Surgical kit for tibial tubercle osteotomy

Abstract

A surgical kit for performing a tibial tubercle osteotomy (TTO) is provided. The surgical kit comprises a primary surgical module configured to be secured to a patient's tibia and a bone-fastener predrilling module. The primary surgical module has a bone-contacting surface configured to be superposable against the patient's tibia and conforming thereto in a single predetermined position and orientation and an operative side. The primary surgical module includes an anchor portion securable to the patient's tibia, a primary cutting portion defining a coronal cutting plane, and a proximal cutting portion defining a proximal cutting plane. The coronal and the proximal cutting planes are configured to guide a surgical cutting tool to create a resection in the patient's tibia and to at least partially delimit a tibial tubercle fragment.

Description

[0001] SURGICAL KIT FOR TIBIAL TUBERCLE OSTEOTOMY

[0002] TECHNICAL FIELD

[0003] The technical field generally relates to tools used in tibial tubercle osteotomy procedures. More particularly, it relates to a surgical kit for a tibial tubercle osteotomy including patient specific components.

[0004] BACKGROUND

[0005] Tibial tubercle osteotomies (TTO) are orthopedic procedures which aim to improve the alignment of the patella for patients who suffer from patellofemoral instability (PFI) or painful patellar maltracking. This is performed by changing the insertion point of the patellar tendon on the tibia (tibial tubercle). By moving the tibial tubercle, it can correct the malalignment of the patella in the groove (trochlea) of the femur (thigh bone) and eliminate symptoms of instability and decrease the symptoms of arthritis.

[0006] A long boney substantially triangular segment of the attachment of the patellar ligament (called the tibial tubercle) is repositioned and held in position with screws, in order for it to heal in this new location. The TTO is performed to relocate the tibial tubercle to the inner / outer side (medial / lateral) and / or further up / down the tibia (distal / proximal) and / or forward / rearwardly (anterior). Existing tools and procedures are limited in the accuracy and precision with which the realignment of the patella can be corrected. There is therefore much room for improvement.

[0007] SUMMARY

[0008] According to an aspect, there is provided a surgical kit for performing a tibial tubercle osteotomy (TTO). The surgical kit comprises a primary surgical module configured to be secured to a patient’s tibia and having a bone-contacting surface configured to be superposable against the patient's tibia and conforming to a surface of the patient’s tibia in a single predetermined position and an operative side opposite the bone-contacting surface, the primary surgical module including an anchor portion securable to the patient’s tibia, a primary cutting portion defining a coronal (or primary) cutting plane, and a proximal cutting portion defining a proximal cutting plane, the coronal cutting plane and the proximal cutting plane being configured to guide a surgical cutting tool to create a resection in the patient’s tibia when the primary surgical module is mounted to the patient’s tibia and to at least partially delimit a tibial tubercle fragment; and a bone-fastener predrilling module having a surgical module mounting portion detachably engageable with the primary surgical module and a drilling portion including at least one drill barrel aligned with and located anteriorly to the tibial tubercle fragment positioned in a predetermined tubercle position.

[0009] According to another aspect, there is provided a surgical kit for performing a tibial tubercle osteotomy (TTO). The surgical kit a primary surgical module configured to be secured to a patient’s tibia and having a bone-contacting surface configured to be superposable against the patient's tibia and conforming to a surface of the patient’s tibia in a single predetermined position and an operative side opposite the bone-contacting surface. The primary surgical module comprises: an anchor portion securable to the patient’s tibia; a primary cutting portion including a primary cutting tool receiving slot defining a coronal cutting plane; a proximal cutting portion comprising a proximal cutting tool receiving slot defining the proximal cutting plane, the primary cutting tool receiving slot and the proximal cutting tool receiving slot being configured to receive and guide a surgical cutting tool to create a resection in the patient’s tibia when the primary surgical module is mounted to the patient’s tibia and to at least partially delimit a tibial tubercle fragment; and a tubercle realignment guide indicative a predetermined tubercle position following displacement of the tibial tubercle fragment.

[0010] According to still another aspect, there is provided a surgical kit for performing a tibial tubercle osteotomy (TTO). The surgical kit comprises: a primary surgical module configured to be secured to a patient’s tibia and having a bone-contacting surface configured to be superposable against the patient's tibia and conforming to a surface of the patient’s tibia in a single predetermined position and orientation and an operative side opposite the bone-contacting surface, the primary surgical module including an anchor portion securable to the patient’s tibia, a primary cutting portion defining a coronal cutting plane, and a proximal cutting portion defining a proximal cutting plane, the coronal cutting plane and the proximal cutting plane being configured to guide a surgical cutting tool to create a resection in the patient’s tibia when the primary surgical module is mounted to the patient’s tibia and to at least partially delimit a tibial tubercle fragment; and a bone-fastener predrilling module having a surgical module mounting portion detachably engageable with the primary surgical module and a drilling portion including at least one drill barrel aligned with and located anteriorly to the tibial tubercle fragment positioned in a predetermined tubercle position and orientation.

[0011] In an embodiment, the surgical kit further comprises a resection predrilling module detachably mounted to the primary surgical module at an intersection of the coronal cutting plane and the proximal cutting plane, the resection predrilling module being configured to guide a drill bit in the patient’s tibia. The resection predrilling module can comprise severable connectors connecting a tubular wall of the resection predrilling module to the primary surgical module, the tubular wall defining a drill receiving channel aligned with the intersection of the coronal cutting plane and the proximal cutting plane.

[0012] In an embodiment, the primary cutting portion comprises a primary cutting tool receiving slot defining the coronal cutting plane and the proximal cutting portion comprises a proximal cutting tool receiving slot defining the proximal cutting plane and the primary cutting tool receiving slot intersects with the proximal cutting tool receiving slot.

[0013] In an embodiment, the anchor portion extends along one side of the primary cutting portion and the drilling portion of the bone-fastener predrilling module is located on an opposed side of the primary cutting portion when engaged with the primary surgical module.

[0014] In an embodiment, each one of the coronal cutting plane and the proximal cutting plane extends in a respective and single plane with the coronal cutting plane extending substantially along a coronal plane of the patient’s tibia and the proximal cutting plane extends substantially along a transversal plane of the patient’s tibia.

[0015] In an embodiment, the primary cutting portion comprises a tubercle realignment guide. The tubercle realignment guide can comprise a tubercle displacement platform coplanar with the coronal cutting plane. The tubercle realignment guide can comprise a tubercle abutting wall having a profile matching contours of a portion of the tibial tubercle fragment abutting on the tubercle abutting wall when configured in the predetermined tubercle position and orientation.

[0016] In an embodiment, the primary cutting portion comprises a tubercle realignment guide and a primary cutting tool receiving slot defining the coronal cutting plane, wherein the tubercle realignment guide comprises a tubercle displacement platform coplanar with the primary cutting tool receiving slot and a tubercle abutting wall and wherein the primary cutting tool receiving slot opens at a junction of the tubercle displacement platform and the tubercle abutting wall.

[0017] In an embodiment, the primary cutting portion comprises a depth limitation indicator providing an indication for an insertion depth of the surgical cutting tool inside the patient’s tibia. The primary cutting portion can comprise a visual indicator indicating a section of the primary cutting tool receiving slot wherein a cutting tool inserted in the primary cutting tool receiving slot must not protrude outwardly of the patient’s tibia.

[0018] In an embodiment, the surgical kit further comprises a displacement validator. The surgical module mounting portion of the bone-fastener predrilling module can be detachably engageable with the displacement validator.

[0019] In an embodiment, the bone-fastener predrilling module further comprises at least one drill sleeve removably engageable with a respective one of the at least one drill barrel, the at least one drill sleeve having a proximal end protruding outwardly from the respective one of the at least one drill barrel when engaged therewith and contacting the tibial tubercle fragment. The proximal end of the at least one drill sleeve can be serrated. The at least one drill sleeve can comprise two drill sleeves, each one of the two drill sleeves having a drill tunnel, the drill tunnels of the two drill sleeves being characterized by a different diameter.

[0020] In an embodiment, the surgical kit further comprises a sagittal guide module having a proximal portion removably engageable with the proximal cutting portion of the primary surgical module and a sagittal cutting portion having a sagittal cutting tool receiving slot extending therethrough. The proximal portion can be engageable with the proximal cutting portion over the proximal cutting portion. The sagittal cutting tool receiving slot can be opened at an end thereof and defines a sagittal cutting plane intersecting with the proximal cutting plane.

[0021] In an embodiment, the bone-fastener predrilling module comprises male connectors and the proximal cutting portion comprises female connectors complementary with the male connectors and the bone-fastener predrilling module is removably engageable with the proximal cutting portion by engaging the male connectors into the female connectors.

[0022] According to a further aspect, there is provided a surgical kit for performing a tibial tubercle osteotomy (TTO). The surgical kit comprises: a primary surgical module configured to be secured to a patient’s tibia and having a bone-contacting surface configured to be superposable against the patient's tibia and conforming to a surface of the patient’s tibia in a single predetermined position and orientation and an operative side opposite the bone-contacting surface. The primary surgical module comprises: an anchor portion securable to the patient’s tibia; a primary cutting portion including a primary cutting tool receiving slot defining a coronal cutting plane; a proximal cutting portion comprising a proximal cutting tool receiving slot defining a proximal cutting plane, the primary cutting tool receiving slot and the proximal cutting tool receiving slot being configured to receive and guide a surgical cutting tool to create a resection in the patient’s tibia when the primary surgical module is mounted to the patient’s tibia in the single predetermined position and orientation and to at least partially delimit a tibial tubercle fragment; and a tubercle realignment guide indicative of a predetermined tubercle position and orientation following displacement of the tibial tubercle fragment.

[0023] In an embodiment, the tubercle realignment guide comprises a tubercle displacement platform coplanar with the primary cutting tool receiving slot. The tubercle realignment guide can comprise a tubercle abutting wall having a profile matching contours of a portion of the tibial tubercle fragment abutting on the tubercle abutting wall when configured in the predetermined tubercle position and orientation.

[0024] In an embodiment, the surgical kit further comprises a bone-fastener predrilling module having a surgical module mounting portion detachably engageable with the primary surgical module and a drilling portion including at least one drill barrel aligned with and located anteriorly to the tibial tubercle fragment positioned in the predetermined tubercle position and orientation. The anchor portion can extend along one side of the primary cutting portion and the drilling portion of the bonefastener predrilling module can be located on an opposed side of the primary cutting portion when engaged with the primary surgical module.

[0025] In an embodiment, the surgical kit further comprises a resection predrilling module detachably mounted to the primary surgical module at an intersection of the coronal cutting plane and the proximal cutting plane, the resection predrilling module being configured to guide a drill bit in the patient’s tibia. The resection predrilling module can comprise severable connectors connecting a tubular wall of the resection predrilling module to the primary surgical module, the tubular wall defining a drill receiving channel aligned with the intersection of the coronal cutting plane and the proximal cutting plane.

[0026] In an embodiment, the primary cutting tool receiving slot and the proximal cutting tool receiving slot intersect. In an embodiment, each one of the coronal cutting plane and the proximal cutting plane extends in a respective and single plane with the coronal cutting plane extending substantially along a coronal plane of the patient’s tibia and the proximal cutting plane extends substantially along a transversal plane of the patient’s tibia.

[0027] In an embodiment, the primary cutting portion comprises a depth limitation indicator providing an indication for an insertion depth of the surgical cutting tool inside the patient’s tibia. The depth limitation indicator can comprise a visual indicator indicating a section of the primary cutting tool receiving slot wherein a cutting tool inserted in the primary cutting tool receiving slot must not protrude outwardly of the patient’s tibia.

[0028] In an embodiment, the surgical kit further comprises a displacement validator. The surgical kit can further comprise a displacement validator and wherein the surgical module mounting portion of the bone-fastener predrilling module is detachably engageable with the displacement validator. The bone-fastener predrilling module can further comprisesat least one drill sleeve removably engageable with a respective one of the at least one drill barrel, the at least one drill sleeve having a proximal end protruding outwardly from the respective one of the at least one drill barrel when engaged therewith and contacting the tibial tubercle fragment. The proximal end of the at least one drill sleeve can be serrated. The at least one drill sleeve can comprise two drill sleeves, each one of the two drill sleeves having a drill tunnel, the drill tunnels of the two drill sleeves being characterized by a different diameter. The surgical kit further comprises a sagittal guide module having a proximal portion engageable with the proximal cutting portion of the primary surgical module and a sagittal cutting portion having a sagittal cutting tool receiving slot extending therethrough. The proximal portion can be engageable with the proximal cutting portion over the proximal cutting portion.

