WO2009040537A2 - Surgical positioning device and apparatus - Google Patents

Surgical positioning device and apparatus Download PDF

Info

Publication number
WO2009040537A2
WO2009040537A2 PCT/GB2008/003263 GB2008003263W WO2009040537A2 WO 2009040537 A2 WO2009040537 A2 WO 2009040537A2 GB 2008003263 W GB2008003263 W GB 2008003263W WO 2009040537 A2 WO2009040537 A2 WO 2009040537A2
Authority
WO
WIPO (PCT)
Prior art keywords
locating
arrangement
positioning device
marker element
surgical positioning
Prior art date
Application number
PCT/GB2008/003263
Other languages
French (fr)
Other versions
WO2009040537A3 (en
Inventor
Gursharan Singh Chana
Christopher John Sloss
Original Assignee
Comis Orthopaedics Limited
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 Comis Orthopaedics Limited filed Critical Comis Orthopaedics Limited
Publication of WO2009040537A2 publication Critical patent/WO2009040537A2/en
Publication of WO2009040537A3 publication Critical patent/WO2009040537A3/en

Links

Classifications

    • 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
    • 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
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
    • A61B5/1072—Measuring physical dimensions, e.g. size of the entire body or parts thereof measuring distances on the body, e.g. measuring length, height or thickness
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
    • A61B5/4528—Joints
    • 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
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30426—Bayonet coupling
    • 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
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30617—Visible markings for adjusting, locating or measuring
    • 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
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4658—Measuring instruments used for implanting artificial joints for measuring dimensions, e.g. length
    • 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
    • A61F2002/4687—Mechanical guides for implantation instruments
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • 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
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0097—Visible markings, e.g. indicia

