A is adjustable. For example, the through holes of the saw clamps 3,7 are preferably dimensioned so that these saw clamps slide along the stem 8A, and adjustable spacers are preferably used to adjust the position of the saw clamps 7 relative to the support mount 9A. An example of a suitable adjustable spacer is described below.

[0041] The lower saw clamp 7 and the upper saw clamp 3 are fixed to opposite sides of the saw 4 when assembled with the stem 3A passing through the slot 4E provided in the saw 4. In this embodiment, the saw 4 is a chainsaw assembly including a saw bar 4A, a chain 4B, and a drive tooth assembly 4C. The illustrated chainsaw assembly is preferably mounted on a handpiece (not shown) and driven by it. Components 5 and 6 represent components of the saw for handling the saw and / or for mounting the saw to the drive mechanism. Although a chainsaw is illustrated, other types of saws can be fixed by the cutting guide system 12.

[0042] The saw clamp 3 and / or saw clamp 7 may have protrusions 3A, 7A on their sides facing the saw, which fit into slots 4E of the sawber. One or more protrusions help guide the longitudinal movement of the saw.

[0043] As described above, the saw clamp 7 is adjustable to the desired position by an adjustable spacer, and then, by turning the knob 1, the saw clamp 3 can be pressed against the saw clamp 7. The knob 1 may have a threaded nut or bore, such a nut or bore that engages with the threaded outer surface of the stem 8A, and as a result, the rotation of the knob 1 causes the knob 1 to move downward along the stem 8A, thereby bringing the saw clamp 3 closer to the saw clamp 7 and securing the saw 4. A spring 2 can be used to help push the saw clamp 3 toward the saw clamp 7, thereby securing the saw 4 between the saw clamp 3 and the saw clamp 7. The securing of the saw between the saw clamps 3 and 7 prevents the saw from moving up and down along the stem 8A, while still allowing it to move in a direction parallel to the length of the sawbar slot 4E by the sawbar 4A pushing it forward or pulling it back. In the embodiment shown in Figure 1, to advance the sober 4A forward relative to the support mount 9A, the sober 4A is moved backward, and to retract the sober 4A, the sober 4A is moved forward. Thus, the cutting tool (e.g., saw) can move longitudinally back and forth relative to the cutting tool support (e.g., stem 8A).

[0044] In some embodiments, the saw clamps 3,7 are preferably rotatable around the stem 8A. In this configuration, the saw can rotate in a plane around the stem 8A, and the axis of the stem 8A is the axis of rotation. This allows the user to move the saw not only in the forward and backward directions but also rotationally in a plane around the axis of the stem 8A. Thus, the cutting tool (e.g., the saw) is preferably rotatable relative to the cutting tool support (e.g., the stem 8A).

[0045] In use, the cutting guide system 12 allows for easy fixation of the cutting guide system 12 to the bone, easy positioning of the saw 4 to the bone, and easy readjustment of such positioning if necessary. The user first attaches the support mount 9A to the bone. As described above, the specific position and orientation of the support mount 9A to the bone is not important, and the user can select a fixing position on the bone that allows for stable fixation. The joint (ball 8B and socket 14) allows the cutting tool support (e.g., stem 8A) to be adjusted relative to the support mount 9A. With the support mount 9A attached to the bone, the user can operate the ball-stem assembly 8 to the desired position. Next, the user positions the locking device 11 to fix its position. If the user wishes to readjust this position, it is best to release the locking device, reposition the ball-stem assembly 8, and then reposition the locking device 11. Next, with the ball-stem assembly 8 locked in place, the user can adjust the position of the saw clamps 3 and 7 along the longitudinal length of the stem 8A. This position can be fixed, and if the user wishes to readjust, this position can be released and the saw clamps 3 and 7 can be repositioned.

[0046] In the example procedure, namely knee joint surgery, positioning may include considerations such as balancing the medial and lateral collateral ligaments, as well as the anterior and posterior cruciate ligaments and the knee joint capsule. The main adjustments are preferably for flexion / extension and varus / valgus positioning. The final adjustment is preferably for the amount of bone cut. In the knee joint surgery and tibia examples, this final adjustment is preferably for the amount of bone cut relative to the long axis of the tibia.

[0047] Alignment guides and styluses and / or preoperative planning are preferable to use, for example in total knee arthroplasty, to assist in the reference of landmarks to obtain proper placement for implant positioning. The objective in such knee joint surgery is to re-establish the normal anatomical and kinematic behavior of the knee joint while balancing the soft tissue structure and maintaining overall stability throughout the range of motion.

[0048] The design described above has additional advantages. The cutting guide system is preferably designed to be usable with a set of various implant sizes. Thus, the cutting guide system can replace the numerous cutting blocks of different sizes currently required with multiple sizes of cutting blocks, for example, seven or eight different sizes. Thus, the cutting guide system described herein can significantly reduce the required inventory and reduce the hospital storage space used. The cutting guide system described herein is also advantageous for portable military or hospital locations where a less complex, more efficient cutting system may be required. In addition, in some embodiments, the simple design of the cutting guide system described herein is useful for disposable supplies.

[0049] Figures 3 and 4A to 4F show another exemplary embodiment of the cutting guide system 30. The cutting guide system 30 includes a track 32. The track 32 may be curved in shape, for example, in the form of an arc with a desired radius of curvature and length.

[0050] The track 32 is preferably attachable to the stem of a swivel joint, for example, the stem 8A of the cutting guide system 12. Thus, for example, the cutting guide system 30 may include the following components of the cutting guide system 12, namely, a support mount 9A, one or more fasteners for attaching the support mount 9A to the bone, a ball-stem assembly 8 (stem 8A, ball 8B, and optional fastener 8C), a lower block 10 (recesses provided in the lower block 10 and the support mount 9A form a socket 14 for the ball 8B), and a locking device 11 (a corresponding threaded insert 9B or threaded hole as an option for the support mount 9A or other locking mechanism). The user uses these components in the same manner as described above, namely attaching the support mount 9A to the bone, manipulating the ball-stem assembly 8 to position the stem 8A in the desired position, and then locking the ball-stem assembly 8 in place by the locking device 11 or other locking mechanism.

[0051] In this embodiment, the track 32 is preferably mountable above the top of the stem 8A. The stem 8A is preferably shorter than the stem shown in Figures 1 and 2, and the track 32 is preferably mountable to the stem 8A either directly or via one or more other components. Adjustable spacers can be used to adjust the spacing of the track 32 relative to the support mount 9A.

[0052] In a modified cutting guide system, the track 32 may be directly attached to the bone or connected to a block directly attached to the bone. The track 32 can be used with or without a swivel joint. The ends of the track 32 are preferably fixed to the bone for stability.

[0053] The curved shape of the orbital 32 is designed to face the desired target location, for example, extending around the location of the desired bone. This allows the orbital 32 to be in close contact with the bone when it wraps around it.

[0054] As can be seen in Figure 3, the track 32 has walls 34 that form a channel 36. A narrow slot 38 provided in the upper wall accesses the channel 36, and wall portions 34A and 34B are provided on each side of the slot 38.

[0055] The cutting guide system 30 further includes an upper saw clamp 42 and a lower saw clamp 44 to fix the opposite sides of the saw 4 and to guide the saw 4 against the track 32. The lower saw clamp 44 has a projection 46 that fits into a channel 36 of the track 32 and a stem 48 that connects the projection 46 to the body of the lower saw clamp 44. In this embodiment, the stem 48 (either alone or in association with the lower saw clamp 44 and the upper saw clamp 42) forms a cutting tool support that supports the saw 4 or other cutting tool. The stem 48 preferably passes through a slot provided in the cutting tool (e.g., the saw 4), so that the cutting tool is rotatable relative to the stem 48 and can move longitudinally back and forth relative to the stem 48. The stem 48 passes through a slot 38 in the track 32, and the projection 46 is too large to fit into the slot 38. This is a dovetail-like structure that prevents the saw clamp 44 from separating from the track 32. This configuration keeps the saw 4 connected to the track 32 while allowing the projection 46 to slide within the channel 36. This allows the lower saw clamp 44, and thus the upper saw clamp 42 and saw 4, to move in the direction of the slot 38, in which case this direction follows the curved path of the track 32.

