Guide for assisting with arrangement of a stock instrument with respect to a patient tissue

Abstract

A guide and a stock instrument in combination. The stock instrument includes a guide interacting feature, a lower instrument surface to abut the patient tissue and an upper instrument surface for contacting the guide. The guide includes a guide body including a lower guide surface and an upper guide surface. The lower guide surface mates with the upper instrument surface of the stock instrument when the lower instrument surface is in contact with the patient tissue. The lower guide surface includes an instrument guiding feature to mate with the guide interacting feature. An orienting feature including an arm extends away from the upper guide surface. The arm has a landmark engaging portion to enter a predetermined relationship with a fixed landmark on the patient tissue. The predetermined relationship indicates that the stock instrument has achieved a predetermined instrument relationship with the patient tissue.

1 . A guide and a stock instrument in combination, the guide being operable to arrange the stock instrument with respect to a patient tissue, the guide and the stock instrument in combination comprising:
 the stock instrument including at least one guide-interacting feature, a lower instrument surface configured to abut the patient tissue, and an upper instrument surface configured to contact the guide;   the guide including a guide body having a lower guide surface and an upper guide surface spaced longitudinally apart from the lower guide surface, the lower guide surface being contoured to substantially mate with at least a portion of the upper instrument surface of the stock instrument when the lower instrument surface of the stock instrument is in contact with the patient tissue, and the lower guide surface of the guide including at least one instrument-guiding feature at a predetermined feature location with respect to the guide body, the instrument-guiding feature configured to mate with the guide-interacting feature of the stock instrument such that the guide and the stock instrument are disposed together in fixed relative orientation and displaceable together as a guide assembly when the instrument-guiding feature is engaged with the guide-interacting feature, the upper guide surface of the guide being accessible to a user when the lower guide surface of the guide is in contact with the upper instrument surface of the stock instrument; and   wherein an orienting feature including an arm extends away from the upper guide surface of the guide body of the guide, the arm having a landmark-engaging portion configured to enter a predetermined orienting relationship with a fixed landmark disposed on the patient tissue while the lower guide surface of the guide is in mating contact with at least a portion of the upper instrument surface of the stock instrument in said fixed relative orientation, the predetermined orienting relationship indicating that the stock instrument has achieved a predetermined instrument relationship with the patient tissue.   
     
     
         2 . The combination of  claim 1 , wherein the orienting feature includes an orienting indicator, and the orienting indicator achieves a predetermined signaling relationship with the landmark while the guide and stock instrument are engaged in the fixed relative orientation to indicate that the stock instrument has achieved a predetermined instrument relationship with the patient tissue. 
     
     
         3 . The combination of  claim 1 , further comprising a pin, the pin comprising said fixed landmark and is adapted to be fastened in place on the patient tissue. 
     
     
         4 . The combination of  claim 1 , wherein the landmark-engaging portion includes a notch formed in the arm of the orienting feature, the notch being configured to receive the fixed landmark at least partially therein. 
     
     
         5 . The combination of  claim 1 , wherein one of the guide-interacting feature of the stock instrument and the instrument-guiding feature of the guide is a protrusion, and the other one of the guide-interacting feature and the instrument-guiding feature is a cavity, and the protrusion and the cavity are configured to mate together to engage the guide and the stock instrument together in said fixed relative orientation. 
     
     
         6 . The combination of  claim 1 , wherein the guide is a custom-manufactured guide configured for a specific patient. 
     
     
         7 . The combination of  claim 1 , wherein the guide is a modified stock guide, the modified stock guide being formed responsive to at least one of preoperative imaging of the patient tissue and preoperative selection of the stock instrument. 
     
     
         8 . The combination of  claim 1 , wherein the stock instrument includes at least one patient tissue-modification feature, the patient tissue-modification feature indicating a predetermined location for a patient tissue-modification procedure when the stock instrument is in said predetermined instrument orientation with respect to the patient tissue.