Patent Application
20140207143
The present invention relates to methods and apparatus for resecting allogeneic grafts and implanting them in a controlled manner. More particularly, the present invention relates to methods and apparatus for resecting allogeneic grafts and implanting them in a patient in a controlled manner through use of an allograft template.
An osteochondral lesion (osteochondritis dissecans or OCD) is an injury or small fracture of the cartilage surface of the talus which typically occurs via a crush or injury to the surface of the bone during the abnormal motion of the ankle in a sprain. The OCD sits on the medial or lateral shoulder of the talar dome and is situated on the top and the side of the joint surface. The talus bone is part of the collection of bones which forms the lower part of the ankle joint.
With an inversion or eversion stress on the ankle, the talus and tibia and/or fibula will contact each other with massive stress, resulting in a compression or shear stress on the surface of the talus and underlying injury.
In an ankle allograft replacement, an entirely new joint surface (made of bone and cartilage harvested from a fresh cadaver) is typically implanted instead of replacing the ankle joint with a replacement made of metal and plastic. The operation involves removal of a segment of bone and cartilage from the recipient ankle and identical bone cuts made on the ankle cadaver graft.
A cutting jig is typically used to harvest the ankle joint from the cadaver ankle. The block is fixed on to the cadaver (e.g., using one or more K-wires) and the cuts are made to remove the ankle joint which is then implanted into the recipient. Properly fitting a donor bone section into the resection site for a patient is important for recovery time, longevity, and performance for the patient.
However, such cutting jigs are time-consuming to set up and use and may not enable enough of a precise cut for providing a bone graft suitable for resection and implantation. Such an ill-fitting graft may subsequently increase the time for bone in-growth and patient recovery time. Moreover, part of the imprecise cuts may occur because of improper offsetting of the jigs in failing to account for kerf losses incurred when cutting into the bone due to the saw or blade.
Accordingly, there exists a need for methods and apparatus which facilitate procedures such as calcaneal osteotomy procedures by providing for easier and more accurate blade positioning and adjustment features and which provide for shorter procedure times.
An allograft template may be used as a cutting jig which allows for en bloc resection and grafting of bone between a donor and a patient. The template may be sized in various configurations such that the template may be used for resection and grafting along various regions of the body. Hence, while one particular application for the template may be for resection and grafting to correct for osteochondral lesions along the talus bone, the template may be used in various alternative orthopedic procedures.
The allograft template may facilitate guidance of the saw to allow for resection of a donor graft in a size which is slightly larger than the portion of bone to be resected from the patient bone. Because the same template may be used between the donor and the patient, the cuts may be maintained in a consistent manner between the resection sites. The cuts may be formed in a parallel or angled manner depending upon the angling of the guidance slots defined along the template. Moreover, by accounting for kerf losses in the bone due to the saw cuts, the resection sizes may be offset accordingly by the template. The resulting donor graft may be implanted in the patient resection site resulting in a press-fit which backfills the patient resection site and ensures a secure graft. Hence, the allograft template reduces errors in forming a resection site in the bone of the patient and further reduces errors (e.g., errors resulting from thickness of the blade, measurement errors, cutting errors, etc.) in the forming and extraction of the graft from the bone of the donor.
Generally, a template for resecting a tissue region may comprise a template frame having a surface for contacting the tissue region and which defines an open area of tissue to be resected, one or more inner guidance slots defined along the frame, where the inner guidance slots are spaced relative to one another to define the tissue within the open area to be resected from a patient, and one or more outer guidance slots defined along the frame and aligned adjacent to the inner guidance slots, where the outer guidance slots are spaced relative to one another to define the tissue to be resected from a donor.
One example of a method of resecting the tissue region may generally comprise securing the template frame upon a first tissue region to be resected, where the frame defines an open area of the first tissue to be resected, resecting the first tissue by cutting along one or more inner guidance slots defined along the frame, removing the template frame from the first tissue region, securing the template frame upon a second tissue region to be resected, where the frame defines the open area of the second tissue to be resected, and resecting the second tissue by cutting along one or more outer guidance slots defined along the frame.
