U.S. patent application number 16/393283 was filed with the patent office on 2019-08-15 for surgical instrument and method of positioning an acetabular prosthetic component.
The applicant listed for this patent is DEPUY SYNTHES PRODUCTS, INC.. Invention is credited to Francisco A. Amaral, Rod G. Cameron, Carl F. Livorsi.
Application Number | 20190247202 16/393283 |
Document ID | / |
Family ID | 47915621 |
Filed Date | 2019-08-15 |
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United States Patent
Application |
20190247202 |
Kind Code |
A1 |
Livorsi; Carl F. ; et
al. |
August 15, 2019 |
SURGICAL INSTRUMENT AND METHOD OF POSITIONING AN ACETABULAR
PROSTHETIC COMPONENT
Abstract
An orthopaedic surgical instrument for positioning an acetabular
prosthetic component in a patient's surgically-prepared acetabulum
includes a surgical tool configured to be coupled to the acetabular
prosthetic component, and a gravity-based position indicator
removably coupled to the surgical tool. The position indicator
includes a first marking indicating a first position of the
acetabular prosthetic component, and a second marking indicating a
second position.
Inventors: |
Livorsi; Carl F.;
(Lakeville, MA) ; Amaral; Francisco A.; (Acushnet,
MA) ; Cameron; Rod G.; (Franklin, MA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
DEPUY SYNTHES PRODUCTS, INC. |
Raynham |
MA |
US |
|
|
Family ID: |
47915621 |
Appl. No.: |
16/393283 |
Filed: |
April 24, 2019 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15175075 |
Jun 7, 2016 |
10285826 |
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16393283 |
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13434154 |
Mar 29, 2012 |
9358130 |
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15175075 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61F 2002/30617
20130101; A61F 2002/4627 20130101; A61F 2/4609 20130101; A61B 90/06
20160201; A61F 2/4657 20130101; A61B 2090/068 20160201; A61F
2002/4629 20130101; A61F 2002/4668 20130101 |
International
Class: |
A61F 2/46 20060101
A61F002/46; A61B 90/00 20060101 A61B090/00 |
Claims
1. An orthopaedic surgical system, the orthopaedic surgical system
comprising: an acetabular prosthetic component sized to be
positioned in a patient's surgically-prepared acetabulum, and a
surgical instrument comprising: a surgical tool configured to be
coupled to the acetabular prosthetic component, and a gravity-based
position indicator removably coupled to the surgical tool, the
position indicator including: (i) a first marking indicating a
first position of the acetabular prosthetic component in the
patient's surgically-prepared acetabulum, wherein the first marking
indicates a first abduction angle of the acetabular prosthetic
component, and (ii) a second marking indicating a second position
of the acetabular prosthetic component in the patient's
surgically-prepared acetabulum, wherein the second marking
indicates: a second abduction angle of the acetabular prosthetic
component different from the first abduction angle, and a first
anteversion angle of the acetabular prosthetic component.
2. The orthopaedic surgical system of claim 1, wherein: the
surgical tool has an aperture defined therein, and the position
indicator includes a rod shaped to match the aperture of the
surgical tool such that the position indicator is coupleable to the
surgical tool in a single predetermined orientation.
3. The orthopaedic surgical system of claim 2, wherein the rod
includes a support arm and a spring arm moveable relative to the
support arm from (i) an uncompressed position wherein the position
indicator is spaced apart from the surgical tool to (ii) a
compressed position wherein the position indicator is coupled to
the surgical tool.
4. The orthopaedic surgical system of claim 3, wherein the spring
arm is biased toward the uncompressed position to prevent
detachment of the position indicator from the surgical tool when
the rod of the position indicator is positioned in the aperture of
the surgical tool.
5. The orthopaedic surgical system of claim 1, wherein the surgical
tool has a plurality of external threads formed on one end, the
plurality of external threads corresponding to a plurality of
internal threads of the acetabular prosthetic component to permit
the surgical tool to be threadingly engaged with the acetabular
prosthetic component.
6. The orthopaedic surgical system of claim 1, wherein the position
indicator includes a third marking indicating a third abduction
angle of the acetabular prosthetic component.
7. The orthopaedic surgical system of claim 6, wherein the third
marking indicates a second anteversion angle of the acetabular
prosthetic component.
8. The orthopaedic surgical system of claim 6, wherein: the
position indicator is bubble indicator having a vial with a bubble
trapped therein, and the first marking is located at the center
point of the vial.
9. The orthopaedic surgical system of claim 8, wherein the second
marking is offset from the center point of the vial.
10. The orthopaedic surgical system of claim 9, wherein a third
marking indicating a third abduction angle of the acetabular
prosthetic component is offset from the center point of the vial
opposite the second marking.
11. The orthopaedic surgical system of claim 1, wherein the first
marking is a customized patient-specific marking.
12. The orthopaedic surgical instrument system of claim 1, wherein
the second marking is a customized patient-specific marking.
13. The orthopaedic surgical instrument system of claim 7, wherein
the third marking is a customized patient-specific marking.