[0029] In an embodiment, the sagittal cutting tool receiving slot is opened at an end thereof and defines a sagittal cutting plane intersecting with the proximal cutting plane. In an embodiment, the bone-fastener predrilling module comprises male connectors and the proximal cutting portion comprises female connectors complementary with the male connectors and the bone-fastener predrilling module is removably engageable with the proximal cutting portion by engaging the male connectors into the female connectors.

[0030] According to another aspect, there is provided a primary surgical module for performing a tibial tubercle osteotomy (TTO). The primary surgical module comprises: a body including a bone-contacting portion, a lateral portion, a medial portion, and a proximal portion, the bone-contacting portion of the body has an anchor portion and a bone-contacting surface configured to be superposable against a patient's tibia and conforming to a surface of the patient’s tibia in a single predetermined position and orientation, the body also includes an operative side opposite the bone-contacting surface, the primary surgical module is securable to the patient’s tibia via the anchor portion, the lateral portion, the medial portion, and the proximal portion comprise respectively a lateral cutting tool supporting surface, a medial cutting tool supporting surface, and a proximal cutting tool supporting surface configured to guide a surgical cutting tool to create a resection in the patient’s tibia when the primary surgical module is mounted to the patient’s tibia in the single predetermined position and orientation to at least partially delimit a tibial tubercle fragment.

[0031] In an embodiment, the lateral cutting tool supporting surface, the medial cutting tool supporting surface, and the proximal cutting tool supporting surface respectively define a lateral cutting plane, a medial cutting plane, and a proximal cutting plane intersecting with one another.

[0032] In an embodiment, each one of the lateral portion, the medial portion, and the proximal portion protrudes anteriorly with respect to the bone-contacting portion.

[0033] In an embodiment, the anchoring portion comprises at least two peripheral tubular walls protruding outwardly on the operative side, each one of the peripheral tubular walls defining a faster-receiving apertures which extends through the primary surgical module.

[0034] BRIEF DESCRIPTION OF THE DRAWINGS

[0035] Figure 1 is a medial side elevation view of a primary surgical module of a surgical kit in accordance with an embodiment, superposed to a tibial bone, adjacent to a tibial tuberosity.

[0036] Figure 2 is a front elevation (anterior-posterior) view (or frontal view) of the primary surgical module of Figure 1 mounted to the tibial bone.

[0037] Figure 3 is a rear elevation view of the primary surgical module of Figure 1 , without a resection predrilling module.

[0038] Figure 4 is a front elevation view of the primary surgical module of Figure 1 with a surgical saw engaged in a primary cutting tool receiving slot of the primary surgical module and the tibial bone.

[0039] Figure 5 includes Figure 5a and Figure 5b, Figure 5a is a front elevation view of the primary surgical module of Figure 1 , without the resection predrilling module, Figure 5b is a medial side elevation view of the primary surgical module of Figure 5a.

[0040] Figure 6 is a front elevation view of the primary surgical module of Figure 5a with the surgical reciprocating saw engaged in the primary cutting tool receiving slot of the primary surgical module and the tibial bone.

[0041] Figure 7 is a front elevation view of the primary surgical module of Figure 1 , with a drilling tool received in a drill receiving channel of the resection predril ling module of the surgical kit, in accordance with an embodiment.

[0042] Figure 8 is a front elevation view of the primary surgical module of Figure 7, in transparency, showing a drill bit of the drilling tool engaged in the tibial bone through the drill receiving channel. Figure 9 is a front elevation view of the primary surgical module of Figure 1 , wherein the resection predrilling module has been removed.

[0043] Figure 10 is a front elevation view of the primary surgical module of Figure 1 , in transparency, without the resection predrilling module, and with an osteotome inserted in a proximal section of the primary surgical module.

[0044] Figure 11 is a front elevation view of the primary surgical module of Figure 1 , with a sagittal guide module of the surgical kit, in accordance with an embodiment, engaged therewith and superposed to the tibial bone.

[0045] Figure 12 is a top plan view of the primary surgical module and the sagittal guide module, of Figure 11 , engaged together and superposed to the tibial bone.

[0046] Figure 13 is a medial side elevation view of the primary surgical module and the sagittal guide module of Figure 11 , in transparency, engaged together with a cutting tool engaged with the sagittal guide module and the tibial bone.

[0047] Figure 14 is a side elevation view of the primary surgical module of Figure 13, once removed from the tibial bone.

[0048] Figure 15 is a front elevation view of the primary surgical module of Figure 14, with a tibial tubercle fragment displaced along a tubercle displacement platform and abutting against a tubercle abutting wall of a tubercle realignment guide of the primary surgical module.

[0049] Figure 16 is a perspective view of the primary surgical module with the tibial tubercle fragment displaced against the tubercle abutting wall of the tubercle realignment guide thereof and a displacement validator of the surgical kit, in accordance with an embodiment, engaged between the tibial bone and the tibial tubercle fragment.

[0050] Figure 16a is a perspective view of the displacement validator of Figure 16 showing an operative end thereof in accordance with an embodiment. Figure 17 is a medial side elevation view of the primary surgical module and the displacement validator of Figure 16, in transparency, showing a k-wire inserted in a validation channel extending through the displacement validator and the tibial bone.

[0051] Figure 18 is a front elevation view of the primary surgical module of Figure 9, with the tibial tubercle fragment positioned in a predetermined tubercle position and orientation and abutting against the tubercle abutting wall of the tubercle realignment guide.

[0052] Figure 19 is a front elevation view of a primary surgical module in accordance with an embodiment, with the tibial tubercle fragment positioned in the predetermined tubercle position and orientation, wherein coronal and proximal cuts are performed up to an outer bone surface.

[0053] Figure 20 is a front elevation view of the primary surgical module of Figure 19 with a displacement validator of the surgical kit, in accordance with another embodiment, wherein the displacement validator contacts an exposed section of a coronal cut surface, an outer bone surface and an unresected surface of the tibial tubercle fragment.

[0054] Figure 21 is a lateral perspective view of the primary surgical module and displacement validator of Figure 20.

[0055] Figure 22 is a rear perspective view of a bone-fastener predrilling module of the surgical kit, in accordance with an embodiment.

[0056] Figure 23 is a front elevation view of the primary surgical module of Figure 1 , with the bone-fastener predrilling module of Figure 22 engaged therewith, and wherein the tibial tubercle fragment is positioned in the predetermined tubercle position and orientation and abuts against the tubercle abutting wall of the tubercle realignment guide.

[0057] Figures 24A and 24B are respectively a first and a second perspective views of a predrill sleeve in accordance with an embodiment. Figure 25 is a medial perspective view of the primary surgical module and the bone-fastener predrilling module of Figure 23, engaged together, with two predrill sleeves of Figure 24 engaged with the predrilling module.

[0058] Figure 26 is a medial perspective view of the primary surgical module, the displacement validator, and the bone-fastener predrilling module, in accordance with another embodiment, wherein the bone-fastener predrilling module is engaged with the primary surgical module and the displacement validator.

[0059] Figure 27 is a front elevation view of the primary surgical module, the displacement validator, and the bone-fastener predrilling module of Figure 26.

[0060] Figure 28 is a medial perspective view of the primary surgical module and the bone-fastener predrilling module of Figure 25.

[0061] Figure 29 is a medial perspective view of the primary surgical module, the displacement validator, and the bone-fastener predrilling module engaged together, and a k-wire inserted in a validation channel of the displacement validator.

[0062] Figure 30 is a medial perspective view of a primary surgical module and a bonefastener predrilling module, in accordance with another embodiment, wherein the bone-fastener predrilling module is engaged with the primary surgical module and includes non-cylindrical drill channels.

[0063] Figure 31 is a front elevation view of the primary surgical module and the bonefastener predrilling module of Figure 30.

[0064] Figure 32 is a top perspective view of a predril I sleeve in accordance with another embodiment, engageable with the non-cylindrical drill channels of the bonefastener predrilling module of Figure 30.

[0065] Figure 33 is a medial perspective view of the primary surgical module in accordance with another embodiment, wherein the primary surgical module includes a coronal cutting plane and a proximal cutting plane. Figure 34 is a front elevation view of the primary surgical module of Figure 33.

[0066] Figure 35 is a lateral side elevation view of the primary surgical module of Figure 33.

[0067] Figure 36 is a medial side elevation view of the primary surgical module of Figure 33.

[0068] Figure 37 is a lateral perspective view of the primary surgical module of Figure 33 is the sagittal guide module of the surgical kit, in accordance with another embodiment, engaged therewith and superposed to the tibial bone.

[0069] Figure 38 is a front elevation view of the primary surgical module of Figure 33 with the sagittal guide module of Figure 37, engaged therewith.

[0070] Figure 39 is a front elevation view of the primary surgical module of Figure 33 with a tibial tubercle fragment displaced medially in the predetermined tubercle position and orientation in accordance with the tubercle realignment guide of the primary surgical module, in accordance with another embodiment.

[0071] Figure 40 includes Figures 40a, 40b, and 40c, which are respectively a front elevation view, a rear perspective view, and a top plan view of a primary surgical module of a surgical kit in accordance with another embodiment.

[0072] Figure 41 is a perspective view of a proximal portion of a tibial bone in accordance with an embodiment, showing a tuberosity bone fragment.

[0073] Figure 42 includes Figures 42a, 42b, and 42c, which are respectively a lateral side elevation view, a front elevation (anterior-posterior) view (or frontal view), and a medial side elevation view of the primary surgical module of Figure 40, superposed to the tibial bone of Figure 41 .

[0074] Figure 43 includes Figures 43a and 43b, which are two different elevation views of the primary surgical module of Figure 40, secured to the tibial bone of Figure 41 , with a surgical saw contacting respectively a medial cutting tool supporting surface and a lateral cutting tool supporting surface. Figure 44 is a top plan view of the primary surgical module of Figure 40, superposed to the tibial bone of Figure 41 .

[0075] Figure 45 is a perspective view of the tibial bone with the tuberosity bone fragment being removed.

[0076] Figure 46 is a perspective view of a surgical kit including the primary surgical module (FIG. 46A), the sagittal guide module (FIG. 46B), the displacement validator (FIG. 46C), and the bone-fastener predrilling module (FIG. 46D) in accordance with an embodiment.

[0077] DETAILED DESCRIPTION

[0078] With reference to Figures 1 to 3, a primary surgical module 20 (or anchor module) of a surgical kit 100 (or a surgical cutting guide system) (Figure 46) is provided according to a non-limitative embodiment. The primary surgical module 20 is configured to be mounted to a patient’s tibial bone B and is part of the surgical kit 100, which includes at least one additional module configure to guide various surgical tools used throughout an osteotomy procedure and, more particularly, a tibial tubercle osteotomy (TTO). The surgical kit 100 is patient-specific in that it is designed and manufactured according to the specific anatomy of a patient. In this fashion, at least the primary surgical module 20 of the surgical kit 100 can be shaped and configured such that it can fit precisely on a predetermined position and orientation on the patient’s tibial bone B and be secured thereto to assure proper alignment of guides for various surgical instruments. In the present embodiment, at least a few modules of the surgical kit 100, including the primary surgical module 20, includes a body made from 3D printed polymer, although it is appreciated that other biocompatible materials compatible with other custom manufacturing methods are also possible.

[0079] The predetermined position and orientation of the primary surgical module 20 on the patient’s tibial bone B are determined by a preoperative planning. In addition, the patient’s specific features of the primary surgical module 20 and the other modules of the surgical kit 100 can also be determ ined / selected during the preoperative planning.

[0080] The body of the primary surgical module 20 comprises a bone-contacting surface 22 (Figure 3) for facing and conforming to the patient’s tibial bone B, and an operative side 24 for facing away from the patient’s tibial bone B. In the present embodiment, the bone-contacting surface 22 is configured to be positioned directly on the patient’s tibial bone B, and has contours complementary in shape to the surface contours of a predetermined area of the patient’s tibial bone B. In this configuration, the bone-contacting surface 22 abuts against the patient’s tibial bone in a single and predetermined position and orientation. It is therefore keyed into a specific positioning of the primary surgical module 20 on the patient’s tibial bone B. The bone-contacting surface 22 perfectly matches the contours of the patient’s tibial bone surface in the single and predetermined position and orientation of the primary surgical module 20. In the present embodiment, the bone-contacting surface 22 includes a solid surface, however it is appreciated that other configurations are possible. For example, the surface can be defined by an open lattice, and can comprise edges conforming to the contours of the patient’s tibial bone B. The operative side 24 is provided opposite the bone-contacting surface 22 and includes a variety of components for interacting with surgical tools, as will be described in more detail hereinafter.

[0081] For the TTO, the primary surgical module 20 is configured to be positioned adjacent to a tibial tuberosity T of the patient’s bone B. In the present embodiment, the primary surgical module 20 has a section located on a medial side and another section located on a proximal side, i.e. closer to a tibial plateau, of the tibial tuberosity T. It is appreciated that, in an alternative embodiment, the primary surgical module 20 can have a section located on a lateral side of the tibial tuberosity T.

