JP2005526524A - 関節の表面を彫成する装置および方法 - Google Patents
関節の表面を彫成する装置および方法 Download PDFInfo
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- JP2005526524A JP2005526524A JP2003504843A JP2003504843A JP2005526524A JP 2005526524 A JP2005526524 A JP 2005526524A JP 2003504843 A JP2003504843 A JP 2003504843A JP 2003504843 A JP2003504843 A JP 2003504843A JP 2005526524 A JP2005526524 A JP 2005526524A
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- bone
- implant
- tool
- attaching
- femur
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- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
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- A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
- A61F2310/00389—The prosthesis being coated or covered with a particular material
- A61F2310/00952—Coating, pre-coating or prosthesis-covering structure made of bone cement, e.g. pre-applied PMMA cement mantle
Abstract
Description
痛みのある関節結合骨表面の治療は、特に関節結合表面に対する損傷の深刻さと、患者の年齢および概略的な身体の強靱さとに依存する。最終的な結果は一般的に関節置換手術を必要とし、その場合に関節の関節結合要素は一般的に、超高分子量ポリエチレン(UHMWPE)から作成された部分と関節結合すべく金属から作成された部分を備える人工要素により置換される。
Claims (144)
- 第2骨に対して通常的に関節結合する第1骨の関節結合表面を彫成する装置において、
第1骨の関節結合表面を彫成する位置において該骨彫成ツールを第2骨に取付けるため、または、前記第2骨が前記第1骨に対して所定の対応で関節結合している間に関節表面を彫成するための取付部分を含む骨彫成ツールを備える第1骨の関節結合表面を彫成する装置。 - 前記骨彫成ツールの前記取付部分に取付けられるべく構成された取付部材であって、前記第1骨に取付可能とされて上記ツールを所定位置に取付けることで前記第1骨の前記関節結合表面を彫成する取付部材を更に備えて成る請求項1記載の装置。
- 前記取付部材は前記第2骨に対して堅固に取付けられるべく構成される請求項2記載の装置。
- 前記取付部材は骨彫成ツールと一体的である請求項2記載の装置。
- 前記取付部材は外部固定具である請求項2記載の装置。
- 前記第1骨は大腿骨であり且つ前記第2骨は脛骨であり、前記骨彫成ツールは大腿骨の関節結合表面を彫成する位置において脛骨に対して取付けられるべく構成される請求項1または2に記載の装置。
- 前記第1骨は寛骨臼であり且つ前記第2骨は大腿骨であり、前記骨彫成ツールは寛骨臼の関節結合表面を彫成する位置において大腿骨に対して取付けられるべく構成される請求項1または2に記載の装置。
- 前記骨彫成ツールの前記取付部分は前記第2骨に対する直接的取付けに適合される請求項1または2に記載の装置。
- 前記骨彫成ツールの前記取付部分は前記第2骨に対する間接的取付けに適合される請求項1または2に記載の装置。
- 前記第2骨は大腿骨であり且つ前記骨彫成ツールの前記取付部分は大腿骨用ブローチに対する取付けに適合される請求項9記載の装置。
- 前記第2骨は大腿骨であり且つ前記骨彫成ツールの前記取付部分は大腿用ステムに対する取付けに適合される請求項9記載の装置。
