Patent Grant
10952863
The present disclosure relates generally to orthopaedic surgical instruments and, more particularly, to surgical instruments used with a patient's tibia.
Joint arthroplasty is a well-known surgical procedure by which a diseased and/or damaged natural joint is replaced by a prosthetic joint. A typical knee prosthesis includes a patella prosthetic component, a tibial tray, a femoral component, and a polymer insert or bearing positioned between the tibial tray and the femoral component. Femoral components are designed to be attached to a surgically-prepared distal end of a patient's femur. Tibial trays are designed to be attached to a surgically-prepared proximal end of a patient's tibia.
To facilitate the replacement of the natural joint with the knee prosthesis, orthopaedic surgeons use a variety of orthopaedic surgical instruments such as, for example, prosthetic trial components, cutting blocks, drill guides, milling guides, and other surgical instruments. Prosthetic trial components, such as, for example, a femoral trial component and a tibial bearing trial component, are used to size and select the components of the knee prosthesis that will replace the patient's natural joint. A procedure that utilizes the trial components to size and select the components of the knee prosthesis is often referred to as a trial reduction.
According to one aspect of the disclosure, an orthopaedic surgical instrument system for use during a surgical procedure to implant an orthopaedic knee prosthesis includes a tibial base trial component adapted to be positioned on a surgically-prepared proximal end of a patient's tibia. The tibial base trial component has an opening defined therein. The instrument system also includes an insert component shaped to be received in the opening defined in the tibial base trial component. The insert component has a base plate and a central post extending upwardly from a superior surface of the base plate. A superior surface of the central post has a ramp surface defined therein, with the ramp surface inclining superiorly in the anterior-to-posterior direction. The instrument system also includes a tibial bearing trial component having an opening defined therein. The central post of the insert component is configured to be received in the opening of the tibial bearing trial assembly.
The central post may include a collar extending outwardly from the longitudinal axis of the central post, with the ramp surface being defined in a superior surface of the collar. Such a ramp surface defined in the collar may include an anterior end and a posterior end. The anterior end of the ramp surface defined in the collar is coplanar with the superior surface of the base plate, and the posterior end of the ramp surface defined in the collar is spaced apart superiorly from the superior surface of the base plate.
The central post may include a connector configured to secure the insert component to a surgical handle. The connector includes a flange extending anteriorly away from the longitudinal axis of the central post, with the ramp surface being defined in a superior surface of the flange of the connector.
The central post may also include an elongated anti-rotation lug extending in a direction away from the longitudinal axis of the central post, with the ramp surface being defined in a superior surface of the elongated anti-rotation lug.
The insert component may be embodied as a tibial evaluation component having a pair of bone engaging spikes extending inferiorly from the inferior surface thereof.
The tibial bearing trial component may include a tibial bearing surface trial component having an articular surface, and a shim removably secured to the tibial bearing surface trial component.
The insert component may be embodied as a keel punch, with the keel punch having a pair of serrated wings extending inferiorly from the inferior surface of the insert component.
According to another aspect, a surgical instrument for use to surgically prepare a proximal end of a patient's tibia during a surgical procedure to implant an orthopaedic knee prosthesis includes a keel punch. The keel punch includes a base plate, and a central post extending upwardly from a superior surface of the base plate. A superior surface of the central post has a ramp surface defined therein, with the ramp surface inclining superiorly in the anterior-to-posterior direction. The keel punch also includes pair of serrated wings extending inferiorly from an inferior surface of the base plate.
The central post may include a collar extending outwardly from the longitudinal axis of the central post, with the ramp surface being defined in a superior surface of the collar. The anterior end of the ramp surface defined in the collar is coplanar with the superior surface of the base plate, and the posterior end of the ramp surface defined in the collar is spaced apart superiorly from the superior surface of the base plate.
The central post may include a connector configured to secure the keel punch to a surgical handle. The connector includes a flange extending anteriorly away from the longitudinal axis of the central post, and the ramp surface is defined in a superior surface of the flange of the connector.
The central post may further include an elongated anti-rotation lug extending in a direction away from the longitudinal axis of the central post. The ramp surface is defined in a superior surface of the elongated anti-rotation lug.
The surgical punch further may further include a tapered cylindrical post extending inferiorly from the inferior surface of the base plate. One of the pair of serrated wings is secured to a medial side of the tapered cylindrical post and extends medially therefrom, with the other serrated wing being secured to a lateral side of the tapered cylindrical post and extending laterally therefrom.
According to another aspect, a method of trialing prosthetic components of a knee prosthesis includes positioning a tibial base trial component on a surgically-prepared proximal end of a patient's tibia, and inserting an insert component into an opening defined in the tibial base trial component. The insert component has a base plate and a central post extending upwardly from a superior surface of the base plate. The superior surface of the central post has a ramp surface defined therein. The method also includes advancing a tibial bearing trial component in the anterior-to-posterior direction such that a leading edge of the tibial bearing trial component contacts, and rides up, the ramp surface so as to urge a posterior edge of the tibial bearing trial component superiorly in a direction away from the tibial base trial component.
