Classifications

• • 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
  • A61B17/1666—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 acetabulum
• • 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
• • 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
• • 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
  • A61B17/1675—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 knee
• • 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
  • A61B17/17—Guides or aligning means for drills, mills, pins or wires
  • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
  • A61B17/1764—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the knee
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/0023—Surgical instruments, devices or methods, e.g. tourniquets disposable
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/08—Accessories or related features not otherwise provided for
  • A61B2090/0814—Preventing re-use

Definitions

• the present invention relates to instruments or ancillaries used for removing bone material for hip or knee prosthesis surgery, in particular to a rasp for placing a hip prosthesis and to a cutting block. for fitting a knee prosthesis.
• the present invention also relates to a kit of ancillaries for surgeon, in particular for the installation of a hip prosthesis comprising a rasp according to the invention and / or for the installation of a knee prosthesis comprising a following cutting block the invention.
• Rasps, cutting blocks or other ancillaries for removing bone material are well known in the art. These ancillaries must be sufficiently hard and resistant to wear to be able to attack bone or withstand the high stresses resulting from the action of a blade, with which they cooperate, on bone. Until now, metallic materials have always been used which are sufficiently resistant to wear to attack the bone. What is more, they can be reused after re-sterilization in an autoclave.
• the invention aims to overcome these drawbacks by proposing an ancillary device for removing bone material, for prosthesis fitting surgery, in particular a rasp for fitting a hip prosthesis and / or a cutting block for fitting a knee prosthesis, which is simpler to manufacture, less expensive and better suited to the production of single-use ancillaries.
• the ancillary device is as defined in claim 1.
• the plastic material used is sufficiently hard, it will be suitable for removing the material or withstanding the stresses linked to the action of a blade on the bone material.
• the ancillary in plastic it increases the capacity to manufacture a disposable ancillary, said "disposable".
• the hardness of the plastic material is chosen to be close to that of the bone material, for example from 5 to 30% higher.
• the rasp or the cutting block in such a material, it is ensured that the ancillary can only be used for a single operation, the material rapidly wearing out during the operation so that the ancillary s 'is too degraded at the end of the operation to be able to be reused for another operation.
• the plastic material is chosen so as to deteriorate at or beyond a temperature Ti of between 50 ° C and 200 ° C preferably between 70 ° and 150 ° in particular at or beyond d '' a temperature equal to 137 °. This ensures that the surgeon, if he performs autoclave sterilization, and in particular sterilization at at least 137 ° C to ensure that all the prions are removed, will see his cutting block or his rasp deteriorate and will no longer be able to use them.
• the first sterilization is carried out by exposure to ⁇ or ⁇ rays. It is only possible once. Indeed, a second exposure deteriorates the plastic material by development of free radicals. Thus, the only possibility of re-sterilization after a first use was until now the passage in autoclave. Next what improvement, this is no longer possible since the ancillary in the autoclave deteriorates and self-destructs. Thus, one can no longer reuse the ancillary, legally, the surgeon can always reuse the ancillary without sterilizing, but obviously at his own risk and peril.
• the plastic is a thermoplastic, in particular a polyvinyl, polyolefin, polyamide or the like, and the deterioration takes place in particular by softening.
• the present invention also relates to a kit for a surgeon for placing a prosthesis, in particular hip or knee, comprising a rasp according to the invention and other ancillaries also made of plastic, or a kit comprising a cutting block according to the invention and one or more other ancillaries also made of plastic, the kit being vacuum-packed or in a sterile atmosphere.
• the ancillary device comprises at least one insert made of a material significantly harder than the plastic material, for example a metal, the insert being embedded at least partially in the plastic material, and being in direct contact with plastic.
• the ancillary device comprises a part made of a shape memory material, harder than plastic, the shape memory material taking a first shape beyond a given temperature Ti, and below this given temperature Ti a second form, the first form being such that when the temperature exceeds Ti and the material takes on its own this first form there follows an at least partial destruction of the ancillary.
• the present invention further relates to a method according to claim 10.
• FIG. 1 represents a rasp according to the invention, for cutting a bone for placing a hip prosthesis.
• FIG. 2 shows a cutting block for cutting a femur or tibia bone.
• FIG. 3 represents a kit according to the invention.
• FIG. 4 represents a variant of the block of FIG. 2.
• FIG. 5 represents a variant of the grater of FIG. 1.
• Figure 6 shows a cup cutter according to the invention.
• a rasp 1 for a hip prosthesis consists of a grip 2 of curved cylindrical shape and a part 3 of a rasp bristling with roughness to rub the bone to reduce it to powder.
• the rasp part 3 snaps at one end of the handle 2 by a snap-on system.
• the grater part 3 is made of plastic, in particular low or high density polyethylene (LDPE, HDPE), polypropylene, polyacetal, PVC, etc.
• LDPE low or high density polyethylene
• HDPE high density polyethylene
• polypropylene polypropylene
• PVC polyacetal
• LDPE softens at 104 ° C and melts at 108 - 120 ° C, its Shore D hardness being 45-55.
• HDPE softens at 123-127 ° C and melts at 125-135 ° C, its Shore D hardness being 65-70.
• the PP softens at 149 ° C and melts at 170 ° C, for a Shore hardness of 80.
• the handle 2 is made of plastic, for example HDPE.
• the rough edges of the rasp part 3 are formed by inserts 4 made of harder material, in particular metal, which protrude from the plastic material, being embedded therein for the most part.
• molding is carried out by casting or injection into a mold, the inserts 4 being positioned prior to injection in the position that is desired for them to have in the final plastic volume, then pour the plastic into the mold and allow to cool to obtain the final grater.
• the inserts also increase the rigidity of the grater.
• the plastic material softens beyond Ti and the inserts detach from the plastic material.
• the grater is no longer usable.
• the asperities are made of plastic harder than the bone
• the rasp is also unusable, the asperities tend to disappear when the plastic softens.
• the rasp 3 is formed by casting or injecting plastic material by coating at least partially, and preferably completely, a rod 5 in a harder material, in particular in a shape memory metal.
• the rod Before pouring the plastic material, the rod is brought to high temperature (greater than Te, which is less than 137 ° C.) and it is given a given shape, for example bent in a U shape, such as when the rod 5 is deformed to take the given form in question, it breaks the material, in particular plastic, less hard than it, which surrounds it and the rasp is unusable.
• Figure 2 there is shown a cutting block 6 for a knee prosthesis.
• This block 6 consists of a body 7 of parallelepiped shape pierced with two bores 8 for fixing by screw to the bone to be cut, and has two slots 9, called horizontal, and two slots 1 1 inclined, through which can be threaded cutting blades to perform the resection of the bones in order to install the prosthesis, the slots 9 and / or 1 1 being chosen according to the angle of attack of the desired cut.
• the cutting block is made of plastic, in particular LDPE, HDPE, PP or the like.
• the metal inserts 10 in the form of wires, are arranged on either side of the openings in the slots 9 and 11, in order to support the blades inserted in the slots during their action of cut on the bone.
• Figure 3 there is shown a tray vacuum packed by a plastic film sealed on the edges of the tray. In this tray, several so-called disposable ancillaries are packed, some of them or preferably all, being partly or entirely made of one or more materials which deteriorate beyond a temperature Ti of between 50 ° C. and 200 ° C. , preferably between 70 ° C and 150 ° C, in particular at or beyond 137 °.
• the hardness of the bone depends on the application, the patient, and in particular his age.
• a suitable plastic material will be chosen depending on whether it is intended to attack spongy (less hard) or cortical (harder) bone.
• FIG. 6 there is shown a rasp for acetabulum, or cutter 20 at acetabulum.
• the cutter 20 has a rod 21 and a hemispherical head 22.
• Metal blades 23 are embedded in the plastic mass of the head 22 and protrude in the form of ribs, in order to attack the bone. It is also possible, instead of the blades, to form the ribs 23 of plastic material harder than the bone, by molding in a suitable mold, that is to say having grooves corresponding to the ribs.

