Surgical instrument for mechanical removal of bone cement, and process for production of shock waves

• US 6,264,660 B1
• Filed: 12/09/1998
• Issued: 07/24/2001
• Est. Priority Date: 06/19/1996
• Status: Expired due to Term

• Current Assignee: Endocon GmbH
• Original Assignee: Ferton Holding SA
• Inventors: Schmidt, Joachim, Simon, Bernard, Merkle, Wolfgang, Menne, Andreas, Klopfenstein, Denis
• Primary Examiner(s): Hirsch, Paul J.
• Assistant Examiner(s): Priddy, Michael B.
• Application Number:
  US09/202,136
• Time in Patent Office: 958 Days
• Field of Search: 600/104, 606/53, 606/79, 606/82, 606/86, 606/99, 606/100
• US Class Current: 606/100
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• 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 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/924 Impact element driving means
• CPC Class Codes: A61F 2/3662 Femoral shafts
• 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: B25D 9/14 Control devices for the reciprocating piston
• CPC Class Codes: G10K 15/043 producing shock waves G10K15/046, G10K15/06 take precedence; generating seismic energy G01V1/02

Abstract

In a surgical instrument for the mechanical removal of bone cement (2), comprising a longitudinal housing (4) with a cylinder (6) in which a piston element can be reciprocated by a drive means (14), wherein the piston element on the distal end (18) of the cylinder (6) exerts an impact on a chisel tool supported axially in the housing (4), it is provided that the piston element (10) comprises a projectile (10) adapted to be accelerated to a high final speed and inducing a shock wave into the chisel tool comprising a metallic shock wave transmission probe (22), the probe tip (26) of the chisel tool transmitting the shock wave to the bone cement (2) at a low movement amplitude of the probe tip (26).

Claims

1. A surgical instrument for the mechanical removal of bone cement comprising a longitudinal housing (4) housing a tubular cylinder (6) in which a piston projectile (10) can be reciprocated, means (14) for driving the piston projectile from a proximal end of the cylinder (6) toward a distal end (18) of the cylinder (6), a shock wave transmission probe (22) having a chisel tip (26) at its distal end and a proximal end (24) adapted to receive impact forces generated by said piston projectile (10), said shock wave transmission probe (22) being secured in a guide means (19,21) against torsion said driving means (14) being constructed and arranged for accelerating said piston projection (10) to a final speed of substantially 5 to 20 m/s thereby inducing a shock wave in the chisel tip (26) which is transmitted to the bone cement, means (30) for limiting the movement amplitude of the probe tip (26) to less than 1.5 mm, and said driving means (14) being constructed and arranged for transferring shock wave energy to said chisel tool (26) in the range of between substantially 0.3 J and 2 J.

2. The instrument according to claim 1, characterized in that the final speed of the piston projectile (10) is about 10 to 15 m/s.

3. The instrument according to claim 1, characterized in that the amplitude of the probe tip (26) is less than 1 mm.

4. The instrument according to claim 1, characterized in that the shock wave energy generated by the piston projectile (10) is in the range between about 0.5 J and about 1.0 J.

5. The instrument according to claim 1, characterized in that the impact frequency of the piston projectile (10) is about 6 to 20 Hz, preferably about 8 to 10 Hz.

6. The instrument according to claim 1, characterized in that the length of the probe is about 100 mm to 500 mm, preferably about 150 mm to 420 mm.

7. The instrument according to claim 1, characterized in that the diameter of the shock wave transmission probe (22) is in the range between about 1 and 6 mm, preferably between about 2 and 4 mm.

8. The instrument according to claim 1, characterized in that the shock wave transmission probe (22) is guided axially in the housing (4), and the means for limiting the movement amplitude of the probe tip (26) includes a damping spring element (30), acting in the axial direction, is arranged between the shock wave transmission probe (22) and the housing (4).

