Improvements in and relating to surgical instruments
By designing a surgical instrument with an adjustable driven axis and multiple adjacent surfaces, the problem of unstable load orientation control in arthroplasty is solved, achieving higher operating accuracy and user comfort.
Patent Information
- Application Number
- CN202380074463.X
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Priority Date
- 2022-10-24
- Filing Date
- 2023-10-24
- Publication Date
- 2025-06-06
AI Technical Summary
In arthroplasty, the prior art is difficult to effectively control the orientation of the load, resulting in unstable alignment and condensation during prosthesis assembly.
A surgical instrument is designed, including a handle element, a driven element and an instrument support section, and the stability and precise control of the load is achieved through different orientations of the driven axis and the design of adjacent surfaces.
Through this design, users can use the instrument at different angles and states, which improves the control accuracy and stability of the load, and reduces operational difficulty and user fatigue.
Smart Images
Figure CN120112252A_ABST
Abstract
Description
Technical Field
[0001] The present disclosure relates generally to surgical instruments, and in particular to orthopedic surgical instruments, kits including such instruments, and methods of using such instruments. More specifically, the present disclosure relates to orthopedic load generating instruments (such as a head to liner press), kits including such instruments, and methods of using such instruments. The present disclosure also has broader relevance in other surgical instruments where it is desirable to generate a load while the user controls the orientation of the instrument. Background Art
[0002] Arthroplasty is a well-known surgical procedure in which a diseased and / or damaged natural joint is replaced with a prosthetic joint. Examples include knee prostheses and hip implants. During the assembly of a prosthesis (e.g., a femoral implant and an acetabular implant), loads need to be applied to the components in the prosthesis to bring them together and into their position for use. In this operation, careful alignment and control of the loads are required. Summary of the invention
[0003] According to a first aspect of the present disclosure, there is provided a surgical instrument, the surgical instrument comprising:
[0004] handle element;
[0005] a driven element mounting section connected to the handle element;
[0006] one or more driven elements, the one or more driven elements including a driven element providing a proximal driver attachment location, the one or more driven elements including a driven element providing a proximal implant component contactor; and
[0007] an instrument support section comprising a first abutment surface and at least a second abutment surface;
[0008] wherein the instrument has a driven axis corresponding to a driven element axis extending from distally to proximally through one or more of the driven elements;
[0009] A first intersection point defined between the driven axis and the first abutment surface forms a first angle, and a second intersection point defined between the driven axis and the second abutment surface forms a second angle that is different from the first angle.
[0010] The first intersection point and / or the second intersection point and / or any and all further intersection points may be defined by a projection of the respective abutment surface onto the driven axis.
[0011] The first abutment surface and / or the second abutment surface and / or any and all further abutment surfaces may be instrument support location abutment surfaces, such as instrument support table surfaces.
[0012] The instrument may have a first state in which the first abutment surface is adapted to contact an instrument support location, such as an instrument support table surface. The instrument may have a second state in which the second abutment surface is adapted to contact an instrument support location, such as an instrument support table surface. The instrument may have a third state in which the third abutment surface is adapted to contact an instrument support location, such as an instrument support table surface. The instrument may have one or more additional states in which one of the one or more additional abutment surfaces is adapted to contact an instrument support location, such as an instrument support table surface.
[0013] The instrument may have a first state in which the driven axis has a first angular orientation relative to the vertical. The instrument may have a second state in which the driven axis has a second, different angular orientation relative to the vertical. The instrument may have a third state in which the driven axis has a third, different angular orientation relative to the vertical. The instrument may have one or more additional states in which the driven axis has a different additional angular orientation relative to the vertical.
[0014] The instrument may have a first state in which the driven axis is + / - 5° from vertical. The instrument may have a second state in which the driven axis is 30° from + / - 5° from vertical. The instrument may have a third state in which the driven axis is 45° from + / - 5° from vertical. The instrument may have one or more additional states in which the driven axis is offset from vertical by more than 55o from + / - 5° from vertical. The instrument may have one or more additional states in which the driven axis is offset from vertical in an angular direction opposite to the first state and / or the second state and / or the third state.
[0015] The instrument may have a first state in which the second abutting surface and / or the third abutting surface and / or any further abutting surface are not suitable for contacting an instrument support position, such as an instrument support table surface. The instrument may have a second state in which the first abutting surface and / or the third abutting surface and / or any further abutting surface are not suitable for contacting an instrument support position, such as an instrument support table surface. The instrument may have a third state in which the first abutting surface and / or the second abutting surface and / or any further abutting surface are not suitable for contacting an instrument support position, such as an instrument support table surface. The instrument may have a further state in which the first abutting surface and / or the second abutting surface and / or the third abutting surface are not suitable for contacting an instrument support position, such as an instrument support table surface.
