DE102007055467A1 - Surgical system for connecting and/or separating two implant parts of articulated part of articular implant, has retaining fluid moistening retaining surface of retaining element of surgical retaining instrument and/or articulated surface - Google Patents

Abstract

The system (10) has a surgical retaining instrument (12) including a retaining element (28) with a retaining surface (30) that corresponds to an articulated surface (26) of an implant part (14). A retaining fluid (104) e.g. liquid viscous medium, moistens the retaining surface and/or the articulated surface. The retaining surface is adapted to the articulated surface in such a manner that a cavity (106) is formed between the articulated surface and the retaining surface during engagement of the articulated surface and the retaining surface. Width of the cavity is 1 millimeter. The retaining fluid is selected from a group consisting of viscous medium e.g. paste viscous medium, polar liquid, water or salt solution. An independent claim is also included for a method for connecting and/or separating implant parts to each other/from each other.

Description

The The present invention relates to a surgical system for interconnecting Connecting and / or separating a first, having a joint surface and a second implant part connected to the first one first joint part of the joint implant and / or for implantation the joint part, comprising a surgical holding instrument with a holding element, which corresponds to a corresponding or substantially corresponding to the articular surface formed holding surface having.

Further The present invention relates to a method of interconnecting Connecting and / or separating a first, having a joint surface and a second implant part connected to the first one first joint part of a joint implant and / or for detachable connection or for holding the first implant part or the joint part with a surgical holding instrument in which the surgical Holding instrument is provided, with a corresponding or a having substantially corresponding to the articular surface formed holding surface Holding member.

surgical Systems and methods of the type described above are in particular in orthopedics known. They are used in particular to inlays with in one Connecting the pelvic bone of a patient implantable sockets or remove them again. Furthermore, they serve to hold of the first joint part during implantation. The holding instrument is therefore often too used as an insertion tool for implanting the first joint part. In numerous hip joint endoprostheses are offered sockets, with which a hollow-calved joint surface bearing Inlays can be connected. Because the inlays are common only in the course of surgery to replace the damaged natural Hip joint selected be, the inlay and the joint socket only then together connected. However, it may happen that a not optimal suitable inlay was connected to the socket. In one In such a case, it is then necessary to return the inlay from the To loosen joint socket. Usually the inlays are positively and / or positively connected to the socket, for example, by specially provided snap-in connections or simply by press or press fit.

Further also an implantation technique is known in which the first Joint part as a unit, so with interconnected first and second implant part, is implanted. In such a case It is not without much effort possible, to hold the first joint part, especially not if the first implant part virtually completely conceals the second implant part, allowing access to the second implant part with a holding or insertion instrument not possible anymore is.

It It is known to use holding instruments connected to the inlay be made by establishing a negative pressure between the joint surface and the holding surface, so that the holding force exerted by the holding instrument is sufficient to to hold the first joint part during implantation. Furthermore, the Holding force can also be used as a pulling force, which is larger as the holding force acting between the inlay and the socket at the mounted joint part. Disadvantageous in the described and However, the known procedure is that a vacuum generating device must be provided, for example, a vacuum pump.

It is therefore an object of the present invention, a surgical System and a method of the type described above so too improve that interconnecting and / or from each other Separate the implant parts and / or the implantation of each other connected implant parts and / or connecting an implant part is simplified with a holding instrument.

These Task is in a surgical system of the type described above Type according to the invention thereby solved, that the system further comprises a holding fluid for wetting the holding surface and / or the articular surface.

The holding fluid makes it possible, in particular, to wet the joint surface and / or the holding surface and then bring the holding surface and the joint surface close to one another such that a connection between the holding element and the first implant part is due to adhesion forces acting between the holding fluid and the joint surface and the holding surface will be produced. Thus, for example, sufficiently large forces can be exerted on the inlay, in particular tensile forces, in order to release the inlay again from the socket if required. The proposed surgical system makes in particular a vacuum pump for connecting the holding instrument to the first implant part superfluous. All components required for evacuating an intermediate space between the holding surface and the joint surface are also not required, in particular corresponding vacuum lines. As a result, if present on the holding instrument, shanks can be made slimmer and more stable, since no vacuum channel has to be provided on them. Thus, the surgical system is particularly suitable for minimally invasive surgical procedures. Furthermore, the holding forces are also sufficient for the first Implan to hold the tatteil with the holding instrument and connect to the second implant part. Furthermore, it is also possible to jointly hold the already interconnected first and second implant parts with the holding instrument and thus to implant the first joint part in a block or as a whole. This is particularly advantageous if a holding or insertion instrument can not be brought into engagement with the second implant part, for example because of a thin wall of the second implant part, which may be, for example, a socket part made of metal, which accommodates a first implant part, for example in FIG Form of an inlays made of a plastic or ceramic, is used.