9. The instrument according to claim 1, characterized in that the piston projectile (10) transmits the impact pulse onto an intermediate element (34) arranged in flush abutment on the shock wave transmission probe (22).

10. The instrument according to claim 9, characterized in that the shock wave transmission probe (22) is hollow, and the tubular cylinder (6) has a radial opening (16) therein.

11. The instrument according to claim 1, characterized in that the acceleration path of the piston projectile (10) is preferably about 100 to 200 mm.

12. The instrument according to claim 1, characterized in that a magnetic holder (50) for the piston projectile (10) is arranged on a proximal end of the cylinder (6).

13. The instrument according to claim 1, characterized in that the shock wave transmission probe (22) is flexible.

14. The instrument according to claim 1, characterized in that the shock wave transmission probe (22) is guided in a working channel (61) of an endoscope.

15. The instrument according to claim 14, characterized in that the endoscope is provided with a lens cleansing means on a distal end.

16. The surgical instrument as defined in claim 1 including an intermediate member (34) disposed between said piston projectile (10) and said probe (22).

17. The surgical instrument as defined in claim 1 including an intermediate tubular connecting element (32) housed within said housing (4) and a headpiece (28) through which projects a distal end of said probe (22).

18. The surgical instrument as defined in claim 1 including an intermediate tubular connecting element (32) housed within said housing (4) and a headpiece (28) through which projects a distal end of said probe (22), an intermediate member (34) disposed between said piston projectile (10) and said probe (22), and said intermediate member (34) being housed at least in part in each of said intermediate connecting element (32) and housing (6).

19. The surgical instrument as defined in claim 1 including an intermediate tubular connecting element (32) housed within said housing (4) and a headpiece (28) through which projects a distal end of said probe (22), said cooperative means (19, 23) are carried one (23) by said probe (22) and one (19) by said tubular connecting element (32), an intermediate member (34) disposed between said piston projectile (10) and said probe (22), said intermediate member (34) being housed at least in part in each of said intermediate connecting element (32) and housing (6), and cooperative means including a collar (37) of said intermediate member (34) for limiting axial reciprocal movement thereof.

20. A surgical instrument for the mechanical removal of bone cement comprising a longitudinal housing (4) housing a tubular cylinder (6) in which a piston projectile (10) can be reciprocated, means (14) for driving the piston projectile from a proximal end of the cylinder (6) toward a distal end (18) of the cylinder (6), a shock wave transmission probe (22) having a chisel tip (26) at its distal end and a proximal end (24) adapted to receive impact forces generated by said piston projectile (10), said shock wave transmission probe (22) being secured by cooperative means (23,29) for substantially preventing rotation of said probe (22), said driving means (14) being constructed and arranged for accelerating said piston projection (10) to a final speed of substantially 5 to 20 ms thereby inducing a shock wave in the chisel tip (26) which is transmitted to the bone cement, means (30) for limiting the movement amplitude of the probe tip (26) to less than 1.5 mm, and said driving means (14) being constructed and arranged for transferring shock wave energy to said chisel tool (26) in the range of between substantially 0.3 J and 2 J.

21. The surgical instrument as defined in claim 20 including an intermediate tubular connecting element (32) housed within said housing (4) and a headpiece (28) through which projects a distal end of said probe (22), and said cooperative means (23,29) are carried one (23) by said probe (22) and one (29) by said tubular connecting element (32).

22. The surgical instrument as defined in claim 20 including an intermediate tubular connecting element (32) housed within said housing (4) and a headpiece (28) through which projects a distal end of said probe (22), said cooperative means (19, 23) are carried one (23) by said probe (22) and one (26) by said tubular connecting element (32), an intermediate member (34) disposed between said piston projectile (10) and said probe (22), and said intermediate member (34) being housed at least in part in each of said intermediate connecting element (32) and housing (6).

23. The surgical instrument as defined in claim 20, said cooperative means (22, 29) comprising a collar (23) having a flattened portion and a guide opening (29) configured to receive said flattened portion of said collar (23).