Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
  • A61B17/1662—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body
  • A61B17/1664—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the hip
  • A61B17/1666—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the acetabulum

Definitions

• the invention relates to surgical products, and in particular, to surgical reamers for cutting shaped cavities in bone.
• the reamer shell or cutting bowl be hemispherical.
• the cutting teeth must be properly located and oriented. Still further, the tooth height is important to the size of bone chip and thus to the accuracy of the shape cut by the reamer.
• an implant in a hip socket is best fixed to a concave, hemispherical cavity.
• a concave, hemispherical cavity is not strictly necessary.
• Other acetabular cutting shells are non- hemispherical but the principle explained here may be adapted to include such other geometries.
• the acetabulum be reamed to an exact form, generally a hemisphere, thus allowing maximal contact between the bone and the definitive (hemispherical) implant.
• the change in surgical procedure includes the fact that the surgeon now more often maintains the acetabular reamer handle on a single axis rather than performing the step of "sweeping" the end of the tool handle through an angle and thus continuously changing the axis of the reamer cut. If a test is made
• U.S. Pat. No. 5,116,165 to Sayler describes a scraper-type reamer having a limited number of discrete blade-like teeth. These teeth are defined by a single curve of the profile of the form to be cut. In other words, these teeth are essentially straight. Such a tooth form thus is not supported in that no structure is provided to help maintain the form of the tooth (other than the tooth itself) when faced with the sometimes unusually high cutting stresses associated with reaming. Further, the integrity of the spherical form of the reamer can be affected when there are a limited number of extensive slits or cuts in the spherical body of the reamer. This integrity is affected by the fact that high stresses are induced at the relatively sharp corners of the slits.
• U.S. Pat. No. 6,730,094 to Sayler describes another embodiment of a scraper-type reamer also having a limited number of discrete blade-like teeth. These teeth too are straight. Such a tooth form is not supported in that no structure is provided to help maintain the form of the tooth (other than the tooth itself) when faced with the sometimes unusually high cutting stresses associated with reaming. Further, the form of the openings provides undesirable snag and tear points (relief slots 40) at the outer edges of the blades, at the point where the supporting portion behind the blades transitions to the shell. During use, these points may inadvertently tear or snag soft tissue against which it slides during use. This is the case too for Fig. 9 of Salyer, presenting the embodiment most likely the most prone to snags and tears (the slot 40 is apparently hidden from view by the tooth).
• the form of a tooth on a reamer is a function of the original material form, the sheet material, the base diameter of the hemisphere or of the manufacturing method. Often no consideration is given to the form of the cut surface. Therefore, the cut of a single tooth often only approximates the required form of a sphere or a hemisphere. For example, it may yield a planar surface or have a radius different than that required and further generate an overall hemispherical form that is irregular.
• a reamer that minimizes the discrete cut surfaces and generates a series of cuts that comprise a single defined geometry. Further, what is needed is a mechanism for properly locating and orienting the cutting teeth. Still further, what is needed is a tooth form that can be controlled independently of the form of the original material form.
• an acetabular reamer for cutting a required cut shape the reamer having a cutting shell on which are located a series of doubly-curved cutting teeth thereon of a quantity to substantially reduce a cutting pressure on each tooth as well as to reduce a size of a typical chip generated upon cutting.
• Substantially all the teeth each have a matched arc cutting edge of substantial length, these cutting edges having a cutting profile which substantially matches a profile of a shape to be cut.
• the configuration of the invention reduces the number of teeth required to cut the shape, by approximately 30%, as compared to a standard "cheese-grater"-type reamer.
• the apertures on which the cutting edge is formed are non-circular, thus providing an indexing surface permitting the accurate locating of tools which form the cutting edge. Still further, by punching up or forming a larger number of smaller teeth, as compared to the scraper-type reamer of the prior art, it is easier to maintain the spherical shape of the reamer.
• the invention thus gives an improved quality and orientation of the cutting edge which results in an improved cut surface while employing fewer teeth.
• FIG. 1 is a perspective view of a reamer of the prior art.
• FIG. 2a is a top view of a tooth of a reamer of the prior art.
• FIG. 2b is a side cross-sectional view of a tooth of a reamer of the prior art .
• FIG. 2c is a front view of a tooth of a reamer of the prior art.
• FIG. 3 is a detail view of an alternate tooth of the prior art.
• FIG. 4a is a top view of a tooth of a reamer of the invention.
• FIG. 4b is a side cross-sectional view of a tooth of a reamer of the invention.
• FIG. 4c is a front view of a tooth of a reamer of the invention.
• FIG. 4d is top view of an alternate embodiment of the tooth of the invention.
• FIG. 4e is top view of an alternate embodiment of the tooth of the invention.
• FIG. 5 is a side view of the reamer of the invention.
• FIG. 6a is a cross sectional side view of the reamer of the invention.
• FIG. 6b is a perspective view of the reamer of the invention.
• FIG. 7 is a table of the wear characteristics of a prior art reamer.
• FIG. 8 is a table of the wear characteristics of the reamer of the invention.
• FIG. 9 is a flow chart of the method of manufacturing the invention.
• the reamer 10 has a cutting bowl or shell 12 defining a surface 14 on which are located teeth 16 adjacent openings 18.
• a base 20 provides a tool-engaging device (not shown).
• a tooth 16 of the reamer 10 is shown.
• the tooth 16 has a diverging surface 22 ("rise”, marked Zone A) backing up the cutting edge 20.
• Zone A a diverging surface 22
• This surface 30 begins to curve inwardly toward the surface of Zone B, and then towards the reamer cutting bowl surface 14.
• Surface reflection lines 28 help indicate the form of these surfaces.
• FIG. 2b a cross sectional side view of the tooth profile 32 of the prior art reamer 10 is shown.
• the form of the profile 32 of the rise 22 is non-linear as indicated.
• Zone A the diverging surfaces 22 of Zone A are visible when one examines a front view of the tooth 16 of the prior art reamer 10.
• corresponding portions of the rise 22 are not visible in a front view but are hidden from view, due to their convergence toward an apex.
• rises 22, respective cutting edges 20, and openings 18 are either positioned on the reamer cutting surface in a spiral arrangement, staggered in another manner, or randomly placed.
• the term "spiral” is meant to include any form in which the cutting teeth 16 are orderly organized in a manner to sweep out the entire shape to be cut
• a preferred spiral arrangement is an arrangement in which adjacent teeth are uniformly angularly offset from each other at any adjacent circle of latitude, namely, that adjacent teeth lie on differing circles of longitude evenly spaced apart from one another. Further, it is preferred that there be a given overlap between adjacent cutting rings (i.e., the rings swept out by each tooth 16).
• prior art reamers 10 have a crest 38, which generally approximates a narrow Peak.
