In-line milling system

• US 8,177,788 B2
• Filed: 02/22/2006
• Issued: 05/15/2012
• Est. Priority Date: 02/22/2005
• Status: Active Grant

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: McLean, Terry W., Kelman, David C.
• Primary Examiner(s): Barrett, Thomas C.
• Assistant Examiner(s): BOLES, SAMEH RAAFAT
• Application Number:
  US11/359,794
• Publication Number:
  US 20060229626A1
• Time in Patent Office: 2,274 Days
• Field of Search: 606/79, 606/130, 606 80- 89, 606 92- 99, 601/2
• US Class Current: 606/80
• CPC Class Codes: A61B 17/1631 Special drive shafts, e.g. flexible shafts A61B17/1642, A61B17/164 take precedence
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/175 for preparing the femur for hip prosthesis insertion
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

Embodiments of the present invention provide a milling system and method that provides a precise triangular cut in a patient'"'"'s proximal femur. The system allows the surgeon to mill in a single direction, that is, the drill is in the same or similar longitudinal place as the handle of the milling system, preventing the surgeon from having to enter the patient'"'"'s leg at two different angles. The present invention also provides a milling system that can be pre-assembled (e.g., on the back table by a nurse while the surgeon is preparing the site), which enables the milling to take place in one step.

Claims

1. An in-line milling system for use with a cutting member, comprising:

(a) a milling handle having a longitudinal axis;

(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;

(c) a securing system configured to lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle; and

(d) a drill directing joint associated with the milling handle and comprising a drill receiving portion having an end adapted to receive a drill substantially parallel with the longitudinal axis of the milling handle and a cutting member receiving portion connected at an angle to the drill receiving portion and having an end adapted to receive the cutting member such that the cutting member extends along an axis that is not parallel to the longitudinal axis of the milling handle;

wherein the drill receiving portion and the cutting member receiving portion remain connected at the angle to form an angled joint when the cutting member is not secured to the end of the cutting member receiving portion.

2. The in-line milling system of claim 1, wherein the drill receiving portion comprises a rotatable shaft, wherein the cutting member receiving portion comprises a rotatable shaft, and wherein, in use, a drill attached to the end of the drill receiving portion rotates both the rotatable shaft of the drill receiving portion and the rotatable shaft of the cutting member receiving portion in order to rotate the cutting member.

3. The in-line milling system of claim 2, wherein the cutting member receiving portion comprises an axis, wherein the axis of the cutting member receiving portion and the axis of the cutting member substantially align, and wherein the cutting member receiving portion is adapted to apply torque about the axis of the cutting member.

4. The in-line milling system of claim 1, wherein the securing system is configured to lock the milling handle to the milling body in one of multiple pre-determined positions to prevent relative translation between the milling body and the milling handle.

5. The in-line milling system of claim 1, wherein the securing system comprises a ball and detent mechanism.

6. The in-line milling system of claim 1, wherein the securing system comprises a cross bar and indentation mechanism.

7. The in-line milling system of claim 6, wherein the cross bar and indentation mechanism comprises at least one indentation located on one of the milling handle and the milling body and a cross bar associated with the other of the milling handle and the milling body.

8. The in-line milling system of claim 7, wherein the at least one indentation is located on the milling body and wherein the cross bar is associated with the milling handle.

9. The in-line milling system of claim 1, wherein the securing system comprises a bayonet and curved receiver mechanism.

10. The in-line milling system of claim 1, wherein the angle is a fixed angle.

11. The in-line milling system of claim 1, wherein the axis of the cutting member is substantially straight.

12. The in-line milling system of claim 1, wherein each of the drill receiving portion and the cutting member receiving portion comprises a first end and a second end, wherein the first end of the drill receiving portion is adapted to receive the drill and the second end of the cutting member receiving portion is adapted to receive the cutting member and wherein the second end of the drill receiving portion and the first end of the cutting member receiving portion are connected at the angle.