Basically Any shapes and configurations of the holding surface conceivable, ie in particular plane, substantially flat, concavely curved surfaces or areas or just arbitrarily freely shaped surfaces or free-form surfaces. Preferably they are designed so that a high degree of congruence between the holding surface and the articular surface is reached, so that the holding surface and the articular surface congruent or are substantially congruent. Conveniently, the support surface is spherical or formed substantially spherical. That way she can to the articular surface, which is preferably hollow spherical, optimally adapted what especially in the case of acetabular parts of hip joint endoprostheses of the case is.

Around one possible huge Contact between the holding surface and the articular surface To be able to produce by means of the holding fluid, it is advantageous if the holding element in the form of a hemisphere or substantially in Formed a hemisphere. Especially with inlays, the have a joint recess in the form of a half hollow sphere, can thus achieve a maximum surface adaptation become.

Especially just lets the first implant part connect to the holding instrument, if the holding surface so to the articular surface adapted to be in engagement with the joint surface and holding surface between the articular surface and the holding surface a cavity is formed. In this cavity can be before or after engaging the articular surface and retaining surface of the Holding fluid are introduced. Be the articular surface and the holding surface brought to each other and not yet wetted with the holding fluid, the then acting capillary forces lead to Penetration of the holding fluid in between the articular surface and defined the holding surface Cavity.

Around preferably size holding forces to be able to apply to the inlay, is it cheap when a width of the cavity defined by a distance of the articular surface of the holding surface at the most 1 mm.

There the larger train and / or holding forces transfer the first implant part can be the smaller a distance of the joint surface from the holding surface, it is advantageous if the distance is at most 0.5 mm, in particular at the most 0.25 mm. Preferably, the distance is less than 0.1 mm.

On easy way lets the holding surface corresponding to the articular surface train when the holding surface has a slightly smaller radius than the articular surface. For example can the radius of the holding surface around the above mentioned Distance between articular surface and holding surface may be reduced by which a radius of the articular surface is typically greater.

Around sufficiently high holding forces transferred to the inlay to be able to is it cheap if the radius of the holding surface at the most 10% smaller than a radius of the articular surface. This can ensure that enough Holding fluid, but not too much, between the holding surface and introduced the articular surface can be.

A even better adhesion and thus connection between the holding surface and the articular surface can be achieved if a radius of the holding surface at most 2%, in particular not more than 1.4% smaller than a radius of the articular surface. Depending on the holding fluid it can however, cheap be if the radius of the holding surface is at most 1% or even more less than 0.5% is considered a radius of articular surface.

conveniently, wear this Holding instrument a sealing element, which adjacent to the support surface is arranged and something about the articular surface protrudes. With the sealing element, a gap between the support surface and the joint surface completely sealed be prevented so that in particular one between the mentioned areas introduced holding fluid which has a low viscosity, can escape. In particular, it can also be prevented that the holding fluid then, for example, if the implant parts inside of a human or animal body are detached from each other, emerge and get into the patient's body. If that Holding instrument is used as an insertion tool that provides Sealing element sure that for holding the first and / or second implant part required Holding force is maintained as long as necessary.

Particularly simple is the structure of the holding instrument when the sealing element in the form of a Seal is formed. Thus, in particular simple and secure sealing of a hemispherical or spherical holding surface can be achieved.

Preferably the sealing element has a circular or substantially circular cross-section on. That way you can in particular, simple O-rings can be used as sealing elements.

According to one preferred embodiment of Invention can be provided that the holding element is a flat, essentially from the holding surface away endface defined and that the sealing element in a defined by the end face Plane or parallel to this is arranged. For example, then if the holding element is designed in the form of a hemisphere, can thus practically the entire dome-shaped outer surface of the holding element, ie the holding surface, be sealed when it is brought to the articular surface. Further is the end face easily accessible ausgestaltbar and can optionally be designed such that it is connectable to a handle or shaft, which is a handling the retaining element improves, for example, the removal of the one Implant part of the other easier.

Around It is to further improve the handling of the holding instrument Cheap, if it has a shaft arranged on the holding element.

Around the shaft optionally also in conjunction with other tools To be able to use instruments for implanting an implant is It is advantageous if the shaft releasably connected to the holding element is.

Easy and connect securely the shaft with the retaining element when he screwed with this is.

Around optionally with the shaft also compressive forces on the holding element and so that exercise an implant part to be able to is it cheap when the shaft has a proximal end facing away from the retaining element having one which is proximal or substantially proximal Direction facing clubface having. In particular, when the shaft releasably connectable formed with the holding element Then, the shaft can also be used in conjunction with an impact tool for one or both implant parts are used, for example, for wrapping a socket in a pelvic bone. The holding instrument in total can also be used as an impact or Insertion tool for the serve the two implant parts comprehensive first hinge part.

