U.S. patent number 3,859,992 [Application Number 05/367,695] was granted by the patent office on 1975-01-14 for vacuum-operated acetabular cup holder and positioner.
Invention is credited to Harlan C. Amstutz.
United States Patent |
3,859,992 |
Amstutz |
January 14, 1975 |
VACUUM-OPERATED ACETABULAR CUP HOLDER AND POSITIONER
Abstract
A vacuum-operated holding and positioning instrument is provided
for use in inserting an acetabular cup during hip surgery. The
instrument includes a cup-engaging head, and means for forming at
least a partial vacuum between the head and the cup to retain the
cup on the head. A suction passage is formed through an instrument
tube and handle between a port in the head and a remote suction
generator. A thumb-operated suction vent is provided to selectively
break the vacuum and deposit the cup at the desired surgical
site.
Inventors: |
Amstutz; Harlan C. (Los
Angeles, CA) |
Family
ID: |
23448225 |
Appl.
No.: |
05/367,695 |
Filed: |
June 6, 1973 |
Current U.S.
Class: |
606/91;
294/183 |
Current CPC
Class: |
A61F
2/4609 (20130101); A61F 2250/007 (20130101); A61F
2002/4685 (20130101); A61F 2002/30589 (20130101) |
Current International
Class: |
A61F
2/46 (20060101); A61F 2/00 (20060101); A61b
017/00 (); A61f 005/04 () |
Field of
Search: |
;3/1
;128/92E,92C,92CA,92R,83,276-278,33R ;294/64R,64A,64B |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Frinks; Ronald L.
Attorney, Agent or Firm: Mugford; David J. Brink; Richard H.
Mentis; George A.
Claims
The invention is claimed as follows:
1. In an instrument for holding and positioning an acetabular cup
during anthroplastic surgery, the improvement comprising a head
member having a distal tip portion contoured to mate with the
interior surface of said cup and a flange extending radially
therefrom, said flange having a planar surface to locate said cup
upon said head member, a resilient member mounted on said tip for
forming a seal of at least partial air-tightness with the surface
of the cup interior and vacuum-forming means including means
forming a fluid pathway between a vacuum port formed in said head
member and remote suction means for forming at least a partial
atmospheric vacuum between said head member and said cup.
2. A device according to claim 1 including selectively operable
venting means communicating with said fluid pathway means for
selectively breaking said vacuum between said tip and said cup,
thereby permitting said cup to be selectively released from said
instrument.
3. A device according to claim 2 wherein said suction vent means
includes valve seat means and a ball valve member positioned for
engagement with said valve seat means to seal said valve seat means
and said vacuum forming means from communication with outside
atmosphere, and lever means for selectively moving said ball valve
member to and from engagement with said valve seat means.
4. A device according to claim 3 wherein said ball valve member is
resiliently urged toward said ball valve seat means, thereby
positioning said valve means in a normally closed
configuration.
5. A device according to claim 4 wherein said lever means includes
retaining means for engaging said ball valve member and pulling
said ball valve member away from said ball seat means when said
lever means is selectively actuated.
6. A device according to claim 1 wherein said means forming a fluid
pathway includes a tube member, a handle member, and a hose barb
member, said members having inter-communicating hollow passageways
formed therein for operably connecting said vacuum port in said
head member with said remote suction means.
7. An instrument according to claim 1 including pusher arm means
engaging said instrument to provide additional manual grasping
means for assisting in locating and inserting said acetabular cup
during said surgery.
8. A device according to claim 7 wherein said pusher means includes
a pusher rod member engaging said head member, and a second handle
member connected to the free end of said rod member.
Description
BACKGROUND OF THE INVENTION
The present invention relates generally to surgical instruments,
and more particularly concerns a device for holding and positioning
an acetabular prosthetic cup during hip surgery.
Hip surgery may include an operation in which a prosthetic cup is
affixed in the skeletal acetabulum, and is intended to restore or
improve hip joint function. Speaking generally, the operation
includes the steps of surgically opening the hip joint,
disarticulating the hip, the head of the femur, reaming the
acetabulum to a hemisphere, implanting the cup in the reamed
acetabular bed and implanting the femoral prosthesis into the
femur. Often, the cup and the femoral prostheses are retained in
their implanted position by a cementitious substance. When the cup
and or femoral prostheses are emplaced, the hip joint is
reassembled and the wound closed.
During any such operation, prompt and precise location of the
prosthetic cup is required. Implacement of the cup should be made
promptly after the surrounding acetabular skeletal material has
been prepared, since hemorrhaging may present difficulty during the
operation. Moreover, the possibility of infection during such
operations encourages their speedy conclusion and wound closure;
operating instruments which permit shortening operating time are
thus desirable. When emplaced, the prosthetic cup must be precisely
located and oriented so that the artificial femoral head can be
engaged from a position which will later allow free and natural hip
movement by the patient.
Since the necessary surgical incisions are often deep and the cup
implacement site may be located at a relatively long distance from
the surgical opening, difficulty may be encountered in emplacing
the acetabular cup as rapidly and as precisely as possible.
Several surgical instruments have previously been provided for
inserting and positioning these acetabular cups in the surgical
site. The Charnley and Bechtol devices each depend upon a friction
fit between pins extending from the instrument and scallops in the
periphery of the cup. The Muller instruments frictionally engage
the inner surface of the cup by a mating spherical surface. Other
devices, such as the McKee-Farr instruments, also depend upon
frictional engagement of the cup upon an instrument head. In using
these instruments, difficulties have occasionally been experienced
in separating the holding instrument and emplaced cup; these
difficulties can result in disturbing the alignment of the cup in
the yet unhardened bone cement, and delay in completing the
operation. Moreover, frictionally engaging the cup upon its inner,
femur-bearing surface can cause scratches or mars which weaken the
cup or damage the contracting head of the femoral prosthesis.