13. An in-line milling system for use with a cutting member having a substantially straight axis, the system comprising:

(a) a milling handle having a shaft with a longitudinal axis;

(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;

(c) a drill directing portion associated with the milling handle, the drill directing portion comprising a drill receiving portion and a cutting member receiving portion having an axis, the drill receiving portion and the cutting member receiving portion connected to one another to form an angled joint such that the drill receiving portion is configured to receive a drill in parallel with the longitudinal axis of the milling handle and the cutting member receiving portion is configured to receive the cutting member such that the axes of the cutting member and the cutting member receiving portion are substantially co-linear and are not parallel to the longitudinal axis of the milling handle; and

(d) a securing system configured to lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle.

14. The in-line milling system of claim 13, wherein the drill receiving portion comprises a rotatable shaft, wherein the cutting member receiving portion comprises a rotatable shaft, and wherein, in use, a drill attached to the end of the drill receiving portion rotates both the rotatable shaft of the drill receiving portion and the rotatable shaft of the cutting member receiving portion in order to rotate the cutting member.

15. The in-line milling system of claim 14, wherein the cutting member receiving portion is adapted to apply torque about the axis of the cutting member.

16. The in-line milling system of claim 13, wherein the securing system is configured to lock the milling handle to the milling body in one of multiple pre-determined positions to prevent relative translation between the milling body and the milling handle.

17. The in-line milling system of claim 13, wherein the securing system comprises a cross bar and indentation mechanism.

18. The in-line milling system of claim 17, wherein the cross bar and indentation mechanism comprises at least one indentation located on one of the milling handle and the milling body and a cross bar associated with the other of the milling handle and the milling body.

19. The in-line milling system of claim 18, wherein the at least one indentation is located on the milling body and wherein the cross bar is associated with the milling handle.

20. The in-line milling system of claim 13, wherein the securing system comprises a ball and detent mechanism.

21. The in-line milling system of claim 13, wherein the securing system comprises a bayonet and curved receiver mechanism.

22. The in-line milling system of claim 13, wherein the drill receiving portion and the cutting member receiving portion remain connected at the angled joint when the cutting member is not secured to the cutting member receiving portion.

23. The in-line milling system of claim 13, wherein the angled joint retains the drill receiving portion and the cutting member receiving portion at a fixed angle.

24. A method for preparing a bone for receiving an implant comprising:

(a) providing a milling system comprising;

(i) a milling handle having a longitudinal axis;

(ii) a milling body adapted to be positioned at least partially within the bone and comprising a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;

(iii) a cutting member; and

(iv) a drill directing portion associated with the milling handle and comprising a drill receiving portion and a cutting member receiving portion having an axis, the drill receiving portion and the cutting member receiving portion connected to one another to form an angled joint, such that the drill receiving portion is configured to receive a drill substantially parallel with the longitudinal axis of the milling handle and the cutting member receiving portion is configured to receive the cutting member such that the cutting member extends along an axis that is not parallel to the longitudinal axis of the milling handle;

(b) assembling the milling system by (i) inserting the milling handle into the channeled portion of the milling body;

(ii) locking the milling handle and the milling body together to prevent relative translation between the milling handle and the milling body; and

(iii) securing the cutting member to the cutting member receiving portion of the drill directing portion such that the axis of the cutting member and the axis of the cutting member receiving portion are substantially co-linear;

(c) inserting the assembled milling system into the bone; and

(d) activating the drill to rotate the cutting member to form a triangular-shaped cavity in the bone.

25. The method of claim 24, wherein locking the milling handle and the milling body together to prevent relative translation between the milling handle and the milling body comprises inserting a cross bar associated with one of the milling handle and the milling body into at least one indentation located on the other of the milling handle and the milling body.

26. The method of claim 25, wherein the at least one indentation comprises a plurality of indentations and wherein the method further comprises disengaging the cross bar from the at least one indentation, translating the milling handle and the milling body relative to each other, and inserting the cross bar into another of the indentations.

27. The method of claim 25, wherein the cross bar is associated with the milling handle and wherein the at least one indentation is located on the milling body.