[0056] The lower saw clamp 44 and the upper saw clamp 42, when assembled, are fixed to opposite sides of the saw 4. Although a chainsaw is illustrated, other types of saws can be fixed by the cutting guide system 30. The sober 4A is provided with a sober slot 4E, and the sober clamps 42 and 44 are connected to each other through this slot, while the sober 4A can move longitudinally in the direction of the sober slot 4E. The saw clamps 42 and 44 prevent the saw 4 from moving away from the track 32, while allowing the saw 4 to move along the direction of the track slot 38 by advancing or retracting the saw 4, and further allowing the sober 4A to move in a direction parallel to the length of the slot 4E of the sober 4A. The sides of the upper saw clamp 42 and the lower saw clamp 44 may be provided with a saw-facing protrusion, similar to a protrusion 3A or 7A, which fits into the slot 4E of the sober. One or more protrusions help guide the saw's longitudinal motion.

[0057] Figures 4A to 4F show various positions of the saw 4 using the cutting guide system 30. Figures 4A to 4F show the following: cutting begins (Figure 4A), moves forward from the right side (Figure 4B), sweeps forward towards the middle or moves outwards (Figures 4C and 4D), and then continues all the way to the left side (Figures 4E and 4F).

[0058] The cutting guide system 30 offers the advantages described above with respect to the cutting guide system 12, while allowing the user to cut the bone from a greater number of locations. The track 32 defines the path, and the cutting tool support is connected to the track in such a way that it stabilizes the cutting tool support relative to the track 32 while allowing the cutting tool support to move in the direction of the path of the track 32.

[0059] Figures 3 and 4A to 4F show a cutting tool support having a track 32 with a channel 36 and a projection 46 that fits into the channel 36. However, other configurations are possible in which the cutting tool support is connected to the track in such a way that it can move in the direction of the track's path. For example, the cutting tool support may have a channel (like the channel 36 of the track 32 described above) with a slot (similar to the slot 38), and the track may have a projection that fits into the channel with a narrow region provided between the track body and the projection. The narrow region fits into the slot in a dovetail configuration, thereby preventing the cutting tool support from separating from the track, while allowing the cutting tool support to move in the direction of the track's path.

[0060] Figures 5A to 5C show a cutting guide system 50 as another exemplary embodiment. The cutting guide system 50 has a track 52 similar to the track 32 described above. The track 52 may be curved, for example, in the form of a circular arc with a desired radius of curvature and length.

[0061] Like the track 32, the track 52 may be attachable to the stem of a swivel joint, for example, the stem 8A of the cutting guide system 12. Thus, for example, the cutting guide system 50 may include the following components of the cutting guide system 12: a support mount 9A, one or more fasteners for attaching the support mount 9A to the bone, a ball-stem assembly 8 (stem 8A, ball 8B, and optional fastener 8C), a lower block 10 (recesses provided in the lower block 10 and the support mount 9A form a socket 14 for the ball 8B), and a locking device 11 (a corresponding threaded insert 9B or threaded hole as an option for the support mount 9A or other locking mechanism). The user uses these components in the same manner as described above, namely attaching the support mount 9A to the bone, manipulating the ball-stem assembly 8 to position the stem 8A in the desired position, and then locking the ball-stem assembly 8 in place by the locking device 11 or other locking mechanism.

[0062] In such embodiments, the track 52 is preferably mounted on top of the stem 8A, similar to the mounting of the track 32. The track 52 is preferably attachable to the stem 8A either directly or via one or more other components. Adjustable spacers can be used to adjust the spacing of the track 52 relative to the support mount 9A.

[0063] Similar to the track 32, the track 52 may be directly attached to the bone or connected to a block directly attached to the bone. The track 52 can be used with or without a swivel joint. The ends of the track 52 should preferably be fixed to the bone for stability.

[0064] Similar to orbital 32, the curved shape of orbital 52 is designed to be oriented towards the desired target location, for example, extending around the location of the desired bone. This allows orbital 52 to be in close contact with the bone when it wraps around it.

[0065] As can be seen in Figures 5A and 5B, the track 52 has walls 54 that form a channel 56. A narrow slot 58 provided in the upper wall accesses the channel 56, and wall portions 54A and 54B are provided on each side of the slot 58.

[0066] The cutting guide system 50 further includes an adapter 62 for fixing the saw blade 70 or guiding the saw blade 70 relative to the track 52. In this embodiment, the adapter 62 forms a cutting tool support for supporting the saw blade 70 or other cutting tool. The cutting tool is preferably able to move longitudinally back and forth relative to the adapter 62. The bottom of the adapter 62 has a projection 66 that fits into a channel 56 of the track 52 and a stem 68 that connects the projection 66 to the body of the adapter 62. The stem 68 passes through a slot 58, and the projection 66 is too large to fit into the slot 58. This is similar to a dovetail configuration and prevents the adapter 62 from separating from the track 52. This configuration keeps the saw 70 connected to the track 52 while allowing the projection 66 to slide within the channel 56. This allows the adapter 62, and thus the saw 70, to move in the direction of the slot 58, in which case this direction follows the curved path of the track 52.

[0067] As shown in Figure 5C, the adapter 62 has an opening to receive the saw 70 and is equipped with side and top wall sections for securing the saw 70, thereby allowing the saw to move longitudinally back and forth along a single axis as shown. The saw shown is a precision saw blade. An example of such a saw blade is the precision saw blade available from Stryker, for example, under part number 6526-127-105. Other types of saws can be secured by the cutting guide system 50. The adapter 62 prevents the saw 70 from moving away from the track 52, while allowing the saw 70 to move along the direction of the slot 58 in the track 52 by advancing or retracting the saw 70, and also allowing the saw 70 to move in a direction parallel to the length of the saw bar indicated by arrow A in Figure 5B.

[0068] The adapter 62 can take on a variety of forms that hold the saw blade within the plane of the bone cutting section as described, such forms include spring-operated, lockable, fully enclosed, and dovetail mechanisms. This system allows the saw blade to advance without abandoning in-plane guidance, as shown in Figure 5B.

[0069] Figure 5B shows a saw blade 70 controlled to produce a flat plane or cut. Figure 5B shows the advancement of the cutting blade from the anterior portion of the tibia toward the posterior region of the bone in preparation for a tibial surface reconstruction implant. The saw blade 70 is preferably positioned using a cutting guide system 50 in a manner similar to that shown in Figures 4A to 4F.

[0070] Figure 5C shows how the blade 70 is wrapped by the adapter 62. This configuration controls and stabilizes the blade while still allowing it to move forward or retract (in the direction of arrow A in Figure 5B) according to user requirements.

[0071] Similar to the cutting guide system 30, the cutting guide system 50 offers the advantages described above with respect to the cutting guide system 12, while allowing the user to cut the bone from a greater number of locations. The track 52 defines the path, and the cutting tool support (adapter 62) is connected to the track in such a way that it stabilizes the cutting tool support relative to the track 52 while allowing the cutting tool support to move in the direction of the path of the track 52.

[0072] As described above with reference to Figures 3 and 4A to 4F, Figures 5A to 5C show a cutting tool support having a track 52 with a channel 56 and a projection 66 that fits into the channel 56. However, other configurations are possible for connecting the cutting tool support to the track in such a way that the cutting tool support can move in the direction of the track's path. For example, the cutting tool support may have a channel (like the channel 56 of the track 52 described above) with a slot (similar to the slot 58), and the track may have a projection that fits into the channel with a narrow region provided between the track body and the projection. The narrow region fits into the slot in a dovetail configuration, thereby preventing the cutting tool support from separating from the track, while allowing the cutting tool support to move in the direction of the track's path.

[0073] The interface between the adapter and the saw blade can take various forms. It may be spring-loaded, fixed, or adjustable; it may have a coating; it may have a plastic bushing; or it may have any of the various mechanisms that dampen vibrations while simultaneously enabling smooth forward movement and control of the plane cut. One of the advantages of the system, for example, the cutting guide system 30 or the cutting guide system 50, is that such a system allows the saw blade to be held very close to the bone. By allowing the saw blade to be held close to the object to be cut, the accuracy of bone cutting can be significantly improved compared to the current cutting block. Stability also helps ensure safety from a safety perspective when controlling the reciprocating vibratory saw.

