摘要:
Apparatus and method for polymerizing cement under pressurized conditions and for applying the cement under pressure at the appropriate time to a human bone cavity for implantation of a prosthesis, including a stemmed femoral component and an acetabular component. This apparatus alters the physical conditions under which bone cement cures, causing a decrease in cement porosity and thus increasing the resultant cement strength. The apparatus includes a pneumatically actuated gun having a piston for applying pressure to the cement, and applying cement to the bone, a pressurizable housing securable to the gun for containing the cement, and a nozzle having a valve which allows the cement to remain pressurized until application thereof through the nozzle. In one embodiment, one component of a two component polymerizable cement is provided in a sealed bladder secured to the nozzle while the other component is injected into the bladder and mixed with the first component when the cement is ready for use. A vent may be provided in the piston of the pneumatic gun to allow air to escape through the piston to prevent the injection of air into the cement. A sealing gasket may be provided on the end of the nozzle for placement over the open end of the bone cavity so that cement can be applied thereto under pressure.
摘要:
A method and apparatus for extracting a prosthesis, particularly a femoral component of a hip prosthesis, which is embedded in a skeletal bone. The apparatus of this invention includes a hollow housing having a lower bearing surface which bears against the proximal end of the bone surrounding the prosthesis to be extracted, a threaded shaft having one end extending into the housing, means mounted externally of the housing which can be rotated to axially advance the shaft and means disposed on the one end of the shaft disposed within the housing for grasping the prosthesis for extraction thereof. A bearing plate may be provided between the proximal end of the skeletal bone and the bearing surface of the housing to evenly distribute the reaction forces applied by the housing over the exposed surface of the proximal end of the bone, and for a cemented prosthesis, over the exposed bone and cement surfaces. This bearing plate may be provided with any desired angle of slope with respect to the proximal end of the bone. Rotation of the threaded shaft causes a controlled, continuous extraction force to be applied to the component to smoothly and slowly break the bonds between the component and the bone or between the component and cement.
摘要:
A tibial milling guide which incorporates a combination of instruments for producing a planar surface on a portion of the tibia using a milling device. The system includes: an extramedullary alignment guide with a detachable reference guide, an adjustable milling base assembly, a detachable milling template, a sizing gauge, and a milling depth gauge. The reference guide is used to position the alignment guide to the tibia. The reference guide has a T-shaped member which provides a planar reference and a centering reference to the tibial head. The reference guide also allows the surgeon to set the rotational alignment before the alignment guide is secured in place. The adjustable milling base assembly is also detachably connected to the alignment guide. The milling base assembly includes a slide and a shiftable base that allows for lateral adjustments of the template with respect to the articular surface after the alignment guide has been properly secured to the tibia. The milling base is also extensibly connected to the alignment guide to allow the spacing between the articular surface and the template to be adjusted.
摘要:
The milling instrumentation of this invention provides a milling guide connected to the femur for accommodating a milling device. The milling instrumentation includes an alignment guide which is used by the surgeon to set a femoral bracket or base on the medial and lateral sides of the exposed femur adjacent its distal end. Once the brackets are set, the alignment guide is removed and a milling guide is connected to the bases. The milling guide establishes a series of reference planes each including a slot. A powered milling device having a burr connected thereto is guided by the slots along the reference planes to accurately mill away a portion of the bone. The milling device includes a bobbin-shaped tip which positively engages the slots to ensure that the milling device is held substantially perpendicular to the reference planes of the milling guide. If necessary, other instrumentation may be connected to the femoral bases which would form a common connection point for the additional instruments thereby ensuring alignment between the various instruments. Optionally, a one piece cutting guide may be connected to the bases to allow resection of the bone by a standard oscillating saw blade. The cutting guide includes a plurality of slots such that all the cuts required for the femur can be made with one cutting guide without reorienting the guide.
摘要:
The alignment guide of this invention includes a cam rotatable about the longitudinal axis of the alignment guide as defined by an intramedullary rod. A base plate is pivotally connected to the intramedullary rod and includes a pair of cam followers positioned on opposite sides of the intramedullary rod. In use, as the cam is rotated relative to the rod, the cam followers ride against the cam causing the plate to pivot or angulate relative to the rod. A plurality of indicia are formed on the cam to indicate to the surgeon the relative angle between the plate and the rod. The base plate includes a quick connect mechanism to permit the surgeon to quickly attach a device such as a cutting guide or pinning guide to the base plate. The cutting guide is fixed relative to the base plate such that the cutting guide will be at the same angular orientation as the plate relative to the intramedullary rod.
摘要:
An implant for use in fixing an resected portion of a bone to a proximal portion of the bone. The implant includes an anatomically shaped plate member having a generally straight first portion and a second portion. The first portion has a bone receiving groove on its inner side and at least one lower wire receiving groove on its exterior side. The bone receiving groove is adapted to receive a generally straight portion of the proximal portion of the bone. The second portion is coupled to the first portion at a first end and terminates at a distal end in at least one inwardly directed hook-shaped member. The second portion is curved to generally match the contour of an end portion of the bone. The hook-shaped member is adapted to abut the resected portion of the bone to prevent the resected portion from migrating from the straight portion of the proximal portion of the bone. A method for fixing an resected greater trochanter to a proximal femur is also provided.
摘要:
A prosthetic device for the human hip having elongated fins or other like protrusions which are provided on the underside of a collar and which extend into previously formed slots or grooves in the bone. Either a plurality of fins, or a single fin having a non-rectilinear shape is provided. Apparatus for formation of the grooves in the bone includes a mill guide which can be mounted onto the proximal end of a rasp embedded in a cavity formed in the bone. A milling bit is used in conjunction with the mill guide to form precisely located and shaped grooves into which the fins can seat. A clamp is provided for securing the prosthetic device to the femur while the cement is hardening.
摘要:
A clamp for the femoral stem of a total hip replacement. The clamp engages a top surface of the stem and a portion of the femur to urge the stem into the femoral cavity during hardening of the cement. The clamp includes a stem having a ball on one end which is adapted to seat in a depression on the upper surface of the stem. In one embodiment, the depression is disposed on a collar extending from the stem. The other end of the clamp includes spikes or the like for engagement of the femur. Typically, a spring biases the ball toward the spike to urge the stem downwardly into the femoral cavity.
摘要:
The invention is directed to milling instrumentation used for preparing a bone for receiving a prosthetic implant. The milling instrumentation includes a milling template for connection to an exposed end of a bone for guiding a milling device along the bone. A detachable cutting guide is removably connected to the milling template to permit a surgeon to either utilize either milling or cutting techniques in resecting the bone.
摘要:
A method and apparatus for centering the stem of a femoral hip prosthesis in the cavity formed in the medullary canal in the proximal end of the femur. The apparatus includes a sleeve or other like device which is mounted onto the neck of the femoral hip prosthesis and which contains at least two projections extending from a lower surface thereof which are adapted to seat in correspondingly formed slots disposed on the upper proximal surface of the femur bone. The slots are positioned such that when the projections reside therein, the stem is centered within the cavity. The slots and projections are elongated in a direction generally transverse to the direction of elongation of the stem, and in this direction of elongation each slot and associated projection is not parallel to the other slot and associated projection. The device of this invention may be used either with prosthesis having a collar, or with a collarless prosthesis. The method of this invention includes the step of mounting a sleeve or other like device on the neck of a femoral hip prosthesis and inserting projections on the device into previously formed slots disposed on the upper proximal surface of the femur bone.