In one variation of an allograft template assembly, the template may generally comprises a first portion of a frame which may lie along a first plane and a second curved portion which may extend or curve in an arcuate manner away from the frame along a second plane. The frame and curved portion may together form a framed opening which defines the border or framed boundary of the bone portion to be either grafted and/or resected. Moreover, the frame and curved portion may define one or more frame guidance slots and guidance slots along the template assembly for defining the tissue area to be cut and for guiding the saw and/or blade along the tissue, as described in further detail below.
Additionally, the frame and/or curved portion may incorporate a cross member extending between the frame members for providing structural support and stability and also for optionally providing one or more cross member openings through which pins or wires may be passed for securement to the underlying tissue or bone, such as the bone to be resected from a patient. To facilitate handling of the template assembly during a grafting and/or resection procedure, one or more handles may be attached, for instance, along the cross member to extend from the template assembly. Handles may be positioned along other sections of the template assembly if so desired.
One or more supporting flanges may also be optionally integrated to extend outwardly along one or both sides of the frame and/or curved portion. These supporting flanges may define one or more flange openings defined at various angles therethrough. Pins or wires may be passed through these flange openings for securement to the underlying tissue or bone, such as the bone of the donor at regions adjacent to the resected bone.
The frame and curved portion may define an inner guidance slot defined along the length and an additional outer guidance slot may also be defined along the length of the frame and part of curved portion in parallel with the inner guidance slot. With the inner and outer guidance slots defined parallel to one, the saw or blades may be inserted through or along a respective guidance slot such that the saw or blade become transversely oriented relative to the inner guidance slot and outer guidance slot.
In use, the template assembly may be used to resect a portion of bone from the bone of the donor which is slightly larger than the corresponding resected opening in the bone of the patient. Hence, the resulting resected bone segment from the donor may result in a graft which can be press-fit into the patient's bone. By accounting for the kerf loss in the bone or tissue typically due to the width of the saw or blade passing through bone or tissue, the width of the resected bone portion may be sized in a consistent and repeatable manner. The opposed inner guidance slots may be separated from one another to have a width of the patient's bone plus the kerf loss to be equal to the width of the donor's bone minus the kerf loss. Hence, the inner guidance slots may define the width of the resected bone to be cut from the patient. Similarly, length of the bone resected from the patient may be equal to the length of the donor graft bone minus the kerf loss. Similarly, the length of the framed opening may marked by the inner guidance slot which may define the length of the resected bone to be cut from the patient.
Because the bone graft to be resected from the donor bone is generally larger than the resected opening in the patient bone, the corresponding bone graft dimensions to be cut from the donor may be demarcated by the outer guidance slots. Thus, the width of the bone graft to be resected from the donor bone may be defined by the outer guidance slots. Generally, the outer guidance slots may have dimensions which account for the saw kerf when cutting the graft from the donor site. Thus, the outer guidance slots may be sized by estimating the graft dimensions as the resection length plus kerf loss, resection width plus kerf loss, and resection thickness plus kerf loss.
As above, the thickness of the bone to be resected from the patient is equal to the thickness of the donor bone minus the kerf loss due to the saw or blade. The corresponding height of the bone to be resected from the patient may be seen by the height extending from the contact surface of frame to the inner guidance slot and the height of the bone to be grafted from the donor may be seen by the height extending from the contact surface of frame to the outer guidance slot.
Once the template assembly has been situated and secured against the region of the bone to be resected, a saw may be initially inserted along the inner guidance slot and advanced into and through the bone to a predetermined depth, such as the length of the template assembly, until the bone has been cut completely over the width of inner guidance slot. The saw may then be removed or left in place within the bone. The saw (or an additional saw) may then be introduced along the inner guidance slot to complete the cut within the bone to a predetermined depth, such as the depth defined by the template assembly. Similarly, additional cuts may be made along the inner guidance slots by the same or additional saws to result in a completely resected bone segment.
