Surgical devices and methods

Abstract

A surgical device and method for performing controlled resection of a femoral neck during hip replacement surgery. The surgical device includes a main body portion. The main body portion has a mounting portion. The mounting portion can be mounted on a femoral head of a femur to position the main body portion relative to the center of the femoral head. The main body portion also has an opening for mounting the main body portion on an intramedullary nail, which is located in the medullary cavity of the femur. The surgical device also includes a resection guide frame. The resection guide frame can be adjustably positioned at multiple positions on the main body portion to position a resection plane indicator of the resection guide frame relative to the femoral neck based on a measured radius / diameter of the femoral head.

Description

Technical Field

[0001] The present invention relates to a surgical device 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 order to install the implant in the medullary cavity, the femoral neck is first excised. The excision 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 excision 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.

[0015] US 2004 / 236341 A1 describes a minimally invasive surgical procedure for total hip surgery, characterized by four unique instruments that are conducive to the operation. A manual intramedullary femoral drill facilitates the axial alignment of the subsequent two instruments attached thereto to achieve alignment and stability. The femoral neck resection guide slides on the proximal portion of the drill and is automatically centered on the femoral head of the patient to determine the height and angular rotation of the femoral neck resection. The ring and cutting arm of the head locator ensure that the system will adapt to any size of femur. The sizer / cutter template is applied to the femoral drill from the top (wherein the top is removed from the medullary cavity), and the raised support of the femoral drill is placed firmly against itself, thereby locking the template in place. The femoral drill is then reinserted into the medullary cavity. When the sizer / cutter template arrives at the greater trochanter, the sizer is adjusted to the rotational anteversion of the cavity. The handle of the femoral drill is then tapped with a hammer until the sizer / cutter template is embedded in the intramedullary bone of the proximal femoral neck. The right-angle anterior acetabular retractor is extended to facilitate reaming of the acetabulum through a smaller anterior incision. The widened, curved proximal portion has angled teeth that dig into the bone of the superior acetabulum to provide a fulcrum for retraction of the overlying soft tissue.

[0016] EP 1797834 A1 describes an alignment guide for femoral head surgery, which includes: a support member; a hollow rod supported by the support member and adjustable relative to the support member; and a positioning arm having a proximal end connected to the support member and a distal end, the distal end having a positioning device for positioning on a high point of the femoral head and a notch guard that extends around at least a portion of the femoral neck during use.

[0017] US 2003 / 009170 A1 describes an auxiliary tool comprising a guide for resection of the ulna and / or radius, the guide being intended to be positioned relative to a trial humeral pulley which also belongs to the auxiliary tool and which represents the anatomical humeral pulley when the trial pulley is in position relative to the corresponding elbow and / or radial articular surfaces. The guide is also adapted to be positioned relative to the ulna and / or radius equipped with the trial pulley. Summary of the invention

[0018] 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.

[0019] According to one aspect of the present invention, there is provided a surgical device for performing controlled resection of a femoral neck during hip replacement surgery, the surgical device comprising:

[0020] The main part includes:

[0021] a mounting portion, wherein the mounting portion is mountable on a femoral head of a femur to position the body portion relative to a center of the femoral head; and

[0022] an opening for mounting the body portion on an intramedullary nail located in the medullary cavity of a femur; and

[0023] A resection guide is adjustably positionable at a plurality of locations on the body portion for positioning a resection plane indicator of the resection guide relative to the femoral neck based on a measured radius / diameter of the femoral head.

[0024] A device according to an embodiment of the present invention can help indicate the correct position of the neck resection plane for restoring leg length and / or femoral eccentricity during hip replacement surgery. An embodiment of the present invention achieves this by providing the following items: a main body portion that can be mounted on the femur using an intramedullary nail located in the medullary cavity of the femur to produce an extramedullary reference for the intramedullary axis; and a mounting portion to reference the center of the femoral head. The resection guide frame can then be positioned on the main body portion based on the measured radius / diameter of the femoral head. Typically, for larger measured sizes of the femoral head, the resection guide frame can be positioned on the main body portion so that the resection plane indicator is positioned farther away from the mounting portion (the reference is obtained by the mounting portion).

