WO2009106866A1 - Instrument utilisable dans une arthroplastie par remplacement - Google Patents

Instrument utilisable dans une arthroplastie par remplacement Download PDF

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Publication number
WO2009106866A1
WO2009106866A1 PCT/GB2009/050111 GB2009050111W WO2009106866A1 WO 2009106866 A1 WO2009106866 A1 WO 2009106866A1 GB 2009050111 W GB2009050111 W GB 2009050111W WO 2009106866 A1 WO2009106866 A1 WO 2009106866A1
Authority
WO
WIPO (PCT)
Prior art keywords
connector sleeve
shell
trial
head
connector
Prior art date
Application number
PCT/GB2009/050111
Other languages
English (en)
Inventor
Andrew Burton
Steven Gowers
Original Assignee
Depuy International Ltd
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 Depuy International Ltd filed Critical Depuy International Ltd
Publication of WO2009106866A1 publication Critical patent/WO2009106866A1/fr

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Classifications

    • 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
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • 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
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2/4684—Trial or dummy prostheses
    • 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
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A61F2002/30352—Protrusion and recess of D-shaped cross-section
    • A—HUMAN NECESSITIES
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    • 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
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30487—Circumferential cooperating grooves and beads on cooperating lateral surfaces of a mainly longitudinal connection
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    • 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
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    • 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
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/305—Snap connection
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
    • 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
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30553—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting a position by translation along an axis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3611—Heads or epiphyseal parts of femur
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/3625—Necks
    • A—HUMAN NECESSITIES
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    • 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
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
    • A61F2002/365—Connections of heads to necks
    • 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
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
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    • A—HUMAN NECESSITIES
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    • 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
    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
    • A61F2002/4641—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis for disconnecting
    • A—HUMAN NECESSITIES
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    • 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
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    • 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
    • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
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    • 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
    • A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
    • A61F2250/0008—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting a position by translation along an axis or two perpendicular axes
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    • 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 an instrument for use in a joint replacement procedure.
  • trial implant instruments in a surgical procedure to implant an orthopaedic prosthesis.
  • the use of a trial instrument has the advantage that the configuration of the instrument can be assessed in relation to a mating instrument or implant with a view to selecting the ultimate implant component with the optimum configuration.
  • US-A-2001/0053935 discloses a trialling system which comprises a plurality of components. It is suitable for use in conjunction with an implant which also comprises a plurality of modular components.
  • the modular trial implant instrument can then enable the configuration of the trial implant instrument to be changed to identify an optimum configuration.
  • trialling systems to include trial implant instruments that couple to orthopaedic prosthesis components that have already been implanted. It is typically required that the trial implant instrument is securely coupled to the orthopaedic prosthesis component to ensure that inaccurate measurements do not occur due to relative movement. If the coupling is overly secure then excessive force may be required to remove the trial implant instrument, risking damage to the orthopaedic prosthesis component, or disturbance of the orthopaedic implant where it is coupled to the patient's body.
  • an instrument for use in a joint replacement procedure comprising: a generally cylindrical shell closed at one end arranged to receive a connector sleeve which is adapted to connect a trial head to a stem part of an orthopaedic joint component which is intended for location in the intramedullary cavity of a bone; wherein the shell comprises at least one connecting means comprising at least one slot or protrusion for engaging a corresponding connecting means comprising the other of the at least one slot or protrusion, the corresponding connecting means forming part of the connector sleeve such that a rotational force applied to the shell when coupled to a connector sleeve is transferred to the connector sleeve part for rotating the connector sleeve relative to the stem part of the orthopaedic joint component.
  • An advantage of the present invention is that the instrument allows a connector sleeve to be quickly and easily removed from a stem part of an orthopaedic implant without disturbing the implanted stem. Rotating the trial implant connector breaks a lock between the connector sleeve and the implanted stem without requiring a large pull out force to be applied to the trial implant connector. The applied rotational force is less likely to disturb the implantation of the stem part.
  • said shell connecting means comprises at least one protrusion extending from the closed end of the shell towards the open end of the shell, the at least one protrusion being arranged to be received within a slot within an end face of the connector sleeve such that a rotational force applied to the shell causes the shell to rotate relative to the connector sleeve until the at least one protrusion engages an end of the connector sleeve slot and transfers rotational force to the connector sleeve.
  • the shell connecting means may comprise two protrusions arranged to be received within a connector sleeve slot. The or each protrusion may be arranged to be received within an curved slot extending in an arc about an axis of the connector sleeve.
  • the protrusion may comprise an curved rib extending towards the open end of the shell through an arc about an axis of the shell, the protrusion being arranged to be received in an curved slot extending in an arc about an axis of the connector sleeve.