[0016] The handle element may be adapted for use in a single hand of a user.The handle element may be adapted for use by the right and / or left hand of a user.
[0017] The handle element may be substantially cylindrical.The handle element may have a tapering cross section, for example tapering to a smaller cross section in an upper direction.
[0018] The handle element may be provided integrally with the driven element mounting section and / or integrally with the instrument supporting section.
[0019] The handle element may extend along the handle element axis. The handle element axis may have a constant intersection angle with the driven axis. The handle element axis may have a constant intersection angle with the driven axis in the first state and / or the second state and / or the third state and / or one or more other states. The handle element axis may, for example, have a constant intersection angle with the instrument support section in the first state and / or the second state and / or the third state and / or one or more other states. The handle element axis may, for example, have a constant intersection angle with the first abutting surface in the first state and / or the second state and / or the third state and / or one or more other intersection states. The handle element axis may, for example, have different constant intersection angles with the second abutting surface in the first state and / or the second state and / or the third state and / or one or more other intersection states. The handle element axis may, for example, have different constant intersection angles with the third abutting surface in the first state and / or the second state and / or the third state and / or one or more other intersection states. The handle element axis may have different constant intersection angles with the one or more further abutment surfaces, eg in the first state and / or the second state and / or the third state and / or one or more further intersection states.
[0020] In the first state, the handle element axis may be 45° from the vertical + / - 5°. In the second state, the handle element axis may be 30° from the vertical + / - 5°. In the third state, the handle element axis may be vertical + / - 5°.
[0021] The driven element mounting section may be substantially cylindrical.The driven element mounting section may, for example, have a substantially constant cross-section along at least 50% of the axial length of the driven element mounting location.
[0022] The driven element mounting section may be provided integrally with the handle element.
[0023] The driven element mounting section may extend along the driven element mounting section axis. The driven element mounting section axis may be coaxial with the instrument driven axis. The driven element mounting section axis may be coaxial with the instrument driven axis in the first state and / or the second state and / or the third state and / or one or more additional states.
[0024] The driven element mounting section axis may, for example, have a constant intersection angle with the instrument support section in the first state and / or the second state and / or the third state and / or one or more other states. The driven element mounting section axis may, for example, have a constant intersection angle with the first adjacent surface in the first state and / or the second state and / or the third state and / or one or more other intersection states. The driven element mounting section axis may, for example, have different constant intersection angles with the second adjacent surface in the first state and / or the second state and / or the third state and / or one or more other intersection states. The driven element mounting section axis may, for example, have different constant intersection angles with the third adjacent surface in the first state and / or the second state and / or the third state and / or one or more other intersection states. The driven element mounting section axis may, for example, have different constant intersection angles with one or more other adjacent surfaces in the first state and / or the second state and / or the third state and / or one or more other intersection states.
[0025] In the first state, the driven element mounting section axis may be + / -5° from the vertical. In the second state, the driven element mounting section axis may be 30° from the vertical + / -5°. In the third state, the driven element mounting section axis may be 45° from the vertical + / -5°.
[0026] A single driven element may be provided, wherein the driven element providing the proximal driver attachment location is the same as the driven element providing the distal implant component contactor.
[0027] The driven element providing the distal implant component connector is reciprocatable relative to the driven element mounting section, in particular along the instrument driven axis. The driven element providing the distal implant component connector may be reciprocatably mounted in the driven element mounting section.
[0028] The proximal driver attachment location may be provided on a different driven element than the driven element providing the distal implant component contactor.
[0029] The driven element providing the proximal driver attachment location is rotatable relative to the driven element mounting section, in particular about the instrument driven axis.The driven element providing the proximal driver attachment location can be rotatably mounted in the driven element mounting section.
[0030] A drive conversion mechanism may be disposed between the driven element providing the proximal driver attachment location and the driven element providing the proximal driver attachment location. The drive conversion mechanism may provide rotational to reciprocating motion conversion. The drive conversion mechanism may be disposed within the driven element mounting section.
[0031] The distal implant component contactor may be distal relative to the one or more driven elements.The distal implant component contactor may be proximal relative to a second implant component contactor associated with the instrument support section.
[0032] The distal implant component contactor may be adapted to receive a prosthetic component, such as a liner. The distal implant component contactor may be dished or recessed, particularly at the top. The distal implant component contactor may provide an inner surface, such as facing the bottom, which is substantially complementary to at least a portion of the prosthetic component.
[0033] The distal driver attachment location may be adapted to receive or be received in a driver device.