[0082] In the present embodiment, the body of the primary surgical module 20 can be subdivided into at least three sections, including an anchoring portion 26, a primary cutting portion 28, and a proximal cutting portion 30. The anchoring portion 26 is configured for securing the primary surgical module 20 to the patient’s tibial bone and more particularly, to abut against a lateral or medial surface of the patient’s tibial bone B. In the non-limitative embodiment shown, the anchoring portion 26 abuts against the medial surface of the patient’s tibial bone B.

[0083] In the present embodiment, the anchoring portion 26 includes a flange with three fastener-receiving apertures 44 extending therethrough. Each one of the fastenerreceiving apertures 44 is opened on the bone-contacting surface 22 and accessible through the operative side 24. Therefore, the primary surgical module 20 is secured to the patient’s tibial bone B via mechanical fasteners 46 inserted into the fastener-receiving apertures 44 of the anchoring portion 26. As shown in Figure 8, the mechanical fasteners 46 can include surgical screws although it is appreciated that other types of mechanical fasteners are also possible. The screws 46 are engaged in the patient’s tibial bone B through the fastener-receiving apertures 44. The fastener-receiving apertures 44 can include sidewalls at a specified angle. In this fashion, the mechanical fasteners 46 drilled into the patient’s tibial bone B through the fastener-receiving apertures 44 can be guided into a predetermined position and orientation such that they can secure the primary surgical module 20 to the patient’s tibial bone B in an optimal fashion, and such that the mechanical fasteners 46 will not interfere with tools used during subsequent steps of the TTO procedure. The sidewalls of the fastener-receiving apertures 44 on the operative side 24 can further be configured to abut against a head of the mechanical fasteners 46 to block the mechanical fasteners 46 from being inserted too deep into the patient’s tibial bone B.

[0084] In the present embodiment, three fastener-receiving apertures 44 are provided for securing the primary surgical module 20 to the patient’s tibial bone B via the same number of mechanical fasteners 46 at strategic locations. It is appreciated, however, that in other embodiments, a different number of fastener-receiving apertures 44 and mechanical fasteners 46 can be provided, and that they can be positioned and oriented differently depending on the patient’s specific anatomy and according to the planned procedure. Moreover, it is appreciated that different sized mechanical fasteners 46 can be used and that the fastener-receiving apertures 44 can be sized and shaped accordingly. Finally, although the mechanical fasteners 46 are guided by the fastener-receiving apertures 44 in the present embodiment, it is appreciated that other screw-guiding (or fastener-guiding) mechanisms are possible in other embodiments.

[0085] As mentioned above, the surgical kit 100 comprises a plurality of modules to guide various surgical tools used throughout the TTO procedure. Each module can perform a different function for assisting with various tasks throughout a TTO procedure. Some modules can form integral parts of the primary surgical module 20 secured directly to the patient’s tibial bone B, whereas other modules can be independent components which can be removably engaged with relative to the patient’s tibial bone B by a detachable attachment to the primary surgical module 20. Although a particular set of modules will be described in detail hereinafter, it is appreciated that other modules and combinations thereof are possible depending on the requirements of the surgical procedure. Moreover, although some modules are described as performing particular functions, it is appreciated that some modules can perform two or more functions and / or have other advantages or uses not explicitly described herein, but that would be readily understood by a person of skill in the art upon reading the present disclosure.

[0086] Primary Surgical Module

[0087] As mentioned above, in addition to the anchoring portion 26, the primary surgical module 20 includes the primary cutting portion 28 and the proximal cutting portion 30.

[0088] The primary cutting portion 28 defines a primary or coronal cutting plane and the proximal cutting portion 30 defines a proximal cutting plane respectively. Each one includes a portion of the bone-contacting surface 22 which abuts the bone surface and follows its contours in the single and predetermined position and orientation.

[0089] In the non-limitative embodiment shown, the primary cutting portion 28 includes two cutting-slot defining walls 38a extending outwardly and defining therebetween a primary cutting tool receiving slot 36. The primary cutting tool receiving slot 36 is opened on the bone-contacting surface 22 and accessible through the operative side 24. The primary cutting tool receiving slot 36 is elongated and straight and is aligned to cut through the patient’s tibial bone B substantially along a coronal plane thereof and, more particularly, from the medial side thereof in the non-limitative embodiment shown.

[0090] Therefore, the coronal cutting plane of the primary cutting portion 28 is defined by the two cutting-slot defining walls 38a. However, it is appreciated that, in an alternative embodiment, which will be described in more details below in reference to Figures 33 to 39, the coronal cutting plane can be defined by a single surface against which the surgical cutting tool is abutted while a cut is performed through the patient’s tibia B. By following the coronal cutting plane, a bone cut is created into the patient’s bone, under the tibial tuberosity T, along a coronal cutting plane, coplanar with the coronal cutting plane of the primary cutting portion 28.

[0091] Similarly, in the non-limitative embodiment shown, the proximal cutting portion 30 includes two cutting-slot defining walls 38b extending outwardly and defining therebetween a proximal cutting tool receiving slot 37. The proximal cutting tool receiving slot 37 is opened on the bone-contacting surface 22 and accessible through the operative side 24. The proximal cutting tool receiving slot 37 is elongated and straight and is aligned to cut through the patient’s tibial bone B substantially along the transverse plane. In the embodiment shown, the proximal cutting tool receiving slot 37 extends substantially perpendicular to the primary cutting tool receiving slot 36 from an upper end thereof, i.e. proximal to the knee / tibial plateau / proximal tibia. In the non-limitative embodiment shown, the proximal cutting tool receiving slot 37 extends from an intersection with the primary cutting tool receiving slot 36 located on the medial side towards the lateral side of the tibia B.

[0092] Therefore, the proximal cutting plane of the proximal cutting portion 30 is defined by the two cutting-slot defining walls 38b. However, it is appreciated that, in an alternative embodiment, which will be described in more details below in reference to Figures 33 to 39, the proximal cutting plane can be defined by a single surface against which the surgical cutting tool is abutted while a cut is performed through the patient’s tibia B. By following the proximal cutting plane, a bone cut is created into the patient’s bone, under the tibial tuberosity T, along a proximal cutting plane, coplanar with the proximal cutting plane of the proximal cutting portion 30.

[0093] In the embodiment shown, the primary cutting tool receiving slot 36 intersects with the proximal cutting tool receiving slot 37 in a manner such that the coronal (or primary) cutting plane and the proximal cutting plane defined by the two slots 36, 37 and the coronal cutting plane and the proximal cutting plane defined by the cuts made through the patient’s tibia B intersect.

[0094] In the non-limitative embodiment shown, at the intersection of the proximal cutting tool receiving slot 37 and the primary cutting tool receiving slot 36, i.e. at the intersection of the primary cutting portion 28 and the proximal cutting portion 30, the surgical kit 100 includes a resection predrilling module 39, which will be described in further details below.

[0095] It is appreciated that, in an alternative embodiment (not shown), the surgical kit 100 can be free of resection predrilling module 39, as shown in Figures 5 and 6.

[0096] Turning now to Figures 4 and 6, there is shown that, once the primary surgical module 20 is secured to the tibial bone B in the predetermined position and orientation, using mechanical fasteners 46 inserted in the fastener-receiving apertures 44, a cutting tool 47 can be inserted in the primary cutting tool receiving slot 36 to perform a bone cut substantially aligned with the coronal plane. More particularly, the cutting tool 47, such as the exemplified surgical saw, creates a planar cut surface 33 (Figures 15 and 18) along the coronal plane in the patient’s tibial bone B, the coronal cut surface 33 being co-planar with the coronal cutting plane of the primary surgical module 20.

[0097] The cutting tool 47 can slide in and out of the primary cutting tool receiving slot 36, while sidewalls 38a around the slot 36 constrict the movement of the cutting tool 47 to the correct position and angle to form the desired cut. As shown in Figures 4 to 6, the primary surgical module 20 can include visual indications 48, provided thereon (such as by printing or engraving), to further help guide the surgeon during resection. For instance, the visual indications 48 regarding the insertion depth (e.g. a depth limitation indicator) can be provided along a length of the primary cutting tool receiving slot 36 (or the coronal cutting plane). These visual indications 48 can correspond to visual indications provided on the cutting tool 49. It is appreciated that the primary surgical module 20 can be free of visual indications 48 or the visual indications 48 can differ from the embodiment shown.

[0098] In addition and / or in alternative, the primary surgical module 20 can include another visual indicator 43 indicating to the surgeon in which section of the primary cutting tool receiving slot 36, a tip 47a of the cutting tool 47 can protrude outwardly of the tibia B, for instance on the lateral side of the tibia B if the cutting tool 47 is inserted from the medial side, as shown in the non-limitative embodiment of Figures 4 to 6, and in section of the primary cutting tool receiving slot 36 the cutting tool 47 must preclude from protruding outwardly of the tibia B. In the non-limitative embodiment of Figures 4 to 6, the cutting tool 47 must preclude from protruding outwardly of the tibia B in the section of the primary cutting tool receiving slot 36 adjacent to the proximal cutting tool receiving slot 37 starting from the visual indicator 43 and can protrude outwardly of the tibia B in the section distal from the proximal cutting tool receiving slot 37 starting from the visual indicator 43.

[0099] In some embodiments such as the one shown in Figures 19 to 21 , it is appreciated that the cutting tool 47 can protrude outwardly of the tibia B along an entire length of the primary cutting tool receiving slot 36, as will be described in more details below.

[0100] In between the visual indications 48, the primary surgical module 20 includes connecting apertures 76 defines therein. The purpose will be described in further details below. In the non-limitative embodiment shown, the primary surgical module 20 includes two spaced-apart connecting apertures 76 but it is appreciated that the number and position can vary from the embodiment shown. Central axes of the connecting apertures 76 are substantially aligned with the sagittal axis of the body.

[0101] Similarly, the cutting tool 47 can slide in and out of the proximal cutting tool receiving slot 37, while sidewalls 38b around the slot 37 constrict the movement of the cutting tool 47 to the correct position and angle to form the desired proximal (or transversal) cut surface 34 (Figures 15 and 18) extending substantially along the transverse plane.

[0102] Predrilling Module(s)

[0103] As mentioned above, the surgical kit 100 can include one or more predrilling module, such as the resection predrilling module 39.

[0104] In an embodiment (not shown), the predrilling module(s) can be provided to assist in creating drill holes in the patient’s tibial bone B in preparation for forming a cut therein, through the primary cutting tool receiving slot 36 and / or the proximal cutting tool receiving slot 37. In the present embodiment, the predrilling module(s) can be removably secured to the body of the primary surgical module 20 such as by clipping at a predetermined position on the primary surgical module 20. In an embodiment, they can be mounted to the primary surgical module 20 via severable connectors extending in between and the predrilling module(s) can be removed from primary surgical module 20 by severing the connectors. In another embodiment, they can be removably engageable together. It is appreciated that other connection mechanisms are possible to secure and position the predrilling module(s) relative to the patient’s tibial bone B and detachably engaged with the primary surgical module 20, such as mechanical fasteners.

[0105] Such as predrilling module(s) can include a plurality of predrill guides, such as guide barrels, for cooperating with corresponding drill bits to guide a position, depth, and angle thereof to form drill holes in the patient’s tibial bone B in a predetermined configuration. The guide barrels can extend from an operative side of the predri II ing module to an opposite side contacting or adjacent to the operative side 24 of the primary surgical module 20. Thus, the guide barrels extend along a lengthwise axis. Each one of the guide barrels defines a hollow interior in the form of a guide tunnel opened / accessible at both ends. The guide tunnels are sized and shaped to receive a corresponding drill bit therein, allowing the drill bit to slide in and out of the tunnels, while sidewalls of barrels constrain movement of the drill bit to a predetermined depth, position, and orientation relative to the patient’s tibial bone. When the predrilling module(s) are engaged with the primary surgical module 20, the guide tunnels are aligned and in communication with a respective one of the primary cutting tool receiving slot 36 and the proximal cutting tool receiving slot 37. Therefore, when a drill bit is engaged in a respective one of the tunnels, it can continuously be inserted into the corresponding one of the primary cutting tool receiving slot 36 and the proximal cutting tool receiving slot 37 to drill into the patient’s tibial bone B.

[0106] As it is known in the art, the length of the guide barrels can be determined to control the insertion of the drill bit inside the bone, i.e. the penetration depth of drill bit into the patient’s tibial bone B. Accordingly, for a same drill bit length, a longer guide barrel results in a shallower bone penetration depth of drill bit, and a shorter guide barrel results in a deeper bone penetration depth. Similarly, the position and orientation of the guide barrels define the position and orientation at which the drill bit penetrates the patient’s tibial bone B.

