Surgical instrument and positioning method

Abstract

A surgical instrument having an anchoring member securable to an anatomical structure and an implement portion which is adjustably repositionable relative to the anchoring member. The implement portion is selectively translatably adjustable and selectively rotatably adjustable relative to the anchoring member. The implement portion may be selectively translatable along and/or selectively rotatable about at least two substantially perpendicular axes. The implement portion may be selectively translatable about three substantially perpendicular axes and/or selectively rotatable about three substantially perpendicular axes. The instrument may also include at least one reference element to facilitate the registration of the implement portion in a computer implemented guidance system. The reference element may be three non-linearly positioned elements disposed on a member which is removably mounted to the instrument. The implement portion may be a resection guide and the instrument may be used in the resection of a tibia when implanting a prosthetic knee joint.

1 - 25 . (canceled)  
   
   
       26 . A method of positioning a surgical instrument relative to an anatomical structure, said method comprising: 
 providing an instrument having an anchoring member and a selectively repositionable implement portion;    securing said anchoring member to the anatomical structure; and    selectively adjusting the position of said implement portion relative to said anchoring member after securing said anchoring member to the anatomical structure, said selective adjustment including selectively translating said implement portion along at least two substantially perpendicular translational axes and selectively rotating said implement portion about at least two substantially perpendicular rotational axes.    
   
   
       27 . The method of  claim 26  further comprising the step of registering the position of said implement portion in a computer implemented image guidance system after said step of securing said anchoring member.  
   
   
       28 . The method of  claim 27  wherein said step of registering the position of said implement portion comprises removably mounting at least three non-linearly positioned reference elements detectable by the computer implemented image guidance system on the instrument body.  
   
   
       29 . The method of  claim 26  wherein said step of selectively adjusting the position of said implement portion includes selectively translating said implement portion along three substantially mutually perpendicular translational axes.  
   
   
       30 . The method of  claim 26  wherein said step of selectively adjusting the position of said implement portion includes selectively rotating said implement portion relative to said anchoring member about three substantially mutually perpendicular rotational axes.  
   
   
       31 . The method of  claim 30  wherein said step of selectively adjusting the position of said implement portion includes selectively translating said implement portion along three substantially mutually perpendicular translational axes.  
   
   
       32 . The method of  claim 31  further comprising the step of registering the position of said implement portion in a computer implemented image guidance system after said step of securing said anchoring member.  
   
   
       33 . A method of positioning a surgical instrument with respect to an anatomical structure, said method comprising: 
 providing an instrument having an anchoring member and a selectively repositionable implement portion;    securing said anchoring member to the anatomical structure;    registering the position of said implement portion in a computer implemented image guidance system after said step of securing said anchoring member; and    selectively adjusting the position of said implement portion relative to said anchoring member, said selective adjustment including positioning said implement portion in a selected translational position along at least one translational axis and positioning said implement portion in a selected rotational position about at least one rotational axis.    
   
   
       34 . The method of  claim 33  wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected translational positions along at least two substantially perpendicular translational axes.  
   
   
       35 . The method of  claim 33  wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected rotational positions about at least two substantially perpendicular rotational axes.  
   
   
       36 . The method of  claim 35  wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected translational positions along at least two substantially perpendicular translational axes.  
   
   
       37 . The method of  claim 33  wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected translational positions along three substantially mutually perpendicular translational axes.  
   
   
       38 . The method of  claim 33  wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected rotational positions about three substantially mutually perpendicular rotational axes.  
   
   
       39 . The method of  claim 38  wherein said step of selectively adjusting the position of said implement portion comprises positioning said implement portion in selected translational positions along three substantially mutually perpendicular translational axes.  
   
   
       40 . The method of  claim 33  wherein said step of selectively adjusting the position of said implement portion comprises securing said implement portion in said selected translational position and independently securing said implement portion in said selected rotational position.  
   
   
       41 . A method of resecting a tibia, said method comprising: 
 providing an instrument having an anchoring member and a resection guide;    securing said anchoring member to the tibia;    registering the position of said resection guide in a computer generated guidance system after said step of securing said anchoring member; and    selectively adjusting the position of said resection guide relative to the anchoring member after said step of registering the position of said resection guide.    
   
   
       42 . The method of  claim 41  wherein said step of selectively adjusting the position of said resection guide comprises securing said resection guide in said selected translational position and independently securing said resection guide in said selected rotational position.  
   
   
       43 . The method of  claim 41  further comprising the step of directly securing said resection guide to the tibia after said step of selectively adjusting the position of said resection guide.  
   
   
       44 . The method of  claim 41  wherein said step of selectively adjusting the position of said resection guide comprises positioning said resection guide in selected translational positions along at least two substantially perpendicular translational axes and positioning said resection guide in selected rotational positions about at least two substantially perpendicular rotational axes.  
   
   
       45 . The method of  claim 41  wherein said step of selectively adjusting the position of said resection guide comprises positioning said resection guide in selected translational positions along three substantially mutually perpendicular translational axes and positioning said resection guide in selected rotational positions about three substantially mutually perpendicular rotational axes.