WO1997030737A1 - Modular sterilization cases - Google Patents

Abstract

Modular sterilization instrument cases (10A) for use during orthopaedic joint replacement surgery include an outer case (11) having a removable cover (12) and inner trays (19, 20, 21) that include full trays (21) for instruments that are not size specific. Half trays (19, 20) are also provided that are size specific for containing trials and related instruments. The use of half trays (19, 20) enables an operating room nurse to select only those half trays (19, 20) to a patient's final prosthesis size, based upon an estimation of size after x-ray analysis.

Description

PATENT APPLICATION

TITLE OF THE INVENTION

"MODULAR STERILIZATION CASES"

5

CROSS-REFERENCE TO RELATED APPLICATIONS

Priority of U.S. Provisional Patent Apphcation Serial No. 60/012,003. filed 0 February 21, 1996, incorporated herein by reference, is hereby claimed.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not applicable REFERENCE TO A "MICROFICHE APPENDD " 5 Not applicable

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates in general to sterilization cases and in particular to sterilization cases for use in joint (e.g., knee, hip, shoulder) 0 replacement surgery.

2. General Background of the Invention

Present medical sterilization cases include all or most of the various sized surgical instruments in a single case. For example, if there are six sizes of femoral components available in a total knee system, all of the matching trials would be in 5 the same case. Similarly, a sterilization case includes the instruments needed to prepare a bone to accept components such as anterior/posterior cutting blocks and chamfer blocks. Likewise, a sterilization case includes instruments for tibial trial trays and articular insert trials.

The disadvantage of the past sterilization cases is that the numerous o instrumentation cases occupy an excessive amount of the limited space within the operating suite. Moreover, during surgery, a surgeon must spend time reviewing the different sized instruments to find the proper instrument, thus lengthening the amount of time in surgery. For example, a surgeon must determine the proper instrument from a femoral instrument tray that includes as many as thirty seven instruments. Similarly, a tibial instrument tray includes as many as fifty instruments. Additionally, a hospital must incur costs of post-operative cleaning of all the instruments brought into the operating suite.

Some patents have issued for surgical packing and/or autoclave trays with instruments contained therein. For examples, U.S. Patent 5,356,006 issued to Alpern et al. discloses a sterile package for endoscopic devices. The package includes a foam member that holds the endoscopic device in a stable position within the package. The package includes at least one sterile overwrap member and one non-sterile overwrap member. The Berry, Jr. Patent 5,415,846 discloses a plastic autoclave enclosure for retaining and storing medical instruments and apparata which must be autoclaved includes a molded tray, a molded lid and a pair of oppositely disposed slide latches which are used to secure the molded lid to the molded tray. The molded tray has an outwardly extending flange and disposed therein a pair of spaced-apart keyhole slots. The slide latches are attached to opposite ends ofthe molded lid and include a protruding pin portion from each latch which has an enlarged head and this enlarged head is received by the corresponding keyhole slot. The base of the molded tray is configured wim two spaced-apart ribs and the molded lid has a pair of spaced-apart ribs which define the top surface into three generally rectangular areas. The spacing and length dimension of the tray ribs is such that the base of the tray may be stacked onto the top of the lid thereby allowing a plurality of autoclave enclosures to be stacked one on top ofthe other.

In U.S. Patent 5,464,406, there is disclosed a set of surgical instruments for use in shaping bones so as to receive one component of a joint prosthesis. U.S. Patent 5,525,314 discloses a surgical tool container system for the organization, sterilization, storage and presentation of a group of surgical instruments for selection and retrieval by a medical practitioner during a surgical procedure. The container system includes an outer case having separable base and lid portions with a tool-holding tray removably inserted within the base portion of the case. The tray is provided with a plurality of holes formed therethrough and wherein a respective plurality of elastomeric grommets are fixed to the tray. Each grommet includes an axially extending bore wherein the shank of a surgical tool may be inserted and frictionally engaged in a generally upright orientation with respect to the tray. The grommets removably secure the tools in their original positions within the container regardless of container orientation, yet also permit the quick and easy one-hand retrieval of a tool from the container during a surgical procedure, as well as equally quick and easy replacement ofthe tool within the container for subsequent sterilization and use cycles. BRIEF SUMMARY OF THE INVENTION The present invention relates to modular sterilization instrumentation cases for use during orthopaedic joint replacement surgery. The modular cases can be custom fitted with whole or full trays of instruments and half trays that include a limited range of instrument sizes that will best fit a patient's anatomy during surgery. The present invention includes a modular case of non-size dependent surgical instruments that are contained on the full size tray and used during most surgeries.