28. A method for preparing a bone for receiving an implant comprising:

(a) selecting from a plurality of implants having a triangular-shaped portion an implant having a desired size;

(b) providing a milling system comprising;

(i) a milling handle having a longitudinal axis;

(ii) a milling body adapted to be positioned at least partially within the bone and comprising a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;

(iii) a cutting member; and

(iv) a drill directing portion associated with the milling handle and comprising a drill receiving portion and a cutting member receiving portion, wherein the drill receiving portion is configured to receive a drill substantially parallel with the longitudinal axis of the milling handle and the cutting member receiving portion is configured to receive the cutting member such that the cutting member extends along an axis that is not parallel to the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion;

(c) assembling the milling system by (i) inserting the milling handle into the channeled portion of the milling body;

(ii) selecting from at least two pre-determined relative positions of the milling handle and the milling body the desired relative position of the milling handle and the milling body based at least partially on the desired size of the implant and locking the milling handle and the milling body in the desired pre-determined relative position to prevent relative translation between the milling body and the milling handle; and

(iii) securing the cutting member to the cutting member receiving portion such that the cutting member extends along an axis that is not parallel to the longitudinal axis of the milling handle;

(d) inserting the assembled milling system into the bone; and

(e) activating the drill to rotate the cutting member to form a triangular-shaped cavity in the bone.

29. The method of claim 28, wherein locking the milling handle and the milling body in the desired pre-determined relative position to prevent relative translation between the milling body and the milling handle comprises inserting a cross bar associated with one of the milling handle and the milling body into one of at least two indentations located on the other of the milling handle and the milling body, wherein each of the at least two indentations represents one of the at least two pre-determined relative positions.

30. The method of claim 29, wherein the cross bar is associated with the milling handle and wherein the at least two indentations are located on the milling body.

31. The method of claim 29, further comprising disengaging the cross bar from the one of the at least two indentations, translating the milling handle and the milling body relative to each other, and inserting the cross bar into another of the at least two indentations.

32. An in-line milling system for use with a cutting member comprising:

(a) a milling handle having a shaft with a longitudinal axis;

(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;

(c) a drill directing portion associated with the milling handle, the drill directing portion comprising a drill receiving portion having an end and a cutting member receiving portion having an end, wherein the drill receiving portion end is adapted to receive a drill in parallel with the longitudinal axis of the milling handle, and the cutting member receiving portion end is adapted to receive the cutting member such that the cutting member extends along an axis that is not parallel with the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion end; and

(d) a securing system adapted to rigidly lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle.

33. An in-line milling system for use with a cutting member comprising:

(a) a milling handle having a shaft with a longitudinal axis;

(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body; and

(c) a drill directing portion associated with the milling handle, the drill directing portion comprising a drill receiving portion and a cutting member receiving portion,

wherein the drill receiving portion is adapted to receive a drill in parallel with the longitudinal axis of the milling handle and the cutting member receiving portion is adapted to receive the cutting member at an angle that is not parallel with the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion, and wherein the cutting member receiving portion is adapted to apply torque about a substantially straight axis shared by both the cutting member receiving portion and a cutting member in use; and

(d) a securing system configured to lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle.

34. A method for preparing a bone for receiving an implant comprising:

(a) providing an in-line milling system comprising;

(i) a milling handle having a longitudinal axis;

(ii) a milling body adapted to be positioned at least partially within the bone and having a length and a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;

(iii) a drill directing portion associated with the milling handle and comprising a drill receiving portion and a cutting member receiving portion adapted to receive a cutting member such that the cutting member is oriented at an angle relative to the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion;

(b) inserting the milling handle into the channeled portion of the milling body;

(c) selecting from a plurality of pre-determined relative positions of the milling handle and the milling body the desired relative position of the milling handle and the milling body and locking the milling handle and the milling body in the desired pre-determined relative position by inserting a cross bar associated with the milling handle into one of a plurality of indentations located along the length of the milling body;

(d) inserting the milling system into the bone; and

(e) activating a drill to rotate the cutting member to form a triangular-shaped cavity in the bone.

