Instrumentation for long stem surgery

Claim 3

The method of claim 1 wherein the reamer is step "d" has a lower distal cutting end portion positioned in the intramedullary canal at the bore and an upper, noncutting end portion that supports the instrumentation.

Claim 4

The method of claim 1 wherein a plurality of reamers of different diameters are sequentially placed in the intramedullary canal beginning with a small reamer having a smaller diameter and inserting progressively larger reamers until a reamer is selected that is capable of reaming three hundred sixty degrees (360°) of cortical bone tissue at the distal end of the reamer.

Claim 5

The method of claim 3 wherein the smallest reamer is about ten (10) millimeters or less in diameter.

Claim 6

The method of claim 1 wherein in step "a" the reamer has upper and lower end portions, and the lower end of the reamer extends into the intramedullary canal, and the upper end portion remains exposed and externally of the intramedullary canal.

Claim 7

The method of claim 1 wherein in step "c" the cutting instrumentation provides one or more flat cutting reference surfaces and in step "d", cuts are made by abutting a selected reference surface with a cutting blade.

Claim 8

The method of claim 1 wherein in step "d", the reamer is advanced sufficiently into the intramedullary canal to create a rotational frictional resistance between the reamer and the cortical bone tissue during reaming.

Claim 9

The method of claim 1 wherein in step "b" the cutting instrumentation is supported upon the reamer at spaced apart locations.

Claim 10

The method of claim 1 wherein a smaller of the reamers is of about a cutting diameter of ten (10) millimeters.

Claim 11

A cutting instrumentation system for use in preparing a patient's bone tissue at the patient's knee joint area for a knee prosthesis, and wherein the bone tissue has a proximal bone tissue surface that is generally transverse to the patient's intramedullary canal, comprising; a) a plurality of elongated rotary reamers, each having an upper proximal end portion and a lower distal end portion having a rotary cutting element thereon, wherein each respective reamer has a rotary cutting element of a progressively larger cutting diameter for reaming the patient's intramedullary canal; b) an instrumentation assembly having means thereon for supporting the assembly during use upon a selected reamer at its upper end portion and in a position externally of the patient's intramedullary canal so that the instrumentation assembly is referenced upon the reamer; c) adjustable referencing member means on the instrumentation assembly for adjustably fixing the angle of the cutting block relative to the reamer, said referencing means means including an opening that closely fits the reamer; d) the instrumentation assembly surrounding the reamer during use and providing a surface portion that closely fits the patient's proximal bone tissue surface at the knee joint area; and e) the instrumentation assembly including a cutting block having a cutting guide surface thereon for referencing a cutting blade so that selected bone tissue cuts can be made adjacent the knee joint area of the patient.

Claim 12

A cutting instrumentation system for use in preparing a patient's bone tissue at the patient's knee joint area for a knee prosthesis, and wherein the bone tissue has a proximal bone tissue surface that is generally transverse to the patient's intramedullary canal, comprising; a) a plurality of elongated rotary reamers, each having an upper proximal end portion and a lower distal end portion having a rotary cutting element thereon, wherein each respective reamer has a rotary cutting element of a progressively larger cutting diameter for reaming the patient's intramedullary canal; b) an instrumentation assembly having means thereon for supporting the assembly during use upon a selected reamer at its upper end portion and in a position externally of the patient's intramedullary canal so that the instrumentation assembly is referenced upon the reamer; c) adjustable referencing member means on the instrumentation assembly for adjustably fixing the angle of the cutting block relative to the reamer, said referencing means means including an opening that closely fits the reamer; d) the instrumentation assembly surrounding the reamer during use and providing a surface portion that closely fits the patient's proximal bone tissue surface at the knee joint area; and e) the instrumentation assembly including a cutting block having a cutting guide surface thereon for referencing a cutting blade so that selected bone tissue cuts can be made adjacent the knee joint area of the patient.

Claim 13

The cutting instrumentation of claim 10 wherein the cutting guide surfaces are generally flat.

Claim 14

The cutting instrumentation of claim 10 further comprising a prosthesis having a stem and a transverse table attached to the upper end of the stem defining an angle therewith, and wherein the cutting block has a flat planar cutting guide surface that intersects the reamer linear axis at said angle.

Claim 15

The cutting instrumentation of claim 12 wherein the stem is of a generally uniform cylindrically-shaped cross section.

Claim 16

The cutting instrumentation of claim 10 wherein said plurality of elongated reamers include a smaller reamer having a cutting diameter of about ten (10) millimeters, and a plurality of larger cutting diameter reamers.

