Apparatus for, and method of, preparing hip prosthesis implantation

• US 5,910,172 A
• Filed: 05/20/1997
• Issued: 06/08/1999
• Est. Priority Date: 05/20/1997
• Status: Expired due to Term

• Current Assignee: Johnson & Johnson
• Original Assignee: Johnson & Johnson
• Inventors: Penenberg, Brad L.
• Primary Examiner(s): Isabella, David J.
• Application Number:
  US08/859,219
• Time in Patent Office: 749 Days
• Field of Search: 606/86, 606/92, 606/95, 606/89, 606/99, 606/94, 623/16, 623/18, 623/23, 128/898
• US Class Current: 623/23.21
• CPC Class Codes: A61B 17/8827 with filtering, degassing, venting or pressure relief means
• CPC Class Codes: A61F 2/30723 Plugs or restrictors for sealing a cement-receiving space tools for inserting plugs A61F2/4614; sealing collars for use during cementing A61B17/8808
• CPC Class Codes: A61F 2/36 Femoral heads ; Femoral endoprostheses
• CPC Class Codes: A61F 2/3662 Femoral shafts
• CPC Class Codes: A61F 2/3676 Distal or diaphyseal parts of shafts
• CPC Class Codes: A61F 2/4601 for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30112 Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2002/30113 circular
• CPC Class Codes: A61F 2002/30153 rectangular
• CPC Class Codes: A61F 2002/30158 trapezoidal
• CPC Class Codes: A61F 2002/30616 Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/3611 Heads or epiphyseal parts of femur
• CPC Class Codes: A61F 2002/3625 Necks
• CPC Class Codes: A61F 2002/3631 with an integral complete or partial peripheral collar or bearing shoulder at its base
• CPC Class Codes: A61F 2002/365 Connections of heads to necks
• CPC Class Codes: A61F 2002/4631 the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2002/4662 for measuring penetration depth
• CPC Class Codes: A61F 2002/4681 by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61F 2230/0004 Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2230/0006 : circular
• CPC Class Codes: A61F 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0026 : trapezoidal
• CPC Class Codes: A61F 2250/0064 : Sets comprising a plurality of prosthetic parts of different sizes
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel

Abstract

Each tamp in a sequence has a collar at a progressively increased distance from the bottom of a cavity in a femur relative to other tamps in the sequence. The collar on each tamp has progressively increased dimensions relative to collars on other tamps to provide a snug fit of such collar against inner walls defining the femur cavity. Bone particles are also disposed in such cavity. After the insertion of each tamp into the cavity, such tamp is driven into the cavity to pack the bone fragments in the cavity against one another, the collar and the femur inner walls. Such tamp is then removed from the cavity and the next tamp in the sequence is inserted, and driven, into the cavity. The distance for driving each tamp into the cavity may be defined by a coincidence between a marking on such tamp and the top of the femur. When the last tamp in the sequence is removed from the cavity, the cavity is filled with a binder which permeates the space between the bone particles through only a limited distance because of the tight packing of the bone particles. The prosthesis may then be properly positioned in the femur cavity. The prosthesis is slightly narrower than the last tamp so that a thin layer of the binder is formed between the prosthesis and the bone fragments. The binder hardens against the prosthesis and the bone particles to retain the prosthesis fixedly in the cavity.

Claims

1. Apparatus for use with a femur in a hip replacement where the femur has a hollow cavity defined by inner walls in the femur and where bone particles are implantable in the hollow cavity in the femur,

a tamp having an elongated shaft shaped to extend into the hollow cavity in the femur, the shaft having a collar at an intermediate position along the length of the shaft, the collar extending outwardly from the shaft in a direction transverse to the length of the shaft and being dimensional for disposition against the inner walls in the femur to provide for a packing of the bone particles in the hollow cavity in the femur in the space in the cavity below the collar.

2. Apparatus as set forth in claim 1 wherein:

a marking is provided on the shaft of the tamp at a position on the shaft to indicate that the tamp, after being driven into the hollow cavity in the femur, has been inserted into the proper depth in the femur.

3. Apparatus as set forth in claim 1 wherein:

a handle is attached to an upper end of the tamp and is provided with a cap at an upper end of the handle to receive forces for driving the tamp into the hollow cavity in the femur.

4. In combination,

a femur having a hollow cavity defined by internal walls in the femur, bone particles disposed in the hollow cavity, and

a plurality of tamps having characteristics for progressive disposition in the hollow cavity,

each individual one of the tamps having an elongated shaft with a collar extending outwardly in a direction transverse to the length of the shaft at an intermediate position along the length of the shaft, the collar in each individual one of the tamps being disposed at an individual one of a plurality of progressive positions along the length of the hollow cavity to provide for the packing of the bone fragments to an individual one of the plurality of the progressive positions along the length of the hollow cavity.

5. In a combination as set forth in claim 4 wherein:

the collar on each individual one of the tamps has dimensions to fit snugly in the hollow cavity at the individual one of the plurality of progressive positions in the hollow cavity.

