U.S. patent application number 15/712447 was filed with the patent office on 2018-03-22 for adjustable glenoid pin insertion guide.
The applicant listed for this patent is Biomet Manufacturing, LLC. Invention is credited to Christopher Eash, Clinton E. Kehres.
Application Number | 20180078267 15/712447 |
Document ID | / |
Family ID | 54291670 |
Filed Date | 2018-03-22 |
United States Patent
Application |
20180078267 |
Kind Code |
A1 |
Eash; Christopher ; et
al. |
March 22, 2018 |
ADJUSTABLE GLENOID PIN INSERTION GUIDE
Abstract
A system and method for aligning a guiding pin relative to a
glenoid including a guiding pin insertion guide for orienting the
guiding pin relative to the anatomic structure and an axis
alignment device. The guiding pin insertion guide includes a base
plate and a movable pin orientation device coupled to and extending
from the base plate. The axis alignment device has a plurality of
through holes that each define a different alignment axis. The
guiding pin mates with one of the through holes to align the
guiding pin at a patient-specific alignment axis, the guiding pin
is then received within the guiding pin insertion guide when mated
with the one of the through holes In align the guiding pin
insertion guide along the patient-specific alignment axis relative
to the base plate, and the guiding pin insertion guide is fixed to
the base plate along the patient-specific alignment axis.
Inventors: |
Eash; Christopher; (Albion,
IN) ; Kehres; Clinton E.; (Warsaw, IN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Biomet Manufacturing, LLC |
Warsaw |
IN |
US |
|
|
Family ID: |
54291670 |
Appl. No.: |
15/712447 |
Filed: |
September 22, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14499965 |
Sep 29, 2014 |
9826994 |
|
|
15712447 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/1778 20161101;
A61B 17/1739 20130101 |
International
Class: |
A61B 17/17 20060101
A61B017/17 |
Claims
1. (canceled)
2. A system for aligning a guiding pin relative to an anatomic
structure, the system comprising: a guiding pin insertion guide for
orienting the guiding pin relative to the anatomic structure, the
guiding pin insertion guide including a base plate and a pin
orientation device coupled to and extending from the base plate,
the pin orientation device being movable relative to the base
plate.
3. The system of claim 2, wherein the base plate includes an
alignment device for aligning the base plate with a location
visible on the anatomic structure, and for aligning the base plate
relative to the axis alignment device.
4. The system of claim 3, wherein the base plate is shaped to
include an apex, and the alignment device is defined by the
apex.
5. The system of claim 2, wherein the pin orientation device is
hollow, and includes a bulbous portion that movably mates with the
base plate.
6. The system of claim 5, wherein the bulbous portion allows the
pin orientation device to articulate relative to the base plate and
lock into place.
7. The system of claim 2, further comprising an axis alignment
device, the axis alignment device having a plurality of through
holes, each of the through holes defining a different alignment
axis.
8. The system of claim 7, wherein one of the through holes is
configured to align the guiding pin at an orientation that is
substantially aligned with a patient-specific alignment axis,
9. The system of claim 7, wherein the plurality of through holes
are arranged in an array defined by a coordinate system.
9. The system of claim 9, wherein each through hole defines a
different alignment axis by a predetermined angular amount, defined
by the coordinate system.
11. The system of claim 2, wherein the guiding pin insertion guide
is configured to receive the guiding pin when the guiding pin is
mated with a through hole of an axis alignment device.
12. The system of claim 2, and the guiding pin insertion guide is
configured to be fixed to the base plate along the patient-specific
alignment axis
13. A system for aligning a guiding pin relative to a glenoid,
comprising: an axis alignment device, the axis alignment device
including a first surface and a second surface having a plurality
of through holes arranged in a coordinated array extending between
the first surface and the second surface, each of the through holes
defining a different alignment axis, wherein one of the through
holes is configured to align the guiding pin at an orientation that
is at least proximate a patient-specific alignment axis defined by
a patient-specific coordinate of the array.
