US20100168752A1 - Orthopaedic cutting tool having a chemically etched metal insert and method of manufacturing - Google Patents
Orthopaedic cutting tool having a chemically etched metal insert and method of manufacturing Download PDFInfo
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- US20100168752A1 US20100168752A1 US12/345,133 US34513308A US2010168752A1 US 20100168752 A1 US20100168752 A1 US 20100168752A1 US 34513308 A US34513308 A US 34513308A US 2010168752 A1 US2010168752 A1 US 2010168752A1
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- Prior art keywords
- cutting
- orthopaedic
- insert
- cutting insert
- chemically etched
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1659—Surgical rasps, files, planes, or scrapers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
- A61B17/154—Guides therefor for preparing bone for knee prosthesis
- A61B17/155—Cutting femur
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
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- C—CHEMISTRY; METALLURGY
- C23—COATING METALLIC MATERIAL; COATING MATERIAL WITH METALLIC MATERIAL; CHEMICAL SURFACE TREATMENT; DIFFUSION TREATMENT OF METALLIC MATERIAL; COATING BY VACUUM EVAPORATION, BY SPUTTERING, BY ION IMPLANTATION OR BY CHEMICAL VAPOUR DEPOSITION, IN GENERAL; INHIBITING CORROSION OF METALLIC MATERIAL OR INCRUSTATION IN GENERAL
- C23F—NON-MECHANICAL REMOVAL OF METALLIC MATERIAL FROM SURFACE; INHIBITING CORROSION OF METALLIC MATERIAL OR INCRUSTATION IN GENERAL; MULTI-STEP PROCESSES FOR SURFACE TREATMENT OF METALLIC MATERIAL INVOLVING AT LEAST ONE PROCESS PROVIDED FOR IN CLASS C23 AND AT LEAST ONE PROCESS COVERED BY SUBCLASS C21D OR C22F OR CLASS C25
- C23F1/00—Etching metallic material by chemical means
- C23F1/10—Etching compositions
- C23F1/14—Aqueous compositions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
- A61B17/154—Guides therefor for preparing bone for knee prosthesis
- A61B17/157—Cutting tibia
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1664—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip
- A61B17/1668—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the upper femur
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00526—Methods of manufacturing
Abstract
Description
- Cross-reference is made to co-pending U.S. Utility patent application Ser. No. ______ entitled “Orthopaedic Cutting Block Having a Chemically Etched Metal Insert and Method of Manufacturing” by Jon Edwards et al. (Attorney Docket No. 265280-207638, DEP-6185), which is assigned to the same assignee as the present application, filed concurrently herewith, and hereby incorporated by reference.
- The present disclosure relates generally to orthopaedic surgical instruments, and more particularly to an orthopaedic cutting tool having a metallic cutting insert with chemically etched holes.
- Joint arthroplasty is a well-known surgical procedure by which a diseased and/or damaged natural joint is replaced by a prosthetic joint. Typical artificial joints include knee prostheses, hip prostheses, shoulder prostheses, ankle prostheses, and wrist prostheses, among others. To facilitate the replacement of the natural joint with the prosthesis, orthopaedic surgeons use a variety of orthopaedic surgical instruments such as, for example, saws, drills, reamers, rasps, broaches, cutting blocks, drill guides, milling guides, and other surgical instruments. Typically, orthopaedic surgical instruments are fabricated from metal using traditional manufacturing processes, such as machining, turning, and drilling, and require sterilization between surgical procedures.
- According to one aspect, an orthopaedic cutting tool may include a metallic cutting insert and a body molded to the cutting insert. The cutting insert may have a plurality of chemically etched holes and may be configured to remove portions of a patient's bone. The body may be molded to the cutting insert such that each of the plurality of chemically etched holes is at least partially filled by a portion of the body.
- In some embodiments, the cutting insert may have an interface surface which contacts the body and a work surface opposite the interface surface. The work surface of the cutting insert may be configured to remove portions of the patient's bone. Each of the plurality of chemically etched holes in the cutting insert may extend from the interface surface to the work surface of the cutting insert. The portion of the body which at least partially fills each chemically etched hole may fill at least half the volume of the hole.
- The cutting insert may include a plurality of cutting teeth configured to remove portions of the patient's bone, a relief surface between the plurality of cutting teeth, and an interface surface opposite the plurality of cutting teeth and the relief surface. The interface surface may contact the body of the orthopaedic cutting tool. Each of the plurality of chemically etched holes may extend from the interface surface to the relief surface of the cutting insert. The portion of the body which at least partially fills each chemically etched hole may fill at least half the volume of the hole. The body may be formed of an injection-molded polymer. The body may further include an integrally formed coupling feature. The body may further include an integrally formed handle portion.
- In another aspect, an orthopaedic surgical instrument may be embodied as an orthopaedic cutting tool. The orthopaedic surgical instrument may include a plurality of metallic cutting inserts, and a body molded to the plurality of cutting inserts. Each cutting insert may have a plurality of chemically etched holes and may be configured to remove portions of a patient's bone. The body may be molded to the cutting inserts such that each of the plurality of chemically etched holes is at least partially filled by a portion of the body.
- In some embodiments, each of the plurality of cutting inserts may have an interface surface which contacts the body, and a work surface opposite the interface surface. The work surface may be configured to remove portions of the patient's bone. Each of the plurality of chemically etched holes may extend from the interface surface to the work surface of the respective cutting insert.
- The body of the orthopaedic surgical instrument may further include a plurality of cutting flutes. The plurality of cutting flutes may be arranged radially around a longitudinal axis of the orthopaedic cutting tool. Each of the plurality of cutting inserts may be disposed on one of the plurality of cutting flutes. Each of the plurality of cutting inserts may also be aligned with a leading edge of one of the plurality of cutting flutes to allow a surgeon to remove portions of the patient's bone by rotating the orthopaedic cutting tool about the longitudinal axis.
