JP7450676B2 - 膝関節形成方法及び器械 - Google Patents
膝関節形成方法及び器械 Download PDFInfo
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Description
本出願は、2017年10月13日に提出された米国仮特許出願第62/572210号(その優先権の利益を本出願によって請求し、その全体が参照により本出願に援用される)の優先権を主張する。
上述の説明は、添付図面を参照しており、図面は説明の一部を形成する。図面は、例示として、本発明を実施できる具体的な実施形態を示す。これらの実施形態を、本明細書において「実施例」とも呼ぶ。これらの実施例は、図示又は説明する要素の他の要素を含むことができる。但し、発明者は、図示し説明する要素のみを含む実施例も想定する。更に、発明者は、特定の実施例(又はその1つまたは複数の形態)に関連して又は本明細書において図示又は説明する他の実施例(又はその1つ又は複数の形態)に関連して図示又は説明する要素の任意の組合せ又は順列を使用する実施例(又はその1つ又は複数の形態)も想定する。
Claims (18)
- 医療機器用組立体であって、
近位面と前記近位面の反対側の遠位面とを有する第1仮成分であって、前記遠位面及び前記近位面の一方が、骨の切除面上に配置されるように構成される、第1仮成分と、
骨の切除面の下方の第1陥凹部の中に配置されるように構成された第2仮成分であって、前記第2仮成分がインプラントのスリーブ成分、コーン成分又はキール成分の少なくとも1つの形状を模倣するように構成される、第2仮成分と、
骨の前記第1陥凹部の下方に連続して延びる第2陥凹部の中に配置されるように構成されたステム仮組立体であって、前記第1仮成分を前記骨の切除面上に配置するために生体内で係合可能に構成されたステム仮組立体と、
前記第1仮成分、前記第2仮成分及び前記ステム仮組立体を1つの組立体として一緒に結合するように構成された締結具であって、前記締結具が、隣り合った前記第1仮成分から前記ステム仮組立体にアクセスできるようにするための通路と、前記通路を画定する前記締結具の中央部分であって、第1の係合特徴部を備える前記締結具の中央部分とを含む締結具と、
を備え、
前記ステム仮組立体は、
近位部分の長手方向軸線と遠位部分の長手方向軸線とがオフセットされたアダプタであって、前記アダプタは、前記近位部分に第2の係合特徴部を含む、アダプタと、
前記アダプタの前記遠位部分と結合されたステム延長体と、を備え、
前記締結具は、ネジ切り部分とヘッド部分とを有し、
前記アダプタは、孔を有しており、前記孔は、
前記締結具の前記ネジ切り部分と結合するように構成された対応するネジ切り部分と、
前記対応するネジ切り部分に隣接する前記孔内のポケット部分であって、前記ポケット部分が、前記締結具の前記ネジ切り部分が前記対応するネジ切り部分から外されたときに、前記締結具を受け入れるように構成される、ポケット部分と、
前記ポケット部分に隣接して配置された制限部であって、前記制限部が、前記締結具の前記ネジ切り部分が前記対応するネジ切り部分から外されたときに、前記ポケット部分内に前記締結具を保持するように前記ヘッド部分の直径と実質的に等しい又はこれより小さい直径を持つように構成される、制限部と、を備え、
該医療機器用組立体の位置は、ハンドル及びドライバ、又は、複数のドライバの使用によって決定され、
前記ハンドルは、前記第2仮成分を前記ステム仮組立体に係合するように構成され、前記ハンドルと係合されたとき、前記第2仮成分及び前記ステム仮組立体がそれぞれ前記骨の前記第1陥凹部及び前記第2陥凹部の中へ挿入可能であり、
単数又は複数の前記ドライバは、
前記ステム仮組立体のネジ切り陥凹部の中へ前記締結具をネジ入れするために前記締結具に係合すること、及び、
前記ステム仮組立体に係合するために前記締結具の前記通路を貫通することであって、前記ドライバと前記ステム仮組立体との間の係合が、前記ステム仮組立体を生体内で回転させ、前記切除面に第1仮成分を位置させる、貫通すること、
の少なくとも1つを行うように構成される、医療機器用組立体。 - 前記ポケット部分が、前記ヘッド部分の直径より大きい直径を有する、請求項1に記載の組立体。
- 前記制限部及び前記締結具の前記ヘッド部分の1つ又はそれ以上が、前記制限部を越えた前記ヘッド部分の挿入を容易にするために傾斜面として作用するように構成された面取り面を有する、請求項1に記載の組立体。
- 前記ステム仮組立体が、前記第1仮成分を前記骨の切除面に位置させる締結具により通路を介して元の位置で係合可能に構成されている、請求項1に記載の組立体。
