Methods and apparatus for conformable prosthetic implants

Abstract

A cutting tool is provided with an arcuate cutting blade that preferably engages a guide tool to create a curved resected surface during an arthroplasty procedure. In one embodiment, a depth of the cutting blade is sufficient to permit the simultaneous creation of resected surfaces on two bones that articulate, such as both the femur and the tibia for a given condyle, without the need to reposition the guide or the leg. In another embodiment, a cutting member has a generally rectangular cross-section along a longitudinal axis with a first and second surface having cutting teeth defined thereon and a third and fourth surface adapted to interface with a cutting guide positioned proximate the bone. In this embodiment, the cutting tool can resect the bone in two different directions without reorienting the cutting member.

1 - 25 . (canceled) 
     
     
         26 . A method for performing a total knee arthroplasty procedure comprising:
 positioning a distal femoral cutting guide against a femur immediately adjacent an anterior periphery of a distal cut to be made on a distal end of the femur, the distal femoral cutting guide having a planar femoral guide surface adapted to guide an oscillating sawblade to create the distal cut, the anterior periphery of the distal cut having a curvilinear shape, and the planar femoral guide surface having a posterior periphery having a curvilinear shape mimicking the shape of the anterior periphery of the distal cut, wherein the shape of the posterior periphery of the planar femoral guide surface is based upon preoperatively acquired three-dimensional digital patient image data;   engaging the sawblade with the planar femoral guide surface and creating the distal cut on the femur using the planar femoral guide surface to guide the sawblade with the planar femoral guide surface coplanar with the distal cut on the femur;   prior to creating the distal cut, creating markings in the distal end of the femur using a marking element;   removing the distal femoral cutting guide after creating the distal cut on the femur and disposing of the distal femoral cutting guide so that it is not used as a part of another total knee arthroplasty procedure;   following removal of the distal femoral cutting guide, attaching a second femoral cutting guide to the femur, wherein the second cutting guide operably references the markings on the femur;   using the second femoral cutting guide to create at least two of an anterior cut, an anterior chamfer cut, a posterior chamfer cut, and a posterior cut on the femur;   positioning a tibial alignment guide on a proximal end of a tibia of the patient, the tibial alignment guide configured based on preoperatively acquired three-dimensional digital patient image data such that the tibial alignment guide simultaneously contacts the tibia at least at nine points that include at least three points on a non-resected medial tibial condyle, at least three points on a non-resected lateral tibial condyle and at least three points on a non-resected anterocentral surface of the tibia located medially of the points of contact with the lateral tibial condyle;   positioning a proximal tibial cutting guide against a medial half of the proximal end of the tibia immediately adjacent an anterior periphery of a planar proximal cut to be made on a proximal end of the tibia with a location and orientation of the proximal tibial cutting guide being dictated by the tibial alignment guide, the proximal tibial cutting guide having only one planar tibial guide surface which is coplanar with the planar proximal cut and adapted to guide an oscillating sawblade to create the planar proximal cut, the anterior periphery of the planar proximal cut having a curvilinear shape, and the one planar tibial guide surface having a posterior periphery having a curvilinear shape mimicking the shape of at least a portion of a medial half of the anterior periphery of the planar proximal cut, wherein the shape of the posterior periphery of the one planar tibial guide surface is based upon preoperatively acquired three-dimensional digital patient image data, and wherein a lateral-most point of the posterior periphery of the planar tibial guide surface is located medially of a lateral-most of the points of contact between the tibial alignment guide and the lateral tibial condyle;   engaging the sawblade with the one planar tibial guide surface of the proximal tibial cutting guide and creating the planar proximal cut on the tibia underlying both a medial condyle and a lateral condyle of the tibia using the one planar tibial guide surface to guide the sawblade with the one planar tibial guide surface positioned coplanar with the planar proximal cut;   removing the proximal tibial cutting guide after creating the planar proximal cut on the tibia and disposing of the proximal tibial cutting guide so that it is not used as a part of another total knee arthroplasty procedure;   implanting a total knee arthroplasty femoral implant on the distal end of the femur; and   implanting a total knee arthroplasty tibial implant on the proximal end of the tibia.   
     