6. In a combination as set forth in claim 4 wherein:

the plurality of progressive positions constitute a first plurality of progressive positions and wherein;

each individual one of the tamps has a depth gauge marking at an individual one of a plurality of second progressive positions along the length of the individual one of the tamps to indicate when the individual one of the tamps has been driven into the cavity to the proper depth in the cavity.

7. In a combination as set forth in claim 4 wherein:

each individual one of the tamps is constructed at its upper end to receive a handle and wherein;

a handle is attachable to each individual one of the tamps at the upper end of the individual one of the tamps and wherein;

the handle is constructed to receive forces for driving each individual one of the tamps into the hollow cavity to provide for a packing of the bone fragments in the cavity.

8. In a combination as set forth in claim 7 wherein:

the collar on each individual one of the tamps has dimensions to fit snugly in the hollow cavity at the individual one of the plurality of progressive positions in the hollow cavity and wherein;

the plurality of progressive positions constitute a first plurality of progressive positions and wherein;

each individual one of the tamps has a depth gauge marking along the length of the individual one of the tamps at an individual one of a plurality of second progressive positions, dependent upon the length of such individual one of the tamps, to indicate when the individual one of the tamps has been driven into the cavity to the proper depth in the cavity.

9. In a method of providing for a prosthesis of a femur in a patient'"'"'s hip, the steps of:

providing a cavity in the patient'"'"'s femur,

disposing a plurality of bone fragments in the femur cavity,

providing a tamp having a shaft with a particular length, the shaft having a collar at an intermediate position along the particular length of the shaft and extending outwardly from the shaft in a direction transverse to the length of the shaft,

inserting the tamp into the cavity after the disposition of the bone fragments in the cavity, and

providing a controlled drive of the tamp into the cavity to pack the tamp against the bone fragments in the cavity.

10. In a method as set forth in claim 9, the additional steps of:

removing the tamp from the cavity,

inserting a fluid binder into the cavity in contact with the packed particles in the cavity through a limited distance to provide for a retention of the packed particles in a fixed relationship to one another and to the inner walls of the femur, and

inserting a prosthesis into the cavity after the disposition of the binder in the cavity.

11. In a method as set forth in claim 10 wherein:

the prosthesis is driven into the cavity after the insertion of the binder into the cavity to provide for the retention of the prosthesis in a fixed relationship to the bone particles in the femur and the inner walls of the femur.

12. In a method as set forth in claim 9 wherein:

the collar on the tamp has dimensions to fit snugly in the cavity against the inner walls of the femur when the tamp has been driven a particular distance into the cavity.

13. In a method as set forth in claim 9 wherein:

a marking is provided on the tamp to indicate relative to the top of the femur when the tamp has been driven into the cavity through a particular distance.

14. In a method as set forth in claim 9 wherein:

a space is provided in the cavity between the prosthesis and the bone fragments and wherein;

the binder is inserted into the space between the prosthesis and the bone fragments to bind the prosthesis to the bone fragments.

15. In a method as set forth in claim 14 wherein:

the binder permeates the bone fragments through a limited distance along the length of the prosthesis.

16. In a method as set forth in claim 9, including the steps of:

the collar on the tamp having dimensions to fit snugly against the inner wall of the femur when the tamp has been driven a particular distance into the cavity,

providing a marking on the tamp to indicate relative to the top of the femur when the tamp has been driven into the cavity through a distance providing the snug relationship between the collar and the inner walls of the femur,

removing the tamp from the cavity,

inserting a fluid binder into the cavity in contact with the packed particles in the cavity and in contact with the inner walls in the femur to retain the packed particles in a fixed relationship to one another and to the inner walls of the femur, and

inserting a prosthesis into the cavity after the insertion of the binder into the cavity.

17. In a method as set forth in claim 16 wherein:

a space is provided in the cavity between the prosthesis and the bone fragments and wherein;

the binder is inserted into the space between the prosthesis and the bone fragments to bind the prosthesis to the bone fragments and wherein;

the binder permeates the bone fragments through a limited distance along the length of the prosthesis.

18. In a method of providing a prosthesis in a femur in a patient'"'"'s hip, the steps of:

providing a cavity in the patient'"'"'s femur,

progressively inserting bone fragments into the cavity,

providing a plurality of tamps, each having a shaft with a bottom and having a collar extending radially outwardly from the shaft at an individual distance from the bottom of the shaft to provide for the disposition of such collar at an individual one of a plurality of progressive positions in the cavity, and

inserting the tamps in sequence into the cavity in accordance with the relative distances of the collar on each of such tamps from the bottom of the shaft on the tamp to provide for the packing of progressive amounts of the bone fragments in the space in the cavity below the collars on the tamps.

19. In a method as set forth in claim 18, the step of:

driving each of the tamps into the cavity, after the insertion of the tamp into the cavity, to pack the bone particles in the cavity against the collar on the tamp and against one another and against the femur.