A femoral trial component and the tibial base trial component are urged in a direction away from one another during advancement of the tibial bearing trial component.
The tibial bearing trial component may a tibial bearing surface trial component secured to a shim. A leading edge of the shim contacts, and rides up, the ramp surface so as to urge a posterior edge of the tibial bearing surface trial component superiorly in a direction away from the tibial base trial component during advancement of the tibial bearing trial component.
The central post comprises a collar extending outwardly from the longitudinal axis of the central post, with the ramp surface being defined in a superior surface of the collar. A leading edge of the shim contacts, and rides up, the ramp surface of the collar so as to urge a posterior edge of the tibial bearing surface trial component superiorly in a direction away from the tibial base trial component during advancement of the tibial bearing trial component.
The central post includes a connector configured to secure the insert component to a surgical handle. The connector includes a flange extending anteriorly away from the longitudinal axis of the central post, with the ramp surface being defined in a superior surface of the flange of the connector. A leading edge of the tibial bearing surface trial component contacts, and rides up, the ramp surface of the connector so as to urge a posterior edge of the tibial bearing surface trial component superiorly in a direction away from the tibial base trial component during advancement of the tibial bearing trial component.
The central post also includes an elongated anti-rotation lug extending in a direction away from the longitudinal axis of the central post, with the ramp surface being defined in a superior surface of the elongated anti-rotation lug. A leading edge of the shim contacts, and rides up, the ramp surface of the anti-rotation lug so as to urge a posterior edge of the tibial bearing surface trial component superiorly in a direction away from the tibial base trial component during advancement of the tibial bearing trial component.
The insert component may define a tibial evaluation component, with the tibial evaluation component having a pair of bone engaging spikes extending inferiorly from the inferior surface of the insert component. The bone engaging spikes of the tibial evaluation component are inserted through the opening defined in the tibial base trail component and into bone tissue.
The insert component may be embodied as a keel punch, with the keel punch having a pair of serrated wings extending inferiorly from the inferior surface of the insert component. The serrated wings of the keel punch are inserted through the opening defined in the tibial base trail component and into bone tissue.
The detailed description particularly refers to the following figures, in which:
While the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific exemplary embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that there is no intent to limit the concepts of the present disclosure to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.
Terms representing anatomical references, such as anterior, posterior, medial, lateral, superior, inferior, etcetera, may be used throughout the specification in reference to the orthopaedic implants and surgical instruments described herein as well as in reference to the patient's natural anatomy. Such terms have well-understood meanings in both the study of anatomy and the field of orthopaedics. Use of such anatomical reference terms in the written description and claims is intended to be consistent with their well-understood meanings unless noted otherwise.
Referring to
As shown in
The system 10 may be utilized to size and select the prosthetic components of a knee prosthesis that will replace the patient's natural joint. To do so, the femoral trial component 18 is attached to a surgically-prepared distal end 600 of a patient's femur 602 (see
The system 10 may be also utilized to surgically prepare the proximal end 604 of a patient's tibia 606 for implantation of a tibial prosthetic component, such as a tibial tray, during the performance of an orthopaedic surgical procedure. The tibial base trial component 14 and the guide tower 24 are positioned on the proximal end 604 of the patient's tibia 606, and the surgeon uses the trial component 14 and the tower 24 to guide, for example, a surgical drill while reaming the proximal end 604 of the patient's tibia 606. Thereafter, the keel punch 22 is impacted into the proximal end 604 of the patient's tibia 606 before the guide tower 24 is removed. An additional trial reduction may be performed with the keel punch 22 before the surgeon installs the components of the knee prosthesis, as described in greater detail below.