- According to another aspect, a method for manufacturing an orthopaedic surgical instrument is disclosed. The method may include chemically etching a plurality of holes into a metallic cutting insert. The method may also include molding a body to the cutting insert to form an orthopaedic cutting tool. The method may include chemically etching each of the plurality of holes through the entire thickness of the cutting insert. The method may also include chemically etching a plurality of cutting teeth into the cutting insert. The plurality of holes and the plurality of cutting teeth may be chemically etched simultaneously.
- In some embodiments, the method may include forming a mask on the cutting insert. The mask may define a plurality of exposed areas on the cutting insert. The method may include placing the cutting insert having the mask in a chemical bath whereby the plurality of exposed areas are chemically etched into the plurality of holes. The method may also include removing the cutting insert having the mask from the chemical bath and removing the mask from the cutting insert. The method may include applying a photoresist material to the cutting insert, selectively exposing portions of the photoresist material to a light source using a patterned photomask, and selectively removing portions of the photoresist material using a developer to define the plurality of exposed areas on the cutting insert.
- In some embodiments, the method may include loading the cutting insert into a mold. The cutting insert may contact a wall of the mold. The method may also include injecting a polymer into the mold. The cutting insert may be pressed against the wall of the mold by the polymer. The polymer may at least partially fill the plurality of holes.
- The detailed description particularly refers to the following figures, in which:
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FIG. 1 is a perspective view of one embodiment of an orthopaedic cutting block; -
FIG. 2 is a partially exploded, perspective view of the orthopaedic cutting block ofFIG. 1 ; -
FIG. 3A is a cross sectional view of a portion of a metallic bearing insert prior to chemical etching; -
FIG. 3B is a cross sectional view of the portion of the metallic bearing insert ofFIG. 3A after chemical etching; -
FIG. 3C is a cross sectional view of a portion of a metallic bearing insert after molding with the body, according to one embodiment. -
FIG. 3D is a cross sectional view of a portion of a metallic bearing insert after molding with the body, according to another embodiment. -
FIG. 4 is a perspective view of the orthopaedic cutting block ofFIG. 1 coupled to a bone of a patient; -
FIG. 5 is a partially exploded, perspective view of another embodiment of an orthopaedic cutting block; -
FIG. 6 is a perspective view of the orthopaedic cutting block ofFIG. 5 coupled to a bone of a patient; -
FIG. 7 is a perspective view of one embodiment of an orthopaedic cutting tool; -
FIG. 8 is a perspective view of the orthopaedic cutting tool ofFIG. 7 ; -
FIG. 9 is a perspective view of another embodiment of an orthopaedic cutting tool; -
FIG. 10 is a perspective view of a portion of the orthopaedic cutting tool ofFIG. 9 ; -
FIG. 11 is a simplified flow diagram of a method for manufacturing an orthopaedic surgical instrument; -
FIG. 12 is a simplified flow diagram of a method for chemically etching a metallic insert; and -
FIG. 13 is a simplified flow diagram of a method for forming a mask on a metallic insert. - 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 this disclosure in reference to both the orthopaedic surgical instruments described herein and a 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 specification and claims is intended to be consistent with their well-understood meanings unless noted otherwise.
- The present disclosure relates generally to orthopaedic surgical instruments which include one or more metallic inserts and a body molded to the metallic inserts. The metallic inserts may be positioned at or near areas of the orthopaedic surgical instrument which are subjected to the greatest forces during use. In some embodiments, the body may be an injection-molded polymer. The metallic inserts include a plurality of chemically etched holes. The chemically etched holes have distinctive structural characteristics and create adhesion between the metallic inserts and the body. The concepts of the present disclosure are applicable both to orthopaedic cutting blocks, which employ metallic bearing inserts, and to orthopaedic cutting tools, which employ metallic cutting inserts.
- Referring generally to
FIGS. 1-4 , one illustrative embodiment of an orthopaedic surgical instrument according to the present disclosure is anorthopaedic cutting block 100 designed to function as a notch guide for use by a surgeon with a surgical bone saw. Similar components are labeled using similar reference numerals in these and all other figures. Theorthopaedic cutting block 100 includes several metallic bearing inserts 118, 120 and abody 102 molded to the bearing inserts 118, 120. - As shown in
FIGS. 1 and 2 , thebody 102 oforthopaedic cutting block 100 includes ananterior plate 104 and twodistal plates 106, generally giving thebody 102 the shape of an inverted “L” when viewed from the side and an inverted “U” when viewed from the top. Thebody 102 further includes acentral notch opening 108 defined by a medially-facingwall 110, a distally-facingwall 112, and a laterally-facingwall 114. Theanterior plate 104 includes a bone-facingsurface 142 which is adapted to contact a resected anterior surface of a patient'sfemur 10. Each of the twodistal plates 106 includes a bone-facingsurface 144 adapted to contact a resected distal surface of the patient'sfemur 10. Thebody 102 also includes six guide holes 116 (four of which can be seen in each ofFIGS. 1 and 2 ). The number and placement of the guide holes 116 may be varied, and not everyguide hole 116 may require abearing insert 118. - The
body 102 may be formed of any material which may be molded to the bearing inserts 118, 120, including, but not limited to, polymers and resins. In some embodiments, thebody 102 may be formed of a material which is less capable than the bearing inserts 118, 120 of withstanding external forces, but which is less expensive, lighter, and/or more easily fabricated into complex shapes. Thebody 102 may be heterogeneous in nature or may be a composite material. In one illustrative embodiment, thebody 102 is formed of an injection-molded polymer. - The metallic bearing inserts 118, 120 are generally positioned at or near areas of the
orthopaedic cutting block 100 which are subjected to the greatest forces during use. The bearing inserts may be formed of a metal or metallic alloy; in one illustrative embodiment, the bearing inserts 118, 120 be formed ofType 316 or Type 17-4 grade stainless steel. Each bearing insert includes aninterface surface 122, which contacts the body (visible in partially exploded view ofFIG. 2 ). Opposite theinterface surface 122, each bearing insert also includes aguide surface guide surface 124 of thebearing insert 118 and not thebody 102. The bearing insert 120 functions as a non-captured cutting guide for thecentral notch opening 108. Theguide surface 126 includes a medially-facingsection 128, a distally-facingsection 130, and a laterally-facingsection 132, which correspond, respectively, to the medially-facingwall 110, the distally-facingwall 112, and the laterally-facingwall 114 of thebody 102. Thus, a bone saw blade 12 (shown inFIG. 4 ) cutting along thecentral notch opening 108 will only, or at least mostly, contact theguide surface 126 of thebearing insert 120 and not thebody 102. In another embodiment, two or more separate bearing inserts may be used in place of the single,multi-sectioned bearing insert 120. - Each bearing
