CN105640676B - 近端扩孔钻 - Google Patents
近端扩孔钻 Download PDFInfo
- Publication number
- CN105640676B CN105640676B CN201610096156.3A CN201610096156A CN105640676B CN 105640676 B CN105640676 B CN 105640676B CN 201610096156 A CN201610096156 A CN 201610096156A CN 105640676 B CN105640676 B CN 105640676B
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- Prior art keywords
- sleeve
- reamer
- handle
- proximal
- implant
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
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Abstract
提供用在关节假体植入中的空腔近端部分上扩孔的扩孔钻。所述扩孔钻用于与矫形植入体部件的近端部分协同作用。所述扩孔钻包括本体,其定义一形成在其内的空腔,用于接收所述矫形植入体部件的至少一部分。所述扩孔钻还包括多个由所述本体向外延伸的切割缘。所述缘适于作用在骨头上。所述扩孔钻还包括由所述本体的端部延伸的柄。
Description
本申请是于2007年9月29日提交的专利申请(中国国家申请号为201280012065.7,发明名称为“近端扩孔钻”)的分案申请。
技术领域
本发明通常涉及整形领域,并且特别涉及用于整形方面的移植体。
背景技术
由骨关节炎和风湿性关节炎引发疼痛和不能活动的病人选择关节置换手术。关节置换手术十分普遍,它能够在关节不可能正常工作时使得许多患者正常行使其功能。人造关节通常是由固定在现有骨头上的金属、陶瓷和/或塑料部件组成。
这种关节置换手术也叫做关节成形术。关节成形术是一种众所周知的外科手术方法,通过该方法用假体关节来替换患病和/或坏损的关节。在典型的完全关节造形术中,切除邻接关节的骨头的终端或末梢部分或者移离该骨头的末梢部分的一部分,并且将人造关节固定在该骨头上。
已知存在很多设计和方法用于制造诸如骨头假体的可植入体。这种骨头假体包括诸如肘关节、髋关节、膝关节和肩关节等人造关节元件。
当前在完全髋关节成形术中,主要遭受质疑的是关于关节的不稳定性。不稳定性与脱位相关。脱位是完全髋关节成形术中的一个突出问题。
与脱位相关的因素包括手术方法、移植体的设计、移植位置以及病人的相关因素。在完全髋关节成形术中,植入体***通过提供一系列的具有横向偏移、颈部偏移、头部偏移和腿部长度的范围的产品来克服这些因素。这四个因素的组合影响软组织的松弛。通过完善生物力学,外科医生能够为患者提供可更防止脱位的稳定髋关节。
为了适配患者的关节病量度,目前由DePuy Orthopaedics公司、本申请的设计者以及其他公司生产了很宽范围的髋植入体几何学图形。特别地,由DePuy Orthopaedics公司提供的S-ROM®完全髋***包括三个偏移、三个颈部长度、四个头部长度和一个腿部长度的调节。所有这些生物力学选项的组合相当复杂。
完全髋***的前倾与关节的稳定性密切相关。不适当的前倾能导致脱位和患者的不适。在所有的髋柄中前倾控制都是很重要的。但是,伴随着具有附加调制性的柄的出现是更加棘手的问题。
现有技术提供了一些针对前倾问题的解决办法。例如,目前的S-ROM®柄在中间柄和近端套筒上具有激光标记。这种标记使得外科医生能够测量这些元件之间的相对定位。因为所述套筒具有不定的前倾,所以没有必要相对于可用于定义前倾的骨骼标志进行定向。事实上,现有的套筒往往使其管口直接侧面对准剩余的可用骨来定向。
当初始或索引全髋关节成形术失败,则执行一修正过程,在该过程中,索引设备(一些或全部)被移除。很多时候剩余骨与初始的髋处理相比更加暴露。在缺少通常用于定位的骨骼标志时经常观察到大量的骨缺失。
在所谓全髋成形术的外科手术过程的一般步骤中,测试柄或替代柄首先被植入到患者体内。所述测试柄用于校验在患者原位上的植入体所选择的尺寸和形状,并且患者将经受所谓的测试还原。这种测试还原表现为移动所述关节,包括所述测试植入体通过用于所述关节的所选典型运动。现有的髋仪器提供一系列不同尺寸的测试体以帮助外科医生估计配合并定位所述植入体。测试体,也被称作临时体,允许外科医生在最终的植入体选择之前执行测试还原从而估计所述植入体的适配性和植入体的稳定性。为了减少创新成本和复杂性,很多测试***被标准化。例如,在Excel™仪器***中,一种DePuy Orthopaedics公司的产品,具有一系列开口和一系列颈部测试体,它们能够混合并适于描述整个范围的植入体。在开口和颈部测试体之间存在单一的固定关系,因为这些测试体描述整体柄植入体的***。
同样地,在目前由DePuy Orthopaedics公司提供的S-ROM®仪器***中,具有颈部测试体、近端体测试体、远端柄测试体、头部测试体和套筒测试体。通过组合所有这些元件,所述植入体被描述出来。由于S-ROM®柄是标准化的并且包括柄和套筒,则所述颈部和所述套筒之间的角度关系或相对前倾是独立的并且由所述颈部和所述近端体测试体之间的齿配合表现出来。所述近端体测试体具有固定的横螺栓,在对直的、初始的柄的测试中其被键固在套筒上。长柄测试体不具有横螺栓,并且因此在测试还原过程中无法保持旋转稳定并且因此通常不被外科医生使用。
随着附加的植入体标准的引入,需要独立定位组成所述植入体的远端柄、近端体和任何套筒。目前为弓形的、整体的柄被提供具有固定量的前倾,其典型为15度。
目前可用的植入体、测试体和仪器导致长时间的手术过程。这种长时间的手术过程包括制备槽道、移除制备槽道的仪器、植入测试体、执行测试还原以及而后植入假体。这种长时间的过程增加了患者手术并发症的风险。
当使用目前可用的仪器、测试体和手术过程时,外科医生必须在执行测试还原之后才能得知关于所述测试体和所述测试体在体内的定位是否适当的反馈。对定位的调节和对测试体以及最终的植入体的选择因此变得困难并且执行起来很费时间。