As can be seen in
The plate 30 also includes a lever-receiving notch 54 that is defined in an anterior aspect 56 thereof. The notch 54 is configured to receive a lever 66 associated with the alignment handle 26 (see
Referring now to
The base plate 78 of the tibial evaluation component 16 includes a central post 94 extending upwardly from a superior surface 96 thereof. The post 94 has a connector 98 formed in its superior end. The connector 98 is configured to receive a locking flange associated with the impaction handle 28 so as to secure the tibial evaluation component 16 to the handle 28. The connector 98 includes a flange 100 that extends anteriorly away from the longitudinal axis of the central post 94. The flange 100 has a ramp surface 102 defined therein. In particular, an inferior surface 104 of the flange 100 extends substantially parallel to the superior surface 96 of the tibial evaluation component's base plate 78, whereas the flange's superior surface 106 inclines superiorly in the anterior-to-posterior direction. In other words, as can be seen clearly in
As shown best in
The central post 94 of the tibial evaluation component 16 has an anti-rotation block or lug 120 extending outwardly from the post's curved sidewall toward the prong 90. As will be described in greater detail below, the anti-rotation lug 120 engages the tibial bearing trial component 20 to prevent or permit the tibial bearing trial component 20 from rotating relative to the tibial base trial component 14. It should be appreciated that in other embodiments the lug 120 might be formed in, for example, the other side of the central post 94 so as to extend toward the prong 88. It should also be appreciated that in other embodiments the tibial evaluation component 16 may include additional anti-rotation lugs. In the illustrative embodiment, the anti-rotation lug 120 has a ramp surface 116 defined therein. In particular, as can be seen in
The central post 94 of the tibial evaluation component 16 has a pair of collars 122 extending outwardly from the longitudinal axis of the post 94. As can be seen in
Returning to
As discussed above, the system 10 also includes a femoral trial component 18 that is configured to be secured to the distal end 600 of the patient's femur 602 (see
Referring now to
As can be seen in
Returning to
The other bearing surface trial 192 shown in
The surgeon may assemble one of the shims 190 with one of the bearing surface trial components 192 to form a tibial bearing trial component 20. For example, the surgeon may select one of the fixed bearing surface trial components 192 and secure the shim 190 thereto to form a fixed bearing trial component 20. During a surgical trialing procedure, the fixed bearing trial component is advanced such that the anti-rotation lug 120 is received in a slot 232 of the shim 190 and the central post 94 is received in a central passageway 222 of the shim. The inner walls of the shim 190 cooperate with the anti-rotation lug 120 to prevent the fixed bearing trial component from rotating relative to the base trial component 14.
Alternatively, the surgeon may assemble one of the shims 190 with one of the mobile bearing surface trial components 192 to form a mobile bearing trial component 20. During a surgical trialing procedure, the mobile bearing trial component is advanced such that the anti-rotation lug 120 is received in the slot 234 of the shim 190 and the central post 94 is received in the central passageway 222 of the shim. The size and arcuate shape of the slot 234 of the shim 190 permits the mobile bearing trial component to rotate relative to the base trial component 14. When the mobile bearing trial component is rotated in one direction, the anti-rotation lug 120 acts as a stop to permit rotation of a defined distance such as, for example, approximately fifty degrees.
Referring now
As can be seen in
As can be seen in
As described above, the system 10 also includes the guide tower 24 (see
Referring now to
The surgeon then performs an initial trial reduction. In doing so, the surgeon uses the system 10 to evaluate and check the stability and kinematics of the patient's femur 602 and tibia 606 for implantation of a fixed bearing knee prosthesis or a mobile bearing knee prosthesis. In the trial reduction process, the surgeon installs the femoral trial component 18 on the distal end 600 of the patient's femur 602, as shown in
As shown in
To position the spiked tibial evaluation component 16 in the plate opening 38 of the base trial component 14, the surgeon may attach the tibial evaluation component 16 to the impaction handle 28. The tibial evaluation component 16 and impaction handle 28 are then positioned over the plate opening 38, and the surgeon may then apply force to the handle 28 to tap the tibial evaluation component 16 into the proximal end 604 of the patient's tibia 606. In doing so, the spikes 130 extending from the prongs 88, 90 of the tibial evaluation component 16 are driven into the proximal end 604 of the patient's tibia 606. The surgeon continues driving the tibial evaluation component 16 into the patient's tibia 606 until the inferior surface 84 of component's rim 82 engages the shelf surface 52 of the tibial base trial component 14.
Once the selected tibial evaluation component 16 (i.e., spiked or spikeless) is properly seated, the surgeon may select a trial shim 190 and a tibial bearing surface trial component 192. If the surgeon desires a fixed bearing trial component, a fixed bearing surface trial component 192 may be selected and attached to one of the trial shims 190.
The surgeon then advances the posterior edge of the assembled tibial bearing surface trial component 192 and shim 190 into the gap between the tibial base trial component 14 and the femoral trial component 18. As can be seen in the progressive motion views of
As shown in
As the range of motion is evaluated, the load on the femoral trial component 18 translates posteriorly as the knee is moved between extension and flexion. To improve performance, the surgeon may remove the fixed bearing trial component 20 from the tibial base trial component 14 to exchange the shim 190 and/or the bearing surface trial component 192. A removal tool (not shown) may be used to detach the fixed bearing trial component 20 from the base trial component 14. The surgeon may use a separator tool (not shown) to detach the shim 190 from the fixed bearing surface trial component 192. The surgeon may then select another shim 190 having a different thickness or choose a fixed bearing surface trial component 192 with an alternative configuration, such as, for example, a fixed bearing surface trial component 192 that is cruciate retaining or posterior stabilized. In some cases, the surgeon may switch to a mobile bearing surface trial component 192. The surgeon may continue to try various combinations of shims 190 and bearing surface trial components 192 to ascertain which final implant will have the best stability in flexion and extension while permitting full extension. Once the revised combination of a shim 190 and bearing surface trial component 192 is selected, the two components are assembled to one another and anteriorly advanced in the gap between tibial base trial component 14 and the femoral trial component 18 in the manner previously discussed.