  • the shell further comprises a slot in a side wall of the shell arranged to be aligned with a rib on the connector sleeve during insertion of the connector sleeve into the shell such that alignment of the or each protrusion with the slot in the connector sleeve is ensured.
  • the slot may further comprise a widened portion at the open end of the shell arranged such that when the connector sleeve is fully inserted into the shell the rib is at least partially received in the widened portion.
  • the shell may further comprise a mark along a side wall of the shell arranged to be aligned with a rib on the connector sleeve when the connector sleeve is being received in the shell such that alignment of the or each protrusion with the slot in the connector sleeve is ensured.
  • Said shell connecting means may comprise or further comprise an elongate slot extending through the shell wall parallel to the axis of the cylinder, the elongate slot being arranged to receive a rib extending from the side wall of a connector sleeve such that a rotational force applied to the shell is transferred to the connector sleeve rib.
  • the elongate slot may extend to the open end of the shell such that as the shell passes over a connector sleeve the shell is arranged to be rotationally aligned with the connector sleeve by alignment of the connector sleeve rib with the elongate slot.
  • the elongate slot may further comprise a widened portion at the open end of the shell to guide the connector sleeve rib into the elongate slot.
  • the widened portion may comprise the elongate slot having outwardly tapering shoulders at the open end of the shell.
  • the instrument further comprises a handle attached to the shell which is arranged to be manipulated to transfer rotational force to the shell.
  • an assembly for use in a joint replacement procedure comprising: an instrument as described above; a trial head which corresponds to the head of an orthopaedic joint component, the trial head having a bore formed in it; and a connector sleeve for connecting the trial head to a stem part of the orthopaedic joint component, which is intended for location in the intramedullary cavity of a bone, in which the connector sleeve can be fitted into the bore in the trial head in one of a plurality of angular orientations, and in which the connector sleeve comprises a body part and a trigger which can be moved relative to the body part between an unlocked position in which the connector sleeve can be moved relative to the head part between different ones of the plurality of angular orientations and a locked position in which the connector sleeve is restrained
  • the connector sleeve and the trial head may present a cooperating rib and groove arrangement which, when the connector sleeve rib is engaged in a groove, resists angular adjustment of the connector sleeve within the bore of the head part.
  • Said shell connecting means may comprise at least one protrusion extending from the closed end of the shell towards the connector sleeve, the connector sleeve connecting means comprising or further comprising a slot within the connector sleeve, the at least one protrusion being arranged to be received within the slot in the connector sleeve such that a rotational force applied to the shell causes the shell to rotate relative to the connector sleeve until the at least one protrusion engages an end of the connector sleeve slot transferring rotational force to the connector sleeve.
  • the shell connecting means may comprise two protrusions arranged to be received within a connector sleeve slot.
  • the connector sleeve slot may comprise a curved slot extending in an arc about an axis of the connector sleeve.
  • the connector sleeve may comprise a body part and a trigger which can be moved relative to the body part between an unlocked position in which the connector sleeve when inserted into a bore formed in a trial head can be moved relative to the head part between different ones of a plurality of angular orientations and a locked position in which the connector sleeve is restrained against such movement, the curved slot being defined between the trigger and the body part.
  • the curved slot may be proximal to the side of the connector sleeve including the trigger, the trigger being coupled to the body part via webs at opposite ends of the curved slot, the webs forming a resilient portion such that the trigger is biased resiliently towards the locked position.
  • the instrument shell may further comprise an internal circumferential groove and the connector sleeve trigger further comprises a rib corresponding to the shell groove arranged such that when the connector sleeve is inserted into the shell the rib engages the circumferential groove and opposes withdrawal of the connector sleeve from the shell, the connector sleeve being adapted such that compressing the trigger part towards the body part releases the rib from the groove such that the connector sleeve can be withdrawn.
  • the circumferential groove may comprise a sloping edge on the side of the open end of the shell, the sloping edge engaging the rib such that if the connector sleeve is subjected to an axial force exceeding a predetermined amount away from the shell, the trigger part is compressed towards the body part of the connector sleeve and the connector sleeve is released from the shell.
  • an assembly for use in a joint replacement procedure comprising: an instrument as claimed in any preceding claim; a trial head and a connector sleeve as claimed in any preceding claim; and an orthopaedic joint component which comprises: a head part having the shape of a truncated sphere with a convex bearing surface which can engage and articulate with the socket component and an opposite reverse face, the head part having a blind bore with a circular cross section within it located eccentrically relative to the axis of the head part, in which the bore extends into the head part from an opening on the reverse face and is inwardly tapered continuously from the opening towards the blind end thereof; a stem part having a distal end and a head end, which can be fitted distal end first into a bone cavity; and a connector part with a circular cross-section which is tapered inwardly along the axis defined by its external surface so that it can be received snugly in the tapered bore in the head part.
  • the instrument of the invention can be made from materials which are commonly used in the manufacture of surgical instruments. Examples of such materials include metals and polymers. Examples of suitable metals which might be used in the instrument of the invention include certain stainless steels, as well as alloys of elements such as titanium. Examples of polymers which might be used in the instrument of the invention include engineering polymers such as polyaryl ether ketones, polyetherether ketones, certain polyamides and polyesters, polyolefins such as certain polyethylenes and polypropylenes, and so on. The properties of the polymer can be adapted to suit particular requirements by addition of a filler, especially a particulate filler.
  • the instrument of the invention can be used in a hip joint replacement procedure, in which case the instrument can include a stem part which can be fitted into the intramedullary cavity of a patient's femur.