The same or additional saws may then be inserted and guided within the respective outer guidance slots to cut along the predetermined paths for resecting a bone section from the donor bone which is slightly larger than the portion resected from the patient bone but which still has the same relative dimensions and consistent cuts to result in a press-fit graft which is consistently sized between donor and patient.
As the saw or blade is inserted along the guidance slots, the depth to which the cuts are made may be controlled through a number of different mechanisms. In one example, the saw may have one or more markers or visual indicators (e.g., laser markers) placed upon the surface of the saw to correspond to the desired cutting depth. Such markers or indicators may be consistent between each guidance slot or they may be varied depending upon which guidance slot the saw is inserted within. Alternatively, rather than a marker or visual indicator, the saw may have a projection or protrusion which functions as a stop such that when the projection or protrusion abuts against the guidance slot of the template assembly, then the desired cutting depth has been reached. By maintaining predetermined cutting depths along the guidance slots, consistent resections or grafted bone segments may be maintained between the donor bone and patient bone with minimal damage to surrounding bone or tissue.
In addition to the saws or blades having indicators for monitoring cutting depth, the one or more securement wires, e.g., K-wires, olive wires, pins, etc., which may be used to secure the template assembly to the donor and/or patient bone may also define one or more respective markings or visual indicators along their lengths such as graduations. The markings may be measured against the respective insertion hole to determine the insertion depth into the donor and/or patient bone and/or tissue. By monitoring the securement wire insertion depth, damage to the underlying bone and/or tissue may be minimized but may still ensure that an adequate insertion depth has been achieved to maintain a secure placement of the template assembly relative to the underlying bone.
In one example of use, the portion of bone to be resected from the patient may be cut and removed first and the same template may then be used to resect the bone graft from the donor bone. Alternatively, the donor graft may be resected first and the portion of bone to be resected from the patient may be then resected. In yet another alternative, both the bone of the patient and the bone of the donor may be resected simultaneously by utilizing multiple template assemblies having identical dimensions.
The portion of the bone to be repaired in the patient may be first identified and the template assembly may then be placed into contact against the patient bone such that the framed opening of template assembly surrounds the portion of the patient resected bone to be repaired. With the template assembly initially held in place against the surface of the patient bone, one or more securement wires may be inserted through the template assembly, e.g., through the openings defined along the cross-member, while monitoring their insertion depth to hold the template in place relative to the bone surface. Because the damaged patient resected bone bounded by the framed opening is to be removed from the patient bone, the one or more securement wires may be inserted specifically into the patient resected bone through the cross-member such that the surrounding bone may remain undamaged or untouched by the securement wires.
With the template assembly secured in place, the saw may be inserted through inner guidance slot and the bottom cut may be made into the bone first while monitoring and/or measuring the cutting depth via the optional graduations along the saw. The saw may be optionally left in place within the bone and the remaining cuts may then be made. Alternatively, the same saw and/or additional saws may be then inserted along the side inner guidance slots to make the cuts into the patient bone while monitoring and/or measuring the cutting depth. The same saw or additional saws may then be used to make the final cut along the distal inner guidance slot. The patient resected bone may be removed by tensioning the handle and/or securement wires to leave the resected channel for grafting. In other variations, the order of the cuts into the bone may be altered as suitable or desired. For instance, the initial cut into the bottom of the patient resected bone may be followed by cuts into the distal end of the bone followed by subsequent cuts along the sides of the bone. In yet other alternatives, an initial cut may be made along the distal end of the patient resected bone followed by cuts along the bottom and/or sides of the bone.
The patient resected bone may be removed from the template assembly which may then be placed into contact against the donor bone such that the framed opening of the template bounds a region of the donor resected bone similar to the patient resected bone. With the handle used to hold the template in place, one or more securement wires may then be passed through the openings defined along the supporting flanges which extend exteriorly of the framed opening and into the underlying donor bone while optionally measuring the insertion depth of the securement wires. Because the donor resected bone is to be removed from the donor bone and grafted into the resected channel defined by the patient resected bone, the one or more securement wires may be inserted through the supporting flanges to secure the template assembly relative to the donor bone. This ensures that the graft donor resected bone remains undamaged by any additional openings which may otherwise be created by the insertion of securement wires.