insert holes 134. In one illustrative embodiment, each of the plurality of chemically etchedholes 134 extends from theinterface surface 122 to theguide surface bearing insert holes 134 have distinctive structural characteristics, which will be further described below with reference toFIGS. 3A-D , and create adhesion between the bearing inserts 118, 120 and thebody 102. It is contemplated that the chemically etchedholes 134 may consist of a variety of shapes and may be arranged in numerous patterns on the surface of the bearing inserts 118, 120. The chemically etchedholes 134, in one illustrative embodiment, are circular in shape and approximately 1/50 of an inch in diameter. The bearing inserts 118, 120 may also include other chemically etched features in addition to the chemically etchedholes 134. In one illustrative embodiment, bearinginsert 120 may further include one or more chemically etchedgrooves 136 and/or chemically etchedindicia 138, such as reference markings, trade names, and product names or numbers, among others. - As will be discussed in more detail below, chemically etched
holes 134, as well as chemically etchedgrooves 136, chemically etchedindicia 138, and other features, may be formed by placing the metallic bearing inserts 118, 120 in a chemical bath which dissolves exposed metal. The bearing inserts 118, 120 may be selectively etched to form features, such as the plurality of chemically etchedholes 134, by forming amask 14, including a plurality of exposedareas 18, around the bearing inserts 118, 120 prior to placement in the chemical bath, as shown inFIG. 3A . Themask 14 may be formed of any material which is not substantially dissolved by the chemical bath. - In one illustrative embodiment, the
mask 14 is a polymeric photoresist material which is formed around thebearing insert 120, but includes a plurality of exposed areas 18 (seeFIG. 3A ). A cross-section of thebearing insert 120 ofFIG. 3A after removal from the chemical bath but prior to removal of thepolymeric photoresist mask 14 is depicted inFIG. 3B . In areas which were exposed to the chemical bath on both sides of thebearing insert 120, the resulting structure is a chemically etchedhole 134. The distinctive structural characteristics of the chemically etchedhole 134 are due in part to the isotropic nature of the wet, or liquid, chemical etch. As can be seen inFIG. 3B , as the chemical bath dissolves the metal of thebearing insert 120 in a vertical direction, it also dissolves the metal in horizontal directions at approximately 20-25% the rate of the vertical direction. In areas which were exposed to the chemical bath on only one side of thebearing insert 120, the resulting structure is a chemically etchedgroove 136. Thegroove 136 may run the entire width of theguide surface 126 of thebearing insert 120. As will be discussed in more detail below, thegroove 136 allows for bending of the bearing insert 120-between the medially-facingsection 128 and the distally-facingsection 130 and between the distally-facingsection 130 and the laterally-facingsection 132 of the guide surface 126-prior to molding of thebody 102 to thebearing insert 120. - The chemically etched
holes 134 create adhesion between the bearinginsert 120 and thebody 102, as shown inFIG. 3C . As thebody 102 is molded to thebearing insert 120, a portion of thebody 102 at least partially fills each of the plurality of chemically etchedholes 134. After molding, thebody 102 contacts thebearing insert 120 at theinterface surface 122 and the sidewalls of the chemically etchedholes 134, but generally does not contact theguide surface 126, providing a substantially allmetallic guide surface 126 configured to support an orthopaedic cutting tool. In one illustrative embodiment, the portion of thebody 102 which at least partially fills each chemically etchedhole 134 may fill at least half the volume of eachhole 134. In another illustrative embodiment, the portion of thebody 102 which at least partially fills each chemically etchedhole 134 may fill between 70-80% of the volume of eachhole 134. - In another illustrative embodiment, shown in
FIG. 3D , the chemically etchedholes 134 of bearinginsert 120 may also be formed by exposing areas on only one side of thebearing insert 120, but allowing thebearing insert 120 to remain in the chemical bath for a longer period of time. This results in a chemically etchedhole 134 with its own distinctive structural characteristics, including a taperedsidewall 140. Again, a portion of thebody 102 at least partially fills each chemically etchedhole 134, but generally does not contact theguide surface 126, providing a substantially allmetallic guide surface 126 configured to support an orthopaedic cutting tool. It should be noted that each of the features described with respect to bearinginsert 120 andFIGS. 3A-D , may apply equally to the bearing inserts 118 and the chemically etchedholes 134 thereof. Furthermore, for these and all other embodiments hereinafter disclosed, while a plurality of the chemically etchedholes 134 are at least partially filled by portions of thebody 102, it is contemplated that some of the chemically etchedholes 134 may not be filled at all. - Placement and use of the
orthopaedic cutting block 100 on the distal end of the patient'sfemur 10 during surgery can be best seen inFIG. 4 . Typically, the surgeon will have performed anterior and distal cuts or resections on the patient'sfemur 10 prior to using theorthopaedic cutting block 100 to perform a notch cut. Theorthopaedic cutting block 100 is positioned such that the bone-facingsurface 142 of theanterior plate 104 contacts the resected anterior surface of the patient'sfemur 10 and the bone-facingsurfaces 144 of the twodistal plates 106 contact the resected distal surface of the patient'sfemur 10. Theorthopaedic cutting block 100 is secured to the patient'sfemur 10 by the placement of one or more (typically, three or more)surgical pins 16 through the guide holes 116. Once theorthopaedic cutting block 100 is secured, the surgeon may use a typical bone saw having a bone sawblade 12 to perform the notch cut using thebearing insert 120 to support the bone sawblade 12. - Referring generally now to
FIGS. 5 and 6 , another illustrative embodiment of an orthopaedic surgical instrument according to the present disclosure is anorthopaedic cutting block 200 designed to function as an anterior/posterior/chamfer cutting guide, also known in the art as a 4-in-1 cutting block, for use by a surgeon with a surgical bone saw. Theorthopaedic cutting block 200 includes several metallic bearing inserts 218-226 and abody 202 molded to the bearing inserts 218-226. - The
body 202 oforthopaedic cutting block 200 may be formed of any material which may be molded to the bearing inserts 218-226, such as the materials discussed above with respect toorthopaedic cutting block 100. As shown inFIG. 5 , thebody 202 includes a pair ofbody components body component 204 and thebody component 206 include bone-facingsurfaces 238 which are adapted to contact a resected distal surface of a patient'sfemur 10. Thebody component 204 further includes anelongated opening 208, generally parallel to an imaginary line drawn between the medial and lateral sides of thebody component 204. Theelongated opening 208 is defined by a first pair of taperedwalls 210 which open toward the distal side of thebody component 204 and by a second pair of tapered walls (not shown) which open toward the proximal side of thebody component 204. The second pair of tapered walls are designed to receive thebody component 206, as indicated inFIG. 5 . Thebody 202 may also include guide holes 216, on both thebody component 204 and thebody component 206. The number and placement of the guide holes 216 may be varied, and not everyguide hole 216 may require abearing insert 218. - Similar to the bearing inserts 118, 120 of