14. The system of claim 13, wherein each through hole defines a
different alignment axis by a predetermined angular amount.
15. The system of claim 14, wherein the predetermined angular
amount is defined by the coordinate system.
16. The system of claim 13, wherein the base plate includes an
alignment device for aligning the base plate with a location
visible on the glenoid, and for aligning the base plate relative to
the axis alignment device.
17. The system of claim 16, wherein the base plate is shaped to
include an apex, and the alignment device is defined by the
apex.
18. The system of claim 13, wherein the pin orientation device is
hollow, and includes a bulbous portion that movably mates with the
base plate.
19. The system of claim 18, wherein the bulbous portion allows the
pin orientation device to articulate relative to the base plate and
lock into place.
20. The system of claim 13, wherein each of the guiding pin
insertion guide and the alignment axis device are reusable.
21. A system for aligning a guiding pin relative to an anatomic
structure, the system comprising: a guiding pin insertion guide for
orienting the guiding pin relative to the anatomic structure, the
guiding pin insertion guide including a base plate and a pin
orientation device coupled to and extending from the base plate,
the pin orientation device being movable relative to the base
plate; and an axis alignment device, the axis alignment device
including a first surface and a second surface having a plurality
of through holes extending between the first surface and the second
surface, each of the through holes defining a different alignment
axis, wherein one of the through holes is configured to align the
guiding pin at an orientation that is substantially aligned with a
patient-specific alignment axis, the guiding pin insertion guide is
configured to receive the guiding pin when the guiding pin is mated
with one of the through holes to align the guiding pin insertion
guide along the patient-specific alignment axis relative to the
base plate, and the guiding pin insertion guide is configured to be
fixed to the base plate along the patient-specific alignment axis.
Description
FIELD
[0001] The present disclosure relates to an adjustable glenoid pin
insertion guide.
BACKGROUND
[0002] This section provides background information related to the
present disclosure which is not necessarily prior art.
[0003] Performing an anatomic or reverse arthroplasty generally
requires the placement of a guide pin or wire in a glenoid.
Considerable surgical skill, however, is generally required to
correctly expose the glenoid and remove the soft tissue surrounding
the glenoid to accurately align the guide pin in the correct
orientation on the glenoid before performing the anatomic or
reverse arthroplasty. It is desirable, therefore, for an instrument
or system that can accurately and quickly orient a guide pin
relative to the glenoid before performing an anatomic or reverse
arthroplasty.
SUMMARY
[0004] This section provides a general summary of the disclosure,
and is not a comprehensive disclosure of its full scope or all of
its features.
[0005] The present disclosure provides a system for aligning a
guiding pin relative to an anatomic structure. The system includes
a guiding pin insertion guide for orienting the guiding pin
relative to the anatomic structure, the guiding pin insertion guide
including a base plate and a pin orientation device coupled to and
extending from the base plate, the pin orientation device being
movable relative to the base plate; and an axis alignment device,
the axis alignment device being a planar member including a first
surface and a second surface having a plurality of through holes
extending between the first surface and the second surface, each of
the through holes defining a different alignment axis, wherein one
of the through holes is configured to align the guiding pin at a
patient-specific alignment axis, the guiding pin insertion guide is
configured to receive the guiding pin when the guiding pin is mated
with one of the through holes to align the guiding pin insertion
guide along the patient-specific alignment axis relative to the
base plate, and the guiding pin insertion guide is configured to be
fixed to the base plate along the patient-specific alignment
axis.
[0006] The present disclosure also provides a system for aligning a
guiding pin relative to a glenoid. The system includes a guiding
pin insertion guide for orienting the guiding pin relative to the
glenoid, the guiding pin insertion guide including a base plate
having an upper surface and a glenoid-engaging surface, and a pin
orientation device coupled to and extending from the upper surface
of the base plate, the pin orientation device being movable
relative to the base plate; and an axis alignment device, the axis
alignment device being a planar member including a first surface
and a second surface having a plurality of through holes arranged
in a coordinated array extending between the first surface and the
second surface, each of the through holes defining a different
alignment axis, wherein one of the through holes is configured to
align the guiding pin at a patient-specific alignment axis defined
by a patient-specific coordinate of the array, the guiding pin
insertion guide is configured to receive the guiding pin when the
guiding pin is mated with the one through hole to align the guiding
pin insertion guide along the patient-specific alignment axis
relative to the base plate, and the guiding pin insertion guide is
configured to be fixed to the base plate along the patient-specific
alignment axis.