使用目前的仪器,所述测试体和植入体均需要被恰当地定位和选择以获得对患者来说最适宜的效果。目前测试体相对于股骨的定位以及植入体相对于测试体的定位各个手术过程之间还存在很大的变动。
为了最优化患者的效果,矫形外科优选尽可能多地保留被切割的骨头。目前的外科手术要求,使用仪器将近端骨头上足够多的骨切割并移除以为近端测试体和近端植入体提供间隙。因此,在目前的技术下,位于骨头近端的材料必须被移除以提供对患者来说最适宜的位置的调节。
名称为“可调节生物力学制模和切割仪器及相关方法”的美国专利申请公开说明书No.20040122439、名称为“用于标准化植入体的定位设备以及方法”的美国专利申请公开说明书No.20040122437以及名称为“用于标准化髋柄测试的仪器和相关方法”的美国专利申请公开说明书No.20040122440的全文结合在此作为参考。
当使用弓形柄执行髋成形术时,远侧槽道使用扩孔钻制得并且所述弓形台阶安置在被铰扩的孔洞内。由于所述远端柄为弓形,因此所述植入体的近端体的纵长中心线并不与远端柄的中心线成一条直线。由于植入体的近端体的中心线与远端柄的中心线不在一条直线上这一事实,用于制备远端孔洞的扩孔钻不能为了最小化骨缺失以精确的方式移除骨头以便为近端体提供间隙。必须通过远端扩孔钻由近端骨上移除多余的材料以允许这种非直线性,或者必须使用诸如骨凿等其他工具进行移除。这两种需要对多余的骨进行移除的方法均不是临床上所期望的。
尽管现有技术已经致力于减少外科技术中的步骤和提高精确移除骨头以制备用于接收近端元件的骨头的能力,但是仍旧需要一种***和仪器来减少使用用于标准化植入体的远端扩孔钻和近端体的外科技术的步骤。
本发明意在减轻至少现有技术中存在的问题。
发明内容
本发明的设计赋予外科医生在植入远端植入体之后使用植入体的固定位置以支持工具移除近端骨这种移除近端骨的能力。
本发明提供一种使用长骨中的远端植入体作为导引的扩孔钻用于在近端铰扩长骨。
在例如髋等长骨被切割之后,你必须远端地铰扩以便为远端柄植入体和近端体植入组件制备开口。使用锥形扩孔钻完成铰孔。远端柄植入体具有3°的弯曲以适应用在修正关节成形术中的长远端柄植入体结构的股骨开口的自然内部弓形。由于该3°的弯曲,近端铰孔必须单独执行以移除不能由远端锥形扩孔钻移除的骨头。一旦植入体被植入之后,外科医生可以运用本发明,使用远端柄植入体的近端或锥形部分作为近端扩孔钻的导引轴。当近端扩孔完成后,保护套筒可置于植入体远端柄元件的锥形部分以防止对该远端柄元件的损害。在近端扩孔之后的用于手术的下一个步骤将行进至植入近端体植入体或近端体测试体。然后执行测试还原并且,如果测试还原包括适当的植入体/测试体组件选择,相应的植入体而后被***道远端柄植入体之内。
根据本发明的一个实施方式,提供对用在关节假体中的槽道的近端部分进行扩孔的扩孔钻。所述扩孔钻与矫形植入体柄的近端部分相互作用。所述扩孔钻包括一本体,在该本体上定义一槽道用于接收所述矫形植入体柄的至少一部分。所述扩孔钻还包括多个由所述本体延伸出来的切割边缘。所述边缘适于与骨头相互作用。所述扩孔钻还包括由所述本体延伸的柄。
根据本发明的另一个实施方式,提供在植入关节假体的矫形植入体柄中扩钻一空腔的扩孔钻组件。所述扩孔钻作用在矫形植入体柄的近端部分。所述扩孔钻组件包括一配合覆盖在矫形植入体柄的近端部分的套筒。所述套筒定义一套筒的***。所述扩孔钻组件还包括一扩孔钻,其具有一本体,该本体定义一形成在该本体上的空腔,用于接收所述套筒的***的至少一部分。所述扩孔钻还具有多个由所述本体向外延伸的切割边缘。所述边缘适于作用在骨头上。所述扩孔钻还具有由所述本体延伸的柄。
根据本发明的另一个实施方式,提供一用在矫形植入体柄和近端扩孔钻上的套筒。该套筒适于覆盖所述矫形植入体柄的近端部分。所述套筒定义一套筒的***。
根据本发明的另一个实施方式,提供用于关节成形术中的工具包。该工具包包括近端矫形植入体柄和套筒,该套筒适于覆在所述矫形植入体柄的近端部分。所述套筒定义一套筒的***。所述工具包还包括一扩孔钻。所述扩孔钻具有一本体,其定义一形成在该本体上的空腔,用于接收所述矫形植入体柄的至少一部分。所述扩孔钻还包括多个由所述本体向外延伸的切割边缘。所述边缘适于作用在骨头上。所述扩孔钻还具有由所述本体延伸的柄。
根据本发明的另外一个实施方式,提供用于提供关节成形术的方法。所述方法包括切割长骨的端部并在所述长骨的髓管中制备一中心纵长开口的步骤。所述方法还包括提供假体柄部件并将该假体柄部件安置入髓管的所述开口中的步骤。所述方法还包括提供包括用于接收所述假体柄部件开口的扩孔钻并将该扩孔钻安置到所述假体柄部件上的步骤,其中所述扩孔钻的开口至少部分定位在所述假体柄部件上。所述方法还包括使用所述扩孔钻在长骨的部分上扩孔、移除所述扩孔钻以及将一假体部件安装到所述假体柄部件上的步骤。
根据本发明的另外一个实施方式,提供用于提供关节成形术组件的方法。所述方法包括切割长骨的端部并在所述长骨的髓管中制备一中心纵长开口的步骤。所述方法还包括提供假体柄部件并将该假体柄部件安置入髓管的所述开口中的步骤。所述方法还包括在所述假体柄部件上安置一套筒并提供包括用于接收所述假体柄部件的开口的扩孔钻的步骤。所述方法还包括将所述扩孔钻定位在所述套筒上并使用所述扩孔钻在长骨的部分上扩孔的步骤。所述方法还包括移除所述扩孔钻以及将一假体部件安装到所述假体柄部件上的步骤。
本发明技术上的优点包括减少在外科技术中执行例如髋植入手术等矫形手术所必须的步骤的能力。例如,根据本发明的一个方面,提供了用于提供关节成形术的方法。所述方法包括切割长骨的端部、在髓管内制备中心纵长开口、提供假体柄部件以及将该柄部件安装入所述开口的步骤。所述方法还包括提供用于接收所述假体柄部件的扩孔钻的步骤。所述扩孔钻至少部分安置在所述假体柄部件上。通过将所述扩孔钻安放在所述假体柄部件上,从而不再需要一单独的工具来导引所述扩孔钻,并且所述假体测试体或其他部件无需定位在髓管内以便为所述扩孔钻提供支持。因此,本发明提供在用于关节成形术的外科技术中的步骤数量的减少。
本发明的技术优点还包括执行关节成形术所需的仪器的数量的减少,仪器盘中的仪器数量的减少以及仪器相关成本的减少。例如,并且根据本发明的另外一个方面,提供用来提供关节成形术的方法和仪器,其中远端柄植入体被植入到扩孔后的骨头髓管内,无需使用远端柄测试体。因此,在本发明的该方面无需使用远端柄测试体。因此本发明提供执行关节成形术所需的仪器数量的减少。