The Handling the surgical system will continue in a simple manner thereby improving that the shaft has a grip area for holding of the instrument. Preferably, the grip area adjoins a proximal end of the shaft or forms a proximal End portion of the same.

Preferably the holding fluid is a viscous medium whose adhesion forces are greater than whose cohesive forces are. Such a holding fluid is ideal for connection the holding surface and the articular surface required forces to be able to raise. In particular, such a holding fluid is also suitable for bring up from the articular surface and the holding surface to be introduced into each other in a space, in which case acting capillary forces Move the holding fluid into the gap or let it flow in.

A particularly easy handling for the surgical system arises when the viscous medium is a liquid or a paste or a liquid or contains a paste. A paste may in particular be gelatinous or greasy, preferably she is very viscous.

Especially high adhesion forces can be reach when the holding fluid is a polar liquid.

Preferably the holding fluid is water or contains water. Water can as biocompatible fluid especially when the implant parts inside a patient's body must be separated from each other.

Especially the polarity of a holding fluid Easily increase in that the holding fluid a saline solution is. This means that the holding fluid is a two or more dissolved salts may contain.

Further It may be advantageous if the holding fluid is gelatin, starch, a absorbable polymer, sugar and / or glucose syrup. The described substances, each for alone or in any combination, are suitable excellent to provide sufficiently large adhesion forces, the one at least temporary Connection between the holding element and the one implant part enable.

Sufficient adhesive forces can be produced if the holding fluid has a surface tension at 20 ° C., which is at most 70 × 10 ^-3 N / m.

An even better connection between the holding element and the one Implan can be achieved if the holding fluid has a surface tension at 20 ° C, which is at most 50 · 10 ^-3 N / m.

Of Further, it is convenient if the holding surface rough or provided with a rough coating. Such Design of the holding surface enlarges one effective surface the holding surface, so that a greater attachment of the holding fluid can be achieved, whereby holding forces for Connecting to each other and / or separating the implant parts be enlarged can. This is particularly advantageous if the holding surface only is very small. Preferably, an effective surface of the holding surface twice, three times or preferably five times or more than five times greater than a projection of the holding surface. One can also say the effective area, which is a microscopic one area is greater than an arbitrary multiple one defined by the holding surface macroscopic surface.

According to one another preferred embodiment can be provided that the joint implant is a hip joint prosthesis is that the first joint part is a socket, that the first Implant part an inlay and the second implant part an artificial, implantable in a pelvis of a human or animal body Pan with a receptacle for the inlay is.

conveniently, the first implant part has a hollow-dome-shaped joint surface. In such a joint surface can in particular a dome-shaped or substantially dome-shaped trained holding element are introduced for producing a Connection with the first implant part.

Preferably are the first implant part and the second implant part in one Implantation position non-positively and / or positively connected with each other. An adhesion can in particular by clamping or pressing be achieved. A positive connection by bringing into engagement with each other corresponding projections for example, in the form of a latching connection or bayonet connection.

Especially Simply connect and disconnect again, the implant parts, if the first implant part and the second implant part in the implantation position clamped together.

advantageously, At least one stop is provided on the holding instrument for support on second implant part, when the holding element and the first implant part connected to each other. In this way, a defined engage between the retaining element and the first implant part be achieved when the first and the second implant part in defined manner are interconnected.

The The object initially set is further in a method of the above described type according to the invention thereby solved, that the articular surface and / or the holding surface be so wetted with a holding fluid and that the holding surface so dense to the articular surface brought is that a connection of the holding member and the first implant part due to between the holding fluid and the articular surface as well the holding surface produced by acting adhesion forces becomes.

The Proposed method is great for simple and safe way without further aids, especially without providing a vacuum pump to handle two interconnected implant parts, to connect each other implanted parts with each other or separate connected implant parts from each other. Further suitable The method is also excellent to a holding instrument, preferably temporarily gently with a first implant part and without damaging the articular surface connect. The first implant part can then with the holding instrument in the desired Be handled, for example, it can after connecting implanted with the holding instrument in a human or animal body be, for example, by wrapping. The holding instrument forms thus simultaneously an insertion instrument. So it will be one Gentle connection method for connecting a holding instrument proposed with at least a first implant part, wherein the first implant part itself with one or more further implant parts can be connected to form a joint part. For example can the articular surface, if concave, with the holding fluid wholly or partially filled be and the holding element can then with the holding surface in the or to the articular surface into or out until, due to the acting adhesion forces, a connection between the articular surface and the holding surface and thus between the first implant part and the holding element will be produced.

conveniently, a spherical or substantially spherical holding surface is used. Such a holding surface is particularly suitable in connection with implant parts, which hohlkalottenförmige joint surfaces For example, inlays of acetabular cups of hip joint endoprostheses or similar.

