Surgical kits and methods

Abstract

A surgical kit and method for performing controlled resection of a femoral neck during hip replacement surgery. The kit includes a mounting portion. The mounting portion includes a guide hole for inserting a guide pin into the femoral head when the mounting portion is located on the front side of the femoral head. The kit also includes a main body portion connected to the mounting portion. The main body portion includes an opening for mounting the main body portion on an intramedullary nail. The kit also includes a resection guide frame including a guide hole having the same layout as the guide hole of the mounting portion to allow the resection guide frame to be mounted on the front side of the femoral head, wherein the guide pin is inserted into the femoral head for positioning a resection plane indicator of the resection guide frame relative to the femoral neck.

Description

Technical Field

[0001] The present invention relates to a surgical kit and method for performing controlled resection of the femoral neck during hip replacement surgery. Background of the Invention

[0003] Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Total hip replacement involves installing an acetabular cup implant in the patient's acetabulum and another implant in the patient's femur. In partial hip replacement, an implant is installed in the patient's femur, but the acetabular cup is not installed in the acetabulum. In either type of surgery, the implant installed in the femur generally includes a rod housed in the medullary cavity, and a head with a bearing surface housed in the acetabulum or acetabular cup implant. The implant generally also includes a neck extending between the proximal end of the rod and the head.

[0004] In conventional surgery, in order to install the implant in the medullary cavity, the femoral neck is first removed. The removal of the femoral neck provides access to the medullary cavity, and subsequently, a drill and a reamer can be used to prepare it into a rod for receiving the implant. During hip replacement surgery, the recovery of leg length is usually the product of good planning and experience, and can usually be controlled by preoperative planning. And the neck resection can usually be freehand cutting. Once the rod has been installed in the medullary cavity, the seating position of the implant can usually depend on the position of the incision. If the incision is not correctly positioned, this may cause the seating position of the implant to be incorrect. This may then have an adverse effect on the resulting leg length of the femur with its femoral implant.

[0005] US 6503255 B1 describes a cutting guide instrument and method that can accurately remove the head of a human femoral neck at a predetermined cutting angle relative to the femoral shaft and a predetermined cutting level relative to the proximal end of the femoral head. During the removal, a support portion is fixed to the femur. A longitudinal guide carrier is supported by the support portion and is aligned along the femoral neck at the predetermined cutting angle relative to the femoral shaft. The cutting guide is supported by the guide carrier and can be moved along the axis of the guide carrier to a cutting position corresponding to the predetermined cutting level.

[0006] WO 2002 / 026145 A1 describes a guide instrument for resection of the femoral neck in connection with total hip replacement, the guide instrument comprising: an instrument body having means for receiving a stem or the like mounted in the medullary canal of the femoral neck, the stem having a longitudinal centre axis, the instrument body being displaceable along the stem, and a guide device having a guide arrangement for the device for performing the femoral neck resection. At least one rotating ruler is attached to the instrument body, the rotating ruler being intended to cooperate with an existing femoral head of the femur.

[0007] US 5578037 A describes a surgical resection guide that enables the surgeon to resect the femoral neck during hip arthroplasty so that a femoral prosthesis can be implanted in the patient to maintain or closely approximate the anatomical center of rotation of the hip. The guide can be used for left or right hip arthroplasty using an anterior or posterior surgical approach.

[0008] US 8246621 B2 describes an instrument kit provided for reaming a bone around the head of the bone, the bone including an implanted epiphyseal component. The instrument kit includes a reaming guide and a reamer. The reaming guide can be coupled to the epiphyseal component and has a first reamer support feature and a second reamer support feature. The reamer can be coupled to one of the first reamer support feature and the second support feature to ream the bone around the epiphyseal component.

[0009] US 7601155 B2 describes an intramedullary femoral drill that aligns two instruments. A femoral neck resection guide slides on the drill and is centered on the patient's femoral head to determine the height and angular rotation of the resection. The ring and cutting arm of the head ensure that the system will adapt to any femur. A template is applied to the femoral drill and positioned against the support of the drill to lock the template in place. The drill is then reinserted into the medullary cavity. When the template reaches the greater trochanter, the sizer is adjusted to the rotational anteversion of the cavity. The handle of the femoral drill is struck with a hammer until the template is embedded in the proximal femoral neck intramedullary bone. A retractor is useful for reaming the acetabulum through a smaller anterior incision. The proximal portion is dug into the bone of the upper acetabulum to allow for retraction of the soft tissue.