- 前記骨彫成ツールは、該ツールの回転軸心の回りで概略的に対称的な骨彫成表面を含み、且つ、
上記骨彫成ツールは、前記各骨の一方に対する他方の通常関節結合により画成される関節結合平面に対して上記回転軸心を略平行として、前記第1骨の前記関節結合表面に関して位置決めされる請求項1または2に記載の装置。 - 前記骨彫成表面は一個以上の切削工具を含み、該一個以上の切削工具は概略的に前後方向に配向された回転軸心を有する請求項12記載の装置。
- 前記骨彫成表面は概略的に円筒形状である請求項12記載の装置。
- 前記骨彫成ツールは、該ツールの回転軸心の回りで概略的に対称的な骨彫成表面を含み、且つ、
上記骨彫成ツールは、前記各骨の一方に対する他方の通常関節結合により画成される関節結合平面に対して上記回転軸心を略直交させて、前記第1骨の前記関節結合表面に関して位置決めされる請求項1または2に記載の装置。 - 前記骨彫成表面は一個以上の切削工具を含み、該一個以上の切削工具は概略的に内外側方向に配向された回転軸心を有する請求項15記載の装置。
- 前記一個以上の切削工具は、内側工具、外側工具および中央工具を含み、上記中央工具は上記内側および外側工具よりも大きな半径を有する請求項13または16に記載の装置。
- 前記一個以上の工具は、前記回転軸心に対して凸状である切削表面を提供すべく形状化される請求項13または16に記載の装置。
- 前記骨彫成表面は概略的に円筒形状とされることで、前記平面内において湾曲された床部であるが上記平面に対して直交する方向においては概略的に直線状である床部を有する彫成溝を生成する請求項15記載の装置。
- 前記骨彫成ツールは回転に対して設計される請求項1、2、7の何れか1項に記載の装置。
- 前記骨彫成ツールは揺動に対して設計される請求項1、2、7の何れか1項に記載の装置。
- 前記骨彫成ツールは半球リーマを備える請求項1、2、7の何れか1項に記載の装置。
- 前記第1および第2骨の間の通常関節結合を許容し乍ら上記第1骨を上記第2骨から伸延させるために上記第1および第2骨の間に挿入されるべく構成された伸延器を更に備えて成る請求項1または2に記載の装置。
- 前記伸延器は固定厚みスペーサである請求項23記載の装置。
- 前記伸延器は、夫々の骨に係合可能な一個以上の表面と、各表面間の距離の調節を可能とする手段とを含む請求項23記載の装置。
- 前記伸延器は流体充填されたカテーテルもしくはバルーンである請求項25記載の装置。
- 前記伸延器は機械的楔である請求項25記載の装置。
- 前記骨彫成ツールは伸張に対して適合される請求項1、2、7の何れか1項に記載の装置。
- 前記骨彫成ツールは回転軸心を有し、且つ、前記伸張は該回転軸心に沿うものである請求項26記載の装置。
- 前記骨彫成ツールの伸張に対する送りネジを更に備えて成る請求項26記載の装置。
- 前記骨彫成ツールの伸張に対する詰め金を更に備えて成る請求項26記載の装置。
- 前記骨彫成ツールの伸張に対する空気圧起動デバイスを更に備えて成る請求項26記載の装置。
- 前記取付部材は、関節結合の間において前記第1骨における骨彫成ツール深度が調節され得る如く可変高度にて前記骨彫成ツールを位置決めする位置決め要素を更に備えて成る請求項2記載の装置。
- 前記取付部材は該ショルダ上に滑走表面を有するショルダを更に含む請求項33記載の装置。
- 前記位置決め要素は前記第1骨と第2骨との間に動的伸延を提供する請求項33記載の装置。
- 前記骨彫成ツールを駆動する駆動機構を更に備えて成る請求項1、2、7の何れか1項に記載の装置。
- 前記駆動機構は取付部材と一体的である請求項36記載の装置。
- 前記駆動機構は大腿用ステムに取付けられるべく構成される請求項36記載の装置。
- 前記駆動機構はギヤボックスを備える請求項36記載の装置。
- 前記駆動機構はウォームおよびウォームギヤの組み合わせを備える請求項36記載の装置。
- 前記駆動機構はベベルギア組み合わせを備える請求項36記載の装置。
- 前記駆動機構はモータを含む請求項36記載の装置。
- 前記モータは、該翼板に対する油圧流体流に応じて該油圧モータを駆動する翼板を有する油圧モータである請求項42記載の装置。
- 前記油圧モータの翼板は前記骨彫成ツールと一体的である請求項42記載の装置。
- 前記駆動機構をモータに対して接続する可撓駆動シャフトを更に備えて成る請求項36記載の装置。