Definitions

  • This invention relates to surgical positioning devices.
  • This invention also relates to surgical positioning apparatus incorporating surgical positioning devices and marker elements. More particularly, but not exclusively, this invention relates to surgical positioning devices and apparatus for use in determining the length and position of a leg during hip replacement surgery.
  • a surgical positioning device comprising a securing assembly, a locating arrangement securable to the securing assembly in a selected position of the locating arrangement, an indicating arrangement securable to the securing assembly in a selected position of the indicating arrangement, the locating arrangement comprising a locating member to locate the positioning device in a desired orientation relative to a first article, and the indicating arrangement comprising indicating means to indicate the position of a second article relative to the first article.
  • a surgical positioning apparatus comprising a surgical positioning device as described above and a marker element which can be mounted on the first article, the marker element comprising a co-operating formation to co-operate with the locating member and hold the locating member on the marker element.
  • the locating arrangement may be movable relative to the securing assembly.
  • the locating arrangement may be linearly movable relative to the securing assembly.
  • the locating arrangement may be slidable relative to the securing assembly.
  • the locating arrangement may be rotatably movable relative to the main body.
  • the locating arrangement may comprise an elongate member, which may have a main axis.
  • the locating arrangement may be rotatably movable about said main axis relative to the securing assembly.
  • the locating arrangement may comprise an elongate main portion, which may be substantially cylindrical in configuration.
  • the main portion may have a cross sectional profile that is generally oblong in configuration.
  • the locating member may be provided at one end of the elongate main portion.
  • the position of the securing assembly can be adjusted relative to the locating arrangement angularly and linearly.
  • the locating member may comprise at least one projection.
  • the locating member may comprise a polygonal member having a polygonal cross- section.
  • the locating member may have a hexagonal cross section.
  • the locating member may comprise a V-shaped projection.
  • the locating arrangement may comprise two V-shaped projections arranged opposite each other.
  • The, or each, V-shaped projection may comprise a pin.
  • the locating arrangement may further include a guide projection to guide the locating member on the marker element.
  • the guide projection may extend downwardly from the main portion, and may be substantially cylindrical.
  • the locating arrangement may further include a fastening assembly to fasten the locating arrangement to the marker element.
  • the fastening assembly may comprise a bayonet type fixing.
  • the fastening assembly may comprise a projecting member on the main portion. The projecting member may extend outwardly from the main portion, and may comprise an outwardly extending flange.
  • the fastening assembly may further include a reaction member movably mounted on the locating arrangement.
  • the reaction member may extend around the locating arrangement and may comprise a sleeve slidably mounted on the locating arrangement.
  • the reaction member may be provided on the elongate main portion.
  • the fastening assembly may comprise urging means extending from the projecting member to the reaction member to urge the reaction member away from the projecting member.
  • the reaction member may comprise an outwardly extending lip.
  • the urging means may extend between the lip and the projecting member. Where the reaction member comprises a sleeve, the outwardly extending lip may extend around the sleeve.
  • a finger may be provided on the reaction member.
  • the projecting member may define an aperture to receive therethrough the finger, which may extend downwardly from the reaction member.
  • the fastening assembly may comprise two fingers which may be arranged substantially opposite each other on the reaction member.
  • the projecting member may define two apertures, and the, or each, apertures may be a curved slot.
  • The, or each, finger may be received through the apertures in the projecting member.
  • The, or each, finger may have an inwardly extending detent formation thereon to cooperate with a respective fastening formation on the marker element.
  • the indicating arrangement may be movable relative to the securing assembly.
  • the indicating arrangement may be movable linearly relative to the securing assembly, and may be slidable relative to the securing assembly.
  • the indicating arrangement may be elongate, and may comprise an elongate arm.
  • the elongate arm may define a slot for co-operating with the securing assembly.
  • the indicating means may be provided at one end of the elongate arm.
  • the indicating means may comprise an indicating member, which may extend transverse to the elongate arm.
  • the indicating member may extend substantially orthogonally to the elongate arm.
  • the indicating member may include an indicating portion that extends transverse to the elongate arm, and conveniently extends orthogonally to the elongate arm.
  • the indicating member is fixed to the elongate arm. In another embodiment, the indicating member is adjustably movable relative to the elongate arm. In this embodiment, the indicating member may be removable from the elongate arm.
  • the indicating means may comprise a locking device on the elongate arm.
  • the locking device may comprise a fixed member mounted on the elongate arm.
  • the fixed member may be configured to receive the indicating member.
  • the fixed member may have a co-operating member to cooperate with the indicating member.
  • the co-operating member may comprise a co-operating collar.
  • the indicating member defines locking formations to co-operate with the co-operating member.
  • the locking formation may be first and second indentations defined in the indicating member.
  • the locking device may include a locking member mounted on the fixed member to lock the indicating member thereto.
  • the locking member is threaded to co-operate with threads on the fixed member.
  • the fixed member may have an externally threaded end portion and the locking member may be correspondingly internally threaded.
  • the apparatus is suitable for use in hip replacement surgery, wherein the first article may comprise a patient's pelvis, and the second article may comprise the patient's femur.
  • the marker element may be mounted on the iliac crest of the patient's pelvis, and the indicating member may indicate a positioning mark on the patient's femur, which may be on the greater trochanter of the patient's femur.
  • the marker element may comprise an insertion element, which may comprise a datum screw.
  • the marker element may have a shank having a screw thread, which may be a self tapping screw thread.
  • the marker element may have a head, which may have a co-operating formation which may be a recess to receive the locating member.
  • the rec «ess may have planar sides to prevent rotation of the locating member relative to the marker element.
  • the co-operating formation may be configured to co-operate with a drive element, such as a key to drive the marker element into the first article.
  • the recess may have the profile of a regular polygon, such as a hexagon, and the locating member may have an outer profile of a regular polygon to correspond with the polygonal profile of the recess.
  • the locating member can be inserted into the recess in the head of the marker element in one of a plurality of different orientations, depending upon the number of faces of the polygonal profile of the recess and the locating member.
  • the marker element comprises a locating formation to locate the locating member thereon.
  • the locating formation may be a locating recess, which may be a V-shaped recess.
  • the marker element has two locating recesses, both of which may be V-shaped recesses. The two locating recesses may be defined in the head of the marker element, and may be arranged opposite each other.
  • the marker element may define a drive recess to receive a drive element.
  • the drive recess may have a profile of a regular polygon, such as a hexagon.
  • the locating recesses may be defined in the head of the marker element on opposite sides of the drive recess.
  • the locating arrangement may comprise two locating members, and each of which may have a V-shaped configuration, corresponding to the shape of the corresponding locating recesses.
  • the marker element may define a central guide recess to receive the locating projection.
  • the central guide recess may be defined between the locating recesses, and may extend into the marker element from the drive recess. Desirably, the guide recess extends axially into the marker element.
  • the central guide recess may be substantially cylindrical.
  • the marker element may have a fastening formation to fasten the locating arrangement to the marker element.
  • the fastening formation may be a recess in the marker element.
  • the recess may be a J-shaped recess.
  • the marker element may comprise two fastening formations opposite each other. Each of the fastening formations may be a J-shaped recess.
  • the apparatus may comprise two of the aforesaid marker elements, one being longer than the other. Where the apparatus is used in hip replacement surgery, the longer or shorter marker elements can be used depending upon the obesity of the patient. A particularly obese patient may require use of the longer marker element, where as a less obese patient may require use of the shorter marker element.
  • the securing assembly may comprise a main body and securing means for securing the locating arrangement and the indicating arrangement to the main body.
  • the securing means may comprise first and second securing members for securing respectively the locating arrangement and the indicating arrangement to the main body.
  • the first and second securing members may comprise first and second screws.