本发明的技术优点还包括在远端柄植入体安装到患者的长骨内后由长骨上近端地移除骨头的能力。例如,根据本发明的另外一个方面,提供用于执行关节成形术的方法,其中包括提供被定位在长骨的髓管内的假体柄部件以及提供用于接收所述假体柄部件的扩孔钻。一近端扩孔钻定位在所述假体柄部件上并且在长骨的近端部分进行扩孔。因此本发明使得可在安装远端柄植入体之后近端地移除骨头。
本发明的技术优点还包括以与具有扩孔钻的远端髓管的中心线偏离的方式移除骨头的能力。例如,根据本发明的另外一个方面,提供一扩孔钻组件,用于对用在植入标准关节假体的近端体植入体的空腔的近端部分上扩孔。所述扩孔钻与远端柄植入体的近端部分协同作用。所述扩孔钻组件包括近端扩孔钻和滑套在远端柄植入体的近端部分上的套筒。所述套筒可以咬入近端扩孔钻的空腔内。所述矫形植入体柄具有与植入体柄的远端部分非线性的近端部分。因此本发明提供移除与具有扩孔钻的远端髓管偏心的骨头的能力。长骨的近端部分的扩孔会比在近端部分钻孔要好,因为骨头可能过于硬或过于软弱,并且很脆无法吸收来自钻削的冲击力。
本发明的技术优点还包括使用植入体作为扩孔的植入体轴的能力。例如,根据本发明的另外一个方面,提供用于在用于关节成形术的空腔的近端部分扩孔的扩孔钻组件。所述组件包括适于套在假体柄上的套筒和适于配置在所述套筒上的扩孔钻,并用于制备长骨的近端部分。因此,本发明提供将植入体作为扩孔钻的导引轴使用的能力。
本发明的技术优点还包括在远端植入体柄的顶端执行原地近端体测试的能力。例如,根据本发明的另外一个方面,提供一提供关节成形术的方法。所述方法包括切割长骨的端部、在髓管内制备开口以及提供远端柄部件的步骤。所述远端柄部件被安置进入所述髓管,并且包括用于接收远端柄部件近端部分的开口的扩孔钻被定位在所述柄上,其中所述扩孔钻对长骨的近端原位扩孔以接收近端体部件。近端体植入体部件或近端体测试体部件可被定位在假体远端柄植入体部件上,并且在远端假体柄植入体部件上执行测试。因此,本发明使得可在远端植入体部件的顶部执行原位近端体扩孔。
由下文的附图、说明和权利要求,本领域的技术人员可轻易地看到本发明的其他技术优点。
附图说明
为了彻底地理解本发明及其优点,现参照下文与附图相联系所作的说明,其中:
图1是定位在长骨内用于制备接收长骨假体柄的骨管的扩孔钻的平面图;
图2是弯曲的长骨远端柄植入体的平面图,该植入体定位在由图1中的用于本发明的扩孔钻制备的管道内;
图2A是直的长骨远端柄植入体的平面图,该植入体定位在由图1中的用于本发明的扩孔钻制备的管道内;
图3是根据本发明的一个实施方式,用于图2的远端长骨柄的套筒的平面图;
图3A是根据本发明的另一个实施方式,具有圆柱形孔和圆柱形***的套筒的平面图;
图3B是根据本发明的另一个实施方式,具有圆柱形孔和锥形***的套筒的平面图;
图3C是根据本发明的另一个实施方式,在套筒的孔内用以配合远端长骨柄上的突起的槽的局部平面图;
图3D是图3C的套筒的顶视图,示出了套筒的孔内的凹槽;
图3E是根据本发明的另外一个实施方式的套筒的顶视图,在套筒的孔内具有三个间隔开的凹槽;
图3F是根据本发明的另一个实施方式,在套筒的孔内用以配合远端长骨柄上的凹槽的突起的局部平面图;
图3G是图3F的套筒的顶视图,示出了套筒的孔内的突起;
图3H是根据本发明的另外一个实施方式的套筒的顶视图,在套筒的孔内具有三个间隔开的突起;
图3I根据本发明的另外一个实施方式的套筒的平面视图,在套筒的***具有突起;
图3J图3I的套筒的顶视图,示出了套筒的***上的突起;
图3K是根据本发明的另外一个实施方式的套筒的顶视图,在套筒的***上具有三个间隔开的突起;
图3L是根据本发明的另外一个实施方式的套筒的顶视图,在套筒的***上有肋或环;
图3M是根据本发明的另外一个实施方式的套筒的平面图,在套筒的***上具有凹槽;
图3N是根据本发明的另外一个实施方式的套筒的平面图,在具有圆柱形孔和圆柱形外部直径的套筒的***上具有凹槽;
图3P是沿3P-3P线在箭头方向上所得的截面图;
图3Q是图3N的套筒的平面图;
图4是具有图3M的套筒的图2的远端植入体柄平面图,所述套筒安置在所述柄上用于形成远端植入体套筒组件;
图4A是根据本发明的另外一个实施方式,具有与图3C的套筒共同使用的外部突起的远端植入体柄的平面图,所述套筒安装在所述柄上以形成远端植入体套筒组件;
图4B是图4A的远端植入体套筒组件的顶视图,示出了远端植入体柄的***上的突起;
图4C是根据本发明的另外一个实施方式,具有与图3E的套筒共同使用的3个间隔开的外部突起的远端植入体柄的顶视图,所述套筒安装在所述柄上以形成远端植入体套筒组件;
图4D是根据本发明的另外一个实施方式,具有与图3F的套筒共同使用的外部凹痕的远端植入体柄的平面图,所述套筒安装在所述柄上以形成远端植入体套筒组件;
图4E是图4D的远端植入体套筒组件的顶视图,示出了远端植入体柄的外部凹痕上的突起;
图4F是根据本发明的另外一个实施方式,具有与图3H的套筒共同使用的3个间隔开的外部凹痕的远端植入体柄的顶视图,所述套筒安装在所述柄上以形成远端植入体套筒组件;
图4G是图4的植入体/套筒组件的顶视图;
图4H是用于图4的组件以保护图3的套筒的导引销的平面图;
图4I是具有图4H的导引销的植入体/套筒/销组件的平面图,其中所述销组装在图4的植入体/套筒组件上;
图5是是根据本发明的另外一个实施方式,用于图4I的植入体/套筒/销组件的扩孔钻的平面图;
图5A是根据本发明的另外一个实施方式,用于具有圆柱形***的远端柄部件的扩孔钻的平面图,其中扩孔钻具有圆柱形开口和圆柱形***;
图5B是根据本发明的另外一个实施方式,用于具有圆柱形***的远端柄部件的扩孔钻的平面图,其中扩孔钻具有圆柱形开口和锥形***;
图5C是根据本发明的另外一个实施方式,用于远端柄部件的扩孔钻的平面图;
图6是图5的扩孔钻的平面图,其中部分为截面;
图6A是图5C的扩孔钻的平面图,其中部分为截面;
图7是图5C的扩孔钻的更加详细的平面图,其中部分为截面;
图7A是图7的部分平面图,更加详细地示出了定位在扩孔钻的孔内以配合套筒的***上的凹槽的弹簧加载制动器;
