Patient-matched total knee arthroscopy

Abstract

A gauge assembly includes a distal femur gauge including medial and lateral condyle paddles each having a shape and size corresponding to a pre-operative planned distal resection of a patient's femur, and a tibial cutting block connected to the distal femur gauge. The condyle paddles include features, for example, pin-receiving holes, that permit intra-operative anterior-posterior and/or internal-external adjustment of the position of the distal femur gauge. The tibial cutting block includes features, for example, pin-receiving slot and holes, that permit fixing of the varus-valgus and flexion-extension degrees of freedom prior to fixing the internal-external and medial-lateral degrees of freedom.

1 - 10 . (canceled) 
     
     
         11 . A gauge assembly, comprising:
 a distal femur gauge comprising medial and lateral condyle paddles; and   a tibial cutting block connected to the distal femur gauge, the tibial cutting block comprising:
 a proximal tibial resection plane, and 
 fixation features that permit fixation of a varus-valgus degree of freedom and a flexion-extension degree of freedom of the tibial cutting block prior to fixation of an internal-external degree of freedom and a medial-lateral degree of freedom of the tibial cutting block. 
   
     
     
         12 . The gauge assembly of  claim 11 , wherein the one or more fixation features comprise two or more slots configured to receive two or more parallel pins extending from a patient's anterior tibia. 
     
     
         13 . The gauge assembly of  claim 12 , wherein the two or more slots are configured to restrict the tibial cutting block to the internal-external and the medial-lateral degrees of freedom when the two or more parallel pins extending from the patient's anterior tibia are disposed in the two or more slots. 
     
     
         14 . The gauge assembly of  claim 12 , wherein the two or more slots are configured to be parallel with the proximal tibial resection plane. 
     
     
         15 . The gauge assembly of  claim 11 , wherein fixation features comprise two or more guide holes configured to receive two or more parallel pins extending from a patient's anterior tibia. 
     
     
         16 . The gauge assembly of  claim 15 , wherein the two or more guide holes are configured to facilitate fixation of the varus-valgus and the flexion-extension degrees of freedom when the two or more parallel pins extending from the patient's anterior tibia are disposed in the two or more guide holes. 
     
     
         17 . The gauge assembly of  claim 15 , wherein the two or more guide holes are configured to be parallel with the proximal tibial resection plane. 
     
     
         18 . The gauge assembly of  claim 15 , wherein the two or more guide holes vary relative to each other by a degree of posterior slope relative to the tibial mechanical axis. 
     
     
         19 . The gauge assembly of  claim 11 , wherein the one or more fixation features comprise one or more customizable features configured to constrain internal-external rotation of the tibial cutting block. 
     
     
         20 . The gauge assembly of  claim 11 , wherein the tibial cutting block further comprises one or more recut pin guides configured to facilitate slope and depth adjustment of the tibial cutting block. 
     
     
         21 . The gauge assembly of  claim 20 , wherein the one or more recut pin guides are further configured to be parallel with the proximal tibial resection plane. 
     
     
         22 . The gauge assembly of  claim 11 , wherein the medial and lateral condyle paddles each have a shape and size corresponding to a pre-operative planned distal resection of a patient's femur. 
     
     
         23 . The gauge assembly of  claim 11 , wherein the medial and lateral condyle paddles comprise features that permit intra-operative anterior-posterior and/or internal-external adjustment of the position of the distal femur gauge. 
     
     
         24 . The gauge assembly of  claim 11 , wherein the medial and lateral condyle paddles each comprise a proximal facing surface that is flat and configured to conform to a distal end of a patient's femur after distal resection of the patient's femur. 
     
     
         25 . The gauge assembly of  claim 24 , wherein the medial and lateral condyle paddles each further comprise a distal facing surface, the distal facing surface of the medial condyle paddle being contoured to replicate the patient's native medial condyle, the distal facing surface of the lateral condyle paddle being contoured to replicate the patient's native lateral condyle. 
     
     
         26 . The gauge assembly of  claim 25 , wherein the medial and lateral condyle paddles each further comprise at least one pin positioned on, and outwardly extending from, the proximal facing surface of each of the medial and lateral condyle paddles, wherein the at least one pin positioned on and outwardly extending from each of the medial and lateral condyle paddles can be inserted into a prepared hole in the distal end of the patient's femur after distal resection of the patient's femur. 
     
     
         27 . The gauge assembly of  claim 26 , wherein the medial and lateral condyle paddles each further comprise at least one pin hole that extends through both the proximal facing surface and the distal facing surface. 
     
     
         28 . The gauge assembly of  claim 27 , wherein the at least one pin hole comprises at least one elongated slot. 
     
     
         29 . The gauge assembly of  claim 27 , wherein the at least one pin hole of each of the medial and lateral condyle paddles comprises a first pin hole and a second pin hole, wherein the first pin hole is positioned to facilitate adjustment of an anterior-posterior position of the distal femur guide, and wherein the second pin hole is positioned to facilitate adjustment of an internal-external rotation of the distal femur guide. 
     
     
         30 . A gauge assembly comprising:
 a distal femur gauge comprising medial and lateral condyle paddles; and   a tibial cutting block connected to the distal femur gauge, the tibial cutting block comprising:
 a proximal tibial resection plane, 
 two or more slots configured to facilitate restriction of the tibial cutting block to an internal-external degree of freedom and a medial-lateral degree of freedom, and 
 two or more guide holes configured to facilitate fixation of a varus-valgus degree of freedom and a flexion-extension degree of freedom of the tibial cutting block.