Preferably, the holding surface is adapted to the joint surface in such a way that when engaged joint surface and holding surface between the Joint surface and the holding surface is formed a cavity which is filled with the holding fluid. Particularly high holding forces can be transmitted when the cavity is completely filled with the holding fluid.

Preferably become the articular surface and the holding surface so close to each other, that a width of the cavity defined by a distance of the articular surface of the holding surface at most 1 mm. Especially with highly viscous holding fluids can already be sufficiently high holding forces between the articular surface and the holding surface act to safely handle the two implant parts together and / or to be able to separate from each other in a simple and secure manner.

conveniently, is the distance at most 0.5 mm. Preferably less than 0.1 mm. Especially at low viscosity Holding fluids, it is advantageous if the distance between the holding surface and the articular surface preferably is low.

Around the holding surface preferably close to the articular surface bring up to be able to is it cheap if a holding surface is used, which has a slightly smaller radius than the articular surface.

Cheap is it if a holding surface is used whose radius is at most 10% smaller than a radius of the articular surface. In particular, highly viscous, for example, paste-like or gelatinous, holding fluids used be to the holding surface and the articular surface through effective adhesion forces connect to.

Preferably in the case of low-viscosity holding fluids, it is advantageous if a holding surface is used whose radius is at most 2% smaller than a radius of the articular surface. Conveniently, there is a difference the radii in a range smaller than 1%.

Around to prevent a portion of the holding fluid, for example excess-provided holding fluid, It can be advantageous if one between the holding surface and the articular surface trained and filled with the holding fluid cavity becomes. Preferably, it is completely sealed.

Especially easy to seal the cavity when used for sealing a sealing element becomes. In particular, you can O-rings are used as sealing elements.

Around completely seal a gap between the articular surface and the support surface can, is it cheap when a holding instrument is used, which is a sealing element wearing, which to the holding surface is disposed adjacent and projects slightly beyond the articular surface.

Around simply handle the implant parts together and / or from each other to be able to disconnect it is advantageous if a holding instrument is used, which having a shaft arranged on the holding element. On the shaft can the holding instrument simply and safely seized by an operator become.

Preferably a shaft is used, which releasably connectable to the holding element is. this makes possible if necessary, to release the shaft from the holding instrument, for example if he is during a interfere with surgical intervention would. Optionally, the shaft can also be used in conjunction with other tools used, that is in particular associated with these to appropriate surgical To be able to intervene.

Around preferably size connecting forces between the articular surface and the holding surface To achieve, it is advantageous if a holding fluid as a viscous Medium is used, the adhesion forces are greater than its cohesive forces. Thus, in particular, the holding fluid only then between the articular surface and the holding surface be introduced if they are already introduced to each other. Due to the special property of the holding fluid can then acting capillary forces, the due to the adhesion of the holding fluid to the respective surfaces arise, the holding fluid in a gap, gap or cavity between the articular surface and the holding surface pour in to let.

Especially simply the implementation of the Method, when the viscous medium is a liquid or a paste or a liquid or contains a paste. Pastes, in particular, adhere well to one or both surfaces. Of Further can greater distances between the articular surface and the holding surface be left, but then still a secure connection achieved between the holding element and the first implant part is used to handle the two implant parts and / or each other to separate.

Especially high adhesion forces can be reach when a polar liquid is used as the holding fluid. One example for a polar liquid is especially water.

A high wetting of many different materials can in particular be achieved when a holding fluid is used which contains water or Water is.

The polarity of the holding fluid can also be in particular, increase such a way when using one which is a saline solution.

ever according to application, it may be advantageous if a holding fluid which gelatin, starch, an absorbable polymer, Contains sugar and / or glucose syrup. All mentioned materials, individually or as any mixture, are ideal to in connection with a patient, especially inside a patient's body to be used.

Sufficient adhesive forces between the hinge surface and the holding fluid may be formed when using a holding fluid having a surface tension at 20 ° C. which is at most 70 × 10 ^-3 N / m.

It is favorable if a holding fluid is used which has a surface tension at 20 ° C., which is at most 50 × 10 ^-3 N / m. Preferably, the surface tension is less than 30 × 10 ^-3 N / m.