图7B是根据本发明的另外一个实施方式的近端扩孔钻的局部平面图,示出了定位在扩孔钻的孔内以配合套筒的***上的凹槽的突起;
图7C是图7B的近端扩孔钻的顶视图,示出定位在扩孔钻的孔内的突起;
图7D是根据本发明的另外一个实施方式,图7B的近端扩孔钻的顶视图,示出了设置在扩孔钻的孔内的3个间隔开的突起;
图7E是根据本发明的另外一个实施方式,近端扩孔钻的局部平面图,示出定位在扩孔钻的孔内以配合套筒上的凹槽的环;
图7F是根据本发明的另外一个实施方式,近端扩孔钻的局部平面图,示出定位在扩孔钻的孔内以配合套筒上的突起的凹槽;
图7G是图5的扩孔钻的更加详细的平面图,其中部分是截面图;
图8是定位在图4的远端植入体/套筒组件上的图5的扩孔钻的局部截面的平面图;
图9是根据本发明的另外一个实施方式,具有图3的套筒的图5的扩孔钻的局部截面的平面图,其中所述套筒定位在图5的扩孔钻上以形成扩孔钻/套筒组件;
图10是与图2的远端柄植入体共同使用的近端体植入体;
图11是包括定位在图2的长骨远端柄植入体上的图10的近端体植入体的长骨植入体组件;
图12是图11的长骨植入体组件的放大的局部平面图,更加详细地示出了锥形连接;
图13是包括头的图11的长骨植入体组件的分解视图;
图14是定位在人体上的图13的长骨植入体组件的组装视图;
图15是与图2的长骨远端柄植入体共同使用的近端测试部件;
图16是根据本发明的另外一个实施方式的用于执行关节成形术的工具包;
图17是根据本发明的另外一个实施方式的外科手术的流程图。
具体实施方式
本发明的实施方式及其优点可参照下文的说明和附图得到最好的理解,其中同样的数字用于指示附图中同样的和相应的部件。
现参照图1,示出了与本发明共同使用的长骨或股骨2。股骨2包括髓内管4,本发明的假体可***到该髓内管内。股骨2通过例如诸如锯的电动工具沿切割线6被切割。对长骨或股骨2的切割暴露出股骨2的髓内管4。扩孔钻8可以是标准的商业上可获得的扩孔钻,其定位在长骨2的髓内管4内以形成接收矫形关节植入体的空腔10。扩孔钻8包括多个纵长延伸的凹槽12,其用于移除骨头和其他来自髓内管4的生物物质以形成空腔10。扩孔钻8可以使用安装在扩孔钻8上的连接件14进行旋转。所述连接件14可以是任何标准的连接件,例如Hudson或A-O连接器。连接器14用于连接到电动工具16以旋转扩孔钻8。所述电动工具16可以是任何标准的电动工具。应当理解扩孔钻8可由诸如“T”形手柄等手动工具通过连接器14进行旋转。
现在参照图2,显示远端植入体柄18装配到形成在长骨或股骨2的髓内管4内的空腔10内。所述远端植入体柄18可以,如图2所示,是弧形的或弯曲的柄的形式。天然股骨具有弯曲,尤其是当远端植入体柄具有特别长的长度时,诸如用于修正关节成形术时,其在植入体部件中被最大限度地复制。远端植入体柄的形状可由从原点21延伸的半径R定义。柄18的弧形或弯曲部分可被大部分定位在柄18的远端。远端植入体柄包括外部锥形近端部分20和由锥形近端部分20近端地定位的具有外部螺纹24的形式的连接器。切割线6可大致相应于所述柄18在植入之后其外部锥形部分20开始的位置。
现参照图2A,应当理解所述柄可以是不包含弧形或弯曲部分的直的或圆柱形的柄18A的形式。在本发明中具有这种圆柱形柄18A的近端扩孔钻的使用可提供骨头的移除以便接收精确的近端体,并且与用于接收近端体的其他移除骨头的方法相比最小化了骨头的移除。
现根据本发明,并参照图3,示出了例如图2的柄18的远端植入体柄一起使用的套筒24X。所述套筒24X与近端扩孔钻58C(见图5C)一起使用。套筒24X,如图3所示,装配在远端植入体柄18的锥形近端部分20上。套筒24X定义一套筒24X的***26X。如图3所示,套筒24X可以是中空的,并且可以包括沿套筒中心线30X纵向延伸的空腔28X。空腔28X可以定义一套筒24X的内壁32X。套筒24X的内壁32X可以具有任何与柄18的锥形近端部分20的***19(见图2)相适配的形状。
再参照图2,柄18包括锥形近端部分20和螺纹部分22。同样地,参照图3,所述内壁32X包括锥形部分34X以适配与柄18的锥形部分20。同样,套筒24X的内壁32X包括螺纹状圆柱形部分36X,其与柄18上形成的内部螺纹25(见图2)相适配。
锥形部分34X和圆柱形部分36X定义一定位在套筒24X的圆柱形部分36X和锥形部分34X之间的台阶或肩部38X。套筒24X可以包括具有适应于近端扩孔钻(见图5C)形状的***26X。***26X可以,如图3所示,是锥形的并且由一内角α定义。内角α可以这样设置从而使得套筒24X具有大致平均的壁厚T。因此套筒24X的内壁32X的锥形部分34X可以包含并由夹角θ定义,而夹角θ与内角α近似。如图3所示,内角α略小于夹角θ。
套筒24X优选被牢固地固定到图2的柄18上从而避免对柄18的锥形近端部分20的磨损或损害。因此套筒24X可包括当组合在一起时柄用于确保18牢固地固定到套筒24X上的特征。在锥形部分34X的内壁的角度αα的设置使得其可提供与柄18的锥形部分20的锁定锥。可选地,内壁32X的圆柱形部分36X可包括,例如,如在剖视图中示出的内部螺纹40X这样的特征,其可以有选择地用于将套筒24X螺旋进入与柄18的外部螺纹23的结合之中。
现参考图3A,示出了作为套筒24A的本发明的一个可选实施方式。套筒24A与图3的套筒24相似,只是套筒24A具有均为圆柱形的***26A和内壁32A。套筒24A适于与具有圆柱形轮廓的驱动表面的扩孔钻一同使用。
现参考图3B,示出了作为套筒24B的本发明的另一个实施方式。套筒24B与图3的套筒24相似,只是套筒24B包括圆柱形的***26B和锥形的内壁32B。应当理解,图3B的套筒24B可以具有不设置台阶或肩部的内壁32B以及简单圆柱形形状的***26B的标准结构。
套筒24可包括由套筒24的底端44的***26向外延伸的环状的环或凸缘42。凸缘42可用于防止套筒24的***26被永久地锁定在近端扩孔钻上。
当在近端扩孔钻与套筒24一起使用时需要将套筒24刚性地固定到远端植入体18上,这种套筒24与植入体柄18之间的刚性结合可由套筒24的内壁32与柄18的锥形外部部分20之间的过盈配合获得,无论所述部件是圆柱形的或锥形锁定与否。
应当理解,为了确保套筒24与柄18的锁定,套筒24可以包括锁定或固定特征46,其与柄18上的连接特征56相互作用以确保套筒24牢固固定在柄18上。