[0034] The instrument supporting section may be adapted to support the instrument in cooperation with a non-instrument surface, such as a table surface or a prosthetic component surface.
[0035] The cross-section of the instrument support section may be substantially rectilinear.The instrument support section may have a substantially constant cross-section, for example over at least 50% of its length.
[0036] The instrument supporting section may be provided integrally with the handle element.
[0037] The instrument support section may include first and second abutment surfaces and at least a third abutment surface.
[0038] In the instrument support section, the first abutment surface may be further away from the handle element than the second abutment surface and / or the third abutment surface. In the instrument support section, the second abutment surface may be further away from the handle element than the third abutment surface and / or closer to the handle element than the first abutment surface. In the instrument support section, the third abutment surface may be closer to the handle element than the first abutment surface and / or the second abutment surface.
[0039] A transition surface may be provided between an abutment surface and another abutment surface. One or more or all of the transition surfaces may be curved. A transition surface may be provided between a first abutment surface and a second abutment surface. A transition surface may be provided between a second abutment surface and a third abutment surface. A transition surface may be provided between a third abutment surface or another abutment surface and a handle element.
[0040] The length of one or more or all of the abutment surfaces is greater than the width. The length can be considered to be relative to the distal-proximal side of the handle element. The width can be considered to be perpendicular to the length and perpendicular to the instrument driven axis. The length of two or more or all of the abutment surfaces can be the same + / - 20%. The width of two or more or all of the abutment surfaces can be the same + / - 20%. The depth of two or more or all of the abutment surfaces can be the same + / - 20%. The depth can be perpendicular to the length and width.
[0041] The first abutment surface and / or the second abutment surface and / or the third abutment surface and / or the further abutment surface may have a similar surface profile. The surface profile may be similar to another surface profile, having the same length + / - 10% and / or the same width + / - 10%. The surface profile may be similar to another surface profile, having the same surface shape over at least 80% of the surface.
[0042] The first abutment surface and / or the second abutment surface and / or the third abutment surface and / or the further abutment surface may comprise a substantially planar surface section.The first abutment surface and / or the second abutment surface and / or the third abutment surface and / or the further abutment surface may be a substantially planar surface section.
[0043] The surface may be substantially planar, wherein all elements of the surface are within less than 1 mm, for example less than 0.5 mm, potentially less than 0.3 mm or possibly less than 0.2 mm relative to a virtual perfectly planar surface. The virtual perfectly planar surface may pass through one or more elements of the surface.
[0044] The surface may be a substantially planar surface wherein the separation between a virtual perfectly planar surface where the uppermost element of the surface lies and a second virtual perfectly planar surface where the lowermost element of the surface lies is less than 1 mm separation, e.g. less than 0.5 mm, potentially less than 0.3 mm or possibly less than 0.2 mm.
[0045] The first abutment surface and / or the second abutment surface and / or the third abutment surface and / or the further abutment surface may provide a planar surface section or be a planar surface section, wherein the surface section is planar in a plane perpendicular to the instrument plane. The instrument plane may be a plane in which two or more or all of the handle element and / or the driven element mounting section and / or one or more driven elements and / or the instrument support section are located or extend.
[0046] The first abutment surface (particularly its planar surface section) may be inclined at an angle of 30°+ / -10° (for example, + / -5°) relative to the second abutment surface (particularly its planar surface section). The first abutment surface (particularly its planar surface section) may be inclined at an angle of 45°+ / -10° (for example, + / -5°) relative to the third abutment surface (particularly its planar surface section). The second abutment surface (particularly its planar surface section) may be inclined at an angle of 15°+ / -10° (for example, + / -5°) relative to the third abutment surface (particularly its planar surface section). The second abutment surface (particularly its planar surface section) may be inclined at an angle of 30°+ / -10° (for example, + / -5°) relative to the first abutment surface (particularly its planar surface section).
[0047] The further abutment surface may be arranged with an inclination relative to the second abutment surface and / or relative to the third abutment surface, which inclination is smaller than the inclination of the first abutment surface. The further abutment surface may be arranged with an inclination relative to the first abutment surface, which inclination is intermediate between the inclinations of the second abutment surface and / or the third abutment surface. The further abutment surface may be arranged with an inclination relative to the first abutment surface and / or relative to the second abutment surface, which inclination is greater than the inclination of the third abutment surface.
[0048] The instrument may have a first abutment surface perpendicular to the driven axis + / - 5°. The instrument may have a second abutment surface at an angle of 60° + / - 5° to the driven axis. The instrument may have a third abutment surface at an angle of 45° + / - 5° to the driven axis. The instrument may have one or more additional abutment surfaces at an angle of less than 55° + / - 5° to the driven axis.