20. In a method as set forth in claim 18 wherein:

the tamps are driven into the cavity in a sequence involving progressive increases in the distance between the bottoms of the tamps and the positions of the collars on the tamps and wherein;

each of the tamps is driven into the cavity to provide for a packing of the collar on such tamp against the bone fragments in the cavity and wherein;

each tamp is removed from the cavity after such packing of the bone fragments in the cavity and the next tamp in the sequence is inserted into the cavity to provide for a packing of the particles in the cavity.

21. In a method as set forth in claim 18 wherein:

the cavity is defined by inner walls in the femur and wherein;

the radial dimensions of the cavity progressively increase at progressive distances from the bottom of the cavity and wherein;

the radial dimensions of the collars on the progressive tamps in the sequence progressively increase to provide a substantially snug relationship between the collars in the sequence and the inner walls of the femur at the progressive distances in the cavity from the bottom of the cavity.

22. In a method as set forth in claim 18 wherein:

the prosthesis is inserted into the cavity in the femur after the removal of the last one of the tamps in the sequence from the cavity and wherein;

the prosthesis is driven into the cavity after its insertion into such cavity.

23. In a method as set forth in claim 19 wherein:

the tamps are inserted into the cavity in a sequence involving progressive increases in the distance between the bottom of the cavity and the positions of the collars on the tamps and wherein;

each of the tamps is driven into the cavity after the insertion of the tamp into the cavity to provide for a packing of the collar on the tamp against the bone fragments in the cavity and wherein;

each tamp is removed from the cavity and the next tamp in the sequence is inserted into the cavity to provide for a packing of the collar on such tamp against the bone fragments in the cavity and wherein;

the cavity is defined by inner walls in the femur and wherein;

the radial dimensions of the cavity progressively increase at progressive distances from the bottom of the cavity and wherein;

the radial dimensions of the collars on the progressive tamps in the sequence progressively increase to provide a substantially snug relationship between the collars in the sequence and the inner walls of the femur at the progressive distances in the cavity from the bottom of the cavity and wherein;

the prosthesis is inserted into the cavity in the femur after the removal of the last one of the tamps in the sequence from the cavity and wherein;

the prosthesis is driven into the cavity after its insertion into such cavity.

24. In a method as set forth in claim 18 wherein:

the radial dimension of the prosthesis at progressive positions along the prosthesis is less than the radial dimension of the cavity to define a space at such progressive positions between the prosthesis and the bone fragments and wherein;

a binder is inserted into such space to bind the bone fragments to the prosthesis.

25. In a method as set forth in claim 24 wherein:

the binder permeates through a limited distance into the space between the bone fragments.

26. In a method as set forth in claim 23 wherein:

the radial dimension of the prosthesis at progressive positions along the prosthesis is less than the radial dimension of the cavity to define a space at such progressive positions between the prosthesis and the bone fragments and wherein;

a binder is inserted into such space to bind the bone fragments to the prosthesis and wherein;

the binder permeates through a limited distance into the space between the bone fragments.

27. In a method of providing for a prosthesis of a femur in a patient'"'"'s hip, the steps of:

providing a cavity in the patient'"'"'s femur,

packing bone fragments into the cavity at progressive incremental heights in the cavity while maintaining the shape of the cavity during such packing to substantially receive the prosthesis, and

inserting the prosthesis into the cavity after the bone fragments have been packed into the cavity at the progressive incremental heights.

28. In a method as set forth in claim 27 wherein:

the bone fragments are packed at progressive incremental heights in the cavity to the top of the cavity while maintaining the shape of the cavity during such packing to subsequently receive the prosthesis.

29. In a method as set forth in claim 27 wherein:

a fluid binder having properties of hardening is inserted into the cavity after the packing of the bone fragments in the cavity to the top of the cavity and before the insertion of the prosthesis into the cavity.

30. In a method as set forth in claim 29 wherein:

the prosthesis is inserted into the cavity after the insertion of the fluid binder into the cavity.

31. In a method as set forth in claim 29 wherein:

the prosthesis is narrower than the cavity at progressive positions along the cavity to define a space between the prosthesis and the cavity and wherein;

the fluid binder is inserted into the space between the prosthesis and the cavity.

32. In a method as set forth in claim 31 wherein:

the binder permeates through a limited distance into the space between the bone fragments.

33. In a method as set forth in claim 28 wherein:

a fluid binder having properties of hardening is inserted into the cavity after the packing of the bone fragments in the cavity to the top of the cavity and before the insertion of the prosthesis into the cavity and wherein;

the prosthesis is inserted into the cavity after the insertion of the fluid binder into the cavity and wherein;

the prosthesis is narrower than the cavity at progressive positions along the cavity to define a space between the prosthesis and the cavity and wherein;

the fluid binder is inserted into the space between the prosthesis and the cavity and wherein;

the binder permeates through a limited distance into the space between the bone fragments.