     
         27 . The method of  claim 26 , where positioning a distal femoral cutting guide against the femur immediately adjacent an anterior periphery of a distal cut to be made on the distal end of the femur includes positioning the distal femoral cutting guide such that a portion of the distal femoral cutting guide wraps around an anteromedial corner of the distal end of the femur and extends at least partially posteriorly along a medial side of the distal end of the femur. 
     
     
         28 . The method of  claim 26 , further comprising utilizing the proximal tibial cutting guide to create a second planar proximal cut on the tibia with the proximal tibial cutting guide, the second planar proximal cut being deeper on the tibia that the planar proximal cut. 
     
     
         29 . The method of  claim 26 , wherein creating the distal cut on the femur using the planar femoral guide surface includes creating the distal cut across all of the distal end of the femur. 
     
     
         30 . The method of  claim 26 , wherein the distal femoral cutting guide includes a second planar femoral guide surface that is not coplanar with the planar femoral guide surface and further comprising engaging the sawblade with the second planar femoral guide surface to create a second cut on the femur using the second planar femoral guide surface to guide the sawblade. 
     
     
         31 . The method of  claim 26 , wherein the tibial implant has a periphery mimicking a periphery of the planar proximal cut, and wherein the periphery of the tibial implant is based on preoperatively acquired three-dimensional digital patient image data. 
     
     
         32 . The method of  claim 26 , wherein the femoral implant has a periphery mimicking a periphery of cut bone surfaces on the femur, and wherein the periphery of the femoral implant is based on preoperatively acquired three-dimensional digital patient image data. 
     
     
         33 . The method of  claim 31 , wherein the femoral implant has a periphery mimicking a periphery of cut bone surfaces on the femur, and wherein the periphery of the femoral implant is based on preoperatively acquired three-dimensional digital patient image data. 
     
     
         34 . A method for performing a total knee arthroplasty procedure comprising:
 positioning a distal femoral cutting guide against a femur immediately adjacent an anterior periphery of a distal cut to be made on a distal end of the femur, the distal femoral cutting guide having a planar femoral guide surface adapted to guide an oscillating sawblade to create the distal cut, the anterior periphery of the distal cut having a curvilinear shape, and the planar femoral guide surface having a posterior periphery having a curvilinear shape mimicking the shape of the anterior periphery of the distal cut, wherein the shape of the posterior periphery of the planar femoral guide surface is based upon preoperatively acquired three-dimensional digital patient image data;   engaging the sawblade with the planar femoral guide surface and creating the distal cut on the femur using the planar femoral guide surface to guide the sawblade with the planar femoral guide surface coplanar with the distal cut on the femur;   prior to creating the distal cut, creating markings in the distal end of the femur using a marking element;   removing the distal femoral cutting guide after creating the distal cut on the femur and disposing of the distal femoral cutting guide so that it is not used as a part of another total knee arthroplasty procedure;   following removal of the distal femoral cutting guide, attaching a second femoral cutting guide to the femur, wherein the second cutting guide operably references the markings on the femur;   using the second femoral cutting guide to create at least two of an anterior cut, an anterior chamfer cut, a posterior chamfer cut, and a posterior cut on the femur;   positioning a tibial alignment guide on a proximal end of a tibia of the patient, the tibial alignment guide configured based on preoperatively acquired three-dimensional digital patient image data such that the tibial alignment guide simultaneously contacts the tibia at least at nine points that include at least three points on a non-resected medial tibial condyle, at least three points on a non-resected lateral tibial condyle and at least three points on a non-resected anterocentral surface of the tibia located medially of the points of contact with the lateral tibial condyle;   positioning a proximal tibial cutting guide against a medial half of the proximal end of the tibia immediately adjacent an anterior periphery of a planar proximal cut to be made on a proximal end of the tibia with a location and orientation of the proximal tibial cutting guide being dictated by the tibial alignment guide, the proximal tibial cutting guide having only one planar tibial guide surface which is coplanar with the planar proximal cut and adapted to guide an oscillating sawblade to create the planar proximal cut, the anterior periphery of the planar proximal cut having a curvilinear shape, and the one planar tibial guide surface having a posterior periphery having a curvilinear shape mimicking the shape of at least a portion of a medial half of the anterior periphery of the planar proximal cut, wherein the shape of the posterior periphery of the one planar tibial guide surface is based upon preoperatively acquired three-dimensional digital patient image data, and wherein a lateral-most point of the posterior periphery of the planar tibial guide surface is located medially of a lateral-most of the points of contact between the tibial alignment guide and the lateral tibial condyle;   engaging the sawblade with the one planar tibial guide surface of the proximal tibial cutting guide and creating the planar proximal cut on the tibia underlying both a medial condyle and a lateral condyle of the tibia using the one planar tibial guide surface to guide the sawblade with the one planar tibial guide surface positioned coplanar with the planar proximal cut;   removing the proximal tibial cutting guide after creating the planar proximal cut on the tibia and disposing of the proximal tibial cutting guide so that it is not used as a part of another total knee arthroplasty procedure;   implanting a total knee arthroplasty femoral implant on the distal end of the femur, and   implanting a total knee arthroplasty tibial implant on the proximal end of the tibia, wherein the tibial implant has a periphery mimicking a periphery of the planar proximal cut, and wherein the periphery of the tibial implant is based on preoperatively acquired three-dimensional digital patient image data.   
     