If the surgeon desires instead a mobile bearing trial component 20, a mobile bearing surface trial component 192 may be selected and attached to one of the trial shims 190. The surgeon then advances the posterior edge of the assembled tibial bearing surface trial component 192 and shim 190 into the gap between the base trial component 14 and the femoral trial 18 in the same manner as described above in regard to the fixed bearing trial component 20. As can be seen in the progressive motion views of
With the femoral trial component 18, the tibial base trial component 14, and the mobile bearing trial component 20 in place, the surgeon may extend the knee and note the anteroposterior stability, medial-lateral stability, and overall alignment in the A/P and M/L planes. The surgeon is also able to assess the bearing rotation and patellofemoral tracking because the mobile bearing trial component 20 is rotatable about the base trial component 14.
Once the surgeon is satisfied with the trial reduction, the tibial trial component 20 and the tibial evaluation component 16 are removed from the tibial base trial component 14.
Referring now to
Subsequently, the surgeon determines whether any additional trial reduction is necessary. If so, the surgeon may utilize the keel punch 22 seated on the tibial base trial component 14 in the proximal end 604 of the patient's tibia 606 to perform an additional trial reduction. As shown in
When the additional trial reduction is complete, the surgeon may use the impaction handle 28 to remove the keel punch 22 from the patient's tibia 606. The resultant features surgically formed in the proximal end 604 of the patient's tibia 606 are configured to receive a tibial tray of a fixed bearing knee prosthesis or a mobile bearing knee prosthesis. The surgeon then completes the surgical procedure of the remaining components of the prosthesis.
While the disclosure has been illustrated and described in detail in the drawings and foregoing description, such an illustration and description is to be considered as exemplary and not restrictive in character, it being understood that only illustrative embodiments have been shown and described and that all changes and modifications that come within the spirit of the disclosure are desired to be protected.
There are a plurality of advantages of the present disclosure arising from the various features of the method, apparatus, and system described herein. It will be noted that alternative embodiments of the method, apparatus, and system of the present disclosure may not include all of the features described yet still benefit from at least some of the advantages of such features. Those of ordinary skill in the art may readily devise their own implementations of the method, apparatus, and system that incorporate one or more of the features of the present invention and fall within the spirit and scope of the present disclosure as defined by the appended claims.
This application is a continuation application and claims priority to U.S. patent application Ser. No. 15/866,047, now U.S. Pat. No. 10,265,183, which is a divisional application that claims priority under 35 U.S.C. § 121 to U.S. patent application Ser. No. 14/265,960, now U.S. Pat. No. 9,861,491, each of which is expressly incorporated herein by reference. Cross-reference is made to U.S. patent application Ser. No. 13/530,771, now U.S. Pat. No. 8,986,390, entitled “SYSTEM AND METHOD FOR TRIALING A KNEE PROSTHESIS” by Tom Wogoman et al. and filed on Jun. 22, 2012, U.S. patent application Ser. No. 13/530,662, now U.S. Pat. No. 8,951,301, entitled “METHOD OF USING A TRIALING SYSTEM FOR A KNEE PROSTHESIS” by Tom Wogoman et al. and filed on Jun. 22, 2012, and U.S. patent application Ser. No. 13/530,649, now U.S. Pat. No. 8,968,412, entitled “TRIALING SYSTEM FOR A KNEE PROSTHESIS AND METHOD OF USE” by Tom Wogoman et al. and filed on Jun. 22, 2012, each of which is assigned to the same assignee as the present application, and each of which is hereby incorporated by reference.