Other instruments used in positioning do not hold the cup. Although
separation of the instrument from the cup is easy, cup insertion
can be awkward, since the cup must be retained, usually by finger
pressure, upon the instrument until contact with the cement or
acetabular bed is accomplished.
It is the general object of the present invention to provide an
instrument for grasping, positioning, and releasing an acetabular
cup during hip arthroplasty which permits the cup to be securely
grasped, easily and quickly emplaced, precisely located, and gently
released without disturbing the cup alignment.
More specifically, it is an object of the invention to provide a
cup holding and emplacing instrument which does not depend upon
frictional inter-engagement between cup and instrument for
retention of the cup upon the instrument.
It is another object of the invention to provide a cup holding and
emplacing instrument in which the cup-engaging parts need not be
mechanically moved or otherwise altered to release the cup.
It is another object of the invention to provide an acetabular cup
holder and emplacing instrument which does not frictionally engage
the cup, thereby preventing accidentally marring the cup on any
surface.
Other objects and advantages of the invention will become apparent
upon reading the following detailed description and upon reference
to the drawings. Throughout the drawings, like reference numerals
refer to like parts.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is an overall elevational view showing the novel cup holding
and positioning instrument in its general aspect;
FIG. 2 is a larger elevational view in partial section showing in
further detail the various parts of the novel instrument;
FIG. 3 is a fragmentary plan view of the instrument tube showing in
further detail a tube vacuum vent; and
FIG. 4 is a sectional view taken substantially in the plane of line
4--4 in FIG. 3 and showing in further detail the vacuum vent.
DETAILED DESCRIPTION
While the invention will be described in connection with a
preferred embodiment, it will be understood that it is not intended
to limit the invention to that embodiment. On the contrary, it is
intended to cover all alternatives, modifications and equivalents
as may be included within the spirit and scope of the
invention.
Turning to the drawings, there is shown a preferred embodiment of
the present novel cup holding and positioning device 10. The device
includes a head member 11 having a distal tip portion 12 contoured
to mate with the interior surface of an acetabular cup (not shown).
A surrounding flange 13 provides a planar surface 14 to precisely
locate the cup upon the head 11.
In accordance with the invention, the available aspirant suction
present in medical operating rooms is utilized to hold an
acetabular cup in its precisely pre-determined position upon the
head 11. This is accomplished by forming at least a partial
atmospheric vacuum between the instrument head 11 and the cup, and
to this end, the vacuum is formed by exhausting atmosphere through
a vacuum port 15 formed in the head 11. To enhance the
effectiveness of the vacuum seal between the distal tip 12 of the
head 11 and the cup, a resilient O-ring 16, which may be made of
rubber, is mounted within a retaining groove 17 formed upon the tip
12. The O-ring 16 is positioned so as not to interfere with removal
of the cup.
Since, as explained above, hip surgery may require deep incisions,
an instrument handle 20 is connected to the head 11 by means of an
elongated tube member 21. This tube member 21 may be of any
convenient length; in the preferred embodiment, the tube is of some
8 inches in extent.
In carrying out the invention, a fluid pathway is provided between
the suction port 15 formed in the head 11 and a remote suction
means (not shown). In the embodiment illustrated, the pathway
includes a fluid passageway 24 formed in the tube 21 and a
communicating passageway 25 formed in the handle 20.
Inter-connection of the handle passageway 25 with a flexible vacuum
tube 27 is accomplished by a hose barb 28.
To further assist in rapidly and accurately positioning the
acetabular cup during surgery, an additional pusher arm 30 is
included. In the illustrated embodiment, this arm 30 includes a
pusher rod 31 and a second handle 32. To encourage deftness in
handling the instrument and to minimize fabrication costs, the arm
30 in the preferred embodiment is separate from but engages the
instrument head 11, which is adapted to receive the end of pusher
rod 31. Alternatively, arm 30 may be attached directly to the
instrument head 11.
In accordance with another aspect of the invention, the cup, once
emplaced, can be easily and quickly released from the instrument
without disturbing its alignment. This is accomplished by breaking
or venting the cup-retaining vacuum at a point between the suction
port 15 and the remote suction generating means. In the illustrated
embodiment, a suction venting device 34 includes a short stem 35
having a passageway 36 which communicates with the fluid path 24
formed in the tube 21. The extremity of the stem 35 is formed with
a seating surface 37 formed to accommodate a valve ball 38. This
ball 38 is mounted upon a valve lever 39 by a retaining collar or
embossment 40. A set screw member 43 is included to permit
insertion or replacement of the ball 38 in the valve lever 39, and
to retain the ball within the lever. The lever is biased, as by a
small spring 44, for rotation about a pivot pin 45, toward the stem
35, thus urging the ball 38 into its seat 37 in a normally closed
configuration. If desired, an off-on vacuum valve can be interposed
between the suction means and the instrument handle 20.
In operation, the acetabular cup is placed over the distal end 12
of the head member 11, and is retained thereon by suction applied
to the port 15 through the flexible tube 27 and the fluid
passageways 24 and 25. The surgeon then grasps the instrument by
its handles 20 and 32. By appropriate manipulation, the acetabular
cup is emplaced in its bed and is precisely located in the desired
position. Actuation of the thumb portion 46 of the valve lever 39
breaks the vacuum and permits the head member 11 to be removed from
the cup, and the instrument extracted from the surgical site,
without disturbing the cup position.
* * * * *