35. The method of claim 34, further comprising disengaging the cross bar from the one of the plurality of indentations, translating the milling handle and the milling body relative to each other, and inserting the cross bar into another of the plurality of indentations.

36. An in-line milling system for use with a cutting member, comprising:

(a) a milling body adapted to be positioned at least partially within a bone and having a channeled portion and a ledge;

(b) a milling handle having a longitudinal axis, a shaft, and a notched receiver, wherein the shaft slides into and is received by the channeled portion of the milling body;

(c) a drill directing portion extending from the milling handle, wherein the drill directing portion comprises a drill receiving portion having an end and a cutting member receiving portion having an end, wherein the drill receiving portion has an axis parallel to the longitudinal axis of the milling handle, wherein the cutting member is located between the cutting member receiving portion end and the notched receiver, and wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion end; and

(d) a securing system configured to lock the milling body to the milling handle in at least one pre-determined position to prevent relative translation between the milling body and the milling handle and to hold the cutting member in a desired position relative to the ledge.

37. The in-line milling system of claim 36, wherein the securing system comprises a cross bar and indentation mechanism.

38. The in-line milling system of claim 37, wherein the cross bar and indentation mechanism comprises at least one indentation located on one of the milling handle and the milling body and a cross bar associated with the other of the milling handle and the milling body.

39. A method for preparing a bone for receiving an implant comprising:

(a) inserting a milling handle into a milling body adapted to be positioned at least partially within the bone;

(b) locking the milling handle and the milling body together to prevent relative translation between the milling handle and the milling body;

(c) securing a cutting member to the milling handle by sliding a locking member distally to fully engage a shank of the cutting member, wherein the milling handle comprises a drill receiving portion and a cutting member receiving portion that remain connected at an angle to form an angled joint when the cutting member is not secured to the milling handle;

(d) inserting the assembled milling system into the bone; and

(e) activating a drill to rotate the cutting member to form a triangular-shaped cavity in the bone.

40. An in-line milling system for use with a cutting member comprising:

(a) a milling handle having a shaft with a longitudinal axis;

(b) a milling body adapted to be positioned at least partially within a bone and having a channeled portion and a conical portion, a distal end of the conical portion defining a ledge, the channeled portion and the conical portion adapted to receive the shaft of the milling handle; and

(c) a securing system adapted to rigidly lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle, wherein the cutting member is associated with the milling handle and the at least one pre-determined position places the cutting member relative to the ledge and wherein the milling handle comprises a drill receiving portion and a cutting member receiving portion that remain connected at an angle to form an angled joint when the cutting member is not associated with the milling handle.

41. An in-line milling system for use with a cutting member comprising:

(a) a milling handle having a shaft with a longitudinal axis;

(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;

(c) a drill directing portion connected to the milling handle, the drill directing portion comprising a drill receiving portion and a cutting member receiving portion adapted to receive the cutting member, the drill receiving portion having an axis substantially parallel with the longitudinal axis of the milling handle and the cutting member receiving portion having an axis that is not parallel with the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion, and wherein the cutting member receiving portion is adapted to apply torque about a substantially straight axis shared by both the cutting member receiving portion and the cutting member in use; and

(d) a securing system adapted to rigidly lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle.

42. A method for preparing a bone for receiving an implant comprising:

(a) inserting longitudinally a shaft of a milling handle into a channel portion of a milling body, the milling handle having a longitudinal axis;

(b) selecting from a plurality of pre-determined relative positions of the milling handle and the milling body the desired relative position of the milling handle and the milling body;

(c) locking the milling handle and the milling body in the desired pre-determined relative position;

(d) securing a cutting member to a cutting member receiving portion of the milling handle;

(e) connecting a drill to a drill receiving portion of the milling handle, the drill receiving portion having an axis substantially parallel to the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion;

(f) inserting the assembled milling system into the bone; and

(g) activating the drill to rotate the cutting member to form a triangular-shaped cavity in the bone.