14. An orthopaedic surgical system for positioning an acetabular
prosthetic component in a patient's surgically-prepared acetabulum,
the instrument system comprising: an acetabular prosthetic
component sized to be positioned in a patient's surgically-prepared
acetabulum, and a surgical instrument comprising: a surgical tool
configured to be coupled to the acetabular prosthetic component,
and a gravity-based position indicator removably coupled to the
surgical tool, the position indicator including: (i) a first
marking indicating a first position of the acetabular prosthetic
component in the patient's surgically-prepared acetabulum, wherein
the first marking indicates a first abduction angle of the
acetabular prosthetic component, and (ii) a second marking
indicating a second position of the acetabular prosthetic component
in the patient's surgically-prepared acetabulum, wherein the second
marking indicates a second abduction angle of the acetabular
prosthetic component different from the first abduction angle.
15. The orthopaedic surgical system of claim 13, wherein the first
marking is a customized patient-specific marking.
16. The orthopaedic surgical system of claim 13, wherein the second
marking a customized patient-specific marking.
17. The orthopaedic surgical system of claim 13 wherein: the
surgical tool has an aperture defined therein, and the position
indicator includes a rod shaped to match the aperture of the
surgical tool such that the position indicator is coupleable to the
surgical tool in a single predetermined orientation.
18. The orthopaedic surgical system of claim 17, wherein the rod
includes a support arm and a spring arm moveable relative to the
support arm from (i) an uncompressed position wherein the position
indicator is spaced apart from the surgical tool to (ii) a
compressed position wherein the position indicator is coupled to
the surgical tool.
19. The orthopaedic surgical system of claim 18, wherein the spring
arm is biased toward the uncompressed position to prevent
detachment of the position indicator from the surgical tool when
the rod of the position indicator is positioned in the aperture of
the surgical tool.
20. The orthopaedic surgical system of claim 14, wherein the
position indicator includes a third marking indicating a third
abduction angle of the acetabular prosthetic component.
Description
[0001] This application is a divisional application and claims
priority to U.S. patent application Ser. No. 15/175,075, which was
filed on Jun. 7 2016, and which is a divisional application that
claims priority to U.S. patent application Ser. No. 13/434,154, now
U.S. Pat. No. 9,358,130, which was filed on Mar. 29, 2012, the
entirety of each of which is expressly incorporated herein by
reference.
TECHNICAL FIELD
[0002] The present disclosure relates generally to orthopaedic
surgical instruments and, more particularly, to surgical
instruments used to trial and install an acetabular prosthetic
component.
BACKGROUND
[0003] Joint arthroplasty is a well-known surgical procedure by
which a diseased and/or damaged natural joint is replaced by a
prosthetic joint. For example, in a hip arthroplasty surgical
procedure, a patient's natural hip ball and socket joint is
partially or totally replaced by a prosthetic hip joint. A typical
prosthetic hip joint includes an acetabular prosthetic component
and a femoral head prosthetic component. An acetabular prosthetic
component generally includes an outer shell configured to engage
the acetabulum of the patient and an inner bearing or liner coupled
to the shell and configured to engage the femoral head. The femoral
head prosthetic component and inner liner of the acetabular
component form a ball and socket joint that approximates the
natural hip joint.
[0004] To facilitate the replacement of the natural joint with a
prosthetic hip joint, orthopaedic surgeons may use a variety of
orthopaedic surgical instruments such as, for example, reamers,
drill guides, drills, positioners, and/or other surgical
instruments.
SUMMARY
[0005] According to one aspect of the disclosure, an orthopaedic
surgical instrument for positioning an acetabular prosthetic
component in a patient's surgically-prepared acetabulum is
disclosed. The orthopaedic surgical instrument includes a shaft
having a first end configured to be coupled to the acetabular
prosthetic component, a handle attached to the shaft at a second
end opposite the first end, and a bubble indicator attached to the
shaft between the first end and the second end. The bubble
indicator has a face and a plurality of markings defined on the
face. The plurality of markings include a first marking indicating
a first abduction angle, and a second marking indicating a second
abduction angle and an anteversion angle of the acetabular
prosthetic component.
[0006] In some embodiments, the second abduction angle may be less
than the first abduction angle. In some embodiments, the first
abduction angle may be approximately 45 degrees. Additionally, in
some embodiments, the second abduction angle may be approximately
40 degrees. In some embodiments, the anteversion angle may be equal
to approximately 15 degrees of rotation about a transverse axis
extending through the patient.
[0007] In some embodiments, the bubble indicator may be detachable
from the shaft. In some embodiments, the first marking and the
second marking may be customized patient-specific markings.
[0008] In some embodiments, the face may be circular and have a
center point. The first marking may be located approximately at the
center point of the face. Additionally, in some embodiments, the
second marking may be offset from the center point of the face.
[0009] In some embodiments, the first marking may include a
graphical indicator and a numerical indicator of the first
abduction angle.