     
         35 . The method of  claim 34 , where positioning a distal femoral cutting guide against the femur immediately adjacent an anterior periphery of a distal cut to be made on the distal end of the femur includes positioning the distal femoral cutting guide such that a portion of the distal femoral cutting guide wraps around an anteromedial corner of the distal end of the femur and extends at least partially posteriorly along a medial side of the distal end of the femur. 
     
     
         36 . The method of  claim 34 , further comprising utilizing the proximal tibial cutting guide to create a second planar proximal cut on the tibia with the proximal tibial cutting guide, the second planar proximal cut being deeper on the tibia that the planar proximal cut. 
     
     
         37 . The method of  claim 34 , wherein creating the distal cut on the femur using the planar femoral guide surface includes creating the distal cut across all of the distal end of the femur. 
     
     
         38 . The method of  claim 34 , wherein the distal femoral cutting guide includes a second planar femoral guide surface that is not coplanar with the planar femoral guide surface and further comprising engaging the sawblade with the second planar femoral guide surface to create a second cut on the femur using the second planar femoral guide surface to guide the sawblade. 
     
     
         39 . The method of  claim 34 , wherein the femoral implant has a periphery mimicking a periphery of cut bone surfaces on the femur, and wherein the periphery of the femoral implant is based on preoperatively acquired three-dimensional digital patient image data. 
     