The present invention solves the disadvantages ofthe prior art by limiting the number of instruments that need be brought into the operating suite. By using X-rays prior to surgery, the surgeon can determine the proper size modular cases to bring into the operating suite and thus reduce the amount of time reviewing instruments during surgery. Moreover, the post-operative cost of sterilization will be reduced because there will be less instrumentation in the operating suite. BRIEF DESCRIPTION OF THE DRAWINGS

For a further understanding ofthe nature, objects, and advantages ofthe present invention, reference should be had to the following detailed description, read in conjunction with the following drawings, wherein like reference numerals denote like elements and wherein:

FIGURE 1 is a perspective, partially cutaway view of a first embodiment ofthe apparatus ofthe present invention; FIGURE 2 is an exploded view of the first embodiment of the apparatus of the present invention;

FIGURE 3 is a fragmentary top view of the first embodiment of the apparatus ofthe present invention illustrating a first size tray portion thereof;

FIGURE 4 is a fragmentary top view of the first embodiment of the apparatus of the present invention illustrating two half tray portions thereof;

FIGURE 5 is a top fragmentary view of the first embodiment of the apparatus of the present invention showing an outer sterilization case portion thereof;

FIGURE 6 is a perspective view of the preferred embodiment of the apparatus of the present invention illustrating the relative sizes between the various sterilization cases;

FIGURE 7 is a top plan view of a second embodiment ofthe apparatus of the present invention with the cover removed and showing the full size instrument tray portion thereof; FIGURE 8 is a top plan view ofthe second embodiment ofthe apparatus of the present invention with the cover and full size instrument tray removed to expose the two half tray portions thereof;

FIGURE 9 is a top plan view ofthe second embodiment ofthe apparatus ofthe present invention; FIGURE 10 is a top view of a third embodiment of the apparatus of the present invention; and

FIGURE 11 is a top view of a fourth embodiment ofthe apparatus ofthe present invention.

DETAILED DESCRIPTION OF THE INVENTION Figures 1-6 show a first embodiment of the apparatus of the present invention designated generally by the numeral 10A in Figure 1. Sterilization case 10A includes a main case body 11 and a removable cover 12 that fits the main body 11 as shown in Figure 1. The cover 1 is held in position on the main body 11 with a pair of spaced apart clamps 13. Handles 14 enable the overall case 10A to be carried from place to place.

Figure 6 shows a plurality of cases 10 A, 10B, IOC, IOD in stacked relationship to illustrate that these cases lOA, 10B, IOC, 10D can be supplied in various thicknesses such as the larger thickness case having a thickness illustrated by the arrow 22, and a thinner case illustrated by the arrow 23. With the present invention, an operating room nurse can switch full trays and half trays from one case to another depending upon the half trays and full trays that are most likely to be used in a particular orthopaedic joint replacement surgical operation.

In Figures 1-6, the case 10A includes a pair of half length trays 19, 20 and a full length tray 21. The trays 19, 20, 21 can be seen more clearly in Figures 2-4. The main body 11 has a bottom 17 and a continuous outer side wall 18.

The half trays 19, 20 fit within the confines of the side wall 18 and upon the bottom 17. Openings 15, 16 in case 10A enable steam to enter the interior of he case so as to sterilize instruments contained on trays 19-21. The full length tray 21 is shown more particularly in Figure 3. This tray is a non-dimensional tray that includes instrumentation that is basically independent of implant/trial size restrictions for a particular patient. The full length tray 21 includes a generally rectangular plate member 24 and a pair of spaced apart handles 25 for lifting tiie tray 21 into or from the interior of main body 11.

