Apparatus and method for removal of cement from bone cavities

• US 5,167,619 A
• Filed: 05/25/1990
• Issued: 12/01/1992
• Est. Priority Date: 11/17/1989
• Status: Expired due to Term

• Current Assignee: Sonokinetics Group
• Original Assignee: Sonokinetics Group
• Inventors: Wuchinich, David G.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Pontius, Kevin
• Application Number:
  US07/529,029
• Time in Patent Office: 921 Days
• Field of Search: 606/46, 606/128, 606/169, 606/170, 606/174, 606/53, 606/79, 606/84, 606/86, 606/88, 606/99, 606/171, 604/22, 604/28, 604/27, 604/43, 604/35, 128/24 AA
• US Class Current: 604/22
• CPC Class Codes: A61B 17/164 intramedullary
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/8847 for removing cement from a bone cavity using surgical bone chisels, drills, mills, rasps, reamers or scrapers A61B17/16; using laser A61B18/20; using ultrasonic surgical instruments A61N7/00
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2017/32007 with suction or vacuum means
• CPC Class Codes: A61B 2017/320089 node location
• CPC Class Codes: A61F 2002/465 using heating means
• CPC Class Codes: A61F 2002/4685 by means of vacuum
• CPC Class Codes: A61F 9/00763 with rotating or reciprocating cutting elements, e.g. concentric cutting needles atherectomy cutting instruments A61B17/3207; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

A surgical apparatus having a handpiece, a vibration source with the handpiece for generating mechanical vibrations in response to current supplied thereto, and elongated hollow tool operatively associated with the vibration source and attached to the handpiece at a point where essentially no vibrational motion occurs, the tool extending away from the handpiece to the cement to be removed. A method removing cement using the surgical apparatus by applying the tool to the cement and thereby applying mechanical vibration to the cement causing the cement to melt. Removing the cement by suction through the hollow elongated tool. Additional alternate method steps include rotating the tool to apply shear forces to the cement being removed, cooling and damping lateral vibrations at the tool end, and irrigating the cement while melting and removing it. Associated with the alternate method steps are embodiments of the apparatus including a motor for rotating the elongated tool while vibrating and a concentric tubular members for cooling, damping, irrigation and aspiration.

Claims

1. A method of unidirectionally removing cement from bone or bone cavities containing same which comprises:

applying mechanical vibrations to cement adherent on a bone or bone cavity of a subject to melt an area of the cement by vibration; and

removing the melted cement unidirectionally from the bone or bone cavity by suction or aspiration wherein no traumatic force is applied to said bone.

2. The method of claim 1 which further comprises shearing the cement from the bone or bone cavity.

3. The method of claim 2 wherein the cement is sheared while the mechanical vibrations are applied to the cement present in the bone or bone cavity.

4. The method of claim 1 which further comprises collecting the melted cement after removal from the subject.

5. The method of claim 1 which further comprises irrigating the cement and bone or bone cavity to assist in the removal of the cement.

6. The method of claim 1 wherein ultrasonic mechanical vibrations are applied to the cement essentially simultaneous with a suction or aspiration for removal of melted cement.

7. A method of unidirectionally removing cement from bone cavities, comprising:

applying an end of an elongated hollow tool, capable of mechanical vibration, to the bone cement;

melting an area of cement by vibration of the hollow tool; and

aspirating the melted cement by suction applied through said hollow tool,

wherein the melted cement is unidirectionally removed through said hollow tool.

8. The method of claim 7, wherein the elongated hollow tool applied to the cement is a part of a surgical apparatus, said apparatus further comprising:

a handpiece having first and second ends with a first opening defined by the first end and said tool extending from said first opening;

a vibration source within the handpiece for generating mechanical vibrations in response to electrical current applied thereto, said vibration source operatively associated with the elongated hollow tool with said tool being attached to the handpiece at a point where no vibration occurs; and

aspiration means for withdrawing melted cement from the bone cavity, so that the method includes controlling the application of the vibrations.

9. The method of claim 8, further comprising rotating said tool to apply shearing forces to the bone cement.

10. The method of claim 9, wherein the apparatus further comprises rotation means operatively associated with said vibration source for rotating the elongated hollow tool enabling said tool to apply shear forces to said cement and wherein said elongated hollow tool is rotated about its longitudinal axis through at least one revolution.

11. The method of claim 10, which further comprises selecting the opening of the elongated hollow tool at the end applied to the cement to have a reduced diameter portion relative to the rest of said tool to focus the mechanical vibrations upon the area of cement to be melted.

12. The method of claim 11, wherein the reduced diameter portion of the elongated hollow tool forms a semicircular trough having longitudinally running edges and said edges are applied to said cement for increased shearing of the melted cement while the tool is rotated.

13. The method of claim 10, which further comprises generating rotational forces by a motor and transmitting said forces to said vibration source and to said elongated hollow tool for rotation thereof.

14. The method of claim 8, which further comprises cooling the elongated hollow tool and damping lateral vibrations at the end of said hollow tool.