• the profile 70 is shown of a prior art tooth 72 of a reamer known as the "DR reamer", the subject of US Patent No. 5,968,049, the content of which is incorporated herein by reference thereto.
• the tooth 72 of the DR reamer forms a chord which intersects the profile 70 of the desired cut at two points 74 and 76. Therefore, these prior art reamers have no peak in the typical case.
• the present invention has a cutting shell 12' on which are located a series of doubly-curved cutting teeth 16' thereon of a quantity to substantially reduce a cutting pressure on each tooth as well as to reduce a size of a typical chip generated upon cutting.
• Substantially all the teeth 16' each have a matched arc cutting edge 20' of substantial length that has a cutting profile which substantially matches a profile of a shape to be cut.
• the matched arc cutting edge 20' is adjacent secondary cutting edges 21' supported by adjacent rise portions 29', characterizable as .gusset or buttress portions, which curve back toward the cutting shell 12' and support the secondary cutting edges 21'.
• the overall cutting edges 20' are therefore doubly-curved in that at least two distinct curves are required to define each cutting edge 20'.
• a smooth-edged opening 18' precedes the cutting edges as the reamer 10' is rotated for cutting.
• the openings 18' as being “smooth-edged”, it is meant to define a non-circular opening in which there are no slits or narrow grooves which can cause stress concentrations or soft tissue snag or tear points.
• Such a configuration reduces the number of teeth required to cut the shape and minimizes the risk of snagging or tearing soft tissue during use.
• the invention thus gives an improved quality of cut surface and allows fewer teeth 16' to be employed.
• the cutting edge 20' appears straight in the figure, it actually follows the contour of the surface to be cut, in this case, a hemispherical surface.
• the radius R of the cutting edge 20' matches the radius of the surface to be cut.
• the new tooth 16' is not generated by the manufacture of a larger or wider opening 18 adjacent to the tooth.
• the opening 18' is, as in the prior art, substantially round in shape.
• the tooth 16' is generated by the manner in which the tooth is deformed and the profile of the eventual shape.
• the rise 22' approximates the shape of a rectangular prism intersecting the cutting bowl at a tangent to the surface of the cutting bowl 12.
• the teeth 16' have clearly diverging surfaces (in Zone A) which follow the cutting edge 20'. Note that common reference numerals are used for the same or analogous features throughout the drawings.
• alternate embodiments of the teeth 16' of the invention include one in which the tooth is formed from the straight side 80 of the hole 18' (Fig. 4e) and one in which the hole is of a triangular shape (FIG. 4d).
• the side and front views of such alternate embodiments are substantially identical to that shown in FIGs. 4b and 4c, respectively.
• a different part of the sector is cut by a different tooth 16'.
• the cutting edge protrudes only 0.5 mm above the surface of the hemispherical shell 14, the fact that the openings are larger means that the effective cutting height may be greater than the 0.5mm, due to the fact that the perpendicular distance from the center of the outermost edge of the cutting edge 20' and a cord extending across the aperture 18' is significantly greater than 0.5mm.
• a series of cutting teeth 16' on the cutting shell 12' substantially reduces the cutting pressure on each tooth as well as reduces the size of a typical chip generated upon cutting.
• the ability to use fewer teeth 16' further allows sections 50 (shown in FIG. 5) of the hemisphere to be removed while maintaining a high quality of cut surface.
• An example of a acetabular reamer with sections cut away is given in the diagrams of PCT applications serial numbers PCI/IB01/02675 and PCI/IB01/02676 entitled HOLDER FOR A SURGICAL REAMER and SURGICAL REAMER, respectively, filed on 21 Dec. 2001, the contents of which are incorporated herein by reference thereto.
• the present invention generates a tooth 16' with a wider cutting profile that is therefore easier to overlap with the cut generated by the next tooth at a different latitudinal elevation on the hemisphere. Additionally the tooth 16' cuts a sector of the required hemisphere, matching the required radius exactly. The improved tooth allows a full hemisphere to be cut with fewer teeth than the typical cheese grater-type reamer..
• the reamer 10' includes a series of cutting teeth 16' arranged uniformly and spaced apart on the cutting shell. These teeth 16' may be arranged in a spiral arrangement on the cutting shell 12'.
• the cutting shell is a portion of a hemisphere, in this case, in which sections 50 (shown by dashed lines) have been removed in the manufacturing process.
• the length of the cutting edges are selected so as to completely cut the shape while being of a number that still ensures good mechanical strength. The longer cutting edges allows the use of less teeth while still cutting a good hemispherical form than permissible with a cutting shell that has a more complete hemispherical shape.
• a tool engaging portion 52 is comprised of two intersecting bars 54 and 56, one bar 54 of which optionally having two flats 60 (only one of which is shown) on its outer ends, adjacent their connecting points on the reamer cutting shell 12'.
• a punch (not shown) of corresponding polygonal form (for which the circumferential location of the edge of the punch used to punch up the cutting edge of the reamer is a known and accurately controlled circumferential distance away from a corresponding flat of the punch) is used to punch up the cutting edge, preferably an amount of 0.5mm, which is half the amount that such teeth are typically punched up.
• FIG. 6 shows the cutting profile 70 as compared to the profile 71 of the hemispherical shell 14.
• the graph of FIG: 7 is a graph of force vs time for a prior art reamer 10 showing how quickly the cutting forces increase with time.
• the same graph of force vs time for the reamer 10' of the present invention shows that the cutting forces remain relatively constant over as many as 20 uses, about two times less than a cheese-grater-type reamer. Lower cutting forces mean lower heat generation and less dead tissue. Less dead tissue improves the recovery time of the patient.
• the method 100 of fabrication of the invention includes several steps.
• a formed blank is formed from sheet material, cast in an investment or die casting, or formed from powered metal which is sintered prior to further processing.
• the apertures 18' are cut, optionally with a laser, and/or broached, so as to include at least one straight indexing edge.
• a punch (not shown) is inserted into each aperture for the forming of a cutting edge, the indexing edge of the blank abutting against a corresponding surface of the punch, this corresponding surface of the punch being oriented in a known manner, at a known distance from a cutting edge forming surface having contoured-to-match-the-cut-form surface on the punch.
• a fourth step 110 via the contoured-to-match-the-cut-form surface on the punch, the punch punches up the cutting edge 20'.
• steps 106 and 110 are repeated until all apertures which are to receive cutting edges are treated, after which, the processed blank is sent downstream for the mounting of cross bars 52 and 54, and further final finishing steps.
• a reamer is provided which substantially reduces a cutting pressure on each tooth as well as reduces the size of a typical chip generated upon cutting.
• the apertures on which the cutting edges are formed are non-circular, thus providing an indexing surface permitting the accurate locating of tools which form the cutting edge.
• the invention results in improved quality of the cut and orientation of the cutting edge, thereby improving the quality of the cut surface and permitting fewer teeth to be used.