Full length tray 21 carries instrumentation that is irrelevant of size for the most part the actual instrument and/or its outline is shown in the drawings to illustrate that each tray (half trays and full trays) holds a number of instruments and/or trials at spaced apart locations on the trays. In some cases, clamp hold the instruments or trials. In other cases, sockets on the tray cradle the instrument/trial. For example, in Figure 3, the instrumentation contained on full size tray 21 includes extramedullary alignment rod 26, long intramedullary alignment rod 27, and short intramedullary alignment rod 28. Tray 21 can also include a femoral intramedullary drill 29, anterior stylus 30, anterior reference sizing guide 31, and posterior reference sizing guide 32.

Full length tray 21 includes a distal femoral cutting blocks 33 (one slotted, one non-slotted) and a pair of quick connect handles 34, 35. The tray 21 includes a detachable handle 36, femoral lug drill 37, femoral modular slot attachment 38, and distal femoral resection stylus 39. A plurality of valgus collets 41, 42, 43 are provided. The additional instruments on tray 21 include femoral alignment viewing template 40, and valgus alignment guide 44. In combination with the instrumentation full size tray 21, the operating room nurse can add half length trays, but only a pair of a selected size that best fits the needs ofthe patient, based upon prior X-ray evaluations. A surgeon is only required to check a single instrument tray for the joint replacement surgical instruments that are shown on full length tray 21. Half trays 19, 20 are selected with the sizes of femoral trials and related cutting blocks that are closest to the patient in question. If, for example, the surgeon studies X-rays and determines that a patient is a probable size 4 or size 5, the surgeon need only use half trays 19 and 20 rather than instrument trays that include all of the sizes 1-8. The half length trays shown in Figure 4 include tray 19 with sizes 3 and 4, and tray 20 with sizes 5 and 6.

In Figure 4, half tray 19 includes a plate member 45 and spaced apart handles 46, 47 that enable the half tray 19 to be lifted from main body 11. The half tray 20 is constructed of a generally rectangular or square plate member 48 having spaced apart handles 49, 50. The first half tray 19 includes femoral trial size 3L and 3R designated by the numeral 51 for the portion of the tray 19 that is a socket that holds those instruments. Femoral trial sizes 4L and 4R are contained at 52 on the half tray 19. Conversely, the half tray 20 includes larger femoral trial sizes 5L, 5R, and 6L, 6R. The larger femoral trial sizes 5L, 5R are held in a socket that is indicated by the numeral 53 in Figure 4. The largest femoral trial sizes 6L, 6R are held in a socket that is indicated as 54 in Figure 4. The instruments fit that portion of tiie tray which has clamps and in some cases, a graphical outline of he instrument to aid the operating room nurse in returning an instrument to its proper location.

Chamfer block sizes 3 and 4 sockets are indicated respectively by the numerals 55, 56 in Figure 4, occupying the smaller size instrument containing tray 19. The larger chamfer block sizes 5 and 6 are contained on the half tray 20 indicated by the numerals 57 and 58 sockets respectively. The half tray 19 includes anterior/posterior cutting block size 3 socket, indicated by tiie numeral 59. An anterior/posterior cutting block size 4 socket is indicated as 60 in Figure 4. The larger anterior/posterior cutting block sizes 5 and 6 sockets are indicated by the numerals 61, 62 respectively on the half tray 20.

Figure 4 thus illustrates that two half trays 19, 20 bearing instruments that are size related can be put in a single case 11 for use in surgery without the necessity of bringing in instruments or trials sizes 1 and 2, or sizes 7 and 8. By using half trays 19, 20, the operating room nurse could have just as easily put in half trays that contain sizes 5 and 6 for one half tray (such as the half tray 20) and a different half tray having sizes 7 and 8, if for example the patient were a larger human being that X-rays indicate to be a size 6 or 7 for example.

Figures 7-9 show a second embodiment of the apparatus of the present mvention designated by the numeral 10B. As with the first embodiment of Figures 1-6, the embodiment of Figures 7-9 includes an overall main body 11, a removable cover 12, clamps 13 to hold the cover to the main body 11, and handles 14 for carrying the overall sterilization case 10B. As with the embodiment of Figures 1- 6, sterilization case 10B provides openings 15, 16 through the wall ofthe main body 11 and the cover 12 as shown in Figure 1. In Figures 7-9, a sample sterilization case is shown in the form of tibial instrumentation for use in knee joint replacement surgery and specifically tibial trial sizes 3 through 6.