如图3C所示,套筒24C被示出,其与图3的套筒24相似,只是套筒24C包括具有凹痕形式的套筒/柄固定特征46C。该凹痕46C可以与由柄18的外部锥形部分20的***26延伸的附加突起(见图2)相互配合。
现参照图3D所示,套筒24C可以包括如图3D所示的单个的凹痕46C。
现参照图3E,示出作为套筒24E的本发明的另一个实施方式。套筒24E与图3C和3D中的套筒24C类似,只是套筒24E包括不止一个凹痕,例如,具有三个间隔开的凹痕46E。
现参照图3F和3G,示出作为套筒24F的本发明的又一个实施方式。套筒24F与图3的套筒24相似,只是套筒24F包括具有由套筒24F的内壁32F向内延伸的突起46F这种形式的套筒/柄固定特征。如图3G所示,突起46F是单个的突起。图3F和3G的突起46F可以与图4F的柄18F的锥形部分20F上形成的凹痕56F相配合。
现参照图3H,示出作为套筒24H的本发明的又一个实施方式。套筒24H类似于套筒24F,只是套筒24H包括三个间隔开的突起46H。
现参照图3I,示出作为套筒24I的本发明的又一个实施方式。套筒24I类似于图3的套筒24,只是套筒24I包括具有定位在套筒24I的肩部38I附近的突起48I形式的套筒/近端扩孔钻固定结构。突起48I由套筒24I的***26I向外延伸。突起48I用于与近端扩孔钻上的凹痕配合从而当近端扩孔钻由柄18拔出时,套筒24I保留在近端扩孔钻上而无需单独由柄18(见图2)上移除。
突起48I可以具有适合的形状并且可以如图3I所示的向下的锥形以更加容易地在向下的方向使突起与扩孔钻的开口配合从而确保套筒24可与近端扩孔钻仪器被移除。这一特征减少了手术过程的步骤并节省了在手术室内的时间。
现参照图3J,套筒24I的突起48I可以是单个的突起。
现参照图3K,示出作为套筒24K的本发明的又一个实施方式。套筒24K包括由套筒24K的***26K向外延伸的突起48K。应当理解,如图3K所示,可以将三个间隔开的突起48K与形成在近端扩孔钻(见图4)上的相应的凹痕一起使用。
现参照图3L,套筒24I的突起48I可以是环绕套筒的***延伸的单个的突起以形成环或凸缘。
现参照图3M,更加详细地示出了套筒24X。套筒24X可以包括套筒扩孔钻连接结构48X,其具有由套筒24X的***26X向内延伸的内部凹槽48X的形式。凹槽48X可以沿套筒24X的纵长轴中心线30X定位在任意位置,但是优选将其定位在靠近套筒24X的肩部38X处。凹槽48X用于配合近端扩孔钻58C(见图7A)上形成的制动器88C。应当理解结构48X应当提供在套筒24X和近端扩孔钻58C之间的相对转动的能力。
根据本发明,并且参照图3N、3P和3Q,示出了与远端植入体柄、例如图2的柄18一起使用的套筒24。套筒24与近端扩孔钻58(见图5)共同使用。套筒24,如图3所示,适配在远端植入体柄18的锥形近端部分20上。套筒24定义套筒24的***26。如图3所示,套筒24可以是中空的并且可以包括沿套筒中心线30纵向延伸的空腔28。空腔28可以定义套筒24的内壁32。套筒24的内壁32可以具有与柄18的锥形近端部分20的***19相配合的形状。内壁19可以是圆柱形的并且过盈配合到图2的柄18的锥形近端部分20上。
再参照图2,柄18包括锥形近端部分20和螺纹部分22。同样地,并且参照图3N、3P和3Q,内壁32包括远端圆柱形部分34以与柄18的锥形部分20过盈配合。同样,套筒24的内壁32包括具有相对的双平面37的近端圆柱形部分36,其与形成在柄18(见图2)上的相对的双平面27相配合。
再参照图3N、3P和3Q,远端圆柱形部分34和近端圆柱形部分36定义一位于套筒24的圆柱形部分36和远端圆柱形部分34之间的台阶或肩部38。套筒24可以包括具有与近端扩孔钻(见图5)相适配的形状的***26。如果近端扩孔钻孔的角度足够小,套筒24的***26可以是圆柱形的。***26可以,如图3所示,是圆柱形的并且由直径DOS定义。套筒24可以具有通常标准的壁厚T。因此套筒24的内壁32的远端圆柱形部分34可以由壁厚T定义。
优选将套筒24牢固在柄18上从而避免柄18的锥形近端部分20不受磨损或损害。因此套筒24可以包括用于在两者组装到一起时确保柄18牢固固定到套筒24上的结构。套筒24的内壁32的远端圆柱形部分34可以这样设计从而使其提供与柄18的锥形部分20的过盈配合。可选择地,内壁32的圆柱形部分36可以包括,例如,内部螺纹(未示出)这样的结构,其能够可选地用于与柄18的外部螺纹23相互结合。
应当理解,为了确保套筒24的圆柱形部分34与扩孔钻8的柄18的锥形部分20之间的过盈配合,套筒可以可选地具有穿过套筒24的壁的纵长槽(未示出)。所述槽可以是单个的槽或多个间隔开的槽。所述槽可以部分沿着套筒24的长度延伸或是沿着整个长度延伸,从而劈开套筒24。所述槽提供附加的过盈配合。
根据本发明并且现参照图4,示出植入体套筒组件50。所述植入体套筒组件50包括定位在图2的矫形植入体柄18上的图3的套筒24。矫形植入体柄18定位在股骨2的髓管4内的软骨或多孔骨的空腔10内。套筒24可以在箭头52的方向安装到矫形植入体柄18上。矫形植入体柄18可以由如虚图所示的加载位置54移动到如实图所示的安装位置56。
尽管套筒24被原位安装到已经安装进入股骨2的空腔10的髓管4内的矫形植入体柄18上,但是可以理解,套筒24可以在执行手术之前预先安装到矫形植入体柄18上从而套筒24可以在装运和将柄安装到股骨2的髓管4的空腔10内的过程中保护柄18的柄锥形部分20的***19。
套筒24优选刚性配合到矫形植入体柄18上。套筒24与柄18的刚性连接可通过套筒24的筒内壁32与柄18的柄锥形部分20的***19之间的配合来实现。套筒24的内壁32可以是圆柱形的并且可以因此与由夹角θθ定义的矫形植入体柄18的柄锥形部分20的***19相配合。
矫形植入体柄18,同套筒24一样,可以包括确保套筒24与柄18之间的刚性固定的结构。例如,并且如图4所示,柄18可以包括柄/套筒连接结构56,其具有用于操作套筒24(见图3)的过盈配合的形式。
现参照图4A和4B,示出作为植入体套筒组件50A的本发明的又一个实施方式。植入体套筒组件50A与图4的植入体套筒组件50相似,只是植入体套筒组件50A包括柄18A,其具有由柄18A延伸的突起56A形式的柄/套筒连接结构。突起56A装配进入形成在图3C和3D的套筒24内的单个凹痕46C中。