[0010] According to another aspect, the orthopaedic surgical
instrument includes a surgical tool configured to be coupled to the
acetabular prosthetic component, and a gravity-based position
indicator removably coupled to the surgical tool. The position
indicator includes a first marking indicating a first position of
the acetabular prosthetic component in the patient's
surgically-prepared acetabulum, and a second marking indicating a
second position of the acetabular prosthetic component in the
patient's surgically-prepared acetabulum.
[0011] In some embodiments, the first marking may indicate a first
abduction angle, and the second marking may indicate a second
abduction angle. The second abduction angle may be different from
the first abduction angle. In some embodiments, the surgical tool
may have an aperture defined therein, and the position indicator
may include a rod shaped to match the aperture of the surgical tool
such that the position indicator is coupled to the surgical tool in
a single predetermined orientation.
[0012] In some embodiments, the surgical tool may have a plurality
of external threads formed on one end. The plurality of external
threads may correspond to a plurality of internal threads of the
acetabular prosthetic component to permit the surgical tool to be
threadingly engaged with the acetabular prosthetic component.
[0013] According to another aspect, a method of positioning an
acetabular prosthetic component in a patient's surgically-prepared
acetabulum is disclosed. The method includes rotating the
acetabular prosthetic component in the patient's
surgically-prepared acetabulum until a bubble of a bubble indicator
is substantially aligned with a first marking. The first marking
indicates a first position of the acetabular prosthetic component.
The method also includes rotating the acetabular prosthetic
component anteriorly until the bubble is substantially aligned with
a second marking. The second marking indicates a second position of
the acetabular prosthetic component.
[0014] In some embodiments, the acetabular prosthetic component may
be at a first abduction angle in the first position, and the
acetabular prosthetic component may be at a second abduction angle
in the second position. The second abduction angle may be less than
the first abduction angle.
[0015] In some embodiments, the first abduction angle may be
approximately 45 degrees. Additionally, in some embodiments, the
second abduction angle may be approximately 40 degrees. In some
embodiments, rotating the acetabular prosthetic component
anteriorly may include rotating the acetabular prosthetic cup
approximately 15 degrees about a transverse axis extending through
the patient.
[0016] In some embodiments, the method may further include rotating
the acetabular prosthetic component in the patient's
surgically-prepared acetabulum until the bubble is substantially
aligned with a third marking. The third marking may correspond to a
third position of the acetabular prosthetic cup.
[0017] In some embodiments, the method may further include
selecting the bubble indicator from a plurality of bubble
indicators, attaching the bubble indicator to a surgical tool, and
threading the acetabular prosthetic component onto the surgical
tool.
[0018] Additionally, in some embodiments, rotating the acetabular
prosthetic component in the patient's surgically-prepared
acetabulum until the bubble of the bubble indicator is
substantially aligned with a first marking may include aligning a
graphical indicator of the first marking with the bubble of the
bubble indicator.
[0019] In some embodiments, the method may also include positioning
the bubble indicator in a coronal plane defined by the patient's
body such that the first marking is aligned with the coronal plane.
Rotating the acetabular prosthetic component in the patient's
surgically-prepared acetabulum may include maintaining alignment
between the first marking and the coronal plane.
BRIEF DESCRIPTION OF THE DRAWINGS
[0020] The detailed description particularly refers to the
following figures, in which:
[0021] FIG. 1 is an exploded perspective view of an orthopaedic
surgical instrument assembly and an acetabular prosthetic
component;
[0022] FIG. 2 is a perspective view of one embodiment of a position
indicator of the orthopaedic surgical instrument assembly of FIG.
1;
[0023] FIG. 3 is a front elevation view of the position indicator
of FIG. 2;
[0024] FIG. 4 is a perspective view of the orthopaedic surgical
instrument assembly of FIG. 1;
[0025] FIG. 5 is a perspective view of the orthopaedic surgical
instrument assembly secured to the acetabular prosthetic component,
which is positioned in a patient's surgically-prepared
acetabulum;
[0026] FIG. 6 is an elevation view of the orthopaedic surgical
instrument assembly and the acetabular prosthetic component in a
predetermined position;
[0027] FIG. 7 is a front elevation view of the position indicator
of the orthopaedic surgical instrument assembly when the
orthopaedic surgical instrument assembly is positioned in the
predetermined position of FIG. 6;
[0028] FIG. 8 is a plan view of the orthopaedic surgical instrument
assembly and the acetabular prosthetic component in another
predetermined position;
[0029] FIG. 9 is a front elevation view of the position indicator
of the orthopaedic surgical instrument assembly when the
orthopaedic surgical instrument assembly is positioned in the
predetermined position of FIG. 8;
[0030] FIG. 10 is an elevation view of the orthopaedic surgical
instrument assembly and the acetabular prosthetic component in the
predetermined position of FIG. 8;
[0031] FIG. 11 is a perspective view of another embodiment of a
position indicator of the orthopaedic surgical instrument assembly
of FIG. 1; and
[0032] FIG. 12 is a perspective view of another embodiment of a
position indicator of the orthopaedic surgical instrument assembly
of FIG. 1.