[0025] The main body portion may include a plurality of discrete connection features, each of which is used to mount the resection guide on the main body portion to place the resection plane indicator at a corresponding position according to the measured radius / diameter of the femoral head. This provides a convenient way to mount the resection guide according to the measured radius / diameter of the femoral head to correctly indicate the resection plane.

[0026] The main body portion may include a connection feature for mounting a resection guide frame on the main body portion. The position of the connection feature can be slidably adjusted within the main body portion for continuously positioning the resection plane indicator of the resection guide frame according to the measured radius / diameter of the femoral head. This provides another convenient way to mount the resection guide frame according to the measured radius / diameter of the femoral head to correctly indicate the resection plane. The slidably adjustable connection feature allows for more accurate positioning of the resection guide frame.

[0027] The or each connection feature may comprise an opening in the body portion into which a mounting member of the cut-out guide frame may be received. This may provide a secure and reliable mounting for the cut-out guide frame.

[0028] The resection guide frame can be detachably mounted on the main body portion. This can allow easier manipulation of the main body portion when the main body portion is installed in the femur before attaching the resection guide frame.

[0029] The mounting portion can be mounted on the front side of the femoral head.

[0030] The surgical device may include a second mounting portion. The second mounting portion can be mounted on the upper side or upper lateral side of the femoral head, while the mounting portion that can be mounted in the front is mounted on the front side of the femoral head. Providing two mounting portions allows the main body portion to be more reliably and accurately mounted on the femur. The upper side of the femoral head is a common wear and tear area in the femur. To this end, the mounting portion mounted on the front side and / or upper lateral side can provide a more accurate reference to the center of the femoral head.

[0031] The anteriorly mountable mounting portion is adjustably positionable relative to the remainder of the body portion in a direction parallel to the intramedullary axis of the femur based on the radius / diameter of the femoral head of the femur.

[0032] The body portion may include markings for reading the radius / diameter of the femoral head based on the position of the anteriorly mountable mounting portion relative to the rest of the body portion. The read value may be used to determine the type of neck / head combination used in the implant for restoring leg length and / or femoral eccentricity of the femur.

[0033] The mounting portion can be mounted on the upper side or the upper outer side of the femoral head.

[0034] The resection plane indicator may include a guide groove or a guide surface.

[0035] 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.

[0036] An opening for mounting the body portion to the intramedullary nail can be adjustably positioned within the body portion depending on the femoral eccentricity of the femur.

[0037] 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 to the intramedullary nail when the mounting portion or each 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.

[0038] The or each mounting portion may comprise a substantially circular femoral head contacting surface.

[0039] The mounting portion may be referred to as a spherometer by those skilled in the art.

[0040] 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 device comprising:

[0041] The main part includes:

[0042] a mounting portion, wherein the mounting portion is mountable on a femoral head of a femur to position the body portion relative to a center of the femoral head; and

[0043] an opening for mounting the body portion on an intramedullary nail located in the medullary cavity of a femur; and

[0044] a resection guide, wherein the resection guide is adjustably positionable at a plurality of locations on the body portion for positioning a resection plane indicator of the resection guide relative to the femur according to a measured radius / diameter of the femoral head,

[0045] The method comprises:

[0046] 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;

[0047] Install the mounting portion on the femoral head;

[0048] positioning a resection guide on the body portion for positioning the resection plane indicator relative to the femur according to a measured radius / diameter of the femoral head; and

[0049] Use the cutting plane indicator to do any of the following:

[0050] Mark the location of the resection plane on the femoral neck; or

[0051] Guide the blade of the cutting device to resect the femoral neck.

[0052] A method according to an embodiment of the present invention can help indicate the correct position of the neck resection plane for restoring leg length and / or femoral eccentricity during hip replacement surgery. An embodiment of the present invention achieves this by providing the following items: a main body portion that can be mounted on the femur using an intramedullary nail located in the medullary cavity of the femur to produce an extramedullary reference for the intramedullary axis; and a mounting portion to reference the center of the femoral head. The resection guide frame can then be positioned on the main body portion based on the measured radius / diameter of the femoral head. Typically, for larger measured sizes of the femoral head, the method may include positioning the resection guide frame on the main body portion so that the resection plane indicator is positioned farther away from the mounting portion (the reference is obtained by the mounting portion).

[0053] The method may include measuring the radius / diameter of the femoral head. This may be done using a caliper or the like, and / or may be done using features of the device itself.