- 前記モータは手術用動力ドリルである請求項42記載の装置。
- 前記取付部材もしくは付加的取付部材に対して取付けられるべく構成された少なくとも一個の付加的な骨彫成ツールを更に備えて成る請求項2記載の装置。
- 前記第2骨と前記第1骨との間に力を提供する衝撃装置であって、該衝撃デバイスを上記第2骨に対して取付ける衝撃取付部分を含む衝撃デバイスを備える衝撃装置を更に備えて成る請求項1または2に記載の装置。
- 前記衝撃装置はインプラントを取付けるアダプタを更に備えて成る請求項48記載の装置。
- 光源と、撮像用基部と、撮像デバイスと、ディスプレイとを備える視覚化装置を更に備えて成る請求項48記載の装置。
- 前記視覚化装置は監視システムを更に含む請求項50記載のシステム。
- 前記撮像用基部は、前記骨彫成装置の前記取付部分に対して取付けられるべく構成された取付部材であって前記第1骨に取付可能な取付部材と一体的である請求項50または51に記載の装置。
- 前記撮像用基部と一体的な潅流装置を更に備えて成る請求項50〜52の少なくとも1項に記載の装置。
- 前記撮像用基部と一体的な吸引装置を更に備えて成る請求項50〜53の少なくとも1項に記載の装置。
- 潅流装置を更に備えて成る請求項48記載の装置。
- 吸引装置を更に備えて成る請求項48または55に記載の装置。
- インプラントを位置決め、整列および監視する外科的索行システムを更に備えて成る請求項48、55、56の何れか1項に記載の装置。
- 前記衝撃デバイスを位置決め、整列および監視する外科的索行システムを更に備えて成る請求項48記載の装置。
- 第1骨の担持表面を擬態して置き換わるべく構成された複数の構成要素から作成された第1骨用インプラントと、
第2骨の担持表面を擬態して置き換わるべく構成された第2骨用基板とを備え、
上記第1骨用インプラントおよび上記第2骨用基板の各構成要素は上記第1骨と上記第2骨との間の関節腔の境界内において接合される、
第1骨は第2骨に対して所定様式で通常的に関節結合するという第1骨と第2骨との間の関節の表面を置き換える装置。 - 前記第1骨用インプラントおよび前記第2骨用基板の複数の構成要素は前記関節腔の境界内において相互に対して整列かつ配向される請求項59記載の装置。
- 前記基板は複数の基板構成要素を更に備えて成る請求項59記載の装置。
- 前記第1骨用インプラントは2個の構成要素から成る請求項59記載の装置。
- 前記第1骨用インプラントは3個の構成要素から成る請求項59記載の装置。
- 前記第1骨は大腿骨であり且つ前記第2骨は脛骨であり、且つ、
前記第1骨用インプラントは大腿骨インプラントであり且つ前記第2骨用基板は脛骨用基板である請求項59記載の装置。 - 前記基板は単一片として構成される請求項59または64に記載の装置。
- 前記基板は、固定担持部取付具およびそれに取付けられた担持部と、可動担持部取付具およびそれに取付けられた担持部とを更に備えて成る請求項64または65に記載の装置。
- 前記基板は脛骨の内側および外側区画に対する別体の基板構成要素を含む請求項64記載の装置。
- 前記基板構成要素の少なくとも一個は固定担持部である請求項61または67に記載の装置。
- 前記基板構成要素の少なくとも一個は可動担持部である請求項61または67に記載の装置。
- 前記各基板構成要素は固定担持部および可動担持部の組み合わせである請求項61または67に記載の装置。
- 前記大腿骨インプラントは内側顆を表面再形成する第1構成要素と外側顆を表面再形成する第2構成要素とを備える請求項64記載の装置。
- 前記第2構成要素は膝蓋骨溝も表面再形成する請求項71記載の装置。
- 前記大腿骨インプラントは、内側顆を表面再形成する第1構成要素と、外側顆を表面再形成する第2構成要素と、膝蓋骨溝を表面再形成する第3構成要素とを備える請求項64記載の装置。
- 支持のために前記インプラントの各構成要素上の中央に配置されたフィンを更に備えて成る請求項59または64に記載の装置。
- 各構成要素は植設のために前記第1骨内に打ち込まれるフィンを更に備えて成る請求項59または64に記載の装置。
- 各構成要素は内面および外側面を有し、且つ、上記内面は複数の可撓セグメントから成る請求項59〜64の少なくとも1項に記載の装置。
- 前記複数のセグメントは関節結合表面に対して結合される請求項76記載の装置。
- 前記外側面はインプラント等級材料の薄寸体である請求項76記載の装置。