[0049] The instrument may have a first state in which the first abutment surface is an abutment surface for contacting a non-instrument surface. The instrument may have a second state in which the second abutment surface is an abutment surface for contacting a non-instrument surface. The instrument may have a third state in which the third abutment surface is an abutment surface for contacting a non-instrument surface. The instrument may have one or more additional states in which one of the additional abutment surfaces is an abutment surface for contacting a non-instrument surface.
[0050] The instrument support section may be connected to the second implant component contactor.The second implant component contactor may be disposed at a distal end of the instrument support section relative to the handle element.
[0051] The second implant component contactor can be adapted to receive a second prosthetic component, such as a head. The second implant component contactor can be shaped to engage with and / or support a second prosthetic component (eg, a cone, etc.).
[0052] The second implant component contactor can contact or engage with the instrument support section, particularly at the distal end thereof relative to the handle element. The second implant component connector can pass between two parts of the instrument support section or the element arranged on the instrument support section. The two parts can be limited by the forked section of the element arranged on the instrument support section or the element arranged on the instrument support section.
[0053] The distal implant component contactor and the second implant contactor may be coaxially disposed.When positioned on the distal implant component contactor and the second implant contactor, the first prosthetic component and the second prosthetic component may be coaxially disposed.
[0054] The distance between the distal implant component contactor and the second implant contactor can be variable. The distance can be increased or decreased by an actuator device.
[0055] Two or more or all different angular orientations of the instrument relative to the vertical may lie in the same plane. Two or more or all different angular orientations of the instrument relative to the vertical may lie in the same plane in the first state and / or the second state and / or the third state and / or one or more or all further states. The same plane may be the instrument plane.
[0056] Two or more or all of the handle element and / or driven element mounting section and / or one or more driven elements and / or instrument support section may be located in the same plane. Two or more or all of the handle element and / or driven element mounting section and / or one or more driven elements and / or instrument support section may be located in the same plane in the first state and / or the second state and / or the third state and / or one or more or all other states. The same plane may be an instrument plane.
[0057] The first aspect of the disclosure may include any of the features, options and possibilities set out elsewhere in this document, including in other aspects of the disclosure.
[0058] According to a second aspect of the present invention, there is provided a kit, the kit comprising:
[0059] Surgical instruments;
[0060] Actuator device;
[0061] The surgical instruments include:
[0062] handle element;
[0063] a driven element mounting section connected to the handle element;
[0064] one or more driven elements, the one or more driven elements including a driven element providing a proximal driver attachment location, the one or more driven elements including a driven element providing a proximal implant component contactor; and
[0065] an instrument support section comprising a first abutment surface and at least a second abutment surface;
[0066] wherein the instrument has a driven axis corresponding to a driven element axis extending from distally to proximally through one or more of the driven elements;
[0067] A first intersection point defined between the driven axis and the first abutment surface forms a first angle, and a second intersection point defined between the driven axis and the second abutment surface forms a second angle that is different from the first angle.
[0068] The drive device may be a rotary drive device, such as a power tool. The drive device may be a linear device, such as a reciprocating device. The drive device may be a ratchet. The drive device may include a ratchet mechanism and / or one or more arms to operate the drive device.
[0069] The driver device may include a driver handle section.The driver device may include a user interface for starting or stopping operation.
[0070] The drive device may have a drive device axis. The drive device axis may be coaxial with the axis of one or more or all of the driven elements. The drive device axis may be parallel to the instrument driven axis or coaxial with the instrument driven axis.
[0071] The driver handle segment may define a user position, such as the center of the segment held by the user.
[0072] The second aspect of the disclosure may include any of the features, options and possibilities set out elsewhere in this document, including in other aspects of the disclosure.
[0073] According to a third aspect of the present invention, there is provided a method of assembling a multi-component surgical implant, the method comprising:
[0074] a) providing at least two components of a multi-component surgical implant;
[0075] b) providing a surgical instrument, the surgical instrument comprising:
[0076] i. handle element;
[0077] ii. a driven element mounting section connected to a handle element;
[0078] iii. one or more driven elements, the one or more driven elements including a driven element providing a proximal driver attachment location, the one or more driven elements including a driven element providing a proximal implant component contactor; and
[0079] iv. an instrument support section comprising a first abutment surface and at least a second abutment surface;
[0080] v. wherein the instrument has a driven axis corresponding to a driven element axis extending from distally to proximally through one or more of the driven elements;
[0081] vi. wherein a first intersection defined between the driven axis and the first abutment surface forms a first angle, and a second intersection defined between the driven axis and the second abutment surface forms a second angle that is different from the first angle;
[0082] c) providing a first component of the surgical implant on the instrument support section;
[0083] d) providing a second component of the surgical implant on the proximal implant component contactor;
[0084] e) abutting selected ones of the abutment surfaces with the non-device surface;
[0085] f) driving the driven element to reduce the separation of the second component relative to the first component and urge the second component and the first component into an assembled form.