  • the trial head can be arranged to articulate with a cup component which can be placed in the patient's acetabulum.
  • the trial head can articulate against the natural acetabulum if the trial head is being used during a hemi-arthroplasty.
  • the instrument of the invention may be used in a shoulder joint replacement procedure, in which case the instrument can include a stem part which can be fitted into the intramedullary cavity of a patient's humerus.
  • the trial head can be arranged to articulate with the patient's glenoid or with the glenoid component which can be fitted in the patient's glenoid.
  • Figure 1 is a view of a prepared acetabulum, in which an acetabular cup component has been implanted;
  • Figure 2 is a view along the anterior posterior axis of the head of a femur, in which a stem part of a femoral component of a hip joint prosthesis has been implanted;
  • Figure 3 is a view from below of a head part of a femoral component
  • Figure 4 is an isometric view from below of a connector in place which can be used to connect the head part shown in Figure 3 to the stem part shown in Figure 2;
  • Figure 5 is a view of the head of a femur to illustrate the offset of the bearing surface of the femoral head relative to the femoral neck;
  • Figure 6 is a view from below of a trial instrument which can be used to select the appropriate offset in an assembled femoral component
  • Figure 7 is a side view of the trial connector of the trial instrument which is shown in Figure 6;
  • Figure 8 is a side view of the head of the femur, with the trial instrument shown in Figure 6 mounted on the stem part;
  • Figure 9 is a side view of a tool which can be used to assemble the head part and the connector, shown in Figures 3 and 4 respectively;
  • Figure 10 is a view from one side of an assembled femoral component of a hip joint prosthesis according to the present invention.
  • Figure 11 is a perspective view of an alternative trial head of a trial instrument which may be substituted for the trial head shown in Figure 6;
  • Figure 12 is a perspective view of another alternative trial head of a trial instrument which may be substituted for the trial head shown in Figure 6;
  • Figure 13 is a perspective view showing a first end of the trial connector of a trial instrument as shown in Figure 7;
  • Figure 14 is a perspective view of a trial connector removal tool suitable for removing a trial connector of a trial instrument as shown in Figure 7 from a stem part of a femoral component of a hip joint prosthesis;
  • Figure 15 illustrates the trial connector removal tool of Figure 14 being aligned for engaging the trial connector of a trial instrument coupled to a stem part of a femoral component of a hip joint prosthesis;
  • Figure 16 illustrates the trial connector tool removal of Figure 14 engaging a trial connector of a trial instrument coupled to a stem part of a femoral component of a hip joint prosthesis
  • Figure 17 is a cross sectional view of the trial connector tool of Figure 14 engaging a trial connector of a trial instrument coupled to a stem part of a femoral component of a hip joint prosthesis;
  • Figure 18 is an alternative view from below of the trial instrument of Figure 6 which can be used to select the appropriate offset in an assembled femoral component;
  • Figure 19 is a view from below of an alternative trial instrument to that of Figures 6 and 18 further including a rotating indicator arranged to indicated the radial direction of maximum eccentricity;
  • Figures 20 and 21 illustrate first and second partially exploded views of the alternative trial instrument of Figure 19, illustrated partly from above and partly from below respectively.
  • Figure 1 shows a pelvis 2 which has been reamed to receive the acetabular cup component 4 of a hip joint prosthesis.
  • the acetabular cup component has been implanted using conventional techniques.
  • Figure 2 shows the head portion of a femur 10 which has been resected at the base of the femoral neck.
  • the intramedullary cavity has been prepared using conventional techniques (by reaming or broaching or a combination of the two) to receive the stem part 12 of the femoral component of a hip joint prosthesis.
  • the stem part can be fastened in the femur by means of a bone cement material, as is known.
  • the stem part can be fastened in the femur without the use of a bone cement material, as is known.
  • the stem part has a tapered spigot 14 at its exposed end on which the head part of the femoral component can be fitted. The dimensions of the spigot on the stem part are in line with existing stem parts of femoral components of hip joint prostheses.
  • Figure 3 shows the head part 20 of a femoral component of a hip joint prosthesis according to the present invention.
  • the head part has a spherical bearing surface 22 and an opposite reverse face 24.
  • the spherical bearing surface extends through an angle of arc of about 200°.
  • the radius of the bearing surface is 18 mm.
  • the distance from the reverse face of the head part to the point where the polar axis intersects the bearing surface is from 28.25 to 41.8 mm.
  • a tapered bore 26 is formed in the reverse face 24.
  • the bore has a circular cross-section.
  • the diameter of the bore is from 24.2 to 28.6 mm.
  • the depth of the bore, measured from the reverse face of the head part to the blind end of the bore, is from 9.0 to 11.5 mm.
  • the angle between the wall of the bore and its axis (which is half of the angle defined by the diametrically opposite walls of the bore) is 5°.
  • the bore 26 is offset relative to the polar axis (which is the axis extending through the centre of the sphere defined by the bearing surface, perpendicular to the reverse face).
  • the distance between the axis of the bore and the polar axis is from 2 to 4 mm.
  • the head part has a series of markings 27 on its reverse face. These relate to the distance through which the head part is offset relative to the axis of the stem part when the femoral component is assembled, as discussed below.
  • the head component has a chamfer surface 28 extending around its periphery where the bearing and reverse faces come together.
  • the chamfer surface is planar when the component is viewed in cross-section.
  • the angle between the chamfer surface and the polar axis is about 50°.
  • the chamfer surface has three markings 29 at spaced apart points. The markings are distinguishable from one another.
  • Figure 4 shows a connector 30 which can be used to connect the head part to the stem part 12 of the femoral component.
  • the connector is circular when viewed from above and is tapered inwardly along the axis defined by its external surface 32.
  • the diameter of the connector at its widest 34 point is from 24.2 to 28.3 mm.
  • the diameter of the connector at its narrowest point 36 is from 22.45 to 20.7 mm.
  • the depth of the connector measured from its top face 38 to its opposite bottom face 40 (not including the skirt which depends from the bottom face) is from 19.75 to 22.25 mm.
  • the angle between the wall of the connector and its axis (which is half of the angle defined by the diametrically opposite walls of the connector) is 5°.
