Ligament Guide Registration

Abstract

A patient-specific guide tool for guiding an instrument toward a bone for implantation of a prosthetic device is disclosed. The guide tool includes a body portion having a guide element, and a patient-specific portion having at least one patient-specific mating feature that is configured to engage a soft tissue at or near the bone. A method of manufacturing a guide tool for guiding an instrument toward a bone is also disclosed.

What is claimed is: 
     
         1 . A patient-specific guide tool for guiding an instrument toward a bone, the guide tool comprising:
 a body portion that includes an engagement surface and a guide element configured to guide movement of the instrument toward the bone; and   a patient-specific soft tissue attachment portion that is coupled to the body portion, the patient-specific soft tissue attachment portion including at least one patient-specific soft tissue mating feature that is configured to engage a first soft tissue at or near the bone to thereby position the engagement surface at a predetermined position relative to the bone.   
     
     
         2 . The patient-specific guide tool according to  claim 1 , further comprising a second patient-specific soft tissue mating feature that is configured to engage a second soft tissue at or near the bone, wherein the second soft tissue is different from the first soft tissue. 
     
     
         3 . The patient-specific guide tool according to  claim 2 , further comprising a third patient-specific soft tissue mating feature that is configured to engage a third soft tissue at or near the bone, wherein the third soft tissue is different from the first and second soft tissues. 
     
     
         4 . The patient-specific guide tool according to  claim 3 , wherein the first patient-specific soft tissue mating feature is configured to engage an anterior cruciate ligament (ACL), the second patient-specific soft tissue mating feature is configured to engage medial collateral ligament (MCL), the third patient-specific soft tissue mating feature is configured to engage a lateral cruciate ligament (LCL), and wherein the engagement surface is configured to engage a tibia. 
     
     
         5 . The patient-specific guide tool according to  claim 1 , wherein the patient-specific soft tissue mating feature is configured to engage a transacetabular ligament and the engagement surface is configured to engage an acetabulum. 
     
     
         6 . The patient-specific guide tool according to  claim 5 , wherein the engagement surface includes a rim portion that is a negative of an acetabular rim, the rim portion configured to engage the acetabular rim in only one position. 
     
     
         7 . The patient-specific guide tool according to  claim 1 , wherein the soft tissue mating feature is a hook, notch, slit, slot, or tab. 
     
     
         8 . The patient-specific guide tool according to  claim 1 , wherein the soft tissue mating feature is configured to engage a ligament, tendon, muscle, fibrous tissue or fat. 
     
     
         9 . The patient-specific guide tool according to  claim 1 , wherein the engaging surface is a mirror image of a site on the bone where the guide tool is to be positioned and nests in only one position on the bone. 
     
     
         10 . The patient-specific guide tool according to  claim 1 , wherein the guide element is a guide bore, slot, or guide surface. 
     
     
         11 . A patient-specific guide tool for guiding an instrument toward a bone, the guide tool comprising:
 a body portion that includes a guide feature having a guide surface, the guide surface configured to guide movement of the instrument toward the bone;   a first patient-specific portion extending from the body portion, the first patient-specific portion including at least one patient-specific soft tissue engaging feature that is configured and shaped to engage soft tissue at or near the bone; and   a second patient-specific portion extending from the body portion, the second patient-specific portion including a patient-specific bone engaging surface configured to nest with the bone,   wherein the guide tool thereby positions the guide feature at a predetermined position relative to the bone.   
     
     
         12 . The patient-specific guide tool according to  claim 11 , wherein the soft tissue engaging feature is configured to engage a transacetabular ligament. 
     
     
         13 . The patient-specific guide tool according to  claim 12 , wherein the patient-specific bone engaging surface comprises a concave surface portion configured to engage and nest with a convex rim of the acetabulum in only one position. 
     
     
         14 . The patient-specific guide tool according to  claim 11 , further comprising a second patient-specific soft tissue engaging feature that is configured to engage a second soft tissue, the second soft tissue being different from the first soft tissue. 
     
     
         15 . The patient-specific guide tool according to  claim 14 , wherein the first soft tissue engaging feature is configured to engage an anterior cruciate ligament and the second soft tissue engaging feature is configured to engage a medial collateral ligament. 
     
     
         16 . The patient-specific guide tool according to  claim 15 , wherein the bone engaging surface is configured to engage a tibia. 
     
     
         17 . The patient-specific guide tool according to  claim 11 , wherein the soft tissue engaging feature is configured in accordance with a two-dimensional or three-dimensional model of the bone and soft tissue of a specific patient reconstructed preoperatively from at least one image scan of the patient. 
     
     
         18 . A method of manufacturing a guide tool for use in guiding an instrument to a bone, the method comprising:
 obtaining images of at least a portion of the bone;   determining the location of soft tissue at or near the bone;   generating a two-dimensional or three-dimensional model of the bone and soft tissue; and   fabricating a patient-specific guide tool having a body portion and a patient-specific portion, the body portion including a guide feature, and the patient-specific portion including at least one soft tissue mating feature that is configured to engage the soft tissue according to the two-dimensional or three-dimensional model.   
     
     
         19 . The method according to  claim 19 , wherein determining the location of soft tissue at or near the bone comprises obtaining an MRI, CT scan or ultrasound of the portion of the bone. 
     
     
         20 . The method according to  claim 18 , wherein determining the location of soft tissue at or near the bone comprises obtaining an X-ray of the bone of the specific patient and locating the position of the soft tissue at or near the bone according to known locations of the soft tissue relative to the bone.