  • the main body may define first and second threaded apertures to receive the first and second screws respectively.
  • the first screw may engage the locating arrangement when the first screw is received in the first aperture to secure the locating arrangement to the securing assembly.
  • the main body may define a main receiving hole for receiving the locating arrangement therethrough.
  • the main receiving hole may overlap with the first aperture whereby the threaded portion of the first securing member can engage the locating arrangement when the locating arrangement is received in the main receiving hole, and the first securing member is received in the first aperture.
  • the main receiving hole and the first aperture may be transverse to each other, and are conveniently substantially mutually orthogonal.
  • the securing assembly may also comprise a guide member to guide movement of the indicating arrangement relative to the main body.
  • the guide member may be mounted on the main body, and may comprise an outwardly extending guide portion and a connecting portion to connect the guide portion to the main body.
  • the guide member may be received by the indicating arrangement.
  • the indicating arrangement comprises an elongate arm having a slot
  • the guide member may be received through the slot.
  • the guide portion When the guide member is received through the slot, the guide portion may extend across the slot and the connecting portion may extend through the slot.
  • the second aperture may be arranged such that the second securing member extends through the slot when the second securing member is received in the second aperture. The head of the second securing member may engage the elongate arm to secure the elongate arm to the securing assembly.
  • the main receiving hole and the second aperture may extend substantially parallel to each other.
  • the surgical positioning apparatus may comprise a drive arrangement to drive the marker element into the first article.
  • the drive arrangement may comprise a drive fitment, which may be mountable on a power tool.
  • the drive fitment may comprise a drive member to be received in the drive recess of the marker element.
  • the drive arrangement may further comprise a fastening assembly to fasten the drive arrangement to the marker element.
  • the fastening assembly may comprise a bayonet type fixing.
  • the fastening assembly may comprise a projecting member on the main portion.
  • the projecting member may extend outwardly from the main portion, and may comprise an outwardly extending flange.
  • the fastening assembly may further include a reaction member movably mounted on the drive arrangement.
  • the reaction member may extend around the drive arrangement and may comprise a sleeve slidably mounted on the drive arrangement.
  • the reaction member may be provided on the elongate main portion.
  • the fastening assembly may comprise urging means extending from the projecting member to the reaction member to urge the reaction member away from the projecting member.
  • the reaction member may comprise an outwardly extending lip.
  • the urging means may extend between the lip and the projecting member. Where the reaction member comprises a sleeve, the outwardly extending lip may extend around the sleeve.
  • a finger may be provided on the reaction member.
  • the projecting member may define an aperture to receive therethrough the finger, which may extend downwardly from the reaction member.
  • the fastening assembly may comprise two fingers which may be arranged substantially opposite each other on the reaction member.
  • the projecting member may define two apertures, and the, or each, aperture may be a curved slot.
  • The, or each, finger may be received through the apertures in the projecting member.
  • The, or each, finger may have an inwardly extending detent formation thereon to cooperate with a respective fastening formation on the marker element.
  • Figure 1 is a side view of a first embodiment of a surgical positioning apparatus
  • Figure 2 is a perspective view of the surgical positioning apparatus shown in Figure 1;
  • Figure 3 is a perspective view of a main body of a securing assembly
  • Figure 4 is a bottom plan view of the main body shown in Figure 3;
  • Figure 5 is a side view of the main body shown in Figure 3;
  • Figure 6 is a top plan view of the main body shown in Figure 3;
  • Figure 7 is a perspective view of a second embodiment of the surgical positioning apparatus.
  • Figure 8 is a lower perspective view of a region of a marking element showing a fastening arrangement thereon;
  • Figure 9 is a side view of the marking element shown in Figure 8.
  • Figure 10 is a side view of a part of a locating arrangement used in the second embodiment
  • Figure 11 is bottom perspective view of the locating arrangement shown in Figure 10;
  • Figure 12 is a perspective view of a part of a fastening arrangement for use in the locating arrangement of the second embodiment
  • Figure 13 is a top perspective view of a top region of a marking element
  • Figure 14 is a top view of a marking element
  • Figure 15 is a side view of an upper region of a marking element
  • Figure 16 is a perspective view of a marking element with a drive arrangement thereon;
  • Figure 17 is a close-up front view of the marking element shown in Figure 11 , showing the fastening of the drive arrangement thereon;
  • Figure 18 is a side view of the marking element shown in Figure 12;
  • Figure 19 shows the second embodiment of the positioning apparatus with a positioning member in a first position;
  • Figure 20 is shows the positioning apparatus shown in Figure 14 with the positioning member in a second position.
  • Figures 1 and 2 show a surgical positioning apparatus 10, which comprises a surgical positioning device 12 and two marker elements, in the form of datum screws 14A, 14B.
  • the surgical positioning device 12 comprises a securing assembly 16, a locating arrangement 18, and an indicating arrangement 20.
  • the securing assembly 16 comprises a main body 22, and securing means comprising first and second securing members in the form of first and second securing screws 24, 26.
  • the main body 22 defines first and second threaded screw receiving apertures 28, 30, shown in Figures 3 to 5.
  • Each of the first and second securing screws 24, 26 has a head 32 and a threaded shank, as would be understood by those skilled in the art.
  • the main body also defines a main hole 36 to receive the locating arrangement, as explained below.
  • Each of the heads 32 defines a recess 33 having a hexagonal profile to receive a hexagonal profiled key, such as an Allen key, which can be used to ensure that the first and second securing screws 24, 26 are screwed in to the respective first and second threaded screw receiving apertures 28, 30 sufficiently securely for the purposes of the use of the surgical positioning apparatus 10.
  • a hexagonal profiled key such as an Allen key
  • the locating arrangement 18 extends through the main hole 36 through the main body 22 of the securing assembly 16.
  • the locating arrangement 18 comprises an elongate cylindrical post 38 and a locating member 40.
  • the locating member 40 has a regular hexagonal profile and can be received by the selected datum screw 14A or 14B, as explained in the paragraph directly below.
  • Each of the datum screws 14A, 14B comprises a threaded shank 42 and a head 44.
  • the top of the head 44 defines a key receiving recess 46 having a profile of a regular hexagon.
  • the key receiving recess 46 can receive a key, such as an Allen key, to drive the respective datum screw 14A or 14B into the iliac crest of a patient's pelvis during total hip arthroplasty.
  • the longer of the two datum screws 14A is selected. If, however, the patient is less, or not, obese, then the shorter datum screw 14B can be selected.
  • the locating member 40 has a profile which corresponds to the profile and size of the key receiving recess 46 and, therefore, is a snug fit within the key receiving recess 46. Thus, when the locating member 40 is received in the key receiving recess 46, the locating arrangement 18 cannot rotate relative to the datum screw 14A or 14B.
  • the locating arrangement 18 When the locating arrangement 18 is received in the main hole 36 of the main body 22, it can be secured therein by the first securing screw 24.
  • the threaded aperture 28 overlaps the main hole 36 so that the shank 34 of the first securing screw 24 engages the elongate cylindrical post 38, thereby securing the locating arrangement 18 to the main body 22 of the securing assembly 16.
  • the main body 22 can be slid up and down the elongate cylindrical post 38, or rotated about the axis of the elongate cylindrical post 38.
  • the first securing screw 24 can be screwed into the threaded aperture 28 to engage the elongate cylindrical post 38 to secure the locating arrangement 18 to the main body 22.
  • the indicating arrangement 20 comprises an elongate arm 48 and indicating means 50 extending from one end of the elongate arm 48.
  • the indicating means comprises an indicating member 51 having an indicating portion 52 which extends orthogonally to the elongate arm 48.
  • the elongate arm 48 defines a positioning slot 54 which extends along a major proportion of the length of the elongate arm 48.
  • the securing assembly 16 further includes a guide member 56 on the main body 22.
  • the guide member 56 comprises an outwardly extending guide portion 58 and a connecting portion 60 to connect the guide portion 58 to the main body 22.
  • the main body 22 and the guide member 56 are arranged such that the guide portion 58 is arranged to extend across an upper surface of the elongate arm 48, with the main body 22 arranged beneath the elongate arm 48.
  • the connecting portion 60 extends from the guide portion 58 to the main body 22 through the positioning slot 54.
  • the guide portion 58 has a width G, which is less than the width S of the positioning slot 54 in the elongate arm 48. Thus, the guide portion 58 can be inserted through the positioning slot 54 and then twisted to its position shown in Figure 2.
  • the elongate arm 48 is provided with a scale 62 in millimetres which can measure the distance moved along the elongate arm 48 by the securing assembly 16.