[0007] The present disclosure also provides a method for aligning a
guiding pin relative to a glenoid. The method includes determining
a patient-specific alignment axis for the guiding pin relative to
the glenoid; providing an axis alignment device defined by a planar
member including a first surface and a second surface having a
plurality of through holes arranged in a coordinated array
extending between the first surface and the second surface, each of
the through holes defining a different alignment axis; determining
a coordinate location of one of the through holes that defines an
alignment axis that corresponds to the patient-specific alignment
axis; mating the guiding pin with the one through hole to orient
the guiding pin along the patient-specific alignment axis; placing
a guiding pin insertion guide over the guiding pin, the guiding pin
insertion guide including a base plate having an upper surface and
a glenoid-engaging surface, and a pin orientation device coupled to
and extending from the upper surface of the base plate, the pin
orientation device being movable relative to the base plate such
that when the guiding pin insertion guide is placed over the
guiding pin, the pin orientation device is aligned along the
patient-specific alignment axis; fixing the pin orientation device
aligned along the patient-specific alignment axis relative to the
base plate; removing the guiding pin along with the guiding pin
insertion device from the axis alignment device; contacting the
glenoid-engaging surface of the base plate with the glenoid; and
securing the guiding pin to the glenoid along the patient-specific
alignment axis.
[0008] Further areas of applicability will become apparent from the
description provided herein. The description and specific examples
in this summary are intended for purposes of illustration only and
are not intended to limit the scope of the present disclosure.
DRAWINGS
[0009] The drawings described herein are for illustrative purposes
only of selected embodiments and not all possible implementations,
and are not intended to limit the scope of the present
disclosure.
[0010] FIG. 1 is an exploded view of a prior art implant for
reverse shoulder arthroplasty;
[0011] FIG. 2 is an environmental view of the prior art implant of
FIG. 1;
[0012] FIG. 3 is a perspective view of a prior art implant for
anatomic shoulder arthroplasty;
[0013] FIG. 4A is an environmental view illustrating a guiding pin
used during reaming in reverse shoulder arthroplasty;
[0014] FIG. 4B is an environmental view illustrating a guiding pin
after reaming in reverse shoulder arthroplasty;
[0015] FIG. 5 is a perspective view of a guiding pin insertion
guide according to a principle of the present disclosure;
[0016] FIG. 6 is a side perspective view of the guiding pin
insertion guide illustrated in FIG. 5;
[0017] FIG. 7 is another perspective view of the guiding pin
insertion guide illustrated in FIG. 5;
[0018] FIG. 8 is a top perspective view of the guiding pin
insertion guide illustrated in FIG. 5;
[0019] FIG. 9 is a perspective view of the guiding pin insertion
guide relative to an axis alignment device according to a principle
of the present disclosure;
[0020] FIG. 10 is a top perspective view of the guiding pin
insertion guide relative to an axis alignment device illustrated in
FIG. 9;
[0021] FIG. 11 is a side perspective view of the guiding pin
insertion guide relative to an axis alignment device illustrated in
FIG. 9;
[0022] FIG. 12 is another side perspective view of the guiding pin
insertion guide relative to an axis alignment device illustrated in
FIG. 9;
[0023] FIG. 13 is another side perspective view of the guiding pin
insertion guide relative to an axis alignment device illustrated in
FIG. 9;
[0024] FIG. 14 is a perspective view of the guiding pin insertion
guide positioned relative to a glenoid according to a principle of
the present disclosure; and
[0025] FIG. 15 is a side perspective view of the guiding pin
insertion guide positioned relative to a glenoid of FIG. 14.