[0010] US 4959066 A describes an osteotomy guide assembly for femoral neck osteotomy, comprising a saddle locator assembly and a saw guide attachment. The saddle locator assembly comprises a cylindrical locating device for locating the saddle region of the proximal femur. The cylinder also comprises a transverse support rod extending from the cylinder. The cylinder is positioned on an intramedullary shaft that is temporarily positioned in and extends from the medullary canal of the femur. A saw guide is used in conjunction with the saddle locator assembly. The saw guide is attached to the support rod by a single locking device that provides position adjustment of the saw guide relative to the support rod in two directions - including adjustment in the anterior-posterior direction along the transverse support rod, and adjustment in the axial direction along the femur via a column extending from the saw guide.

[0011] US 7833275 B2 describes a method and apparatus for performing minimally invasive total hip arthroplasty. An anterior incision of about 3.75 cm-5 cm (1.5 inch-2 inch) is made along the femoral neck. The femoral neck is cut off from the femoral shaft and removed through the anterior incision. The acetabulum is prepared to receive the acetabular cup through the anterior incision, and the acetabular cup is placed in the acetabulum through the anterior incision. A posterior incision of about 2 cm-3 cm (0.8 inch-1.2 inch) is roughly aligned with the axis of the femoral shaft and provides access to the femoral shaft. The femoral shaft is prepared through the posterior incision, including reaming and filing it, and a femoral stem is inserted through the posterior incision to be implanted in the femur. A variety of new instruments are used to perform total hip arthroplasty, including an osteotomy guide; an awl for positioning a posterior incision aligned with the axis of the femoral shaft; a tubular posterior retractor; a file handle portion with a selectively lockable engagement guide; and a selectively lockable temporary neck.

[0012] US 5607431 A describes a surgical instrument system for preparing the medullary canal of the femur for implantation of a prosthetic femoral component, the surgical instrument system including a template for use in determining the osteotomy position by x-ray. A gauge is provided to locate and mark the position on the anterior femur. A distal reamer with an elongated drive shaft is used to form a cavity to receive the distal stem of the femoral component. A metaphyseal template is used to determine the correct anteversion / retroversion, and a chisel is used to cut the lateral region of the femur, both of which are guided by the elongated reamer shaft. A proximal drill, also guided by the reamer shaft, is used to shape the proximal medullary canal.

[0013] US 7582091 B2 describes an osteotomy guide for indicating a femoral neck resection on a femur and proposes a method of use thereof. The osteotomy guide includes an indexing feature for aligning the guide with an anatomical landmark and a resection guide frame for indicating the resection relative to the indexing feature.

[0014] US 4621630 A describes a guide for femoral neck osteotomy, comprising a longitudinal rod having an attachment structure at its lower end for fixing the rod to the femur at the greater trochanter. A support arm extending laterally is fixed to the rod adjacent to the lower end of the rod, and a guide rod is connected to the support arm. The guide rod has at least one elongated flat surface arranged at a 45 degree angle to the axis of the rod. In use, the rod is aligned with the long axis axis of the femur and is attached to the femur at the greater trochanter. The rod is manipulated until the long axis axis of the support arm and the tibia are arranged in the same plane. The surgery correctly positions the elongated flat surface of the guide rod, whereby the instrument engaged with the surface traverses the femoral neck at an angle of 45 degrees to the long axis axis of the femur. Summary of the invention

[0015] Aspects of the invention are presented in conjunction with the independent and dependent claims. Combinations of features from the dependent claims may be combined with features of the independent claims as appropriate and not just as explicitly presented in the claims.

[0016] According to one aspect of the present invention, there is provided a surgical kit for performing controlled resection of a femoral neck during hip replacement surgery, the surgical kit comprising:

[0017] a mounting portion, wherein the mounting portion includes at least two guide holes for inserting a guide pin into the femoral head when the mounting portion is located on the anterior side of the femoral head;

[0018] a body portion connected to the mounting portion, wherein the body portion includes an opening for mounting the body portion on an intramedullary nail located in the medullary cavity of the femur; and

[0019] A resection guide frame includes at least two guide holes having the same layout as the guide holes of the mounting portion to allow the resection guide frame to be mounted on the front side of the femoral head, wherein a guide pin is inserted into the femoral head for positioning the resection plane indicator of the resection guide frame relative to the femoral neck.