- 前記可撓セグメントをセメント固定する硬化可能流体を更に備えて成る請求項76記載の装置。
- 前記硬化可能流体は各構成要素上に被覆される請求項79記載の装置。
- 該衝撃デバイスを第2骨に対して取付けるための取付部分を含む衝撃デバイスと、
第1骨に対して固定されるインプラントとを備える、
隣接する第1および第2骨の間に力を与えてインプラントを固定する装置。 - 前記インプラントを配向する外部整列案内要素を更に備えて成る請求項81記載の装置。
- 前記第1骨に関して前記インプラントを位置決め且つ整列する外科的索行システムを更に備えて成る請求項81記載の装置。
- 前記第1骨に関して前記衝撃デバイスを位置決め、監視かつ整列する外科的索行システムを更に備えて成る請求項81記載の装置。
- 前記取付部分に取付けられて前記第2骨に取付けられ得る取付部材を更に備えて成る請求項81記載の装置。
- 前記インプラントは寛骨臼用シェルであり、且つ、前記衝撃デバイスは上記寛骨臼用シェルを寛骨臼内に固定すべく構成される請求項81記載の装置。
- 前記インプラントを前記衝撃デバイスに取付けるアダプタを更に備えて成る請求項81または86項に記載の装置。
- 前記アダプタは前記インプラントが回転するのを制限する請求項87記載の装置。
- 前記取付部分は前記第2骨に対する直接的取付けに適合される請求項86記載の装置。
- 前記取付部分は前記第2骨に対する間接的取付けに適合される請求項86記載の装置。
- 前記衝撃デバイスは空気圧衝撃ハンマである請求項81記載の装置。
- 前記衝撃デバイスは線形アクチュエータである請求項81記載の装置。
- 前記衝撃デバイスは油圧ピストンである請求項81記載の装置。
- 前記衝撃デバイスはスプリング起動される請求項81記載の装置。
- 前記衝撃デバイスは、起動毎の単一衝撃サイクルに対して起動されるべく構成される請求項81記載の装置。
- 前記衝撃デバイスは、起動されている間の多重衝撃サイクルに対して起動されるべく構成される請求項81記載の装置。
- 骨彫成ツールを配備する段階と、
第1骨の関節結合表面を彫成する位置において上記骨彫成ツールを第2骨に取付ける段階と、
上記骨彫成ツールを上記第2骨の関節結合表面に係合することにより上記第1骨の関節結合表面を彫成する段階とを備える、
第2骨に対して通常的に関節結合する第1骨の関節結合表面を彫成する方法。 - 前記第1骨の前記関節結合表面を彫成する前記段階は、各骨の一方を他方に関して関節運動させる段階を更に含む請求項97記載の方法。
- 前記骨彫成ツールを前記第2骨に対して整列させる段階を更に備えて成る請求項97記載の方法。
- 前記骨彫成ツールを前記第1骨に取付ける前記段階は、上記骨彫成ツールを大腿骨に取付ける段階を備え、
上記骨彫成ツールを前記第2骨に対して整列させる前記段階は、上記骨彫成ツールを寛骨臼内に載置する段階を備え、且つ、
上記第2骨の前記関節結合表面に係合することにより該第2骨の関節結合表面を彫成する前記段階は、寛骨臼の関節結合表面に係合することで寛骨臼の関節結合表面を彫成する段階を備える請求項99記載の方法。 - 前記骨彫成ツールを前記第2骨に取付ける前記段階は、上記骨彫成ツールを上記第2骨に対して直接的に取付ける段階を含む請求項99または100に記載の方法。
- 前記骨彫成ツールを前記第2骨に取付ける前記段階は、上記骨彫成ツールを上記第2骨に直接的に取付ける段階を含む請求項97〜100の少なくとも1項に記載の方法。
- 前記第2骨は大腿骨であると共に前記第1骨は寛骨臼であり、且つ、
前記骨彫成ツールを上記第2骨に取付ける前記段階は、上記骨彫成ツールを大腿骨試作物に取付ける段階と、上記大腿骨試作物を大腿骨内に載置する段階とを備える請求項102記載の方法。 - 前記第2骨は大腿骨であると共に前記第1骨は寛骨臼であり、且つ、
前記骨彫成ツールを上記第2骨に取付ける前記段階は、上記骨彫成ツールをブローチに取付ける段階と、上記ブローチを大腿骨内に載置する段階とを備える請求項102記載の方法。 - 前記第2骨は大腿骨であると共に前記第1骨は寛骨臼であり、且つ、
前記骨彫成ツールを上記第2骨に取付ける前記段階は、上記骨彫成ツールを大腿骨インプラントに取付ける段階と、上記大腿骨インプラントを大腿骨内に載置する段階とを備える請求項102記載の方法。 - 前記骨彫成ツールを前記第2骨に取付ける前記段階は、上記骨彫成ツールを受容する取付部材を配備する段階と、前記第1骨の前記関節結合表面を彫成する位置に上記骨彫成ツールを置き乍ら上記取付部材を上記第2骨に取付ける段階とを更に含む請求項97〜102の少なくとも1項に記載の方法。