On easy way lets an inlay is released from a socket of a hip joint endoprosthesis when the procedure is applied to a joint implant in the form of a Hip joint prosthesis, where the first joint part is a joint socket, wherein the first implant part an inlay and wherein the second implant part is an artificial, implantable in a pelvis of a human or animal body Pan with a receptacle for the inlay. Further leaves itself with the method, a joint part comprising the first and handle second implant part and into a human or animal body implant.

The The following description of a preferred embodiment of the invention serves in conjunction with the drawings for further explanation.

It demonstrate:

1 a perspective view of a connected to an acetabulum holding instrument of a surgical system for inserting a two parts of the implant comprehensive hinge part; and

2 a sectional view taken along line 2-2 in FIG 1 ,

In 1 is a total with the reference numeral 10 provided with a surgical system provided with a reference numeral 12 provided holding instrument comprises for connecting to a first implant part 14 , which with a second implant part 16 a first joint part 18 a joint implant 20 can be connected. The joint implant 20 is formed in the embodiment shown in the figures in the form of a hip joint endoprosthesis, wherein in the 1 and 2 only a first joint part 18 is shown in the form of a socket, but not the same to the joint implant 20 belonging prosthesis stem with neck and ball head. The second implant part 16 is formed in the form of a cup made of a body compatible metal part, the first implant part 14 in the form of a clamping part held in the cup, preferably made of a biocompatible plastic or ceramic inlays.

The implant parts 14 and 16 are held together by clamping, by abutting conical annular surfaces 22 and 24 of the second or first implant part 16 . 14 , They are pressed into each other by pressing in or pushing together and held in a force-locking manner. Optionally, the implant parts 14 and 16 also be positively connected or additionally positively connected with each other. The first implant part 14 has a hollow spherical or Hohlkalottenförmige joint surface 26 on, the second joint part 16 points away.

The holding instrument 12 includes a holding element 28 with a substantially hemispherical holding surface 30 which has a radius which is at most 10%, preferably 2% or smaller than a radius of the articular surface 26 , The holding element 28 is formed substantially rotationally symmetrical. It includes a basic body 32 which has a distal end surface 34 which is coaxial with a longitudinal axis 36 a threaded pin 38 with an external thread 40 extending in the distal direction. On the threaded pin 38 screwed on is a holding body 42 which is coaxial with the longitudinal axis 36 oriented bore, which is equipped, which with an external thread 40 corresponding internal thread 44 is provided, so that the holding body 42 on the threaded pin 38 can be screwed until a pointing in the proximal direction flat end surface 46 of the holding body 42 at the likewise flat end surface 34 is applied. A distal facing end face 48 of the threaded pin 38 is also flat and runs parallel to the end face 46 , The face 48 also forms part of the holding surface 30 ,

The holding body 42 is spherically shaped pointing in the distal direction, wherein an opening angle 50 from the holding body 42 defined articular surface 26 has a value of about 140 °, in particular enclosed between an edge 52 which is defined as the intersection between the Hal tefläche 30 and the endface 46 ,

The endface 34 extends in the radial direction from the longitudinal axis 36 away, but not quite as far as the edge 52 , so that essentially a ring-shaped return 54 is formed, which is the inclusion of a sealing element 56 in the form of an O-ring which is circular in cross-section and dimensioned to slightly over the support surface 30 out in the direction of the articular surface 26 protrudes. At the receding in the proximal direction 54 closes in the radial direction another return 58 which is again set back in the proximal direction and radially outward from a pointing in the distal direction annular projection 60 is limited, so that a total of an annular groove open in the distal direction 62 is formed, which is the inclusion of a flat plastic ring 63 serves, which assumes the function of a damping element, in particular impact forces from the retaining element 28 on the first implant part 14 to be transferred. An end face 64 of the annular projection 60 points in the distal direction and serves as a stop surface for a facing in the proximal direction end face 66 of the second implant part 16 which is formed substantially in the form of a ring surface facing in the proximal direction.

Proximalseitig is the holding body 42 delimited by a slightly concave and substantially in the proximal direction facing annular surface, which in a proximal flat end surface 70 passes, which are perpendicular to the longitudinal axis 36 is oriented. In the end area 46 incorporated is a polygonal recess 72 , in the form of a flat hexagon socket. The recess 72 defines one with respect to the end face 70 bottom surface set back in the distal direction 74 which are also perpendicular to the longitudinal axis 36 is oriented. Starting from the bottom surface 74 is coaxial with the longitudinal axis 36 one with an internal thread 78 provided blind hole 80 intended.

The holding instrument 12 further comprises a shaft 82 , its proximal end portion by a grip area 84 is defined. A proximal end of the shaft 82 is characterized by a relative to the handle rotatable impactor 86 formed, which one pointing in the proximal direction and perpendicular to the longitudinal axis 36 oriented face 88 includes. The impact body limits the grip area 84 proximally. Distal side becomes the grip area 84 by a radial, hexagonal projection 90 limited, which is integrally connected to the handle portion.