[0026] Corresponding reference numerals indicate corresponding
parts throughout the several views of the drawings.
DETAILED DESCRIPTION
[0027] Example embodiments will now be described more fully with
reference to the accompanying drawings.
[0028] The present teachings generally provide reusable surgical
instruments that may be configured to be patient-specific. The
surgical instruments may include, for example, alignment guides,
drill guides, and other tools for use in shoulder joint
replacement, shoulder resurfacing procedures and other procedures
related to the shoulder joint or the various bones of the shoulder
joint, including the glenoid face or cavity of the scapula, the
humeral head and adjacent shoulder bones. The present teachings can
be applied to anatomic shoulder replacement and reverse shoulder
replacement. The instruments can be used either with conventional
implant components or with patient-specific implant components
and/or bone grafts that are prepared using computer-assisted image
methods according to the present teachings. Computer modeling for
obtaining three-dimensional images of the patient's anatomy using
medical scans of the patient's anatomy (such as MRI, CT,
ultrasound, X-rays, PET, etc.), the patient-specific prosthesis
components and the patient-specific guides, templates and other
instruments, can be prepared using various commercially available
CAD programs and/or software available, for example, by Object
Research Systems or ORS, Montreal, Canada.
[0029] The instruments, when patient-specific, and any associated
patient-specific implants and bone grafts can be generally designed
and manufactured based on computer modeling of the patient's 3-D
anatomic image generated from medical image scans including, for
example, X-rays, MRI, CT, PET, ultrasound or other medical scans.
Very small irregularities need not be incorporated in the
three-dimensional engagement surface. The patient-specific
instruments can include custom-made guiding formations, such as,
for example, guiding bores or cannulated guiding posts or
cannulated guiding extensions or receptacles that can be used for
supporting or guiding other instruments, such as drill guides,
reamers, cutters, cutting guides and cutting blocks or for
inserting guiding pins, K-wire, or other fasteners according to a
surgeon-approved pre-operative plan.
[0030] In various embodiments, the instruments of the present
teachings can also include one or more patient-specific tubular
guides for receiving and guiding a tool, such as a drill or pin or
guide wire at corresponding patient-specific insertion points and
orientations relative to a selected anatomic or reverse axis for
the specific patient. The instruments can include guiding or
orientation formations and features for guiding the implantation of
patient-specific or off-the-shelf implants associated with the
surgical procedure. The geometry, shape and orientation of the
various features of the instruments, as well as various
patient-specific implants and bone grafts, if used, can be
determined during the pre-operative planning stage of the procedure
in connection with the computer-assisted modeling of the patient's
anatomy. During the pre-operative planning stage, patient-specific
instruments, custom, semi-custom or non-custom implants and other
non-custom tools, can be selected and the patient-specific
components can be manufactured for a specific-patient with input
from a surgeon or other professional associated with the surgical
procedure.
[0031] Referring to FIGS. 1-2, a prior art reverse shoulder implant
10 is illustrated. The reverse shoulder implant 10 includes a
humeral stem 12, a humeral tray 14, a humeral bearing 16, a
glenosphere 18 and a baseplate 20 having a plate portion 22 and a
central boss 24. The humeral stem 12 is implanted in the humeral
bone 26 and has a proximal end 28 coupled via a Morse taper
connection to a male taper 30 extending from a plate 32 of the
humeral tray 14. The glenosphere 18 can be modular and include a
head 34 articulating with the bearing 16 and an offset double-taper
component 36. The double-taper component 36 has a first tapered
portion 38 coupled to a corresponding tapered opening 40 of the
head 34 and a second tapered portion 42 coupled to the central boss
24 of the glenoid baseplate 20. A central screw 44 passes through
the baseplate 20 into the glenoid face 46 of the patient's scapula.
Peripheral screws 48 are used to lock the baseplate 20 in the
glenoid face 46.