[0107] The predrill guides are configured for cooperating with a drill bit, which can be a calibrated drill bit having a fixed operative length. The guide barrels of the drill guides are positioned and arranged to create drill holes in a predefined pattern to weaken the patient’s tibial bone B in preparation for a planar cut via the primary cutting tool receiving slot 36 and the proximal cutting tool receiving slot 37. More specifically, the predrill guides can be positioned and oriented in a co-planar, parallel arrangement to define parallel drill holes in the patient’s tibial bone B in a common plane. In an embodiment, the number of predrill guides is selected such as a length of the predrill guide row substantially corresponds to a length of the primary cutting tool receiving slot 36 and the proximal cutting tool receiving slot 37 respectively. Referring now to Figures 1 and 2, another type of predri II ing module is described. More particularly, the resection predrilling module 39 of the surgical kit 100 is configured to be aligned with the primary cutting tool receiving slot 36 and the proximal cutting tool receiving slot 37 at their intersection (or at the corner junction). The resection predrilling module 39 extends outwardly from the operative side 24 of the primary surgical module 20 and is connected thereto via a plurality of severable connectors 41 . The resection predril ling module 39 includes a tubular wall 40 delimiting a drill receiving channel 42. The drill receiving channel 42 is aligned with the proximal cutting tool receiving slot 37 and the primary cutting tool receiving slot 36 at the intersection thereof. Therefore, as shown in Figures 7 and 8, a drilling bit 56 can be inserted continuously into the drill receiving channel 42, the proximal cutting tool receiving slot 37 and the primary cutting tool receiving slot 36, and into the tibia B onto which the primary surgical module 20 is mounted to. As shown in Figures 7 and 8, the drill bit 56 can be a calibrated drill bit including a stopper 57 limiting an insertion depth thereof by abutting against the resection predrilling module 39. Creating a drill hole inside the tibia B at the intersection of the primary cutting tool receiving slot 36 and the proximal cutting tool receiving slot 37 weakens the tibia B and ensures that the cuts made through the tibia B via slots 36, 37 are connected, i.e. continuous.

[0108] Following drilling of the tibia B with the resection predrilling module 39, the resection predrilling module 39 can be detached from the primary surgical module 20. In the non-limitative embodiment shown, the resection predrilling module 39 can be detached by cutting the severable connectors 41 therebetween with a severing tool (such as cutting pliers, a saw, or scissors, for example). Figure 9 shows the primary surgical module 20 once the resection predrilling module 39 is detached therefrom.

[0109] It is appreciated that the detachable connection between the resection predrilling module 39 and the primary cutting module 20 can differ from the several connectors shown. For instance and without being limitative, the resection predrilling module 39 can be clippable onto the primary surgical module 20 and, thereby, being selectively engageable / disengeable therewith.

[0110] Then, once the resection predrilling module 39 is detached the primary cutting module 20, a cutting tool 58, such as the exemplified osteotome shown in Figure 10, can be inserted into the proximal cutting tool receiving slot 37 to create a bone cut aligned therewith. The planar bone cut created by inserting the cutting tool 58 through the proximal cutting tool receiving slot 37 is substantially aligned with the transversal plane, as mentioned above.

[0111] The cutting tool 58 can slide in and out of the proximal cutting tool receiving slot 37, while sidewalls 38b around the slot 37 constrict the movement of the cutting tool 58 to the correct position and angle to form the desired cut.

[0112] Sagittal Guide Module

[0113] Referring to Figures 11 to 13, the surgical kit 100 can further include a sagittal guide module 90 detachably engageable with the primary surgical module 20. In the non-limitative embodiment shown, the sagittal guide module 90 is detachably engageable with the proximal cutting portion 30. When the sagittal guide module 90 and the primary surgical module 20 are engaged together, the sagittal guide module 90 is positioned at a single and predetermined position and orientation with respect to the patient’s tibia B.

[0114] The sagittal guide module 90 includes a proximal portion 92 and a sagittal cutting portion 94. The proximal portion 92 defines an insertion box with a recess (not shown) accessible from a bone-facing side 93 thereof. The proximal cutting portion 30 of the primary surgical module 20 is engageable in the recess of the sagittal guide module 90 to mount the sagittal guide module 90 to the primary surgical module 20. When the proximal cutting portion 30 is at least partially inserted in the recess of the sagittal guide module 90, the insertion box at least partially surrounds the proximal cutting portion 30. When the primary surgical module 20 and the sagittal guide module 90 are engaged together, the proximal portion 92 extends substantially parallel to the proximal cutting portion 30 of the primary surgical module 20.

[0115] The sagittal cutting portion 94 extends at a non-void angle with the proximal portion 92. It includes two cutting-slot defining walls 98 extending defining therebetween a sagittal cutting tool receiving slot 96. The sagittal cutting tool receiving slot 96 is opened on the bone-facing side 93 and accessible through an operative side 95 of the sagittal guide module 90. The sagittal cutting tool receiving slot 96 is elongated and straight and is aligned to cut through the patient’s tibial bone B along a plane extending along an anterior-posterior axis. The sagittal cutting tool receiving slot 96 is spaced-apart from the cut performed with the primary cutting tool receiving slot 36. In the non-limitative embodiment shown, the primary cutting tool receiving slot 36 is located on the medial side of the tibia B while the sagittal cutting tool receiving slot 96 is located on a lateral side thereof. However, it is appreciated that, in an alternative embodiment (not shown), the primary cutting tool receiving slot 36 can be located on the lateral side of the tibia B and the sagittal cutting tool receiving slot 96, on the medial side thereof.

[0116] In the non-limitative embodiment shown, the sagittal cutting tool receiving slot 96 defines an obtuse angle with the proximal cutting tool receiving slot 37.

[0117] In the non-limitative embodiment shown in Figure 11 , the sagittal cutting tool receiving slot 96 is opened at a distal end thereof, i.e. the end opposed to the end connecting with the proximal portion 92.

[0118] The sagittal cutting tool receiving slot 96 is configured in a manner such that the sagittal bone cut surface 35 (Figures 15 and 18) created therewith extends downwardly, i.e. away from the knee / tibial plateau / proximal tibia, starting from an end of the cut created with the proximal cutting tool receiving slot 37. The cut surfaces 33, 34 made with the proximal cutting tool receiving slot 37 and the sagittal cutting tool receiving slot 96, through the patient’s tibia B intersects.

[0119] In the embodiment shown, along a longitudinal axis, the sagittal cutting tool receiving slot 96 is shorter in length than the primary cutting tool receiving slot 36. Therefore, the bone cut performed with the sagittal cutting tool receiving slot 96 is shorter in length than the bone cut performed with the primary cutting tool receiving slot 36.

[0120] In some embodiments, a distal end of the sagittal cutting tool receiving slot 96 is substantially aligned with the visual indicator 43. The sagittal cutting tool receiving slot 96 is aligned with a section of the primary cutting tool receiving slot 36 along which the cutting tool 47 must preclude from protruding outwardly of the tibia B.

[0121] The bone-facing side 93 can be spaced-apart from the bone surface, can match and conform to the contours of the bone surface onto which it is superposed or can be a combination thereof. Therefore, the bone-facing side 93 of the sagittal guide module 90 does not compulsorily contact and conforms to the bone surface.

[0122] Referring now to Figure 12, there is shown that, in the non-limitative embodiment shown, the bone-facing side 93 of the sagittal cutting portion 94 of the sagittal guide module 90 matches and conforms to the contours of the bone surface onto which it is superposed. In turn, the bone-facing side 93 of the proximal portion 92 of the sagittal guide module 90 is spaced-apart from the bone surface. More particularly, the bone-facing side 93 of the proximal portion 92 includes a concavity 91 configured to receive the patella tendon of the patient when the sagittal guide module 90 is engaged with the primary surgical module 20 mounted to the patient’s tibial bone B, i.e. the sagittal cutting portion 94 of the sagittal guide module 90 is configured to bridge the patellar ligament.

[0123] When the sagittal guide module 90 is mounted to the primary surgical module 20, a cutting tool 99, such as the exemplified osteotome shown in Figure 13, can be inserted into the sagittal cutting tool receiving slot 96 to create a bone cut aligned therewith. The planar bone cut created by inserting the cutting tool 99 through the sagittal cutting tool receiving slot 96 extends in a plane defined between an anterior location to a posterior location. The cutting tool 99 can slide in and out of the sagittal cutting tool receiving slot 96, while sidewalls 98 around the slot 96 constrict the movement of the cutting tool 99 to the correct position and angle to form the desired cut.

[0124] Once the bone cut is performed, the sagittal guide module 90 can be detached and removed from the primary surgical module 20.

[0125] It is appreciated that the sagittal guide module 90 can be detachably mounted to the primary surgical module 20 by other connecting means than complementary male-female members shown in the Figures and described above. For instance and without being limitative, the sagittal guide module 90 mounted to the primary surgical module 20 using mechanical fasteners, severable or detachable connectors, and the like.

[0126] The cutting tools 47, 58, 99 can be the same cutting tools or different ones. Furthermore, they can differ from the one shown in the non-limitative examples of the Figures.

[0127] Visual indication(s) related to the insertion depth can be provided along a length of the sagittal guide module 90 and, more particularly, along the sagittal cutting tool receiving slot 96 to guide the surgeon during surgery.

[0128] It is appreciated that, in an alternative example such as the one shown in Figures 19 to 21 , the surgical kit 100 can be provided free of sagittal guide module 90.

[0129] Using the primary cutting tool receiving slot 36, the proximal cutting tool receiving slot 37, and the sagittal cutting tool receiving slot 96, planar cut surfaces 33, 34, 35 were created along a coronal (or primary) cutting plane, a proximal (transverse) cutting plane, and a sagittal cutting plane respectively. In the non-limitative embodiment shown, the coronal cutting plane and the sagittal cutting plane are located respectively on a medial side and a lateral side of the patient’s tibia.

[0130] Thus, the primary cutting tool receiving slot 36, the proximal cutting tool receiving slot 37, and the sagittal cutting tool receiving slot 96 (if any) assist in cutting the patient’s tibial bone B. They define cutting tool guides for guiding a corresponding cutting tool (such as and without being limitative a surgical saw or an osteotome) to cut the patient’s tibial bone B at predetermined position, orientation and / or depth and to create a planar cut in the patient’s tibial bone B in the area, which can have been pre-weakened by the drill holes formed using the predrilling module(s), as described above.

[0131] The coronal cut surface 33, the proximal (or transverse) cut surface 34, and the sagittal cut surface 35 are intersecting planar surfaces delimitating a tibial tubercle fragment 80 (Figures 15 and 16), also referred to as tuberosity or tubercle, having substantially a triangular shape and pivotable about a hinge portion 82, i.e. the tibial tubercle fragment 80 is still connected to a remaining portion of the tibial bone B.

[0132] It is appreciated that, in an alternative embodiment (not shown), the tibial tubercle fragment 80 can be entirely detached from the tibial bone B.

[0133] Referring now to Figures 2 and 14, there is shown that the primary surgical module 20 includes a tubercle realignment guide 50. The tubercle realignment guide 50 includes a tubercle displacement platform 52, which is substantially planar, and a tubercle abutting wall 54, which is located at an inner end of the tubercle displacement platform 52. In the embodiment shown, the tubercle displacement platform 52 is coplanar with the coronal cutting plane and / or the primary cutting tool receiving slot 36 and / or the coronal cut surface 33.

[0134] The primary cutting tool receiving slot 36 opens at a junction of the tubercle displacement platform 52 and the tubercle abutting wall 54. The tubercle displacement platform 52 extends continuously, in a same plane, as one of the primary cutting-slot defining walls 38a. Therefore, when the cutting tool 47 is inserted in the primary cutting tool receiving slot 36, it slides along the tubercle displacement platform 52. Together, the primary cutting-slot defining wall 38a and the tubercle displacement platform 52, which are co-planar, defines the coronal cutting plane. Furthermore, the coronal cut surface 33, opposed to an inner surface of the tibial tubercle fragment 80 and defined by the coronal cutting plane, is aligned and co-planar with the tubercle displacement platform 52. The inner surface of the tibial tubercle fragment 80 is slidable (or translatable) along the tubercle displacement platform 52.

[0135] The tubercle abutting wall 54 limits the displacement of the tibial tubercle fragment 80 along the tubercle displacement platform 52. Therefore, its post-surgery position and orientation are predetermined in accordance with a surgical planning (or preoperative plan). In an embodiment, the shape / the contours of the tubercle abutting wall 54 conforms / matches the shape / contours of a portion of the tibial tubercle fragment 80 abutting thereon when the predetermined tubercle position and orientation, according to the preoperative plan, is reached.