[0020] The kit according to an embodiment of the present invention can help indicate the correct position of the neck resection plane for restoring leg length in hip replacement surgery. The embodiment of the present invention achieves this by providing the following items: a main body portion, which can be mounted on the femur with an intramedullary nail (such as a starting rod or a reamer) located in the medullary cavity of the femur to produce an extramedullary reference of the intramedullary axis; and a mounting portion, which can be used to refer to the center of the femoral head when inserting the guide nail into the femoral head; and a resection guide frame, which has a corresponding guide hole for mounting the resection guide frame on the guide nail so that the correct resection plane is then indicated at a position on the femoral neck relative to the center of the femoral head.

[0021] The resection plane indicator may, for example, indicate the positions of the two resection planes. This may allow for a neck resection utilizing two angled incisions. The two resection planes may be oriented at an angle of about 127°, 129°, or 135° relative to each other.

[0022] The resection plane indicator may include a guide groove or a guide surface.

[0023] The guide groove or guide surface may be a cutting groove or cutting guide surface for receiving a blade of a cutting device during neck resection.

[0024] The resection guide frame may include a plurality of guide hole groups. Each guide hole group may include at least two guide holes having the same layout as the guide holes of the mounting portion. The plurality of guide hole groups may be positioned in the resection guide frame respectively to allow the position of the resection plane indicator relative to the femoral neck to be adjusted by mounting the resection guide frame on the front side of the femoral head, wherein the guide pin is inserted into the guide hole of one of the guide hole groups.

[0025] The mounting portion may include three guide holes. This may provide additional stability / accuracy in the mounting portion and subsequent installation of the cut-out guide frame.

[0026] The guide holes of the mounting portion may include:

[0027] a center guide hole for aligning with the center of the femoral head when the mounting portion is located on the anterior side of the femoral head; and

[0028] an outer guide hole located on a first side of the central guide hole; and

[0029] An inner guide hole is located on a second side of the central guide hole opposite the first side.

[0030] The surgical kit may also include a plurality of guide pins.

[0031] An opening for mounting the body portion on the intramedullary nail can be adjustably positioned within the body portion depending on the femoral eccentricity of the femur.

[0032] The main body may include markings for reading the femoral eccentricity of the femur according to the position of the opening for mounting the main body on the intramedullary nail when the mounting portion is mounted on the femoral head. The femoral eccentricity value read can be used to determine the type of neck / head combination used in the implant for restoring the femoral eccentricity.

[0033] The kit may include a plurality of resection guides, each having different shapes and / or sizes according to corresponding implant geometries, for positioning the resection plane indicator of the selected resection guide relative to the femoral neck. The implant geometries may, for example, include standard lateralized shorter necks and / or coxa vara geometries.

[0034] The mounting portion may include a substantially circular femoral head contact surface.

[0035] The mounting portion may be referred to as a spherometer by those skilled in the art.

[0036] According to another aspect of the present invention, there is provided a method of performing controlled resection of a femoral neck during hip replacement surgery using a surgical kit comprising:

[0037] a mounting portion, wherein the mounting portion includes at least two guide holes for receiving the nails;

[0038] a main body portion connected to the mounting portion, the main body portion having an opening; and

[0039] a cut-out guide frame, wherein the cut-out guide frame comprises at least two guide holes having the same layout as the guide holes of the mounting portion,

[0040] The method includes:

[0041] installing the body portion on the nail by inserting the intramedullary nail located in the medullary cavity of the femur into the opening in the body portion;

[0042] placing the mounting portion on the anterior side of the femoral head;

[0043] inserting a corresponding guide pin through each guide hole of the mounting portion and into the femoral head;

[0044] removing the mounting portion from the femoral head;

[0045] Mounting a resection guide on the anterior side of the femoral head, wherein the guide pin is inserted into the femoral head for positioning a resection plane indicator of the resection guide; and

[0046] Use the cutting plane indicator to do any of the following:

[0047] Mark the location of the resection plane on the femoral neck; or

[0048] Guide the blade of the cutting device to resect the femoral neck.

[0049] The method according to an embodiment of the present invention can help indicate the correct position of the neck resection plane for restoring leg length in hip replacement surgery. The embodiment of the present invention achieves this by: using a main body portion that can be mounted on the femur with an intramedullary nail (such as a starting rod or a reamer) located in the medullary cavity of the femur to produce an extramedullary reference for the intramedullary axis; using a mounting portion to reference the center of the femoral head when inserting a guide nail into the femoral head; and using a resection guide frame having a corresponding guide hole for mounting the resection guide frame on the guide nail so that the correct resection plane is then indicated at a position on the femoral neck relative to the center of the femoral head.