[0032] Referring to FIG. 3, a prior art anatomic shoulder implant
50 is illustrated. The anatomic shoulder implant 50 includes a
humeral stem 52, a glenosphere 54 and a bearing 56 with peripheral
pegs 58 and a removable or non-removable central peg 60.
[0033] FIG. 4A illustrates using a guiding pin 62 to guide reaming
of the glenoid face 46 in reverse shoulder arthroplasty using a
reaming device 64. FIG. 4B illustrates the guiding pin 62 through a
hole 66 formed using reaming device 64 through the glenoid face 46.
The guiding pin 62 is used to guide placement of the reverse
implant 10 or the anatomic implant 50, discussed above. A hole (not
shown) may be pre-drilled in glenoid face 46 before receiving
guiding pin 62, or guiding pin 62 may be K-wire that is aligned
relative to glenoid face 46 before insertion into glenoid face 46.
Each of these processes will be described in more detail below.
[0034] Referring to FIGS. 5-8, an exemplary patient-specific
guiding pin insertion guide 68 is illustrated. Patient-specific
guiding pin insertion guide 68 is configured to guide the guiding
pin 62 during insertion into glenoid 46, and provide an implant
alignment orientation for reverse as well as anatomic shoulder
arthroplasty at the surgeon's discretion. The guiding pin insertion
guide 68 includes a base plate 70 having an upper (or outer) planar
surface 72 and a lower (or inner) planar or anatomy-engaging
surface 74 that references the glenoid face 46. Although lower
surface 74 is illustrated as being planar, it should be understood
that it is not out of the scope of the present disclosure that
lower surface 74 be patient-specific such that lower surface 74 is
three-dimensionally contoured to correspond to the patient-specific
contours of glenoid 46 such that lower surface 74 rests in only one
position on glenoid 46. In other words, lower surface 74 may be
contoured such that lower surface 74 is a negative surface of
glenoid 46. As illustrated, the labrum can be completely removed
such that the lower surface 74 references and mirrors only the bone
surface of the glenoid cavity or glenoid face 46.
[0035] Base plate 70 may be tear-drop shaped such that an apex 76
of base plate 70 defines an alignment device 78. Alignment device
78 can be used to align base plate 70 in the proper orientation
relative to glenoid face 46 by pointing the apex 76 at an
anatomical reference point of the glenoid 46. For example,
alignment device 78 can be used to orient base plate 70 such that
apex 76 points at a visual landmark such as the superior apex of
the glenoid 46. Base plate 70 may be formed from materials such as
titanium, surgical steel, and polymeric materials such as
polyethylene. Moreover, it will be appreciated that base plate 70
may be any shape desired so long as an alignment device 78 is
defined that can point at a visual landmark of the patient's
anatomy such as the superior apex of the glenoid 46.
[0036] A pin orientation device or guide tube 80 is coupled to and
extends outward from base plate 70. Pin orientation device 80
includes a cylindrical guide 82 having a proximal end 84 and a
distal end 86. Proximal end 84 defines a bulbous portion 88 that
mates with base plate 70. In this regard, base plate 70 includes an
aperture 90 that is shaped to receive bulbous portion 88, and allow
pin orientation device 80 to be movable or articulate relative to
base plate 70 in a manner similar to a joystick. Bulbous portion 88
may be unitary with cylindrical guide 82, or may be manufactured
separately and bonded to cylindrical guide 82 by welding, brazing,
or the like. Regardless, cylindrical guide 82 and bulbous portion
are preferably formed from the same materials as base plate 70.
Namely, materials such as titanium, surgical steel, and polymeric
materials such as polyethylene. Cylindrical guide 82 is hollow and
defines an elongate channel 92 for receipt of guiding pin 62.
[0037] To allow bulbous portion 88 to articulate relative to base
plate 70, base plate 70 includes a slit 89 formed therein that
extends from an end portion 91 to aperture 90 such that opposing
ends 93 and 95 of base plate 70 face each other. In addition, ears
97 extend from opposing ends 93 and 95, respectively, with each ear
97 including an aperture 99 for receipt of a set screw 71. Thus,
when bulbous portion 88 is to be fixed relative to base plate 70,
screw 71 may be engaged with apertures 99 to draw opposing ends 93
and 95 tightly together to clamp bulbous portion 88 at the desired
orientation.
