Patient-Specific Guides for Latarjet Procedure Graft Positioning

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Solution Overview

Problem

The Latarjet procedure for treating glenohumeral instability is technically challenging due to the need for precise positioning and preparation of the coracoid graft on the glenoid, with conventional methods relying on manual techniques that are tedious and prone to malpositioning, leading to potential graft failure and joint degeneration.

Innovation Solution

A patient-specific surgical assembly comprising a coracoid guide and a glenoid guide, designed to conform to the patient's anatomy, facilitates precise placement and preparation of the coracoid graft, ensuring proper alignment and osseous healing through 3D preoperative planning and guided cutting slots and holes for accurate graft positioning.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Manufacturing precision

If manual techniques are used to prepare and position the coracoid graft, then the surgeon has flexibility in adapting to anatomical variations, but the procedure becomes tedious and is prone to malpositioning

Engineering Contradiction:

Improvepositioning precisionVSAvoidprocedure complexity

Core Design Contradiction:

Manufacturing precisionVSDevice complexity

Solution Approach 1:

Patient-specific guides are fabricated preoperatively based on CT imaging and 3D modeling of the patient's anatomy. These guides incorporate pre-calculated cutting slots, drill hole positions, and graft positioning features that are customized to each patient's unique coracoid and glenoid geometry, eliminating the need for intraoperative manual measurement and positioning

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The patient-specific guide acts as an intermediary device between the surgeon's intent and the actual bone preparation and graft positioning. The guide translates preoperative planning into precise intraoperative execution by providing mechanical constraints for cutting tools and graft placement, ensuring accuracy without requiring complex manual techniques

Inventive Principle:

Principle #24Intermediary (Mediator)

2Reliability

If visual and tactile assessment is used to position the graft, then the surgeon can make real-time adjustments, but malpositioning can occur leading to graft failure or joint degeneration

Engineering Contradiction:

Improvegraft positioning accuracyVSAvoidrisk of malpositioning

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The patent replaces subjective visual and tactile assessment with objective mechanical guidance provided by the patient-specific guide. The guide's pre-fabricated features such as cutting slots, drill holes, and positioning surfaces provide mechanical constraints that objectively define the correct position, eliminating human error in visual-tactile judgment

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

Solution Approach 2:

The patient-specific guide is created as a precise physical copy or replica of the patient's unique anatomy based on preoperative imaging. This custom-made guide perfectly matches the patient's coracoid and glenoid geometry, allowing for accurate reproduction of the preplanned positioning without relying on the surgeon's subjective assessment during surgery

Inventive Principle:

Principle #26Copying

3Strength

If excessive lateralization of the graft is performed to ensure coverage, then the graft may be more stable, but it can result in degeneration of the shoulder joint

Engineering Contradiction:

Improvegraft stabilityVSAvoidjoint degeneration

Core Design Contradiction:

StrengthVSObject-affected harmful factors

Solution Approach 1:

The patient-specific guide incorporates pre-calculated parameters for optimal graft positioning that balance stability and joint preservation. Based on preoperative 3D modeling, the guide defines the precise lateralization distance and angular orientation that achieve adequate graft coverage while maintaining the graft-glenoid interface within safe parameters to prevent joint degeneration

Inventive Principle:

Principle #35Parameter changes

4Productivity

If conventional manual preparation is used, then the equipment and setup are simple, but the procedure is tedious and time-consuming

Engineering Contradiction:

Improvesurgical efficiencyVSAvoidguidance system complexity

Core Design Contradiction:

ProductivityVSDevice complexity

Solution Approach 1:

All complex planning, measurement, and calculation are performed preoperatively using CT imaging and 3D modeling software. The patient-specific guide is fabricated with all necessary cutting slots, drill hole positions, and positioning features already determined, transforming the complex intellectual work into a simple physical guide that speeds up the actual surgical procedure

Inventive Principle:

Principle #10Preliminary action

Data Source

PatentUS12137922B2Patient-specific guides for Latarjet procedure

Publication Date: 2024.11.12 SMITH & NEPHEW INC

AI summary

Patient-specific guides for the Latarjet procedure, as well as surgical systems and methods of performing the Latarjet procedure to treat glenohumeral instability using such patient-specific guides are disclosed. A patient-specific coracoid guide and a patient-specific glenoid guide may be configured based on preoperatively generated three-dimensional models of the patient's shoulder anatomy. Guides may be configured for coracoid graft preparation and glenoid decortication. The coracoid graft may be placed in the desired position based on three-dimensional (3D) preoperative planning.