现参照图4C,示出作为植入体套筒组件50C的本发明的又一个实施方式。植入体套筒组件50C与图4A和4B的植入体套筒组件50A相似,只是植入体套筒组件50C的柄18包括由柄18C延伸的多个间隔开的突起56C。突起56C与套筒24E的凹痕46E相互配合。
现参照图4D和4E,示出作为植入体套筒组件50D的本发明的又一个实施方式。植入体套筒组件50D包括形成在柄18D上的单个的凹痕56D。柄18D上的凹痕56D与形成在图3F和图3G的套筒24F上的单个突起46F相互配合。
现参照图4F,示出作为植入体套筒组件50F的本发明的又一个实施方式。植入体套筒组件50F与图4E和4D的植入体套筒组件50D相似。植入体套筒组件50F包括柄18F,其包括三个间隔开的凹痕56F。柄18F的凹痕56F与形成在图3H的套筒24H上的突起46H相互配合。
现参照图4G,示出与远端扩孔钻8的柄18相互配合的套筒24。远端扩孔钻8的柄18包括形成在该柄18上的相对的双平面27。套筒24的近端圆柱形部分36包括形成在该套筒24的近端圆柱形部分36相对的双平面37。形成在该套筒24的近端圆柱形部分36相对的双平面37与形成在柄18上的相对的双平面27相配合。远端扩孔钻8的柄18还包括由远端扩孔钻8的柄18的端部31延伸的纵长中心槽29。
现参照图4H,与图4的植入体套筒组件50一起使用以保护图3N、3P和3Q的套筒18的导引销33。导引销33适配在图1的远端扩孔钻8的柄18上的外部螺纹23上。导引销33包括内部螺纹35用于配合远端扩孔钻8的柄18上的外部螺纹23。导引销33具有任何用于适配到图5的近端扩孔钻58内的形状。例如导引销33可以具有由直径DGP定义的大致圆柱形的形状。导引销33可以具有圆形的或子弹形鼻部43以帮助将扩孔钻58引导到导引销33上。导引销可以包括横向贯穿的开口51用于拔出导引销33。
现参照图4I,示出图4H的导引销33组装到图4的植入体/套筒组件50上以形成植入体/套筒/销组件45。图5的近端扩孔钻58被导引到植入体/套筒/销组件45上。
现参照图5,示出作为扩孔钻58的本发明的又一个实施方式。扩孔钻58用于对形成在股骨2的髓管4内的空腔10的近端部分62扩孔。扩孔钻58用于关节假体62的植入中。关节假体62包括远端柄部分18。扩孔钻58包括本体66,其定义一形成在本体66内的远端空腔68。远端空腔68适于接收矫形植入体部件,例如柄18,的至少一部分。
扩孔钻58还包括多个由本体66向外延伸的切割缘70。缘70适于对例如股骨2的骨头进行操作。扩孔钻58还包括由本体66的端部74延伸的柄72。本体66可以具有任意适合的形状,并且可以例如,是圆柱形的、具有多边形截面或具有锥形的***76。柄72可以具有任意适合的形状并且可以包括连接器78,其具有,例如,诸如AO连接器或Hudson连接器等标准商业上可得的连接器的形式,其能够接收例如用于在箭头82的方向旋转扩孔钻58的驱动器80等的工具。扩孔钻58包括结合并移除骨头的切割缘70。
扩孔钻58可以具有任意适合的形状并且可以具有任何数量的切割缘70。例如,可以有两个、三个、四个、五个、七个或更多槽。优选地,槽等距地分开并沿近端扩孔钻58的纵长中心线84延伸。槽70可以随着纵长轴84纵向延伸,或可以如图5中所示的那样为螺旋形或形成一个角度,例如相对于水平面成ββ角。
形成在近端扩孔钻58内的远端空腔68可具有任意适合的形状并且可以例如是圆柱形的或具有定义一个锥形的***86。近端扩孔钻58的内壁86定义远端空腔68并且,优选地,具有与柄18的近端部分20相配合的形状。
如图5所示,扩孔钻58的***71由切割缘70定义并且可以是锥形的。由远端空腔68形成的内壁86也可以是锥形的。应当理解,其它形状的这些部件都可能落入本发明的范围。扩孔钻58包括近端内部空腔39用于接收图4H的导引销33。近端内部空腔39定义一该内部空腔的端部41从而提供用于与导引销33的子弹形鼻部43相配合的阻挡部。扩孔钻58还可以包括由扩孔钻58的***49延伸到近端内部空腔39的纵长槽47用于观察导引销33向扩孔钻58内的***并方便清洁扩孔钻58。扩孔钻58可以具有单个或多个(例如3个等距间隔开的)槽47。
现参照图5A,示出作为近端扩孔钻58A的本发明的又一个实施方式。近端扩孔钻58A与图5的近端扩孔钻58相似,只是近端扩孔钻58A包括形成一圆柱形***71A的切割缘70A。并且,空腔68A形成一同样为圆柱形的内壁86A。
现参照图5B,示出作为扩孔钻58B的本发明的又一个实施方式。扩孔钻58B与图5的扩孔钻58相似只是扩孔钻58B包括形成一圆柱形内壁86B的空腔68B。切割缘70B形成一为减缩形或圆锥形的***71B。***71B由夹角αα定义。
现参照图5C,示出作为扩孔钻58C的本发明的又一个实施方式。扩孔钻58C用于在股骨2的髓管4内形成的空腔10的近端62C上扩孔。扩孔钻58C用于关节假体62的植入。关节假体62包括远端柄部分18。扩孔钻58C包括本体66C,其定义一形成在本体66C内的远端空腔68C。远端空腔68C适于接收矫形植入体部件,例如柄18,的至少一部分。
扩孔钻58C还包括多个由本体66C向外延伸的切割缘70C。缘70C适于对例如股骨2的骨头进行操作。扩孔钻58C还包括由本体66C的端部74C延伸的柄72C。本体66C可以具有任意适合的形状,并且可以例如,是圆柱形的、具有多边形截面或具有锥形的***76C。柄72C可以具有任意适合的形状并且可以包括连接器78C,其具有,例如,诸如AO连接器或Hudson连接器等标准商业上可得的连接器的形式,其能够接收例如用于在箭头82C的方向旋转扩孔钻58C的驱动器80C等的工具。扩孔钻58C包括结合并移除骨头的切割缘70C。
扩孔钻58C可以具有任意适合的形状并且可以具有任何数量的切割缘70C。例如,可以有两个、三个、四个、五个、七个或更多槽。优选地,槽等距地分开并沿近端扩孔钻58C的纵长中心线84C延伸。槽70C可以随着纵长轴84C纵向延伸,或可以如图5C中所示的那样为螺旋形或形成一个角度,例如相对于水平面成ββ角。
