Tissue preserving and minimally invasive hip replacement surgical procedure

• US 7,105,028 B2
• Filed: 10/21/2003
• Issued: 09/12/2006
• Est. Priority Date: 10/21/2003
• Status: Active Grant

• Current Assignee: MicroPort Orthopedics Holdings, Inc. (MicroPort Scientific Corp.)
• Original Assignee: Wright Medical Technology Incorporated (Stryker Corporation)
• Inventors: Murphy, Stephen B.
• Primary Examiner(s): McDermott, Corrine
• Assistant Examiner(s): SWEET, THOMAS
• Application Number:
  US10/691,800
• Publication Number:
  US 20050081867A1
• Time in Patent Office: 1,057 Days
• Field of Search: 623/22.11, 623/22.4, 128/898, 606/80
• US Class Current: 623/22.4
• 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 17/56 Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• 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 2/3662 Femoral shafts
• CPC Class Codes: A61F 2/4609 of acetabular cups
• CPC Class Codes: A61F 2/4684 Trial or dummy prostheses
• CPC Class Codes: A61F 2002/3611 Heads or epiphyseal parts of femur
• CPC Class Codes: A61F 2002/3625 Necks
• CPC Class Codes: A61F 2002/4635 using minimally invasive surgery
• CPC Class Codes: A61F 2002/4681 by applying mechanical shocks, e.g. by hammering

Abstract

A minimally invasive hip replacement surgical procedure that is also tissue preserving is disclosed. By making a superior incision, rather than a posterior incision, neither the posterior hip capsule, nor the gluteus medius or minimus are dissected. This results in improved post-operative results in the form of less dislocations and better healing.

Claims

1. A tissue preserving surgical procedure for the replacement of a hip joint, including a step consisting of making a single incision for accessing the hip joint, said incision being a superior incision, wherein the superior incision begins at a point which is a superior projection of a tip of a greater trochanter and the superior incision proceeds superiorly for about 8 cm or less,

making a superior capsulotomy for accessing the hip joint, the superior capsulotomy being carried out through the superior incision, and

wherein said superior capsulotomy is performed while preserving most or all of the short rotators and the posterior capsule.

2. The surgical procedure according to claim 1, wherein said superior capsulotomy is performed while preserving all of the short rotators and the posterior capsule.

3. A minimally invasive and tissue preserving surgical procedure for the replacement of a hip joint, including the steps of:

making a superiorly positioned incision; and

preparing the femoral canal of a patient'"'"'s natural femur for receipt of a femoral implant, through said superior incision, while the patient'"'"'s natural femoral head is still within the patient'"'"'s natural acetabulum.

4. The procedure of claim 3, wherein said step of preparing said femoral canal is carried out without the need to transect any of the patient'"'"'s abductors.

5. The procedure of claim 3, wherein said step of preparing said femoral canal is carried out without dissecting any of the patient'"'"'s abductors.

6. The procedure of claim 5, wherein said step of preparing includes leaving the femoral broach in the femur for use as a template.

7. The method of claim 5, further comprising performing a vertical capsulotomy on the hip joint and placing retractors inside the hip joint on both sides of the femoral neck while said femoral head is within the acetabulum.

8. The method of claim 6, further comprising the step of extracting the patient'"'"'s natural femoral head from the patient'"'"'s natural acetabulum, after said step of preparing the femoral canal.

9. The procedure of claim 8, wherein said step of extracting includes simultaneously severing the patient'"'"'s natural femoral head from the patient'"'"'s femur.

10. The procedure of claim 9, further including the step of preparing the patient'"'"'s natural acetabulum for receipt of an acetabular shell, through said superiorly positioned incision.

11. The procedure of claim 10, wherein said step of preparing the patient'"'"'s natural acetabulum is carried out using an angled reamer.

12. The procedure of claim 11, wherein said angled reamer is hand-held.

16. The procedure of claim 3, wherein said step of preparing said femoral canal is carried out while

preserving the short rotators and posterior capsule;

and

preserving the abductors.

17. The surgical procedure according to claim 3, further comprising making a superior capsulotomy for accessing the hip joint, the superior capsulotomy being carried out through the superior incision.

18. The surgical procedure according to claim 17, wherein said superior capsulotomy is performed while preserving most or all the short rotators and the posterior capsule.

13. The procedure of 12, further comprising the step of inserting an acetabular shell and liner in said prepared natural acetabulum through said superior incision.

14. The procedure of claim 13, wherein said femoral implant is inserted in said femoral canal through said superior incision after the insertion of said acetabular shell and liner.

15. The procedure of claim 14, wherein a femoral ball implant is implanted in the patient after the insertion of the femoral implant and the acetabular shell and liner.