  • the cylindrical post 38 is provided with a further scale 64 in millimetres which can measure the distance moved by the cylindrical post 38 through the main body 22.
  • the placement of the femoral and acetabular implant will change the medial/lateral and proximal/distal position of the joint centre of rotation which may affect leg length and offset. This is corrected using various angles of femoral stem neck and femoral head offset but the correct positioning is estimated by using trial components, comparing the patient's limbs and checking joint laxity.
  • the above described embodiment of the surgical positioning apparatus 10 provides an initial datum measurement of the joint positioning prior to cutting the bone, and allows corrections to be made to alter the datum position according to estimates made from the x-rays prior to surgery. Then the patient's physiology can be adjusted using the trials/implants to meet the positioning shown by the surgical positioning apparatus 10.
  • one of the datum screws 14A or 14B is screwed into the iliac crest on the patient's pelvis, and stands just proud of the patient's skin.
  • a hole is first drilled in the iliac crest, using a drill bit supplied with the positioning apparatus 10.
  • a drill guide (not shown) is also provided with the surgical positioning apparatus 10 to guide the drilling of the hole.
  • one of the datum screws 14A or 14B is inserted into the hole and screwed in.
  • the datum screws 14A and 14B are self tapping screws and therefore create threads in the bone as they are screwed in.
  • the locating member 40 is inserted into the key receiving recess 46 in the top of the head 44.
  • the cylindrical post 38 is received through the main hole 36 in the main body 22 of the securing assembly 16.
  • the first securing screw 24 is screwed into the first screw receiving aperture 28 in the main body 22, until the shank of the first securing screw 24 engages the cylindrical post 38, thereby securing the cylindrical post 38 to the main body 22.
  • the indicating arrangement 20 is arranged as shown in Figures 1 and 2 and the second securing screw 26 is received in the second screw receiving aperture 30 at the top of the main body 22.
  • the second securing screw 26 is screwed into the second screw receiving aperture 30 until the head 32 engages the elongate arm 48, thereby securing the indicating arrangement 20 to the main body 22 of the securing assembly 16.
  • the first and second securing screws 24, 26 can be released to allow adjustment of the position of the locating arrangement 18 relative to the main body 22, and of the position of the indicating arrangement 20 relative to the main body 22.
  • the first and second securing screw 24, 26 can be tightened against the suitable post 38 and the elongate arm 48 respectively to secure of the locating arrangement 18 and the indicating arrangement 20 to the main body 22.
  • the locating arrangement 18 and the indicating arrangement 20 are arranged so that the indicating portion 52 of the indicating member 50 is disposed over of the greater trochanter, and a mark is then made on the greater trochanter.
  • the surgical positioning device 12 With the surgical positioning device 12 so arranged and secured as described above, it is removed from the datum screw 14A or 14B, and put to one side. If desired, the positions of the locating arrangement 18 and the indicating arrangement 20 can be adjusted by the surgeon in order to improve the position of the patient's leg after surgery.
  • Precise adjustments can be made by the use of the scales 62 on the elongate arm 48, with the guide portion 58 of the guide member 56 being used to determine the distance moved by the main body 22 relative to the elongate arm 48.
  • the scale 64 on the cylindrical post 38 allows precise positioning of the cylindrical post 38. Such adjustments may be desirable if, for example, the joint was damaged by arthritis.
  • the datum screw 14A or 14B remains in situ during surgery. After surgery has been completed, the surgical positioning device 12 is then mounted again on the datum screw 14A or 14B, and the patient's leg is positioned such that the mark already made on the greater trochanter is arranged directly below the indicating portion 52. Thus, the leg is either returned back to its pre-surgical position or, if adjustments were made to the position of the locating arrangement 18 and the indicating arrangement 20 by the surgeon, and the leg is disposed in an improved position.
  • the key receiving recesses 46 in the tops of the datum screws 14A, 14B may be of any regular polygonal profile.
  • FIG. 7 to 20 A modification of the surgical positioning apparatus 10 is shown Figures 7 to 20, and comprises many of the features of the embodiment shown in Figures 1 to 6 and these features have been designated with the same reference numerals as the corresponding features in Figures 1 to 6.
  • the embodiment shown in Figures 7 to 20 differs as follows.
  • each datum screw 14A, 14B is provided with two V- shaped locating recesses 146 on opposite sides of the hexagonal key receiving recess 46.
  • a substantially cylindrical central guide recess 147 extends from the hexagonal key receiving recess 46 into the datum screw 14A or 14B.
  • the locating arrangement 18 comprises an elongate post 138 having an oblong cross-sectional profile.
  • the locating arrangement 18 further includes a pair of pins 140 of a corresponding shape to the V-shaped locating recesses 146, so that the pins 140 are a tight fit in the locating recesses 146.
  • the locating arrangement further includes a substantially cylindrical guide projection 149 (see Figures 10 and 11), which can be received in the central guide recess 147.
  • the guide projection 149 is received in the central guide recess 147 to guide the locating arrangement onto the datum screw 14A or 14B.
  • the pins 140 are received in the V-shaped recesses 146 to arrange the locating arrangement 18 in the desired orientation.
  • the locating arrangement 18 further includes a fastening assembly 148 (see Figures 8, 9 and 12) to fasten the locating arrangement to the datum screw 14A or 14B.
  • the fastening assembly 148 comprises a flange 150 defining two curved slots 152 opposite each other.
  • the flange 150 is fixedly mounted on the elongate post 138 and extends radially outwardly therefrom.
  • the fastening assembly 148 further includes a sleeve member 154 (see Figure 12) which defines a hole 155 therethrough to slidably mount the sleeve member 154 around the elongate post 138, and a pair of fingers 156 extend from the sleeve member 154. Each finger 156 extends through a respective one of the curved slots 152. A detent formation 158 is provided on, and extends inwardly from, each finger 156.
  • the sleeve member 154 has a radially outwardly extending lip 159 extending therefrom. Urging means in the form of a spring 161 is arranged between the lip 159 and the flange 150.
  • each of the datum screws 14A, 14B defines co-operating recesses 160, arranged opposite each other.
  • the co-operating recesses 160 are generally J-shaped, and are configured to cooperate with the detent formations 158 in the manner of a bayonet type fitting, to fasten the locating arrangement 18 to the datum screw 14A or 14B.
  • the spring 161 urges the lip 159 away from the flange 150, and thus assists in fastening the datum screw 14A or 14B to the locating arrangement 18.
  • a drive arrangement 162 is provided (see Figures 11 to 13), which comprises a drive fitment 164 to be connected to a power tool, and a further fastening assembly 248, which is generally the same as the first mentioned fastening assembly 148, and operates in the same way.
  • the drive fitment 164 includes a drive member 166 having a hexagon shaped profile, which is received in the hexagonal key receiving recess 46 to drive the datum screw 14A, 14B.
  • the drive fitment 164 also includes a mounting member 167 to mount the drive fitment on a power tool (not shown) to drive the screw 14A or 14B into the bone.
  • the further fastening assembly 248 comprises the same features as the first mentioned fastening assembly 148.
  • the further fastening assembly 248 comprises a flange 150 extending from the power tool fitment.
  • the flange 150 defines two curved slots 152 through which fingers 156 on a sleeve member 154 can be received.
  • the lip 159 extends radially outwardly from the sleeve member 154, and a spring 161 is mounted between the flange 150 and the lip 159.
  • Inwardly extending detent formations 158 on the fingers are provided to cooperate with the co-operating recesses 160 on the datum screws 14A, 14B.
  • the further fastening assembly 248 fastens the drive fitment 164 to the datum screw 14A or 14B to allow it to be driven into the patient's iliac crest.
  • the surgical positioning device 12 comprises an adjustable indicating means 250 comprising a movable indicating member 252, which is movable relative to the arm 48 between a first position shown in Figure 14 and a second position shown in Figure 15. This allows the surgical positioning device 12 to accommodate differing anatomies of different patients.
  • the indicating means 250 further includes a locking device 254 to lock the indicating member 252 in its first or second positions.
  • the locking device 254 comprises a fixed member 256 mounted on the arm 48.
  • the fixed member 256 defines an aperture 258 through which the indicating member 252 can be received.
  • the fixed member 256 also has a co-operating collar 257 to cooperate with locking formations on the indicating member 252, as explained below.
  • the fixed member 256 has an externally threaded end portion on which an internally threaded locking member 259 can be screwed.
  • the locking member 259 may comprises a nut.
  • the indicating member 252 defines locking formations in the form of first and second indentations 260, 262 defined in the indicating member 252.
  • the first and second indentations 260, 262 help secure the indicating member 252 in the first or second position.
  • the first indentation 260 is received over the co-operating collar 257 and is secured in that position by the locking member 259.
  • the second indentation 262 is received over the locking collar 257 and is secured in that position by the locking member 259.