形成在近端扩孔钻58C内的远端空腔68C可具有任意适合的形状并且可以例如是圆柱形的或具有定义一个锥形的***86C。近端扩孔钻58C的内壁86C定义远端空腔68并且,优选地,具有与柄18的近端部分20相配合的形状。
如图5C所示,扩孔钻58C的***71C由切割缘70C定义并且可以是锥形的。由远端空腔68C形成的内壁86C也可以是锥形的。应当理解,其它形状的这些部件都可能落入本发明的范围。
现参照图6,扩孔钻58的切割缘70可以具有任意适合的形式。例如,切割缘70可以包括多个间隔开的槽73。每一个槽73可以如图6所示包括一群间隔开的离隙75。离隙75可以定位在每一个槽73上,并且可以形成圆环或如图6所示环绕扩孔钻***71离散地定位。
扩孔钻58可以包括用于结合套筒24的连接结构88从而当扩孔钻完成对近端体制备空腔的任务后套筒24可随着扩孔钻58被移除。连接结构88可以具有任意有助于使得套筒24可随扩孔钻58移除的适合的尺寸和形状。
现参照图6A,扩孔钻58C的切割缘70C可以具有任意适合的形式。例如,切割缘70C可包括多个间隔开的槽73C。每一个槽73C可以如图6C所示包括一群间隔开的离隙75C。离隙75C可以定位在每一个槽73C上,并且可以形成圆环或如图6A所示环绕扩孔钻***71C离散地定位。
扩孔钻58C可以包括用于结合图3的套筒24X的连接结构88C从而当扩孔钻完成对近端体制备空腔的任务后套筒24X可随着扩孔钻58C被移除。连接结构88C可以具有任意有助于使得套筒24X可随扩孔钻58C移除的适合的尺寸和形状。
现参照图7,更加详细的示出了连接结构88C。连接结构88C可以是突起的形式或是如图7所示为弹簧加载的制动器的形式。
现参照图7A,更加详细的示出了扩孔钻58C的弹簧加载的制动器88C。弹簧加载的制动器88C包括由弹簧在空腔68C的方向上偏置的球83C。弹簧85C和制动器88C均定位在开口87C内。制动器88C通过压缩弹簧85C并向内移动球83C而接收套筒24C。然后弹簧85C延伸以与套筒24C内的凹槽48C结合从而套筒24C可以与扩孔钻58C一起被移除。
制动器88C的球83C与图3M所示的套筒58C的凹槽48C相结合。通过提供与例如图3M的凹槽48M的凹槽适配的制动器88C, 扩孔钻58C可以在套筒24X静止或被固定在远端柄18上时进行旋转。
现参照图7B和7C,示出作为扩孔钻58B的本发明的又一个实施方式。扩孔钻58B与图7的扩孔钻58相似只是扩孔钻58B具有由扩孔钻58B的空腔68B的内壁86B向内延伸的固定的单个突起88B。扩孔钻58B的突起88B与如图3M所示的套筒24M的凹槽48相配合。
根据本发明并且现参照图7D,示出作为扩孔钻58D的本发明的另外一个实施方式。扩孔钻58D与图7B和7C的扩孔钻58B相似,只是扩孔钻58D包括由扩孔钻58D的空腔68D的内壁86D向内延伸出的三个间隔开的突起88D。扩孔钻58D的突起88D与如图3M所示的套筒58的凹槽48相配合。
图7B和7C的突起88B和图7D的扩孔钻58D的突起58D与具有凹槽的套筒,例如如图3M所示的具有凹槽48的套筒24,相配合。所述突起和凹槽相互配合从而当柄18和套筒24固定时近端扩孔钻58可以旋转。
现参照图7E,示出作为近端扩孔钻58E的本发明的另外一个实施方式。近端扩孔钻58E与图7D的扩孔钻58D相似,只是具有由空腔68E的内壁86E向内延伸的联系的肋88E。肋88E与形成在图3M所示的套筒24内的凹槽48相配合。
现参照图7F,示出作为扩孔钻58F的本发明的另外一个实施方式。扩孔钻58F与图7E的扩孔钻58E相似,只是扩孔钻58F包括由形成在扩孔钻58F的空腔68F内的内壁86F上向外延伸的周向内部凹槽88F。凹槽88F与,例如,图3K的突起24A或图3K的套筒24K内形成的肋48K,相互配合。
现参照图7G,更加详细的示出连接结构88。连接结构88可以具有突起的形式或图7所示具有弹簧加载的制动器的形式。
弹簧加载制动器88包括由弹簧在空腔68的方向上偏置的球83。弹簧85和制动器88均定位在开口87内。制动器88通过压缩弹簧85并向内移动球83而接收套筒24 。然后弹簧85延伸以与套筒24内的凹槽48结合从而套筒24可以与扩孔钻58一起被移除。
制动器88的球83与图3N所示的套筒58的凹槽48相结合。通过提供与例如图3N的凹槽48的凹槽适配的制动器88, 扩孔钻58可以在套筒24静止或被固定在远端柄18上时进行旋转。
现参照图8并且根据本发明,示出了扩孔钻组件90。套筒24和导引销33定位在形成于近端扩孔钻58内的近端内部空腔39内。矫形植入体柄18定位在扩孔钻58的远端空腔68内并且柄18的近端部分20的***19与套筒24的内壁32相结合。套筒***26可旋转地与扩孔钻58的内壁86相结合。套筒24的固定结构48结合在扩孔钻58的连接结构88上。同样地,柄18的固定结构56结合在套筒24的锁定结构46上。
现参照图9,示出了作为扩孔钻套筒组件92的本发明的又一实施方式。扩孔钻套筒组件92包括扩孔钻58和套筒24。如图9所示,扩孔钻套筒组件包括在扩孔钻58上形成的制动器88,其与形成在套筒24内的凹槽48配合。由扩孔钻58的切割缘70定义的***71用于从股骨2的近端部分89上移除骨头。扩孔钻58的切割缘70在股骨2的近端部分89上制备空腔91。近端空腔91由角ααα定义,该角度与扩孔钻58的***71定义的角度β大致相同。
现参照图9,应当预见,套筒24上的凸缘42与形成在套筒24内的凹槽48和制动器88配合以牢固地将套筒24置于扩孔钻58内。
现参照图10,示出与柄18一起使用的矫形植入体近端部件90。矫形植入体近端部件90包括用于接收假体头部96的本体93。本体93定义一纵长开口97用于接收柄18。本体93还定义一外部部分98,其尺寸适于配合进入由扩孔钻58在股骨2的近端部分89上制备的开口91内(见图9)。
现参照图11,示出与本发明的扩孔钻和扩孔钻组件一起使用的髋柄组件99。髋柄组件99包括远端植入体柄18,近端本体93牢固地固定在该柄上。柄18的锥形部分20配合进入形成在近端部件92的本体93内的开口97中。柄18的锥形部分20可以包括形成在柄18的螺纹部分22上的外部螺纹21。具有螺母100的形式的紧固件可用于确保柄18的锥形部分20完全座套进入纵长开口97内。螺母100可以留在矫形柄组件99上或者可以在柄18牢固地配合到近端部件92上之后被移除。