| Number | Name | Date | Kind |
|---|---|---|---|
| 4135517 | Reale | Jan 1979 | A |
| 4211228 | Cloutier | Jul 1980 | A |
| 4378607 | Wadsworth | Apr 1983 | A |
| D269547 | Rosenthal | Jun 1983 | S |
| 4659331 | Matthews et al. | Apr 1987 | A |
| 4938769 | Shaw | Jul 1990 | A |
| 4944757 | Martinez et al. | Jul 1990 | A |
| 5019103 | Van Zile et al. | May 1991 | A |
| 5047058 | Roberts et al. | Sep 1991 | A |
| 5152797 | Luckman et al. | Oct 1992 | A |
| 5197488 | Kovacevic | Mar 1993 | A |
| D338270 | Stephens et al. | Aug 1993 | S |
| 5282866 | Cohen et al. | Feb 1994 | A |
| 5306276 | Johnson et al. | Apr 1994 | A |
| 5344458 | Bonutti | Sep 1994 | A |
| 5356414 | Cohen et al. | Oct 1994 | A |
| 5364401 | Ferrante et al. | Nov 1994 | A |
| 5387241 | Hayes | Feb 1995 | A |
| 5464406 | Ritter et al. | Nov 1995 | A |
| 5470354 | Hershberger | Nov 1995 | A |
| 5472415 | King et al. | Dec 1995 | A |
| 5486178 | Hodge | Jan 1996 | A |
| 5514143 | Bonutti et al. | May 1996 | A |
| 5540696 | Booth, Jr. et al. | Jul 1996 | A |
| 5569260 | Petersen | Oct 1996 | A |
| 5569263 | Hein | Oct 1996 | A |
| 5597379 | Haines et al. | Jan 1997 | A |
| 5601565 | Huebner | Feb 1997 | A |
| 5607431 | Dudasik et al. | Mar 1997 | A |
| 5611802 | Samuelson et al. | Mar 1997 | A |
| 5613970 | Houston et al. | Mar 1997 | A |
| 5643272 | Haines et al. | Jul 1997 | A |
| 5649928 | Grundei | Jul 1997 | A |
| 5683469 | Johnson et al. | Nov 1997 | A |
| 5690636 | Wildgoose et al. | Nov 1997 | A |
| 5702464 | Lackey et al. | Dec 1997 | A |
| 5704941 | Jacober et al. | Jan 1998 | A |
| 5709689 | Ferrante et al. | Jan 1998 | A |
| 5716361 | Masini | Feb 1998 | A |
| 5720752 | Elliott et al. | Feb 1998 | A |
| 5733292 | Gustilo et al. | Mar 1998 | A |
| 5735904 | Pappas | Apr 1998 | A |
| 5749876 | Duvillier et al. | May 1998 | A |
| 5766261 | Neal et al. | Jun 1998 | A |
| 5769854 | Bastian et al. | Jun 1998 | A |
| 5776200 | Johnson et al. | Jul 1998 | A |
| 5776201 | Colleran et al. | Jul 1998 | A |
| 5782925 | Collazo et al. | Jul 1998 | A |
| 5788700 | Morawa et al. | Aug 1998 | A |
| 5792143 | Samuelson et al. | Aug 1998 | A |
| 5860969 | White et al. | Jan 1999 | A |
| 5860980 | Axelson, Jr. et al. | Jan 1999 | A |
| 5860982 | Ro et al. | Jan 1999 | A |
| 5928286 | Ashby et al. | Jul 1999 | A |
| 5935128 | Carter et al. | Aug 1999 | A |
| 5941884 | Corvelli et al. | Aug 1999 | A |
| 5976147 | Lasalle et al. | Nov 1999 | A |
| 5989261 | Walker et al. | Nov 1999 | A |
| 6022377 | Nuelle et al. | Feb 2000 | A |
| 6024746 | Katz | Feb 2000 | A |
| 6080196 | Bertin | Jun 2000 | A |
| 6090144 | Letot et al. | Jul 2000 | A |
| 6102953 | Huebner | Aug 2000 | A |
| 6102955 | Mendes et al. | Aug 2000 | A |
| 6106529 | Techiera | Aug 2000 | A |
| 6159216 | Burkinshaw et al. | Dec 2000 | A |
| 6193758 | Huebner | Feb 2001 | B1 |
| 6214052 | Burkinshaw | Apr 2001 | B1 |
| 6277123 | Maroney et al. | Aug 2001 | B1 |
| 6344043 | Pappas | Feb 2002 | B1 |
| 6355045 | Gundlapalli et al. | Mar 2002 | B1 |
| 6478799 | Williamson | Nov 2002 | B1 |
| 6485521 | Say et al. | Nov 2002 | B1 |
| 6500208 | Metzger | Dec 2002 | B1 |
| 6641614 | Wagner et al. | Nov 2003 | B1 |
| 6660039 | Evans et al. | Dec 2003 | B1 |
| 6663636 | Lin | Dec 2003 | B1 |
| 6673114 | Hartdegen et al. | Jan 2004 | B2 |
| 6702824 | Maroney et al. | Mar 2004 | B2 |
| 6712824 | Millard et al. | Mar 2004 | B2 |
| 6723097 | Fraser et al. | Apr 2004 | B2 |
| 6736852 | Callaway et al. | May 2004 | B2 |