- 前記骨彫成ツールを前記取付部材に取付けるべく調節可能取付具を配備する段階を更に備えて成る請求項106記載の方法。
- 前記第1骨を前記第2骨から術前的に伸延させることで、上記第1骨に対する上記第2骨の動作の範囲および患者の運動特性を評価する段階を更に備えて成る請求項107記載の方法。
- 前記第1骨の前記関節結合表面を彫成する前記段階の間において上記第1骨を前記第2骨から伸延させる段階を更に備えて成る請求項107記載の方法。
- 前記第2骨から前記第1骨を伸延させる前記段階は、上記第1骨の前記関節結合表面を彫成する前記段階の間において上記第2骨が上記第1骨に対する柔軟組織取付部から自由に吊下するのを許容する段階を含む請求項109記載の方法。
- 伸延器を配備する段階と、該伸延器により前記第1骨を前記第2骨から伸延させる段階とを更に備えて成る請求項108または109に記載の方法。
- 前記伸延器は膨張可能であり、且つ、
前記第2骨から前記第1骨を伸延させる前記段階は上記伸延器を膨張させる段階を更に含む請求項111記載の方法。 - 前記伸延器は前記骨彫成ツールと一体的である請求項111記載の方法。
- 前記骨彫成ツールを伸張して寛骨臼に係合させる段階と、前記関節に張り亙る柔軟組織構造を張設する段階とを更に備えて成る請求項100記載の方法。
- 寛骨臼内に前記骨彫成ツールを載置する前記段階を促進すべく上記骨彫成ツール引込める段階を更に備えて成る請求項100記載の方法。
- 骨彫成ツールを配備する段階と、
第1骨の関節結合表面を彫成する位置において上記骨彫成ツールを第2骨に取付ける段階と、
上記骨彫成ツールを上記第2骨の関節結合表面に係合することにより上記第1骨の関節結合表面を彫成する段階と、
上記第1骨の上記関節結合表面に置き換わるインプラントを配備する段階と、
上記第1骨の上記関節結合表面を上記インプラントで置き換える段階とを備える、
第2骨に対して所定様式にて通常的に関節結合する第1骨の関節結合表面を置き換え且つ第2骨の関節結合表面を置き換える方法。 - 該方法は、前記第2骨の一部を切除して該第2骨に切除キャビティを配備する段階を更に備え、且つ、
上記第2骨に対して前記骨彫成ツールを取付ける前記段階は、上記骨彫成ツールを上記切除キャビティ内に位置決めする段階を含む請求項116記載の方法。 - 前記第2骨の一部を切除する前記段階は、上記第2骨内に直接的に切削ミルを前進させる段階を含む請求項117記載の方法。
- 該方法は、取付部材を配備する段階を更に備え、
前記骨彫成ツールを前記第2骨に取付ける前記段階は、上記骨彫成ツールを上記取付部材に取付ける段階と、上記取付部材を上記第2骨に取付ける段階とを包含する請求項116または117に記載の方法。 - 前記第1骨の前記関節結合表面を彫成する前記段階は、前記各骨の一方を他方に関して関節運動させる段階を含む請求項116〜119の少なくとも1項に記載の方法。
- 前記第1骨用インプラントは複数の構成要素を備える請求項116〜120の少なくとも1項に記載の方法。
- 前記第1骨用インプラントの各構成要素は内面および外側面を有し、
上記内面は複数の可撓セグメントから成り、且つ、
上記第1骨用インプラントの各構成要素を前記第1骨切除部内に載置する前記段階は、上記第1骨切除部に沿い硬化可能流体を配備する段階と、該硬化可能流体が硬化するのを許容する段階とを更に含む請求項121記載の方法。 - 前記第1骨切除部の形状に沿い前記第2骨用基板が前記可撓セグメントを成形する如く、上記第1骨に関して上記第2骨を関節運動させる段階を更に備えて成る請求項121記載の方法。
- 第2骨用基板を配備する段階と、前記第2骨の前記関節結合表面を該第2骨用基板で置き換える段階とを更に備えて成る請求項116〜123の少なくとも1項に記載の方法。
- 前記第1骨用インプラントおよび前記第2骨用基板の各構成要素を関節腔の境界内で接合する段階を更に備えて成る請求項123記載の方法。
- 前記接合段階は、前記第1骨用インプラントおよび前記第2骨用基板の各構成要素を関節腔の境界内で整列かつ配向する段階を更に備えて成る請求項125記載の方法。
- 前記骨彫成ツールを前記第1骨と整列する段階を更に備えて成る請求項116記載の方法。
