GB2315679A - Tool for melting cement in revision arthroplasty - Google Patents

Tool for melting cement in revision arthroplasty Download PDF

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Publication number
GB2315679A
GB2315679A GB9722270A GB9722270A GB2315679A GB 2315679 A GB2315679 A GB 2315679A GB 9722270 A GB9722270 A GB 9722270A GB 9722270 A GB9722270 A GB 9722270A GB 2315679 A GB2315679 A GB 2315679A
Authority
GB
United Kingdom
Prior art keywords
tool
cement
revision arthroplasty
stem
prosthesis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
GB9722270A
Other versions
GB2315679B (en
GB9722270D0 (en
Inventor
Michael John Radley Young
Brian Robert Denis Pe Bradnock
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to GB9722270A priority Critical patent/GB2315679B/en
Publication of GB9722270D0 publication Critical patent/GB9722270D0/en
Publication of GB2315679A publication Critical patent/GB2315679A/en
Application granted granted Critical
Publication of GB2315679B publication Critical patent/GB2315679B/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8802—Equipment for handling bone cement or other fluid fillers
    • A61B17/8847—Equipment for handling bone cement or other fluid fillers for removing cement from a bone cavity
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4619—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof for extraction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/4631—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor the prosthesis being specially adapted for being cemented
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2002/465—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using heating means

Abstract

A spoon shaped tool 81 is ultrasonically driven by piezoelectric ceramic transducer means 80 through stem 82. The ultrasonic vibration melts cement which passes through apertures 83 and is then removed from the bone to expose the prosthesis.

Description

METHOD AND APPARATUS FOR REMOVAL OF OSTEAL PROSTHESES The invention relates to an ultrasonic method and means for removing an osteal prosthesis from cemented installation in a living bone, as in the course of revision arthroplasty.
It is known from U.S. Patents 4,248,232 and 5,151,099 that ultrasound may be used to facilitate removal of bone cement (PMMA) during revision arthroplasty. Local heating, by preferential absorption of ultrasound energy, raises the temperature of a small volume of the cement above the glass-transition temperature, thus allowing the cement to flow and to be manipulated into a shape and form which may be readily removed from the revision site.
It has also been claimed (Hood, et al., U.S. Patent 5,045,054) that the application of ultrasound'directly to the prosthesis can break the bond between the prosthesis and surrounding cement or, in the case of uncemented prostheses, between the prosthesis and ingrown cancellous bone. The direction of applied ultrasonic energy is in line with the central axis of an implanted prosthetic devise, such as the axis of stem support for the ball of a hipjoint replacement. But the in-line application of force, as in the context of the Hood, et al.
system, is to require the patient to oppose the force, with inevitable trauma for the patient.
It is an object of the invention to provide an improved method and means for dislodging an installed osteal prosthesis with a minimum of trauma for the patient who is faced with the need of revision arthroplasty.
A specific object is to meet the above object for the case of revision arthroplasty of a hipjoint prosthesis that has been implanted and cemented in a femur.
It is a general object to meet the above objects with a method and apparatus of reliably high performance without a daunting level of operating complexity, which method and apparatus are applicable to the full variety of currently available prostheses.
The body annulus will also accommodate a special tool which may be selected from one of a group of chucks, each of which is configured to coupling to the buried end of a broken fragment of a prosthetic shaft, with an ability to transfer sufficient ultrasonic energy through the tool and into the broken and buried prosthetic fragment, for clean and efficient dislodging and extraction of the buried fragment.
According to the present invention a tool for use in revision arthroplasty wherein a prosthetic member to be removed is at least partially encumbered by bone cement, charaterised in that it comprises a stem connected to ultrasonic transducer means, said stem having a spoon shaped distal end provided with apertures through which cementXmelted by ultrasonic vibration of said tool may pass to be removed and in that said tool is so dimensioned that it is adapted to remove cement immediately adjacent said prosthetic member.
An embodiment of the present invention will now be more particularly described by way of example and with reference to the accompanying drawings, in which: Fig. 1 is a front elevation of a tool element for removing small quantities of cement; Fig. 2 is a side elevation of the tool element shown in Fig. 1; and Fig. 3 is a plan view of the tool shown in Figs. 1 and 2.
A tool 80 based on the technology described in Patent Application number 94302231.9 is shown in Figs 1 and 2. A claw probe attachment 81 may be used to melt and extract the cement in small quantities around the periphery of the end of the fragment to provide an enlarged opening. The tool comprises a stem 82 having at its distal end a small saucer shaped cup 81, having apertures 83 therethrough, through which cement melted by ultrasonic vibration of the cup 81 may pass. The cup 81 is driven by piezoelectric ceramic transducer means 80 through the stem 82. The tool can be withdrawn periodically to extract cement or other material and thereby to form the enlarged opening. In this way, it functions as a scraper to provide or enlarge a space allowing engagement of an end of the broken prosthesis by the extraction tool. Providing space allows, a tool having a larger spoon shaped end may be inserted alongside the prosthesis to engage beneath its distal end.
Having thus prepared the enlargement in bone cement at the proximal end of a femur and a depth of beyond the break responsible for the embedded fragment, all is in readiness for use of a special tool bit as a replacement for the chuck or collet element in any of the embodiments described in application number 9406254.4.