In yet another variation of the template assembly, a template may utilize a first template for placement upon a bone of the donor and an additional second template for placement upon a bone of the patient. A common guide housing may be utilized between the two different templates to maintain consistency between the resected bone from the patient and the resected bone from the donor for grafting into the patient bone.
Generally, such a template assembly may comprise a first template for placement upon a bone of a donor, where the first template comprises a first frame which defines an open area of tissue upon the bone of the donor, a second template for placement upon a bone of a patient, where the second template comprises a second frame which defines an open area of tissue upon the bone of the patient, and a guide housing which defines a receiving channel for tissue, where the guide housing is further configured to engage the open area of the first template and the open area of the second template.
One example for using the template assembly may generally comprise securing the first template upon a first tissue region to be resected, where the first template defines an open area of the first tissue to be resected, engaging the guide housing along the first template over the open area of the first tissue, resecting the first tissue by cutting along first guidance slots defined between the first template and the guide housing, engaging the second template upon a second tissue region to be resected, where the second template defines an open area of the second tissue to be resected, engaging the guide housing along the second template over the open area of the second tissue, and resecting the second tissue by cutting along second guidance slots defined between the second template and the guide housing.
An internal saw guide assembly may utilize a guide housing between the bone of the patient and the bone of the donor to maintain cutting consistency. The guide housing may form a housing which is open along the portion which contacts the surface of the bone (both donor and patient) to be resected. The guide housing may have a handle which extends from the housing and may further define channels along the sides and bottom portion of the housing for guiding and/or receiving one or more saws. The top of the guide housing may define one or more openings through which one or more corresponding securement wires or pins may be inserted for securing the guide housing to the underlying bone.
The guide housing may be engaged with or inserted along a donor template as well as a corresponding patient template, as described below. The donor template may define one or more openings through which securement wires or pins may be inserted for securing the template to the donor bone. The donor template may accordingly define a contact surface for placement along or upon the underlying bone as a well as a curved template portion to facilitate conformance against the bone surface.
In use, a patient template which defines a curved template portion and a contact surface for conformance against the underlying patient bone may be placed upon a region of the patient bone such that the framed opening bounds the portion of the patient resected bone which is damaged and which is to be replaced by a graft. The patient template may be maintained in place against the patient bone by the handle attached to the template and/or by one or more securement wires which may be inserted through the template and into the underlying bone. A first saw may be inserted through a saw guide defined along the template to a predetermined depth. Then the guide housing may be advanced along and within the framed opening such that the guide housing is fully engaged within the template. The guide housing may be secured and maintained against the patient template as well as the patient bone by inserting one or more securement wires or pins through the openings defined through the guide housing. Moreover, the securement wires or pins may be secured directly to the patient respected bone to be removed and replaced by the graft.
With the guide housing secured within the patient template and against the patient resected bone, a second saw may be inserted between the patient template and the distal portion of the guide housing. The saw may be inserted to a predetermined depth, e.g., by one or more graduations defined along the saw body, or until the distal cutting edge comes into contact against the first saw which may be left in place within the bone to define a stop or boundary to prevent the further advancement of the saw into the underlying patient bone. The remaining saws may be advanced along the sides of the guide housing and within the patient template to completely resect the patient resected bone within the guide housing.
With the patient bone resected, the donor bone may also be resected in a similar manner but with a second donor template which defines an opening which corresponds in size with the patient template framed opening. The donor template may similarly define a contact surface for placement against the donor bone such that the opening of the donor template frames the donor resected bone to be grafted. Hence, the framed donor resected bone may be consistent in size with the channel defined by the patient resected bone in the patient bone. The donor template similarly defines one or more openings through which the securement wires or pins may be inserted away from the donor resected bone to maintain the integrity of the graft. The donor template may define a receiving channel along the template for receiving the guide housing in a consistent orientation. Hence, the same guide housing used to create the patient resected bone may be advanced into a sliding engagement optionally through the receiving channel upon the donor bone.