现参照图12,更加详细的示出近端部件92。如图12所示,示出远端部件18的近端部分20配合进入近端部件92的纵长开口92内。柄18的螺纹部分22上的螺纹21结合螺母100并牵引柄与近端部件92结合。近端部件92的***98装配入由近端扩孔钻58形成的空腔91内。颈部94支持一外部锥形***95,具有圆球形式的头部96固定安装在该锥形***95上。
现参照图13,示出柄组件99的部件的分解图。柄18、近端部件92、头部96以及螺母100显示处于组装之前的相应位置。如图13所示,柄18具有弓形的形状。本发明特别适于与具有弧形的或弯曲的柄的矫形植入体一同使用。但是,应当预见,本发明也可与直的或圆柱形的或线形的柄一起使用。应当预见,当使用具有弧形或弓形的柄时,扩孔钻不能同时既为远端扩孔钻制备远端空腔又为近端本体制备精密的装配扩孔部分,因为这两个部件不具有共同的中心线并且因此无法同时扩孔。
现参照图14,示出具有髋假体102形式的矫形植入体组件。髋假体102包括柄组件99和头部96。壳或杯104可以安装到髋臼窝106上。壳或杯104可以直接与头部96配合或者可在杯104和头部96之间设置衬垫或轴承108。矫形植入体102可以由任何适合的材料制得。柄99可以由任何与人体解剖学相容的材料制得,并且可以例如可由金属制成。如果由金属制得,矫形植入体部件可以由,例如,钴铬合金、不锈钢合金或钛合金制得。应当预见,衬垫或轴承108可由金属制得,或由塑料,例如聚乙烯制得。
现参照图15,示出与远端植入体柄18一起使用的测试颈部110。测试颈部110替代近端部件92并且可以用于提供测试还原以保证所使用的是恰当的近端部件。一旦完成测试还原并且发现近端测试颈部110是适合的之后,与测试颈部110类似的近端植入体将被取代,从而制造适于该患者的相应的近端部件。
现参照图16,提供了用于执行关节成形术中的工具包112。工具包112包括近端扩孔钻58和套筒24以及远端植入体柄18。工具包112还可以包括远端扩孔钻8。工具包112还可以包括近端测试体110。工具包112还可以包括进行植入体部件92。工具包112还可以包括导引销33。
根据本发明并且现参照图17,提供了用于执行关节成形术的方法220。所述方法220包括切除长骨端部的第一步骤222。所述方法220还包括在长骨的髓内管内制备中心纵长开口的第二步骤224。所述方法220还包括提供矫形柄部件的第三步骤226和将矫形柄部件安装进入髓内管的开口内的第四步骤228。
所述方法220还包括提供包括用于接收矫形柄部件开口的扩孔钻的第五步骤230和将扩孔钻定位在矫形柄部件上从而使得扩孔钻的开口定位在矫形柄部件的至少一部分上的第六步骤232。
所述方法220还包括使用扩孔钻在长骨的一部分上扩孔的第七步骤234和移除扩孔钻的第八步骤236。所述方法220还包括将矫形本体部件安装到矫形柄部件上的第九步骤238。
尽管已经详细描述了本发明及其优点,但是应当理解,可以在不脱离由附加的权利要求所定义的本发明的精神和范围内的情况下对其进行各种改变、置换和变更。
Claims (4)
1.一种用于结合矫形植入体柄和近端扩孔钻使用的套筒,包括:
孔,所述孔构造成用以适配地接收矫形植入体柄的近端部分;以及
***,所述***与扩孔钻中的空腔相适配地形成,其中,
所述套筒构造成用以滑动地接收所述矫形植入体柄,
所述套筒包括用于将所述套筒固定至所述矫形植入体柄的近端部分上的结构,以及
所述孔大体上限定圆锥形状。
2.根据权利要求1所述的套筒,其特征在于,所述扩孔钻的空腔具有大致圆柱形状。
3.根据权利要求1所述的套筒,其特征在于,所述结构包括凹痕。
4.根据权利要求1所述的套筒,其特征在于,所述结构包括突起。
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US11/529,799 US8597298B2 (en) | 2006-09-29 | 2006-09-29 | Proximal reamer |
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-
2006
- 2006-09-29 US US11/529,799 patent/US8597298B2/en active Active
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- 2007-09-27 EP EP07253847A patent/EP1905394B1/en active Active
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JP2012213661A (ja) | 2012-11-08 |
US20130226184A1 (en) | 2013-08-29 |
EP1905394B1 (en) | 2010-11-03 |
ATE486548T1 (de) | 2010-11-15 |
US8852188B2 (en) | 2014-10-07 |
DE602007010219D1 (de) | 2010-12-16 |
JP5539467B2 (ja) | 2014-07-02 |
CN101152101A (zh) | 2008-04-02 |
JP2008086771A (ja) | 2008-04-17 |
EP2241293A1 (en) | 2010-10-20 |
CN105640676A (zh) | 2016-06-08 |
US8597298B2 (en) | 2013-12-03 |
CN101152101B (zh) | 2016-03-23 |
EP1905394A1 (en) | 2008-04-02 |
US20130289567A1 (en) | 2013-10-31 |
US8852189B2 (en) | 2014-10-07 |
US20080161811A1 (en) | 2008-07-03 |
JP5265164B2 (ja) | 2013-08-14 |
EP2241293B1 (en) | 2013-06-05 |
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