[0074] An additional advantage of some cutting guide systems described herein is that the system can provide an accessible reference system for visualization. For example, the user can observe the top of the adapter 62. The top section of the adapter is a visually accessible reference system for reading the thrust depth marks, which are better marked on the blade. In this configuration, the user has a very precise and visual reference for the depth of the cut.

[0075] In some embodiments, the penetration depth can be measured by an electronic linear measuring instrument, and the measurement can be transmitted, for example, via Bluetooth or Wi-Fi to a workstation containing information about the procedure.

[0076] As those skilled in the art will understand, the cutting guide systems described herein not only allow for the guidance of a saw without the use of existing cumbersome cutting blocks, but the embodiments can also be appropriately configured to suit different types of saws, such as chainsaws, saws with only the tip vibrating and / or reciprocating, and other saws. The saw may be guided by a fitted adapter (e.g., adapter 62) that is received in a saw bar slot (e.g., saw bar slot 4E) and fixes the saw while allowing longitudinal movement, or by another way of holding the saw while fixing it while allowing longitudinal movement consistent with the disclosure. Various such embodiments can be used in swivel joints and / or curved tracks as described herein.

[0077] The embodiments described herein can be used in a variety of ways. For example, these embodiments can be used manually or with a robotic platform, in which case the saw is operated by a robot.

[0078] Figures 6 to 15 show a cutting guide system 101 as another exemplary embodiment. Figure 15 shows the cutting guide system 101 attached to the proximal (upper) end of the tibia T. Figure 15 shows the cutting guide system 101 used to guide the saw so that a lateral cut can be made in the tibia T in the horizontal plane of the human body.

[0079] The cutting guide system 101 includes a support mount 110 that can be attached to a bone, for example, the proximal anterior tibia T shown in Figure 15, or another suitable bone. The support mount 110 may be attached to the bone in a conventional manner. For example, the support mount 110 may be attached to the bone by one or more fasteners being inserted into one or more holes 112 provided in the support mount 110 and then penetrating into the bone. The fasteners may be conventional fixing pins, pins with trocar tips, screws, and / or other fasteners. Additionally or alternatively, spikes may be provided on the contact surfaces of the support mount 110, and driving such spikes into the bone can attach the support mount 110 to the bone and / or help the stability and rigidity of the support mount 110 relative to the bone. The support mount 110 can be attached in a fixed relationship to the bone or other object to be cut by the cutting tool, either directly or via one or more other components.

[0080] Once the support mount 110 is attached to the bone, its specific position is not critical as far as its location and rotational orientation relative to the bone are concerned. Rather than being limited to precise location and alignment, the user can position the support mount 110 on a stable topology of the patient's bone. Since precise positioning of the support mount 110 relative to the bone is not critical, the user may position the support mount 110 on a bone region that facilitates the achievement of stability for the support mount 110.

[0081] The first rod 114 is part of or rigidly attached to the support mount 110. When the support mount 110 is attached to the bone, the first rod extends away from the bone. The axis 114A of the first rod is shown in Figures 10 and 11. A first adjustment guide 120 is attached to the first rod so as to be rotatable around the first rod and the first rod axis 114A. The first adjustment guide 120 has an opening (recess or hole) into which the first rod is fitted in a relative rotational motion manner, thereby allowing the first adjustment guide 120 to rotate around the first rod and the first rod axis 114A. In a modified configuration example, the first rod may be part of or rigidly attached to the first adjustment guide 120, and the support mount 110 may have a corresponding opening (recess or hole) for receiving the first rod. In this modified configuration example, the first rod rotates together with the first adjustment guide 120 (i.e., the first rod rotates within the opening of the support mount 110). In both configuration examples, the first adjustment guide 120 is rotatably mounted relative to the support mount 110 around the axis 114A of the first rod.

[0082] The second rod 124 is part of or rigidly attached to the first adjustment guide 120, which extends laterally from there. The axis 124A of the second rod is shown in Figures 12 and 13. The second adjustment guide 130 is attached to the second rod so as to be rotatable around the second rod and the second rod axis 124A. The second adjustment guide 130 has an opening (recess or hole) into which the second rod is fitted in a relative rotational manner, thereby allowing the second adjustment guide 130 to rotate around the second rod and the second rod axis 124A. In a modified configuration example, the second rod may be part of the second adjustment guide 130 or rigidly attached thereto, and the first adjustment guide 120 may have a corresponding opening (recess or hole) for receiving the second rod. In this modified configuration, the second rod rotates together with the second adjustment guide 130 (i.e., the second rod rotates within the opening of the first adjustment guide 120). In both configurations, the second adjustment guide 130 is rotatably mounted relative to the first adjustment guide 120 about the axis 124A of the second rod.

[0083] The first rod and / or the second rod do not need to continuously penetrate the portion to which they relate. For example, the second rod may include two rod portions extending from either side of the first adjustment guide 120, or one rod portion extending from one side of the first adjustment guide 120. The first rod and the corresponding opening in which the first rod is housed in a relative rotatable manner together form a first hinge, thereby allowing the first adjustment guide 120 to rotate about the first axis 114A. The second rod and the corresponding opening in which the second rod is housed in a relative rotatable manner together form a second hinge, thereby allowing the second adjustment guide 130 to rotate about the second axis 124A. In this embodiment, the joint for positioning the cutting tool includes the first hinge and the second hinge. Thus, as an example of permissible directions of motion, the joint can be used to rotate the cutting tool support from side to side about a first axis 114A, and to rotate it about a second axis 124A to move it closer to or further away from the object to be cut (e.g., bone). A schematic diagram of an example of a hinge in which rods 114, 124, 214, 224 are positioned within the opening 115 so as to be rotatable relative to the rods and the opening is shown in Figure 14A. The rods can rotate within the opening and / or a component P (e.g., an adjustment guide) with an opening can rotate around the rods. The wall with the opening 115 may extend over 360° around the corresponding rod, or over less than 360° (e.g., 270°, 225°, etc.) around the corresponding rod.

[0084] A locking mechanism 126 is associated with the first adjustment guide 120 to allow the first adjustment guide 120 to rotate around the first rod axis 114A selectively, or to prevent the first adjustment guide 120 from rotating around the first rod axis 114A. In the illustrated embodiment, the locking mechanism 126 includes a set screw 128 which, when turned, can be firmly engaged with the first rod, thereby locking the first adjustment guide 120 so as not to rotate, or when the set screw is turned in the opposite direction, the first rod can be released, thereby allowing the second adjustment guide 130 to rotate around the second rod axis 124A. Similarly, a locking mechanism 136 is associated with the second adjustment guide 130 to allow the second adjustment guide 130 to rotate around the second rod axis 124A, or to prevent the second adjustment guide 130 from rotating around the second rod axis 124A. In the illustrated embodiment, the locking mechanism 136 includes a set screw 138 which, when turned, can be securely engaged with the second rod, thereby locking the second adjustment guide 130 from rotating, or the set screw 138 can be turned in the opposite direction to release the second rod, thereby allowing the second adjustment guide 130 to rotate around the second rod axis 124A. Other locking (fastening, clamping, or fixing) mechanisms can be used for the locking mechanisms 126, 136.

[0085] Preferably, a transducer 140 is provided in association with the first adjustment guide 120 and the second adjustment guide 130. The transducer 140 is configured to detect the amount of rotation of the adjustment guides 120 and 130 around their respective rotation axes 114A and 124A. The transducer 140 converts the rotational motion of the adjustment guides 120 and 130 into an electrical signal, so that the user can obtain an accurate measurement of the angular position of the adjustment guides 120 and 130. Thus, the transducer 140 is preferably an electronic device that outputs the angular change or angular position of each adjustment guide 120 or 130 to the user.

[0086] An example of an exemplary transducer 140 is shown in Figure 14B. In this exemplary embodiment, the transducer has a stator 142 and a rotor 144. The stator 142 is configured to remain rotationally fixed, and the rotor 144 rotates with the adjustment guide 120 or 130 as the adjustment guide rotates around its respective rod axis 114A or 124A. The stator 142 is preferably coupled to the rod. For example, in the illustrated embodiment, the stator has an engagement recess 143 (e.g., hexagonal or other shape) which is configured to match the outer surface of the corresponding shape of the rod. The rotor 144 is preferably coupled to the adjustment guide 120 or 130. For example, the rotor may have a pin 145 which fits into a corresponding hole in the adjustment guide 120 or 130, so that the rotor 144 rotates with the adjustment guide 120 or 130.