[0136] Referring now to Figure 15, there is shown the primary surgical module 20, wherein the tibial tubercle fragment 80 has been translated / displaced along the tubercle displacement platform 52 until it abuts against the tubercle abutting wall 54 and has reached the predetermined tubercle position and orientation.

[0137] For its displacement along the tubercle displacement platform 52, the tibial tubercle fragment 80 is pivoted about the hinge portion 82. It is appreciated that, if the tibial tubercle fragment 80 is detached from a remaining portion of the tibial bone B, the tibial tubercle fragment 80 can be slid along the tubercle displacement platform 52. The complementary (or matching) contours between the tibial tubercle fragment 80 and the tubercle abutting wall 54 ensures that the tibial tubercle fragment 80 is positioned at the predetermined tubercle position and orientation.

[0138] Displacement Validator

[0139] With reference now to Figures 16 and 17, the surgical kit 100 can further include a displacement validator 60 (or validation tool) for validating the displacement of the tibial tubercle fragment 80 and its position / orientation respective to the predetermined tubercle position and orientation by validating a size and / or a shape of an exposed section of the coronal cut surface 33. In the non-limitative embodiment shown, the exposed section of the coronal cut surface 33 corresponds to an opening 81 formed between the remaining patient’s tibial bone B, i.e. the proximal and the sagittal cut surfaces 34, 35, and the displaced tibial tubercle fragment 80, as shown in Figures 15 and 18. The opening 81 is located on a side of the tibial tubercle fragment 80 opposed to the side of the tibial tubercle fragment 80 abutted against the tubercle abutting wall 54 (or opposed to a displacement direction of the tibial tubercle fragment 80). As can be appreciated, the size and / or a shape of the opening 81 can be predetermined according to the preoperative plan. Although the tubercle abutting wall 54 can provide an indication that the tibial tubercle fragment 80 is configured in the predetermined tubercle position and orientation according to the preoperative plan, the displacement validator 60 can provide an additional confirmation as to whether the tibial tubercle fragment 80 has been displaced to attain the desired predetermined tubercle position and orientation. Accordingly, the displacement validator 60 is provided to directly measure the opening 81 formed between the remaining patient’s tibial bone B and the displaced tibial tubercle fragment 80.

[0140] In the present embodiment, the displacement validator 60 is a patient-specific tool designed to match the anatomy of the patient’s tibial bone B. More specifically, the displacement validator 60 is shaped and configured to fit snugly in the opening 81 formed between the remaining patient’s tibial bone B and the displaced tibial tubercle fragment 80 based on the expected shape thereof as determined according to a preoperative plan. During the surgical procedure, once the tibial tubercle fragment 80 is configured in a position corresponding to the predetermined tubercle position and orientation and the opening 81 is formed, the displacement validator 60 can be inserted into the opening 81 . A snug fit of the displacement validator 60 can confirm that the correct tubercle displacement has been made and that the tibial tubercle fragment 80 is in the predetermined tubercle position and orientation, whereas an incorrect fit can indicate that an adjustment of tubercle position is necessary. It is appreciated that other mechanisms for validating the tubercle position are also possible.

[0141] As shown in Figures 16 and 17, the displacement validator 60 includes a unitary body 61 , made from a rigid, biocompatible material. In the present embodiment, the body 61 is made from a 3D printed plastic, although it is appreciated that other materials are possible, and that the displacement validator 60 can be made using other custom manufacturing processes. The body 61 includes a handle end 63 and an operative end 65.

[0142] Handle end 63 is configured to facilitate manipulation of the displacement validator 60 during the surgical procedure. It is appreciated, however, that other interfaces for manipulating the displacement validator 60 are also possible. In the present embodiment, the handle end 63 has a substantially trapezoidal-shaped profile. It is appreciated, however, that other shapes of handle end 63 are also possible.

[0143] The operative end 65, better shown in Figure 16a, is configured to engage with the opening 81 formed in the patient’s tibial bone B, when the tibial tubercle fragment 80 has been displaced to attain the predetermined tubercle position and orientation. More specifically, the operative end 65 comprises a substantially triangular element sized and shaped to fit in the opening 81 . The operative end 65 is shaped to conform to the contour of interior surfaces of the patient’s tibial bone B formed by the two planar cuts along the proximal cutting plane and the sagittal cutting plane and a surface of the tibial tubercle fragment 80, opposed to the side of the tibial tubercle fragment 80 abutted against the tubercle abutting wall 54. Any mismatch between the surfaces of the operative end 65 of the displacement validator 60 and the surfaces of the patient’s tibial bone B can indicate that adjustment of the position of the tibial tubercle fragment 80 is required.

[0144] As can be appreciated, the displacement validator 60 can be used to assure that the position / orientation of the tibial tubercle fragment 80 corresponds to the predetermined tubercle position and orientation before proceeding with subsequent steps of the procedure. For example, it can confirm the position / orientation of the tibial tubercle fragment 80 prior to securing the tibial tubercle fragment 80 to the remaining portion of the tibia B, as will be described below. As another example, as illustrated in Figures 18 to 29, the displacement validator 60 can confirm the position / orientation of the tibial tubercle fragment 80 prior to attaching a bone-fastener predrilling module 70, such that fastener holes can be drilled in the tibial tubercle fragment 80 and the patient’s tibial bone B after the tibial tubercle fragment 80 has been displaced to the predetermined tubercle position and orientation.

[0145] Still referring to Figures 16 and 17, the body 61 of the tibial tubercle fragment 80 can include a k-wire receiving channel 62 extending longitudinally therethrough, the channel 62 being opened at both ends of the body 61 with a first end located at the handle end 63 and a second end located at the operative end 65. As shown in Figures 16 and 17, a k-wire 68 can be inserted into the channel 62 and into the patient’s tibial bone B to temporary attach the displacement validator 60 to the patient’s bone B.

[0146] Turning now to Figures 19 to 21 , there is shown an alternative embodiment of the displacement validator 60 wherein the features are numbered with reference numerals in the 400 series which correspond to the reference numerals of the previous embodiment. As mentioned above, the tibial tubercle fragment 80 is free of planar cut surface along the sagittal plane. The coronal and the proximal cuts are performed up to an outer surface 83 of the patient’s bone B. As the tibial tubercle fragment 80 is translated along the planar coronal cut surface 433, a section of the planar coronal cut surface 433 is exposed anteriorly.

[0147] As for the displacement validator 60, the displacement validator 460 is a patientspecific tool designed to match the anatomy of the patient’s tibial bone B and, more particularly, an exposed section of the planar coronal cut surface 433 following displacement of the tibial tubercle fragment 80 to the predetermined tubercle position and orientation. More specifically, the operative end 465 of the displacement validator 460 is shaped and configured to fit snugly in the exposed section 481 formed between the remaining patient’s tibial bone B and the displaced tibial tubercle fragment 80 based on the expected shape thereof as determined according to a preoperative plan. During the surgical procedure, once the tibial tubercle fragment 80 is configured in a position corresponding to the predetermined tubercle position and orientation and the exposed section 481 is formed, the displacement validator 460 is engaged with / superposed to the exposed surface 481. In addition to the exposed surface 481 , the displacement validator 460 can contact unresected sections of the tibial tubercle fragment 80 and / or the outer bone surface 83, adjacent to the exposed section 481 of the planar coronal cut surface 433. A snug fit between the displacement validator 460 and the contacted exposed surface 481 , an unresected surface 66 of tibial tubercle fragment 80 and / or the outer bone surface 83 can confirm that the correct tubercle displacement has been made and that the tibial tubercle fragment 80 is in the predetermined tubercle position and orientation, whereas an incorrect fit can indicate that an adjustment of tubercle position is necessary.

[0148] As for the above-described embodiment, the displacement validator 460 can include a unitary body 461 with a handle end 463 and the patient-specific operative end 465. The handle end 463 is similar to the handle end 63 and will not be described in further details.

[0149] The operative end 465, better shown in Figure 21 is configured to engage with at least a portion of the exposed surface 481 of the planar coronal cut surface 433 (formed in the patient’s tibial bone B), a portion of the unresected surface 66 of tibial tubercle fragment 80 and / or a portion of the outer bone surface 83, when the tibial tubercle fragment 80 has been displaced to attain the predetermined tubercle position and orientation. The shape of the portion of the unresected surface 66 of tibial tubercle fragment 80 and the portion of the outer bone surface 83, as well as the dimension and shape of the contacted exposed surface 481 , adjacent thereto, are patient’s specific and only matches with the shape of the operative end 465 when the tibial tubercle fragment 80 is in the predetermined tubercle position and orientation. More specifically, the operative end 465 is shaped to conform to the contour of the patient’s tibial bone B formed by adjacent portions of the exposed surface 481 of the planar coronal cut surface 433, the unresected surface 66 of tibial tubercle fragment 80 and / or the outer bone surface 83. Any mismatch between the surfaces of the operative end 465 of the displacement validator 460 and these surfaces can indicate that adjustment of the position of the tibial tubercle fragment 80 is required. Bone-fastener predrilling Module

[0150] With reference to Figures 18 to 20, the surgical kit 100 can further include a bonefastener predrilling module 70 for predri Hing holes in the tibial tubercle fragment 80 and the patient’s tibial bone B for eventually receiving surgical fasteners to secure the tibial tubercle fragment 80 to the patient’s tibial bone B at the predetermined tubercle position and orientation. In the embodiment shown in Figures 23 and 25, the bone-fastener predrilling module 70 can be engaged with the primary surgical module 20 once the displacement validator 60 is disengaged from the tibia B. In an alternative embodiment, which will be described below in reference to Figures 26 and 27, the displacement validator 60 can remain positioned between the tibial tubercle fragment 80 and the patient’s tibial bone B and the bone-fastener predrilling module 170 can be connected to both the primary surgical module 20 and the displacement validator 60.

[0151] The bone-fastener predrilling module 70 can be patient-specific in that it is custom made according to the anatomy of the patient’s tibial bone B and according to a preoperative plan. In this fashion, the bone-fastener predrilling module 70 can be configured to precisely fit on a predetermined position and orientation of the patient’s tibial bone B to assure proper alignment, and to assist in drilling holes in the patient’s tibial bone B in predetermined positions, orientations and depths.

[0152] In the illustrated embodiment, the bone-fastener predrilling module 70 comprises a body 72 with a surgical module mounting portion 73 and a drilling portion 74. The body 72 further includes a bone-facing side 71 and an operative side 77. The surgical module mounting portion 73 includes two spaced-apart pins 75 (or male connectors) protruding from a bone-facing side 71 of the body 72. The pins are engageable in the connecting apertures 76 (or female connectors) defined in the primary surgical module 20 to detachably engage the bone-fastener predrilling module 70 to the primary surgical module 20. As the primary surgical module 20 is mounted to the tibia B in the predetermined position and orientation, the bonefastener predrilling module 70 is also mounted to the bone in a predetermined position and orientation according to the preoperative planning. In the non- limitative embodiment shown, the anchor portion 26 extends along one side of the primary cutting portion 28 and the drilling portion 74 of the bone-fastener predrilling module 70 is located on an opposed side of the primary cutting portion 28 when engaged with the primary surgical module 20.

[0153] The surgical module mounting portion 73 provides both the functions of securing and aligning the bone-fastener predrilling module 70 relative to the tibial tubercle fragment 80 and the patient’s tibial bone B, it is appreciated that in other embodiments, different mechanisms can be provided to align and / or to secure the bone-fastener predrilling module 70, and that separate mechanisms can be provided to respectively perform the alignment or attachment functions. For example, in some embodiments, the bone interface side 71 of the bone-fastener predrilling module 70 can be shaped to have contours complementary in shape to the contours of a specific area of the patient’s tibial bone B and / or the tibial tubercle fragment 80.

[0154] The drilling portion 74 includes two drill barrels 78, spaced-apart from one another, and located above (or anteriorly to) the tibial tubercle fragment 80 when the bonefastener predrilling module 70 is engaged with the primary surgical module 20. Each one of the drill barrels 78 has a drill channel 79 extending continuously therethrough, along a lengthwise axis, extending from the bone-facing side 71 to the operative side 77 and opened on both sides 71 , 77.

[0155] In the embodiment shown, the drill barrels 78 on the operative side 77 are located close to the tibial tubercle fragment 80 when the bone-fastener predrilling module 70 is engaged with the primary surgical module 20, without compulsorily engaging it or conforming to it.