[0038] As discussed above, pin orientation device 80 is movable
relative to base plate 70. This allows guiding pin 62 to be
oriented in any desired axial direction relative to glenoid 46
before insertion into glenoid 46. Preferably, the desired axial
directions (i.e., for anatomic and reverse arthroplasty) are
determined and designed according to pre-operative plans for the
patient to define patient-specific anatomic alignment axes and
insertion points for guiding pin 62. To assist in orienting pin
orientation device 80 relative to base plate 70 at the correct
axial direction for either anatomic or reverse arthroplasty, the
present disclosure provides an axis alignment device 94.
[0039] As best shown in FIGS. 9-13, axis alignment device 94 is a
planar member 96. Planar member 96 includes a first surface 98, a
second surface 100, and a plurality of side surfaces 102 connecting
first and second surfaces 98 and 100. Planar member 96 also
includes a plurality of through holes 104 that pass through planar
member 96 from first surface 98 to second surface 100 at different
angles. Moreover, although through holes 104 are only illustrated
as being positioned in a single quadrant 106 of planar member 96,
it should be understood that the entirety of planar member 96 may
be provided with through holes 104, with each through hole 104
defining a different axial angle through planar member 96. It
should be understood base plate 70 is not illustrated as including
ears 97 in FIGS. 9-13 for ease of illustration only.
[0040] Axis alignment device 94 can include a coordinate system
108. Coordinate system 108 assists in organizing the axial angle of
each through hole 104. In the illustrated embodiment, the
coordinate system 108 includes the coordinates 0, 2, 4, 6, 8, and
10 in each of the x- and y-directions. At the through hole 104 that
corresponds to coordinates (0,0--with the first zero corresponding
to the x-axis and the second zero corresponding to the y-axis), the
axial angle may be ninety degrees such that pin orientation device
80 will extend normal to base plate 70 when aligned using this
through hole 104. At the through hole 104 that corresponds to
coordinates (0,2), the axial angle of through hole 104 may be
tilted by two degrees in the y-direction. In another example, at
the through hole 104 that corresponds to coordinates (4, 6), the
through hole 104 will define an angle that has first been tilted
four degrees in the x-direction from the position normal, and then
titled four degrees in the y-direction.
[0041] The remaining quadrants 106 may include through holes (not
shown) that define angles that are titled in the negative x- and
y-directions relative first surface 98. In this manner, the axis
alignment device 94 provides for a full range of axial angles
relative first surface 98 for proper orientation of pin orientation
device relative to base plate 70. Although the coordinate system
108 described above corresponds to changes in the axial alignment
of two degree increments in each of the x- and y-directions, it
should be understood that any incremental change (e.g., increments
less than one degree, one degree, two degrees, three degrees, etc.)
can be defined by coordinate system 108. Moreover, although numbers
are used to identify various coordinates, it should be understood
that letters, symbols, or any combination of letters, symbols, and
numbers may also be used. For example, the x-axis may use numbers
while the y-axis uses letters to identify each through hole
104.
[0042] As noted above, the preferable axial angle at which pin
orientation device 80 is to be oriented relative to base 70 can be
determined pre-operatively such that the preferable axial angle is
patient-specific. This specific axial angle can then be assigned
the proper coordinates on axis alignment device 94 that provides an
orientation for guiding pin 62 that is as close as possible to the
patient-specific orientation. Alternatively, a plurality of axis
alignment devices 94 may be provided with different angular
increments, and the proper angular increment selected to best match
the patient-specific orientation.