[0087] The transducer 140 may further have a housing 146 that houses a component for converting the rotational motion of the adjustment guide 120 or 130 into an electrical signal. Various mechanisms can be used for this conversion. For example, this mechanism may be a potentiometer, an optical encoder, a capacitance-based device, or other suitable mechanism. The housing 146 may also house a battery and / or a transmitter for transmitting the signal, such as a Bluetooth transmitter or other wireless transmitter. For example, the signal may be transmitted by Bluetooth or other transmission method to a device readable by a user, such as a computer, a handheld device, a mobile phone, an iPad, or a surgical station.

[0088] The cutting guide system 101 further includes a stem 150 attached to or integrated with the second adjustment guide 130. In the illustrated embodiment, the stem 150 extends from the top of the second adjustment guide 130 and has a lower section 158 with a first diameter and an upper section 156 with a second diameter, the first diameter being greater than the second diameter. The lower section 158 and the upper section 156 are preferably screwed together.

[0089] The cutting guide system 101 further includes a lower saw clamp 152 and an upper saw clamp 154 ​​that secure the opposite sides of the saw 4. The saw clamps 152 and 154 have through holes for receiving the stem 150, so that the stem 150 passes through both through holes of the saw clamps 152 and 154. The positioning of the saw clamps 152 and 154 along the longitudinal length of the stem 150 is adjustable (in a modified embodiment, the positioning of the saw clamps 152 and 154 along the longitudinal length of the stem 150 may be fixed). For example, the through holes of the saw clamps 152 and 154 are often dimensioned so that these saw clamps slide along the stem 150, and the position of the lower saw clamp 152 relative to the second adjustment guide 130 can be adjusted using a lower adjustment nut 160 that is screwed into a lower section 158 of the stem 150. Once the lower adjustment nut 160 and the lower saw clamp 152 are in place, the upper saw clamp 154 ​​can be tightened into place by the upper adjustment nut 162, which is screwed into the upper section 156 of the stem 150. Optionally, a spring can be used to push the saw clamps against each other, helping to secure the saw 4 between them.

[0090] The lower saw clamp 152 and the upper saw clamp 154 ​​are fixed to opposite sides of the saw 4 during assembly, with the stem 150 passing through a slot 4E provided in the saw 4. In this embodiment, the stem 150 (either alone or in association with the lower saw clamp 152 and the upper saw clamp 154) forms a cutting tool support that supports the saw 4 or other cutting tool. The stem 150 preferably passes through a slot 4E provided in the cutting tool (e.g., the saw 4), so that the cutter is rotatable relative to the stem 150, and the cutting tool can move longitudinally back and forth relative to the stem 150. In this embodiment, the saw 4 is a chainsaw assembly including a sawbar 4A, a chain, and a drive tooth assembly. The illustrated chainsaw assembly is preferably mounted on and driven by a handpiece (not shown). Although a chainsaw is illustrated, other types of saws can be fixed by the cutting guide system 101.

[0091] The saw clamps 152 and / or saw clamps 154 may have protrusions on their sides facing the saw, which fit into slots 4E of the sawber. One or more protrusions help guide the longitudinal motion of the saw.

[0092] The saw is secured between the saw clamps 152 and 154, preventing it from moving up and down along the stem 150, but the sober 4A can still move in a direction parallel to the length of the sober slot 4E by being advanced or retracted. In the embodiment shown in Figure 15, the sober 4A is moved backward to advance it forward relative to the support mount 110, and the sober 4A is moved forward to retract it.

[0093] In some embodiments, the saw clamps 152 and 154 are preferably rotatable around the stem 150. In this configuration, the saw can rotate in a plane around the stem 150, and the axis of the stem 150 is the axis of rotation. This allows the user to move the saw not only in the forward and backward directions but also rotationally in a plane around the axis of the stem 150.

[0094] An embodiment using the cutting guide system 101 is as follows: First, the user fixes the support mount 110 to the bone. Next, the user may rotate the first adjustment guide 120 or the second adjustment guide 130 to the desired position. By mounting as shown in Figure 15, the first adjustment guide 120 can be adjusted to adjust the eversion / varus positioning as shown in Figures 10 and 11. The user can visually evaluate the alignment with respect to anatomical landmarks, such as on the tibia or the center of the ankle, with or without additional alignment tools, such as an alignment rod that can be attached to the first adjustment guide 120. Once the first adjustment guide 120 is in the desired position, the user can fix its position using the locking mechanism 126, for example, by tightening a set screw 128.

[0095] Next, the user may adjust the other adjustment guides. By adjusting the second adjustment guide 130 in the manner shown in Figure 15, the flexion / extension positioning can be adjusted as shown in Figures 12 and 13. The user can visually evaluate the position with or without additional alignment tools, such as an alignment rod that can be attached to the second adjustment guide 130. Once the second adjustment guide 130 is in the desired position, the user can fix its position using the locking mechanism 136, for example, by tightening the set screw 138. The first adjustment guide 120 is preferably adjusted before the second adjustment guide 130, or vice versa.

[0096] Using a stylus, it is possible to measure the desired height adjustment value for the amount of bone to be removed. For example, the stylus is positioned at the location where the sawber 4A will be placed. The saw clamps 152, 154 and / or adjustment nuts 160, 162 can be used with the stylus or removed for the stylus mechanism. The stylus gives the user the ability to determine the desired height for the saw. It is then possible to remove the stylus and use the saw clamps 152, 154 and adjustment nuts 160, 162 to place the saw in place with its height adjusted to the desired height.

[0097] When performing various positioning procedures, the user is preferably guided by and / or coordinated with optical visual systems, preoperative evaluations, X-rays, CAT scans, MRI, etc. At any given time, the user may release the locking mechanisms 126, 136, readjust the respective adjustment guides 120, 130, and then re-position the locking mechanisms 126, 136 to secure the adjustment guides 120, 130. Similarly, the user may readjust the height of the sawbar by releasing the adjustment nuts 160, 162, adjusting the height, and then re-locking the saw.

[0098] The rotational positions of the adjustment guides 120 and 130 are preferably transmitted using the transducer 140 as described above. The user may use the positional information to perform positioning and / or adjustment and / or additional cuts. For example, if the user desires an extra 2 degrees of cutting, the user may use feedback from the transducer 140 to reset the first cutting position to zero and then move the adjustment mechanism 2 degrees. Optionally, the cutting guide system 101 may include a worm gear or link arrangement, thereby allowing for fine rotational adjustments to the adjustment guides 120 and 130 like a micrometer, enabling dial adjustments with extremely specific degrees of rotation. Another option is to adjust the cutting guide system to move the adjustment guides 120 and / or 130 using one or more motors, such as stepping motors.

[0099] The cutting guide system 101 separates the two main degrees of freedom with the separate and independent adjustability of the first adjustment guide 120 and the second adjustment guide 130. The user may align the cutting guide system 101 in one plane or one degree of freedom, lock it in place, and then adjust it in another plane or other degree of freedom. Thus, for example, the user can separate varus / valgus adjustment independently of flexion / extension adjustment.

[0100] Figure 16 shows several typical osteotomies made in the femur F for knee arthroplasty. Figure 16 shows the distal end of the femur F, i.e., the end facing the knee joint. The following osteotomies, namely the distal femoral osteotomy DF, anterior femoral osteotomy AF, posterior femoral osteotomy PF, anterior chamfered osteotomy AC, and posterior chamfered osteotomy PC, are made in the femur F shown in Figure 16.

[0101] Figures 17–45 show another exemplary embodiment of the cutting guide system 201. Figures 17–45 show the cutting guide system 201 attached to the distal (lower) end of the femur F. These figures illustrate exemplary use of the cutting guide system 201 to create the distal femoral cut section DF, the anterior femoral cut section AF, the posterior femoral cut section PF, the anterior chamfered cut section AC, and the posterior chamfered cut section PC.