[0054] The method may include mounting a resection guide on the body portion using one of a plurality of discrete connection features of the body portion to set a resection plane indicator according to a measured radius / diameter of the femoral head. This is a convenient way to mount a resection guide according to a measured radius / diameter of the femoral head to correctly indicate the resection plane.

[0055] The method may include: mounting a resection guide on the body portion using a connection feature of the body portion; and slidably adjusting the position of the connection feature within the body portion to set a resection plane indicator according to a measured radius / diameter of the femoral head. This is another convenient way to mount the resection guide according to the measured radius / diameter of the femoral head to correctly indicate the resection plane. The slidably adjustable connection feature allows for more accurate positioning of the resection guide.

[0056] The method may include mounting a mounting portion on the anterior side of the femoral head.

[0057] The method may include mounting a second mounting portion of the surgical device on the upper or upper lateral side of the femoral head. Using two mounting portions may allow the main body portion to be more reliably and accurately mounted on the femur. The upper side of the femoral head is a common wear and tear area in the femur. To this end, using a mounting portion mounted on the front side and / or the upper lateral side may provide a more accurate reference to the center of the femoral head.

[0058] The method may include adjusting the position of the anteriorly mounted mounting portion relative to the remainder of the body portion in a direction parallel to the intramedullary axis of the femur based on the radius / diameter of the femoral head of the femur.

[0059] The method may include using markings on the body portion to read the radius / diameter of the femoral head based on the position of the anteriorly mounted mounting portion relative to the remainder of the body portion (e.g., the second mounting portion).

[0060] The method may include mounting the mounting portion on the superior or superior lateral side of the femoral head.

[0061] The method may include adjustably positioning the opening for mounting the body portion to the intramedullary nail relative to a remainder of the body portion based on a femoral eccentricity of the femur.

[0062] The method may comprise reading the femoral eccentricity of the femur according to the position of the femoral eccentricity of the femur relative to the remainder of the body portion when the or each mounting portion is mounted to the femoral head based on the opening for mounting the body portion on the intramedullary nail.

[0063] The method may include using the radius / diameter of the femoral head and / or the femoral offset values ​​read from the surgical device to determine the leg length and / or femoral offset of a femoral implant to be installed in a hip replacement procedure.

[0064] The method may include inserting the intramedullary nail into the medullary cavity of the femur before mounting the body portion on the intramedullary nail.

[0065] The or each mounting portion may comprise a substantially circular femoral head contacting surface.

[0066] The mounting portion may be referred to as a spherometer by those skilled in the art. BRIEF DESCRIPTION OF THE DRAWINGS

[0067] 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:

[0068] Figure 1 A device mounted on a femur according to an embodiment of the present invention is shown;

[0069] Figure 2 Shown is the installation on the femur Figure 1 A front view of the device;

[0070] Figure 3A Shows Figure 1 An inner side view of the device;

[0071] Figure 3B Shown along Figure 3A The line AA in Figure 1 cross section of the device;

[0072] Figure 4 Shows Figure 1 A bottom view of the device; and

[0073] Figure 5 A device according to another embodiment of the invention is shown. DETAILED DESCRIPTION

[0074] Embodiments of the present invention are described below with reference to the accompanying drawings.

[0075] Figure 1 A surgical device 10 is shown mounted on a femur in accordance with an embodiment of the present invention. Figure 2 , 3A and 4 show Figure 1 10 , a front view, an inner side view and a bottom view. Figure 3B Shown along Figure 3A The line AA in Figure 1 Cross section of the device. Figures 1 to 4The surgical device 10 in the present invention can be used to perform controlled resection of the femoral neck during hip replacement surgery.

[0076] The device 10 includes a body portion 2. The body portion 2 includes a mounting portion 6. The mounting portion 6 may be referred to as a spherometer by those skilled in the art. The mounting portion 6 includes a surface 66 facing the femur. The surface facing the femur may be substantially concave and curved (see Figure 3B The mounting portion 6 may include a substantially circular femoral head contact surface. For example, Figure 3B As shown, the edges of the femoral-facing surface 66 can be substantially circular for resting against the femoral head 62. In some embodiments, the femoral-facing surface 66 can include a ring that forms a substantially circular femoral head contact surface that can rest against the femoral head 62. The mounting portion 6 can thus be removably mounted on the femoral head 62. Other mounting portions described herein can be shaped and constructed in the same manner as described above with respect to the mounting portion 6.

