Bicruciate Retaining Knee Arthroplasty Tibial Resection Guide
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Solution Overview
Problem
Current total knee arthroplasty procedures often require sacrificing the anterior cruciate ligament (ACL) and/or posterior cruciate ligament (PCL), leading to inadequate proprioception, kinematics, and biomechanical functions, with existing implants and methods being inefficient and inaccurate for bicruciate retaining knee replacements.
Innovation Solution
The development of specialized instrumentation and methods for resecting the proximal tibia, including a mounting base with a cutting guide and an elongate pin to guide cutting devices, ensuring precise resection cuts and preserving the cruciate ligaments, allowing for bicruciate retaining implants.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional total knee prosthesis structures and mechanisms are used to replace ACL and PCL functions, then knee joint replacement can be performed, but the proprioception, kinematics, and biomechanical functions are inadequate
Solution Approach 1:
The invention extracts and preserves the cruciate ligaments (ACL and PCL) from the joint, eliminating the need for mechanical substitutes that fail to replicate natural ligament function. By removing the requirement for complex prosthetic mechanisms to replace ligament functions, the system achieves superior biomechanical outcomes while reducing implant complexity.
Solution Approach 2:
The natural cruciate ligaments continue to perform their proprioceptive and biomechanical functions self-service after preservation, eliminating the need for artificial mechanisms. The ligaments inherently provide the necessary kinematic control and sensory feedback without requiring complex prosthetic structures.
2Reliability
If bicruciate retaining knee replacements are performed with existing instrumentation, then cruciate ligaments can be preserved, but the procedures are associated with knee stiffness and implant failure due to inadequate implant design, instrumentation, and implantation technique
Solution Approach 1:
The instrumentation enables preliminary positioning and alignment of the tibial component before final implantation. The guide channels and reference features allow the surgeon to pre-establish the correct resection plane and component orientation, ensuring optimal ligament balance and reducing the risk of postoperative stiffness and failure.
Solution Approach 2:
The invention replaces complex mechanical alignment systems with a simplified guide-based approach that uses geometric constraints and reference features to achieve accurate component positioning. This substitution reduces instrumentation complexity while maintaining or improving implantation precision.
3Manufacturing precision
If existing devices and methods are used for preparing femurs and tibias, then knee procedures can be performed, but the preparation is less than ideal for bicruciate retaining implants
Solution Approach 1:
The cutting guide serves as an intermediary device that translates the desired resection plane into an executable cutting path. By introducing this intermediate tool with predefined geometric constraints, the system achieves superior resection accuracy without requiring complex direct bone-to-implant alignment techniques.
Solution Approach 2:
The cutting guide replicates the ideal resection geometry through its guide channels and reference surfaces, allowing the surgeon to copy the desired final configuration during the preparation phase. This ensures that the bone resection accurately matches the implant requirements for bicruciate retaining procedures.
Data Source
AI summary
Methods and devices for performing knee arthroplasty including but not limited to bicruciate retaining knee arthroplasty are provided. Methods and devices for preparing a proximal tibia for a tibial implant are also provided. These methods and devices, in at least some embodiments and uses, facilitate decreasing the complexity of knee arthroplasty procedures such as bicruciate retaining procedures while maintaining, if not improving on, the safety, accuracy and/or effectiveness of such procedures.