A distal end of the shaft 82 is formed by a sleeve 92 , the distal end a hexagonal end section 94 has, which corresponds to the recess 72 is formed and positively inserted into this. An inner diameter of the sleeve 92 narrowed in the area of the end section 94 one-step, so that a narrowing 96 , So a section with a smaller inner diameter is formed. Proximal side of the end section 94 is in the sleeve 92 a free end of a shaft sleeve 98 introduced, which has an outer diameter, which to the inner diameter of the sleeve 92 proximal end of the end portion 94 corresponds. The shaft sleeve 98 is in a distal end of the grip area 84 inserted and rotatably connected to this.

Inside the shaft sleeve 98 is a clamp bar 100 coaxial to the longitudinal axis 36 guided, whose proximal end against rotation with the striker 86 connected is. At its distal end, the clamping bar has a short bolt-shaped male threaded portion 102 on, which corresponds to the internal thread 78 is trained. An inner diameter of the constriction 96 of the end section 94 is at an outer diameter of the male threaded portion 102 adjusted, so that the latter through the narrowing 96 can be moved in the proximal and / or distal direction.

For connecting the shaft 82 with the holding element 28 will be with the sleeve 92 equipped shaft sleeve 98 with the end section 94 into the recess 72 introduced. Then the one with the through the grip area 84 with the striker 84 connected clamping bar 100 with its male thread section 102 in the blind hole 76 screwed in until a proximal end of the grip area 84 clamped against the striker 86 is pressed. The shaft 82 and the holding element 28 are then positively and positively connected with each other and can be solved again if necessary.

Furthermore, the surgical system comprises a holding fluid 104 , which wetting the holding surface 30 and / or the articular surface 26 serves.

The operation of the surgical system is explained in more detail below:
Around the interconnected first and second implant parts 14 and 16 to implant as a unit, namely as the first joint part, becomes the first joint part 18 preferably oriented such that the longitudinal axis 36 oriented parallel to the direction of gravity and the articular surface 26 points away from the center of the earth. Subsequently, a holding fluid 104 in the first implant part 14 filled. Next is the holding instrument 12 with the holding element 28 moving forward into one of the articular surface 26 limited recess of the first implant part 14 introduced until the end face 64 at the frontal area 66 essentially flat. When inserting will excess holding fluid 104 from the first implant part 14 displaced, but only so long, until the sealing element 56 at the articular surface 26 abuts and one between the articular surface 26 and the holding surface 30 defined cavity 106 completely closes, then with the holding fluid 104 is filled. The hinge part 18 is now sufficiently strong on the holding instrument 12 held, so that the hinge part 18 can be hammered into a pelvic bone of a patient, especially by knocking on the clubface 88 ,

The holding fluid used is a viscous medium whose adhesion forces are greater than its cohesive forces. It can be a liquid or a paste or a medium containing a liquid or a paste. Preferably, the holding fluid is a polar liquid such as water. A polarity of the holding fluid can be increased by adding salt to form a saline solution. Alternatively or additionally, the holding fluid may contain gelatin, starch, an absorbable polymer, sugar and / or glucose syrup. Further, the holding fluid preferably has a surface tension at 20 °, which is at most 70 × 10 ^-3 N / m, preferably, the surface tension is less than 50 × 10 ^-3 N / m.

The holding surface 30 may also be roughened to an active surface on which the holding fluid 104 can attack, increase.

One between the articular surface 26 and the holding surface 30 acting holding force is predetermined by the holding fluid 104 own adhesion and cohesive force, the smaller of these two forces determines the maximum holding power. An optimal connection between the articular surface 26 and the holding surface 30 is formed when the acting adhesion and cohesive forces are equal. For example, by appropriate choice of the holding fluid 104 a connection force between the holding element 28 and the first implant part 14 be applied, which is greater than a clamping force between the two implant parts 14 and 16 so that they can be separated from each other.

A distance of the articular surface 26 and the holding surface 30 from each other is typically not more than 1.4 mm, preferably less than 1 mm, less than 0.2 mm or less than 0.1 mm.

The surgical system described allows two implant parts 14 and 16 separate from each other, without provision of a vacuum device, for example in the form of a pump. It is in the surgical system and the method described is a cost-effective, space-saving and easy-to-use solution. Furthermore, it allows the surgical system 10 , the design of the second implant part 16 to optimize such that no protrusion with respect to the first implant part is required and thus the second implant part must be formed only as thick as actually required.