[0050] The resection guide frame may include a plurality of guide hole groups. Each guide hole group may include at least two guide holes having the same layout as the guide holes of the mounting portion. A plurality of guide hole groups may be positioned in the resection guide frame respectively to allow the position of the resection plane indicator relative to the femoral neck to be adjusted by mounting the resection guide frame on the front side of the femoral head, wherein the guide pin is inserted into a guide hole of one of the guide hole groups. The method may include:

[0051] Selecting a guide hole group; and

[0052] The resection guide is mounted on the anterior side of the femoral head, wherein the guide pin is inserted into the guide hole of one of the selected guide hole groups.

[0053] The method may include adjustably positioning an opening for mounting the body portion on the intramedullary nail relative to a remainder of the body portion based on a femoral eccentricity of the femur.

[0054] The method may include reading the femoral eccentricity of the femur based on the position of the femoral eccentricity of the femur relative to the rest of the body portion when the mounting portion is mounted on the femoral head based on the opening for mounting the body portion on the intramedullary nail.

[0055] The method may include using the femoral offset value to determine the femoral offset of a femoral implant to be installed in a hip replacement procedure.

[0056] The kit may include a plurality of excision guide frames, each of which has different shapes and / or sizes according to the corresponding implant geometry, for positioning the excision plane indicator of the excision guide frame selected relative to the femoral neck. The method may also include: selecting a kind of excision guide frame; and the selected excision guide frame is installed on the front side of the femoral head, wherein the guide pin is inserted into the femoral head. The implant geometry may for example include standard lateralized shorter neck and / or coxa vara geometry.

[0057] The method may include inserting the intramedullary nail into the medullary cavity of the femur before mounting the body portion on the intramedullary nail.

[0058] The mounting portion may include a substantially circular femoral head contact surface.

[0059] The mounting portion may be referred to as a spherometer by those skilled in the art. BRIEF DESCRIPTION OF THE DRAWINGS

[0060] Embodiments of the invention will hereinafter be described, by way of example only, with reference to the accompanying drawings, in which like reference numerals associate with like elements, and in which:

[0061] Figure 1AA device mounted on the proximal end of a femur is shown according to an embodiment of the present invention;

[0062] Figure 1B A resection guide frame according to an embodiment of the present invention is shown;

[0063] Figure 1C A schematic diagram showing a device mounted on the proximal end of a femur according to an embodiment of the present invention. Figure 1B The resection guide frame;

[0064] Figure 2 Shown is the installation on the femur Figure 1A Devices and Figure 1B Front view of the cut-away guide frame ( Figure 2 Show Figure 1A Devices and Figure 1B of the resection guide frame, thereby demonstrating the alignment of their respective features with the anatomical features of the femur, however, from e.g. Figures 1A to 1C The description should be understood, Figure 1A Devices and Figure 1B The resection guide is usually not installed on the femur at the same time);

[0065] Figure 3 Shows a front view of the mounting portion of the device of FIG. 1 mounted on the front side of a femoral head;

[0066] Figure 4 shows a top view of a portion of the device of FIG. 1 mounted on a femur; and

[0067] Figure 5 A front view of the resection fixture mounted on the anterior side of the femoral head is shown. DETAILED DESCRIPTION

[0068] Embodiments of the present invention are described below with reference to the accompanying drawings.

[0069] Figure 1A , 1B , 1C and 2 show components of a kit 10 for performing controlled resection of the neck of a femur 60 during hip replacement surgery. As shown, the various parts of the kit can be installed on the femur 60 during hip replacement surgery to determine one or more resection planes.

[0070] Kit 10 includes a mounting portion 310. The mounting portion 310 may be referred to as a spherometer by those skilled in the art. The mounting portion 310 may be mounted on the front side of the femoral head 62. The mounting portion 310 includes a surface facing the femur. The mounting portion 310 may include a substantially circular femoral head contact surface. The surface facing the femur may be substantially concave and curved so as to fit against the femoral head 62. The edge of the surface facing the femur may be substantially circular for leaning against the femoral head 62. In an embodiment of the present invention, the surface facing the femur includes a ring 320, which forms a substantially circular femoral head contact surface that can lean against the femoral head, as shown.