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Abstract

A surgical positioning device (12) comprises a securing assembly (16), a locating arrangement (18) securable to the securing assembly in a selected position of the locating arrangement, and an indicating arrangement (20) securable to the securing assembly in a selected position of the indicating arrangement. The locating arrangement comprises a locating member (40) to locate the positioning device in a desired orientation relative to a first article. The indicating arrangement further comprises indicating means (50) to indicate the position of a second article relative to the first article.

Description

Surgical Positioning Device and Apparatus
This invention relates to surgical positioning devices. This invention also relates to surgical positioning apparatus incorporating surgical positioning devices and marker elements. More particularly, but not exclusively, this invention relates to surgical positioning devices and apparatus for use in determining the length and position of a leg during hip replacement surgery.
During hip replacement surgery, it is important to ensure that the patient has leg length equality and accurate lateralisation of the hip joint. This is particularly so during minimal invasive surgery. Present methods for determining the leg length or lateralisation of the joint lack the required accuracy.
According to one aspect of this invention, there is provided a surgical positioning device comprising a securing assembly, a locating arrangement securable to the securing assembly in a selected position of the locating arrangement, an indicating arrangement securable to the securing assembly in a selected position of the indicating arrangement, the locating arrangement comprising a locating member to locate the positioning device in a desired orientation relative to a first article, and the indicating arrangement comprising indicating means to indicate the position of a second article relative to the first article.
According to another aspect of this invention, there is provided a surgical positioning apparatus comprising a surgical positioning device as described above and a marker element which can be mounted on the first article, the marker element comprising a co-operating formation to co-operate with the locating member and hold the locating member on the marker element.
The locating arrangement may be movable relative to the securing assembly. The locating arrangement may be linearly movable relative to the securing assembly. The locating arrangement may be slidable relative to the securing assembly. The locating arrangement may be rotatably movable relative to the main body. The locating arrangement may comprise an elongate member, which may have a main axis.
In one embodiment, the locating arrangement may be rotatably movable about said main axis relative to the securing assembly. The locating arrangement may comprise an elongate main portion, which may be substantially cylindrical in configuration. In another embodiment, the main portion may have a cross sectional profile that is generally oblong in configuration.
The locating member may be provided at one end of the elongate main portion. Thus, in one embodiment, the position of the securing assembly can be adjusted relative to the locating arrangement angularly and linearly.
The locating member may comprise at least one projection. In one embodiment, the locating member may comprise a polygonal member having a polygonal cross- section. In this embodiment, the locating member may have a hexagonal cross section.
In another embodiment, the locating member may comprise a V-shaped projection. The locating arrangement may comprise two V-shaped projections arranged opposite each other. The, or each, V-shaped projection may comprise a pin.
The locating arrangement may further include a guide projection to guide the locating member on the marker element. The guide projection may extend downwardly from the main portion, and may be substantially cylindrical.
The locating arrangement may further include a fastening assembly to fasten the locating arrangement to the marker element. The fastening assembly may comprise a bayonet type fixing. The fastening assembly may comprise a projecting member on the main portion. The projecting member may extend outwardly from the main portion, and may comprise an outwardly extending flange.
The fastening assembly may further include a reaction member movably mounted on the locating arrangement. The reaction member may extend around the locating arrangement and may comprise a sleeve slidably mounted on the locating arrangement. The reaction member may be provided on the elongate main portion.
The fastening assembly may comprise urging means extending from the projecting member to the reaction member to urge the reaction member away from the projecting member. The reaction member may comprise an outwardly extending lip. The urging means may extend between the lip and the projecting member. Where the reaction member comprises a sleeve, the outwardly extending lip may extend around the sleeve.
A finger may be provided on the reaction member. The projecting member may define an aperture to receive therethrough the finger, which may extend downwardly from the reaction member. Conveniently, the fastening assembly may comprise two fingers which may be arranged substantially opposite each other on the reaction member.
The projecting member may define two apertures, and the, or each, apertures may be a curved slot. The, or each, finger may be received through the apertures in the projecting member. The, or each, finger may have an inwardly extending detent formation thereon to cooperate with a respective fastening formation on the marker element. The indicating arrangement may be movable relative to the securing assembly. The indicating arrangement may be movable linearly relative to the securing assembly, and may be slidable relative to the securing assembly.
The indicating arrangement may be elongate, and may comprise an elongate arm. The elongate arm may define a slot for co-operating with the securing assembly.
The indicating means may be provided at one end of the elongate arm. The indicating means may comprise an indicating member, which may extend transverse to the elongate arm. In one embodiment, the indicating member may extend substantially orthogonally to the elongate arm. The indicating member may include an indicating portion that extends transverse to the elongate arm, and conveniently extends orthogonally to the elongate arm.
In one embodiment, the indicating member is fixed to the elongate arm. In another embodiment, the indicating member is adjustably movable relative to the elongate arm. In this embodiment, the indicating member may be removable from the elongate arm.
The indicating means may comprise a locking device on the elongate arm. The locking device may comprise a fixed member mounted on the elongate arm. The fixed member may be configured to receive the indicating member.
The fixed member may have a co-operating member to cooperate with the indicating member. The co-operating member may comprise a co-operating collar.
Desirably, the indicating member defines locking formations to co-operate with the co-operating member. The locking formation may be first and second indentations defined in the indicating member. The locking device may include a locking member mounted on the fixed member to lock the indicating member thereto. Desirably, the locking member is threaded to co-operate with threads on the fixed member. The fixed member may have an externally threaded end portion and the locking member may be correspondingly internally threaded.
One embodiment of the apparatus is suitable for use in hip replacement surgery, wherein the first article may comprise a patient's pelvis, and the second article may comprise the patient's femur. In one use of this embodiment, the marker element may be mounted on the iliac crest of the patient's pelvis, and the indicating member may indicate a positioning mark on the patient's femur, which may be on the greater trochanter of the patient's femur.
The marker element may comprise an insertion element, which may comprise a datum screw. The marker element may have a shank having a screw thread, which may be a self tapping screw thread. The marker element may have a head, which may have a co-operating formation which may be a recess to receive the locating member. The rec «ess may have planar sides to prevent rotation of the locating member relative to the marker element. The co-operating formation may be configured to co-operate with a drive element, such as a key to drive the marker element into the first article.
In one embodiment, the recess may have the profile of a regular polygon, such as a hexagon, and the locating member may have an outer profile of a regular polygon to correspond with the polygonal profile of the recess. Thus, the locating member can be inserted into the recess in the head of the marker element in one of a plurality of different orientations, depending upon the number of faces of the polygonal profile of the recess and the locating member.
In another embodiment, the marker element comprises a locating formation to locate the locating member thereon. The locating formation may be a locating recess, which may be a V-shaped recess. Desirably, the marker element has two locating recesses, both of which may be V-shaped recesses. The two locating recesses may be defined in the head of the marker element, and may be arranged opposite each other.
The marker element may define a drive recess to receive a drive element. The drive recess may have a profile of a regular polygon, such as a hexagon. The locating recesses may be defined in the head of the marker element on opposite sides of the drive recess. In this embodiment, the locating arrangement may comprise two locating members, and each of which may have a V-shaped configuration, corresponding to the shape of the corresponding locating recesses.
The marker element may define a central guide recess to receive the locating projection. The central guide recess may be defined between the locating recesses, and may extend into the marker element from the drive recess. Desirably, the guide recess extends axially into the marker element. The central guide recess may be substantially cylindrical.
The marker element may have a fastening formation to fasten the locating arrangement to the marker element. The fastening formation may be a recess in the marker element. The recess may be a J-shaped recess. The marker element may comprise two fastening formations opposite each other. Each of the fastening formations may be a J-shaped recess.