Claim 17

The cutting instrumentation of claim 14 wherein the plurality of reamers have cutting diameters of between ten (10) and twenty-two (22) millimeters.

Claim 18

A cutting instrumentation apparatus for use in preparing bone tissue at one end of a patient's leg bone at the patient's knee joint area for receiving a knee prosthesis, and wherein the leg bone has and end portion that is generally transverse to the patient's intramedullary canal, comprising: a) referencing means that includes at least in part a plurality of reamers of progressively larger diameter, each with a longitudinal axis for tracking and referencing the patient's intramedullary canal by forming a reamed opening in the intramedullary canal of the patient's long bone; b) cutting instrumentation means that fits the reamed opening to reference the instrumentation assembly to the reamed opening, the instrumentation means including a cutting block that has cutting guide surfaces thereon, at least one of the surfaces being generally perpendicular to the patient's mechanical axis; c) the cutting guide surfaces being positioned to guide surgical cuts of the long bone end portion with at least an anterior cut; and d) a prosthesis having a stem that fits the reamed opening.

Claim 19

A cutting instrumentation apparatus for use in preparing bone tissue at one end of a patient's leg bone at the patient's knee joint area for receiving a knee prosthesis, and wherein the leg bone has and end portion that is generally transverse to the patient's intramedullary canal, comprising: a) referencing means that includes at least in part a plurality of reamers of progressively larger diameter, each with a longitudinal axis for tracking and referencing the patient's intramedullary canal by forming a reamed opening in the intramedullary canal of the patient's long bone; b) cutting instrumentation means that fits the reamed opening to reference the instrumentation assembly to the reamed opening, the instrumentation means including a cutting block that has cutting guide surfaces thereon, at least one of the surfaces being generally perpendicular to the patient's mechanical axis; c) the cutting guide surfaces being positioned to guide surgical cuts of the long bone end portion with at least an anterior cut; and d) a prosthesis having a stem that fits the reamed opening.

Claim 20

The apparatus of claim 16 wherein the cutting guide surfaces include at least one generally flat cutting guide surface.

Claim 21

The apparatus of claim 16 wherein the reamer has a diameter of between about ten (10) and twenty two (22) millimeters.

Claim 22

The apparatus of claim 16 wherein the cutting block has a generally flat surface that is generally perpendicular to the patient's mechanical axis.

Claim 23

The apparatus of claim 16 wherein the cutting guide surfaces include a block portion with one or more saw blade slots.

Claim 24

The apparatus of claim 16 wherein the cutting guide block has multiple saw blade slots.

Claim 25

The apparatus of claim 16 wherein the cutting guide surfaces include anterior and posterior surfaces.

Claim 26

A cutting instrumentation apparatus for use in preparing bone tissue at one end of a patient's leg bone at the patient's knee joint area for receiving a knee prosthesis, and wherein the leg bone has and end portion that is generally transverse to the patient's intramedullary canal, comprising: a) referencing means that includes at least in part a plurality of reamers of progressively larger diameter, each with a longitudinal axis for tracking and referencing the patient's intramedullary canal, each of the reamers being sized and shaped to form a reamed opening in the intramedullary canal of the patient's long bone; b) cutting instrumentation means that fits the reamed opening during a cutting of the patient's bone tissue for referencing cuts to the reamed opening; c) the instrumentation means including a cutting block that has cutting guide surfaces thereon; d) at least one of the surfaces being generally perpendicular to the patient's mechanical axis; and e) the cutting guide surfaces being positioned to guide surgical cuts of the long bone end portion with at least anterior and posterior cuts.

Claim 27

A cutting instrumentation apparatus for use in preparing bone tissue at one end of a patient's leg bone at the patient's knee joint area for receiving a knee prosthesis, and wherein the leg bone has and end portion that is generally transverse to the patient's intramedullary canal, comprising: a) referencing means that includes at least in part a plurality of reamers of progressively larger diameter, each with a longitudinal axis for tracking and referencing the patient's intramedullary canal, each of the reamers being sized and shaped to form a reamed opening in the intramedullary canal of the patient's long bone; b) cutting instrumentation means that fits the reamed opening during a cutting of the patient's bone tissue for referencing cuts to the reamed opening; c) the instrumentation means including a cutting block that has cutting guide surfaces thereon; d) at least one of the surfaces being generally perpendicular to the patient's mechanical axis; and e) the cutting guide surfaces being positioned to guide surgical cuts of the long bone end portion with at least anterior and posterior cuts.

Claim 30

The method of claim 24 wherein the step of attaching the cutting block is performed subsequent to the step of inserting the guide member in the reamed opening.