| 6743258 | Keller | Jun 2004 | B1 |
| 6746487 | Scifert et al. | Jun 2004 | B2 |
| 6821470 | Gundlapalli et al. | Nov 2004 | B2 |
| 6827723 | Carson | Dec 2004 | B2 |
| 6827739 | Griner et al. | Dec 2004 | B2 |
| 6916324 | Sanford et al. | Jul 2005 | B2 |
| 6916340 | Metzger | Jul 2005 | B2 |
| 6923817 | Carson et al. | Aug 2005 | B2 |
| D518178 | Christiansen | Mar 2006 | S |
| 7104996 | Bonutti | Sep 2006 | B2 |
| 7105026 | Johnson et al. | Sep 2006 | B2 |
| 7135044 | Bassik et al. | Nov 2006 | B2 |
| 7141067 | Jones et al. | Nov 2006 | B2 |
| 7247169 | Lo et al. | Jul 2007 | B1 |
| 7291174 | German et al. | Nov 2007 | B2 |
| 7309363 | Dietz | Dec 2007 | B2 |
| 7338496 | Winslow et al. | Mar 2008 | B1 |
| 7338499 | Kuczynski et al. | Mar 2008 | B1 |
| 7344541 | Haines et al. | Mar 2008 | B2 |
| 7435263 | Barnett et al. | Oct 2008 | B2 |
| 7632283 | Heldreth | Dec 2009 | B2 |
| 7632314 | Dietz | Dec 2009 | B2 |
| 7634306 | Sarin et al. | Dec 2009 | B2 |
| 7658767 | Wyss | Feb 2010 | B2 |
| 7683812 | Lewin | Mar 2010 | B2 |
| 7691150 | Cronin et al. | Apr 2010 | B2 |
| 7695519 | Collazo | Apr 2010 | B2 |
| 7699853 | Durand-Allen et al. | Apr 2010 | B2 |
| 7731755 | Wyss et al. | Jun 2010 | B2 |
| D619251 | Justiniano-Garcia et al. | Jul 2010 | S |
| 7837690 | Metzger | Nov 2010 | B2 |
| 7854737 | Daniels et al. | Dec 2010 | B2 |
| 7959635 | Bonutti | Jun 2011 | B1 |
| 7963969 | Sanford | Jun 2011 | B2 |
| 8012215 | Metzger | Sep 2011 | B2 |
| 8029574 | Kellar et al. | Oct 2011 | B2 |
| 8052758 | Winslow | Nov 2011 | B1 |
| 8065927 | Crottet et al. | Nov 2011 | B2 |
| 8066777 | Palmer et al. | Nov 2011 | B2 |
| 8070752 | Metzger et al. | Dec 2011 | B2 |
| 8070823 | Kellar et al. | Dec 2011 | B2 |
| 8092545 | Coon et al. | Jan 2012 | B2 |
| 8105387 | Barnett et al. | Jan 2012 | B2 |
| 8109942 | Carson | Feb 2012 | B2 |
| 8128705 | Birkbeck et al. | Mar 2012 | B2 |
| 8133282 | Hushka et al. | Mar 2012 | B2 |
| 8137358 | Winslow et al. | Mar 2012 | B2 |
| 8141437 | Amirouche et al. | Mar 2012 | B2 |
| 8142512 | Brooks et al. | Mar 2012 | B2 |
| 8187283 | Thomas | May 2012 | B2 |
| 8197489 | Chessar et al. | Jun 2012 | B2 |
| 8197549 | Amirouche et al. | Jun 2012 | B2 |
| 8231631 | Lavallee et al. | Jul 2012 | B2 |
| D666713 | Waite et al. | Sep 2012 | S |
| 8357166 | Aram et al. | Jan 2013 | B2 |
| 8403993 | Aram et al. | Mar 2013 | B2 |
| 8414653 | Burstein et al. | Apr 2013 | B2 |
| 8419740 | Aram et al. | Apr 2013 | B2 |
| 8425615 | Berelsman et al. | Apr 2013 | B2 |
| 8435304 | Dietz | May 2013 | B2 |
| 8480677 | Groh | Jul 2013 | B2 |
| 8491589 | Fisher et al. | Jul 2013 | B2 |
| 8491664 | McMahon et al. | Jul 2013 | B2 |
| 8498711 | Roche | Jul 2013 | B2 |
| 8506571 | Chana et al. | Aug 2013 | B2 |
| 8529578 | Daniels et al. | Sep 2013 | B2 |
| 8535382 | Kehres et al. | Sep 2013 | B2 |
| 8551179 | Jones et al. | Oct 2013 | B2 |
| 8568485 | Ries et al. | Oct 2013 | B2 |
| 8585710 | Fischer et al. | Nov 2013 | B2 |
| 8585711 | Klotz et al. | Nov 2013 | B2 |
| 8591593 | Metzger | Nov 2013 | B2 |
| 8597358 | Landry et al. | Dec 2013 | B2 |
| 8603101 | Claypool et al. | Dec 2013 | B2 |
| 8617250 | Metzger | Dec 2013 | B2 |
| 8852197 | Waite, II | Oct 2014 | B2 |
| 8926619 | Waite, II | Jan 2015 | B2 |
| 8951301 | Wogoman | Feb 2015 | B2 |
| 8968412 | Wogoman | Mar 2015 | B2 |
| 8979847 | Belcher et al. | Mar 2015 | B2 |
| 8986390 | Wogoman | Mar 2015 | B2 |
| 9114012 | Wogoman | Aug 2015 | B2 |
| 9132011 | Wogoman | Sep 2015 | B2 |