[0102] The cutting guide system 201 includes a support mount 210 that can be attached to a bone, for example, the anterior distal femur F shown in Figure 17 or another suitable bone. The support mount 210 may be attached to the bone in a conventional manner. For example, it may be attached to the bone by one or more fasteners being inserted into one or more holes provided in the support mount 210 and penetrating into the bone. The fasteners may be conventional fixing pins, pins with trocar tips, screws, and / or other fasteners. Additionally or alternatively, spikes may be provided on the contact surfaces of the support mount 210, and driving such spikes into the bone can attach the support mount 210 to the bone and / or help the stability and rigidity of the support mount 210 to the bone. In the illustrated embodiment, as can be seen in Figure 24, the exemplary support mount 210 has spikes 216 that can bite into the bone, and threaded fasteners 218 can also be used to attach the support mount 210 to the bone. The support mount 210 can be attached in a fixed relationship to a bone or other object to be cut by a cutting tool, either directly or via one or more other components.

[0103] As shown in Figure 17, the exemplary support mount 210 has a base 212, and a first rod 214 extending from the base 212, the first rod 214 being configured to extend away from the bone when the support mount 210 is attached to the bone. The spike 216 is preferably configured to extend from the base 212 toward the bone. The fastener 218 is preferably configured to fit into the hollow central region of the first rod 214, pass through a hole provided in the base 212, and bite into the bone.

[0104] As in the embodiments described herein, once the support mount 210 is attached to the bone, the specific position is not important as far as the location and rotational orientation of the support mount 210 relative to the bone is concerned. The user can position the support mount 210 on a region of bone that facilitates the achievement of stability of the support mount 210.

[0105] The support mount 210 may be attached to the bone either by itself or with one or more other components of the cutting guide system 201 attached. In one embodiment, the support mount 210 may be attached to the bone first, and then the assembly of other components shown in Figure 18 may be attached to the support mount 210. As a variation, the support mount 210 may be assembled to the other components shown in Figure 18 before being attached to the bone.

[0106] The cutting guide system 201 further includes a first adjustment guide 220 and a second adjustment guide 230. The first adjustment guide 220 is mounted on the first rod 214 so as to be rotatable around the first rod axis 214A. The first adjustment guide 220 has an opening (recess or hole) into which the first rod 214 is fitted so as to be rotatable relative to it, thereby allowing the first adjustment guide 220 to rotate around the first rod 214 and the first rod axis 214A. In a modified configuration, the first rod may be part of the first adjustment guide 220 or rigidly attached thereto, and the support mount 210 may have a corresponding opening (recess or hole) for receiving the first rod. In this modified configuration, the first rod rotates together with the first adjustment guide 220 (i.e., the first rod rotates within the opening of the support mount 210). In each configuration example, the first adjustment guide 220 is rotatably mounted to the support mount 210 around the first rod axis 214A.

[0107] The second rod 224 is part of or rigidly attached to the first adjustment guide 220, which extends laterally from there. The axis 224A of the second rod is shown in Figure 21. The second adjustment guide 230 is attached to the second rod so as to be rotatable around the second rod and the second rod axis 224A. The second adjustment guide 230 has an opening (recess or hole) into which the second rod is fitted in a relative rotational motion manner, thereby allowing the second adjustment guide 230 to rotate around the second rod and the second rod axis 224A. In a modified configuration example, the second rod may be part of the second adjustment guide 230 or rigidly attached thereto, and the first adjustment guide 220 may have a corresponding opening (recess or hole) for receiving the second rod. In this modified configuration, the second rod rotates together with the second adjustment guide 230 (i.e., the second rod rotates within the opening of the first adjustment guide 220). In both configurations, the second adjustment guide 230 is rotatably mounted relative to the first adjustment guide 220 about the axis 224A of the second rod.

[0108] The first rod and / or the second rod do not need to continuously penetrate the portion to which they relate. For example, the second rod may include two rod portions extending from either side of the first adjustment guide 220, or one rod portion extending from one side of the first adjustment guide 220. The first rod and the corresponding opening in which the first rod is housed in a relative rotatable manner together form a first hinge, thereby allowing the first adjustment guide 220 to rotate about the first axis 214A. The second rod and the corresponding opening in which the second rod is housed in a relative rotatable manner together form a second hinge, thereby allowing the second adjustment guide 230 to rotate about the second axis 224A. In this embodiment, the joint for positioning the cutting tool includes the first hinge and the second hinge. Thus, as an example of permissible directions of movement, the joint can be used to rotate the cutting tool support from side to side about the first axis 214A, and to rotate it about the second axis 224A to move it closer to or further away from the object to be cut (e.g., bone).

[0109] A locking mechanism 226 is associated with the first adjustment guide 220 to allow the first adjustment guide 220 to rotate around the first rod axis 214A selectively, or to prevent the first adjustment guide 220 from rotating around the first rod axis 214A. In the illustrated embodiment, the locking mechanism 226 includes a set screw 228 which, when turned, can be firmly engaged with the first rod, thereby locking the first adjustment guide 220 so as not to rotate, or when the set screw is turned in the opposite direction, can be released from the first rod, thereby allowing the first adjustment guide 220 to rotate around the first rod axis 214A. Similarly, a locking mechanism 236 is associated with the second adjustment guide 230 to allow the second adjustment guide 230 to rotate around the second rod axis 224A, or to prevent the second adjustment guide 230 from rotating around the second rod axis 224A. In the illustrated embodiment, the locking mechanism 236 includes a set screw 238 which, when turned, can be securely engaged with the second rod, thereby locking the second adjustment guide 230 from rotating, or the set screw 238 can be turned in the opposite direction to release the second rod, thereby allowing the second adjustment guide 230 to rotate around the second rod axis 224A. Other locking (fastening, clamping, or fixing) mechanisms can be used for the locking mechanisms 226, 236.

[0110] As described above and as shown in Figure 14B, it is preferable that a transducer 140 be provided in association with the first adjustment guide 220 and the second adjustment guide 230. The transducer 140 is configured to detect the amount of rotation of the adjustment guides 220 and 230 around their respective rotation axes 214A and 224A. The transducer 140 converts the rotational motion of the adjustment guides 220 and 230 into an electrical signal, and as a result, the user can obtain an accurate measurement of the angular position of the adjustment guides 220 and 230.

[0111] As described above, the transducer 140 has a stator 142 and a rotor 144. The stator 142 is configured to remain rotationally fixed, and the rotor 144 is configured to rotate with the adjustment guides 220 or 230 as the adjustment guides 220 or 230 rotate around their respective rod axes 214A or 224A. The stator 142 is preferably coupled to the rod. The rotor 144 is preferably coupled to the adjustment guides 220 or 230 so that the rotor 144 rotates together with the adjustment guides 120 or 130. The other components of the transducer 140 and their operation are similar to those described above with respect to the cutting guide system 101.

[0112] The first adjustment guide 220 and / or the second adjustment guide 230 may have one or more features, parts, or components associated with them to assist the user in adjusting the alignment. For example, a projection 231 may extend from the second adjustment guide 230 to receive an alignment rod 232. The alignment rod 232 may be connected to the projection 231 after the components of Figure 18 have been attached to the bone (for example, by inserting it into a hole provided in the projection 231 and holding it in place by friction fit or in any other way). Figure 19 shows the assembly of Figure 18 with the alignment rod 232 attached to this assembly. Similarly, the first adjustment guide 220 may have one or more holes to receive one or more alignment rods. Alignment rods (for example, alignment rods 232 and / or other alignment rods connected to the first adjustment guide 220 and / or the second adjustment guide 230) allow the user to visualize the positioning state well, thereby helping to align the cutting guide system 201.

[0113] It is preferable that one or more threaded adjustment screws 233 pass through threaded holes provided in the second adjustment guide 230 to assist in positioning and / or maintaining its position. It is preferable that the threaded adjustment screws 233 be rotated so that their distal ends contact the bone. After the distal ends of the threaded adjustment screws 233 are in contact with the bone, further rotation of the threaded adjustment screws causes the second adjustment guide 230 to rotate away from the bone, thereby allowing for fine positioning adjustments.

[0114] Each of the threaded adjustment screws 233 is preferably sheathed, that is, has a hollow bore, so that a fastener (e.g., a pin, e.g., a pin with a trocar at its tip) 234 can pass through the adjustment screw 233. Once the user has positioned the cutting guide system 201 in the desired position, it is preferable to advance the fastener 234 into the bone to hold the cutting guide system 201 in place as shown in Figure 24.

