Instruments and method for minimally invasive surgery for total hips

• US 20040236341A1
• Filed: 05/20/2003
• Published: 11/25/2004
• Est. Priority Date: 05/20/2003
• Status: Active Grant

• Current Assignee: Thomas D. Petersen
• Original Assignee: Thomas D. Petersen
• Inventors: Petersen, Thomas D.
• Granted Patent: US 7,601,155 B2
• Time in Patent Office: Days
• US Class Current: 606/89
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion

Abstract

A minimally invasive surgical procedure for total hip surgery features four unique instruments that facilitate the procedure. A manual Intramedullary Femoral Broach facilitates axial alignment of the subsequent two instruments that attach to it for alignment and stability. The Femoral Neck Resector Guide slides over the proximal portion of the Broach and self centers on the patient'"'"'s femoral head to determine the height and angular rotation of resection of the femoral neck. The circular ring of the head locator and the cutting arms assure that the system will fit any size femur. The Sizer/Cutter Template is applied to the Femoral Broach from the tip with the tip removed from the intermedullary canal and seats itself firmly against the Femoral Broach raised buttress locking it into place. The Femoral Broach is then is reinserted into the intramedullary canal. When the Sizer/Cutter Template reaches the greater trochanter the Sizer is adjusted to the rotational anteversion of the canal. The handle of the Femoral Broach then is struck with a mallet until the Sizer/Cutter Template is imbedded into the proximal femoral neck intramedullary bone. The right angled Anterior Acetabulum Retractor is elongated to facilitate reaming of the acetabulum through a small anterior incision. A broadened curved proximal portion has angulated teeth that dig into the bone of the superior acetabulum to provide the fulcrum for retraction of the overlying soft tissues.

Claims

1. In an instrument system for preparing a proximal femur for total hip replacement, the improvement comprising an intermedullary femoral broach, including:

a) an elongated body having a proximal portion, a distal portion, and a buttress between said portions;

b) said proximal portion having smooth outer walls and a proximal end; and

c) said distal portion having a sharp pointed distal end and peripheral walls including longitudinally extending cutting edges.

2. The system of claim 1, wherein said buttress comprises an annular protrusion including a proximally facing shoulder and a distally facing shoulder.

3. The system of claim 1, wherein said proximal end of said proximal portion includes a broach coupling.

4. The system of claim 3, further including a handle having a handle coupling releasably attachable to said broach coupling.

5. The system of claim 1, wherein said distal portion has an outer surface comprising a plurality of flat surfaces, each of said surfaces having longitudinally extending sharp edges.

6. The system of claim 5, wherein between adjacent ones of said flat surfaces, a longitudinally extending groove is formed.

7. The system of claim 5, wherein said plurality of flat surfaces comprises six surfaces.

8. The system of claim 7, wherein between adjacent ones of said flat surfaces, a longitudinally extending groove is formed.

9. The system of claim 8, wherein six longitudinally extending grooves are provided.

10. The system of claim 1, further including a femoral neck resector guide, comprising:

a) a body having an opening therethrough permitting said body to slide over said outer walls of said proximal portion of said broach; and

b) a ring extending laterally of said body;

c) said ring sized to sit on top of a femoral head of a femur when said distal portion of said broach is placed within an intermedullary canal of said femur.

11. The system of claim 10, wherein said ring is connected to said body with an extension rod permitting said ring to self center on said femoral head.

12. The system of claim 10, wherein said ring is located to determine height and angular rotation (anteversion) of resection of a femoral neck.

13. The system of claim 10, further including a horizontal passageway through said body, and a cutting head having a body with a saw blade guiding slot therethrough and a rod receivable within said horizontal passageway to releasably attach said cutting head to said guide body.

14. The system of claim 13, wherein said cutting head has a lateral surface contoured to fit snugly against a patient'"'"'s bone.

15. The system of claim 13, wherein said cutting head comprises a left cutting head adapted to guide resection of a left femoral head, said system further including a right cutting head symmetrical to said right cutting head and adapted to be receivable in said horizontal passageway from an end opposite to an end by which said left cutting head rod is insertable into said horizontal passageway, said right cutting head being adapted to guide resection of a right femoral head.

16. The system of claim 13, wherein said horizontal passageway has a locking keyway adjacent thereto and said rod has a key extending therefrom and entering said locking slot when said rod enters said horizontal passageway to fix a rotative orientation of said cutting head with respect to said guide.

17. The system of claim 1, further including a template having a body with an opening therethrough sized to be slidably received over said distal portion of said broach, and an undersurface having a sharp periphery adapted to cut into a proximal femur after a femoral head thereof has been resected.

18. The system of claim 17, wherein said buttress comprises an annular protrusion including a proximally facing shoulder and a distally facing shoulder.

19. The system of claim 18, wherein said template body has an upper surface adapted to engage said distally facing shoulder of said buttress.

20. The system of claim 19, wherein said proximal end of said proximal portion includes a broach coupling, further including a handle having a handle coupling releasably attachable to said broach coupling.

21. The system of claim 20, wherein said handle is T-shaped and has a proximal surface adapted to be struck to drive said distally facing surface of said template into said proximal femur.

22. The system of claim 17, wherein said peripheral walls of said distal portion of said broach and said template body opening have complimentary non-circular cross-sections, thereby locking a rotative orientation of said template on said broach.

23. An anterior acetabulum retractor, comprising an L-shaped body having a proximal portion, a bend and a distal portion, said proximal portion having a longitudinally extending arcuate configuration and a proximal end.

24. The retractor of claim 23, wherein said proximal end has a plurality of teeth.