As with resection of the patient bone, once the guide housing is secured along the donor template, the first saw may be advanced along the bottom portion of the donor resected bone. The additional saws may be advanced into contact against the first saw to form the distal end of the donor resected bone and the remaining saws may be advanced along the respective sides of the guide housing between the donor template to completely resect the donor resected bone within the guide housing. The donor resected bone may then be removed from the donor bone and grafted into the channel formed by the patient resected bone.
In yet another variation of a resection template, a guide template may be configured to be placed against an anterior portion of a bone to be resected. The anterior guide template may be configured to form a bone receiving channel defined by contact surfaces formed along template walls extending partially from a transversely oriented guide surface. A handle may extend from the anterior guide template to facilitate handling of the template and the guide surface may define one or more openings for the passage of securement wires or pins into the underlying bone to be resected. The guide surface may also define one or more guidance slots which may be aligned in a transverse orientation such that one or more corresponding saws may be inserted into the respective slots to cut the bone contained within the bone receiving channel. Other variations of an anterior resection template may omit the bone receiving channel.
An allograft template may be used as a cutting jig which allows for en bloc resection and grafting of tissue, namely portions of bone, between a donor and a patient. The template may be sized in various configurations such that the template may be used for resection and grafting along various regions of the body. Hence, while one particular application for the template may be for resection and grafting to correct for osteochondral lesions along the talus bone, the template may be used in various alternative orthopedic procedures.
The allograft template may facilitate guidance of the saw to allow for resection of a donor graft in a size which is slightly larger than the portion of bone to be resected from the patient bone. Because the same template may be used between the donor and the patient, the cuts may be maintained in a consistent manner between the resection sites. Moreover, by accounting for kerf losses in the bone due to the saw cuts, the resection sizes may be offset accordingly by the template. The resulting donor graft may be implanted in the patient resection site resulting in a press-fit which backfills the patient resection site and ensures a secure graft. Hence, the allograft template reduces errors in forming a resection site in the bone of the patient and further reduces errors (e.g., errors resulting from thickness of the blade, measurement errors, cutting errors, etc.) in the forming and extraction of the graft from the bone of the donor.
The template assembly 10 may also define a contact surface 14 for placement against the surface of the bone or tissue to be grafted and/or resected. The contact surface 14 may simply follow the frame 12A and curved portion 12B or the contact surface 14 may be specially contoured to conform to any number of tissue regions such as the superior region of a talus bone. Additionally, the frame 12A and/or curved portion 12B may incorporate a cross member 16 extending between the frame 12A members for providing structural support and stability and also for optionally providing one or more cross member openings 28 through which pins or wires may be passed for securement to the underlying tissue or bone, such as the bone to be resected from a patient. To facilitate handling of the template assembly 10 during a grafting and/or resection procedure, one or more handles 34 may be attached, for instance, along the cross member 16 to extend from the template assembly 10. Handles may be positioned along other sections of the template assembly 10 if so desired.
One or more supporting flanges 20, 22 may also be optionally integrated to extend outwardly along one or both sides of the frame 12A and/or curved portion 12B. These supporting flanges 20, 22 may define one or more flange openings 24, 26 defined at various angles therethrough. Pins or wires may be passed through these flange openings 24, 26 for securement to the underlying tissue or bone, such as the bone of the donor at regions adjacent to the resected bone.