- 前記第2骨に取付けられるべく構成された衝撃デバイスを備える衝撃装置を配備する段階と、
上記衝撃装置を上記第2骨に取付ける段階と、
前記インプラントを上記衝撃装置上に載置する段階と、
前記第1骨および上記第2骨により反動される力を上記インプラントに与えることで該インプラントを上記第1骨に対して固定する段階とを更に備えて成る請求項116または127に記載の方法。 - 視覚化装置、潅流装置および吸引装置を含む監視デバイスにより前記関節結合表面の置き換えを監視する段階を更に備えて成る請求項116、127、128の何れか1項に記載の方法。
- 前記潅流装置および前記吸引装置を用いて骨破片および血液の部位を清浄化する段階を更に備えて成る請求項116、127、128の何れか1項に記載の方法。
- 外科的索行システムによる、骨調製、インプラントの位置決め、整列および監視の各段階を更に備えて成る請求項116、127、128の何れか1項に記載の方法。
- 外科的索行システムにより前記衝撃デバイスを位置決め、整列および監視する各段階を更に備えて成る請求項128記載の方法。
- 前記骨彫成ツールを前記第1骨に取付ける前記段階は、上記骨彫成ツールを大腿骨に取付ける段階を備え、
上記骨彫成ツールを前記第2骨に整列させ且つ上記第2骨の関節結合表面を彫成する前記段階は、上記骨彫成ツールを寛骨臼内に載置する段階および寛骨臼の関節結合表面を彫成する段階を備え、
前記衝撃装置を上記第1骨に取付ける前記段階は、上記衝撃装置を大腿骨に取付ける段階を備え、且つ、
前記インプラントに力を与える前記段階は、寛骨臼および大腿骨により反動される力を寛骨臼用シェルに与えて該寛骨臼用シェルを寛骨臼に固定する段階を備える請求項128記載の方法。 - 衝撃デバイスを配備する段階と、
上記衝撃デバイスを第1骨に取付ける段階と、
上記衝撃デバイス上にインプラントを載置し且つ該インプラントを第2骨に整列させる段階と、
上記第2骨および上記第1骨により反動される力を上記インプラントに与える段階とを備える、
第1骨と関節結合する第2骨に対してインプラントを固定する方法。 - 力を与える前記段階は起動サイクル毎に1回実施される請求項134記載の方法。
- 力を与える前記段階は起動サイクル毎に複数回実施される請求項134記載の方法。
- 外科的索行システムにより前記寛骨臼用シェルを位置決め、整列かつ監視する各段階を更に備えて成る請求項134記載の方法。
- 外科的索行システムにより前記衝撃デバイスを位置決め、整列かつ監視する各段階を更に備えて成る請求項134記載の方法。
- 前記衝撃デバイスを第1骨に取付ける前記段階は、上記衝撃デバイスを大腿骨に取付ける段階を備え、
上記衝撃デバイス上にインプラントを載置し且つ該インプラントを前記第2骨に整列させる前記段階は、上記衝撃デバイス上に寛骨臼用シェルを載置し且つ該寛骨臼用シェルを寛骨臼内に位置決めする段階を備え、且つ、
上記インプラントに力を与える前記段階は、寛骨臼および大腿骨により反動される力を上記寛骨臼用シェルに与える段階を備える請求項134記載の方法。 - 前記衝撃デバイスを大腿骨に取付ける前記段階は、上記衝撃デバイスを直接的に大腿骨に取付ける段階を含む請求項139記載の方法。
- 前記衝撃デバイスを大腿骨に取付ける前記段階は、上記衝撃デバイスを間接的に大腿骨に取付ける段階を含む請求項139記載の方法。
- 前記衝撃デバイスを大腿骨に取付ける前記段階は、上記衝撃デバイスを大腿骨試作物に取付ける段階および該大腿骨試作物を大腿骨内に載置する段階を備える請求項141記載の方法。
- 前記衝撃デバイスを大腿骨に取付ける前記段階は、上記衝撃デバイスをブローチに取付ける段階および該ブローチを大腿骨内に載置する段階を備える請求項141記載の方法。
- 前記衝撃デバイスを大腿骨に取付ける前記段階は、上記衝撃デバイスを大腿骨インプラントに取付ける段階および該大腿骨インプラントを大腿骨内に載置する段階を備える請求項141記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/882,591 US6482209B1 (en) | 2001-06-14 | 2001-06-14 | Apparatus and method for sculpting the surface of a joint |