- 前記第1仮成分、前記第2仮成分及び前記ステム仮組立体が、前記骨から取り外される際に、相互に対する各構成成分の位置を維持したまま前記組立体として一緒に前記骨から取り外し可能である、請求項1に記載の組立体。
- 前記ハンドルの少なくとも一部分がカニューレ式であり、前記ステム仮組立体に結合するポストを受け入れるように構成されている、請求項1に記載の組立体。
- 前記ポスト及び前記ステム仮組立体の一部を受け入れるように構成されたカニューレ式リーマであって、前記カニューレ式リーマが前記第1陥凹部を生成するために前記骨を除去するように構成されている、カニューレ式リーマをさらに含む、請求項6に記載の組立体。
- 前記ステム仮組立体が、複数のアダプタのひとつと、複数のステム延長体のひとつと、から構成され、前記複数のアダプタが前記複数のステム延長体と取り代え可能に結合するように構成されている、請求項1に記載の組立体。
- 前記第2仮成分と結合するように構成された大腿骨成分をさらに含み、前記大腿骨成分は、そこにピンを受け入れるように構成された細長いスロットを有し、前記細長いスロットは、元の位置での前記ステム仮組立体の調整により、前記ピンに対して前記大腿骨成分の近位-遠位移動を許容するように構成される、請求項1に記載の組立体。
- 前記ハンドルはオフセットブローチと結合するように構成され、前記オフセットブローチは、前記オフセットブローチは、その第1側面に沿ってのみ切断面を有し、前記第1側面の反対の第2側面が、リーマを受け入れこれと境界を接するように構成され、前記オフセットブローチが、前記第2陥凹部に対して前記第1陥凹部をオフセットするように構成される、請求項1に記載の組立体。
- 前記ハンドルが、カニューレ式シャフトを有し、かつ、前記ハンドルの前記シャフトに沿って移動可能でありかつこれに固定可能であるように構成されるスラップハンマを含む、請求項1に記載の組立体。
- 前記ステム仮組立体に取り付け可能であるように構成されかつ前記スリーブ成分又は前記コーン成分のためのブリーチ加工の前に前記骨を予備穿孔するように構成されたドリルガイドをさらに備える、請求項1に記載の組立体。
- 前記切除面を形成する切除を案内するように構成された脛骨カットガイド組立体をさらに備え、前記脛骨カットガイド組立体が、ブームアームと、カラーによって前記ブームアームに結合された本体と、を有し、前記カラーが、前記骨に対する前記本体の位置を変更することなく前記カラーから前記ブームアームを取り外せるように構成された開口を含む、請求項1に記載の組立体。
- 請求項1から請求項3の何れか1項に記載の医療機器用組立体の位置を決定するために、整形処理中に骨を取り除くためのリーマであって、
遠位ノーズ部分と、
近位シャフト部分と、
前記遠位ノーズ部分と前記近位シャフト部分との間の切断部分であって、前記切断部分は前記遠位ノーズ部分及び前記近位シャフト部分に比較して拡大された直径を持ち、前記切断部分は、
前記遠位ノーズ部分に近接する第1テーパー区分であって、前記リーマの長手軸線に沿って遠位-近位方向に計測した漸増直径を有する、第1テーパー区分と、
前記第1テーパー区分の遠位でありかつ前記近位シャフト部分に近接する第2テーパー区分であって、第2テーパー区分が前記リーマの長手軸線に沿って遠位-近位方向に計測した漸減直径を有するように、前記第1テーパー区分に対してバックテーパーを有する、第2テーパー区分と、
を含む前記切断部分と、
を含む、リーマ。 - 前記切断部分は、前記第1テーパー区分と前記第2テーパー区分との間に移行部を含み、前記移行部は、最大直径を有する前記リーマの領域を含み、前記領域は、16mmから60mmの間の前記リーマの前記長手軸線に沿った両端を含む長さを有する、請求項14に記載のリーマ。
- 前記第1テーパー区分は、11mmから24mmの間の前記リーマの前記長手軸線に沿った長さと、前記第1テーパー区分の外面から前記長手軸線までを計測して10度から40度の角度と、を有する、請求項14に記載のリーマ。
- 前記第2テーパー区分は、20mmから60mmの間の前記リーマの前記長手軸線に沿った長さと、前記第2テーパー区分の外面から前記長手軸線までを計測して4度から16度の角度と、を有する、請求項16に記載のリーマ。
- 前記遠位ノーズ部分は丸く鈍い先端と、前記丸く鈍い先端から前記第1テーパー区分の始点まで計測して15mmから70mmの間の前記リーマの前記長手軸線に沿った長さと、を有する、請求項14に記載のリーマ。
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