DETAILED DESCRIPTION OF THE DRAWINGS
[0033] While the concepts of the present disclosure are susceptible
to various modifications and alternative forms, specific exemplary
embodiments thereof have been shown by way of example in the
drawings and will herein be described in detail. It should be
understood, however, that there is no intent to limit the concepts
of the present disclosure to the particular forms disclosed, but on
the contrary, the intention is to cover all modifications,
equivalents, and alternatives falling within the spirit and scope
of the invention as defined by the appended claims.
[0034] Terms representing anatomical references, such as anterior,
posterior, medial, lateral, superior, inferior, etcetera, may be
used throughout the specification in reference to the orthopaedic
implants and surgical instruments described herein as well as in
reference to the patient's natural anatomy. Such terms have
well-understood meanings in both the study of anatomy and the field
of orthopaedics. Use of such anatomical reference terms in the
written description and claims is intended to be consistent with
their well-understood meanings unless noted otherwise.
[0035] Referring to FIG. 1, an acetabular prosthetic component 10
and an orthopaedic surgical instrument assembly 12 (hereinafter
assembly 12) are shown. The assembly 12 may be used during a hip
arthroplasty surgical procedure to trial and install the acetabular
prosthetic component 10 in a patient's bone. It should be
appreciated, however, that although the assembly 12 is described
below in regard to the performance of a hip arthroplasty surgical
procedure, certain concepts associated with the assembly 12 may be
utilized in replacement procedures of numerous other joints
throughout the body. In other words, one or more of the elements of
the assembly 12 may be incorporated into surgical instruments used
in, for example, knee, spinal, shoulder, or other replacement
procedures.
[0036] The acetabular prosthetic component 10 includes an
acetabular shell component 14 configured to be implanted within a
surgically-prepared acetabulum 16 (see FIG. 5) of a patient. The
acetabular shell component 14 includes an outer surface 20 having a
convex shape that is hemispherical or partially spherical. The
acetabular shell component 14 also includes an inner surface 22
having a concave shape that is partially spherical in shape. The
inner surface 22 defines a cavity 24 in the acetabular shell
component 14 that is sized to receive a metallic or polymeric
insert.
[0037] The acetabular shell component 14 has an opening 26 defined
in the outer surface 20, and an inner wall 28 extends inwardly from
the opening 26 to an opening 30 defined in the inner surface 22.
The inner wall 28 defines a passageway 32 through the acetabular
shell component 14. As shown in FIG. 1, the inner wall 28 has a
plurality of internal threads 34 defined thereon.
[0038] The orthopaedic surgical instrument assembly 12 includes a
surgical tool 40 and a position indicator 42. In the illustrative
embodiment, the surgical tool 40 is an impaction tool. It should be
appreciated that in other embodiments the surgical tool 40 may be a
positioning tool or other surgical device configured to be secured
to the acetabular prosthetic component 10. The surgical tool 40 has
a shaft 44 that includes a plurality of external threads 46
corresponding to the threads 34 of the acetabular shell component
14. As shown in FIG. 1, the external threads 46 are defined at an
end 48 of the shaft 44 such that the acetabular shell component 14
may be threaded onto the end 48 of the shaft 44, thereby coupling
the acetabular shell component 14 to the surgical tool 40 for
trialing or implantation.
[0039] The shaft 44 of the surgical tool 40 has a cylindrical body
50 that extends from the end 48 to an end 52 and defines a
longitudinal axis 54. The surgical tool 40 includes a handle 56
that is coupled to the end 52 of the shaft 44. As shown in FIG. 1,
the handle 56 includes a handle body 58, and, in the illustrative
embodiment, the shaft 44 is operable to pivot about the
longitudinal axis 54 relative to the handle body 58.
[0040] The surgical tool 40 also includes a locking mechanism 60
configured to prevent the shaft 44 from pivoting about the axis 54.
The locking mechanism 60 is positioned in the handle body 58 and
includes a button 62 positioned in an opening 64 defined in the
handle body 58. A user may operate the button 62 to release the
locking mechanism 60 such that the shaft 44 may be pivoted about
the axis 54. It should be appreciated that in other embodiments the
locking mechanism 60 may include a switch, tab, or other
user-operated device to release and lock the shaft 44 relative to
the handle body 58. It should be appreciated that in other
embodiments the shaft 44 and the handle 56 may be formed as a
single monolithic component such that the shaft 44 does not pivot
or rotate relative to the handle 56.
[0041] As shown in FIG. 1, the handle 56 of the surgical tool 40
also includes a grip 66 secured to the handle body 58. The grip 66
includes a knurled outer surface 68 that is sized to receive the
hand of a surgeon or other user. It should be appreciated that in
other embodiments the outer surface may be substantially smooth or
include a number of ribs to support the hand of a user.