     
         40 . A method for performing a total knee arthroplasty procedure comprising:
 positioning a distal femoral cutting guide against a femur immediately adjacent an anterior periphery of a distal cut to be made on a distal end of the femur, the distal femoral cutting guide having a planar femoral guide surface adapted to guide an oscillating sawblade to create the distal cut, the anterior periphery of the distal cut having a curvilinear shape, and the planar femoral guide surface having a posterior periphery having a curvilinear shape mimicking the shape of the anterior periphery of the distal cut, wherein the shape of the posterior periphery of the planar femoral guide surface is based upon preoperatively acquired three-dimensional digital patient image data;   engaging the sawblade with the planar femoral guide surface and creating the distal cut on the femur using the planar femoral guide surface to guide the sawblade with the planar femoral guide surface coplanar with the distal cut on the femur;   prior to creating the distal cut, creating markings in the distal end of the femur using a marking element;   removing the distal femoral cutting guide after creating the distal cut on the femur and disposing of the distal femoral cutting guide so that it is not used as a part of another total knee arthroplasty procedure;   following removal of the distal femoral cutting guide, attaching a second femoral cutting guide to the femur, wherein the second cutting guide operably references the markings on the femur;   using the second femoral cutting guide to create at least two of an anterior cut, an anterior chamfer cut, a posterior chamfer cut, and a posterior cut on the femur;   positioning a tibial alignment guide on a proximal end of a tibia of the patient, the tibial alignment guide configured based on preoperatively acquired three-dimensional digital patient image data such that the tibial alignment guide simultaneously contacts the tibia at least at nine points that include at least three points on a non-resected medial tibial condyle, at least three points on a non-resected lateral tibial condyle and at least three points on a non-resected anterocentral surface of the tibia located medially of the points of contact with the lateral tibial condyle;   positioning a proximal tibial cutting guide against a medial half of the proximal end of the tibia immediately adjacent an anterior periphery of a planar proximal cut to be made on a proximal end of the tibia with a location and orientation of the proximal tibial cutting guide being dictated by the tibial alignment guide, the proximal tibial cutting guide having only one planar tibial guide surface which is coplanar with the planar proximal cut and adapted to guide an oscillating sawblade to create the planar proximal cut, the anterior periphery of the planar proximal cut having a curvilinear shape, and the one planar tibial guide surface having a posterior periphery having a curvilinear shape mimicking the shape of at least a portion of a medial half of the anterior periphery of the planar proximal cut, wherein the shape of the posterior periphery of the one planar tibial guide surface is based upon preoperatively acquired three-dimensional digital patient image data, and wherein a lateral-most point of the posterior periphery of the planar tibial guide surface is located medially of a lateral-most of the points of contact between the tibial alignment guide and the lateral tibial condyle;   engaging the sawblade with the one planar tibial guide surface of the proximal tibial cutting guide and creating the planar proximal cut on the tibia underlying both a medial condyle and a lateral condyle of the tibia using the one planar tibial guide surface to guide the sawblade with the one planar tibial guide surface positioned coplanar with the planar proximal cut;   removing the proximal tibial cutting guide after creating the planar proximal cut on the tibia and disposing of the proximal tibial cutting guide so that it is not used as a part of another total knee arthroplasty procedure;   implanting a total knee arthroplasty femoral implant on the distal end of the femur, wherein the femoral implant has a periphery mimicking a periphery of cut bone surfaces on the femur, and wherein the periphery of the femoral implant is based on preoperatively acquired three-dimensional digital patient image data; and   implanting a total knee arthroplasty tibial implant on the proximal end of the tibia, wherein the tibial implant has a periphery mimicking a periphery of the planar proximal cut, and wherein the periphery of the tibial implant is based on preoperatively acquired three-dimensional digital patient image data.   
     
     
         41 . The method of  claim 40 , where positioning a distal femoral cutting guide against the femur immediately adjacent an anterior periphery of a distal cut to be made on the distal end of the femur includes positioning the distal femoral cutting guide such that a portion of the distal femoral cutting guide wraps around an anteromedial corner of the distal end of the femur and extends at least partially posteriorly along a medial side of the distal end of the femur. 
     
     
         42 . The method of  claim 40 , further comprising utilizing the proximal tibial cutting guide to create a second planar proximal cut on the tibia with the proximal tibial cutting guide, the second planar proximal cut being deeper on the tibia that the planar proximal cut. 
     
     
         43 . The method of  claim 40 , wherein creating the distal cut on the femur using the planar femoral guide surface includes creating the distal cut across all of the distal end of the femur. 
     
     
         44 . The method of  claim 40 , wherein the distal femoral cutting guide includes a second planar femoral guide surface that is not coplanar with the planar femoral guide surface and further comprising engaging the sawblade with the second planar femoral guide surface to create a second cut on the femur using the second planar femoral guide surface to guide the sawblade.