orthopaedic cutting block 100, the bearing inserts 218-226 may be formed of a metal or metallic alloy and are generally positioned at or near areas of theorthopaedic cutting block 200 which are subjected to the greatest forces during use. Each bearing insert includes aninterface surface 236, which contacts thebody 202. Opposite theinterface surface 236, each bearing insert also includes a guide surface 228-232 (and others not shown), which is configured to support a bone cutting tool. Each bearing insert 218 functions as a bushing for one of the guide holes 216. A drill bit or pin passing through one of the guide holes 216 will only, or at least mostly, contact the guide surface of thebearing insert 218 and not thebody 202. The bearing insert 220 functions as a non-captured cutting guide for performing an anterior cut on the patient'sfemur 10. A bone sawblade 12 cutting along the anterior side of theorthopaedic cutting block 200 will only, or at least mostly, contact theguide surface 232 of thebearing insert 220 and not thebody 202. Similarly, the bearing insert 222 functions as a non-captured cutting guide for performing a posterior cut on the patient'sfemur 10. A bone sawblade 12 cutting along the posterior side of theorthopaedic cutting block 200 will only, or at least mostly, contact the guide surface (not shown) of thebearing insert 222 and not thebody 202. In another illustrative embodiment, the anterior and posterior cutting guides oforthopaedic cutting block 200 may alternatively be captured cutting slots, similar to those described below, rather than non-captured cutting guides. - The
orthopaedic cutting block 200 also includes two captured cutting slots which may support a bone sawblade 12 when performing a pair of chamfer cuts on the patient'sfemur 10. As discussed above, thebody component 204 includes anelongated opening 208, which is in part defined by a second pair of tapered walls which open toward the proximal side of thebody component 204. A metallic bearing insert is disposed on each of the second pair of tapered walls: bearing insert 224 on the lower tapered wall, and another bearing insert (not shown) on the upper tapered wall. Thebody component 206 also has abearing insert 226. The guide surface of thebearing insert 226 includes a downwardly-facingsection 228 and an upwardly-facingsection 230. When thebody component 204 and thebody component 206 are assembled, these bearing inserts form two captured cutting slots. The downwardly-facingsection 228 of bearinginsert 226 opposes thebearing insert 224 with a gap therebetween to form a downwardly-angled, captured cutting slot. The upwardly-facingsection 230 of bearinginsert 226 opposes the other bearing insert (not shown) with a gap therebetween to form a upwardly-angled, captured cutting slot. A bone saw blade 12 (shown inFIG. 6 ) cutting along theelongated opening 108 through one of the captured cutting slots will only, or at least mostly, contact the guide surfaces of the bearing inserts 224, 226 and not thebody 202. In another embodiment, two or more separate bearing inserts may be used in place of themulti-sectioned bearing insert 226. In yet another embodiment, any of the captured cutting slots may be formed by a single bearing insert functioning as an elongated bushing, rather than by a pair of opposed bearing inserts. - Each bearing insert 218-226 includes a plurality of chemically etched
holes 234 which create adhesion between the bearing inserts 218-226 and thebody 202. The chemically etchedholes 234 have the same distinctive structural characteristics as the chemically etchedholes 134, described above with respect to theorthopaedic cutting block 100 and shown inFIGS. 3A-D . As thebody 202 is molded to the bearing inserts 218-226, a portion of thebody 202 at least partially fills the chemically etchedholes 234. After molding, thebody 202 contacts the bearing inserts 218-226 at the interface surfaces 236 and the sidewalls of the chemically etchedholes 234, but generally does not contact the guide surfaces, providing substantially all metallic guide surfaces configured to support an orthopaedic cutting tool. - The bearing inserts 218-216 may also include other chemically etched features in addition to the chemically etched
holes 234, such as chemically etched grooves or indicia. In one illustrative embodiment, a chemically etched groove may run the entire width of theinterface surface 236 of thebearing insert 226. This chemically etched groove would allow for bending of thebearing insert 226 between the downwardly-facingsection 228 and the upwardly-facingsection 230 prior to molding of thebody 202 to thebearing insert 226. - Placement and use of the
orthopaedic cutting block 200 on the distal end of the patient'sfemur 10 during surgery can be best seen inFIG. 6 . Typically, the surgeon will have performed a distal cut or resection on the patient'sfemur 10 prior to using theorthopaedic cutting block 200 to perform one or more of an anterior cut, a posterior cut, or a chamfer cut. Theorthopaedic cutting block 200 is positioned such that the bone-facingsurfaces 238 of thebody component 204 and of thebody component 206 rest on the resected distal surface of the patient'sfemur 10. Theorthopaedic cutting block 200 is secured to the patient'sfemur 10 by the placement of one or more (typically, two)surgical pins 16 through the guide holes 216 of thebody component 204 and thebody component 206. Once theorthopaedic cutting block 200 is secured, the surgeon may use a typical bone saw having a bone sawblade 12 to perform an anterior resection using thebearing insert 220 for support (shown completed), to perform a posterior resection using thebearing insert 222 for support (also shown completed), or to perform two chamfer resections using the captured cutting slots, as shown inFIG. 6 . When the surgeon uses one of the captured cutting slots, the bone sawblade 12 is guided by the bearing inserts 224, 226, and avoids contact with thebody 202, including the first pair of taperedwalls 210. - It should be noted that an orthopaedic surgical instrument according to the present disclosure may be embodied as additional or different orthopaedic cutting blocks, other than those discussed above. By way of illustrative example, a distal femoral cutting block might include an injection-molded body and a metallic bearing insert having a plurality of chemically etched holes and positioned to allow a surgeon to perform a distal cut on a patient's femur using the bearing insert for support. As a further illustrative example, a proximal tibial cutting block might include an injection-molded body and a metallic bearing insert having a plurality of chemically etched holes and positioned to allow a surgeon to perform a proximal cut on a patient's tibia using the bearing insert for support. Indeed, it is believed that there are few, if any, orthopaedic cutting blocks to which the principles of the present disclosure would not be applicable.