[0071] During hip replacement surgery, the surgeon may mount the mounting portion 310 on the anterior side of the femoral head 62 so that when the femoral head 62 is viewed from an anterior position, the central axis of the mounting portion 310 (see, e.g., FIG. Figure 1A The dotted arrow marked A in the figure) is aligned with the center of the femoral head 312. This can usually be achieved by visually inspecting the front side of the femur 60 and the femoral head 62 while manually positioning the mounting portion 310.

[0072] The mounting portion 310 includes at least two guide holes. The guide holes extend through the mounting portion 310 to allow the guide pins 340, 342, 344 of the kit 10 to be inserted into the femoral head when the mounting portion 310 is located on the front side of the femoral head 62, such as Figure 1A The distal ends of the guide pins 340 , 342 , 344 of the kit 10 may be sharp, may have grooves, or may be otherwise configured to facilitate their insertion into the femoral head 62 .

[0073] In an embodiment of the present invention, there are three guide holes, but it is contemplated that two of the three or more guide holes may also be provided. For example, the central guide hole of an embodiment of the present invention may be omitted so that only an outer guide hole and an inner guide hole are present. The guide holes in an embodiment of the present invention are disposed in respective substantially cylindrical members 330, 320, 334. The substantially cylindrical members 330, 320, 334 in an embodiment of the present invention may be connected to the ring 320 so that their positions relative to the ring 320 are fixed.

[0074] The three guide holes in the embodiment of the present invention include a central guide hole, an outer guide hole on a first side of the central guide hole, and an inner guide hole on a second side of the central guide hole opposite to the first side. The central guide hole passes through the cylinder 330, the outer guide hole passes through the cylinder 332, and the inner guide hole passes through the cylinder 334. The central guide pin 340 can be inserted into the central guide hole, the outer guide pin 342 can be inserted into the outer guide hole, and the inner guide pin 344 can be inserted into the inner guide hole.

[0075] The central guide hole extends along the central axis of the mounting portion 310 so that once the mounting portion 310 is mounted on the front side of the femoral head 62 as described above, the central guide pin 340 can be inserted into the femoral head 62 along the central axis of the mounting portion 310. Once inserted, the central guide pin is thus directly pointed at the femoral head center 312. Similarly, once the mounting portion 310 is mounted on the front side of the femoral head 62 as described above, the lateral guide pin 342 and the medial guide pin 344 can be inserted through their respective guide holes and into the femoral head 62. The long axes of the guide holes are generally parallel to each other to allow the resection guide frame 200 of the kit 10 to be subsequently mounted on the guide pins, as will be explained in more detail below.

[0076] The kit 10 may also include a body portion 20 connected to the mounting portion 310. The body portion may help properly position the mounting portion 310 on the femoral head 62 and may also allow for femoral eccentricity measurement. Further details about the body portion 20 will be provided below.

[0077] Once the guide pins 340 , 342 , 344 have been inserted into the femoral head 62 , the mounting portion 310 (and the body portion 20 ) may be removed from the femur 60 .

[0078] The kit 10 also includes a cut-away guide frame 200 (see Figure 1B ). The resection guide frame 200 is a separate component of the kit 10, which can be used to indicate the position of the one or more resection planes.

[0079] The resection guide frame 200 includes at least two guide holes 210. The guide holes 210 of the resection guide frame 200 have the same layout as the guide holes of the mounting portion 310. This allows the resection guide frame 200 to be mounted on guide pins (guide pins 340, 342, 344 in this embodiment) that have been inserted into the femoral head using the mounting portion 310, such as Figure 5 Thus, using the guide pins 340, 342, 344, the resection guide frame 200 can be mounted on the front side of the femoral head 62 at a predetermined position relative to the center 312 of the femoral head (see Figure 1C ).

[0080] In an embodiment of the present invention, the cut-out guide frame 200 includes a plurality of guide hole groups 210A, 210B, 210C. Each guide hole group 210A, 210B, 210C has a plurality of guide holes whose layout matches the layout of the guide holes of the mounting portion 310 to allow the cut-out guide frame 200 to be mounted on the guide pins as described above using the guide holes in the group. The purpose of these groups 210A, 210B, 210C of guide holes will be explained below. However, it is contemplated that some embodiments may not include more than one guide hole group. For example, guide hole groups 210A and 210C may be omitted so that the cut-out guide frame 200 shown in the figure only includes guide holes corresponding to those in guide hole group 210B.

