Patient-specific partial knee guides and other instruments

Abstract

A patient-specific unicompartmental tibial guide has a patient-specific body with an inner surface. The inner surface is preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a proximal portion of a tibial bone of a specific patient. The tibial guide includes a vertical resection channel having a variable width preoperatively configured for guiding a vertical resection through the proximal portion of the tibial bone.

What is claimed is: 
     
         1 . A surgical kit for unicompartmental knee arthroplasty comprising:
 a patient-specific unicompartmental tibial guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a proximal portion of a tibial bone of a specific patient, the tibial guide including a vertical resection channel having a first width formed between first and second flanges of the tibial guide; and   a cutting insert having a first plate receivable in the vertical resection channel and changing the first width of the resection channel to a second width smaller than the first width.   
     
     
         2 . The surgical kit of  claim 1 , wherein the cutting insert includes an open channel formed between the first plate and a second plate. 
     
     
         3 . The surgical kit of  claim 2 , wherein the first and second plates have different thicknesses. 
     
     
         4 . The surgical kit of  claim 1 , further comprising additional cutting inserts configured for changing the first width of the resection channel to corresponding different widths. 
     
     
         5 . The surgical kit of  claim 1 , wherein the tibial guide includes a drill guide portion preoperatively configured for drilling first and second anterior holes into the tibial bone for guiding a horizontal tibial resection. 
     
     
         6 . The surgical kit of  claim 1 , wherein the drill guide portion is unitarily attached to the patient-specific body. 
     
     
         7 . The surgical kit of  claim 1 , wherein the vertical resection channel ends in a safety hole formed between the first and second resection flanges, the safety hole configured to receive a stop pin limiting a depth of the vertical resection. 
     
     
         8 . The surgical kit of  claim 1 , wherein the patient-specific body includes a proximal portion configured to be engageable with a surface of a proximal plateau of the tibia bone and an anterior portion configured to be engageable with an anterior surface of the tibial bone. The surgical kit of  claim 8 , wherein the patient-specific body defines an elongated window passing through the body. 
     
     
         10 . The surgical kit of  claim 1 , further comprising a unitary patient-specific unicompartmental femoral guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a distal portion of a distal femoral bone of the specific patient, the femoral guide including an elongated slot with a tapered inner wall. 
     
     
         11 . A surgical kit for a unicompartmental knee arthroplasty, comprising:
 a patient-specific unicompartmental tibial guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with at least an anterior portion of a tibial bone of a specific patient, the tibial guide including a vertical resection channel having a first width formed between first and second flanges of the tibial guide; and   a plurality of cutting inserts, each cutting insert having a first plate receivable in the vertical resection channel and configured to change the first width of the resection channel to a second width smaller than the first width, wherein each plate has a different thickness to provide a plurality of different second widths.   
     
     
         12 . The surgical kit of  claim 11 , wherein the patient-specific body is further configured to conform and mate in only one position with a proximal portion of the tibial bone of the specific patient. 
     
     
         13 . The surgical kit of  claim 11 , wherein each cutting insert is U-shaped to define an open channel formed between the first plate and a second plate. 
     
     
         14 . The surgical kit of  claim 13 , wherein the first plate is thicker than the second plate. 
     
     
         15 . The surgical kit of  claim 11 , wherein the vertical resection channel is formed within a resection guide portion extending from the patient-specific body. 
     
     
         16 . The surgical kit of  claim 15 , wherein the resection guide portion further includes a drill guide portion preoperatively configured for drilling first and second anterior holes into the tibia bone for use in guiding a horizontal tibial resection. 
     
     
         17 . The surgical kit of  claim 14 , wherein each open channel of each cutting insert is configured to be received on either the first or second flange of the tibial guide with the first plate positioned within the vertical resection channel, wherein the first and second flanges define opposed planar surfaces. 
     
     
         18 . The surgical kit of  claim 11 , further comprising a unitary patient-specific unicompartmental femoral guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with an anterior portion and a distal portion of a distal femoral bone of the specific patient, the femoral guide including an elongated slot with a tapered inner wall. 
     
     
         19 . A surgical kit for a unicompartmental knee arthroplasty, comprising:
 a patient-specific unicompartmental tibial guide having a patient-specific body with an inner surface configured to nestingly conform to an anterior portion and a proximal portion of a tibial bone of a specific patient, the tibial guide further including a drill/resection block coupled to the patient-specific body, the drill/resection block defining a vertical resection channel having a first width formed between first and second flanges and defining at least one bore configured for use in drilling at least one hole into the tibial bone; and   a removable cutting insert having a plate receivable in the vertical resection channel and configured for changing the first width of the resection channel to a second width smaller than the first width.   
     
     
         20 . The surgical kit of  claim 19 , further comprising a unitary patient-specific unicompartmental femoral guide having a patient-specific body with an inner surface preoperatively configured to nestingly conform and mate in only one position with a distal femoral bone of the specific patient, the femoral guide defining an elongated slot passing through the guide.