  • the connector is therefore a snug fit in the bore 26 in the head part, with the top face 38 located within the bore 26 in the head part, and the bottom face 40 located adjacent to the reverse face 24 of the head part.
  • the length of the contacting surfaces of the connector and the bore measured along the axis of the bore, is from 19.75 to 22.25 mm.
  • the widest point at which the connector is in contact with the bore is at the widest part of the connector (that is at the bottom face 40).
  • the ratio of the length of the contacting surfaces of the bore in the head part and the connector when assembled, measured along the axis of the bore in the head part, to the diameter of the bore in the head part at the widest point at which it contacts the external surface of the connector is 1.23 (24.2:19.75) or 1.27 (28.3:22.25) in the two embodiments which are discussed.
  • the connector 30 has a bore 42 within it extending from the bottom face 40.
  • the bore is tapered inwardly in a direction away from the bottom face of the connector.
  • the bore is open at its opposite narrow end.
  • the bore can be blind at its narrow end.
  • a skirt 43 surrounds the bore at its open end on the bottom face 40.
  • the bore 42 in the connector is sized so that the spigot 14 on the stem is a snug fit within it.
  • Figure 5 shows the head portion of a femur prior to any resection step in a procedure for replacement of a hip joint.
  • the femur has a head part 50 and a neck 52 which extends between the head part and the femoral shaft 54.
  • the outer bearing surface 56 of the head part is smooth, for articulation with a corresponding bearing surface within the acetabulum, and extends over the head part towards the femoral shaft to a boundary line 58.
  • the bearing surface of the head part is defined by part of a sphere.
  • the axis of the head part passes through the centre of the sphere, in a direction which is perpendicular to the plane which is defined by the boundary line 58.
  • the femoral neck 52 defines an axis which extends along its central core, between the femoral shaft and the head part.
  • the head part 50 of the femur can be offset relative to the femoral neck.
  • a translational offset arises when there is a gap between the axis of the head part and the axis of the femoral neck.
  • the size of the gap between the axes can be different from one patient to another, for example in the range 0 to 10 mm.
  • the direction in which the axes are offset can vary, around the axis of the femoral neck.
  • the spherical outer surface 66 of the trial head has three notches 73 at spaced apart points.
  • the notches are distinguishable from one another, for example by means of distinguishing markings located adjacent to the notches.
  • the trial connector 64 is formed from a polymeric material. It comprises a body part 74 and a trigger 76 which is connected to the body part at one end 77.
  • the material of the trigger 76, and of the body part when the trial connector is formed as a single piece) is sufficiently resilient that the trigger can be deformed inwardly towards the body part.
  • the body part has a rib 80 which is dimensioned so that it can fit into one of the grooves 72 in the side wall of the recess.
  • the corresponding marking 67 about the perimeter of the trial head for the selected groove 72 indicates the direction of the maximum offset.
  • the surgeon is therefore able to appropriately determine the required magnitude of offset by engaging rib 80 into a chosen groove 72 and orientate the offset by rotating the trial instrument 60 upon stem part 12 until the marking 67 on the perimeter of the trial head 62 corresponding to the selected groove 72 points in the correct direction.
  • Figure 9 shows an assembly tool 90 which can be used in the assembly of the head part 20 of the femoral component and the connector 30.
  • the tool comprises a base 92 having an upstanding spigot 94.
  • the spigot has a collar 96 around it, which presents an upwardly facing surface.
  • a pair of compressible O-rings 98 is provided on the spigot, located in annular grooves therein. The sizes of the spigot and the O-rings are such that the O-rings are compressed on contact with the internal wall of the bore 42 in the connector 30 when the connector is seated on the tool with the bottom face of the skirt 43 in contact with the collar 96 on the tool. This can help to retain the connector on the spigot, by virtue of the friction forces between the O-rings and the internal surface of the bore in the connector.
  • the assembly tool 90 is made from stainless steel. It can have a ring of a rubber material located in a groove in its lower face such that it protrudes from the groove to engage the surface on which the tool is placed when in use.
  • Figure 10 shows the femoral component of a hip joint prosthesis according to the present invention which has been assembled.
  • the assembled femoral component comprises the head part 20, with the connector 30 located in the bore 26 therein.
  • the spigot 14 on the stem part 12 of the femoral component is located in the bore 42 in the connector.
  • Dislocation and leg length discrepancy are important considerations during hip arthroplasty.
  • the ability to offset the axis of a head part of a femoral implant from the neck axis of the femoral implant as described above has provided for an increased ability to reproduce the natural joint's biomechanics.
  • Certain femoral stem implants have limited flexibility in terms of stem anteversion (which may be required in order to imitate the natural joint). Therefore, it can be particularly advantageous to position the head part of the femoral implant with a pronounced anterior or posterior offset.
  • the orientation of the offset about the stem 12 for the trial head 62 can be determined by inspection of corresponding markings 67 about the perimeter of the trial head 62.
  • this illustrates an alternative trial head 100 which may be substituted for the trial head 62 illustrated in Figure 6.
  • the pole of the trial head 100 is resected to provide a substantially flattened surface 102 to host the offset markings 104 (that is, markings that indicate the direction of the offset for a corresponding magnitude of offset which is set by setting the angular position of the trial connector within the bore in the reverse surface of trial head 100).
  • the offset markings 104 may extend from the flattened surface 102 onto the articulating surface 108.
  • Figure 11 further illustrates markings 106 about the perimeter of trial head 100 which are in the same position as for markings 67 for trial head 62 illustrated in Figure 6.
  • markings 104 and 106 are numbered 1 to 8 and correspond to respective grooves 72 formed in the recess 70 on the reverse surface of trial head 100 (which is the same as for trial head 62 shown in Figure 6). Consequently, once a surgeon has selected a groove 72 to be engaged by rib 80 on the trial connector 64 (that is, the surgeon has selected the required size of offset between the axis of the trial head 100 and the axis of stem part 12) the corresponding marking 104 can be identified. The trial implant instrument 100 can then be rotated about the stem part 12 until the identified marking 104 (and also marking 106, which may not be visible to the surgeon) extends in the correct radial direction about the stem part 12.
  • larger flattened surfaces 102 increase the visibility of the markings 104.