[0042] The handle body 58 of the surgical tool 40 also includes a
platform 70 configured to receive the position indicator 42. The
platform 70 has an upper surface 72, and an opening 74 is defined
in the upper surface 72. As shown in FIG. 1, the opening 74 is
defined by a substantially straight edge 76 and a curved or rounded
edge 78. A substantially planar inner wall 80 slopes inwardly from
the edge 76. The inner wall 80 cooperates with a curved inner wall
82 that slopes inwardly from the rounded edge 78 to define an
aperture 84 in the handle body 58. As described in greater detail
below, the aperture 84 is sized and shaped to receive a rod 86 of
the position indicator 42.
[0043] Referring now to FIG. 2, the position indicator 42 of the
assembly 12 has a longitudinal axis 88 that extends a housing 90
and the rod 86, which is secured to a lower end 92 of the housing
90. The rod 86 includes a cantilevered support arm 94 that extends
from the lower end 92 of the housing 90. The support arm 94 has a
curved outer surface 96 that is shaped to match the curved inner
wall 82 of the handle body 58. The support arm 94 has a
substantially planar surface 98 that is positioned opposite the
outer surface 96.
[0044] The rod 86 of the position indicator 42 also includes a
cantilevered spring arm 100 that extends from the lower end 92 of
the housing 90. The spring arm 100 includes a substantially planar
surface 102 that faces the surface 98 of the support arm 94. The
spring arm 100 also includes another substantially planar surface
104, which is positioned opposite the surface 102. The surface 104
of the spring arm 100 is shaped to match the substantially planar
inner wall 80 of the handle body 58.
[0045] In the illustrative embodiment, the spring arm 100 of the
rod 86 is configured to flex and move relative to the support arm
94 between an uncompressed position and a compressed position. As
shown in FIG. 2, the tip 106 of the spring arm 100 and the tip 108
of the support arm 94 define an uncompressed thickness 110 of the
rod 86. The uncompressed thickness 110 is greater than the size of
the opening 74 of the handle body 58.
[0046] To attach the position indicator 42 to the surgical tool 40,
the rod 86 is advanced into the aperture 84 defined in the handle
body 58. The arms 94, 100 of the rod 86 are advanced into contact
with the inner walls 82, 80, respectively, of the handle body 58
that define the aperture 84. When the spring arm 100 engages the
inner wall 80, the spring arm 100 moves relative to the support arm
94 from the uncompressed position to the compressed position,
thereby permitting the rod 86 to advance along the inner walls 82,
80 of the handle body 58. When the position indicator 42 is
attached to the surgical tool 40 as shown in FIG. 4, the spring arm
100 acts as a biasing element to prevent inadvertent detachment of
the position indicator 42 from the handle body 58.
[0047] The arms 94, 100 of the rod 86 are keyed to match the shape
of the aperture 84 such that the position indicator 42 is located
in a single predetermined orientation relative to the surgical tool
40. It should be appreciated that in other embodiments the rod of
the position indicator 42 may be a single shaft that is similarly
keyed to match the structure of the aperture of the handle body 58.
Additionally, in other embodiments, the aperture may be cylindrical
and the rod may have a single cylindrical shaft sized to be
received in the aperture. In other embodiments, the position
indicator and the surgical tool may be configured such that the
position indicator is permitted to rotate about its axis 88 between
multiple predetermined positions.
[0048] It should also be appreciated that in other embodiments the
assembly 12 may include other locking mechanisms, such as, for
example, latches, pins, threaded fasteners, and other retention
devices to secure the position indicator to the handle body. It
should also be appreciated that in other embodiments the position
indicator 42 may be fixed to the handle body 58 such that the
position indicator 42 cannot be detached from the handle body 58
during normal use.
[0049] Referring now to FIG. 3, the position indicator 42 of the
assembly 12 includes a housing 90 having a gravity-based indicator
112 secured thereto. As used herein, a "gravity-based indicator" is
a sensor that indicates position based on gravity. In the
illustrative embodiment, the gravity-based indicator 112 is a
bubble indicator 114. In other embodiments, the gravity-based
indicator 112 may be a tilt sensor, including, for example, an
enclosed shallow dish filled with fluid. A ball bearing is
positioned in the shallow dish and is configured to move based on
the angle or tilt of the shallow dish.
[0050] The bubble indicator 114 of the position indicator 42
includes a vial 116 that defines a chamber 118 filled with a fluid
such as, for example, isopropyl alcohol. In the illustrative
embodiment, the vial 116 defines a dome-shaped chamber 118. A
bubble 120 is trapped within the chamber 118. Gravity and the
physical difference between the gas of the bubble 120 and the fluid
in the chamber 118 control the function of the bubble indicator
114, with the bubble 120 floating toward the side of the vial 116
that constitutes the high side of the vial 116.
[0051] The vial 116 of the bubble indicator 114 has a face plate
122 that is substantially transparent. In that way, a user may look
through the face plate 122 to determine the position of the bubble
120. As shown in FIG. 3, the bubble indicator 114 has a plurality
of markings 124 etched into an outer surface 126 of the face plate
122. Each of the markings 124 indicates a predetermined position of
the acetabular prosthetic component 10 within the patient's
surgically-prepared acetabulum 16.