While the size of template assembly 10 may be varied according to the size of the bone or tissue to be resected as well as the shape of the anatomy within the body, the template assembly 10 may be varied in dimension. For illustrative purposes, the variation shown may generally have a width of about 0.90 inches and a height of about 0.75 inches. The supporting flanges 20, 22 may also have a width of about 0.19 inches while the inner guidance slots 40A, 40B, 40C and the outer guidance slots 42A, 42B, 42C may be sized to have a width to accommodate any number of saws or blades, e.g., 0.02 inches. Typical surgical saw blades (e.g., available from Synvasive®, Stryker®, etc.) may range in thickness from, e.g., 0.005, 0.010, 0.015 inches or more; hence, a guidance slot width of 0.02 inches is sufficient to accommodate many surgical saws although the slot width may be sized to be greater if needed or desired, as well as the angle of control the template places on the blade may be varied. For example a 2.5 degree angle on the outer slot can help create a tighter press fit, as described in further detail herein. The remaining inner and outer guidance slots 44, 46 may also have width, e.g., ranging from 0.02 to 0.04 inches.
In use, the template assembly 10 may be used to resect a portion of bone from the bone of the donor which is slightly larger than the corresponding resected opening in the bone of the patient. Hence, the resulting resected bone segment from the donor may result in a graft which can be press-fit into the patient's bone. By accounting for the kerf loss in the bone or tissue typically due to the width of the saw or blade passing through bone or tissue, the width of the resected bone portion may be sized in a consistent and repeatable manner. As shown in the top view of template assembly 10 in
Because the bone graft to be resected from the donor bone is generally larger than the resected opening in the patient bone, the corresponding bone graft dimensions to be cut from the donor may be demarcated by the outer guidance slots 42A, 42B, 42C. Thus, the width of the bone graft DW to be resected from the donor bone may be defined by the guidance slots 42B, 42C. Similarly, the length of the bone graft DL to be resected from the donor bone may be defined by the guidance slot 42A. Generally, the outer guidance slots 42A, 42B, 42C may have dimensions which account for the saw kerf when cutting the graft from the donor site. Thus, the outer guidance slots may be sized by estimating the graft dimensions as the resection length plus kerf loss, resection width plus kerf loss, and resection thickness plus kerf loss.
Likewise, the height of the bone to be resected may be demarcated by the guidance slots as shown in the end view of
In either case, once the template assembly 10 has been situated and secured against the region of the bone to be resected (in this example the bone of the patient), a saw 50D may be initially inserted along the inner guidance slot 44 and advanced into and through the bone to a predetermined depth, such as the length of the template assembly 10, until the bone has been cut completely over the width of inner guidance slot 44. The saw 50D may then be removed or left in place within the bone. The saw 50D (or an additional saw 50A) may then be introduced along the inner guidance slot 40A to complete the cut within the bone to a predetermined depth, such as the depth defined by the template assembly 10. Similarly, additional cuts may be made along the inner guidance slots 40B, 40C by the same or additional saws 50B, 50C to result in a completely resected bone segment.
The same template 10 is also shown in the perspective view of
As the saw or blade is inserted along the guidance slots, the depth to which the cuts are made may be controlled through a number of different mechanisms. In one example, the saw may have one or more markers or visual indicators (e.g., laser markers) placed upon the surface of the saw to correspond to the desired cutting depth. Such markers or indicators may be consistent between each guidance slot or they may be varied depending upon which guidance slot the saw is inserted within. Alternatively, rather than a marker or visual indicator, the saw may have a projection or protrusion which functions as a stop such that when the projection or protrusion abuts against the guidance slot of the template assembly 10, then the desired cutting depth has been reached. By maintaining predetermined cutting depths along the guidance slots, consistent resections or grafted bone segments may be maintained between the donor bone and patient bone with minimal damage to surrounding bone or tissue.
In addition to the saws or blades having indicators for monitoring cutting depth, the one or more securement wires 70, 74, e.g., K-wires, olive wires, pins, etc., which may be used to secure the template assembly 10 to the donor and/or patient bone may also define one or more respective markings or visual indicators along their lengths such as graduations 72, 76 as shown in the perspective view of
With the template assembly 10 secured accordingly, the saw 50D may be inserted through the appropriate guidance slot and the same or additional saws 50A may be inserted through its respective guidance slot to further cut around the bone. As shown, with the graduations 58 marked along the body of saw 50A, the cutting depth may be monitored and measured by the degree to which the saw 50A is cut into the bone relative to the guidance slot.
