Joint replacement methods and apparatus

Abstract

Apparatus and surgical techniques provide alternative cutting fixtures and other features to improve bone resection accuracy and joint stability. According to one embodiment, stabilizers are removably attached to a cutting guide to temporarily lengthen the surface against which a saw or other cutting device rests. Another embodiment provides differently shaped saw blades, having curved distal ends and right-angle bends applicable to box cuts of the type associated with cruciate sacrifice knee-replacement surgery. Methods are also disclosed whereby the box cuts, distal and posterior augment cuts may be approached from a distal perspective, both laterally and medially. A different embodiment provides a trial/cutting guide having flat surfaces as opposed to curved surfaces adapted for articulation within a joint. Yet a further alternative embodiment teaches a device for determining the joint line relative to a tibia using the fibula as reference.

I claim:  
     
         1 . Apparatus for use in conjunction with a cutting tool to resect the end of a bone having a longitudinal axis and medial and lateral sides, the apparatus comprising: 
 a body adapted for placement relative to one of the medial or lateral sides of the bone,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a resection is made to the bone along a plane generally transverse to the longitudinal axis.    
     
     
         2 . The apparatus of  claim 1 , wherein the resection is a distal resection.  
     
     
         3 . The apparatus of  claim 1 , wherein the resection is a posterior resection.  
     
     
         4 . The apparatus of  claim 1 , wherein the resection is an anterior resection.  
     
     
         5 . The apparatus of  claim 1 , wherein the resection is a chamfer resection.  
     
     
         6 . The apparatus of  claim 1 , wherein the cutting guide is a surface against which the cutting tool slides.  
     
     
         7 . The apparatus of  claim 1 , wherein the cutting guide is in the form of a slot.  
     
     
         8 . The apparatus of  claim 1 , further including: 
 a joint trialing device having medial and lateral sides; and    wherein the body is adapted for placement relative to the medial or lateral side of the joint trialing device.    
     
     
         9 . The apparatus of  claim 1 , further including: 
 a joint trialing device having cutting guides or surfaces; and    wherein the body is adapted to extend one or more of the cutting guides or surfaces of the joint trialing device.    
     
     
         10 . The apparatus of  claim 1 , further including a prosthetic component including a surface that contacts the resection when implanted.  
     
     
         11 . The apparatus of  claim 10 , wherein the prosthetic component forms part of a knee joint.  
     
     
         12 . Apparatus for resecting the end of a bone having a longitudinal axis and medial and lateral sides to receive an implant having a generally planar surface associated with fixation, the apparatus comprising: 
 a body adapted for placement relative to one of the medial or lateral sides of the bone,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a resection is made to contact the generally planar surface of the implant associated with fixation.    
     
     
         13 . The apparatus of  claim 12 , wherein the resection is a distal resection.  
     
     
         14 . The apparatus of  claim 12 , wherein the resection is a posterior resection.  
     
     
         15 . The apparatus of  claim 12 , wherein the resection is an anterior resection.  
     
     
         16 . The apparatus of  claim 12 , wherein the resection is a chamfer resection.  
     
     
         17 . The apparatus of  claim 12 , wherein the cutting guide is a surface against which the cutting tool slides.  
     
     
         18 . The apparatus of  claim 12 , wherein the cutting guide is in the form of a slot.  
     
     
         19 . The apparatus of  claim 12 , further including: 
 a trialing device having medial and lateral sides that is temporarily placed on the bode before the implant is installed; and    wherein the body is adapted for placement relative to the medial or lateral side of the joint trialing device.    
     
     
         20 . The apparatus of  claim 12 , further including: 
 a trialing device having medial and lateral sides that is temporarily placed on the bode before the implant is installed; and    the body is adapted to extend one or more of the cutting guides or surfaces of the joint trialing device.    
     
     
         21 . The apparatus of  claim 12 , further including a prosthetic component including a surface that contacts the resection when implanted.  
     
     
         22 . A method of resecting the end of a bone having a longitudinal axis and medial and lateral sides, comprising: 
 providing an implant having a generally planar surface associated with fixation;    positioning a cutting guide relative to one of the medial or lateral sides of the bone; and    resecting the bone using the guide to create a surface that corresponds to the surface of the implant.    
     
     
         23 . The method of  claim 22 , wherein the resection and implant surface are distal.  
     
     
         24 . The method of  claim 22 , wherein the resection and implant surface are anterior.  
     
     
         25 . The method of  claim 22 , wherein the resection and implant surface are posterior.  
     
     
         26 . A method of the resecting the end of a bone having a longitudinal axis and medial and lateral sides, comprising: 
 positioning a cutting guide relative to the medial side of the bone; and    resecting the bone using the guide to create one or more planar surfaces that are generally transverse to the longitudinal axis.    
     
     
         27 . A method of the resecting the end of a bone having a longitudinal axis and medial and lateral sides, comprising: 
 positioning a cutting guide relative the lateral side of the bone; and    resecting the bone using the guide to create one or more planar surfaces that are generally transverse to the longitudinal axis.    
     
     
         28 . Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising: 
 a body adapted for placement relative to the medial side of the distal femur,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a distal resection is performed.    
     
     
         29 . Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising: 
 a body adapted for placement relative to the medial side of the distal femur,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, an anterior resection is performed.    
     
     
         30 . Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising: 
 a body adapted for placement relative to the medial side of the distal femur,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a posterior resection is performed.    
     
     
         31 . Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising: 
 a body adapted for placement relative to the medial side of the distal femur,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a chamfer resection is performed.    
     
     
         32 . Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising: 
 a body adapted for placement relative to the lateral side of the distal femur,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a distal resection is performed.    
     
     
         33 . Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising: 
 a body adapted for placement relative to the lateral side of the distal femur,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, an anterior resection is performed.    
     
     
         34 . Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising: 
 a body adapted for placement relative to the lateral side of the distal femur,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a posterior resection is performed.    
     
     
         35 . Apparatus for use with a cutting tool in resecting the distal end of a femur having medial and lateral sides to receive an implant in conjunction with knee-replacement surgery, the apparatus comprising: 
 a body adapted for placement relative to the lateral side of the distal femur,    the body including a cutting guide configured such that when the cutting tool is guided by the cutting guide, a chamfer resection is performed.