[0052] In the illustrative embodiment, the markings 124 of the
bubble indicator 114 include a plurality of graphical indicators
128 that correspond to the plurality of predetermined positions of
the acetabular prosthetic component 10. The markings 124 also
include a plurality of numerical indicators 130 that are associated
with the graphical indicators 128. As shown in FIG. 3, the
graphical indicators 128 include rings 132, 134, 136, and the
bubble 120 is configured to align with each of the rings 132, 134,
136 based on the position of the acetabular prosthetic component 10
within the patient's surgically-prepared acetabulum 16, as
described in greater detail below. The markings 124 further include
side indicators 138, which associate the graphical indicators 128
and the numerical indicators 130 with a particular side of a
patient's body (i.e., right or left).
[0053] The housing 90 of the position indicator 42 is formed from
an implant grade metallic material, such as, for example, aluminum
or titanium. The vial 116 is sealed within the housing 90 such that
the position indicator 42 may be autoclaved for multiple uses. In
other embodiments the housing 90 may be molded from a polymeric
material, such as, for example, plastic. It should be appreciated
that the position indicator 42 may be a reusable or disposable
surgical instrument.
[0054] In use, a surgeon or other user may utilize the assembly 12
to trial and implant the acetabular prosthetic component 10. To do
so, the surgical tool 40 is assembled with the position indicator
42 and the acetabular prosthetic component 10, as shown in FIG. 4.
As shown in FIGS. 5 and 6, the surgical tool 40 may be used to
position the acetabular prosthetic component 10 within the
patient's acetabulum 16 at an initial predetermined position at a
predetermined abduction angle. As shown in FIGS. 8 and 10, the
surgical tool 40 may be used to position the acetabular prosthetic
component 10 within the patient's acetabulum 16 at another
predetermined position at another predetermined abduction
angle.
[0055] As shown in FIG. 4, the position indicator 42 may be
attached to the tool 40. As described above, the rod 86 of the
position indicator 42 is advanced into the aperture 84 defined in
the handle body 58. The arms 94, 100 of the rod 86 are advanced
into contact with the inner walls 82, 80, respectively, of the
handle body 58 that define the aperture 84. When the spring arm 100
engages the inner wall 80, the spring arm 100 moves relative to the
support arm 94 from the uncompressed position to the compressed
position, thereby permitting the rod 86 to advance along the inner
walls 82, 80 of the handle body 58 such that the position indicator
42 is assembled with the tool 40.
[0056] The acetabular prosthetic component 10 may also be attached
to the tool 40. To do so, the passageway 32 defined in the
acetabular shell component 14 is aligned with the shaft 44 of the
tool 40. The acetabular shell component 14 may be advanced into
contact with the end 48 of the shaft 44 such that the threads 34 of
the acetabular shell component 14 engage the threads 46 of the
shaft 44. One of the tool 40 and the acetabular shell component 14
may then be rotated relative to the other component to thread the
acetabular shell component 14 onto the end 48 of the shaft 44,
thereby securing the acetabular shell component 14 to the surgical
tool 40.
[0057] With the acetabular shell component 14 secured to the
surgical tool 40, the acetabular shell component 14 may be advanced
into the patient's surgically-prepared acetabulum 16, as shown in
FIG. 5. To do so, the patient may be placed into a right or left
lateral decubitus position such that the patient's
surgically-prepared acetabulum 16 faces upward. As shown in FIG. 6,
in the lateral decubitus position, the patient's body 140 defines a
transverse axis 142 that extends parallel to the ground, as
indicated by an imaginary axis 144. The patient's body 140 also
defines a coronal plane 146, and a coronal axis 148 extends
orthogonally to the coronal plane 146 and the transverse axis
142.
[0058] A user may utilize the tool 40 to rotate the acetabular
shell component 14 to an initial predetermined position within the
patient's surgically-prepared acetabulum 16. As shown in FIG. 6,
the surgical tool 40 is located in the coronal plane 146 defined by
the patient's body 140 such that the longitudinal axis 54 of the
surgical tool 40 and the longitudinal axis 88 of the position
indicator 42 are located in the coronal plane 146. While
maintaining the surgical tool 40 in the coronal plane 146, a user
may rotate the surgical tool 40 about the coronal axis 148 to move
the acetabular shell component 14. As the surgical tool 40 is
pivoted about the axis 148, the bubble 120 is moved within the vial
116 of the position indicator 42.
[0059] As shown in FIG. 7, the acetabular shell component 14 is
located in the initial predetermined position when the bubble 120
is aligned with the ring 132 defined on the face plate 122 of the
vial 116. The longitudinal axis 88 of the position indicator 42
extends outwardly through the center 156 of the face plate 122, and
the ring 132 is aligned with the center 156. In the initial
predetermined position, the coronal plane 146 is aligned with the
longitudinal axis 88 and bisects the ring 132, as shown in FIG.
7.