[0115] The second adjustment guide 230 has one or more recesses 239 that receive corresponding arms 256 of the saw mount 250. The saw mount 250 has an adjustment base 255 having one or more arms 256 that match the recesses 239. The saw mount 250 may further have a stem 251 connected to or integrated with the adjustment base 255. In the illustrated embodiment, the stem 251 extends from the top of the adjustment base 255.

[0116] In the illustrated embodiment, the adjustment base 255 has two arms 256, one on each side of the adjustment base 255. The second adjustment guide 230 has two recesses 239 that are dimensioned and positioned to receive the arms 256. To connect the saw mount 250 to the assembly in Figure 24, the user positions the arms 256 relative to the recesses 239 and then slides the arms 256 into the recesses 239 as shown in Figures 25 and 26.

[0117] The user can adjust how deeply the arm 256 extends into the recess 239 to position the saw mount 250 at a desired height relative to the bone. Once the saw mount 250 is positioned at the desired height, the user may use a locking mechanism 260 to fix the position of the saw mount 250. In the illustrated embodiment, the locking mechanism 260 is a clamp. The clamp has a pin 262 for each arm 256. The pin 262 is integral with or connected to a bar 264. A knob 266 is connected to or in contact with the bar 264. The knob 266 turns a first threaded element (not shown), which screws into a second threaded element (not shown) that is attached to or integral with a second adjustment guide 230. In one version, the knob 266 rotates a male threaded element which is integrated with or connected to a second adjustment guide 230 and engages with a female threaded element. In a modified version, the knob 266 rotates a female threaded element which is integrated with or connected to a second adjustment guide 230 and engages with a male threaded element. By rotating the knob 266, the bar 264 and pin 262 move forward or backward depending on the direction of rotation of the knob 266. When the arm 256 is positioned in the recess 239, rotating the knob 266 can press the pin 262 against the arm 256, thereby locking the saw mount 250 in place. Rotating the knob 266 in the other direction releases the pin 262 from engagement with the arm 256, thereby allowing the position of the saw mount 250 to be adjusted or the saw mount 250 to be removed. Other locking (fastening, clamping, or fixing) mechanisms can be used in place of the locking mechanism 260.

[0118] The cutting guide system 201 further includes a lower saw clamp 252 and an upper saw clamp 254 to secure the opposite sides of the saw 4. In this embodiment, the saw mount 250 (either alone or in association with the lower saw clamp 252 and the upper saw clamp 254) forms a cutting tool support for the saw 4 or other cutting tool. The stem 251 preferably passes through a slot 4E provided in the cutting tool (e.g., the saw 4), so that the cutting tool is rotatable relative to the stem 251 and can move longitudinally back and forth relative to the stem 251. The saw clamps 252,254 have through holes to receive the stem 251, so that the stem 251 passes through both through holes of the saw clamps 252,254. The positioning of the saw clamps 252,254 along the longitudinal length of the stem 251 may be fixed or adjustable. For example, the saw clamps 252 and 254 are often sized so that when the saw 4 is in a fixed position, these saw clamps fit between the adjustment base 255 and the upper nut 257 provided on the stem 251, thereby preventing the saw clamps 252 and 254 from moving along the longitudinal length of the stem.

[0119] The lower saw clamp 252 and the upper saw clamp 254 are fixed on opposite sides of the saw 4 during assembly, with the stem 251 passing through the slot 4E of the sober 4A. In this embodiment, the saw 4 is a chainsaw assembly including the sober 4A, a chain, and a drive tooth assembly. The illustrated chainsaw assembly is preferably mounted on and driven by a handpiece (not shown). Although a chainsaw is illustrated, other types of saws can be fixed by the cutting guide system 210.

[0120] The saw clamps 252 and / or 254, which may have a ridge on their side facing the saw, which fits into a slot 4E of the sawber. One or more ridges help guide the longitudinal motion of the saw.

[0121] The saw is secured between the saw clamps 252 and 254, preventing it from moving up and down along the stem 251, but the sober 4A can still move in a direction parallel to the length of the sober slot 4E by being advanced or retracted. In the embodiments shown in Figures 26 to 28, the sober 4A is moved backward to advance it forward relative to the support mount 210, and the sober 4A is moved forward to retract it.

[0122] In some embodiments, the saw clamps 252, 254 are preferably rotatable around the stem 251. In this configuration, the saw can rotate in a plane around the stem 251, and the axis of the stem 251 is the axis of rotation. This allows the user to move the saw not only in the forward and backward directions but also rotationally in a plane around the axis of the stem 251.

[0123] When assembling the saw mount 250 to the assembly shown in Figure 24, it may be advantageous that the saw mount 250 can first support a stylus (not shown) that can be used to measure a desired cutting height, instead of the saw 4. For example, the stem 251 may support the stylus between the adjustment base 255 and the upper nut 257 on the stem 251, thereby preventing the stylus from moving along the longitudinal length of the stem 251. Saw clamps 252, 254 can optionally be used to secure the stylus. Using the stylus, the user can determine a desired cutting height that can be used when positioning the saw. The arm 256 and the second adjustment guide 230 may have indicators to show the height measured by the stylus. The stylus may then be removed and replaced with the saw 4 and optionally the saw clamps 252, 254. Using a measuring height, for example, indicated by an indicator, the user can position the saw mount 250 to the desired cutting height.

[0124] Figures 27 and 28 show the use of saw 4 to create distal femoral section DF. The position of saw 4 is determined by the positioning and locking of the first adjustment guide 220, the second adjustment guide 230, and the saw mount 250, as described above.

[0125] After creating the distal femoral section DF, it is preferable to remove the saw mount 250 and saw 4. Next, as shown in Figure 29, it is preferable to connect the guide mount 270 to the assembly in Figure 24, for the purpose of positioning the cutting mount block 280. The dimensions of the cutting mount block 280 should be selected based on the size of the implant (for example, SIZE #2 as indicated in the example drawing).

[0126] The guide mount 270 is connected to the assembly in Figure 24 in the same manner as the saw mount 250. In the illustrated embodiment, the guide mount 270 has a guide mount adjustment base 275 with two arms 276, one arm on each side of the guide mount adjustment base 275. The arms 276 are dimensioned and positioned similarly to the arms 256 to be received by recesses 239 of the second adjustment guide 230. To connect the guide mount 270 to the assembly in Figure 24, the user positions the arms 276 relative to the recesses 239 and then slides the arms 276 onto the recesses 239 as shown in Figures 29 and 30.

[0127] As described above, the user can adjust how deeply the arm 276 extends into the recess 239, as well as the positioning of the saw mount 250. Once the guide mount 270 is positioned at the desired height, the user may use the locking mechanism 260 to fix the position of the saw mount 250. That is, the arm 276 can be locked by the locking mechanism 260 in the same manner as described above with respect to the arm 256.

[0128] The guide mount 270 further comprises a body 272 connected to or integrated with the guide mount adjustment base 275, a stem 271 extending from the body 272, and an upper nut 277 screwed to the stem 271. The guide mount 270 further comprises an adjustment bar 278, the adjustment bar having a slot 279. During assembly, the stem 271 passes through the slot 279. Loosening the nut 277 allows the adjustment bar 278 to be moved back and forth, or, in some embodiments, rotated around the stem 271. Tightening the nut 277 fixes the position of the adjustment bar 278.

[0129] The guide mount 270 supports the cutting mount block 280. In the illustrated embodiment, the cutting mount block 280 is removably attached to the adjustment bar 278, for example, by screwing fasteners into threaded holes 282 provided in the cutting mount block 280. Optionally, an alignment rod 284 can be used to assist in aligning the cutting mount block 280. The alignment rod 284 is preferably fitted into a hole 283 provided in the cutting mount block 280 by friction or other fitting.

[0130] The user can adjust the position of the cutting mount block 280 to its desired position. The height of the cutting mount block 280 can be adjusted by the amount the arm 276 extends into the recess 239 and can be locked in place by the locking mechanism 260. In some embodiments, it is desirable to adjust the height so that the flat surface at the bottom of the cutting mount block 280 abuts against and is flush with the flat surface of the distal femoral cutting section DF. To adjust the anterior-posterior (front-rear) position of the cutting mount block 280, it is preferable to loosen the upper nut 277 and adjust the position of the adjustment bar 278, as shown in Figure 31. The position of the adjustment bar 278 can be fixed by tightening the upper nut 277. To adjust the angular position of the cutting mount block 280, it is preferable to rotate the cutting mount block around its connecting axis with the adjustment bar 278, as shown in Figures 32 and 33. At any point, if the user wishes to use a cutting mount block 280 of a different size, it is preferable for the user to use the desired substitute.

