Patient-specific femoral guide

Abstract

A medical device for preparing an elongated bone, such as a proximal femoral bone, for receiving an implant includes a patient-specific femoral guide and an elongated alignment element. The femoral guide has a patient-specific three-dimensional bone-engaging surface configured according to a preoperative plan based on a three-dimensional image model of the femoral bone to mate complementarily with the surface of the proximal femoral bone extending between the greater trochanter, the femoral neck and the femoral shaft of the proximal femur. The femoral guide includes a first guide end forming a planar guide configured for guiding a neck resection. The alignment member can be removably attached to the femoral guide and defines a reference axis for guiding a cutting tool into the femoral bone through a resected surface of the femoral neck.

1 .- 20 . (canceled) 
     
     
         21 . A guide for preparing a proximal portion of an elongated bone for receiving an implant comprising:
 a body having a patient-specific three-dimensional bone-engaging surface configured according to a preoperative plan based on a three-dimensional image model of the proximal portion of the elongated bone to mate complementarily with a surface thereof;   a resection surface formed by an edge of the body and positioned thereby, wherein the resection surface is configured for guiding a resection of a neck of the elongated bone; and   one or more holes defined by the body and configured to receive one or more pins that mount the guide to the proximal portion of the elongated bone in a patient-specific position such that the patient-specific three-dimensional bone-engaging surface of the body mates complimentary with the surface of the proximal portion of the elongated bone.   
     
     
         22 . The guide of  claim 21 , wherein the body is configured to extend around less than an entirety of the proximal portion of the elongated bone such that the body is configured to engage with one of an anterior of the surface or a posterior of the surface of the proximal portion of the elongated bone. 
     
     
         23 . The guide of  claim 22 , wherein at least one of the one or more holes are positioned adjacent a medial edge of the body. 
     
     
         24 . The guide of  claim 22 , wherein the body is formed as a single one-piece component. 
     
     
         25 . The guide of  claim 22 , wherein the body is configured to partially wrap a lateral side and a medial side of the proximal portion of the elongated bone. 
     
     
         26 . The guide of  claim 25 , wherein the body has a curved medial flange and a curved lateral flange configured to partially wrap the medial side and the lateral side, respectively. 
     
     
         27 . The guide of  claim 21 , wherein the body is configured for viewing of at least a part of the proximal portion of the elongated bone. 
     
     
         28 . The guide of  claim 21 , wherein the elongated bone comprises a femur, and wherein the body is configured to extending between a greater trochanter, a femoral neck and a femoral shaft of the femoral bone. 
     
     
         29 . The guide of  claim 21 , wherein the elongated bone comprises a femur, and wherein the resection surface is configured to guide the resection of a femoral neck along a resection plane, thereby removing a femoral head and exposing a resected surface of the femoral neck, wherein the resection plane is selected during pre-operative planning to conserve healthy bone, adjust or conform to patient-specific anteversion or other angles and in conformance with the planned implant for the femoral joint. 
     
     
         30 . A method for preparing a proximal femoral bone for an implant comprising:
 attaching a femoral guide to the proximal femoral bone, wherein the femoral guide has a body with a patient-specific three-dimensional bone-engaging surface configured according to a preoperative plan based on a three-dimensional image model of the proximal femoral bone to mate complementarily with a surface thereof; and   guiding a cutting instrument along a resection surface of the femoral guide to cut a femoral neck of the proximal femoral bone along a patient-specific plane, wherein the resection surface is formed by an edge of the femoral guide.   
     
     
         31 . The method of  claim 30 , wherein attaching the femoral guide includes positioning the body to extend around less than an entirety of the proximal femoral bone such that the body is configured to engage with one of an anterior of the surface or a posterior of the surface of the proximal portion of the elongated bone. 
     
     
         32 . The method of  claim 31 , wherein the body is configured to partially wrap a lateral side and a medial side of the proximal femoral bone. 
     
     
         33 . The method of  claim 32 , wherein the body has a curved medial flange and a curved lateral flange configured to partially wrap the medial side and the lateral side, respectively. 
     
     
         34 . A guide for preparing a proximal femoral bone for receiving an implant comprising:
 a body having a patient-specific three-dimensional bone-engaging surface configured according to a preoperative plan based on a three-dimensional image model of the proximal femoral bone to mate complementarily with a surface thereof, wherein the body is configured to extend around less than an entirety of the proximal femoral bone such that the body is configured to engage with one of an anterior of the surface or a posterior of the surface of the proximal femoral bone;   one or more holes defined by the body and configured to receive one or more pins that mount the guide to the proximal femoral bone in a patient-specific position such that the patient-specific three-dimensional bone-engaging surface of the body mates complimentary with the surface of the proximal femoral bone;   a resection surface formed by an edged of the body and positioned thereby, wherein the resection surface is configured for guiding a resection of a neck of the proximal femoral bone along a resection plane, thereby removing a femoral head and exposing a resected surface of the femoral neck, and wherein the resection plane is selected during pre-operative planning to conserve healthy bone, adjust or conform to patient-specific anteversion or other angles and in conformance with the planned implant for the femoral joint.   
     
     
         35 . The guide of  claim 34 , wherein at least one of the one or more holes are positioned adjacent a medial edge of the body. 
     
     
         36 . The guide of  claim 34 , wherein the body is formed as a single one-piece component. 
     
     
         37 . The guide of  claim 34 , wherein the body is configured to partially wrap a lateral side and a medial side of the proximal femoral bone. 
     
     
         38 . The guide of  claim 37 , wherein the body has a curved medial flange and a curved lateral flange configured to partially wrap the medial side and the lateral side, respectively. 
     
     
         39 . The guide of  claim 34 , wherein the body is configured for viewing of at least a part of the proximal femoral bone.