  • larger flattened surfaces 102 reduce the extent of the articulating surface 108, and thus can interfere with the purpose of the trial implant instrument, that is checking that the final implanted prosthesis will function correctly and correctly articulate within the acetabular cup.
  • the border 108 may be defined by the angle it subtends with the polar axis at the centre of the sphere defining the articulating surface 108. Preferably this angle is no more than 60° and no less than 20°.
  • the flattened surface may comprise not more than 50% of surface area of the upper surface of the trial head 100. More preferably the flattened surface comprises not more than 30% and not less than 10% of the surface area of the upper surface of the trial head 100.
  • the size of the flattened surface is limited so as to not significantly affect the articulation of the upper surface of the trial head within the acetabular cup or against the natural acetabulum. Additionally, if the resection is too deep into the trial head then it could intersect the bore in the reverse surface of the trial head.
  • An alternative method of defining the size of the flattened surface is by reference to the reduction in the height of the trial head (measured along the polar axis of the trial head defined by the spherical articulating surface).
  • the height of the resected surface at the pole is no less than 70% of the height that the sphere would be if it was not resected.
  • the modular flattened surface 202 comprises a flattened disc 206 and at least one leg 208 (shown in outline) extending towards the articulating surface 204.
  • the leg 208 is received within a corresponding socket 210 in the articulating surface 204.
  • the at least one socket 210 and leg 208 are arranged such that the flattened surface can only be coupled to the trial head in one rotational position.
  • the leg 208 and socket 210 are key shaped, thereby ensuring correct alignment. Alternative shapes which are not rotationally symmetrical could be used.
  • the modular flattened surface 202 may support any form of marking, not limited to markings indicating a radial direction of maximum eccentricity.
  • the flattened surface 202 is located proximal to, or about, the pole of the spherical articulating surface 204.
  • the flattened surface 202 need not be planar, or circular.
  • the radius of curvature is greater than that for the spherical articulating surface.
  • the markings 106 provided around the lower periphery of the trial head could be extended upwards to close to the pole of the trial head. It will be appreciated that this would have the effect of increasing the visibility of the markings to the surgeon, though may not be as effective at increasing their visibility as providing a flattened surface to display the markings.
  • a procedure in which the invention can be implemented to provide a femoral component of a hip joint prosthesis can include the following steps.
  • Initial steps involve preparing the femur to receive the stem part. These steps are conventional, and include resection of the neck and head of the femur, and working on the intramedullary cavity in the femoral shaft so that it is appropriately dimensioned to receive the stem part.
  • the markings 104 on flattened surface 102 advantageously assist the surgeon in orientating the trial components correctly about the stem part 12 may being more visible to the surgeon than the corresponding markings 106 about the periphery of the trial head.
  • Trial connector 64 is intended to lock securely to the stem part 12 onto the implant femoral implant stem 12 during trialling in order to prevent the trial implant instrument 60 spinning during trialling, in particular during trial reduction of the joint to assess the configuration of the trial implant instrument.
  • the trial connector 64 is further compressed on to the stem 12, which can cause it to be difficult to later remove.
  • Figure 13 illustrates trial connector 64 showing the upper end 77 of the connector, (which is the face of the trial connector 64 which would be visible to a surgeon once the trial head 62, 100, 200 has been removed).
  • Upper end 77 comprises a circular hole 120 which extends through to bore 82 which receives the stem part 12 and an curved slot 122 extending through no more than 120° of the upper surface 77 towards the outer edge of the upper surface 77 proximal the trigger 76.
  • Curved slot 122 is not of uniform width throughout its length.
  • Curved slot 122 is defined by an inner curved edge and an outer curved edge joined by curved ends.
  • the inner curved edge is defined by a portion of a circle centred on the centre of the circular hole 120.
  • the outer curved edge is defined by a portion of a circle centred on the axis of the trial connector 64. As the curvature of radius of each edge differs, the curved slot 122 is wider in the centre of the slot.
  • the trial connector removal tool 124 comprises a generally cylindrical shell 126, which is appropriately sized to pass over trial connector 64, coupled to a handle 128. At a closed end 130 of shell 126 (coupled to handle 128) there is a circular recess 132. Circular recess 132 corresponds to hole 120 in the trial connector 64. In certain embodiments, a range of trial connectors of varying sizes may be provided. The bore within each trial connectors may differ. Specifically, the shape of the bore for each trial connector causes each trial connector to lock to the spigot at a different axial position along the spigot.
  • the point at which the trial connector locks to the spigot may be such that the tip of the spigot extends through the hole 120 in the trial connector 64 when the trial connector 64 is tightly locked onto the femoral stem.
  • Circular recess 132 prevents the tip of the femoral stem from limiting the insertion of the trial connector 64 into the shell 126.
  • Extending from closed end 130 are first and second protrusions 134, 136 which are arranged to engage the curved slot 122, as will be described below.
  • the removal tool 124 may be more or less protrusions for engaging the curved slot 122. For instance, there may only be a single protrusion comprising a curved rib forming the male counterpart to the female slot 122.
  • the shell 126 further comprises a slot 138.
  • the slot 138 assists the surgeon in aligning the rib 80, which ensures that the protrusions 134, 136 are received in the slot 122.
  • the slot 138 incorporates a widened portion 140 towards the open end of shell 126.
  • the rib 80 may be designed to have rotational force applied to it by the removal tool 124 in order to rotate the trial connector 64 on the spigot 14. In such embodiments the rib 80 is received in the slot and engages the sides of the slot.
  • a marking may be applied to the outside of the shell 126 for alignment with rib 80.
  • An advantage of having slot 138 is that the surgeon will be aligning the removal tool 124 while looking along the axis of the tool. The slot 138 allows the rib 80 to remain visible through the shell 126.
  • FIG. 15 this illustrates the shell of the trial connector removal tool 124 passing over the top of the trial connector 64 secured on stem part 12.
  • Slot 138 is aligned with rib 80, thereby ensuring that the protrusions 134, 136 are correctly aligned with the curved slot 122.