[0156] In a first embodiment, when the bone-fastener drilling module 70 is provided without drill sleeve, each one of the drill barrels 78 defines a predrill guide for receiving and guiding corresponding drill bits through the tibial tubercle fragment 80 and the tibia B. The drill channels 79 extend at a predetermined angle and they are sized and shaped in accordance with the size and the shape of the corresponding drill bit to be received therein. The sidewalls of the barrels 78 delimitating the channels 79 constrain movement of the drill bit to a predetermined depth, position, and / or orientation relative to the tibial tubercle fragment 80 and the patient’s tibial bone B. An abutting member on the drill bit can limit an insertion depth of an operative end of the drill bit into the channel 79 as it abuts with drill barrel 78 on the operative side 77. As can be appreciated, in this configuration, the length of drill barrel 78 can limit an insertion depth of a drill bit and assure the depth of drill holes formed therewith and the length of each drill channel can be selected to limit the insertion depth of the drill bit, creating drill holes with potentially different and predetermined depths. Similarly, diameters of each one of the drill channels 79 can be adjusted to accommodate drill bits of different diameters to create drill holes of different sized for accommodating different sizes of fasteners. The position and the orientation of drill channels 79 can be adjusted to define drill holes which extend at different angles and orientations.

[0157] The drill barrels 78 are configured to cooperate with a calibrated drill bit which can have a fixed operative length. The drill channels 79 of the drill barrels 78 are sized, positioned and oriented to create drill holes in a predefined pattern for receiving fasteners to secure the tibial tubercle fragment 80 to the patient’s tibial bone B. Based on the anatomy of the patient’s tibial bone B, the preoperative plan can define a configuration of fasteners, including size, depth, orientation, and position, such that the tibial tubercle fragment 80 can be affixed optimally. The drill barrels 78 can thus be configured to guide drill bits to form drill holes in preparation for receiving the configuration of fasteners defined in the preoperative plan.

[0158] Referring now to Figures 24 and 25, there is shown an alternative embodiment wherein the bone-fastener predrilling module 70 further includes one or more drill sleeves 84 removably engageable with the drill barrels 78 from the operative side. In the non-limitative embodiment shown, each one of the drill sleeves 84 is substantially tubular in shape with a proximal segment 85 at least partially engageable in a respective one of the drill channels 79 from the operative side 77 thereof and a distal segment 86 extending outwardly from the drill barrels 78 when the drill sleeve 84 is engaged with the drill barrels 78. Each one of the drill sleeves 84 includes a drill tunnel 87 extending lengthwise and open at both ends. In the non-limitative embodiment shown, an outer surface of the distal segment 86 is fluted to ease prehension while an outer surface of the proximal segment 85 is substantially smooth to ease insertion into the drill channels 79. A proximal end of the proximal segment 85 is serrated to contact and engage the tibial tubercle fragment 80 when inserted into the drill channels 79 of the drilling portion 74 of the body 72 of the bone-fastener predrilling module 70 mounted to the primary surgical module 20 mounted to the patient’s tibial bone B. The distal segment 86 has a greater outer diameter than the proximal segment 85 defining an annular shoulder 88 inbetween. The annular shoulder 88 can abut against a respective one of the drill barrels 78 when the proximal segment 85 is inserted in the respective one of the drill channels 79.

[0159] An outer diameter of the proximal segment 85 substantially corresponds to an inner diameter of the drill channels 79.

[0160] In a non-limitative embodiment, the drill sleeves 84 are made of surgically approved metal alloy.

[0161] In such embodiment, instead of the drill barrels 78, each one of the drill tunnels 87 of the drill sleeves 84 defines the predrill guide for receiving and guiding corresponding drill bits through the tibial tubercle fragment 80 and the tibia B. The drill tunnels 87 extend at a predetermined angle and they are sized and shaped in accordance with the size and the shape of the corresponding drill bit to be received therein. The sidewalls of drill sleeves 84 delimitating the drill tunnels 87 constrain movement of the drill bit to a predetermined depth, position, and orientation relative to the tibial tubercle fragment 80 and the patient’s tibial bone B. An abutting member on the drill bit can limit an insertion depth of an operative end of the drill bit into the drill sleeve 84 as it abuts with a distal end of the drill sleeve 84. As can be appreciated, in this configuration, the length of drill sleeve 84 can limit insertion depth of a drill bit and assure the depth of drill holes formed therewith and the length of each drill tunnel 87 can be selected to limit the insertion depth of the drill bit, creating drill holes with different predetermined depths. Similarly, diameters of each one of the drill tunnels 87 can be adjusted to accommodate drill bits of different diameters to create drill holes of different sized for accommodating different sizes of fasteners. The position and the orientation of drill tunnels 87 can be adjusted to define drill holes which extend at different angles and positions.

[0162] In such embodiment, the length and the diameter of the drill channels 79 are not selected in accordance with the drill bit and / or the drill hole to be performed in the tibial tubercle fragment 80 and the patient’s tibial bone B. The characteristics of the drill holes to be performed in the tibial tubercle fragment 80 and the patient’s tibial bone B are controlled by the characteristics such as the length and diameter of the drill tunnels 87. However, the position and the orientation of the drill holes, i.e. the drilling pattern, are still controlled with the drill barrel(s) 78 and the drill channel(s) 79 extending therealong.

[0163] Thus, in the embodiment wherein the bone-fastener drilling module 70 includes one or more drill sleeve 84, the drill sleeve(s) 84 are configured to cooperate with a calibrated drill bit which can have a fixed operative length. The drill tunnel(s) 87 of the drill sleeve(s) 84 are sized (diameter and length) to create drill holes for receiving fasteners to secure the tibial tubercle fragment 80 to the patient’s tibial bone B in accordance with the preoperative plan.

[0164] In an embodiment, the surgical kit 100 can include at least two drill sleeves 84, each one being characterized by a different drill tunnel diameter. A first one of the drill sleeves 84, characterized by a narrower drill tunnel diameter, can be first engaged with the predrilling module 70 to perform a first drill hole inside the tibial tubercle fragment 80 and the patient’s tibial bone B. Then, the first drill sleeve 84 can be disengaged from the bone-fastener predrilling module 70, and a second one of the drill sleeves 84, characterized by a larger drill tunnel diameter, can be engaged with the bone-fastener predrilling module 70 to perform a second drill hole, concentric with the first drill hole, inside the tibial tubercle fragment 80 and the patient’s tibial bone B. In an alternative embodiment, a first drill hole inside the tibial tubercle fragment 80 and the patient’s tibial bone B can be performed with a drill sleeve 84 engaged with the drill barrel(s) 78 of the bone-fastener predri II ing module 70. Once the first drill hole is created, the drill sleeve 84 can be disengaged from the predrilling module 70 and a second drill hole, concentric with the first drill hole and characterized by a larger diameter, can be performed by inserting the drill bit directly inside the drill channel 79 of the drill barrel 78.

[0165] Although in the illustrated embodiment the bone-fastener predrilling module 70 is configured to drill holes following to a change in the position of the tibial tubercle fragment 80 relative to the remaining portion of the patient’s tibial bone B, it is appreciated that the bone-fastener predrilling module 70 can be configured differently according to the requirements of the surgical procedure. For example, it can be configured to drill holes into the tibial tubercle fragment 80 before its position relative to the remaining portion of the patient’s has been surgically altered.

[0166] Referring now to Figures 26 and 27, there is shown an alternative embodiment of the bone-fastener predrilling module 70 wherein the features are numbered with reference numerals in the 100 series which correspond to the reference numerals of the previous embodiment. In such embodiment, the displacement validator 160 remains in contact with the tibia B, in the predetermined position, when the bonefastener predrilling module 170 is engaged with the primary surgical module 20. In addition to being removably engaged with the primary surgical module 20, the bone-fastener predrilling module 170 is removably engaged with the displacement validator 160, which can be temporarily attached to the tibia B via the k-wire inserted into the k-wire receiving channel 162 of the displacement validator 160.

[0167] In such embodiment, the displacement validator 160 includes a protruding tab 164 protruding laterally from the handle end 163. The protruding tab 164 has a connecting aperture 166 extending therethrough. The connecting portion 173 of the body 172 of the bone-fastener predrilling module 170 includes a pin 175, i.e. a male connector, removably engageable in the connecting aperture 166 of the displacement validator 160. Thus, the bonefastener predrilling module 170 is engaged with both the primary surgical module 20 and the displacement validator 160 for additional stability during the drilling process.

[0168] Once again, it is appreciated that the number and configuration of the drill barrels 178 can vary from the embodiment shown.

[0169] Referring now to Figures 28 and 29, there is shown the two non-limitative embodiments of the bone-fastener drilling module 70, 170 with drill sleeves 84 removably engaged with the drilling portion 74. 174. In Figure 29, the k-wire 68 is inserted into the k-wire receiving channel of the displacement validator 60 and drill bits 56 are inserted in both drill sleeves 84. Figure 29 shows that, even if the bonefastener drilling module 170 is detached from the displacement validator 60 during the drilling process, the displacement validator 60 can remain in contact with the tibia B to further stabilize the tibial tubercle fragment 80 in the predetermined tubercle position and orientation.

[0170] After drill holes are formed through the tibial tubercle fragment 80 and the patient’s tibial bone B, the bone-fastener predrilling module 70, 170 and the displacement validator 60, 160 can be removed. Mechanical fasteners, such as surgical screws, can be inserted in the drill holes to secure the tibial tubercle fragment 80 to the remaining portion of the patient’s tibial bone B in the predetermined tubercle position and orientation.

[0171] Turning now to Figures 30 to 32, there is shown an alternative embodiment of the bone-fastener predrilling module 70, 170 wherein the features are numbered with reference numerals in the 500 series which correspond to the reference numerals of the previous embodiment. The bone-fastener predrilling module 570 is similar to the bone-fastener predrilling module 70 except that the drill channels 579 are non-cylindrical to prevent rotation of the drill sleeves 584 when engaged therewith. In the non-limitative embodiment shown, each one of the drill channels 579 includes two planar surfaces 589a. As shown in Figure 32, the distal segment 586 of the drill sleeve 584 is complementary in shape and also includes two planar surfaces 589b. It is appreciated that the shape of the drill channel(s) 579 and the complementary distal segment 586 of the drill sleeve 584 can vary from the non- limitative embodiment shown. For instance, the drill channel(s) 579 and the complementary distal segment 586 of the drill sleeve 584 can include any other non-circular profile, e.g. only one planar surface. As for the above-described embodiment, the shape and the configuration of the bone-fastener predrilling module as well as the number of drill barrel 578 can vary from the embodiment shown.

[0172] Anchor Module

[0173] As mentioned above, the primary surgical module 20 acts an anchor module for other components of the surgical kit 100, including the sagittal guide module 90 and the bone-fastener predrilling module 70, 170, 570. It is appreciated that some of the additional modules of the surgical kit 100 including the sagittal guide module 90, the displacement validator 60, 160, 460, and / or the bone-fastener predrilling module 70, 170, 570 can be optional.

[0174] Since the sagittal guide module 90 and the bone-fastener predrilling module 70, 170, 570 are engaged with the primary surgical module 20 when mounted to the patient’s tibial bone, the positioning of the primary surgical module 20 ensures the positioning of the sagittal guide module 90 and the bone-fastener predrilling module 70, 170, 570 with respect to the patient’s tibial bone B and in accordance with the preoperative planning. As mentioned above, the primary surgical module 20 is provided with a patient’s specific bone contacting surface 22 which conforms to the patient’s tibial bone in a single position / orientation, thereby ensuring that it is secured to the patient’s tibial bone B in the predetermined position / orientation according to the preoperative planning. The primary surgical module 20 is affixed directly to the patient’s tibial bone B via fasteners 46 and comprises a module interface for interfacing with removable modules, such as the sagittal guide module 90 and the bone-fastener predrilling module 70, 170, 570. The anchor module thus acts as a secure base to which other modules can be removably attached, allowing the removable modules to be properly aligned relative to the patient’s tibial bone B at relevant steps during the surgical procedure. In the present embodiment, the module interface of the primary surgical module 20 includes the proximal cutting portion 30 and the connecting apertures 76, i.e. female connectors, for receiving corresponding pins 75 (or protrusions, i.e. male connectors) extending from a removable module, although it is appreciated that other removable connection interfaces are possible.

[0175] Referring now to Figures 33 to 36, there is shown an alternative embodiment of the primary surgical module 20 wherein the features are numbered with reference numerals in the 200 series which correspond to the reference numerals of the previous embodiment. In such embodiment, the primary cutting portion 228 and the proximal cutting portion 230 are provided with planar surfaces as the coronal and proximal cutting planes instead of the primary cutting tool receiving slot 36 and the proximal cutting tool receiving slot 37. Thus, the primary surgical module 220 includes a primary cutting tool supporting surface 236 and a proximal cutting tool supporting surface 237. Therefore, to create the bone cut, the cutting tool 47 abuts against the primary cutting tool supporting surface 236 and the proximal cutting tool supporting surface 237 respectively, which define the cutting planes.