Claims (2)

CLAIMS:
1. A tool for use in revision arthroplasty wherein a prosthetic member to be removed is at least partially encumbered by bone cement, characterised in that it comprises a stem connected to ultrasonic transducer means, said stem having a spoon shaped distal end provided with apertures through which cement melted by ultrasonic vibration of said tool may pass to be removed and in that said tool is so dimensioned that it is adapted to remove cement immediately adjacent said prosthetic member.
2. A tool for use in revision arthroplasty substantially as herein described with reference to the accompanying drawings.
GB9722270A 1994-03-29 1994-03-29 Method and apparatus for removal of osteal prostheses Expired - Lifetime GB2315679B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
GB9722270A GB2315679B (en) 1994-03-29 1994-03-29 Method and apparatus for removal of osteal prostheses

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB9722270A GB2315679B (en) 1994-03-29 1994-03-29 Method and apparatus for removal of osteal prostheses
GB9406254A GB2288120A (en) 1994-03-29 1994-03-29 Ultrasonic apparatus for removal of osteal prosthesis

Publications (3)

Publication Number Publication Date
GB9722270D0 GB9722270D0 (en) 1997-12-17
GB2315679A true GB2315679A (en) 1998-02-11
GB2315679B GB2315679B (en) 1998-06-24

Family

ID=10752718

Family Applications (2)

Application Number Title Priority Date Filing Date
GB9722270A Expired - Lifetime GB2315679B (en) 1994-03-29 1994-03-29 Method and apparatus for removal of osteal prostheses
GB9406254A Withdrawn GB2288120A (en) 1994-03-29 1994-03-29 Ultrasonic apparatus for removal of osteal prosthesis

Family Applications After (1)

Application Number Title Priority Date Filing Date
GB9406254A Withdrawn GB2288120A (en) 1994-03-29 1994-03-29 Ultrasonic apparatus for removal of osteal prosthesis

Country Status (1)

Country Link
GB (2) GB2315679B (en)

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB0703249D0 (en) 2007-02-20 2007-03-28 Sra Dev Ltd Removal of spinal prostheses
GB0711151D0 (en) 2007-06-11 2007-07-18 Sra Dev Ltd Switch for use with an ultrasonic surgical tool
EP3698734A1 (en) * 2019-02-21 2020-08-26 Orthofix S.R.L. System and method for driving an ultrasonic device

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4248232A (en) * 1977-09-13 1981-02-03 Eckart Engelbrecht Method of dissolving the bond between interconnected components
EP0238667A1 (en) * 1985-09-20 1987-09-30 Sumitomo Bakelite Company Limited Ultrasonic instrument for surgical operations
WO1993003676A1 (en) * 1991-08-24 1993-03-04 Michael John Radley Young Improved tool for removal of plastics material

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5045054A (en) * 1990-02-06 1991-09-03 Advanced Osseous Technologies Inc. Apparatus for implantation and extraction of osteal prostheses

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4248232A (en) * 1977-09-13 1981-02-03 Eckart Engelbrecht Method of dissolving the bond between interconnected components
EP0238667A1 (en) * 1985-09-20 1987-09-30 Sumitomo Bakelite Company Limited Ultrasonic instrument for surgical operations
WO1993003676A1 (en) * 1991-08-24 1993-03-04 Michael John Radley Young Improved tool for removal of plastics material

Also Published As

Publication number Publication date
GB2315679B (en) 1998-06-24
GB2288120A (en) 1995-10-11
GB9406254D0 (en) 1994-05-18
GB9722270D0 (en) 1997-12-17

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Date Code Title Description
PE20 Patent expired after termination of 20 years

Expiry date: 20140328