In Figure 7, the cover 12 has been removed to show the main body 11 and a full size instrumentation tray 63. The full tray 63 is comprised of a rectangular plate member 64 and spaced apart handle 65, 66 for lifting and manipulating the tray 63. Various knee joint replacement surgical instruments are contained on plate member 64 of frill tray 63. These knee joint replacement surgical instruments are generally independent of size requirements and thus the surgeon conveniently has all the knee instruments on a single tray, the full size tray 63. 5 Figure 8 illustrates two half trays 67, 68 that are contained underneath the full tray 63. Thus, when a surgeon opens the sterilization tray 10B and removes both the cover 12 and the full size tray 63, the half trays 67, 68 are exposed as shown in Figure 8. Half tray 67 is comprised of a generally rectangular or square plate member 69 and spaced apart handles for lifting the tray 69 can be provided. l o Half tray 68 is comprised of a plate member 70 and can have spaced apart handles to use in lifting. The handles of half tray 67 are indicated by the numeral 71. The lifting handles of half tray 68 are indicated by the numeral 72.

Full size instrumentation tray 63 can include a number of selected knee joint replacement surgical instruments. In Figure 7, tibial non-spiked fixation rod

15 73, tibial fixation rod 74, and tibial saw capture 75 include for example tibial instrumentation surgical instruments. These instruments and the other instruments shown on tray 63 are used in knee joint replacement surgery. The tray 63 includes tibial extrarnedullary alignment guide 76, primary tibial stylus 77, tibial ankle clamp 78, and intramedullary trial alignment guide 79. The additional instruments

20 on tray 63 include tibial drill 80, tibial punches 81 and 82, collets 83-85.

The half trays 67, 68 are shown in Figure 8 as containing instruments that are of a particular selected size such as 3, 4, 5, 6. These sizes are known in the art and are used in knee joint replacement surgery to designate a particular size for the final prosthesis (e.g., tibial component femoral component) that will be implanted

25 by the surgeon. Trial instruments must be of the size of the final selected prosthesis if the surgical procedure is to be successful with a good fit achieved for tiie patient In Figure 8, the tray 67 is comprised of a plate member 69 and having a pair of handles 71 for lifting the tray. The instruments on half tray 67 include tibial drill guides 90, 91, and a plurality of tibial insert trials 92-97. A cemented

30 trial punch 98 is contained on the half tray 67. Other instruments on the half tray 67 include a plurality of insert trial spacers 99-103. There are also provided on half tray 67 a plurality of non-porous tibial trials in sizes 3L, 3R, 4L, 4R, designated respectively by the numerals 104, 105, 106, 107. The half tray 68 is also formed of a plate member 70 and provides handles 72 for lifting the half tray 68. The instruments on the half tray 68 are the same as those contained on the tray 67, but are of a larger size. While the instruments on the tray 67 are of sizes 3 and 4, the instruments on half tray 68 are sizes 5 and 6. On half tray 68, there is provided a pair of tibial drill guides 108, 109 and a plurality of tibial insert trials 110-115. A cemented trial punch 116 is contained on the half tray 68. Other instruments on the half tray 68 include a plurality of insert trial spacers 117-121. There are also provided a plurality of non-porous tibial trials in sizes 5L, 5R, 6L, 6R designated respectively by the numerals 122, 123, 124, 125.

Figure 10 shows a third embodiment of the apparatus of the present invention designated by the numeral 10C in Figure 10. Sterilization tray 10C includes a main body 11, cover 12, clamps 13, and handles 14 as with the embodiment of Figure 1. However, because ofthe tray 10C includes no full length tray, and only two half trays 132, 133, there is no need for a thickness as great as that of the tray apparatus 10A of Figure 1. Therefore, the two half trays 132, 133 can for example be contained in a thinner tray. Half tray 132 is comprised of a plate member 134 that is generally square or rectangular having a pair of spaced apart handles 135, 136 that enable a surgeon or operating room nurse to manipulate the half tray 132. Similarly, the half tray 133 includes a rectangular or square plate member 137 having a pair of spaced apart handles 138, 139.