[0131] Once the cutting mount block 280 is in the desired position, it is preferable to attach the cutting mount block 280 to the bone using one or more fasteners 285, for example, as shown in Figure 34. Next, in order to remove the guide mount 270 from the cutting mount block 280, it is preferable to remove, for example, the fastener (not shown) that is engaged with the threaded hole 282 of the cutting mount block 280. The assembly shown in Figure 24 is also preferably removed, leaving only the cutting mount block 280 (and any fasteners for this purpose) in its attached state, as shown in Figure 35.

[0132] The first adapter 290 is dimensioned and shaped to connect to a cutting mount block 280 that positions a saw 4 for making an anterior femoral section AF and / or a posterior femoral section PF, as shown in Figures 36 and 37. The lower side of the adapter 290 is preferably shaped to fit over the cutting mount block 280. The adapter 290 is preferably connected to the cutting mount block 280 by fasteners through a hole 291 in the adapter 290 and a hole 282 in the cutting mount block 280. Figure 38 shows the first adapter 290 positioned over the cutting mount block 280.

[0133] Once the first adapter 290 is in place, the saw 4 can be attached to this first adapter. For example, Figure 39 shows the saw 4 attached to the front surface 292 of the first adapter 290. The front surface 292 is shaped to position the saw 4 to create the anterior femoral section AF, and may be inclined, for example. The front surface 292 may have holes 294 for receiving a stem, which can be attached in the same manner as described above with the lower saw clamp 252 and upper saw clamp 254 positioned between them. In a modified configuration, the stem is integral with the first adapter 290 and extends from the front surface 292 where the holes 294 are located. By attaching the sorb 4A to the stem, the sorb 4A can be advanced forward, retracted, and rotated around the stem in the same manner as described above. Once positioned on the anterior surface 292, saw 4 can be used to create the anterior femoral section AF, as shown in Figures 39 and 40.

[0134] Figure 41 shows the saw 4 attached to the posterior surface 293 of the first adapter 290. Similar to the anterior surface 292, the posterior surface 293 is shaped to position the saw 4 to create a posterior femoral section PF, and may be, for example, inclined. The posterior surface 293 may have holes 294 for receiving a stem, which can be attached in the same manner as described above with the lower saw clamp 252 and upper saw clamp 254 positioned between them. In a modified configuration example, the stem is integral with the first adapter 290 and extends from the posterior surface 293 at the location of the holes 294. By attaching the sorb 4A to the stem, the sorb 4A can be advanced forward, retracted, and rotated around the stem in the same manner as described above. Once positioned on the posterior surface 293, the saw 4 can be used to create a posterior femoral section PF as shown in Figures 41 and 42.

[0135] The second adapter 295 is dimensioned and shaped to connect to a cutting mount block 280 that positions the saw 4 for creating the anterior femoral section AC and / or posterior femoral section PC, as shown in Figures 43 to 45. The lower side of the second adapter 295 is preferably shaped to overlap the cutting mount block 280, similar to the first adapter 290. The second adapter 295 is preferably connected to the cutting mount block 280 by fasteners via holes 296 in the adapter 295 and holes 282 in the cutting mount block 280.

[0136] Once the second adapter 295 is in place, the saw 4 can be attached to this second adapter. For example, Figures 43 and 44 show the saw 4 attached to the front surface 297 of the second adapter 295. The front surface 297 is shaped to position the saw 4 to make the anterior femoral section AC, and may be inclined, for example. The front surface 297 may have holes for receiving a stem, which can be attached in the same manner as described above with the lower saw clamp 252 and the upper saw clamp 254 positioned between them. In a modified configuration, the stem is integrated with the second adapter 295 and extends from the front surface 297 where the holes are located. By attaching the sorb 4A to the stem, the sorb 4A can be advanced forward, retracted, and rotated around the stem in the same manner as described above. Once positioned on the anterior surface 297, the saw 4 can be used to create the anterior femoral section AC, as shown in Figures 43 and 44.

[0137] Figure 45 shows the saw 4 attached to the posterior surface 298 of the second adapter 295. Similar to the anterior surface 297, the posterior surface 298 is shaped to position the saw 4 for creating a posterior femoral cross section PC, and may be, for example, inclined. The posterior surface 298 may have holes for receiving a stem, which can be attached in the same manner as described above with the lower saw clamp 252 and the upper saw clamp 254 positioned between them. In a modified configuration, the stem is integrated with the second adapter 295 and extends from the posterior surface 298 where the holes are located. By attaching the sorb 4A to the stem, the sorb 4A can be advanced forward, retracted, and rotated around the stem in the same manner as described above. Once positioned on the posterior surface 298, the saw 4 can be used to create a posterior femoral cross section PC as shown in Figure 45.

[0138] In modified embodiments, one or more mounting surfaces for the anterior femoral section AF, posterior femoral section PF, anterior chamfered section AC, and / or posterior chamfered section PC may be part of the cutting mount block 280, and therefore one or more separate adapters 290, 295 may not be required. For example, Figure 31 shows one version of the cutting mount block 280 with surfaces for making one or more of these cutting sections.

[0139] One embodiment using the cutting guide system 201 is as follows: First, the user fixes the support mount 210 to the bone. The assembly shown in Figure 18 may be attached to the support mount 210, or it may be attached to it afterward. Next, the user may rotate the first adjustment guide 220 and / or the second adjustment guide 230 to the desired position. By adjusting the first adjustment guide 220, the valgus / varus positioning may be adjusted, and by adjusting the second adjustment guide 230, the flexion / extension positioning can be adjusted, as shown in the mountings in Figures 18 to 23. The user can visually evaluate the alignment state against anatomical landmarks, with or without additional alignment devices, such as alignment rods that can be attached to the first adjustment guide 220 and / or the second adjustment guide 230. Once the first adjustment guide 220 and / or the second adjustment guide 230 are in the desired position, the user can fix their position using the locking mechanism 226 and / or 236, for example, by tightening the set screws 228 and / or 238. The first adjustment guide 220 can be adjusted, and then the second adjustment guide 230 can be adjusted, and vice versa, and each of these adjustment guides can be readjusted after the other has been adjusted.

[0140] The saw mount 250 is preferably attached to the assembly shown in Figures 18 to 24, as described above. As described above, the stylus can be used to measure the desired height adjustment value for the amount of bone to be removed. For example, the stylus can be positioned at the location where the sawber 4A will be placed. The saw clamps 252 and 254 can be used with the stylus or removed for the stylus mechanism. In a modified example, a stylus mount may be used instead of the saw mount 250. The stylus gives the user the ability to determine the desired height for the saw. The stylus can then be removed, and the saw mount 250 can be used to position the saw with its height adjusted to the desired height. The saw mount 250 is preferably locked in place using the locking mechanism 260.

[0141] When performing various positioning tasks, the user is preferably guided by and / or coordinated with optical visual systems, preoperative evaluations, X-rays, CAT scans, MRI, etc. At any given time, the user may release the locking mechanisms 226, 236, readjust the respective adjustment guides 220, 230, and then re-position the locking mechanisms 226, 236 to secure the adjustment guides 220, 230. Similarly, the user may readjust the height of the sober by releasing the locking mechanism 260, adjusting its height, and then re-locking the saw mount 250 using the locking mechanism 260.

[0142] The rotational positions of the adjustment guides 220 and 230 are preferably transmitted using the transducer 140 as described above. The user can then use the positional information to perform positioning and / or adjustment and / or additional cutting. Optionally, the cutting guide system 201 may include a worm gear or link arrangement, thereby allowing for fine rotational adjustment of the adjustment guides 220 and 230 like a micrometer, enabling dial adjustment with extremely specific degrees of rotation. Another option is to adjust the cutting guide system using one or more motors, such as stepping motors, to move the adjustment guides 220 and / or 230.

