Surgical technique and instrumentation for minimal incision hip arthroplasty surgery

• US 20050171548A1
• Filed: 11/18/2004
• Published: 08/04/2005
• Est. Priority Date: 11/18/2003
• Status: Active Grant

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Kelman, David C.
• Granted Patent: US 7,591,821 B2
• Time in Patent Office: Days
• US Class Current: 606/79
• 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 17/1604 Chisels; Rongeurs; Punches; Stamps
• 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 17/1675 for the knee
• 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 2017/320008 Scrapers
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• 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 2002/4635 using minimally invasive surgery

Abstract

Improved instruments for modifying a shape of a proximal femur of a patient for installation of a stem of a femoral component of a prosthetic hip during hip replacement surgery, comprising a handle including an elongated shaft extending downward approximately in a z-direction, a first offset extending from a bottom of the elongated shaft approximately in a y-direction, a second offset extending from the second offset approximately in an x-direction, and a shaping member elongated downward from the second offset approximately in the z-direction. Provided is an improved femoral broach and an improved osteotome. Also provided is a method of improving a patient'"'"'s positioning during hip replacement surgery by using a variable configuration mattress for positioning the patient.

Claims

1. An instrument for modifying a shape of a proximal femur of a patient for installation of a stem of a femoral component of a prosthetic hip during hip replacement surgery, comprising:

a handle including an elongated shaft extending approximately in a z-direction;

a first offset extending from a lower end of the elongated shaft approximately in a y-direction;

a second offset extending from the second offset approximately in an x-direction; and

a shaping member elongated downward from the second offset approximately in the z-direction.

2. The instrument of claim 1, wherein the shaping member further comprises cutting elements.

3. The instrument of claim 2, wherein the instrument is an osteotome for resecting at least a portion of a femoral trochanter.

4. The instrument of claim 3, wherein the osteotome is a box osteotome.

5. The instrument of claim 1, wherein the instrument is a femoral broach for preparation of a central femoral cavity for receiving the stem of the femoral component of the prosthetic hip.

6. The instrument of claim 2, wherein the instrument is a femoral broach for preparation of a central femoral cavity for receiving the stem of the femoral component of the prosthetic hip.

7. The instrument of claim 1, wherein the instrument further comprises fiducials for tracking the instrument during computer-assisted surgery.

8. The instrument of claim 1, wherein the instrument is a modular instrument.

9. The instrument of claim 1, wherein the handle further comprises a knob mounted to an upper end of said elongated shaft.

10. A method of installing a femoral component of a prosthetic hip in a patient, comprising the steps of:

providing an instrument for modifying a shape of a proximal femur of a patient for installation of a stem of a femoral component of a prosthetic hip during hip replacement surgery, comprising a handle including a shaft extending downward approximately in a z-direction, a first offset extending from a bottom of the elongated shaft approximately in a y-direction, a second offset extending from the second offset approximately in an x-direction, and a shaping member elongated downward from the second offset approximately in the z-direction;

inserting the instrument into the hip joint through a surgical incision;

positioning the instrument;

shaping the femur with the instrument;

removing the instrument from the hip joint;

installing the femoral component in the femur; and

completing the surgery.

11. The method of claim 10, wherein in step of inserting the instrument into the hip joint, the surgical incision is an anterior surgical incision.

12. The method of claim 10, wherein in step of inserting the instrument into the hip joint, the surgical incision is a minimally invasive surgical incision.

13. The method of claim 10, wherein in step of inserting the instrument into the hip joint, the surgical incision is from approximately 4 cm to approximately 16 cm in length.

14. The method of claim 10, wherein the instrument is a femoral broach.

15. The method of claim 10, wherein the instrument is a box osteotome.

16. A method for improved positioning of a patient during a hip replacement surgery, comprising the steps of:

positioning a variable configuration mattress under a torso of the patient during the hip replacement surgery;

changing the configuration of the mattress to elevate the torso of the patient relative to a leg of the patient.

17. The method of claim 16, wherein the variable configuration mattress is an air mattress.

18. The method of claim 17, wherein in step of positioning the mattress under the torso, the air mattress is at least partially deflated, and the step of changing configuration of the mattress further comprises inflating the air mattress.

19. The method of claim 16, further comprising the steps of:

providing a surgical incision to install a femoral component in a femur of the patient;

installing the femoral component in the femur; and

completing the surgery.

20. The method of claim 19, wherein in step of providing the surgical incision to install the femoral component, the surgical incision is an anterior surgical incision.

21. The method of claim 19, wherein in step of providing the surgical incision to install the femoral component, the surgical incision is a minimally invasive surgical incision.