[0176] Furthermore, the tubercle realignment guide 250 includes a substantially L-shaped guiding groove 251 defined in the primary cutting portion 228 and, more particularly, from the primary cutting tool supporting surface 236. The shape, position and orientation of the guiding groove 251 corresponds to the position / orientation of the tibial tubercle fragment 80 at the predetermined tubercle position and orientation. Thus, following its resection, the tibial tubercle fragment 80 is displaced along the primary cutting tool supporting surface 236 until the positions of two of its edges are aligned with the guiding groove 251 , as shown in Figure 39. In the embodiment shown, the primary cutting tool supporting surface 236 defines the tubercle displacement platform 252 of the tubercle realignment guide 250. The inner surface of the tibial tubercle fragment 80 is slidable along the tubercle displacement platform 252.

[0177] Turning now to Figures 37 and 38, there is shown an alternative embodiment for the sagittal guide module 290 which is detachably engaged with the primary surgical module 220 and, more particularly, the proximal cutting portion 230 thereof. As for the above-described embodiment, it includes a proximal portion 292 and a sagittal cutting portion 294. Engagement between the proximal portion 292 of the sagittal guide module 290 and the proximal cutting portion 230 of the primary surgical module 220 is similar to the one described above in reference to Figures 11 and 12 and will not be described in further details.

[0178] The sagittal cutting portion 294 extends at a non-void angle and, more particularly, an oblique angle with the proximal portion 292. It includes two cutting-slot defining walls 298 extending defining therebetween the sagittal cutting tool receiving slot 296, which is similar to the sagittal cutting tool receiving slot 96 and will not be described in further details.

[0179] Referring now to Figures 27 to 45, there is shown an alternative embodiment of the primary surgical module 20 wherein the features are numbered with reference numerals in the 300 series which correspond to the reference numerals of the previous embodiment. The primary surgical module 320 is designed to perform a multi-directional tibial tubercle displacement. As the above-described primary surgical modules 20, 220, the primary surgical module 320 includes a body having a bone-contacting surface 322 and an operative side 324. As for the abovedescribed embodiments, the bone-contacting surface 22 perfectly matches the contours of the patient’s tibial bone surface in the single and predetermined position and orientation. It also includes an anchoring portion 326 to secure the primary surgical module 320 to the patient’s tibial bone B at the single predetermined position and orientation. The primary surgical module 320 can be divided into a bone-contacting (or central) portion 334, a lateral portion 328, a medial portion 394, and a proximal portion 330, wherein the lateral and the medial portions 328, 394 are located on a respective side of the bone-contacting portion 334. In turn, the proximal portion extends above the central portion 334, i.e. closer to the patient knee joint. Each one of the lateral portion 328, the medial portion 394, and the proximal portion 330 protrudes anteriorly with respect to the central portion 334.

[0180] In the non-limitative embodiment shown, the anchoring portion 326 is located in the bone-contacting portion 334 and includes two peripheral tubular walls protruding outwardly on the operative side 324, i.e. they protrude anteriorly. Each one of the peripheral tubular walls defines a faster-receiving apertures 344 which extends through the primary surgical module 320. Each one of the fastenerreceiving apertures 344 is opened on the bone-contacting surface 322 and accessible through the operative side 324. Therefore, the primary surgical module 320 can be secured to the patient’s tibial bone B with mechanical fasteners 46 (Figures 42B, 43A, 43B, and 45) inserted into the fastener-receiving apertures 344 of the anchoring portion 326. As for the above-described embodiments, the mechanical fasteners 46 can include surgical screws although it is appreciated that other types of mechanical fasteners are also possible.

[0181] In the non-limitative embodiment shown, two fastener-receiving apertures 344 are provided for securing the primary surgical module 320 to the patient’s tibial bone B via the same number of mechanical fasteners 46 at strategic locations. It is appreciated, however, that in other embodiments, a different number of fastenerreceiving apertures 344 and mechanical fasteners 46 can be provided, and that they can be positioned and oriented differently depending on the patient’s specific anatomy and according to the planned procedure. Moreover, it is appreciated that different sized mechanical fasteners 46 can be used and that the fastenerreceiving apertures 344 can be sized and shaped accordingly. Finally, although the mechanical fasteners 46 are guided by the fastener-receiving apertures 344 in the present embodiment, it is appreciated that other screw-guiding (or fastenerguiding) mechanisms are possible in other embodiments.

[0182] Each one of the lateral portion 328, the medial portion 394, and the proximal portion 330 is provided with an outer planar surface defining respectively a lateral cutting plane, a medial cutting plane, and a proximal cutting plane. Thus, the primary surgical module 220 includes a lateral cutting tool supporting surface 336, a medial cutting tool supporting surface 396, and a proximal cutting tool supporting surface 337. Therefore, to create the bone cuts in the patient’s tibial bone B, the cutting tool 47 successively abuts and slides against the lateral, medial, and proximal cutting tool supporting surfaces 336, 396, 337, as shown in Figures 43A and 43B. Thus, the lateral cutting plane, the medial cutting plane, and the proximal cutting plane delimit a tibial tubercle fragment 80 (Figure 41 ), having substantially a triangular shape. In the non-limitative embodiment shown, the tibial tubercle fragment 80 is entirely detachable from the tibial bone B. Figure 45 shows the patient’s tibial bone without the tibial tubercle fragment with a cavity 83 formed therein. As for the above-described primary surgical modules, the primary surgical module 320 can be provided in a surgical kit 100 with modules to align and secure the tibial tubercle fragment 80 in the predetermined tubercle position and orientation, including validation tool(s).

[0183] As for the above-described embodiments, visual indicators visual can be provided on the primary surgical module 320 (such as by printing or engraving), to further help guide the surgeon during resection.

[0184] Preoperative Planning and Surgical Toolkit

[0185] As can be appreciated, the tools and guides described above can be provided as part of a surgical toolkit comprising generic and patient-specific components. In other word, the toolkit includes components designed specifically for a patient, and which can only be used to carry out a specific planned surgery (i.e. single use components), and non-specific components which can be re-used during subsequent surgical procedures (i.e. multi-use / reusable components). The patient-specific components can be designed and fabricated to assist in performing steps of a TTO procedure as determined according to a preoperative plan.

[0186] The patient-specific components can be designed based on 3D model of a patient’s tibial bones. The 3D model can be constructed, for example, by using different types of medical imaging techniques, such as a CT scan, ultrasounds and / or a MRI, to acquire images of the patient’s tibial bones, and assembling said images to form a 3D model which describes the structure of the patient’s tibial bones, including their shapes, surfaces, and / or volumes, among other parameters. The 3D model can subsequently be used to preoperatively simulate the effect of surgical interventions on the patient’s tibial bones.

[0187] For instance, a computer program can be used to calculate the mechanical axis of the patient’s knee and / or the distribution of stresses within the patient’s knee, using the 3D model. The computer program can allow modifying the 3D model to adjust the position / orientation of the patient’s tibia tubercle.

[0188] Once corrected position of patient’s tibia tubercle is determined, the surgical kit 100 and all its patient-specific components can be designed.

[0189] Referring now to Figure 46, there is shown one embodiment of the surgical kit 100 including the primary surgical module 20, the sagittal guide module 90, the displacement validator 60, and the bone-fastener predrilling module 70. It is appreciated that the embodiment of each one of the module(s) / validator included in the kit 100 can vary from the embodiment shown in Figure 6 For instance and without being limitative, the primary surgical module 20 can be replaced with the primary surgical module 220, 320 and / or the bone-fastener predrilling module 70 can be replaced with the bone-fastener predrilling modules 170, 570. The surgical kit 100 can include additional module(s) / tool(s) in addition to or in replacement to the one shown in Figure 46. Furthermore, the surgical kit 100 can be exempt of at least one of the module(s) / validator shown in Figure 46. For instance and without being limitative, the surgical kit 100 can be exempt of displacement validator 60.

[0190] Surgical Procedure As can be appreciated, the surgical kit 100 described above can be used to assist in a TTO procedure to correct the alignment of a patient’s knee in accordance with the preoperative plan. It is appreciated that the surgical procedure can be performed with any of the primary surgical modules 20, 220, 320 and other modules described above and any alternatives thereof.

[0191] As shown in Figures 1 and 2, a first step of the surgical procedure can comprise positioning the primary surgical module 20 of the surgical kit 100 on the patient’s tibial bone B. As can be appreciated, the bone-contacting surface 22 of the primary surgical module 20 is configured to conform to the surface of the patient’s tibial bone B in the single predetermined position and orientation. Therefore, an explorer tool can be used to help position the primary surgical module 20 correctly, for example by verifying that there are no gaps between the bone-contacting surface 22 and the surface of the patient’s tibial bone B.

[0192] Once the bone-contacting surface 22 has been positioned, mechanical fasteners 46 can be screwed into the fastener-receiving apertures 44 of the anchoring portion 26 to secure the primary surgical module 20 to the patient’s tibial bone B. As can be appreciated, drill bits can be used to predrill holes to prepare for receiving the mechanical fasteners 46, if necessary.

[0193] After the primary surgical module 20 has been secured, the patient’s tibial bone B can then be weakened in preparation for forming planar cuts. In this step, calibrated drill bits (not shown) can be inserted through guide cylinders in a predrilling module (not shown) aligned with the primary cutting tool receiving slot 36 and / or the proximal cutting tool receiving slot 37. The predrilling module(s) is(are) then removed to expose the primary cutting tool receiving slot 36 and the proximal cutting tool receiving slot 37.

[0194] Cutting tools, such as surgical saws and / or osteotomes, are then inserted through the primary cutting tool receiving slot 36 and / or the proximal cutting tool receiving slot 37 (or along the primary cutting tool supporting surface 136 and the proximal cutting tool supporting surface 137) of the primary surgical module 20, and the patient’s tibial bone B can be cut, as shown in Figures 4 and 6.

[0195] In some embodiments, referring to Figures 7 and 8, a drill bit 56 can be inserted in the resection predrilling module 39 to ensure that the coronal cut surface 33 made along the coronal cutting plane intersects with the proximal cut surface 34. The resection predrilling module 39 can be removed once the drill bit 56 has been inserted in the patient’s tibial bone B and subsequently withdrawn from the resection predrilling module 39.

[0196] Then, referring to Figures 11 to 13, the sagittal guide module 90 can be mounted to the primary surgical module 20 and a cutting tool can be used to create a cutting plane in the patient’s tibial bone using the sagittal cutting tool receiving slot 96. The sagittal guide module 90 can subsequently be removed.

[0197] After the sagittal guide module 90 has been removed, if any, the tibial tubercle fragment 80 can be displaced to the predetermined tubercle position and orientation using the tubercle realignment guide, as shown in Figure 15. The position / orientation of the tibial tubercle fragment 80 can be confirmed / adjusted using the displacement validator 60, 160, 460, which is insertable in an exposed section of the coronal cut surface 33, e.g. the opening 81 , formed between the remaining patient’s tibial bone B and the displaced tibial tubercle fragment 80, as shown in Figures 16 and 17.

[0198] Once the position / orientation of the tibial tubercle fragment 80 is confirmed, with or without removing the displacement validator 60, the bone-fastener predrilling module 70, 170, 570 can be engaged with the primary surgical module 20, as shown in Figures 23 to 33. Drill sleeve(s) 84, 584 can be engaged with drill barrel(s) of the bone-fastener predrilling module 70, 170, 570. Drill bits can subsequently be inserted into the drill channel(s) 79, 179, 579 of the drill barrel(s) 78, 178, 578 or the drill tunnel(s) of the drill sleeve(s) 84, 584, if any, to create the drill holes for eventually receiving surgical fasteners for securing the tibial tubercle fragment 80 to the remaining patient’s tibial bone B in the predetermined tubercle position and orientation.

[0199] After drill holes have been formed, the bone-fastener predril ling module 70 can be disengaged from the primary surgical module 20 and mechanical surgical fasteners can be inserted in the drill holes to secure the tibial tubercle fragment 80 to the remaining patient’s tibial bone B at the predetermined tubercle position and orientation.

[0200] Finally, the primary surgical module 20 can be detached from the patient’s tibial bone B, leaving the tibial tubercle fragment 80 attached to patient’s tibial bone B at the predetermined tubercle position and orientation.

[0201] Although the exemplary procedure described above was in connection with a standard tibial tubercle osteotomy, it is appreciated that similar steps can apply in connection with other types of tibial tubercle osteotomies. Moreover, although the surgical procedure was described with a particular set and configuration of tools, it is appreciated that a similar procedure can be applied using a different set and configuration of tools.

[0202] The TTO surgical kit 100 is designed to execute more accurate surgeries (cut and repositioning of the tibial tubercle) than conventional free hand surgeries. The cutting plan and the final position of the tubercle are preplanned and the surgical tools of the TTO surgical kit 100 are designed and manufactured based on this preplanning.