[0060] As shown in FIG. 6, an angle .alpha. is defined between the
longitudinal axis 54 of the surgical tool 40 and the transverse
axis 142 at the predetermined position corresponding to the ring
132. In the illustrative embodiment, the angle .alpha. is equal to
a predetermined amount of rotation about the coronal axis 148 and a
predetermined abduction angle. The face plate 122 of the position
indicator 42 includes a numerical indicator 150 that indicates to
the user the magnitude of the angle .alpha., as shown in FIG. 7. In
the illustrative embodiment, the angle .alpha. has a magnitude of
45 degrees.
[0061] As shown in FIG. 8, the user may utilize the tool 40 to
rotate the acetabular shell component 14 from the initial
predetermined position to another predetermined position within the
patient's surgically-prepared acetabulum 16. To do so, a user may
rotate the surgical tool 40 about the transverse axis 142 and/or
the coronal axis 148 to move the acetabular shell component 14. In
the illustrative embodiment, the user rotates the surgical tool 40
about the transverse axis 142 such that the surgical tool 40 is
angled out of the coronal plane 146. As shown in FIG. 8, the
surgical tool 40 is rotated anteriorly relative to the coronal
plane 146. The user also rotates the surgical tool 40 relative to
the coronal axis 148.
[0062] As the surgical tool 40 is pivoted about the axes 142, 148,
the bubble 120 is moved within the vial 116 of the position
indicator 42. As shown in FIG. 9, the acetabular shell component 14
is located in the second predetermined position when the bubble 120
is aligned with the ring 134 defined on the face plate 122 of the
vial 116.
[0063] As shown in FIG. 8, an angle .beta. is defined between the
longitudinal axis 54 of the surgical tool 40 and the coronal plane
146 at the predetermined position corresponding to the ring 134. In
the illustrative embodiment, the angle .beta. is equal to a
predetermined amount of rotation about the transverse axis 142 and
a predetermined anteversion angle. As shown in FIG. 10, an angle
.PHI. is defined between the longitudinal axis 54 of the surgical
tool 40 and the transverse axis 142 at the predetermined position
corresponding to the ring 134. In the illustrative embodiment, the
angle .PHI. is equal to a predetermined amount of rotation about
the coronal axis and a predetermined abduction angle. The face
plate 122 of the position indicator 42 includes numerical
indicators 152, 154 that indicate to the user the magnitudes of the
angles .beta., .PHI., as shown in FIG. 9. In the illustrative
embodiment, the angle .beta. has a magnitude of 15 degrees the
angle .PHI. has a magnitude of 40 degrees.
[0064] It should be appreciated that the magnitudes of the angles
.alpha., .beta., .PHI. may vary according to anatomy of a
particular patient. For example, the magnitude of the angles
.alpha., .PHI. may be between 35 degrees and 50 degrees, or, for
example, the magnitude of the angle .beta. may be between 15 and 30
degrees. It should be appreciated that different position
indicators with markings indicating different predetermined
positions may be used during the installation process. In other
embodiments, the position indicator may be a customized,
patient-specific position indicator. As used herein, the term
"customized, patient-specific" refers to a structure that has been
created for use with a single patient. For example, the position
indicator may include markings corresponding to custom,
predetermined positions of the acetabular prosthetic component that
are unique to a particular patient. In other embodiments, the
markings of the position indicator may be based on
surgeon-preferences.
[0065] Additionally, while the assembly 12 is used with the
acetabular prosthetic component 10 in the procedure outlined above,
the assembly 12 may also be used with an acetabular prosthetic
trial component. When attached to a trial component, the user may
use the assembly 12 to determine the type, configuration, and
installed position of the acetabular prosthetic component that is
to be implanted. It should be appreciated that different position
indicators with markings indicating different predetermined
positions may be used during the trialing process to determine the
installed position of the acetabular prosthetic component.
[0066] Referring now to FIG. 11, another embodiment of a position
indicator (hereinafter position indicator 242) is shown. Some
features of the embodiment illustrated in FIG. 11 are substantially
similar to those discussed above in reference to the embodiment of
FIGS. 1-10. Such features are designated in FIG. 11 with the same
reference numbers as those used in FIGS. 1-10. The position
indicator 242, like the position indicator 42, is configured to be
attached to the surgical tool 40.
[0067] The position indicator 242 includes a housing 90 and a rod
(not shown) sized to be received in the aperture 84 of the handle
body 58. The position indicator 242 includes a bubble indicator 244
having a vial 246 that defines a dome-shaped chamber 118 filled
with a fluid such as, for example, isopropyl alcohol. Like the vial
116 of the position indicator 42, a bubble 120 is trapped within
the chamber 118. Gravity and the physical difference between the
gas of the bubble 120 and the fluid in the chamber 118 control the
function of the bubble indicator 244, with the bubble 120 floating
toward the side of the vial 246 that constitutes the high side of
the vial 246.
[0068] The vial 246 of the bubble indicator 244 has a face plate
248 that is substantially transparent. In that way, a user may look
through the face plate 248 to determine the position of the bubble
120. As shown in FIG. 11, the bubble indicator 244 has a plurality
of markings 250 etched into an outer surface 252 of the face plate
248. Each of the markings 250 corresponds to a predetermined
position of the acetabular prosthetic component 10 within the
patient's surgically-prepared acetabulum 16.