[0043] Once the glenoid face 46 has been prepared for insertion of
guiding pin 62, the surgeon may place the axis alignment device 94
flat on a table. The guiding pin 62 (e.g., a Steinmann pin, guide
pin, or K-wire) can then be inserted into the through hole 104 at
the predetermined coordinates. The guiding pin insertion guide 68
including base plate 70 and pin orientation device 80 may then be
placed over the guiding pin 62 resting in the predetermined through
hole 104 such that lower surface 74 of base plate 70 rests flat
against first surface 98 of axis alignment device 94. With base
plate 70 resting against first surface 98, apex 76 should always
point in the positive y-direction, and be aligned with the through
hole 104 in the same column as the selected coordinate through hole
104. Because pin orientation device 80 is movable relative to base
plate 70, this process will orient pin orientation device 80 at the
proper axial angle relative to base plate 70. Pin orientation
device 80 may then be fixed relative to base plate 70 using set
screw 71 as described above such that the proper axial angle
between pin orientation device 80 and base plate 70 is maintained.
Then, guiding pin insertion guide 68 may be removed from guiding
pin 62 and transferred to the patient.
[0044] Once guiding pin insertion guide 68 is transferred to the
patient. base plate 70 is placed on the glenoid face 46, preferably
as close to the center of the glenoid face 46 as possible. In this
regard, it has been determined that surgeons are capable of
accurately determining the center of the glenoid face 46. To ensure
proper alignment of base plate 70 on the glenoid face 46, apex 76
of alignment device 78 is pointed at the visible landmark of the
patient's anatomy such as the superior apex of the glenoid 46.
Then, with pin orientation device 80 already correctly axially
aligned relative to base plate 70 due to coordination with axis
alignment device 94, the guiding pin 62 may be inserted through
elongate channel 92 of pin orientation device 80 and inserted into
the glenoid face 46 at the correct axial orientation for either
anatomic or reverse arthroplasty (e.g., if guiding pin 62 is a
K-wire). The guiding pin insertion guide 68 may then be removed
from the guiding pin 62, leaving the guiding pin 62 inserted into
the glenoid face 46. Alternatively, a drill may be placed through
the aligned pin orientation device 80 to pre-drill a hole (not
shown) along the desired patient-specific axis that will
subsequently receive guiding pin 62. Regardless, after proper
placement of guiding pin 62, the surgeon may then proceed with
either the selected anatomic or reverse arthroplasty procedure.
[0045] It should be understood that the pre-operative plan for the
patient may include coordinates for each of an anatomic or reverse
arthroplasty. In this manner, once the glenoid 46 has been prepared
for surgery, the surgeon can determine intra-operatively the
correct procedure to perform. Moreover, it should be understood
that the coordinates determined pre-operatively can be changed
intra-operatively. That is, if the surgeon determines that the
axial angle at which the guiding pin 62 is to be inserted into the
glenoid 46 will be insufficient, the surgeon may select a different
axial angle for the guiding pin 62 by selecting one of the
plurality of through holes 104 having a different axial angle than
the through hole 104 that was pre-selected pre-operatively. For
example, if the surgeon determines intra-operatively that the
designed axial angle should be shifted by two degrees in the
x-direction, the surgeon may select that through hole 104 on axis
alignment device 94 when orienting pin orientation device 80
relative to base plate 70. Alternatively, the surgeon may select
another axis alignment device 94 with less angular differences
between each of the coordinate through holes 104.
[0046] Lastly, it should be understood that guiding pin insertion
guide 68 and axis alignment device 94 may be reusable.
Specifically, each of guiding pin insertion guide 68 and axis
alignment device 94 may be formed from materials such as titanium
or surgical steel that allows these devices to be sterilized and
re-used. As noted above, however, it should be understood that
lower surface 74 of base plate 70 may include a patient-specific
surface, if desired.
[0047] The foregoing description of the embodiments has been
provided for purposes of illustration and description. It is not
intended to be exhaustive or to limit the disclosure. Individual
elements or features of a particular embodiment are generally not
limited to that particular embodiment, but, where applicable, are
interchangeable and can be used in a selected embodiment, even if
not specifically shown or described. The same may also be varied in
many ways. Such variations are not to be regarded as a departure
from the disclosure, and all such modifications are intended to be
included within the scope of the disclosure.
* * * * *