The apparatus may comprise two of the aforesaid marker elements, one being longer than the other. Where the apparatus is used in hip replacement surgery, the longer or shorter marker elements can be used depending upon the obesity of the patient. A particularly obese patient may require use of the longer marker element, where as a less obese patient may require use of the shorter marker element. The securing assembly may comprise a main body and securing means for securing the locating arrangement and the indicating arrangement to the main body. The securing means may comprise first and second securing members for securing respectively the locating arrangement and the indicating arrangement to the main body.
The first and second securing members may comprise first and second screws. The main body may define first and second threaded apertures to receive the first and second screws respectively. The first screw may engage the locating arrangement when the first screw is received in the first aperture to secure the locating arrangement to the securing assembly.
The main body may define a main receiving hole for receiving the locating arrangement therethrough. The main receiving hole may overlap with the first aperture whereby the threaded portion of the first securing member can engage the locating arrangement when the locating arrangement is received in the main receiving hole, and the first securing member is received in the first aperture. The main receiving hole and the first aperture may be transverse to each other, and are conveniently substantially mutually orthogonal.
The securing assembly may also comprise a guide member to guide movement of the indicating arrangement relative to the main body. The guide member may be mounted on the main body, and may comprise an outwardly extending guide portion and a connecting portion to connect the guide portion to the main body.
The guide member may be received by the indicating arrangement. Where the indicating arrangement comprises an elongate arm having a slot, the guide member may be received through the slot. When the guide member is received through the slot, the guide portion may extend across the slot and the connecting portion may extend through the slot. The second aperture may be arranged such that the second securing member extends through the slot when the second securing member is received in the second aperture. The head of the second securing member may engage the elongate arm to secure the elongate arm to the securing assembly.
In one embodiment, the main receiving hole and the second aperture may extend substantially parallel to each other.
The surgical positioning apparatus may comprise a drive arrangement to drive the marker element into the first article. The drive arrangement may comprise a drive fitment, which may be mountable on a power tool.
The drive fitment may comprise a drive member to be received in the drive recess of the marker element. The drive arrangement may further comprise a fastening assembly to fasten the drive arrangement to the marker element. The fastening assembly may comprise a bayonet type fixing.
The fastening assembly may comprise a projecting member on the main portion. The projecting member may extend outwardly from the main portion, and may comprise an outwardly extending flange.
The fastening assembly may further include a reaction member movably mounted on the drive arrangement. The reaction member may extend around the drive arrangement and may comprise a sleeve slidably mounted on the drive arrangement. The reaction member may be provided on the elongate main portion.
The fastening assembly may comprise urging means extending from the projecting member to the reaction member to urge the reaction member away from the projecting member. The reaction member may comprise an outwardly extending lip. The urging means may extend between the lip and the projecting member. Where the reaction member comprises a sleeve, the outwardly extending lip may extend around the sleeve.
A finger may be provided on the reaction member. The projecting member may define an aperture to receive therethrough the finger, which may extend downwardly from the reaction member. Conveniently, the fastening assembly may comprise two fingers which may be arranged substantially opposite each other on the reaction member.
The projecting member may define two apertures, and the, or each, aperture may be a curved slot. The, or each, finger may be received through the apertures in the projecting member. The, or each, finger may have an inwardly extending detent formation thereon to cooperate with a respective fastening formation on the marker element.
An embodiment of the invention will now be described by way of example only, with reference to the accompanying drawings, in which:
Figure 1 is a side view of a first embodiment of a surgical positioning apparatus;
Figure 2 is a perspective view of the surgical positioning apparatus shown in Figure 1;
Figure 3 is a perspective view of a main body of a securing assembly;
Figure 4 is a bottom plan view of the main body shown in Figure 3;
Figure 5 is a side view of the main body shown in Figure 3;
Figure 6 is a top plan view of the main body shown in Figure 3; Figure 7 is a perspective view of a second embodiment of the surgical positioning apparatus.
Figure 8 is a lower perspective view of a region of a marking element showing a fastening arrangement thereon;
Figure 9 is a side view of the marking element shown in Figure 8;
Figure 10 is a side view of a part of a locating arrangement used in the second embodiment;
Figure 11 is bottom perspective view of the locating arrangement shown in Figure 10;
Figure 12 is a perspective view of a part of a fastening arrangement for use in the locating arrangement of the second embodiment;
Figure 13 is a top perspective view of a top region of a marking element;
Figure 14 is a top view of a marking element;
Figure 15 is a side view of an upper region of a marking element;
Figure 16 is a perspective view of a marking element with a drive arrangement thereon;
Figure 17 is a close-up front view of the marking element shown in Figure 11 , showing the fastening of the drive arrangement thereon;
Figure 18 is a side view of the marking element shown in Figure 12; Figure 19 shows the second embodiment of the positioning apparatus with a positioning member in a first position; and
Figure 20 is shows the positioning apparatus shown in Figure 14 with the positioning member in a second position.
Figures 1 and 2 show a surgical positioning apparatus 10, which comprises a surgical positioning device 12 and two marker elements, in the form of datum screws 14A, 14B. The surgical positioning device 12 comprises a securing assembly 16, a locating arrangement 18, and an indicating arrangement 20.
The securing assembly 16 comprises a main body 22, and securing means comprising first and second securing members in the form of first and second securing screws 24, 26.
The main body 22 defines first and second threaded screw receiving apertures 28, 30, shown in Figures 3 to 5. Each of the first and second securing screws 24, 26 has a head 32 and a threaded shank, as would be understood by those skilled in the art. The main body also defines a main hole 36 to receive the locating arrangement, as explained below.
Each of the heads 32 defines a recess 33 having a hexagonal profile to receive a hexagonal profiled key, such as an Allen key, which can be used to ensure that the first and second securing screws 24, 26 are screwed in to the respective first and second threaded screw receiving apertures 28, 30 sufficiently securely for the purposes of the use of the surgical positioning apparatus 10.
The locating arrangement 18 extends through the main hole 36 through the main body 22 of the securing assembly 16. The locating arrangement 18 comprises an elongate cylindrical post 38 and a locating member 40. The locating member 40 has a regular hexagonal profile and can be received by the selected datum screw 14A or 14B, as explained in the paragraph directly below.
Each of the datum screws 14A, 14B comprises a threaded shank 42 and a head 44. The top of the head 44 defines a key receiving recess 46 having a profile of a regular hexagon. The key receiving recess 46 can receive a key, such as an Allen key, to drive the respective datum screw 14A or 14B into the iliac crest of a patient's pelvis during total hip arthroplasty.
If the patient is particularly obese, then the longer of the two datum screws 14A is selected. If, however, the patient is less, or not, obese, then the shorter datum screw 14B can be selected.
The locating member 40 has a profile which corresponds to the profile and size of the key receiving recess 46 and, therefore, is a snug fit within the key receiving recess 46. Thus, when the locating member 40 is received in the key receiving recess 46, the locating arrangement 18 cannot rotate relative to the datum screw 14A or 14B.
When the locating arrangement 18 is received in the main hole 36 of the main body 22, it can be secured therein by the first securing screw 24. The threaded aperture 28 overlaps the main hole 36 so that the shank 34 of the first securing screw 24 engages the elongate cylindrical post 38, thereby securing the locating arrangement 18 to the main body 22 of the securing assembly 16.
It will be appreciated that the main body 22 can be slid up and down the elongate cylindrical post 38, or rotated about the axis of the elongate cylindrical post 38. When the desired position of the main body 22 can be selected the first securing screw 24 can be screwed into the threaded aperture 28 to engage the elongate cylindrical post 38 to secure the locating arrangement 18 to the main body 22. The indicating arrangement 20 comprises an elongate arm 48 and indicating means 50 extending from one end of the elongate arm 48. The indicating means comprises an indicating member 51 having an indicating portion 52 which extends orthogonally to the elongate arm 48.
The elongate arm 48 defines a positioning slot 54 which extends along a major proportion of the length of the elongate arm 48.
The securing assembly 16 further includes a guide member 56 on the main body 22. The guide member 56 comprises an outwardly extending guide portion 58 and a connecting portion 60 to connect the guide portion 58 to the main body 22. In use, the main body 22 and the guide member 56 are arranged such that the guide portion 58 is arranged to extend across an upper surface of the elongate arm 48, with the main body 22 arranged beneath the elongate arm 48. The connecting portion 60 extends from the guide portion 58 to the main body 22 through the positioning slot 54.
The guide portion 58 has a width G, which is less than the width S of the positioning slot 54 in the elongate arm 48. Thus, the guide portion 58 can be inserted through the positioning slot 54 and then twisted to its position shown in Figure 2.
The elongate arm 48 is provided with a scale 62 in millimetres which can measure the distance moved along the elongate arm 48 by the securing assembly 16. In addition, the cylindrical post 38 is provided with a further scale 64 in millimetres which can measure the distance moved by the cylindrical post 38 through the main body 22.