  • widened portion 140 may comprise sloping shoulders forming an outward taper at the open end of the shell to slot 138 further assisting the alignment of the rib 80 with slot 138.
  • the trial connector 64 and the trial connector removal tool 124 may be varied, so long as there remains at least one point of engagement between the two which can transfer a rotational force applied to the tool to the trial connector.
  • a partially circumferential groove 220 is provided around the inside of the shell 126.
  • Groove 220 is arranged to receive the circumferential rib 81 provided on the trigger part 76 of the trial connector 64.
  • Figure 17 illustrates in cross section the connection between the trial connector 64 and the removal tool 124.
  • the groove 220 differs from the groove within the recess 70 in the trial head. Groove 220 is provided with a sloping edge 222 on the side of the groove 220 towards the open end of the shell 126. When the trial connector 64 is inserted into the shell 126 the rib 81 snaps into groove 220 and the trial connector is retained in place.
  • the assembled head component (comprising the head part 20 and the connector 40) is positioned on the spigot 14 on the stem part 12.
  • the rotational alignment of the head component on the stem part offset that is determined using the trial head and the trial connector is reproduced in the head component with reference to a selected one of the markings 29 on the chamfer surface 28 which is aligned with the mark on the bone made using diathermy adjacent to the corresponding notch on the trial head.
  • An impaction force is applied to the head component through an appropriate protector (such as a block of polyethylene which is configured to be a conforming fit on the bearing surface 22 of the head part 20) to cause the head component to become secured to the stem part.
  • an appropriate protector such as a block of polyethylene which is configured to be a conforming fit on the bearing surface 22 of the head part 20
  • the trial heads incorporate markings to allow for identification of the direction of maximum eccentricity (that is, the offset between the axis of the femoral component neck and the axis of the head part) such that this information can be recorded and transferred to the final orthopaedic prosthesis.
  • the markings may not be easily visible to a surgeon. For instance, if a significant degree of anteversion is applied to a trial implant instrument which includes a marker indicating the radial direction of maximum eccentricity, the marker may be obscured within the wound. The problem is particularly acute for minimally invasive surgery where visibility of implants and trial implant instruments in general is limited. Limited visibility can result in misidentification of the correct marking indicating the radial direction of maximum eccentricity.
  • FIG 18 this illustrates the underside of the trial instrument 60 of Figure 6, further illustrating the variation in the direction of maximum eccentricity about the centre of the stem part 12 according to the selected groove 72.
  • a rib 80 forming part of trial connector 64 is engaged in a selected groove 72 within recess 70 on the underside of trial head 62.
  • the centre 150 of the trial connector 64 is offset from the centre 152 of the trial head.
  • the trial connector 64 is rotatable within recess 70, which is similarly offset.
  • Trial connector 64 incorporates a recess 82, the centre 154 of which is offset from the centre 150 of the trial connector 64.
  • Stem part 12 fits into recess 82, such that centre 154 is coincident with the axis of stem part 12.
  • Figure 18 illustrates rib 80 being engaged in the groove 72 labelled "5".
  • the magnitude of the offset between the axis of stem part 12 and the axis of the trial head is given by the distance between the centre 154 of the stem part 12 and the centre 152 of the trial head 62, and is identified by line 156.
  • the direction of maximum eccentricity is given by a vector originating at the centre 154 of the stem part 12 and extending through the centre 152 of the trial head 62, as shown by line 158.
  • Trial instrument 160 further includes a rotating indicator disc 174 (shown partly transparent to allow the underlying features to be seen), which substantially comprises a circular disc having the same radius as the underside of the trial head 162.
  • Rotating indicator 174 is pivoted about the centre 168 of trial head 162 (as will be described below).
  • Rotating indicator 174 further includes a slot 176.
  • Stem part 12 passes through the slot 176 to engage recess 166 in trial connector 164.
  • the stem part 12 engages the sides of slot 176 causing the rotating indicator to rotate about centre 168 of the trial head 162.
  • the spigot 14 is caused to move along the length of slot 176 as the distance between the centre 168 of the trial head 162 and the centre 172 of the stem part 12 varies.
  • Rotation of the rotating indicator 174 is relative to the trial head 162.
  • the long axis 178 of slot 176 (which passes through centre 168 of trial head 162 and centre 172 of stem part 12) is aligned with the direction of maximum eccentricity of the trial head 162. Consequently, the direction of maximum eccentricity of trial head 162 about the axis of the stem part 12 for any rotational position of the trial connector 164 relative to trial head 162 can be indicated by a single mark 180 on the outside edge of the rotating indicator 174. This advantageously allows a surgeon to readily identify the direction of maximum eccentricity of the trial head 162 without having to identify which of a plurality of markings he should refer to.
  • the rotating indicator need not be positioned on the underside of the trial head as shown in figures 19 to 21.
  • the rotating indicator is provided towards or at the pole of the trial head (driven by a coupling between the polar axis of the trial head and spigot 14 internal to the trial head).
  • Providing the rotating indicator closer to the pole of the trial head advantageously increases the visibility of indicator mark 180, indicating the direction of the offset (that is, the direction of maximum eccentricity).
  • a rotating indicator towards the pole of the trial head may take the form of a slice of the spherical articulating surface that is free to rotate relative to the remainder of the articulating surface.
  • the slice of the articulating surface may include the pole of the trial head.
  • connection between the trial head bore and the trial connector is smooth (that is, without the rib and groove arrangement described above in connection with figures 6, 7 and 18). Consequently, the trial connector is free to rotate within the trial head bore.
  • rotating the rotating indicator relative to the trial head has the effect of driving the rotation of the trial connector within the trial head bore (thereby varying the magnitude and direction of offset).
  • Driving the trial connector in this way has the result that the surgeon is able to set the direction of the offset by aligning the mark on the rotating indicator in the appropriate direction. The surgeon is then able to vary the magnitude of the offset by rotating the trial head while holding the rotating indicator in position. Rotating the trial head causes the trial connector to rotate within the bore in the trial head (driven by the rotating indicator) varying the magnitude of the offset.