[0077] During hip replacement surgery, the surgeon may mount the mounting portion 6 on the front side of the femoral head 62 so that when the femoral head 62 is viewed from the front position, the central axis of the mounting portion 6 (see FIG. Figure 1 The mounting portion 6 is mounted on the femoral head in such a manner that the main body portion 2 is positioned relative to the center 312 of the femoral head.

[0078] In some embodiments, as shown in the figure, the main body portion 2 may include a second mounting portion 4. The second mounting portion 4 may be referred to as a spherometer by those skilled in the art. The second mounting portion 4 in the embodiment of the present invention is positioned on the lower side (facing the lower side) of the main body portion 2 so that it can be mounted on the upper side of the femoral head 62, while the anteriorly mountable mounting portion 6 is mounted on the anterior side of the femoral head 62. The second mounting portion 4 also includes a surface facing the femur. The surface facing the femur may be substantially concave and curved (see Figure 4 The second mounting portion 4 may include a substantially circular femoral head contact surface. Figure 4 As shown, the edge of the femoral-facing surface 74 can be substantially circular for resting against the femoral head 62. In some embodiments, the femoral-facing surface can include a ring that forms a substantially circular femoral head contact surface that can rest against the femoral head 62. Therefore, the second mounting portion 4 can also be detachably mounted on the femoral head 62.

[0079] The second mounting portion 4 can help to properly position the main body portion 2 relative to the femoral head center 312. The second mounting portion 4 can also allow the device 10 to be more securely mounted on the femoral head 60 when the device 10 is in use. The upper side of the femoral head 60 is a common wear and tear area in the femur. Therefore, it is also contemplated that the second mounting portion of the device can be alternatively positioned on the main body portion 2 so that it can be mounted on the upper and outer sides of the femoral head 62, while the anteriorly mountable mounting portion 6 is mounted on the anterior side of the femoral head 62 (see Figure 5 Implementation examples are described in more detail below).

[0080] The device 10 also includes a resection guide 34. The resection guide includes a resection plane indicator for indicating a resection plane on the femoral neck 60. In an embodiment of the present invention, the resection plane indicator of the resection guide 34 includes a guide slot 36. The guide slot 36 can be defined by a pair of jaws 38. When viewed from an anterior position of the femur 60, the resection plane indicated by the guide slot 36 can be relative to the intramedullary axis of the femur 60 (see Figure 2 The dashed line marked as B in FIG. 1 ) extends at an angle θ. The angle θ may be, for example, about 127°, 129°, or 135°.

[0081] The resection plane indicator may alternatively include a guide surface. For example, the peripheral edge of the resection plane indicator may be a substantially flat surface for indicating the resection plane.

[0082] The guide groove 36 (or guide surface) can be used to mark the resection plane using a pen or a scribe, etc. The guide groove 36 (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 .

[0083] In an embodiment of the present invention, the resection guide 34 includes a first arm 32 that can extend outwardly and forwardly from the body portion 2 when the mounting portion 6 is mounted on the anterior side of the femoral head 62 as described above. The resection guide 34 also includes a second arm 35 that can extend substantially perpendicular to the first arm 32 and generally toward the intramedullary axis B when viewed from an anterior position of the femur 60. A pair of jaws 38 can extend from the second arm 34 to define a guide slot 36 as described above.

[0084] 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.

[0085] During hip replacement surgery, the size (e.g., diameter / radius) of the femoral head 62 can be measured. This can be done using a caliper or the like, or can be done using a feature of the device 10 itself (e.g., a ruler 27 to be described below). The resection guide 34 can be adjustably positioned at multiple positions on the main body 2 to position the resection plane indicator of the resection guide 34 relative to the femoral neck according to the measured radius / diameter of the femoral head 62. Therefore, the femoral head center 312 can be used as a reference and the resection plane indicator can be positioned at a certain distance from the femoral head center, and the distance is determined by the measured size of the femoral head 62. Typically, for larger measured sizes of the femoral head 62, the resection guide 34 can be positioned on the main body 2 so that the resection plane indicator is positioned farther away from the mounting parts 6, 4 (the reference is obtained by the mounting parts). 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 in which the neck length of the implant is constant, this can be advantageous in particularly, but not necessarily exclusively, restoring the leg length and / or femoral offset of the resulting femur 60 having its femoral implant.