The trays 132, 133 carry a plurality of trials that are used in knee joint replacement surgery. The trays 132, 133 are sized dependent. For example, the tray 132 includes sizes 3 and 4 while the half tray 133 includes sizes 5-6. The trays 132, 133 include a plurality of constrained femoral trials 140-147. The tray 132 includes constrained femoral trials 140-143 that respectively include sizes 3L, 3R, 4L, and 4R. The half tray 133 includes sizes 5L, 5R, 6L, 6R. Those trials being designated by the numerals 144-147 respectively. A plurality of conversion module trials are provided in sizes 3L-6R on the trays 132, 133. The half tray 132 includes conversion module trial size 3L, 3R,

4L, and 4R designated respectively by the numerals 149, 150, 151, 152. The half tray 133 includes a plurality of conversion module trials in sizes 5L, 5R, 6L, 6R, designated respectively by the numerals 153, 154, 155, 156.

The half tray 132 includes two constrained insert trials 157, 158. Larger constrained insert trials are contained on the tray 133, designated by the numerals 160, 161. An articular insert spacer 159 is contained on the half tray 132. Similarly, a larger articular insert spacer 162 is contained on the half tray 133. The half tray 132 includes revision cutting block sizes 3 and 4 sockets, designated by the numerals 163, 164. The half tray 133 includes revision cutting blocks sizes 5 and 6, designated by the numerals 165, 166.

Figure 11 shows a fourth embodiment of the apparatus of the present invention, designated generally by the numeral 10D. As with the embodiment of Figure 10, sterilization tray 10D includes a main body 11, cover 12, clamps 13, and handles 14 as shown in Figure 1. Similarly, openings 15, 16 are provided for enabling steam to reach the interior of sterilization tray 10D and the two half trays 170, 171.

The half tray 170 is comprised of a square or rectangular plate member 172 having spaced apart handles 173, 174. Similarly, the half tray 171 is comprised of a rectangular or square plate member 175 and spaced apart handles 176, 177.

The tray 10D is a posterior stabilized/revision instrument tray for sizes 1-2.

The tray 10D includes the two half trays 170, 171. Various instruments are contained on the two trays as shown in Figure 11. The tray 170 includes constrained femoral trial sizes IL and IR, designated by the numerals 178, 179. Other constrained femoral trial sizes 2L and 2R are designated by the numerals 180, 181 respectively. The tray 170 includes four constrained module trials in sizes IL, IR, 2L, 2R designated by the numerals 182, 183, 184, 185 respectively. Constrained inserts 186, 187 are also provided on half tray 170. Revision cutting blocks sockets 188, 189 are provided respectively in sizes 1 and 2 on half tray 170. Tray 171 includes posterior/stabilized femoral trials IL, IR, 2L, 2R sockets designated by the numerals 190, 191. The half tray 171 provides housing resection blocks sockets in sizes 1 and 2, designated by the numerals 192, 193. The half tray 171 provides anterior/posterior cutting block sockets sizes 1 and 2, designated by the numerals 194 and 195. The half tray 171 also contains housing box chisel socket 196.

The following table lists the parts numbers and parts descriptions as used herein and in the drawings attached hereto.

