Method and apparatus for performing a minimally invasive total hip arthroplasty

• US 6,953,480 B2
• Filed: 01/22/2002
• Issued: 10/11/2005
• Est. Priority Date: 04/26/2000
• Status: Expired due to Term

• Current Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Technology Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Zwirkoski, Paul A., Mears, Dana, Greig, Kevin
• Primary Examiner(s): Robert, Eduardo C.
• Application Number:
  US10/053,931
• Publication Number:
  US 20020116067A1
• Time in Patent Office: 1,358 Days
• Field of Search: 623/22.1, 623 2315- 2338
• US Class Current: 623/22.11
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/142 with reciprocating saw blades, e.g. with cutting edges at the distal end of the saw blades
• CPC Class Codes: A61B 17/144 with cutting edges at the side of the saw blades
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/164 intramedullary
• 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 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion
• CPC Class Codes: A61B 17/1796 for holes for sutures or flexible wires
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/8866 for gripping or pushing bones, e.g. approximators joint distractors A61B17/025
• CPC Class Codes: A61B 17/8872 Instruments for putting said fixation devices against or away from the bone A61B17/7074, A61B17/808 take precedence
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61F 2/0095 Packages or dispensers for prostheses or other implants for intraocular lenses A61F2/1691; for dental surgery A61C19/02
• CPC Class Codes: A61F 2/32 for the hip
• 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 2/4609 : of acetabular cups
• CPC Class Codes: A61F 2/4684 : Trial or dummy prostheses
• CPC Class Codes: A61F 2002/30718 : Means for protecting prosthetic parts, e.g. during operation
• CPC Class Codes: A61F 2002/3403 : Polar aperture
• CPC Class Codes: A61F 2002/3611 : Heads or epiphyseal parts of femur
• CPC Class Codes: A61F 2002/3621 : pierced with a longitudinal bore
• CPC Class Codes: A61F 2002/3625 : Necks
• CPC Class Codes: A61F 2002/4622 : having the shape of a forceps or a clamp
• CPC Class Codes: A61F 2002/4627 : with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4628 : with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping
• CPC Class Codes: A61F 2002/4629 : connected to the endoprosthesis or implant via a threaded connection
• CPC Class Codes: A61F 2002/4635 : using minimally invasive surgery
• CPC Class Codes: A61F 2002/4681 : by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61G 13/0036 : Orthopaedic operating tables devices for stretching fractured limbs A61F5/04
• CPC Class Codes: B25B 13/06 : of socket type
• CPC Class Codes: B25B 13/48 : for special purposes
• CPC Class Codes: B25B 13/481 : for operating in areas having limited access
• CPC Class Codes: B25B 7/02 : Jaws
• CPC Class Codes: B27G 17/06 : Rasps
• CPC Class Codes: F16D 3/20 : one coupling part entering a sleeve of the other coupling part and connected thereto by sliding or rolling members F16D3/18, F16D3/24 take precedence

Abstract

A method and apparatus for performing a minimally invasive total hip arthroplasty. An approximately 3.75-5 centimeter (1.5-2 inch) anterior incision is made in line with the femoral neck. The femoral neck is severed from the femoral shaft and removed through the anterior incision. The acetabulum is prepared for receiving an acetabular cup through the antenor incision, and the acetabular cup is placed into the acetabulum through the anterior incision. A posterior incision of approximately 2-3 centimeters (0.8-1.2 inches) is generally aligned with the axis of the femoral shaft and provides access to the femoral shaft. Preparation of the femoral shaft including the reaming and rasping thereof is performed through the posterior incision, and the femoral stem is inserted through the posterior incision for implantation in the femur. A variety of novel instruments including an osteotomy guide; an awl for locating a posterior incision aligned with the axis of the femoral shaft; a tubular posterior retractor; a selectively lockable rasp handle with an engagement guide; and a selectively lockable provisional neck are utilized to perform the total hip arthroplasty of the current invention.

Claims

1. A method for preparing a femur to receive a femoral stem, comprising:

making a posterior incision; and

preparing the femur to receive the femoral stem through said posterior incision, wherein said step of making a posterior incision comprises making a posterior incision substantially aligned with a central axis of a femoral shaft.

2. The method of claim 1, wherein said step of making a posterior incision comprises making a step of making posterior incision having a length of about 2.5 to 3 cm.

3. The method of claim 1, wherein said step of making a posterior incision comprises the step of making a posterior incision having a length of about 2 to 3 cm.

4. A method for preparing a femur to receive a femoral stem, comprising:

making a posterior incision; and

preparing the femur to receive the femoral stem through said posterior incision, wherein said step of making a posterior incision comprises the step of making a posterior incision having a length of about 2.5 to 3 cm substantially aligned with a central axis of a femoral shaft.

5. A method for preparing a femur to receive a femoral stem, comprising:

making a posterior incision; and

preparing the femur to receive the femoral stem through said posterior incision, wherein said step of making a posterior incision comprises the step of making a posterior incision having a length of about 2 to 3 cm substantially aligned with a central axis of a femoral shaft.

6. A method for preparing a femur to receive a femoral stem, comprising:

making a posterior incision;

performing a blunt dissection to provide an access through said posterior incision to expose a shaft of said femur;

inserting a retractor into said access, said retractor comprising a tunnel sized for insertion through said access; and

preparing the femur to receive the femoral stem through said posterior incision, wherein said step of preparing a femur to receive a femoral stem through said posterior incision comprises the step of preparing a femur to receive a femoral stem through said retractor.