[0069] In the illustrative embodiment, the markings 250 of the
bubble indicator 244 include a plurality of graphical indicators
254 that correspond to a plurality of predetermined positions of
the acetabular prosthetic component 10. As shown in FIG. 11, the
graphical indicators 254 include rings 132, 134, 136, which
correspond to the angles .alpha., .beta., .PHI. described above in
reference to the embodiment of FIGS. 1-10. The graphical indicators
254 of the bubble indicator 244 also include a plurality of
additional arcs 256 that correspond to additional predetermined
positions of the acetabular prosthetic component 10. In the
illustrative embodiment, the markings 254 also include a plurality
of numerical indicators 258 that are associated with the graphical
indicators 254 and indicate to the user the magnitude of the angles
.alpha., .beta., .PHI. at various predetermined positions.
[0070] In use, the position indicator 242 may be used by a surgeon
to determine the proper position of the acetabular prosthetic
component 10 from the plurality of predetermined positions
indicated by the markings 250. For example, when used with an
acetabular prosthetic trial component, the user may use the
position indicator 242 to determine the type, configuration, and
installed position of the acetabular prosthetic component 10 by
moving the acetabular prosthetic component 10 between multiple
predetermined positions.
[0071] Referring now to FIG. 12, another embodiment of a position
indicator (hereinafter indicator 342) is shown attached to the
surgical tool 40. Some features of the embodiment illustrated in
FIG. 12 are substantially similar to those discussed above in
reference to the embodiment of FIGS. 1-10. Such features are
designated in FIG. 12 with the same reference numbers as those used
in FIGS. 1-10. The position indicator 242, like the position
indicator 42, is configured to be attached to the surgical tool
40.
[0072] The position indicator 342 includes a housing 344 and a rod
86 sized to be received in the aperture 84 of the handle body 58.
The housing 344 includes an arm 346 that extends parallel to the
longitudinal axis 54 of surgical tool 40 and a base 348 that
extends orthogonal to the arm 346. As shown in FIG. 12, the
position indicator 342 includes a bubble indicator 350 secured to
the arm 346 and another bubble indicator 352 secured to the base
348.
[0073] The bubble indicator 350 includes an oblong-shaped vial 354
that extends parallel to the axis 54 of the surgical tool 40. The
vial 354 defines a chamber 356 filled with a fluid such as, for
example, isopropyl alcohol, and a bubble 358 is trapped within the
chamber 356. The bubble indicator 352 includes an oblong-shaped
vial 360 that extends orthogonal to the vial 354. The vial 360
defines a chamber 362 filled with a fluid, and a bubble 364 is
trapped within the chamber 362. Gravity and the physical difference
between the gas of the bubbles 358, 364 and the fluid in the
chamber 356, 362, respectively, control the function of the bubble
indicators 350, 352, with the bubbles 358, 364 floating toward the
high sides of the vials 354, 360.
[0074] Each of the bubble indicators 350, 352 includes a face plate
370, 372, respectively. The face plates 370, 372 are substantially
transparent. In that way, a user may look through the face plates
370, 372 to determine the respective positions of the bubbles 350,
352. The face plate 370 has a plurality of markings 374 that
indicate a plurality of predetermined positions of the acetabular
prosthetic component 10 within the patient's surgically-prepared
acetabulum 16. In the illustrative embodiment, the markings 374
correspond to predetermined amounts of rotation about the coronal
axis 148 and predetermined abduction angles.
[0075] The face plate 372 of the bubble indicator 352 has a
plurality of markings 376 that indicate a plurality of
predetermined positions of the acetabular prosthetic component 10
within the patient's surgically-prepared acetabulum 16. In the
illustrative embodiment, the markings 376 correspond to
predetermined amounts of rotation about the transverse axis 142 and
predetermined anteversion angles.
[0076] In the illustrative embodiment, the markings 374, 376 of the
bubble indicator 350, 352 include a plurality of graphical
indicators 380, 382 that correspond to a plurality of predetermined
positions of the acetabular prosthetic component 10 within the
patient's surgically-prepared acetabulum 16. It should be
appreciated that in other embodiments the markings 374, 376 may
include numerical or side indicators similar to those described
above in regard to FIGS. 1-10.
[0077] While the disclosure has been illustrated and described in
detail in the drawings and foregoing description, such an
illustration and description is to be considered as exemplary and
not restrictive in character, it being understood that only
illustrative embodiments have been shown and described and that all
changes and modifications that come within the spirit of the
disclosure are desired to be protected.
[0078] There are a plurality of advantages of the present
disclosure arising from the various features of the method,
apparatus, and system described herein. It will be noted that
alternative embodiments of the method, apparatus, and system of the
present disclosure may not include all of the features described
yet still benefit from at least some of the advantages of such
features. Those of ordinary skill in the art may readily devise
their own implementations of the method, apparatus, and system that
incorporate one or more of the features of the present invention
and fall within the spirit and scope of the present disclosure as
defined by the appended claims.
* * * * *