Furthermore, the holding instrument is suitable 12 also for implantation of the first joint part 18 because then when the holding element 28 in the manner described with the first implant part 14 connected, the complete first joint part 18 can be hit by exerting force on the clubface 88 , The through the holding fluid 104 applied holding force ensures that the first joint part 18 not from the holding instrument 12 triggers when on the clubface 88 is acted upon.

With the holding instrument 12 can thus be a first joint part 18 in the form of a Monoblockpfanne, wherein the second implant part 16 already firmly with the first implant part 14 is connected and a commonly used insertion instrument no longer connected to the second joint part, in particular can be screwed, held and implanted as a unit.

Claims (53)

Surgical System ( 10 ) for interconnecting and / or separating a first, a joint surface ( 26 ) and a second, with the first connected implant part ( 14 . 16 ) of a first joint part ( 18 ) of a joint implant ( 20 ) and / or for implanting the joint part ( 18 ) comprising a surgical holding instrument ( 12 ) with a holding element ( 28 ) which corresponds to a corresponding or substantially corresponding to the articular surface ( 26 ) formed holding surface ( 30 ), characterized in that the system ( 10 ) further a holding fluid ( 104 ) for wetting the holding surface ( 30 ) and / or the articular surface ( 26 ). Surgical system according to claim 1, characterized in that the holding surface ( 30 ) is spherical or substantially spherical. Surgical system according to claim 1 or 2, characterized in that the retaining element ( 28 ) is in the form of a hemisphere or substantially in the form of a hemisphere. Surgical system according to one of the preceding claims, characterized in that the holding surface ( 30 ) to the articular surface ( 26 ), that when the articular surface is in engagement ( 26 ) and holding surface ( 30 ) between the Articular surface ( 26 ) and the holding surface ( 30 ) a cavity ( 106 ) is trained. Surgical system according to claim 4, characterized in that a width of the cavity ( 106 ) defined by a distance of the articular surface ( 26 ) from the holding surface ( 30 ) is at most 1 mm. Surgical system according to claim 5, characterized in that that the distance is at most 0.5 mm. Surgical system according to one of the preceding claims, characterized in that the holding surface ( 30 ) has a slightly smaller radius than the articular surface ( 26 ). Surgical instrument according to claim 7, characterized in that the radius of the holding surface ( 30 ) is at most 10% smaller than a radius of the articular surface ( 26 ). Surgical instrument according to claim 8, characterized in that a radius of the holding surface ( 30 ) is at most 2% smaller than a radius of the articular surface ( 26 ). Surgical system according to one of the preceding claims, characterized in that the holding instrument ( 12 ) a sealing element ( 56 ), which on the holding surface ( 30 ) is disposed adjacent and slightly above the articular surface ( 26 ) protrudes. Surgical system according to claim 10, characterized in that the sealing element ( 56 ) is formed in the form of a sealing ring. Surgical system according to claim 10 or 11, characterized in that the sealing element ( 56 ) has a circular or substantially circular cross-section. Surgical system according to one of claims 10 to 12, characterized in that the holding element ( 28 ) a plane, substantially of the holding surface ( 30 ) away end surface ( 46 ) and that the sealing element ( 56 ) in one of the end surface ( 46 ) defined plane or parallel to this is arranged. Surgical system according to one of the preceding claims, characterized in that the holding instrument ( 12 ) one on the holding element ( 28 ) arranged shaft ( 82 ) having. Surgical system according to claim 14, characterized in that the shaft ( 82 ) with the retaining element ( 28 ) is releasably connectable. Surgical system according to claim 14 or 15, characterized in that the shaft ( 82 ) with the retaining element ( 28 ) is screwed. Surgical system according to one of claims 14 to 16, characterized in that the shaft ( 82 ) one of the retaining element ( 28 ) having a proximal end facing away from it, which has a striking surface (10) pointing in the proximal or substantially proximal direction ( 88 ) having. Surgical system according to one of claims 14 to 17, characterized in that the shaft ( 82 ) a grip area ( 84 ) for holding the instrument ( 12 ) having. Surgical system according to one of the preceding claims, characterized in that the holding fluid ( 104 ) is a viscous medium whose adhesion forces are equal to or substantially equal to its cohesive forces. Surgical system according to claim 19, characterized in that the viscous medium ( 104 ) is a liquid or a paste or contains a liquid or a paste. Surgical system according to one of the preceding claims, characterized in that the holding fluid ( 104 ) is a polar liquid. Surgical system according to one of the preceding claims, characterized in that the holding fluid ( 104 ) Contains water or is water. Surgical system according to one of the preceding claims, characterized in that the holding fluid ( 104 ) is a saline solution. Surgical system according to one of the preceding claims, characterized in that the holding fluid ( 104 ) Contains gelatin, starch, an absorbable polymer, sugar and / or glucose syrup. Surgical system according to one of the preceding claims, characterized in that the holding fluid ( 104 ) has a surface tension at 20 ° C, which is at most 