[0143] The cutting guide system 201 separates the two main degrees of freedom with the separate and independent adjustability of the first adjustment guide 220 and the second adjustment guide 230. The user can align the cutting guide system 201 in one plane or one degree of freedom, lock it in place, and then adjust it in the other plane or other degrees of freedom. Thus, for example, the user can separate varus / valgus adjustment separately from flexion / extension adjustment.

[0144] The cutting guide system 201 can be used to create the distal femoral cutting section DF as shown in Figures 27 and 28. After creating the distal femoral cutting section DF, it is preferable to remove the saw mount 250 and the saw 4. Next, it is preferable to connect the guide mount 270 to the assembly in Figure 24 as shown in Figure 29. The user may adjust the positioning of the cutting mount block 280 to the desired position. The user can adjust the height of the cutting mount block 280 by the amount by which the arm 276 extends into the recess 239 and is locked in place by the locking mechanism 260. The user can adjust the anterior-posterior (front-rear) position of the cutting mount block 280 by adjusting the position of the adjustment bar 278 as shown in Figure 31. The user can adjust the angular position of the cutting mount block 280 by rotating the cutting mount block 280 around its connecting axis with the adjustment bar 278 as shown in Figures 32 and 33.

[0145] Once the cutting mount block 280 is in the desired position, the user may attach the cutting mount block 280 to the bone using one or more fasteners 285, for example, as shown in Figure 34. Next, the guide mount 270 may be removed from the cutting mount block 280 by removing a fastener (not shown) that is engaged with the threaded hole 282 of the cutting mount block 280. The assembly shown in Figure 24 may also be removed, leaving only the cutting mount block 280 (and any fasteners for this purpose) in its mounted state, as shown in Figure 35. The user may optionally use the cutting mount block 280 to create an anterior femoral cutting section AF, a posterior femoral cutting section PF, an anterior chamfered cutting section AC, and / or a posterior chamfered cutting section PC using one or more adapters 290, 295.

[0146] Some or all of the components of the cutting guide system described herein may be reusable or disposable. For example, the support mounts 110, 210 and adjustment guides 120, 130, 220, 230 may be made of surgical stainless steel or anodized aluminum and may be sterilized and reused. The transducer 140 may be made of plastic and may be inexpensive and disposable. Similarly, the sober clamp and sober may be disposable.

[0147] In use, some embodiments of the cutting guide system described herein allow for simple fixation of the cutting guide system to the bone, easy positioning of the saw relative to the bone, and easy readjustment of said positioning if necessary. Some embodiments of the cutting guide system described herein facilitate good visibility by the user. Some embodiments of the cutting guide system described herein are preferably designed to be used with a set of implants of different sizes.

[0148] In any of the cutting guide systems described herein, after a cut is made, the user can evaluate this cut and make one or more additional cuts. For example, the user may measure the excised bone fragment and then add the cuts of the saw cut to determine the amount of cutting. The user may then evaluate whether to make one or more additional cuts.

[0149] After creating the desired cut using one or more of the cutting guide systems described herein, the user may place test prostheses for testing. For example, the user may place test femoral and test tibial prostheses and move the leg through its range of motion. In this embodiment, the user may return the patella to its original position so that the joint is fully covered by the skin in order to perform a more complete evaluation. The user may evaluate, for example, the overall leg alignment, valgus / varus positioning, and flexion / extension to avoid poor hyperextension for instability and to avoid insufficient flexion so that a good range of motion is present. If desired, the user may return and create additional cuts based on the positioning of the cutting guide system.

[0150] While some embodiments described herein have been described in relation to bone cutting, the cutting guide systems disclosed herein can also be used in other fields, such as construction. For example, the cutting guide system can be configured and used to stabilize a cutting tool for cutting wood, drywall, plastic, and other materials. The support mount is preferably mountable in a fixed relationship with the object to be cut by the cutting tool. For example, the cutting guide system can be used to guide a cut for an air register, socket, window, or other area where it would be useful to have a cut. The support mount can be mounted on the object to be cut or an adjacent object (e.g., an adjacent beam, panel, support, or other object) in a fixed relationship with the object to be cut. In one embodiment, the cutting guide system can be used to guide a cutting tool (e.g., a chainsaw, other saw, other knife, etc.) to make a cut in a material (e.g., drywall, wood, etc.) and / or to guide the cutting tool along a desired cutting path (e.g., an opening for an air duct, socket, light switch, window, etc.).

[0151] As described above, the systems described herein can be used manually or with a robotic platform, in which case the cutting tool is operated by a robot. The cutting guide system may include, for example, motors, linear or rotary actuators, stepping motors, etc., to move the cutting guide system and / or the cutting tool (e.g., to rotate joints, adjust the height of the cutting tool, advance / move the cutting tool, etc.). The motion may be programmed so that a cut section (e.g., a bone cut section, an air duct, a socket, a light switch, a window opening, etc.) is made in the object to be cut along a predetermined path.

[0152] The cutting guide systems described herein can offer one or more advantages compared to systems of the prior art. These advantages include being less expensive, easier to use, more accurate alignment, more accurate cuts, shorter cutting times, shorter procedure times, shorter recovery times, and / or better results.

[0153] As those skilled in the art will understand, the embodiments included in the present invention are not limited to the specific exemplary embodiments described above. Although exemplary embodiments have been illustrated and described, a wide range of modifications, alterations, and substitutions are envisioned in the present invention. As will be understood, such modifications relating to the above are possible without departing from the scope of the invention.

Claims

1. A cutting guide system for stabilizing a chainsaw-shaped cutting tool, comprising a sober and a cutting chain around the sober, wherein the cutting guide system is A support mount that can be attached in a fixed relationship to the object to be cut by the cutting tool, Cutting tool support, Including joints, The joint is configured to allow the cutting tool support to be adjusted relative to the support mount. The joint is configured to allow the cutting tool support to rotate around at least two axes, The cutting tool support comprises a stem, a first saw clamp, and a second saw clamp. A cutting guide system comprising a first saw clamp and a second saw clamp configured to fix the cutting tool to the stem, wherein the sober is rotatable within the cutting plane and the sober is movable longitudinally back and forth within the cutting plane.

2. The cutting guide system according to claim 1, wherein the joint comprises a ball and a socket.

3. The cutting guide system according to claim 1, wherein the joint comprises a first rod and a first opening, the first rod being positioned within the first opening to allow relative rotational motion between the first rod and the first opening.

4. The cutting guide system according to claim 3, further comprising a first transducer adapted to detect the relative rotational momentum between the first rod and the first opening.

5. The cutting guide system according to claim 3, wherein the joint further comprises a second rod and a second opening, the second rod being positioned within the second opening to allow relative rotational movement between the second rod and the second opening.

6. The cutting guide system according to claim 5, further comprising a second transducer adapted to detect the relative rotational momentum between the second rod and the second opening.

7. The cutting guide system according to claim 1, wherein the position of the cutting tool along the longitudinal axis of the stem is adjustable.

8. The cutting guide system according to claim 1, wherein the stem penetrates a slot in the sober, the sober is rotatable around the stem, and the sober is able to move longitudinally back and forth relative to the stem along the direction of the slot.

9. Further comprising a guide mount and a cutting mount block, The guide mount is adapted to position the cutting mount block, The position of the guide mount relative to the adjustment guide is adjustable in the longitudinal direction. The cutting guide system according to claim 1, wherein the cutting mount block is adapted to be fixed to an object to be cut by the cutting tool.

10. The cutting guide system according to claim 9, further comprising an adapter for attaching a cutting tool to the cutting mounting block.

11. The cutting guide system according to claim 10, wherein the adapter includes a plurality of fixing positions for the cutting tool, each of the plurality of fixing positions is configured to align the cutting tool for each different planar cut.

12. A cutting guide system for stabilizing a cutting tool in the shape of a chainsaw, comprising a sober and a cutting chain around the sober, wherein the cutting guide system is Cutting tool support, The cutting tool support includes a track member that defines the path along which the cutting tool support moves, The cutting tool support is connected to the track member in such a manner that it is stabilized relative to the track member, while allowing the cutting tool support to move in the direction of the path of the track member. The cutting tool support comprises a stem, a first saw clamp, and a second saw clamp. A cutting guide system comprising a first saw clamp and a second saw clamp configured to fix the cutting tool to the stem, wherein the sober is rotatable within the cutting plane and the sober is movable longitudinally back and forth within the cutting plane.

Images