| 9314257 | Waite, II | Apr 2016 | B2 |
| 9402747 | Wogoman | Aug 2016 | B2 |
| 9861491 | Waite, II | Jan 2018 | B2 |
| 10265183 | Waite, II | Apr 2019 | B2 |
| 20010053935 | Hartdegen et al. | Dec 2001 | A1 |
| 20020082607 | Heldreth | Jun 2002 | A1 |
| 20030093156 | Metzger | May 2003 | A1 |
| 20040039450 | Griner et al. | Feb 2004 | A1 |
| 20040097951 | Steffensmeier | May 2004 | A1 |
| 20040186583 | Keller | Sep 2004 | A1 |
| 20040225368 | Plumet et al. | Nov 2004 | A1 |
| 20050075640 | Collazo et al. | Apr 2005 | A1 |
| 20050246027 | Metzger | Nov 2005 | A1 |
| 20060069447 | DiSilvestro et al. | Mar 2006 | A1 |
| 20060089641 | Collazo | Apr 2006 | A1 |
| 20060111790 | Dietz | May 2006 | A1 |
| 20060184176 | Straszheim-Morley et al. | Aug 2006 | A1 |
| 20070233137 | Seo et al. | Oct 2007 | A1 |
| 20070239165 | Amirouche | Oct 2007 | A1 |
| 20080004708 | Wyss | Jan 2008 | A1 |
| 20080091273 | Hazebrouck | Apr 2008 | A1 |
| 20080114464 | Barnett et al. | May 2008 | A1 |
| 20080119938 | Oh | May 2008 | A1 |
| 20080147075 | Bonutti | Jun 2008 | A1 |
| 20080154270 | Haines et al. | Jun 2008 | A1 |
| 20080221569 | Moore et al. | Sep 2008 | A1 |
| 20080269901 | Baynham et al. | Oct 2008 | A1 |
| 20090076514 | Haines | Mar 2009 | A1 |
| 20090082773 | Haines | Mar 2009 | A1 |
| 20090084491 | Uthgenannt et al. | Apr 2009 | A1 |
| 20090125114 | May et al. | May 2009 | A1 |
| 20090138018 | Haines | May 2009 | A1 |
| 20090216325 | May et al. | Aug 2009 | A1 |
| 20090240254 | Arnhold | Sep 2009 | A1 |
| 20090265013 | Mandell | Oct 2009 | A1 |
| 20100010635 | Straszheim-Morley et al. | Jan 2010 | A1 |
| 20100016979 | Wyss et al. | Jan 2010 | A1 |
| 20100063594 | Hazebrouck et al. | Mar 2010 | A1 |
| 20100076438 | Correia et al. | Mar 2010 | A1 |
| 20100082111 | Thomas | Apr 2010 | A1 |
| 20100125337 | Grecco et al. | May 2010 | A1 |
| 20100298941 | Hes et al. | Nov 2010 | A1 |
| 20100305711 | McKinnon et al. | Dec 2010 | A1 |
| 20110066246 | Ries et al. | Mar 2011 | A1 |
| 20110178605 | Auger et al. | Jul 2011 | A1 |
| 20120041566 | Lenz et al. | Feb 2012 | A1 |
| 20120158152 | Claypool | Jun 2012 | A1 |
| 20120209391 | Cipolletti et al. | Aug 2012 | A1 |
| 20120226481 | Carson | Sep 2012 | A1 |
| 20120239160 | Belew et al. | Sep 2012 | A1 |
| 20120259339 | Hood et al. | Oct 2012 | A1 |
| 20120259421 | Satterthwaite et al. | Oct 2012 | A1 |
| 20120265317 | Metzger | Oct 2012 | A1 |
| 20120310246 | Belcher et al. | Dec 2012 | A1 |
| 20120323334 | Jones et al. | Dec 2012 | A1 |
| 20130006252 | Waite, II | Jan 2013 | A1 |
| 20130006253 | Waite, II | Jan 2013 | A1 |
| 20130006370 | Wogoman | Jan 2013 | A1 |
| 20130006371 | Wogoman | Jan 2013 | A1 |
| 20130006376 | Wogoman | Jan 2013 | A1 |
| 20130006377 | Waite, II | Jan 2013 | A1 |
| 20130006378 | Wogoman | Jan 2013 | A1 |
| 20130013075 | Fisher et al. | Jan 2013 | A1 |
| 20130020733 | Berger | Jan 2013 | A1 |
| 20130024001 | Wentorf et al. | Jan 2013 | A1 |
| 20130030538 | Metzger et al. | Jan 2013 | A1 |
| 20130046385 | Hartdegen et al. | Feb 2013 | A1 |
| 20130079671 | Stein et al. | Mar 2013 | A1 |
| 20130096567 | Fisher et al. | Apr 2013 | A1 |
| 20130103153 | Blackwell et al. | Apr 2013 | A1 |
| 20130103160 | Young | Apr 2013 | A1 |
| 20130173011 | Otto et al. | Jul 2013 | A1 |
| 20130184834 | Brooks et al. | Jul 2013 | A1 |
| 20130190885 | Ammann et al. | Jul 2013 | A1 |
| 20130204267 | Dietz | Aug 2013 | A1 |
| 20130204377 | Samuelson et al. | Aug 2013 | A1 |