In one example of use, the portion of bone to be resected from the patient may be cut and removed first and the same template may then be used to resect the bone graft from the donor bone. Alternatively, the donor graft may be resected first and the portion of bone to be resected from the patient may be then resected. In yet another alternative, both the bone of the patient and the bone of the donor may be resected simultaneously by utilizing multiple template assemblies having identical dimensions.
In yet another variation of the template assembly, the outer guide 73A along the frame 12A and/or curved portion 12B may be angled relative to a normal axis L defined by the framed opening 18, as shown in the cross-sectional side view of
An additional chamfer 75 may be formed along the entry of the outer guide 73A to facilitate the insertion of the saw into the guide. By angling the outer guide 73A in such a manner relative to the inner guide 71A, the saw may be correspondingly guided at an angle along the guide 73A such that the bone graft resected from the donor bone DBN may be formed with tapered sides which may help to form a tighter press-fit graft when implanted into the patient.
In other variations, the inner guide may be angled relative to the normal axis L or both the inner 71A and outer 73A guides may be angled relative to one another and/or relative to the normal axis L of the framed opening 18. In either case, the use of angled guidance slots may be utilized in combination with any of the embodiments described herein as practicable.
As shown in
With the template assembly secured in place, the saw 50D may be inserted through inner guidance slot 44, as shown in
The patient resected bone PRS may be removed from the template assembly 10 which may then be placed into contact against the donor bone DBN from a donor D such that the framed opening 18 of template 10 bounds a region of the donor resected bone DRS, as shown in
As illustrated in
In yet another variation of the template assembly,
As shown in the perspective view of
The guide housing 82 may be engaged with or inserted along a donor template 92, as shown, as well as a corresponding patient template, as described below. The donor template 92 may define one or more openings 94, 96 through which securement wires or pins may be inserted for securing the template 92 to the donor bone. The donor template 92 may accordingly define a contact surface 98 for placement along or upon the underlying bone as a well as a curved template portion 100 to facilitate conformance against the bone surface. A handle 102 may also extend from the donor template 92 to facilitate handling of the assembly.
In use, a patient template 110 which defines a curved template portion 112 and a contact surface 116 for conformance against the underlying patient bone PBN may be placed upon a region of the patient bone PBN such that the framed opening 118 bounds the portion of the patient resected bone PRS which is damaged and which is to be replaced by a graft, as shown in the perspective view of
With the guide housing 82 secured within the patient template 110 and against the patient resected bone PRS, a second saw 86D may be inserted between the patient template 110 and the distal portion of the guide housing 82, as shown in
With the patient bone resected, the donor bone may also be resected in a similar manner but with a second donor template 92 which defines an opening which corresponds in size with the patient template framed opening 118. The donor template 92 may similarly define a contact surface for placement against the donor bone DBN such that the opening of the donor template 92 frames the donor resected bone DRS to be grafted, as shown in the perspective view of
As with resection of the patient bone PBN, once the guide housing 82 is secured along the donor template 92, the first saw 86A may be advanced along the bottom portion of the donor resected bone DRS, as shown in
In yet another variation of a resection template,
In yet another variation,
Another variation is shown in the perspective and end views of
The applications of the devices and methods discussed above are not limited to bone resection along the talus bone but may include any number of other bones or tissue regions in the body. Modification of the above-described assemblies and methods for carrying out the invention, combinations between different variations as practicable, and variations of aspects of the invention that are obvious to those of skill in the art are intended to be within the scope of the claims.
This application claims the benefit of priority to U.S. Prov. App. 61/756,214 filed Jan. 24, 2013, which is incorporated herein by reference in its entirety.
| Number | Date | Country | |
|---|---|---|---|
| 61756214 | Jan 2013 | US |