[0203] K-wire implementation

[0204] In an alternative implementation, a primary cutting module can be superposed to the tibial bone B using one or more k-wires as guiding tools for positioning the primary cutting module at a predetermined position. Then, cuts can be made through the bone B using the primary cutting module and the resected tibial tubercle fragment can be displaced to the predetermined tubercle position and orientation still using the k-wires as guides. While the above description provides examples of the embodiments, it will be appreciated that some features and / or functions of the described embodiments are susceptible to modification without departing from the spirit and principles of operation of the described embodiments. Accordingly, what has been described above has been intended to be illustrative and non-limiting and it will be understood by persons skilled in the art that other variants and modifications may be made without departing from the scope of the invention as defined in the claims appended hereto.

Claims

CLAIMS:1 . A surgical kit for performing a tibial tubercle osteotomy (TTO), the surgical kit comprising: a primary surgical module configured to be secured to a patient’s tibia and having a bone-contacting surface configured to be superposable against the patient's tibia and conforming to a surface of the patient’s tibia in a single predetermined position and orientation and an operative side opposite the bone-contacting surface, the primary surgical module including an anchor portion securable to the patient’s tibia, a primary cutting portion defining a coronal cutting plane, and a proximal cutting portion defining a proximal cutting plane, the coronal cutting plane and the proximal cutting plane being configured to guide a surgical cutting tool to create a resection in the patient’s tibia when the primary surgical module is mounted to the patient’s tibia and to at least partially delimit a tibial tubercle fragment; and a bone-fastener predrilling module having a surgical module mounting portion detachably engageable with the primary surgical module and a drilling portion including at least one drill barrel aligned with and located anteriorly to the tibial tubercle fragment positioned in a predetermined tubercle position and orientation.

2. The surgical kit according to claim 1 , further comprising a resection predrilling module detachably mounted to the primary surgical module at an intersection of the coronal cutting plane and the proximal cutting plane, the resection predrilling module being configured to guide a drill bit in the patient’s tibia.

3. The surgical kit according to claim 2, wherein the resection predrilling module comprises severable connectors connecting a tubular wall of the resection predrilling module to the primary surgical module, the tubularwall defining a drill receiving channel aligned with the intersection of the coronal cutting plane and the proximal cutting plane.

4. The surgical kit according to any one of claims 1 to 3, wherein the primary cutting portion comprises a primary cutting tool receiving slot defining the coronal cutting plane and the proximal cutting portion comprises a proximal cutting tool receiving slot defining the proximal cutting plane and the primary cutting tool receiving slot intersects with the proximal cutting tool receiving slot.

5. The surgical kit according to any one of claims 1 to 3, wherein the anchor portion extends along one side of the primary cutting portion and the drilling portion of the bone-fastener predrilling module is located on an opposed side of the primary cutting portion when engaged with the primary surgical module.

6. The surgical kit according to any one of claims 1 to 5, wherein each one of the coronal cutting plane and the proximal cutting plane extends in a respective and single plane with the coronal cutting plane extending substantially along a coronal plane of the patient’s tibia and the proximal cutting plane extends substantially along a transversal plane of the patient’s tibia.

7. The surgical kit according to any one of claims 1 to 6, wherein the primary cutting portion comprises a tubercle realignment guide.

8. The surgical kit according to claim 7, wherein the tubercle realignment guide comprises a tubercle displacement platform coplanar with the coronal cutting plane.

9. The surgical kit according to claim 7 or 8, wherein the tubercle realignment guide comprises a tubercle abutting wall having a profile matching contours of a portion of the tibial tubercle fragment abutting on the tubercleabutting wall when configured in the predetermined tubercle position and orientation.

10. The surgical kit according to any one of claims 1 to 3, wherein the primary cutting portion comprises a tubercle realignment guide and a primary cutting tool receiving slot defining the coronal cutting plane, wherein the tubercle realignment guide comprises a tubercle displacement platform coplanar with the primary cutting tool receiving slot and a tubercle abutting wall and wherein the primary cutting tool receiving slot opens at a junction of the tubercle displacement platform and the tubercle abutting wall.11 . The surgical kit according to any one of claims 1 to 10, wherein the primary cutting portion comprises a depth limitation indicator providing an indication for an insertion depth of the surgical cutting tool inside the patient’s tibia.

12. The surgical kit according to claim 10, wherein the primary cutting portion comprises a visual indicator indicating a section of the primary cutting tool receiving slot wherein a cutting tool inserted in the primary cutting tool receiving slot must not protrude outwardly of the patient’s tibia.

13. The surgical kit according to any one of claims 1 to 12, further comprising a displacement validator.

14. The surgical kit according to claim 13, wherein the surgical module mounting portion of the bone-fastener predrilling module is detachably engageable with the displacement validator.

15. The surgical kit according to any one of claims 1 to 14, wherein the bonefastener predrilling module further comprises at least one drill sleeve removably engageable with a respective one of the at least one drill barrel, the at least one drill sleeve having a proximal end protruding outwardly from the respective one of the at least one drill barrel when engaged therewith and contacting the tibial tubercle fragment.

16. The surgical kit according to claim 13, wherein the proximal end of the at least one drill sleeve is serrated.

17. The surgical kit according to claim 15 or 16, wherein the at least one drill sleeve comprises two drill sleeves, each one of the two drill sleeves having a drill tunnel, the drill tunnels of the two drill sleeves being characterized by a different diameter.

18. The surgical kit according to any one of claims 1 to 17, further comprising a sagittal guide module having a proximal portion removably engageable with the proximal cutting portion of the primary surgical module and a sagittal cutting portion having a sagittal cutting tool receiving slot extending therethrough.

19. The surgical kit according to claim 18, wherein the proximal portion is engageable with the proximal cutting portion over the proximal cutting portion.

20. The surgical kit according to claim 18 or 19, wherein the sagittal cutting tool receiving slot is opened at an end thereof and defines a sagittal cutting plane intersecting with the proximal cutting plane.21 . The surgical kit according to any one of claims 1 to 20, wherein the bonefastener predrilling module comprises male connectors and the proximal cutting portion comprises female connectors complementary with the male connectors and the bone-fastener predrilling module is removably engageable with the proximal cutting portion by engaging the male connectors into the female connectors.

22. A surgical kit for performing a tibial tubercle osteotomy (TTO), the surgical kit comprising: a primary surgical module configured to be secured to a patient’s tibia and having a bone-contacting surface configured to be superposableagainst the patient's tibia and conforming to a surface of the patient’s tibia in a single predetermined position and orientation and an operative side opposite the bone-contacting surface, the primary surgical module comprising: an anchor portion securable to the patient’s tibia; a primary cutting portion including a primary cutting tool receiving slot defining a coronal cutting plane; a proximal cutting portion comprising a proximal cutting tool receiving slot defining a proximal cutting plane, the primary cutting tool receiving slot and the proximal cutting tool receiving slot being configured to receive and guide a surgical cutting tool to create a resection in the patient’s tibia when the primary surgical module is mounted to the patient’s tibia in the single predetermined position and orientation and to at least partially delimit a tibial tubercle fragment; and a tubercle realignment guide indicative of a predetermined tubercle position and orientation following displacement of the tibial tubercle fragment.

23. The surgical kit according to claim 22, wherein the tubercle realignment guide comprises a tubercle displacement platform coplanar with the primary cutting tool receiving slot.

24. The surgical kit according to claim 22 or 23, wherein the tubercle realignment guide comprises a tubercle abutting wall having a profile matching contours of a portion of the tibial tubercle fragment abutting on the tubercle abutting wall when configured in the predetermined tubercle position and orientation.

25. The surgical kit according to any one of claims 22 to 24, further comprising a bone-fastener predrilling module having a surgical module mountingportion detachably engageable with the primary surgical module and a drilling portion including at least one drill barrel aligned with and located anteriorly to the tibial tubercle fragment positioned in the predetermined tubercle position and orientation.

26. The surgical kit according to claim 25, wherein the anchor portion extends along one side of the primary cutting portion and the drilling portion of the bone-fastener predrilling module is located on an opposed side of the primary cutting portion when engaged with the primary surgical module.

27. The surgical kit according to any one of claims 22 to 26, further comprising a resection predrilling module detachably mounted to the primary surgical module at an intersection of the coronal cutting plane and the proximal cutting plane, the resection predrilling module being configured to guide a drill bit in the patient’s tibia.

28. The surgical kit according to claim 27, wherein the resection predrilling module comprises severable connectors connecting a tubular wall of the resection predrilling module to the primary surgical module, the tubular wall defining a drill receiving channel aligned with the intersection of the coronal cutting plane and the proximal cutting plane.

29. The surgical kit according to any one of claims 22 to 28, wherein the primary cutting tool receiving slot and the proximal cutting tool receiving slot intersect.

30. The surgical kit according to any one of claims 22 to 29, wherein each one of the coronal cutting plane and the proximal cutting plane extends in a respective and single plane with the coronal cutting plane extending substantially along a coronal plane of the patient’s tibia and the proximal cutting plane extends substantially along a transversal plane of the patient’s tibia.

31. The surgical kit according to any one of claims 22 to 30, wherein the primary cutting portion comprises a depth limitation indicator providing an indication for an insertion depth of the surgical cutting tool inside the patient’s tibia.

32. The surgical kit according to claim 31 , wherein the depth limitation indicator comprises a visual indicator indicating a section of the primary cutting tool receiving slot wherein a cutting tool inserted in the primary cutting tool receiving slot must not protrude outwardly of the patient’s tibia.

33. The surgical kit according to any one of claims 22 to 32, further comprising a displacement validator.

34. The surgical kit according to claim 25 or claim 26, further comprising a displacement validator and wherein the surgical module mounting portion of the bone-fastener predrilling module is detachably engageable with the displacement validator.

35. The surgical kit according to claim 25 or claim 26, wherein the bonefastener predrilling module further comprises at least one drill sleeve removably engageable with a respective one of the at least one drill barrel, the at least one drill sleeve having a proximal end protruding outwardly from the respective one of the at least one drill barrel when engaged therewith and contacting the tibial tubercle fragment.

36. The surgical kit according to claim 35, wherein the proximal end of the at least one drill sleeve is serrated.

37. The surgical kit according to claim 35 or 36, wherein the at least one drill sleeve comprises two drill sleeves, each one of the two drill sleeves having a drill tunnel, the drill tunnels of the two drill sleeves being characterized by a different diameter.

38. The surgical kit according to any one of claims 22 to 37, further comprising a sagittal guide module having a proximal portion engageable with the proximal cutting portion of the primary surgical module and a sagittal cutting portion having a sagittal cutting tool receiving slot extending therethrough.

39. The surgical kit according to claim 38, wherein the proximal portion is engageable with the proximal cutting portion over the proximal cutting portion.

40. The surgical kit according to claim 38 or 39, wherein the sagittal cutting tool receiving slot is opened at an end thereof and defines a sagittal cutting plane intersecting with the proximal cutting plane.

41. The surgical kit according to claim 25 or claim 26, wherein the bonefastener predrilling module comprises male connectors and the proximal cutting portion comprises female connectors complementary with the male connectors and the bone-fastener predrilling module is removably engageable with the proximal cutting portion by engaging the male connectors into the female connectors.

42. A primary surgical module for performing a tibial tubercle osteotomy (TTO), the primary surgical module comprising: a body including a bonecontacting portion, a lateral portion, a medial portion, and a proximal portion, the bone-contacting portion of the body has an anchor portion and a bone-contacting surface configured to be superposable against a patient's tibia and conforming to a surface of the patient’s tibia in a single predetermined position and orientation, the body also includes an operative side opposite the bone-contacting surface, the primary surgical module is securable to the patient’s tibia via the anchor portion, the lateral portion, the medial portion, and the proximal portion comprise respectively a lateral cutting tool supporting surface, a medial cutting tool supporting surface, and a proximal cutting tool supporting surface configured to guidea surgical cutting tool to create a resection in the patient’s tibia when the primary surgical module is mounted to the patient’s tibia in the single predetermined position and orientation to at least partially delimit a tibial tubercle fragment.

43. The primary surgical module of claim 42, wherein the lateral cutting tool supporting surface, the medial cutting tool supporting surface, and the proximal cutting tool supporting surface respectively define a lateral cutting plane, a medial cutting plane, and a proximal cutting plane intersecting with one another.

44. The primary surgical module of claim 42 or claim 43, wherein each one of the lateral portion, the medial portion, and the proximal portion protrudes anteriorly with respect to the bone-contacting portion.

45. The primary surgical module of any one of claims 42 to 44, wherein the anchoring portion comprises at least two peripheral tubular walls protruding outwardly on the operative side, each one of the peripheral tubular walls defining a faster-receiving apertures which extends through the primary surgical module.

Images