[0086] The adjustable position of the resection guide 34 on the body portion 2 for properly positioning the resection plane indicator can be achieved in a variety of ways.

[0087] The main body portion 2 may, for example, include a plurality of discrete connection features, each of which is used to mount the resection guide 34 on the main body portion 2 so as to set the resection plane indicator at a corresponding position according to the measured radius / diameter of the femoral head. In an embodiment of the present invention, these discrete connection features are implemented as openings 18 in the front surface 30 of the main body portion 2. The size and shape of each opening 18 is set to tightly receive the end of the first arm 32, which constitutes a mounting member for the resection guide 34. Figure 4 As shown, the rear surface of the body portion 2 may be provided with a corresponding opening, whereby the first arm 32 may pass completely through the body portion 2 for more secure mounting of the resection guide frame 34. It is contemplated that the connection arrangement between the first arm 32 and the opening 18 may be reversed - for example, the body portion may include a plurality of pegs on the front surface 30 for receipt in openings on the ends of the first arms 32.

[0088] The openings 34 may be distributed in rows on the main body portion 2. Figure 2 As best shown in , the row may be oriented in a direction substantially perpendicular to the resection plane indicated by the resection guide. While in embodiments of the present invention, device 10 includes four discrete connection features, it is contemplated that more or fewer such discrete connection features may be provided.

[0089] The following will combine Figure 5 Another example of achieving an adjustable position of the resection guide frame 34 on the main body portion 2 for correctly positioning the resection plane indicator is described with reference to the embodiment of FIG.

[0090] In some embodiments, the body portion 2 can assist in properly positioning the mounting portions 6, 4 onto the femoral head 62 and can also allow for femoral eccentricity measurements.

[0091] In an embodiment of the present invention, the main body portion 20 includes an opening 8 for mounting the main body portion 2 on an intramedullary nail 50, which is located in the medullary cavity of a femur 60. Before the main body portion 2 is mounted on the femur 60, the intramedullary nail 50 can be inserted into the medullary cavity to provide an extramedullary reference for the intramedullary axis B. The intramedullary nail 50 can, for example, include an initial rod or a reamer. Mounting the main body portion 2 in this manner allows the main body portion 2 to be positioned relative to both the extramedullary reference for the intramedullary axis B provided by the intramedullary nail 50 and the reference for the femoral head center 312 provided by the mounting portion 6,4. Mounting the main body portion 2 in this manner can also provide additional stability, for example, to keep the mounting portion 6,4 and the main body portion 2 in place when using the resection guide frame 34 and / or obtaining the readings described below.

[0092] The opening 8 may, for example, comprise an aperture through the body portion 22 (as shown). Alternatively, the opening 8 may comprise a recess on the body portion, within which the intramedullary nail 50 may be received. The body portion 2 may be provided with means for securing and retaining the intramedullary nail 50 in the opening 8. For example, in an embodiment of the present invention, the opening 8 is provided with a split bushing 72 having an external thread (see Figure 3B ), on which a ring 70 with an internal thread is mounted. Once the main body and mounting portion 6,4 have been set on the femur 60, the split bushing 72 can be abutted against the intramedullary nail 50 by rotating the ring 70 to fix the position of the main body 2 relative to the intramedullary nail 50.

[0093] The position of the opening 8 can be adjustably positioned in the body part 2 according to the femoral eccentricity of the femur 60. This allows the body part 2 to be adjusted so that the body part is correctly fitted on the intramedullary nail 50 when the mounting parts 6,4 are mounted on the front side of the femoral head 62 as described above. The body part 2 may also include a mark 25 for reading the femoral eccentricity of the femur 60 according to the position of the opening 8 relative to the mounting parts 6,4 when the mounting parts 6,4 are mounted on the femoral head 62. In an embodiment of the present invention, this is achieved by providing an opening 8 through a slidable member 74, which is slidably mounted in the body part 2. The slidable member 74 may include a bolt 14, which is slidably received in a groove 12 located on the front surface 30 (and optionally also the rear surface) of the body part 2. The groove 12 may extend in the outer-medial direction on the body part 2. The groove 12 may be provided with the aforementioned mark 25 for reading the femoral eccentricity of the femur 60 by detecting the position of the bolt 14 in the groove 12.

