Methods and apparatus for arthroscopic prosthetic knee replacement

• US 5,304,181 A
• Filed: 10/09/1991
• Issued: 04/19/1994
• Est. Priority Date: 01/08/1990
• Status: Expired due to Term

• Current Assignee: Zimmer Technology Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: James T. Treace, Jeffrey G. Roberts, Richard B. Caspari
• Inventors: Roberts, Jeffrey G., Caspari, Richard B., Treace, James T.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): DAWSON, GLENN K
• Application Number:
  US07/773,213
• Time in Patent Office: 923 Days
• Field of Search: 606/80, 606/81, 606/87, 606/88, 606/96, 606/167, 606/170, 606/180, 606/183, 606/1, 606/79, 606/86, 606/89-91, 606/97-98, 606/168, 606/169, 606/171, 604/22, 604/27, 604/35, 408/56-59, 408/67, 408/88, 408/99, 408/110, 408/203.5, 408/237, 407/53, 407/54
• US Class Current: 606/80
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1624 Drive mechanisms therefor
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/7098 wherein the implant is permeable or has openings, e.g. fenestrated screw hollow surgical screws A61B17/864
• CPC Class Codes: A61B 17/8822 characterised by means facilitating expulsion of fluid from the introducer, e.g. a screw pump plunger, hydraulic force transmissions, application of vibrations or a vacuum
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/1602 Mills
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61M 1/84 Drainage tubes; Aspiration tips for negative pressure wound therapy A61M1/90; for surgical cutting instruments A61B17/32
• CPC Class Codes: A61M 2205/103 rotating
• CPC Class Codes: Y10S 623/919 Bone
• CPC Class Codes: Y10T 407/1948 with cutting edge entirely across end of tool [e.g., router bit, end mill, etc.]

Abstract

Methods and apparatus for prosthetic knee replacement permit preparation of tibial plateau and femoral condyle surfaces and implant of tibial and femoral protheses components with the use of arthroscopic surgical techniques. The bone surfaces are resected by moving a rotating milling cutter longitudinally across the bone surface and moving the rotating milling cutter substantially laterally across the bone. Cement is supplied between the prostheses and the bone surfaces after positioning of the prostheses on the bone, and cement bonding is enhanced by applying suction to the bone to draw the cement into the bone. The apparatus for resecting the bone surfaces includes a rotating milling cutter having a body with cutting edges and holes extending through the body communicating with the interior of the body. Suction is applied to the end of the body to draw out tissue fragments through the holes and out of the body.

Claims

1. Apparatus for resecting bone in the body of a patient comprising

a rotatable elongate milling cutter having a body terminating at a distal end, a plurality of radially extending end cutting edges disposed on said distal end and a plurality of side cutting edges extending along said milling cutter body for resecting bone externally of said milling cutter body whereby bone chips are produced externally thereof, and an interior passage in said milling cutter body;

and

means on said milling cutter for evacuating bone chips from externally of said milling cutter body to said interior passage for evacuation from the patient'"'"'s body through said passage.

2. Apparatus for resecting bone as recited in claim 1 wherein said milling cutter is hollow and said evacuating means includes at least one aperture disposed in said milling cutter body and communicating with said interior passage.

3. Apparatus for resecting bone as recited in claim 2 including a plurality of said apertures with at least one of said apertures disposed between each pair of said side cutting edges.

4. Apparatus for resecting bone as recited in claim 3 wherein said milling cutter includes a longitudinal axis, said distal end cutting edges are disposed in a plane extending transverse to said longitudinal axis of said milling cutter and said side cutting edges each extend from one of said distal end cutting edges and having a helical configuration.

5. Apparatus for resecting a bone in the body comprising

milling cutter means;

platform means for supporting said milling cutter means for movements therealong in a cutting plane and including means for supporting said milling cutter means for longitudinal and pivotal movements relative to said platform means in said cutting plane;

means for mounting said platform means relative to the bone; and

longitudinal adjustment means coupled with said platform means for moving said platform means and said cutting plane relative to said mounting means in a direction perpendicular to said cutting plane.

6. Apparatus for resecting bone as recited in claim 5 wherein said platform means includes a pivotally mounted slide member supporting said milling cutter means for sliding movement therealong.

7. Apparatus for resecting bone as recited in claim 6 wherein said platform means includes stop means for limiting pivotal movement of said slide member.

8. Apparatus for resecting bone as recited in claim 6 wherein said platform means includes a support member pivotally mounting said slide member and selectively engageable clamp means for securing said slide member at a selected angular position relative to said support member.

9. Apparatus for resecting a bone as recited in claim 8 wherein said slide member supports said milling cutter means for movement in said cutting plane, said support member is movably mounted to adjust the position of said milling cutter means in said cutting plane, and said longitudinal adjustment means is coupled with said support member.

10. Apparatus for resecting bone as recited in claim 9 wherein said platform means includes angular adjustment means coupled with said support member for adjusting the angular orientation of said cutting plane.

11. Apparatus for resecting a bone in the body comprising

milling cutter means;

platform means for supporting said milling cutter means for movements therealong in a cutting plane and including means for supporting said milling cutter means for longitudinal and pivotal movements relative to said platform means in said cutting plane; and

means for mounting said platform means relative to the bone, said mounting means including a jig for attachment to the bone and adjustment means coupled with said platform means for adjusting the angular position of said platform means relative to said jig.

12. Apparatus for resecting a bone in the body comprising

milling cutter means;

platform means for supporting said milling cutter means for movements therealong in a cutting plane and including means for supporting said milling cutter means for longitudinal and pivotal movements relative to said platform means in said cutting plane; and

means for mounting said platform means relative to the bone, said mounting means including a jig for attachment to the bone and adjustment means coupled with said platform means for adjusting the longitudinal position of said platform means relative to said jig.

13. Apparatus for resecting a bone in the body comprising

milling cutter means;

platform means for supporting said milling cutter means for movements therealong in a cutting plane and including means for supporting said milling cutter means for longitudinal and pivotal movements relative to said platform means in said cutting plane; and

means for mounting said platform means relative to the bone, said mounting means including a jig for attachment to the bone and adjustment means coupled with said platform means for adjusting the lateral position of said platform means relative to said jig.

14. Apparatus for resecting a bone in the body comprising

milling cutter means;

platform means for supporting said milling cutter means for movements therealong in a cutting plane and including means for supporting said milling cutter means for longitudinal and pivotal movements relative to said platform means in said cutting plane; and

means for mounting said platform means relative to the bone, said mounting means including a jig for attachment to the bone and adjustment means coupled with said platform means for adjusting the longitudinal and lateral positions of said platform means relative to said jig.