EP-4740879-A2 - JOINT SPACER SYSTEMS

Abstract

In some examples, a method for preparing one or more bones involves inserting a spacer into a space defined between a first bone and a second bone, such as a joint space between a first metatarsal and medial cuneiform. A bone preparation guide can be aligned with opposed ends of the first bone and the second bone using the spacer as an alignment reference. For example, the bone preparation guide may include an opening such that the guide can be installed across the joint space with the spacer received in the opening. A clinician may use the bone preparation guide to guide a tissue removing instrument to cut or otherwise prepare the ends of the first bone portion and second bone portion.

Inventors

• BAYS, F. BARRY
• DAYTON, PAUL
• FERGUSON, JOE WILLIAM
• GIL, CARLOS EDUARDO
• SANTROCK, ROBERT D.
• SCANLAN, Sean F.
• SMITH, W. Bret
• TREACE, JOHN T.

Assignees

• Treace Medical Concepts, Inc.

Dates

Publication Date

20260513

Application Date

20160916

Claims (15)

1. A bone preparation guide comprising: a body configured to be positioned across a tarsometatarsal joint, the tarsometatarsal joint separating a metatarsal from a cuneiform, the body extending from a first end configured to be positioned over the metatarsal to a second end configured to be positioned over the cuneiform, the body defining a guide surface configured to be positioned over an end of the metatarsal to be cut, the guide surface being configured to guide a tissue removing instrument for cutting the end of the metatarsal; and a spacer extending downwardly relative to the body and being configured to be inserted into the tarsometatarsal joint to orient the guide surface.
2. The bone preparation guide of claim 1, wherein the spacer includes a first portion configured to extend into the tarsometatarsal joint and a second portion configured to extend above the tarsometatarsal joint.
3. The bone preparation guide of either of claims 1 or 2, wherein the spacer is configured to contact a lateral half of the end face of the metatarsal and the end face of the cuneiform defining the tarsometatarsal joint without contacting a medial half of the end face of the metatarsal and the end face of the cuneiform defining the tarsometatarsal joint.
4. The bone preparation guide of either of claims 1 or 2, wherein the spacer is symmetric in a medial-lateral direction.
5. The bone preparation guide of any one of claims 1 to 4, wherein the spacer is integral with the body.
6. The bone preparation guide of claim 5, wherein the body and the spacer are fabricated together to form a unibody.
7. The bone preparation guide of any one of claims 1 to 4, wherein the body comprises an opening and the spacer is engageable with the body in the opening.
8. The bone preparation guide of any one of claims 1 to 7, further comprising a facing surface spaced from the guide surface to define a guide slot.
9. The bone preparation guide of claim 8, further comprising a second guide surface configured to be positioned over an end of the cuneiform to be cut.
10. The bone preparation guide of claim 9, further comprising a second facing surface spaced from the second guide surface to define a second guide slot.
11. The bone preparation guide of claim 9, wherein the guide surface is parallel to the second guide surface.
12. The bone preparation guide of claim 9, wherein the guide surface is angled relative to the second guide surface.
13. The bone preparation guide of any one of claims 1 to 12, wherein the spacer has a length greater than a width and a thickness.
14. The bone preparation guide of any one of claims 1 to 13, wherein the spacer defines a tapers toward an end of the spacer.
15. The bone preparation guide of any one of claims 1 to 14, wherein the metatarsal is a first metatarsal and the cuneiform is a medial cuneiform.

Description

CROSS-REFERENCE This application claims the benefit of US Provisional Patent Application No. 62/366,219, filed July 25, 2016, and US Provisional Patent Application No. 62/220,530, filed September 18, 2015. The entire contents of both these applications are incorporated herein by reference. TECHNICAL FIELD This disclosure relates generally to devices and methods for preparing and realigning bones. BACKGROUND Bones, such as the bones of a foot, may be anatomically misaligned. In certain circumstances, surgical intervention is required to correctly align the bones to reduce patient discomfort and improve patient quality of life. SUMMARY In general, this disclosure is directed to devices and techniques for preparing and realigning one or more bones from an anatomically misaligned position to an anatomically aligned position. In some examples, the devices and techniques are utilized to correct a bunion deformity where a first metatarsal is anatomically misaligned relative to a medial cuneiform and/or second metatarsal. To correct such a misalignment, a system may be utilized that includes a bone preparing guide and a spacer. The bone preparing guide can provide one or more cutting surfaces and/or cutting slots along or through which a cutting instrument can be translated to prepare opposed ends of the first metatarsal and/or medial cuneiform for relative realignment. The spacer can serve as an alignment and/or reference tool for the bone preparing guide. In some examples, a clinician inserts the spacer into the joint space between the first metatarsal and medial cuneiform. The spacer can have a variety of different configurations, such as a centered insertion portion, an offset insertion portion, a constant thickness, a tapered thickness, or the like. After suitably positioning the spacer, the clinician may insert the bone preparing guide across the joint space, e.g., by installing the bone preparing guide over a portion of the spacer projecting out of the joint space. The clinician can then use the bone preparing guide to cut the end of the first metatarsal and/or the end of the medial cuneiform to facilitate realignment of the bones relative to each other. In some examples, the clinician utilizes a tissue removing instrument location check to check the position and/or orientation of one or more cutting surfaces or slots relative to the bone(s) to be cut before making such cuts. In either case, the clinician may adjust the position of the first metatarsal either before or after making the cuts to achieve realignment of the metatarsal. In one example, a method for preparing one or more bones is described. The method includes inserting a spacer into a space defined between a first bone and a second bone. The method further involves aligning a bone preparation guide with a portion of the first bone or the second bone while the spacer is inserted into the space, using the spacer as a reference. In addition, the method includes contacting the portion of the first bone or the second bone with a tissue removing instrument using the bone preparation guide to guide the tissue removing instrument. In another example, a bone preparation guide is described that includes a body and a spacer. The body has a first guide surface to define a first preparing plane and a second guide surface to define a second preparing plane. The first and second guide surfaces are spaced from each other by a distance. The example specifies that a first end extends from the body in a first direction and a second end extends from the body in a second direction, the second direction being different than the first direction, with each of the first end and the second end including a fixation aperture configured to receive a fixation device. The example also specifies that the spacer extends from the body in a third direction, the third direction being different than the first and second directions. The spacer is configured to be placed into a joint space between opposing bones. In another example, a spacer configured to be inserted into a joint space between first and second opposing bones is described. The spacer includes a first portion configured to extend into the joint space and a second portion, opposite the first portion, configured to extend above the joint space. The spacer also includes an intermediate portion disposed between the first portion and the second portion. The example specifies that the spacer is configured to serve as a reference to position a tissue removing instrument with respect to the first and/or second bone. The details of one or more examples are set forth in the accompanying drawings and the description below. Other features, objects, and advantages will be apparent from the description and drawings, and from the claims. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of a bone preparing guide and spacer in accordance with an embodiment of the invention.FIG. 2A is a perspective view of a spacer in accor