- Referring generally now to
FIGS. 7-8 , another illustrative embodiment of an orthopaedic surgical instrument according to the present disclosure is anorthopaedic cutting tool 300 designed to function as drill bit for use by a surgeon with a surgical bone drill. Theorthopaedic cutting tool 300 includes a plurality of metallic cutting inserts 322 and abody 302 molded to the plurality of cutting inserts 322. - The
body 302 oforthopaedic cutting tool 300 may be formed of any material which may be molded to the plurality of cuttinginserts 322, such as the materials discussed above with respect toorthopaedic cutting block 100. In one illustrative embodiment, thebody 302 of theorthopaedic cutting tool 300 is formed of an injection-molded polymer. As shown inFIG. 7 , thebody 302 is generally cylindrical in shape, having a longitudinal axis L. Thebody 302 may be a generally solid cylinder or may optionally includevoids 312, such as those shown inFIG. 7 , in order to decrease the amount of material used to create thebody 302. Thebody 302 includes acutting segment 314, on which the plurality of cuttinginserts 322 are disposed. Thebody 302 may also include an integrally formedcoupling feature 304, at the end opposite thecutting segment 314 along the longitudinal axis L. Thecoupling feature 304 may includenarrower sections 306,wider sections 308, and/or non-cylindrically-shapedsections 310 to allow a typical surgical bone drill (not shown) to couple to theorthopaedic cutting tool 300. - The cutting
segment 314 of thebody 302 oforthopaedic cutting tool 300, which is shown in detail inFIG. 8 , includes a plurality of cuttingflutes 316. The plurality of cuttingflutes 316 are arranged radially outward around the longitudinal axis L of theorthopaedic cutting tool 300. Achannel 318 is situated between each pair of adjacent cuttingflutes 316 to allow bone fragments removed by theorthopaedic cutting tool 300 to exit the patient's bone. In operation, a surgeon may couple theorthopaedic cutting tool 300 to the surgical bone drill to cause rotation of thecutting segment 314 about the longitudinal axis L in the direction of arrow R indicated inFIG. 8 . The cuttingsegment 314 of thebody 302 may also include apointed tip 320 to assist in guiding theorthopaedic cutting tool 300. - Similar to the bearing inserts 118, 120 of
orthopaedic cutting block 100, the cutting inserts 322 of theorthopaedic cutting tool 300 may be formed of a metal or metallic alloy. Each of the plurality of cuttinginserts 322 is disposed on one of the plurality of cuttingflutes 316 and is generally aligned with a leading edge of the cuttingflute 316 on which it is disposed. It is also contemplated that some, but not all, of the plurality of cuttingflutes 316 may have acutting insert 322 disposed thereon. Each cuttinginsert 322 includes aninterface surface 328, which contacts thebody 302. Opposite theinterface surface 328, each cuttinginsert 322 also includes awork surface 324 which is configured to contact and remove portions of the patient's bone during rotation of theorthopaedic cutting tool 300 in the direction of the arrow R. - Each cutting
insert 322 includes a plurality of chemically etchedholes 326 which create adhesion between the plurality of cuttinginserts 322 and thebody 302. The chemically etchedholes 326 have the same distinctive structural characteristics as the chemically etchedholes 134, described above with respect toorthopaedic cutting block 100 and shown inFIGS. 3A-D . As thebody 302 is molded to the cutting inserts 322, a portion of thebody 302 at least partially fills each of the plurality of chemically etchedholes 326. After molding, thebody 302 contacts the plurality of cuttinginserts 322 at the interface surfaces 328 and the sidewalls of the chemically etchedholes 326, but generally does not contact the work surfaces 324, providing substantially allmetallic work surfaces 324 configured to remove portions of a patient's bone. - Referring generally now to
FIGS. 9-10 , another illustrative embodiment of an orthopaedic surgical instrument according to the present disclosure is anorthopaedic cutting tool 400 designed to function as a rasp for use by a surgeon in manually removing portions of a patient's bone. Theorthopaedic cutting tool 400 includes ametallic cutting insert 412 and abody 402 molded to the cuttinginsert 412. - The
body 402 oforthopaedic cutting tool 400 may be formed of any material which may be molded to themetallic cutting insert 412, such as the materials discussed above with respect toorthopaedic cutting block 100. In one illustrative embodiment, thebody 402 of theorthopaedic cutting tool 400 is formed of an injection-molded polymer. As shown inFIG. 9 , thebody 402 includes acutting segment 404, on which thecutting insert 412 is disposed. Thebody 402 also includes an integrally formedhandle 406, at the end opposite thecutting segment 404, which may be gripped by the surgeon during use. Thehandle 404 may be ergonomically shaped and thebody 402 may also includebulges 408 near the ends of thehandle 406 so that theorthopaedic cutting tool 400 may be more easily grasped by the surgeon. Thebody 402 may be generally solid or may optionally includevoids 410, such as those shown inFIG. 9 , in order to decrease the amount of material used to create thebody 402. - The cutting
segment 404 of thebody 402 oforthopaedic cutting tool 400, which is shown in detail inFIG. 10 , is molded to the cuttinginsert 412. Similar to the bearing inserts 118, 120 oforthopaedic cutting block 100, the cuttinginsert 412 of theorthopaedic cutting tool 400 may be formed of a metal or metallic alloy. The cuttinginsert 412 includes aninterface surface 422, which contacts thebody 402. Opposite theinterface surface 422, the cuttinginsert 412 also includes awork surface 414, which is configured to remove portions of the patient's bone during motion of theorthopaedic cutting tool 400 in the direction of the arrow M indicated inFIG. 10 . In operation, a surgeon may grip theorthopaedic cutting tool 400 at thehandle 406, place thework surface 414 in contact with the patient's bone, and move to theorthopaedic cutting tool 400 reciprocally in the direction of arrow M. - The cutting