[0094] The body portion 2 also includes a slidably adjustable arm on which the mounting portion 6 is slidably mounted. The arm in this embodiment is generally L-shaped and includes an elbow 22, which can also serve as a handle for adjusting the position of the arm relative to the rest of the body portion 2.

[0095] The mounting portion 6 is slidably mounted on the first portion 26 of the arm. When the mounting portion 6 is mounted on the femoral head 62 as described above, the first portion 26 of the arm extends substantially parallel to the intramedullary axis B. The first portion 26 of the arm can pass through an opening 29 in the mounting portion 6 to allow the mounting portion 6 to slide back and forth on the first portion 26 of the arm. The mounting portion 6 can be provided with an internally threaded ring 24 that can be rotated onto corresponding threads on the mounting portion 6 to abut against the first portion 26 of the arm so as to lock the mounting portion 6 relative to the first portion 26 of the arm.

[0096] The mounting portion 6 may include a window 28 through which markings 27 located on the first portion 26 of the arm may be viewed. These markings 27 may be used to read the size (diameter / radius) of the femoral head (assuming the mounting portion 6 is properly aligned with the femoral head center 312 as described above, the markings 27 may represent the distance between the femoral head center 312 and the second mounting portion 4).

[0097] The arm also includes a second portion 16. The second portion 16 of the arm can extend substantially parallel to the central axis A of the mounting portion 6. The second portion 16 of the arm can be slidably received in a slot 46 in the main body portion 2. This can allow the arm (and therefore the mounting portion 6) to move back and forth in the posterior / anterior direction for accommodating femoral heads 62 of different sizes, thereby positioning the mounting portion 6 relative to the rest of the main body portion 2 so that the mounting portion 6 can be mounted on the anterior side of the femoral head 62 when the intramedullary nail 50 is received in the opening 8 (and if the second mounting portion 4 is included in the device 10, when the second mounting portion is mounted on the femoral head). Moving the second portion 16 of the arm in this manner can also allow the position of the mounting portion 6 to be adjusted so that the device 10 can be used for either leg of the patient.

[0098] Implant to be installed in femur 60 can generally include a rod to be received in the medullary cavity, and a head with a bearing surface to be received in acetabulum or acetabular cup implant. Implant can also generally include a neck extending between the proximal end of rod and the head. Rod and neck can be integrally formed. The head can be attached to the end of the neck. The reading obtained using mark 25 and / or 27 can be used to inform the selection of the head to be used, for recovering femoral eccentricity.

[0099] Figure 5 A surgical device 10 according to another embodiment of the present invention is shown. Figure 5 The surgical device 10 in the present invention can be used to perform controlled resection of the femoral neck during hip replacement surgery. Figure 5 The device 10 in some aspects is similar to Figures 1 to 4 10, and only the significant differences therebetween will be described in detail below.

[0100] In an embodiment of the present invention, the second mounting portion 104 is also located on the underside of the main body portion 2, but is positioned and oriented to be mounted on the upper and outer sides of the femoral head 62, while the anteriorly mountable mounting portion 6 is mounted on the anterior side of the femoral head 62. Figures 1 to 4 implementation plan, Figure 5 The mounting portion 6, 104 in the embodiment may be referred to as a spherometer by those skilled in the art.

[0101] As previously explained, the upper side of the femoral head 60 is a common area of ​​wear and tear in the femur. This may prevent the device 10 having the second mounting portion 6 mounted on the upper portion from being effectively used (e.g., the distance from the surface of the upper side of the femoral head 62 and the femoral head center 312 may be different from healthy values). The device 10 having the second mounting portion 104 positioned for superolateral mounting can therefore be used in patients with a significant amount of such wear and tear. The construction of the arm on which the mounting portion 6 is mounted can be similar to that described above with respect to Figures 1 to 4The ruler 27 can still use the relative position of the central axis A of the mounting portion 6 and the second mounting portion 104 to determine the size of the femoral head 62 .