During total hip replacement surgery the placement of the femoral and acetabular implant will change the medial/lateral and proximal/distal position of the joint centre of rotation which may affect leg length and offset. This is corrected using various angles of femoral stem neck and femoral head offset but the correct positioning is estimated by using trial components, comparing the patient's limbs and checking joint laxity.
The above described embodiment of the surgical positioning apparatus 10 provides an initial datum measurement of the joint positioning prior to cutting the bone, and allows corrections to be made to alter the datum position according to estimates made from the x-rays prior to surgery. Then the patient's physiology can be adjusted using the trials/implants to meet the positioning shown by the surgical positioning apparatus 10.
During such surgery, one of the datum screws 14A or 14B is screwed into the iliac crest on the patient's pelvis, and stands just proud of the patient's skin. A hole is first drilled in the iliac crest, using a drill bit supplied with the positioning apparatus 10. A drill guide (not shown) is also provided with the surgical positioning apparatus 10 to guide the drilling of the hole. When the hole has been drilled, one of the datum screws 14A or 14B is inserted into the hole and screwed in. The datum screws 14A and 14B are self tapping screws and therefore create threads in the bone as they are screwed in.
The locating member 40 is inserted into the key receiving recess 46 in the top of the head 44. The cylindrical post 38 is received through the main hole 36 in the main body 22 of the securing assembly 16.
The first securing screw 24 is screwed into the first screw receiving aperture 28 in the main body 22, until the shank of the first securing screw 24 engages the cylindrical post 38, thereby securing the cylindrical post 38 to the main body 22.
The indicating arrangement 20 is arranged as shown in Figures 1 and 2 and the second securing screw 26 is received in the second screw receiving aperture 30 at the top of the main body 22. The second securing screw 26 is screwed into the second screw receiving aperture 30 until the head 32 engages the elongate arm 48, thereby securing the indicating arrangement 20 to the main body 22 of the securing assembly 16.
The first and second securing screws 24, 26 can be released to allow adjustment of the position of the locating arrangement 18 relative to the main body 22, and of the position of the indicating arrangement 20 relative to the main body 22. When the locating arrangement 18 and the indicating arrangement 20 are in a desired position, the first and second securing screw 24, 26 can be tightened against the suitable post 38 and the elongate arm 48 respectively to secure of the locating arrangement 18 and the indicating arrangement 20 to the main body 22.
During these initial stages of surgery, the locating arrangement 18 and the indicating arrangement 20 are arranged so that the indicating portion 52 of the indicating member 50 is disposed over of the greater trochanter, and a mark is then made on the greater trochanter.
With the surgical positioning device 12 so arranged and secured as described above, it is removed from the datum screw 14A or 14B, and put to one side. If desired, the positions of the locating arrangement 18 and the indicating arrangement 20 can be adjusted by the surgeon in order to improve the position of the patient's leg after surgery.
Precise adjustments can be made by the use of the scales 62 on the elongate arm 48, with the guide portion 58 of the guide member 56 being used to determine the distance moved by the main body 22 relative to the elongate arm 48. Similarly, the scale 64 on the cylindrical post 38 allows precise positioning of the cylindrical post 38. Such adjustments may be desirable if, for example, the joint was damaged by arthritis. The datum screw 14A or 14B remains in situ during surgery. After surgery has been completed, the surgical positioning device 12 is then mounted again on the datum screw 14A or 14B, and the patient's leg is positioned such that the mark already made on the greater trochanter is arranged directly below the indicating portion 52. Thus, the leg is either returned back to its pre-surgical position or, if adjustments were made to the position of the locating arrangement 18 and the indicating arrangement 20 by the surgeon, and the leg is disposed in an improved position.
There is thus described an effective embodiment of a surgical positioning apparatus which allows hip replacement surgery to take place and to ensure that, after surgery, the leg is in the same, or an improved, position as before.
Various modifications can be made without departing from the scope of the invention. For example, the key receiving recesses 46 in the tops of the datum screws 14A, 14B may be of any regular polygonal profile.
A modification of the surgical positioning apparatus 10 is shown Figures 7 to 20, and comprises many of the features of the embodiment shown in Figures 1 to 6 and these features have been designated with the same reference numerals as the corresponding features in Figures 1 to 6. The embodiment shown in Figures 7 to 20 differs as follows.
Referring to Figures13 to 15, each datum screw 14A, 14B is provided with two V- shaped locating recesses 146 on opposite sides of the hexagonal key receiving recess 46.
A substantially cylindrical central guide recess 147 extends from the hexagonal key receiving recess 46 into the datum screw 14A or 14B.
The locating arrangement 18 comprises an elongate post 138 having an oblong cross-sectional profile. The locating arrangement 18 further includes a pair of pins 140 of a corresponding shape to the V-shaped locating recesses 146, so that the pins 140 are a tight fit in the locating recesses 146. The locating arrangement further includes a substantially cylindrical guide projection 149 (see Figures 10 and 11), which can be received in the central guide recess 147.
The guide projection 149 is received in the central guide recess 147 to guide the locating arrangement onto the datum screw 14A or 14B. The pins 140 are received in the V-shaped recesses 146 to arrange the locating arrangement 18 in the desired orientation.
The locating arrangement 18 further includes a fastening assembly 148 (see Figures 8, 9 and 12) to fasten the locating arrangement to the datum screw 14A or 14B. The fastening assembly 148 comprises a flange 150 defining two curved slots 152 opposite each other. The flange 150 is fixedly mounted on the elongate post 138 and extends radially outwardly therefrom.
The fastening assembly 148 further includes a sleeve member 154 (see Figure 12) which defines a hole 155 therethrough to slidably mount the sleeve member 154 around the elongate post 138, and a pair of fingers 156 extend from the sleeve member 154. Each finger 156 extends through a respective one of the curved slots 152. A detent formation 158 is provided on, and extends inwardly from, each finger 156.
The sleeve member 154 has a radially outwardly extending lip 159 extending therefrom. Urging means in the form of a spring 161 is arranged between the lip 159 and the flange 150.
The upper region of each of the datum screws 14A, 14B defines co-operating recesses 160, arranged opposite each other. The co-operating recesses 160 are generally J-shaped, and are configured to cooperate with the detent formations 158 in the manner of a bayonet type fitting, to fasten the locating arrangement 18 to the datum screw 14A or 14B. The spring 161 urges the lip 159 away from the flange 150, and thus assists in fastening the datum screw 14A or 14B to the locating arrangement 18.
In order to drive the screw 14A or 14B into the iliac crest of the patient, a drive arrangement 162 is provided (see Figures 11 to 13), which comprises a drive fitment 164 to be connected to a power tool, and a further fastening assembly 248, which is generally the same as the first mentioned fastening assembly 148, and operates in the same way.
The drive fitment 164 includes a drive member 166 having a hexagon shaped profile, which is received in the hexagonal key receiving recess 46 to drive the datum screw 14A, 14B. The drive fitment 164 also includes a mounting member 167 to mount the drive fitment on a power tool (not shown) to drive the screw 14A or 14B into the bone.
The further fastening assembly 248 comprises the same features as the first mentioned fastening assembly 148. In particular, the further fastening assembly 248 comprises a flange 150 extending from the power tool fitment. The flange 150 defines two curved slots 152 through which fingers 156 on a sleeve member 154 can be received. The lip 159 extends radially outwardly from the sleeve member 154, and a spring 161 is mounted between the flange 150 and the lip 159. Inwardly extending detent formations 158 on the fingers are provided to cooperate with the co-operating recesses 160 on the datum screws 14A, 14B.
Thus, the further fastening assembly 248 fastens the drive fitment 164 to the datum screw 14A or 14B to allow it to be driven into the patient's iliac crest.
In a further modification, and with reference to Figures 7, 19 and 20, the surgical positioning device 12 comprises an adjustable indicating means 250 comprising a movable indicating member 252, which is movable relative to the arm 48 between a first position shown in Figure 14 and a second position shown in Figure 15. This allows the surgical positioning device 12 to accommodate differing anatomies of different patients.
The indicating means 250 further includes a locking device 254 to lock the indicating member 252 in its first or second positions. The locking device 254 comprises a fixed member 256 mounted on the arm 48. The fixed member 256 defines an aperture 258 through which the indicating member 252 can be received. The fixed member 256 also has a co-operating collar 257 to cooperate with locking formations on the indicating member 252, as explained below.
The fixed member 256 has an externally threaded end portion on which an internally threaded locking member 259 can be screwed. The locking member 259 may comprises a nut.
The indicating member 252 defines locking formations in the form of first and second indentations 260, 262 defined in the indicating member 252. The first and second indentations 260, 262 help secure the indicating member 252 in the first or second position. When the indicating member 252 is in the first position, the first indentation 260 is received over the co-operating collar 257 and is secured in that position by the locking member 259. Similarly, when the indicating member is in the second position, the second indentation 262 is received over the locking collar 257 and is secured in that position by the locking member 259.