insert 412 includes a plurality of chemically etchedholes 416 which create adhesion between the cuttinginsert 412 and thebody 402. The chemically etchedholes 416 have the same distinctive structural characteristics as the chemically etchedholes 134, described above with respect toorthopaedic cutting block 100 and shown inFIGS. 3A-D . As thebody 402 is molded to the cuttinginsert 412, a portion of thebody 402 at least partially fills each of the plurality of chemically etchedholes 416. After molding, thebody 402 contacts the cuttinginsert 412 at theinterface surface 422 and the sidewalls of the chemically etchedholes 416, but generally does not contact thework surface 414, providing substantially allmetallic work surface 414 configured to remove portions of a patient's bone. - To assist in the removal of portions of the patient's bone, the
work surface 414 of the cuttinginsert 412 includes a plurality of chemically etched cuttingteeth 418. In one illustrative embodiment, shown inFIG. 10 , the plurality of chemically etched cuttingteeth 418 are etched into thework surface 414 of the cuttinginsert 412 to have a cross-section consisting of two steps with sharp, generally right-angled edges configured to remove portions of the patient's bone. The chemically etched cuttingteeth 418 span the entire width of the cuttinginsert 412 and are arranged perpendicularly to the length of the cuttinginsert 412. Thework surface 414 also includes arelief surface 420 situated between each pair of adjacent cuttingteeth 412. In this embodiment, the plurality of chemically etchedholes 416 extend from theinterface surface 422 to the relief surfaces 420 of the cuttinginsert 412. It is contemplated that thework surface 414 may take other forms, such as asingle relief surface 420 with a plurality of chemically etched cuttingteeth 418 raised above therelief surface 420 and arranged in various patterns. Various configurations of thework surface 414 may be formed by selectively exposing areas on one or both sides of the cuttinginsert 412 to the chemical bath in a single or multi-step etching process, as discussed below. - It should be noted that an orthopaedic surgical instrument according to the present disclosure may be embodied as additional or different orthopaedic cutting tools, in addition to those discussed above. By way of illustrative example, an orthopaedic surgical reamer might include an injection-molded body and a plurality of metallic cutting inserts having chemically etched holes and disposed at the cutting edges of the instrument to allow a surgeon to ream an intramedullary canal of a long bone using the cutting inserts. As a further illustrative example, an orthopaedic surgical broach might include an injection-molded body and a metallic cutting insert having chemically etched holes and cutting teeth to allow a surgeon to prepare a femur for placement of a femoral component during a hip arthroplasty. Indeed, it is believed that there are few, if any, orthopaedic cutting tools to which the principles of the present disclosure would not be applicable.
- Referring generally now to
FIGS. 11-13 , an illustrative embodiment of a method for manufacturing an orthopaedic surgical instrument according to the present disclosure is illustrated as a series of simplified flow diagrams. Themanufacturing process 500 may be used to fabricate an orthopaedic cutting block, in which case one or more metallic bearing inserts would be used, or may be used to fabricate an orthopaedic cutting tool, in which case one or more metallic cutting inserts would be used. In describing the illustrative embodiments of this method, the term “insert(s),” without a modifier, shall be used to signify either one or more metallic bearing inserts or one or more metallic cutting inserts. Themanufacturing process 500 includes a number of process steps 502-512, as shown inFIG. 11 . - The
manufacturing process 500 begins withprocess step 502, in which the insert or inserts to be used in forming the orthopaedic surgical instrument are chemically etched to include a plurality of holes and any other desired features. The chemical etching may be performed with any chemical which dissolves metal, including, but not limited to, hydrochloric acid, ammonium persulfate, and ferric chloride. As will be described in more detail below with respect toFIG. 12 ,process step 502 will include chemically etching a plurality of holes into the insert in every embodiment, but may also include etching additional features, including grooves, indicia, cutting teeth, and/or relief surfaces, in some illustrative embodiments.Process step 502 may involve a single chemical etch or may involve multiple chemical etches, as needed. - After
process step 502, themanufacturing process 500 optionally proceeds to processstep 504, in which the insert or inserts may be bent into the approximate shape needed for the orthopaedic surgical instrument, if necessary.Process step 504 may be used when a single insert will occupy multiple planes in the finished surgical instrument. For instance, bearinginsert 120 in orthopaedicsurgical block 100 and bearinginsert 226 in orthopaedicsurgical block 200 is bent prior toprocess step 506. Bending of the insert may be facilitated by one or more chemically etched grooves, such as thegroove 136 described above and shown inFIG. 3B . The insert need only be bent to its approximate shape, asprocess step 508 will further form the insert to the correct shape, as discussed below. - After
process step 502, oroptional process step 504, themanufacturing process 500 proceeds to processstep 506, in which the insert or inserts are loaded into a mold. In one illustrative embodiment, the insert is loaded into the mold such that a guide surface (if a bearing insert) or a work surface (if a cutting insert) contacts a wall or walls of the mold. The inserts may be held in place in the mold in a number of ways, including gravitational, magnetic, or other forces. - After
process step 506, themanufacturing process 500 proceeds to processstep 508, in which the body material is injected into the mold. As discussed above, the body material may be any substance which may be molded to the inserts, including, but not limited to, polymers and resins. In some illustrative embodiments, the body material may be a substance which is less expensive, lighter, and/or more easily fabricated into complex shapes than the metallic inserts.Process step 508 may include heating the body material to make the material suitable for injecting into the mold. Inprocess step 508, the force of the body material injected into the mold presses the inserts to the walls of the mold, further shaping inserts which were bent duringoptional process step 504 into the proper shape. A portion of the body material may at least partially fill the plurality of holes in the insert which were chemically etched inprocess step 502. In some embodiments, the body material will substantially fill all of the holes in the insert. In other embodiments, many or most of the holes will be filled, while others will be left unfilled. - After