70 x 10 ^-3 N / m. Surgical system according to claim 25, characterized in that the holding fluid ( 104 ) has a surface tension at 20 ° C, which is at most 50 x 10 ^-3 N / m. Surgical system according to one of the preceding claims, characterized in that the holding surface ( 30 ) rough or rough layering is provided. Surgical system according to one of the preceding claims, characterized in that the joint implant ( 20 ) a hip joint prosthesis ( 20 ) is that the first joint part ( 18 ) a socket ( 18 ) is that the first implant part ( 14 ) an inlay ( 14 ) and that the second implant part ( 16 ) an artificial, in a basin of a human or animal body implantable pan part ( 16 ) with a receptacle for the inlay ( 14 ). Surgical system according to one of the preceding claims, characterized in that the first implant part ( 14 ) a hollow dome-shaped joint surface ( 26 ) having. Surgical system according to one of the preceding claims, characterized in that the first implant part ( 14 ) and the second implant part ( 16 ) are non-positively and / or positively connected with each other in an implantation position. Surgical system according to claim 30, characterized in that the first implant part ( 14 ) and the second implant part ( 16 ) are clamped together in the implantation position. Method for interconnecting and / or each other Separating a first, having a joint surface and one second, with the first connected implant part of a first joint part a joint implant and / or for releasably connecting or holding the first implant part or the joint part with a surgical holding instrument, in which the surgical holding instrument is provided with a corresponding or substantially corresponding to articular surface trained holding surface having a retaining element, characterized in that the joint surface and / or the holding surface be so wetted with a holding fluid and that the holding surface so dense to the articular surface brought is that a connection of the holding member and the first implant part due to between the holding fluid and the articular surface as well the holding surface acting adhesion forces is produced. Method according to claim 32, characterized in that that uses a spherical or substantially spherical holding surface becomes. A method according to claim 32 or 33, characterized that the holding surface so to the articular surface is adapted to be in a handle joint surface and holding surface between the articular surface and the holding surface a cavity is formed, which is filled with the holding fluid. A method according to claim 34, characterized that the articular surface and the holding surface brought so close to each other Be that defines a width of the cavity by a distance the articular surface from the holding surface at most 1 mm. Process according to claim 35, characterized in that that the distance is at most 0.5 mm. Method according to one of claims 32 to 36, characterized that uses a holding surface which has a slightly smaller radius than the articular surface. Method according to claim 37, characterized in that that a holding surface is used whose radius is at most 10% smaller than a radius of the articular surface. Method according to claim 38, characterized in that that a holding surface is used whose radius is at most 2% smaller than a radius of the articular surface. Method according to one of Claims 32 to 39, characterized that one between the holding surface and the articular surface trained and filled with the holding fluid cavity is sealed. Device according to claim 40, characterized in that in that a sealing element is used for sealing. Method according to claim 41, characterized that a holding instrument is used, which is a sealing element wearing, which to the holding surface is disposed adjacent and projects slightly beyond the articular surface. Method according to one of claims 32 to 42, characterized that a holding instrument is used, which one on the holding element arranged shaft. Method according to claim 43, characterized in that that a shank is used, which releasably connectable to the holding element is. Method according to one of claims 32 to 44, characterized that as a holding fluid, a viscous medium is used whose adhesion forces the same big or essentially the same size as whose cohesive forces are. A method according to claim 45, characterized ge indicates that the viscous medium is a liquid or a paste or contains a liquid or a paste. Method according to one of claims 32 to 46, characterized that a polar liquid is used as the holding fluid. Method according to one of claims 32 to 47, characterized that a holding fluid is used which contains water or Water is. Method according to one of Claims 32 to 48, characterized that a holding fluid is used which is a saline solution. Method according to one of claims 32 to 49, characterized that a holding fluid is used, which gelatin, starch, a absorbable polymer, sugar and / or glucose syrup. Method according to one of claims 32 to 50, characterized in that a holding fluid is used, which has a surface tension at 20 ° C, which is at most 70 · 10 ^-3 N / m. A method according to claim 51, characterized in that a holding fluid is used, which has a surface tension at 20 ° C, which is at most 50 · 10 ^-3 N / m. Method according to one of claims 32 to 52, characterized that the method is applied to a joint implant in the form a hip joint prosthesis, wherein the first hinge part is a socket, wherein the first Implant part an inlay and wherein the second implant part an artificial, implantable in a pelvis of a human or animal body Pan with a receptacle for the inlay is.