[0081] The resection guide 200 includes a resection plane indicator. The resection plane indicator indicates the position of one or more resection planes for resecting the femoral neck. When the resection guide 200 is mounted on the guide pins 340, 342, 344 as described above, the resection plane indicator of the resection guide 200 is positioned in a predetermined position relative to the center of the femoral head 62. This allows one or more resection planes for resecting the femoral neck to be determined in a controlled manner.

[0082] In an embodiment of the present invention, the resection plane indicator of the resection guide 200 includes a guide slot 202 / 204. The first portion 202 of the guide slot indicates the first resection plane, and the second portion 204 of the guide slot indicates the second resection plane. When viewed from the anterior position of the femur 60, the second resection plane (corresponding to the second portion 204 of the guide slot) may be substantially parallel to the intramedullary axis of the femur 60 (which is, for example, at Figure 2 The first resection plane (corresponding to the first portion 202 of the guide slot) extends at an angle θ relative to the second resection plane. The angle θ may be, for example, about 127°, 129°, or 135°. Although the resection plane indicator in embodiments of the present invention indicates two resection planes, it is contemplated that the resection plane indicator may indicate a single resection plane (e.g., a resection plane corresponding to the first portion 202 of the guide slot).

[0083] The resection plane indicator may alternatively include a guide surface. For example, the peripheral edge of the resection plane indicator may include one or more substantially flat surfaces (e.g., such as Figure 2 Surfaces 203, 205 shown in FIG.

[0084] The guide groove 202 / 204 (or guide surface) can be used to mark the resection plane using a pen or a scribe, etc. The guide groove 202 / 204 (or guide surface) can also be used as a cutting groove or cutting guide surface for receiving a blade of a cutting device during resection of the neck of the femur 60.

[0085] Reference Figure 2 For purposes of this disclosure, the leg length (LL) of the femur 60 may be defined as the distance between the lesser trochanter 64 and the center of the femoral head along a direction parallel to the intramedullary axis B. Referring again to Figure 2 For purposes of the present disclosure, the femoral eccentricity of the femur 60 may be defined as the distance between the center of the femoral head and the intramedullary axis B in a direction perpendicular to the intramedullary axis B.

[0086] Therefore, the femoral head center 312 can be used as a reference to position the resection plane indicator. In this way, the position of one or more resection planes can be determined in a controlled manner. This in turn means that once the rod of the implant has been installed in the medullary cavity, the seating position of the implant can be controlled. When using an implant system with a constant neck length of the implant, this can be beneficial to particularly but not necessarily exclusively restore the leg length and / or femoral eccentricity of the resulting femur 60 with its femoral implant. Kit 10 may include a plurality of resection guide frames 200 of different shapes and / or sizes. Each resection guide frame 200 is used according to the implant geometry used during hip replacement surgery. The implant geometry can, for example, include a standard lateralized shorter neck and / or coxa vara geometry.

[0087] The resection guide 200 may include a feature for fine-tuning the position of the resection plane indicator relative to the center of the femoral head 62. For example, as described above, in an embodiment of the present invention, the resection guide 200 includes a plurality of guide hole groups 210A, 210B, 210C. The guide hole group 210B in this embodiment can be used for a normal, unadjusted installation of the resection guide 200 for positioning the resection plane indicator relative to the center of the femoral head 62. The guide hole group 210A is positioned so that when the resection guide 200 is mounted on the guide pins 340, 342, 344 using the group, the resection plane indicator is positioned at a slightly lower position on the femur 60 for indicating a lower resection of the femur 60. Since the resection position of the femoral neck determines the seating position of the implant, this can in turn allow the surgeon to select a slightly lower seating position. On the other hand, the guide hole group 210B is positioned so that when the resection guide frame 200 is installed on the guide pins 340, 342, 344 using this group, the resection plane indicator is positioned at a slightly higher position on the femur 60 for indicating a higher resection of the femur 60. Similarly, since the resection position of the femoral neck determines the seating position of the implant, this can in turn allow the surgeon to select a slightly higher seating position. In some embodiments, a visual indicator 208 (e.g., L for low, N for normal, and H for high) can be provided on the resection guide frame for the surgeon's reference. It is contemplated that any combination of guide hole groups can be provided on the resection guide frame 200. For example, these groups can include a first group for installing the resection guide frame 200 "normally" without adjustment on the guide pins 340, 342, 344, plus zero or more "high" groups, plus zero or more "low" groups.

[0088] As previously mentioned, the mounting portion 310 can be connected to the body portion 20. The body portion 20 can help to properly position the mounting portion 310 on the femoral head 62 and can also allow for femoral offset measurements.