15. The method of claim 14, which further comprises irrigating the area of melted cement to assist in removal of the melted cement.

16. The method of claim 14, which further comprises orienting and positioning means for cooling and dampening the hollow tool, concentrically with the aspiration means to assist in the removal of the melted cement.

17. A method of unidirectionally removing cement from a bone or bone cavity, which comprises:

placing a surgical apparatus, including a handpiece, a vibration source within the handpiece for generating mechanical vibrations in response to electrical current applied thereto, an elongated hollow tool operatively associated with said vibration source and attached to said handpiece at a point where essentially no vibration occurs, means for aspiration of the cement, and means for cooling and damping said hollow tool, in contact with the cement at an end of the elongated hollow tool;

melting the cement by applying energy to said vibration source and thereby transferring mechanical vibration to the cement through the elongated hollow tool to melt said cement without apply traumatic force to the bone;

aspirating the melted cement by applying suction to remove said cement unidirectionally through said elongated hollow tool; and

selectively cooling and damping lateral vibrations in said hollow tool as required to aid in aspirating by applying a cooling fluid to said elongated hollow tool.

18. The method of claim 17, which further comprises irrigating the area of melted cement to assist in removal of the melted cement.

19. The method of claim 17 which further comprises shearing the melted cement from the bone or bone cavity.

20. The method of claim 19, wherein the melted cement is sheared by rotating the hollow tool.

21. A surgical apparatus for removing cement from bone or bone cavities comprising:

an elongated hollow tool for applying mechanical vibrations to cement present on a bone or bone cavity of a subject to melt the cement by vibration;

means for removing the melted cement from the bone or bone cavity unidirectionally through the elongated tool by suction or aspiration;

a handpiece having first and second ends with a first opening defined by the first end and said tool extending from said first opening;

a vibration source within the handpiece for generating mechanical vibrations in response to electrical current applied thereto, said vibration source operatively associated with the elongated hollow tool to vibrate said tool with said tool being attached to the handpiece at a point where no vibration occurs; and

means for rotation of said tool operatively associated with said vibration source wherein said means for rotation enables said tool to rotate about its longitudinal axis through at least one revolution while vibrating to apply shearing forces to the cement;

wherein no traumatic force is applied to the bone by the vibration and rotation of the tool.

22. The surgical apparatus of claim 21, wherein the opening of the elongated hollow tool at the end applied to the cement to has a reduced diameter portion relative to the rest of said tool.

23. The surgical apparatus of claim 22, wherein the reduced diameter portion of the elongated hollow tool forms a semicircular trough having longitudinally running edges for shearing the cement.

24. The surgical apparatus of claim 21, wherein said rotation means comprises a motor for generating rotational forces and means for transmitting said forces to said vibration source and to said elongated hollow tool for rotation thereof.

25. The surgical apparatus of claim 21, wherein said vibration source includes:

a tubular piezoelectric crystal having means for electrical contact;

a union member for connecting said crystal to said elongated hollow tool and having a central passage therethrough, communicating with the elongated hollow tool; and

a hollow stem disposed inside said crystal, extending opposite from said elongated hollow tool.

26. A surgical apparatus for removing cement from bone or bone cavities, comprising:

an elongated hollow tool for applying mechanical vibrations to cement present on a bone or bone cavity of a subject to melt the cement by vibration;

means for removing the melted cement from the bone or bone cavity through the elongated tool by suction or aspiration;

a handpiece having first and second ends with a first opening defined by the first end and said tool extending from said first opening;

a vibration source within the handpiece for generating mechanical vibrations in response to electrical current applied thereto, said vibration source operatively associated with the elongated hollow tool to vibrate said tool with said tool being attached to the handpiece at a point where no vibration occurs; and

means for rotation of said tool operatively associated with said vibration source wherein said means for rotation enables said tool to rotate about its longitudinal axis through at least one revolution while vibrating to apply shearing forces to the cement;

wherein said vibration source includes;

a tubular piezoelectric crystal having means for electrical contact;

a union member for connecting said crystal to said elongated hollow tool and having a central passage therethrough, communicating with the elongated hollow tool; and

a hollow stem disposed inside said crystal extending opposing from said elongated hollow tool;

wherein the stem has a length which is not resonant at the operating frequency of the crystal, and the elongated hollow tool means has a length of Γ

/4+nΓ

/2 where n is 0 or a positive integer and Γ

=f/c where f is the frequency of operation and c is the velocity of the extensional waves in said elongated hollow tool.

27. A surgical apparatus for removing cement from bone or bone cavities comprising:

an elongated hollow tool for applying mechanical vibrations to cement present on a bone or bone cavity of a subject to melt the cement by vibration without applying traumatic force to the bone;

means for removing the melted cement from the bone or bone cavity unidirectionally through the elongated tool by suction or aspiration;

a handpiece having first and second ends with a first opening defined by the first end and said tool extending from said first opening;

a vibration source within the handpiece for generating mechanical vibrations in response to electrical current applied thereto, said vibration source operatively associated with the elongated hollow tool to vibrate said tool with said tool being attached to the handpiece at a point where no vibration occurs; and

means for cooling and damping lateral vibration at the end of said hollow tool to assist in removal of the melted cement wherein said cooling and damping means is oriented and positioned concentrically about the hollow tool.