| 20130211531 | Steines et al. | Aug 2013 | A1 |
| 20130245769 | Gimbel et al. | Sep 2013 | A1 |
| 20130245803 | Lang | Sep 2013 | A1 |
| 20130261505 | Sherman et al. | Oct 2013 | A1 |
| 20130261758 | Claypool et al. | Oct 2013 | A1 |
| 20130261759 | Claypool | Oct 2013 | A1 |
| 20130282132 | White et al. | Oct 2013 | A1 |
| 20130289569 | Wilkinson | Oct 2013 | A1 |
| 20130289726 | Curran et al. | Oct 2013 | A1 |
| 20130304221 | Blaylock et al. | Nov 2013 | A1 |
| 20140039636 | Kurtz | Feb 2014 | A1 |
| 20140052269 | Claypool et al. | Feb 2014 | A1 |
| 20140066934 | Deirmengian et al. | Mar 2014 | A1 |
| 20140081412 | Metzger | Mar 2014 | A1 |
| 20140155902 | Sikora et al. | Jun 2014 | A1 |
| 20140156017 | Salyer | Jun 2014 | A1 |
| 20140159282 | Smith et al. | Jun 2014 | A1 |
| 20140172112 | Marter | Jun 2014 | A1 |
| 20140276858 | Major et al. | Sep 2014 | A1 |
| 20140277539 | Cook et al. | Sep 2014 | A1 |
| 20150313727 | Waite, II | Nov 2015 | A1 |
| 20180125666 | Waite, II | May 2018 | A1 |
| 20190240033 | Waite, II | Aug 2019 | A1 |
| Number | Date | Country |
|---|---|---|
| 102740788 | Oct 2012 | CN |
| 103037807 | Apr 2013 | CN |
| 103379880 | Oct 2013 | CN |
| 0890340 | Jan 1999 | EP |
| 1219269 | Jul 2002 | EP |
| 1415625 | May 2004 | EP |
| 1836997 | Sep 2007 | EP |
| 2168537 | Mar 2010 | EP |
| 2540256 | Jan 2013 | EP |
| 2323037 | Sep 1998 | GB |
| 9925263 | May 1999 | WO |
| 0013597 | Mar 2000 | WO |
| 2008024836 | Feb 2008 | WO |
| 2008054389 | May 2008 | WO |
| 2011073632 | Jun 2011 | WO |
| 2013006823 | Jan 2013 | WO |
| Entry |
|---|
| Extended European Search Report, European Application No. 16181964.4-1654 dated Oct. 25, 2016, 8 pages. |
| Zimmer NexGen LCCK, Surgical Technique for use with LCCK 4-in-1 Instrument, 2009, 52 pages. |
| DePuy Orthopaedics, Inc., Sigma Revision and M.B.T. Revision Tray, Surgical Technique, 2008, 82 pages. |
| Smith & Nephew, Legion, Revision Knee System, Surgical Technique, 2005, 40 pages. |
| Biomet, Vanguard SSK, Revision System, Surgical Technique, Feb. 2008, 64 pages. |
| GMK Revision, Surgical Technique, Ref. 99.27.12US rev. 1, 1999, 74 pages. |
| PFC Sigma RP-F, Specialist 2 Instruments, Surgical Technique, Performance in Flexion, 2007, 32 pages. |
| P.F.C. Sigma Rotating Platform Knee System with M.B.T Tray, Primary Procedure with a Curved or Posterior Stabilized Implant, 2003, 43 pages. |
| LCS High Performance Instruments, Surgical Technique, 2008, 44 pages. |
| Sigma High Performance Instruments, Design Rationale, 2007, 12 pages. |
| Sigma High Performance Instruments, Classic Surgical Technique, 2010, 52 pages. |
| Coordinate Ultra Revision Knee System, Surgical Technique, 1997, p. 24. |
| P.F.C. Sigma Knee System, Revision, Surgical Technique, 2000, p. 66. |
| Sigma Revision and M.B.T. Revision Tray, Surgical Technique, 2012, p. 84. |
| S-Rom Noiles Rotating Hinge, Surgical Technique, 2012, p. 76. |
| European Search Report for European Application No. 12174178.9-2310, dated Sep. 6, 2012, 6 pages. |
| Declaration of Thomas E. Wogoman (with Exhibits A-I), executed Aug. 11, 2014, 145 pages. |
| Extended European Search Report, European Application No. 16194469.9-1664 / 3158953, Jun. 22, 2017, 13 pages. |
| Number | Date | Country | |
|---|---|---|---|
| 20190240033 A1 | Aug 2019 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 14265960 | Apr 2014 | US |
| Child | 15866047 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 15866047 | Jan 2018 | US |
| Child | 16390667 | US |
