Plug pulling method

• US 5,382,251 A
• Filed: 02/14/1992
• Issued: 01/17/1995
• Est. Priority Date: 01/31/1989
• Status: Expired due to Fees

• Current Assignee: Biomet Manufacturing, LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Hughes, Gregg, Watson, Woodrow W., Klapper, Robert C., Carlson, Ted, Caillouette, James T., Berkman, John, Hood, Larry L.
• Primary Examiner(s): Hafer, Robert A.
• Assistant Examiner(s): KENEALY, DAVID
• Application Number:
  US07/836,109
• Time in Patent Office: 1,068 Days
• Field of Search: 128/24 A, 128/399, 128/400, 606/86, 606/82, 606/99, 606/92-95, 606/127, 606/128, 606/79, 606/80, 606/2, 606/15, 606/28, 623/22, 623/23, 623/16
• US Class Current: 606/99
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/22004 using mechanical vibrations, e.g. ultrasonic shock waves A61B17/225 takes precedence
• 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 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/32007 with suction or vacuum means
• CPC Class Codes: A61B 2017/320078 Tissue manipulating surface
• CPC Class Codes: A61B 2017/320089 node location
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/36 Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4607 of hip femoral endoprostheses
• CPC Class Codes: A61F 2/4657 Measuring instruments used for implanting artificial joints for surgical instruments A61B90/06
• CPC Class Codes: A61F 2002/4619 for extraction
• CPC Class Codes: A61F 2002/4631 the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/465 using heating means
• 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
• CPC Class Codes: B06B 3/00 Methods or apparatus specially adapted for transmitting mechanical vibrations of infrasonic, sonic, or ultrasonic frequency
• CPC Class Codes: F16B 21/02 Releasable fastening devices locking by rotation with snap-action F16B21/06; studs or coupling pins with resilient protrusions F16B21/08
• CPC Class Codes: F16L 37/2445 : in which a male cylindrical element is introduced into a female cylindrical element, each element containing several threads axially spaced and circumferentially discontinuous which engage with each other as a result of the rotation of one of the elements

Abstract

Disclosed is a method and apparatus for removing a polymethylmethacrylate or other cement plug from the medullary canal during hip-revision surgery. In accordance with the method, a portion of the PMMA plug is softened and a plug removal tool is advanced through the softened portion to become imbedded in the plug. The plug is permitted to harden around the tool, and the tool is withdrawn thereby pulling the plug with it. Softening may be accomplished by conducting ultrasonic energy through the removal tool tip, or by other means. Hardening is accomplished by removing the heat source and permitting passive cooling of the material, or by accelerating cooling of the material through the use of a heat sink or a circulating media such as a compressed gas. Also disclosed is a self-cooling tool tip.

Claims

1. A method of removing a deposit of cement from a cavity in a bone, comprising the steps of:

identifying a deposit of a cement in a bone cavity;

providing a removal tool comprising a working tip;

transmitting coherent light through a fiber optic waveguide to said working tip of said removal tool;

converting the energy of the coherent light to thermal energy at the working tip of the removal tool to heat at least a portion of the working tip;

conducting heat from said removal tool to the cement;

converting at least a portion of the cement from a first hardened state to a second softened state;

advancing the working tip of the removal tool into the softened portion of the cement;

permitting the softened portion of the cement to return to the first hardened state; and

thereafter

withdrawing the removal tool, thereby withdrawing the cement from the bone cavity.

2. A method as in claim 1, wherein the cement comprises polymethylmethacrylate.

3. A method as in claim 1, additionally comprising the step of deactivating the transmission of coherent light.

4. A method as in claim 1, additionally comprising the step of conducting heat away from the cement and the working tip of the tool, to permit the cement to harden around the working tip.

5. A method as in claim 4, wherein said step of conducting comprises contacting the cement with a heat sink.

6. A method as in claim 5, wherein said step of conducting comprises contacting the cement with a coolant.

7. A method as in claim 6, wherein said coolant comprises carbon dioxide.

8. A method as in claim 4, wherein said step of conducting heat away from the cement comprises the step of flowing a coolant medium through an interior passage which extends through said working tip.

9. A method as in claim 8, wherein said coolant comprises carbon dioxide.

10. A method as in claim 1, wherein the cross-sectional area through at least a portion of the working tip is greater than the cross-sectional area through at least a portion of the removal tool on the proximal side of the working tip, and wherein the method additionally comprises the step of rotating said tool to position the working tip beneath a portion of the cement remaining in the first hardened state to interlock the tool with the deposit of cement.

11. A method as in claim 1, wherein said working tip has at least one barb and the method additionally comprises the step of rotating said removal tool to position the barb beneath a portion of the cement remaining in the first hardened state to interlock the tool with the deposit of cement.