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  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un instrument (124) utilisable dans une arthroplastie par remplacement, qui comprend un corps (126) généralement cylindrique fermé à une extrémité et conçu pour recevoir un manchon de raccord (64) servant à fixer une tête d'essai (60) à une tige (12) d'un élément d'articulation orthopédique destiné à se loger dans la cavité intramédullaire d'un os. Le corps (126) comprend au moins un moyen de raccordement (134, 136) muni au moins d'une fente ou d'une saillie de mise en prise avec un moyen de raccordement (122) correspondant comportant l'autre fente ou saillie solidaire du manchon de raccord (64), si bien qu'une force de rotation appliquée sur le corps (126), lorsque celui-ci est fixé au manchon de raccord (64), est transférée à ce dernier (64) pour l'entraîner en rotation par rapport à une tige (12) de l'élément d'articulation orthopédique. L'invention concerne en outre un ensemble utilisable dans une arthroplastie par remplacement, qui comprend l'instrument (124) de l'invention, une tête d'essai (60) percée d'un alésage (70) et conjuguée à la tête (20) d'un élément d'articulation orthopédique, et un manchon de raccord (64) pour fixer la tête d'essai (60) à une tige (12) de l'élément d'articulation orthopédique. L'ensemble peut en outre comprendre un élément d'articulation orthopédique comportant une tête (20), une tige (12) et un raccord (38).
PCT/GB2009/050111 2008-02-29 2009-02-05 Instrument utilisable dans une arthroplastie par remplacement WO2009106866A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
GBGB0803742.6A GB0803742D0 (en) 2008-02-29 2008-02-29 An instrument for use in a joint replacement procedure
GB0803742.6 2008-02-29
GBGB0803734.3A GB0803734D0 (en) 2008-02-29 2008-02-29 An instrument for use in a joint replacement procedure