US10/075,829 US6723102B2 (en) | 2001-06-14 | 2002-02-12 | Apparatus and method for minimally invasive total joint replacement |
PCT/US2002/018742 WO2002102254A2 (en) | 2001-06-14 | 2002-06-14 | Apparatus and method for sculpting the surface of a bone joint |
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- 2002-06-14 AT AT02742045T patent/ATE385407T1/de not_active IP Right Cessation
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JP2009525095A (ja) * | 2006-02-03 | 2009-07-09 | ツィンマー・ゲーエムベーハー | 脛骨プラットフォームインプラント |
JP2010523229A (ja) * | 2007-04-04 | 2010-07-15 | アレクサンドリア リサーチ テクノロジーズ, エルエルシー | 関節の表面を造形するための装置および方法 |
JP2010528786A (ja) * | 2007-06-07 | 2010-08-26 | スミス アンド ネフュー インコーポレーテッド | 膝外科手術においてインプラントのために膝関節を手術するためのシステム、方法、及びデバイス |
KR101377309B1 (ko) | 2011-12-13 | 2014-03-24 | 조규만 | 대퇴골머리/목 절제술에서 대퇴관절의 최소 침습 접근법 |
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DE60224934D1 (de) | 2008-03-20 |
EP1416864B1 (en) | 2008-02-06 |
IL200686A (en) | 2010-12-30 |
EP1416864A2 (en) | 2004-05-12 |
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CA2648357A1 (en) | 2002-12-27 |
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CA2469555A1 (en) | 2002-12-27 |
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DE60224934T2 (de) | 2009-01-22 |
WO2002102254A3 (en) | 2003-05-22 |
US20020193797A1 (en) | 2002-12-19 |
CA2469555C (en) | 2009-03-17 |
WO2002102254B1 (en) | 2003-06-26 |
CA2776468A1 (en) | 2002-12-27 |
WO2002102254A2 (en) | 2002-12-27 |
JP2012016609A (ja) | 2012-01-26 |
JP4128951B2 (ja) | 2008-07-30 |
EP1745763A2 (en) | 2007-01-24 |
US6723102B2 (en) | 2004-04-20 |
EP1745764B1 (en) | 2015-12-23 |
IL200685A (en) | 2014-03-31 |
EP1745764A2 (en) | 2007-01-24 |
IL159325A0 (en) | 2004-06-01 |
JP2008110243A (ja) | 2008-05-15 |
ATE385407T1 (de) | 2008-02-15 |
CA2648357C (en) | 2012-08-21 |
MXPA03011642A (es) | 2005-03-07 |
AU2002315105B2 (en) | 2007-07-12 |
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