[0089] The main body portion 20 includes an opening 52 for mounting the main body portion 20 on an intramedullary nail 50, which is located in the medullary cavity of the femur 60. The intramedullary nail 50 may, for example, include an initial rod or a reamer. Before the main body portion 20 and the mounting portion 310 are mounted on the femur 60, the intramedullary nail 50 may be inserted into the medullary cavity to provide an extramedullary reference for the intramedullary axis B. Mounting the main body portion 20 in this manner may help, for example, when inserting the guide pins 340, 342, 344 (and / or when taking the readings described below), by providing a reference for the intramedullary axis B and by providing additional stability for keeping the mounting portion 310 and the main body portion 20 in the appropriate position to correctly place the guide pins 340, 342, 344. The opening 52 may, for example, include an orifice through the main body portion 20. Alternatively, the opening 52 may include a recess on the main body portion, and the intramedullary nail 50 may be received within the recess.

[0090] The position of the opening 52 can be adjustably positioned in the body portion 20 according to the femoral eccentricity of the femur 60. This allows the body portion to be adjusted so that the body portion is correctly fitted on the intramedullary nail 50 when the mounting portion is mounted on the front side of the femoral head 62 as described above. The body portion 20 may also include markings for reading the femoral eccentricity of the femur 60 according to the position of the opening 52 relative to the mounting portion 310 when the mounting portion 310 is mounted on the femoral head 62.

[0091] The main body portion 20 in this embodiment includes a plurality of arms 315 , 302 , 326 .

[0092] The first arm 315 connects the mounting portion 310 to the remainder of the body portion. In this embodiment, the first arm 315 extends in a direction substantially parallel to the intramedullary axis B when the mounting portion 310 is mounted on the femoral head 62 as described above.

[0093] The first arm 315 is connected to the second arm 302 of the main body portion 20. The second arm 302 extends in a direction perpendicular to the first arm 315, so that when the mounting portion 310 is mounted on the femoral head 62 as described above, the second arm 302 extends laterally relative to the mounting portion 310 in a direction perpendicular to the intramedullary axis B and also perpendicular to the central axis of the mounting portion 310.

[0094] The main body portion also includes a third arm 326. The third arm 326 is connected to the second arm 302 at a lateral position relative to the mounting portion 310. The third arm 326 extends in a direction substantially parallel to the central axis of the mounting portion 310, so that when the mounting portion 310 is mounted on the femoral head 62 as described above, the third arm extends in a direction substantially perpendicular to the intramedullary axis B. The opening 52 may be provided in the third arm 326. In an embodiment of the present invention, the opening 52 is located at the rear end of the third arm 326. The other end of the third arm 326 may include a handle 316 for manually positioning and adjusting the third arm 326, for example, when the opening is mounted on the intramedullary nail 50.

[0095] The relative positions of the arms 315, 302, 326 may be adjustable to allow the body portion 20 to be adjusted so that it properly fits over the intramedullary nail 50 with the mounting portion 310 mounted on the anterior side of the femoral head 62 as described above.

[0096] In an embodiment of the present invention, the second arm 302 is slidably received in an aperture located at the upper end 304 of the first arm 315. This allows the second arm 32 to slide back and forth in the lateral / medial direction relative to the first arm 32. Similarly, the third arm 326 is slidably received in an aperture located at the lateral end 324 of the second arm 302. This allows the third arm 326 to slide back and forth in the posterior / anterior direction relative to the second arm 302.

[0097] like Figure 3 As shown, the upper end 304 of the first arm 315 may include a window through which markings 306 located on the second arm 302 can be viewed. When the mounting portion 310 and the main body portion 20 are located on the femur 60 as described above, these markings 306 can be used to read the femoral eccentricity of the femur 60.

[0098] like Figure 4 As shown, the lateral end 324 of the second arm 326 may include a window through which markings 328 located on the third arm 326 can be viewed. When the mounting portion 310 and the main body portion are located on the femur 60 as described above, these markings 328 can be used to measure the anterior-posterior offset and to indicate the native femoral pattern.

[0099] Implant to be installed in femur 60 can generally include the rod to be received in the medullary cavity, and the head with bearing surface to be received in acetabulum or acetabular cup implant.Implant can also generally include the neck extending between the proximal end of rod and the head.Rod and neck can be formed as one body.Head can be attached to the end of neck.The reading obtained using mark 306 and the size (diameter / radius) of femoral head 62 can be used to inform the selection of the head to be used, for recovering femoral eccentricity.