Claims

1. A surgical positioning device comprising a securing assembly, a locating arrangement securable to the securing assembly in a selected position of the locating arrangement, an indicating arrangement securable to the securing assembly in a selected position of the indicating arrangement, the locating arrangement comprising a locating member to locate the positioning device in a desired orientation relative to a first article, and the indicating arrangement comprising indicating means to indicate the position of a second article relative to the first article.
2. A surgical positioning device according to Claim 1 , wherein the locating arrangement is movable relative to the securing assembly.
3. A surgical positioning device according to Claim 2, wherein the locating arrangement is linearly movable relative to the securing assembly.
4. A surgical positioning device according to Claim 2 or 3, wherein the locating arrangement is rotatably movable relative to the main body.
5. A surgical positioning device according to any preceding Claim, wherein the locating arrangement comprises an elongate main portion, and the locating member is provided at one end of the elongate main portion.
6. A surgical positioning device according to any preceding Claim, wherein the locating member comprises at least one projection.
7. A surgical positioning device according to Claim 6, wherein the locating member comprises a substantially polygonal member having a polygonal cross- section.
8. A surgical positioning device according to Claim 6, wherein the locating member comprises a V-shaped projection.
9. A surgical positioning device according to Claim 6 or 8, wherein the locating arrangement comprises two V-shaped projections arranged opposite each other.
10. A surgical positioning device according to Claim 8 or 9, wherein the locating arrangement comprises a guide projection extending substantially centrally from the main portion.
11. A surgical positioning device according to Claim 10, wherein the guide projection is substantially cylindrical.
12. A surgical positioning device according to Claim 9, 10 or 11 wherein the locating arrangement further includes a fastening assembly to fasten the locating arrangement to a marker element
13. A surgical positioning device according to Claim 12, wherein the fastening assembly comprises a projecting member on the main portion, the projecting member extending outwardly from the main portion.
14. A surgical positioning device according to Claim 13, wherein the fastening assembly further includes a reaction member movably mounted on the locating arrangement, the reaction member extending around the locating arrangement.
15. A surgical positioning device according to Claim 14, wherein the reaction member comprises a sleeve slidably mounted on the locating arrangement.
16. A surgical positioning device according to according to Claim 14 or 15, wherein the fastening assembly comprises urging means extending from the projecting member to the reaction member to urge the reaction member away from the projecting member.
17. A surgical positioning device according to Claim 16, wherein the reaction member comprises an outwardly extending lip, and the urging means extends between the lip and the projecting member.
18. A surgical positioning device according to any of Claims 14 to 17, wherein a finger extends downwardly from the reaction member, and the projecting member defines an aperture to receive therethrough the finger.
19. A surgical positioning device according to Claim 18, wherein the fastening assembly comprises two fingers which are arranged substantially opposite each other on the reaction member.
20. A surgical positioning device according to Claim 19, wherein the projecting member defines two apertures, and each finger is received through the apertures in the projecting member.
21. A surgical positioning device according to Claim 18, 19 or 20, wherein the, or each, finger has an inwardly extending detent formation thereon to cooperate with a respective fastening formation on the marker element.
22. A surgical positioning device according to any preceding Claim, wherein the indicating arrangement is linearly movable relative to the securing assembly.
23. A surgical positioning device according to Claim 22, wherein the indicating arrangement is elongate, and comprises an elongate arm, the elongate arm defining a slot for co-operating with the securing assembly.
24. A surgical positioning device according to Claim 23, wherein the indicating means is provided at one end of the elongate arm, and comprise an indicating member, which extends transverse to the elongate arm.
25. A surgical positioning device according to Claim 24, wherein the indicating member may includes an indicating portion that extends transverse to the elongate arm.
26. A surgical positioning device according to Claim 24 or 25, wherein the indicating member is fixed to the elongate arm.
27. A surgical positioning device according to Claim 24 or 25, wherein the indicating member is adjustably movable relative to the elongate arm.
28. A surgical positioning device according to Claim 27, wherein the indicating means comprises a locking device on the elongate arm, the locking device comprising a fixed member mounted on the elongate arm, the fixed member being configured to receive the indicating member, and the locking device further comprising a locking member to lock the indicating member to the locking device.
29. A surgical positioning device according to Claim 28, wherein the fixed member has a co-operating member to cooperate with the indicating member.
30. A surgical positioning device according to Claim 28 or 29, wherein the indicating member defines locking formations to co-operate with the co-operating member.
31. A surgical positioning device according to Claim 30, wherein the locking formations are first and second indentations defined in the indicating member.
32. A surgical positioning device according to any of Claims 28 to 31 , wherein the locking member is threaded to co-operate with threads on the fixed member, and the fixed member has an externally threaded end portion and the locking member is correspondingly internally threaded.
33. A surgical positioning device according to any preceding Claim, wherein the securing assembly comprises a main body and securing means for securing the locating arrangement and the indicating arrangement to the main body.
34. A surgical positioning device according to Claim 33, wherein the securing means comprises first and second securing members for securing respectively the locating arrangement and the indicating arrangement to the main body.
35. A surgical positioning device according to Claim 34, wherein the first and second securing members comprise first and second screws, and the main body defining first and second threaded apertures to receive the first and second screws respectively, and the first screw engaging the locating arrangement when the first screw is received in the first aperture to secure the locating arrangement to the securing assembly.
36. A surgical positioning device according to Claim 34 or 35, wherein the main body defines a main receiving hole for receiving the locating arrangement therethrough, and the main receiving hole overlapping with the first aperture whereby the threaded portion of the first securing member can engage the locating arrangement when the locating arrangement is received in the main receiving hole, and the first securing member is received in the first aperture.
37. A surgical positioning device according to any of Claims 33 to 36, wherein the securing assembly comprises a guide member to guide movement of the indicating arrangement relative to the main body, the guide member being mounted on the main body, and comprising an outwardly extending guide portion and a connecting portion to connect the guide portion to the main body.
38. A surgical positioning device according to Claim 37, wherein the guide member is received by the indicating arrangement.
39. A surgical positioning device according to Claim 38, wherein the indicating arrangement comprises an elongate arm having a slot, and the guide member can be received through the slot.
40. A surgical positioning device according to Claim 39, wherein when the guide member is received through the slot, the guide portion extends across the slot and the connecting portion may extend through the slot.
41. A surgical positioning device according to Claim 39 or 40, wherein the second aperture is arranged such that the second securing member extends through the slot when the second securing member is received in the second aperture, and the head of the second securing member can engage the elongate arm to secure the elongate arm to the securing assembly.
42. A marker element which can be mounted on a first article, the marker element comprising a co-operating formation to co-operate with a locating member and hold the locating member on the marker element.
43. A marker element according to Claim 42, wherein the marker element comprises an insertion element, having a shank with a screw thread, and the marker element further having a head with a co-operating formation to cooperate with the locating member.
44. A marker element according to Claim 42 or 43, wherein the co-operating formation is configured to co-operate with a drive element to drive the marker element into the first article.
45. A marker element according to Claim 42, 43 or 44, wherein the cooperating formation comprises a recess to receive the locating member
46. A marker element according Claim 45, wherein the recess has a polygonal profile and the locating member has a corresponding outer profile.
47. A marker element according to any of Claims 42 to 46, wherein the cooperating formation comprises a locating formation to locate the locating member thereon.
48. A marker element according to Claim 47, wherein the marker element defines a drive recess to receive a drive element, the drive recess having a polygonal profile.
49. A marker element according to Claim 48, wherein the locating formation is defined in the head of the marker element adjacent the drive recess.
50. A marker element according to Claim 48 or 49, wherein the marker element has two locating formations, each being defined in the head of the marker element.
51. A marker element according to Claim 50, wherein the locating formations are provided on opposite sides of the drive recess.
52. A marker element according to any of Claims 48 to 51 , wherein each locating formation is a substantially V-shaped locating recess.
53. A marker element according to Claim 52, wherein the locating arrangement comprises at least one locating member and the, or each, locating member is of a V-shaped configuration, corresponding to the shape of the corresponding locating recesses.
54. A marker element according to any of Claims 48 to 53, wherein the marker element defines a guide recess to receive a guide projection on the locating arrangement.
55. A marker element according to Claim 54, wherein the guide recess extends axially from the drive recess into the marker element.
56. A marker element according to Claim 54 or 55, wherein the guide recess is substantially cylindrical.
57. A marker element according to any of Claims 44 to 56, wherein the marker element has a fastening formation to fasten the locating arrangement to the marker element, the fastening formation being a recess in the marker element.
58. A marker element according to Claim 57, wherein the recess is a J- shaped recess.
59. A marker element according to Claim 57 or 58, wherein the marker element comprises two fastening formations opposite each other.
60. A drive arrangement to drive the marker element into the first article, the drive arrangement comprising a drive fitment, which is mountable on a power tool.
61. A drive arrangement according to Claim 60, wherein the drive fitment comprises a drive member to co-operate with the co-operating formation of the marker element, the drive arrangement comprising a fastening assembly to fasten the drive arrangement to the marker element.
62. A drive arrangement according to Claim 61 , wherein the fastening assembly on the drive arrangement comprises a projecting member on the main portion, the projecting member extending outwardly from the main portion.
63. A drive arrangement according to Claim 62, wherein the fastening assembly on the drive arrangement further includes a reaction member movably mounted on the drive arrangement, the reaction member extending around the drive arrangement.
64. A drive arrangement according to Claim 63, wherein the reaction member comprises a sleeve slidably mounted on the drive arrangement.
65. A drive arrangement according to Claim 63 or 64, wherein the fastening assembly comprises urging means extending from the projecting member to the reaction member to urge the reaction member away from the projecting member.
66. A drive arrangement according to Claim 65, wherein the reaction member comprises an outwardly extending lip, and the urging means extends between the lip and the projecting member.
67. A drive arrangement according to any of Claims 62 to 66 comprising a finger on the reaction member, extending downwardly therefrom, wherein the projecting member defines an aperture to receive therethrough the finger.
68. A drive arrangement according to Claim 67, wherein the fastening assembly comprises two fingers which arranged substantially opposite each other on the reaction member.
69. A drive arrangement according to any of Claims 62 to 68, wherein the projecting member defines two apertures, and each, aperture is in the form of a curved slot.
70. A drive arrangement according to Claim 69, wherein each finger is received through a respective one of the apertures in the projecting member, each finger having an inwardly extending detent formation thereon to cooperate with a respective fastening formation on the marker element.
71. A surgical positioning apparatus comprising a surgical positioning device as claimed in any of Claims 1 to 43 and a marker element as claimed in any of Claims 47 to 59.
72. A surgical positioning apparatus according to Claim 71 including a drive arrangement as claimed in any of Claims 60 to 70.
PCT/GB2008/003263 2007-09-25 2008-09-25 Surgical positioning device and apparatus WO2009040537A2 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB0718623.2A GB0718623D0 (en) 2007-09-25 2007-09-25 Surgical positioning device
GB0718623.2 2007-09-25

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WO2009040537A3 WO2009040537A3 (en) 2009-07-23

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2483119A (en) * 2010-08-26 2012-02-29 Herbert David Perriton A datum and gauge to assist accurate joint replacement
CN104000648A (en) * 2014-05-15 2014-08-27 南华大学 Positioning platform of sighting device positioning device
US10244967B2 (en) 2013-04-03 2019-04-02 Brainlab Ag Method and apparatus for determining differences in geometry of subject element using landmarks

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5700268A (en) * 1997-01-06 1997-12-23 Zimmer, Inc. Device for measuring leg length and off-set for a total hip replacement
WO2000032093A1 (en) * 1998-11-25 2000-06-08 Chan Kwan Ho Apparatus and method for determining the relative position of bones during surgery
WO2001030247A1 (en) * 1999-10-25 2001-05-03 Doron Sher Device for measuring leg length
EP1310221A1 (en) * 2001-11-12 2003-05-14 Depuy Orthopaedics, Inc. Apparatus for bone positioning
WO2006119776A1 (en) * 2005-05-12 2006-11-16 Om Surgical (Uk) Limited System, method and tool for ensuring correct insertion of an artificial hip joint

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5700268A (en) * 1997-01-06 1997-12-23 Zimmer, Inc. Device for measuring leg length and off-set for a total hip replacement
WO2000032093A1 (en) * 1998-11-25 2000-06-08 Chan Kwan Ho Apparatus and method for determining the relative position of bones during surgery
WO2001030247A1 (en) * 1999-10-25 2001-05-03 Doron Sher Device for measuring leg length
EP1310221A1 (en) * 2001-11-12 2003-05-14 Depuy Orthopaedics, Inc. Apparatus for bone positioning
WO2006119776A1 (en) * 2005-05-12 2006-11-16 Om Surgical (Uk) Limited System, method and tool for ensuring correct insertion of an artificial hip joint

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2483119A (en) * 2010-08-26 2012-02-29 Herbert David Perriton A datum and gauge to assist accurate joint replacement
US10244967B2 (en) 2013-04-03 2019-04-02 Brainlab Ag Method and apparatus for determining differences in geometry of subject element using landmarks
CN104000648A (en) * 2014-05-15 2014-08-27 南华大学 Positioning platform of sighting device positioning device
CN104000648B (en) * 2014-05-15 2016-01-20 南华大学 The locating platform of sight positioner

Also Published As

Publication number Publication date
GB0718623D0 (en) 2007-10-31
WO2009040537A3 (en) 2009-07-23

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