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• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Medical Informatics (AREA)
• Animal Behavior & Ethology (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Dentistry (AREA)
• Molecular Biology (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Physical Education & Sports Medicine (AREA)
• Transplantation (AREA)
• Prostheses (AREA)
• Materials For Medical Uses (AREA)
• Surgical Instruments (AREA)

Applications Claiming Priority (3)

Publications (1)

Family

ID=32241513

Family Applications (1)

Country Status (7)

Families Citing this family (35)

Citations (2)

Family Cites Families (24)

• 2002
  • 2002-11-22 FR FR0214638A patent/FR2847453B1/fr not_active Expired - Lifetime
• 2003
  • 2003-11-14 CA CA2505701A patent/CA2505701C/fr not_active Expired - Fee Related
  • 2003-11-14 US US10/534,567 patent/US8679127B2/en active Active
  • 2003-11-14 EP EP03782559A patent/EP1565112A1/de not_active Ceased
  • 2003-11-14 CN CNA2003801039422A patent/CN1713855A/zh active Pending
  • 2003-11-14 AU AU2003290196A patent/AU2003290196A1/en not_active Abandoned
  • 2003-11-14 WO PCT/FR2003/003374 patent/WO2004047655A1/fr not_active Application Discontinuation
• 2014
  • 2014-01-09 US US14/151,023 patent/US9949742B2/en active Active

Patent Citations (2)

Non-Patent Citations (1)

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