[0102] Although the resection guide frame of the embodiment of the present invention is not Figure 5 , but it may be substantially as described above with respect to Figures 1 to 4 The described resection guide frame. In an embodiment of the present invention, the connection between the resection guide frame and the main body 2 is realized in the form of a slidable member 150 including an opening 118. The slidable member 150 is slidably mounted in a groove 120 located in the front surface 30 of the main body 2. It should be noted that the rear surface may also include such a groove for more securely mounting the slidable member 150. The size and shape of the opening 118 are set to tightly receive the end of the first arm 32 of the resection guide frame 34. Similarly, it is contemplated that the connection arrangement between the first arm 32 and the opening 118 can be reversed - for example, the slidable member 150 may include a bolt for being received in an opening located on the end of the first arm 32 of the resection guide frame 34. As described above with respect to Figure 4 In the embodiment described above, the rows of openings 18 , the slots 120 may be oriented in a direction substantially perpendicular to the resection plane indicated by the resection guide 34 .

[0103] The slidable member 150 can slide back and forth within the slot 120 to set the resection plane indicator at a certain position according to the measured radius / diameter of the femoral head 62. Figures 1 to 4 This may allow finer (ie continuous) adjustment of the position of the resection plane indicator than discrete openings 18 of the type described. The slot may be provided with markings 124, such as a ruler that may be referenced by the surgeon to set the slidable member in the correct position according to the measured radius / diameter of the femoral head 62.

[0104] In the above-described embodiment, the cutting guide frame 34 can be detachably mounted on the main body portion 2. Figure 5 For embodiments of the present invention, it is contemplated that the cut-out guide frame 34 may be integrally formed with the slidable member 150 , whereby the cut-out guide frame 34 is permanently attached to the main body portion 2 .

[0105] Therefore, a surgical device and method for performing controlled resection of a femoral neck during hip replacement surgery are described. The surgical device includes a main body portion having a mounting portion. The mounting portion can be mounted on a femoral head of a femur to position the main body portion relative to the center of the femoral head. The surgical device also includes a resection guide frame. The resection guide frame can be adjustably positioned at multiple positions on the main body portion to position a resection plane indicator of the resection guide frame relative to the femoral neck based on a measured radius / diameter of the femoral head. The method includes measuring the radius / diameter of the femoral head. The method also includes mounting the mounting portion on the femoral head. The method also includes positioning the resection guide frame on the main body portion to position the resection plane indicator relative to the femur based on the measured radius / diameter of the femoral head. 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.

[0106] 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 device for performing controlled resection of a femoral neck during hip replacement surgery, the surgical device comprising: The main body part comprises: a mounting portion slidably coupled to the body portion, the mounting portion being mountable on an anterior side of a femoral head of the femur to position the body portion relative to a center of the femoral head; a second mounting portion, wherein the second mounting portion is mountable on a superior or superior lateral side of the femoral head while the anteriorly mountable mounting portion is mounted on the anterior side of the femoral head; and a slidable member defining an opening extending therethrough for mounting the body portion on an intramedullary nail extending along a longitudinal axis within the medullary cavity of the femur; and a resection guide, wherein the resection guide is adjustably positionable at a plurality of locations on the body portion for positioning a resection plane indicator of the resection guide relative to the femoral neck based on a measured radius / diameter of the femoral head; wherein the main body portion includes a plurality of discrete connection features, each discrete connection feature being used to mount the resection guide on the main body portion so as to place the resection plane indicator at a corresponding position according to the measured radius / diameter of the femoral head; The anteriorly mountable mounting portion is constructed for slidable adjustment along a first mark on the main body portion in a direction parallel to the longitudinal axis of the intramedullary nail to measure the radius / diameter of the femoral head, and the slidable member is constructed for adjustable sliding along a second mark on the main body portion in a direction perpendicular to the longitudinal axis of the intramedullary nail to measure the femoral eccentricity of the femur.

2. The surgical device according to claim 1, wherein: Each of the connection features includes an opening in the body portion within which a mounting member of the resection guide frame is receivable.

3. The surgical device according to claim 1, wherein: The resection guide frame can be detachably mounted on the main body portion.

4. The surgical device according to claim 1, wherein: The resection plane indicator includes a guide groove or a guide surface.

5. The surgical device according to claim 4, wherein: The guide groove or the guide surface is a cutting groove or a cutting guide surface for receiving a blade of a cutting device during resection of the neck.

6. The surgical device according to claim 1, wherein: The mounting portion includes a substantially circular femoral head contacting surface.

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