28. The surgical apparatus of claim 27, wherein said vibration source includes:

a tubular piezoelectric crystal having means for electrical contact;

a union member for connecting said crystal to said elongated hollow tool and having a central passage therethrough, communicating with the elongated hollow tool; and

a hollow stem disposed inside said crystal, extending opposite from said elongated hollow tool.

29. The surgical apparatus of claim 28, wherein said cooling and clamping means comprises:

a hollow sleeve having first and second ends surrounding the elongated hollow tool defining an interspace between said tool and said sleeve, said sleeve first end communicating with the first opening in the handpiece, and said hollow tool extending beyond said sleeve second end, wherein a portion of the hollow tool at the end contacting the cement is cut away to define a trough shape at the end, with said cut away beginning inside the second end of the sleeve; and

a hollow tube disposed inside said hollow stem defining a second interspace between said tube and said stem, said tube communicating with said central passage for the passage of aspirated material therethrough, and said second interspace communicating with said first interspace through cooling ports defined by the union member for the passage of cooling and damping fluid therethrough.

30. A surgical apparatus for removing cement from bone or bone cavities, comprising:

an elongated hollow tool for applying mechanical vibrations to cement present on a bone or bone cavity of a subject to melt the cement by vibration;

means for removing the melted cement from the bone or bone cavity through the elongated tool by suction or aspiration;

a handpiece having first and second ends with a first opening defined by the first end and said tool extending from said first opening;

a vibration source within the handpiece for generating mechanical vibrations in response to electrical current applied thereto, said vibration source operatively associated with the elongated hollow tool to vibrate said tool with said tool being attached to the handpiece at a point where no vibration occurs; and

means for cooling and damping lateral vibration at the end of said hollow tool to assist in removal of the melted cement;

wherein said cooling and damping means is oriented and positioned concentrically about the hollow tool;

wherein said vibration source includes;

a tubular piezoelectric crystal having means for electrical contact;

a union member for connecting said crystal to said elongated hollow tool and having a central passage therethrough, communicating with the elongated hollow tool; and

a hollow stem disposed inside said crystal extending opposing from said elongated hollow tool; and

wherein said cooling and damping means comprises;

a hollow sleeve having first and second ends surrounding the elongated hollow tool defining an interspace between said tool and said sleeve, said sleeve first end communicating with the first opening in the handpiece, and said hollow tool extending beyond said sleeve second end, wherein a portion of the hollow tool at the end contacting the cement is cut away to define a trough shape at the end, with said cut away beginning inside the second end of the sleeve; and

a hollow tube disposed inside said hollow stem defining a second interspace between said tube and said stem, said tube communicating with said central passage for the passage of aspirated material therethrough, and said second interspace communicating with said first interspace through cooling ports defined by the union member for the passage of cooling and damping fluid therethrough;

wherein the stem has length which is not resonant at the operating frequency of the crystal, and the elongated hollow tool means has a length or Γ

/4+nΓ

/2 wherein n is 0 or a positive integer and Γ

=f/c where f is the frequency of operation and c is the velocity of extensional waves in said elongated hollow tool.

31. A surgical apparatus for removing cement from bone or bone cavities comprising:

a handpiece;

a vibration source within the handpiece for generating mechanical vibrations in response to electrical current applied thereto, said vibration source including a tubular piezoelectric crystal, a union member having a central passage therethrough, and a hollow stem disposed inside said crystal;

an elongated hollow tool connected to the vibration source at the union member and vibrated thereby, said tool attached to said handpiece at a point where essentially no vibration occurs, said hollow tool including an inner tubular member communicating with the central passage of the union member at one end and extending beyond an outer tubular at the opposite end for apply vibration to bone cement without applying traumatic force to the bone, said outer tubular member defining an interspace between said tubular members, and said interspace communicating with cooling ports defined by the union member; and

means for aspiration of the cement, cooling the hollow tool and damping lateral vibrations in the hollow tool, said means including a hollow tube disposed inside said hollow stem defining a second interspace between said tube and said stem, said tube communicating with said central passage for the unidirectional passage of aspirated cement material therethrough, and said second interspace communicating with said first interspace through said cooling ports for the passage of cooling and damping fluid therethrough, and wherein a portion of the inner tubular member is cut away to form a trough the end extending beyond the outer tubular member, said trough extending from the end of the inner tubular member to inside the outer tubular member.

32. The apparatus of claim 31 wherein the elongated tool means is vibrated and rotated simultaneously.

33. A method of removing cement from bone or bone cavities containing same which comprises:

applying mechanical vibrations to cement present on a bone or bone cavity of a subject to melt an area of the cement by vibration; and

removing the melted cement from the bone or bone cavity by suction or aspiration wherein no traumatic force is applied to the bone, wherein the cement is removed without interruption.