process step 508, themanufacturing process 500 proceeds to processstep 510, in which the body material is allowed to set into its final, rigid form.Process step 510 may involve allowing the heated body material to cool to a temperature lower than its temperature when injected into the mold. In some illustrative embodiments, the body material will reach the wall of the mold during injection inprocess step 508 and be flush with the guide surface (if a bearing insert) or the work surface (if a cutting insert). Duringprocess step 510, the body material may retract slightly while setting, resulting in the portion of the body only partially filling the hole, as shown in the cross-sections ofFIGS. 3C and 3D . - After
process step 510, themanufacturing process 500 proceeds to processstep 512, in which a formed body and insert(s) are removed from the mold. At this point, another insert or set of inserts, which have been chemically etched according toprocess step 502, may be loaded into the mold according toprocess step 506 and the process may be repeated. It is also contemplated that themanufacturing process 500 may include additional process steps. For instance, in some embodiments, after the formed body and insert(s) are removed from the mold inprocess step 512, additional assembly of the orthopaedic surgical instrument may be required. - One illustrative embodiment of
process step 502 of themanufacturing process 500 is shown in detail inFIG. 12 as a chemical etching sub-process consisting of process steps 520-526. In every embodiment, thechemical etching sub-process 502 will include chemically etching a plurality of holes into an insert. In some illustrative embodiments, thechemical etching sub-process 502 may also include etching additional features, including grooves, indicia, cutting teeth, and/or relief surfaces into the insert. These features may be chemically etched into the insert along with the holes simultaneously, that is during a single iteration of thechemical etching sub-process 502. Alternatively, the process steps 520-526 may be repeated, as needed, to form the appropriate chemically etched features before returning tomanufacturing process 500. - The
chemical etching sub-process 502 begins withprocess step 520, in which a mask is formed on the insert or inserts. As shown in the cross-section ofFIG. 3A , themask 14 is formed around the metal to be chemically etched into the inserts, but includes a plurality of exposedareas 18. The mask may be formed from any material which is not substantially dissolved by the chemical bath ofprocess step 522. As will be described in more detail below with respect toFIG. 13 , one illustrative embodiment ofprocess step 520 may include forming a layer of polymeric photoresist around the inserts to act as a mask during etching. The mask may be formed on one side, both sides, or neither side of the insert at various positions, depending on the desired feature at that position. - After
process step 520, thechemical etching sub-process 502 proceeds to processstep 522, in which the insert or inserts having the mask or masks are placed in a chemical bath. The chemical bath may include any chemicals which dissolve the metal of the inserts, but do not substantially dissolve the mask material, including, but not limited to, hydrochloric acid, ammonium persulfate, and ferric chloride. Duringprocess step 522, the chemical bath selectively attacks and dissolves the metal of the inserts at the plurality of exposed areas 18 (FIG. 3A ). As a wet, or liquid, chemical etch is isotropic in nature, the chemical bath dissolves the metal of the inserts in horizontal directions, as well as the vertical direction, resulting in the structures shown inFIG. 3B-D . Etching occurs in the horizontal directions at approximately 20-25% the rate of the vertical direction. - After
process step 522, thechemical etching sub-process 502 proceeds to processstep 524, in which the insert or inserts having the mask or masks are removed from the chemical bath after a predetermined amount of time. In addition to the pattern of the mask applied inprocess step 520, the form of the inserts will also be determined by the amount of time elapsed between process steps 522 and 524. If the chemical etch is allowed to proceed for approximately the time required to dissolve half the thickness of an insert, areas which were exposed to the chemical bath on both sides of the insert will result in a hole which extends through the entire thickness of the insert, while areas which were exposed to the chemical bath on only one side of the insert will result in a groove, as shown inFIG. 3B . If the chemical etch is allowed to proceed for approximately the time required to dissolve the entire thickness of an insert, areas which were exposed to the chemical bath on only one side of the insert will result in a hole with a tapered sidewall, similar in structure to that shown inFIG. 3D . It is contemplated that holes and other features of various other cross-sections may formed by chemically etching a particular distance into the insert from one side using a first mask, then repeating thechemical etching sub-process 502 using a second mask and chemically etching the remainder of the thickness of the insert from the opposite side. - After
process step 524, thechemical etching sub-process 502 proceeds to processstep 526, in which the mask applied inprocess step 520 is removed from the insert or inserts. At this point, the chemically etchingsub-process 502 may be repeated, if necessary, or themanufacturing process 500 may proceed to one ofprocess step 504 orprocess step 506. It should also be noted that thechemical etching sub-process 502 may be applied to one insert at a time, or multiple inserts may be chemically etched in parallel. In one illustrative embodiment, a large metallic sheet of appropriate thickness, containing multiple rows and columns of inserts, may proceed through thechemical etching sub-process 502. The mask formed inprocess step 520 may include an outline around all or substantially all of each insert, such that the inserts either fall out of the sheet during chemical etching or may be easily removed afterward. - One illustrative embodiment of the