Landscapes

• 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)
• Prostheses (AREA)
• Surgical Instruments (AREA)
• Electrical Discharge Machining, Electrochemical Machining, And Combined Machining (AREA)
• Mounting, Exchange, And Manufacturing Of Dies (AREA)
• Threshing Machine Elements (AREA)

Priority Applications (6)

Applications Claiming Priority (2)

Publications (1)

Family

ID=37758783

Family Applications (1)

Country Status (7)

Cited By (3)

Families Citing this family (24)

Citations (3)

Family Cites Families (29)

• 2005
  • 2005-10-24 US US11/257,417 patent/US7909828B2/en active Active
• 2006
  • 2006-10-19 WO PCT/IB2006/002927 patent/WO2007049113A1/en not_active Ceased
  • 2006-10-19 EP EP06809067A patent/EP1951131B1/en active Active
  • 2006-10-19 JP JP2008537212A patent/JP5308158B2/ja active Active
  • 2006-10-19 DE DE602006019976T patent/DE602006019976D1/de active Active
  • 2006-10-19 AT AT06809067T patent/ATE497363T1/de not_active IP Right Cessation
  • 2006-10-19 CN CN2006800466965A patent/CN101325917B/zh active Active
  • 2006-10-19 US US12/091,298 patent/US7922722B2/en not_active Expired - Lifetime

Patent Citations (3)

Also Published As

Similar Documents

Legal Events