PARTS LIST Part Number Description

10A sterilization case

10B sterilization case

IOC sterilization case

10D sterilization case 11 main body

12 cover

13 clamp

14 handle

15 openings 16 openings

17 bottom

18 side wall

19 half tray

20 half tray 21 full tray

22 arrow

23 arrow

24 plate member

25 handles 26 extramedullary alignment rod 27 long i.m. alignment rod

28 short intramedullary alignment rod

29 femoral intramedullary drill

30 anterior stylus 31 anterior reference sizing guide

32 posterior reference sizing guide

33 distal femoral cutting guide

34 quick connect handle

35 quick connect handle 36 detachable handle

37 femoral lug drill

38 femoral modular slot attachment

39 distal femoral resection stylus

40 femoral alignment viewing template 41 valgus collet

42 valgus collet

43 valgus collet

44 valgus alignment guide

45 plate member 46 handle

47 handle

48 plate member

49 handle

50 handle 51 femoral trial size 3L, 3R socket

52 femoral trial size 4L, 4R socket

53 femoral trial size 5L, 5R socket

54 femoral trial size 6L, 6R socket

55 chamfer block size 3 socket 56 chamfer block size 4 socket -13-

57 chamfer block size 5 socket

58 chamfer block size 6 socket

59 anterior/posterior cutting block size 3 socket

60 anterior/posterior cutting block size 4 socket

61 anterior/posterior cutting block size 5 socket

62 anterior/posterior cutting block

10 size 6 socket

63 full tray

64 plate member

65 handle

66 handle

15 67 half tray

68 half tray

69 plate member

70 plate member

71 handle

20 72 handle

73 tibial non-spiked fixation rod

74 spiked fixation rod

75 tibial saw capture

76 trial extramedullary alignment guide

25 77 primary tibial stylus

78 tibial ankle clamp

79 intramedullary trial alignment guide

80 tibial drill

81 tibial punch

30 82 tibial punch 83 collet

84 collet

85 collet

90 tibial drill guide

91 tibial drill guide

92 tibial insert trial

93 tibial insert trial

94 tibial insert trial

95 tibial insert trial

96 tibial insert trial

97 tibial insert trial

98 cemented trial punch

99 insert trial spacer

100 insert trial spacer

101 insert trial spacer

102 insert trial spacer

103 insert trial spacer

104 non-porous tibial trial size 3L

105 non-porous tibial trial size 3R

106 non-porous tibial trial size 4L

107 non-porous tibial trial size 4R

108 tibial drill guide

109 tibial drill guide

110 tibial insert trial

111 tibial insert trial

112 tibial insert trial

113 tibial insert trial

114 tibial insert trial

115 tibial insert trial

116 cemented trial punch 117 insert trial spacer 118 insert trial spacer 119 insert trial spacer 120 insert trial spacer 121 insert trial spacer 122 non-porous tibial trial size 5L 123 non-porous tibial trial size 5R 124 non-porous tibial trial size 6L 125 non-porous tibial trial size 6R

10 126 half tray 127 half tray 128 arrow 129 arrow 130 arrow

15 131 arrow 132 half tray 133 half tray 134 plate member 135 handle

20 136 handle 137 plate member 138 handle 139 handle 140 constrained femoral trial size 3L

25 141 constrained femoral trial size 3R 142 constrained femoral trial size 4L 143 constrained femoral trial size 4R 144 constrained femoral trial size 5L 145 constrained femoral trial size 5R

30 146 constrained femoral trial size 6L 147 constrained femoral trial size 6R

149 conversion module trial size 3L

150 conversion module trial size 3R

1 1 conversion module trial size 4L 152 conversion module trial size 4R

153 conversion module trial size 5L

154 conversion module trial size 5R

155 conversion module trial size 6L

156 conversion module trial size 6R 157 constrained insert trial

158 constrained insert trial

159 articular insert spacer

160 constrained insert trial

161 constrained insert trial 162 articular insert spacer

163 revision cutting block size 3 socket

164 revision cutting block size 4 socket

165 revision cutting block size 5 socket

166 revision cutting block size 6 socket 170 half tray

171 half tray

172 plate member

173 handle

174 handle 175 plate member

176 handle

177 handle

178 constrained femoral trial size IL

179 constrained femoral trial size IR 180 constrained femoral trial size 2L 181 constrained femoral trial size 2R

182 conversion module trial size IL

183 conversion module trial size IR

184 conversion module trial size 2L 185 conversion module trial size 2R

186 constrained insert

187 constrained insert

188 revision cutting block size 1 socket

189 revision cutting block size 2 socket 190 P/S femoral trial size IL, IR socket

191 P/S femoral trial size 2L, 2R socket

192 housing resection block size 1 socket

193 housing resection block size 2 socket

194 A/P cutting block size 1 socket 195 A/P cutting block size 2 socket

196 housing box chisel socket

Because many varying and different embodiments may be made within the scope of he inventive concept herein taught, and because many modifications may be made in the embodiments herein detailed in accordance with the descriptive requirement of the law, it is to be understood that the details herein are to be interpreted as illustrative and not in a limiting sense.