process step 520 of thechemical etching sub-process 502 is shown in detail inFIG. 13 as a mask forming sub-process consisting of process steps 530-536. Themask forming sub-process 520 is a photolithography process in which one or more patterned photomasks are used to form a light-sensitive material into a mask having a plurality of exposed areas on the insert or inserts. - The
mask forming sub-process 520 begins withprocess step 530, in which a photoresist material is applied to substantially cover the exterior of the insert or inserts. The photoresist material is a polymeric substance which changes its structure in response to exposure to an ultraviolet (“UV”) light source. The coating of photoresist material may be a positive photoresist, which becomes more soluble when exposed to UV light. Alternatively, the coating of photoresist material may be a negative photoresist, which becomes polymerized and less soluble when exposed to UV light. The coating of photoresist material may be applied in numerous ways, including high-velocity spin coating. The photoresist material may also need to be heated slightly before becoming light-sensitive. - After
process step 530, the mask forming sub-process 520 proceeds to processstep 532, in which a first patterned photomask is positioned between a UV light source and a first side of the insert covered in photoresist material. The first patterned photomask includes both translucent and opaque portions. If a positive photoresist is used inprocess step 530, the translucent portions of the photomask will correspond to the plurality of exposedareas 18 in the mask 14 (FIG. 3A ). If a negative photoresist is used inprocess step 530, the opaque portions of the photomask will correspond to the plurality of exposedareas 18 in the mask 14 (FIG. 3A ). - After
process step 532, the mask forming sub-process 520 proceeds to processstep 534, in which the UV light source is turned on and areas of the photoresist material are selectively exposed to the light source through the translucent portions of the first patterned photomask. In response, the chemical structure of the exposed areas of photoresist will change, becoming more or less soluble depending on the type of photoresist used. Process steps 530 and 532 may be repeated using a second photomask and a second side of the insert, if needed. Alternatively, the first and second photomasks may be positioned at the same time, each with its own light source, and the first and second sides of the insert may be exposed simultaneously. - After
process step 534, the mask forming sub-process 520 proceeds to processstep 536, in which a developer is applied to the insert to selectively remove areas of the photoresist material to define the plurality of exposed areas on the insert. The developer is a chemical solution which dissolves the more soluble areas of the photoresist material, but not the less soluble areas. The developer may be applied in numerous ways, including high-velocity spin coating. After developing, the remaining photoresist material may again need to be heated to harden into a mask that can withstand the chemical bath. At this point, themask forming sub-process 520 is complete, and the chemically etchingsub-process 502 may proceed to processstep 522. - 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 apparatus and method described herein. It will be noted that alternative embodiments of the apparatus and methods 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 apparatus and methods 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.
Claims (20)
Priority Applications (11)
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US12/345,133 US20100168752A1 (en) | 2008-12-29 | 2008-12-29 | Orthopaedic cutting tool having a chemically etched metal insert and method of manufacturing |
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EP09178343.1A EP2228023B1 (en) | 2008-12-29 | 2009-12-08 | Orthopaedic cutting tool |
ES09178343.1T ES2541440T3 (en) | 2008-12-29 | 2009-12-08 | Orthopedic cutting tool |
ES15151259T ES2743530T3 (en) | 2008-12-29 | 2009-12-08 | Orthopedic cutting tool |
AU2009245859A AU2009245859B2 (en) | 2008-12-29 | 2009-12-09 | Orthopaedic cutting tool having a chemically etched metal insert and method of manufacturing |
ZA2009/09217A ZA200909217B (en) | 2008-12-29 | 2009-12-23 | Orthopaedic cutting tool having a chemically etched metal insert and method of manufacturing |
JP2009296982A JP5595722B2 (en) | 2008-12-29 | 2009-12-28 | Orthopedic cutting tool having a chemically etched metal insert |
CN200910262524.7A CN101791237B (en) | 2008-12-29 | 2009-12-29 | There is orthopaedic cutting tool and the manufacture method of chemically etched metal insert |
US15/165,974 US9883876B2 (en) | 2008-12-29 | 2016-05-26 | Orthopaedic cutting block having a chemically etched metal insert and method of manufacturing |
US15/166,013 US9987023B2 (en) | 2008-12-29 | 2016-05-26 | Orthopaedic cutting tool having a chemically etched metal insert and method of manufacturing |
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US12/345,133 US20100168752A1 (en) | 2008-12-29 | 2008-12-29 | Orthopaedic cutting tool having a chemically etched metal insert and method of manufacturing |
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US12/345,118 Continuation US9375221B2 (en) | 2008-12-29 | 2008-12-29 | Orthopaedic cutting block having a chemically etched metal insert |
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US15/166,013 Division US9987023B2 (en) | 2008-12-29 | 2016-05-26 | Orthopaedic cutting tool having a chemically etched metal insert and method of manufacturing |
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Also Published As
Publication number | Publication date |
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EP2228023B1 (en) | 2015-04-08 |
CN101791237B (en) | 2015-11-25 |
EP2228023A1 (en) | 2010-09-15 |
ES2541440T3 (en) | 2015-07-20 |
EP2896374B1 (en) | 2019-06-05 |
US9987023B2 (en) | 2018-06-05 |
ZA200909217B (en) | 2011-10-26 |
AU2009245859A1 (en) | 2010-07-15 |
EP2896374A1 (en) | 2015-07-22 |
JP2010158519A (en) | 2010-07-22 |
AU2009245859B2 (en) | 2015-05-21 |
JP5595722B2 (en) | 2014-09-24 |
US20160262771A1 (en) | 2016-09-15 |
ES2743530T3 (en) | 2020-02-19 |
CN101791237A (en) | 2010-08-04 |
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