Publications (1)

Publication Number Publication Date
WO2009106866A1 true WO2009106866A1 (fr) 2009-09-03

Family

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Family Applications (2)

Application Number Title Priority Date Filing Date
PCT/GB2009/050110 WO2009106865A1 (fr) 2008-02-29 2009-02-05 Instrument utilisable dans une arthroplastie par remplacement
PCT/GB2009/050111 WO2009106866A1 (fr) 2008-02-29 2009-02-05 Instrument utilisable dans une arthroplastie par remplacement

Family Applications Before (1)

Application Number Title Priority Date Filing Date
PCT/GB2009/050110 WO2009106865A1 (fr) 2008-02-29 2009-02-05 Instrument utilisable dans une arthroplastie par remplacement

Country Status (2)

Country Link
GB (2) GB0803734D0 (fr)
WO (2) WO2009106865A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013117909A1 (fr) * 2012-02-08 2013-08-15 The University Of Warwick Dispositif pour empêcher une dislocation et usure prothétique
WO2018189128A1 (fr) * 2017-04-12 2018-10-18 Depuy Ireland Unlimited Company Kit et ensemble d'essai fémoral
US11344437B2 (en) 2017-10-03 2022-05-31 Depuy Ireland Unlimited Company Trial neck apparatus and method
US11369492B2 (en) 2017-08-22 2022-06-28 Depuy Ireland Unlimited Company Trial neck
US12127955B2 (en) 2021-04-29 2024-10-29 Depuy Ireland Unlimited Company Trial component and method

Citations (7)

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Publication number Priority date Publication date Assignee Title
DE3142528A1 (de) * 1981-10-27 1983-05-11 Peter Welter GmbH + Co. KG, 5042 Erftstadt "steckschluessel, insbesondere zuendkerzenschluessel"
US20010053935A1 (en) * 2000-05-03 2001-12-20 Hartdegen Vernon D. Multi modular trialing system and instrumentation
US20050197708A1 (en) * 2001-07-11 2005-09-08 Stone Kevin T. Shoulder prosthesis
US20070107564A1 (en) * 2005-11-15 2007-05-17 Chang Sheng M Tool connecting device
FR2913590A1 (fr) * 2007-03-14 2008-09-19 Mouzayek Hicham Tige femorale de reprise modulaire
WO2008117053A1 (fr) * 2007-03-28 2008-10-02 Depuy International Limited Élément de tête de prothèse d'articulation orthopédique
WO2008132424A1 (fr) * 2007-04-28 2008-11-06 Depuy International Limited Procede permettant de determiner le decalage de la partie tete d'un composant tige de prothese articulaire orthopedique

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1258233A1 (fr) * 2001-05-18 2002-11-20 Sulzer Orthopedics Ltd. Rotule d'essai pour prothèse de hanche

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3142528A1 (de) * 1981-10-27 1983-05-11 Peter Welter GmbH + Co. KG, 5042 Erftstadt "steckschluessel, insbesondere zuendkerzenschluessel"
US20010053935A1 (en) * 2000-05-03 2001-12-20 Hartdegen Vernon D. Multi modular trialing system and instrumentation
US20050197708A1 (en) * 2001-07-11 2005-09-08 Stone Kevin T. Shoulder prosthesis
US20070107564A1 (en) * 2005-11-15 2007-05-17 Chang Sheng M Tool connecting device
FR2913590A1 (fr) * 2007-03-14 2008-09-19 Mouzayek Hicham Tige femorale de reprise modulaire
WO2008117053A1 (fr) * 2007-03-28 2008-10-02 Depuy International Limited Élément de tête de prothèse d'articulation orthopédique
WO2008132424A1 (fr) * 2007-04-28 2008-11-06 Depuy International Limited Procede permettant de determiner le decalage de la partie tete d'un composant tige de prothese articulaire orthopedique

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013117909A1 (fr) * 2012-02-08 2013-08-15 The University Of Warwick Dispositif pour empêcher une dislocation et usure prothétique
WO2018189128A1 (fr) * 2017-04-12 2018-10-18 Depuy Ireland Unlimited Company Kit et ensemble d'essai fémoral
US11826267B2 (en) 2017-04-12 2023-11-28 Depuy Ireland Unlimited Company Femoral trialling kit and assembly
US11369492B2 (en) 2017-08-22 2022-06-28 Depuy Ireland Unlimited Company Trial neck
US11344437B2 (en) 2017-10-03 2022-05-31 Depuy Ireland Unlimited Company Trial neck apparatus and method
US12127955B2 (en) 2021-04-29 2024-10-29 Depuy Ireland Unlimited Company Trial component and method

Also Published As

Publication number Publication date
WO2009106865A1 (fr) 2009-09-03
GB0803734D0 (en) 2008-04-09
GB0803742D0 (en) 2008-04-09

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