What is claimed as invention is:

Claims

CLAIMS 1. A method of supplying sterilized surgical instruments for use in a surgical procedure wherein a surgeon implants an orthopaedic surgical prosthesis into a patient's bone tissue, comprising the steps of; a) providing a plurality of cases that can hold a collection of orthopaedic surgical instruments, each case having a length, a width and a depth; b) providing a plurality of trays that selectively and interchangeably fit inside the cases, the trays including a plurality of half trays that are sized and shipped to fit two at a time, side-by-side inside of one ofthe cases; c) wherein in step "b" at least one ofthe trays is of a length that approaches tiie length of a case, enabling the full length tray to fit inside of a case occupying substantially the entire length thereof; d) wherein in step "b" at least one of the cases is sized and shaped to hold two half trays and one full length tray, each tray having holders for holding ortiiopaedic surgical instruments or trial components, wherein the half pans hold orthopaedic surgical trial components; e) placing a selected pair of half pans in first of the trays; f) placing a selected pair of half pans and full length pans in a second of the trays; and g) autoclaving tiie cases and contained pans for use in orthopaedic surgery.

2. The method of claim 1 wherein in step "e" at least one ofthe cases being sized and shaped to hold a pair of half pans only.

3. The method of claim 1 further comprising the step of using the half pans to hold trial components of different sizes.

4. The method of claim 1 further comprising the step of using one half pan to hold components of two different sizes.

5. The method of claim 1 further comprising the step of using one half pan to hold trial components of two different sizes and another half pan to hold trial components of two additional different sizes so that the two half pans hold components of four (4) different sizes.

6. The method of claim 1 wherein the plurality of cases include at least two cases having differing depths.

7. The method of claim 1 wherein at least one of the trays carries a plurality of trials that are used in knee joint replacement surgery.

8. The method of claim 7 wherein at least one of the trays carries a plurality of femoral trials that are used in knee joint replacement surgery.

9. The method of claim 7 wherein at least one of the trays includes a plurality of tibial trials that are used in knee joint replacement surgery.

10. The method of claim 7 wherein at least one of the trays includes knee joint replacement surgical instruments at least some of which are alignment guides.

11. The method of claim 1 wherein at least one ofthe trays is a full sized tray that includes knee joint replacement surgical instruments at least some of the instruments including alignment rods, sizing guides, and cutting blocks.

12. The method of claim 1 wherein one of the trays carries a plurality of femoral trials, and a plurality of cutting blocks.

13. The method of claim 1 wherein one of the half trays contains knee cutting instruments for instrument sizes 1 and 2.

14. The method of claim 1 wherein one of the half trays contains knee cutting instruments for instrument sizes 3 and 4.

15. The method of claim 1 wherein one of the half trays contains knee cutting instruments for instrument sizes 5 and 6.

16 The method of claim 1 wherein one of the half trays contains knee cutting instruments for instrument sizes 7 and 8.

17. The method of claim 1 wherein one of the half trays includes tibial trial instruments that include non-porous tibial trials, tibial insert trials, and tibial drill guides of differing sizes.

18. The method of claim 1 wherein one ofthe half trays includes femoral trials of differing sizes including constrained femoral trials and conversion modules of differing sizes.

19. The method of claim 1 wherein one of the half trays includes revision cutting blocks of differing sizes.

20. The method of claim 1 wherein one of the half trays includes posterior stabilized femoral trials of differing sizes.

21. The method of claim 1 wherein one of the half trays includes housing resection blocks of different sizes.

22. The method of claim 1 wherein one of the half trays includes anterior/posterior cutting blocks in differing sizes.

23. A method of supplying sterilized surgical instruments for use in a surgical procedure wherein a surgeon implants an orthopaedic surgical prosthesis into a patient's bone tissue, comprising the steps of; a) providing a plurality of cases that can hold a collection of orthopaedic surgical instruments, each case having a length, a width and a depth; b) providing a plurality of trays that selectively and interchangeably fit inside the cases, the trays including a plurality of half trays that are sized and shipped to fit two at a time, side-by-side inside of one of the cases; and c) autoclaving the cases and contained pans for use in orthopaedic surgery.