[0100] Therefore, a surgical kit and method for performing controlled resection of a femoral neck during hip replacement surgery is described. The kit includes a mounting portion. The mounting portion includes at least two guide holes for inserting guide pins into the femoral head when the mounting portion is located on the front side of the femoral head. The kit also includes a resection guide frame including at least two guide holes, the at least two guide holes having the same layout as the guide holes of the mounting portion to allow the resection guide frame to be installed on the front side of the femoral head, wherein the guide pins are inserted into the femoral head for positioning a resection plane indicator of the resection guide frame relative to the femoral neck. The method also includes placing the mounting portion on the front side of the femoral head. The method also includes inserting corresponding guide pins through each guide hole of the mounting portion and into the femoral head. The method also includes removing the mounting portion from the femoral head. The method also includes installing the resection guide frame on the front side of the femoral head, wherein the guide pins are inserted into the femoral head for positioning the resection plane indicator of the resection guide frame. The method also includes using the resection plane indicator to perform any of the following operations: marking the location of the resection plane on the femoral neck; or guiding the blade of the cutting device to resect the femoral neck.

[0101] Although specific embodiments of the invention have been described, it will be appreciated that numerous modifications / additions and / or supplements may be made within the scope of the invention as claimed.

Claims

1. A surgical kit for performing controlled resection of a femoral neck during hip replacement surgery, the surgical kit comprising: a mounting portion, wherein the mounting portion comprises: a surface facing the femur, comprising a ring for resting against the femoral head; and at least two guide holes for inserting a guide pin into the femoral head when the mounting portion is located on the anterior side of the femoral head; a body portion connected to the mounting portion, wherein the body portion includes an opening for mounting the body portion on an intramedullary nail located in the medullary cavity of the femur; and A resection guide frame, the resection guide frame includes at least two guide holes, and the at least two guide holes have the same layout as the guide holes of the mounting portion to allow the resection guide frame to be installed on the front side of the femoral head, wherein the guide pin is inserted into the femoral head to position the resection plane indicator of the resection guide frame relative to the femoral neck, wherein the resection plane indicator indicates the position of one or more resection planes for resecting the femoral neck.

2. A surgical kit according to claim 1, wherein the resection plane indicator indicates the positions of two resection planes.

3. A surgical kit according to claim 2, wherein the two resection planes are oriented at an angle of 127°, 129° or 135° relative to each other.

4. A surgical kit according to any one of claims 1-3, wherein the resection plane indicator comprises a guide groove or a guide surface.

5. The surgical kit of claim 4, wherein the guide slot or the guide surface is a cutting slot or a cutting guide surface for receiving a blade of a cutting device during neck resection of the femoral neck.

6. A surgical kit according to claim 1, wherein the resection guide frame includes a plurality of guide hole groups, wherein each guide hole group includes at least two guide holes, and the at least two guide holes have the same layout as the guide holes of the mounting portion, wherein the plurality of guide hole groups are respectively positioned in the resection guide frame to allow the position of the resection plane indicator relative to the femoral neck to be adjusted by mounting the resection guide frame on the anterior side of the femoral head, and wherein the guide pin is inserted into the guide hole of one of the guide hole groups.

7. A surgical kit according to claim 1, wherein the mounting portion includes three of the guide holes.

8. The surgical kit of claim 7, wherein the guide hole of the mounting portion comprises: a center guide hole for aligning with the center of the femoral head when the mounting portion is located on the anterior side of the femoral head; as well as an outer guide hole located on a first side of the central guide hole; as well as An inner guide hole is located on a second side of the central guide hole opposite the first side.

9. The surgical kit of claim 1 further comprising a plurality of said guide pins.

10. The surgical kit of claim 1, wherein the opening for mounting the body portion on the intramedullary nail is adjustably positionable within the body portion depending on femoral eccentricity of the femur.

11. The surgical kit of claim 10, wherein the body portion includes markings for reading the femoral eccentricity of the femur based on a position of the opening for mounting the body portion on the intramedullary nail when the mounting portion is mounted on the femoral head.

12. A surgical kit according to claim 1, wherein the surgical kit comprises a plurality of the resection guides, each of which has a different shape and / or size according to the corresponding implant geometry, for positioning the resection plane indicator of the selected resection guide relative to the femoral neck.

13. The surgical kit of claim 1, wherein the mounting portion comprises a substantially circular femoral head contact surface.

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