Appeal No. 2005-1675 Page 12
Application No. 09/523,503
The resection guide 113 is then removed from the instrument body
construct 25, turned up on end and mounted to the instrument body construct 25
in the second position using the pins 129, etc. The resection guide 113 may then
adjusted for more or less resection if so desired. Bone clamps, nails or pins may
be used to hold the resection guide 113 firmly in place on the distal femur 13.
Thus, for example, the resection guide 113 can be securely pinned to the distal
femur 13 by inserting one or more headless bone pins 141 or the like through
apertures 143 in the body member 115 and into the distal femur 13 as shown in
FIG. 18. The instrument body construct 25 and intramedullary rod 135 may then
be removed from the distal femur 13. The thickness of the distal femoral
resection 17 should be equal to the thickness replaced by the distal condyle of
the implant unless special ligament problems dictate otherwise. For example, a
significant flexion contracture may require one to three millimeters of additional
distal femoral resection. Recurvatum may require one to three millimeters less
distal femoral resection. The distal femoral resection 17 is then cut by passing
the bone resection member 16 of the bone resection tool 15 through the
appropriate slot 117, 119 of the body member 115 of the resection guide 113.
Once the distal femoral resection 17 has been completed, the resection guide
113 can be removed from the distal femur 13 and various additional resections or
cuts can be made including, for example, an anterior flange or condylar cut, an
anterior bevel cut or cuts, a posterior cut or cuts, a posterior bevel cut or cuts, a
patellar track groove cut, a posterior stabilized cut, etc., to prepare the distal
femur 13 to receive a trial prosthesis, etc.
The appellant's argue (brief, p. 5) that:
Although the White patent does disclose a reference guide 91, this is used
to measure the anterior-posterior thickness of the distal femur to determine the
cuts for a particular size implant, and has nothing to do with measuring the distal
extent of either condyle or the trochlear region. Reference is made to Figure 11
of White, for example, which clearly shows the way in which the reference guide
91 is used on the anterior side of the bone. ln addition, reference is made to
column 9, lines 34-39, where it is explained that:
".. . valgus module 61, 63, 65 [is] moved proximately until the planar face
portion 30 of the distal aspect of butting surface 29 abuts the distal aspect
19 the distal femur 13.''
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