[0086] The method may provide that the instrument support section supports the instrument in cooperation with a non-instrument surface. The non-instrument surface may be a work surface.
[0087] The method may provide that the first component and the second component are placed in cooperation with each other outside the patient's body. The method may provide that the first component and the second component are placed in cooperation with each other, wherein neither component is in contact with the patient nor implanted in the patient's body. The method may provide that the first component and the second component are placed in cooperation with each other outside the patient's body during the assembly method.
[0088] The multi-component surgical implant may be an orthopedic implant. The multi-component surgical implant may be a hip prosthesis. The multi-component surgical implant may be a shoulder prosthesis. The multi-component surgical implant may be a knee prosthesis. The first component may be a liner. The second component may be a head.
[0089] The method may include moving the instrument to change the abutment surface that abuts the non-instrument surface.
[0090] The method may include connecting a driver device to a proximal driver attachment location. The method may include activating the driver device to drive a driven element. The driver device may include a driver handle section, wherein the driver handle section potentially defines a user position in the environment of the instrument. The method may include changing an adjacent position for changing the user position in the environment of the instrument. The method may include changing an adjacent position for changing the tilt of the driven axis.
[0091] The third aspect of the disclosure may include any of the features, options and possibilities set out elsewhere in this document, including in other aspects of the disclosure.
[0092] According to a fourth aspect of the present invention, there is provided a surgical method of using a multi-component surgical implant, the method comprising:
[0093] a) providing at least two components of a multi-component surgical implant;
[0094] b) providing a surgical instrument, the surgical instrument comprising:
[0095] i. handle element;
[0096] ii. a driven element mounting section connected to a handle element;
[0097] iii. one or more driven elements, the one or more driven elements including a driven element providing a proximal driver attachment location, the one or more driven elements including a driven element providing a proximal implant component contactor; and
[0098] iv. an instrument support section comprising a first abutment surface and at least a second abutment surface;
[0099] v. wherein the instrument has a driven axis corresponding to a driven element axis extending from distally to proximally through one or more of the driven elements;
[0100] vi. wherein a first intersection defined between the driven axis and the first abutment surface forms a first angle, and a second intersection defined between the driven axis and the second abutment surface forms a second angle that is different from the first angle;
[0101] c) providing a first component of the surgical implant on the instrument support section;
[0102] d) providing a second component of the surgical implant on the proximal implant component contactor;
[0103] e) abutting selected ones of the abutment surfaces with the non-device surface;
[0104] f) driving the driven element to reduce the separation of the second component relative to the first component and urge the second component and the first component into an assembled form.
[0105] The method may provide that the instrument support section supports the instrument in cooperation with a non-instrument surface. The non-instrument surface may be part of a prosthesis or implant in situ in a patient's body.
[0106] The method may provide that the first prosthetic component and the second prosthetic component are placed in cooperation with each other in the patient. The method may provide that the first prosthetic component and the second prosthetic component are placed in cooperation with each other, wherein one or both prosthetic components are in contact with the patient or implanted in the patient. The method may provide that the first prosthetic component and the second prosthetic component are placed in cooperation with each other in a surgical method step.
[0107] The multi-component surgical implant may be an orthopedic implant. The multi-component surgical implant may be a hip prosthesis. The multi-component surgical implant may be a shoulder prosthesis. The multi-component surgical implant may be a knee prosthesis. The first component may be a liner. The second component may be a head.
[0108] The method may include moving the instrument to change the abutment surface that abuts the non-instrument surface.
[0109] The method may include connecting a driver device to a proximal driver attachment location. The method may include activating the driver device to drive a driven element. The driver device may include a driver handle section, wherein the driver handle section potentially defines a user position in the environment of the instrument. The method may include changing an adjacent position for changing the user position in the environment of the instrument. The method may include changing an adjacent position for changing the tilt of the driven axis.
[0110] The fourth aspect of the disclosure may include any of the features, options and possibilities set out elsewhere in this document, including in other aspects of the disclosure. BRIEF DESCRIPTION OF THE DRAWINGS
[0111] Various embodiments of the present disclosure will now be described, by way of example only, and with reference to the accompanying drawings, in which:
[0112] Figure 1 It is a head to liner press apparatus of the prior art;
[0113] Figure 2a is a head-to-liner press in one state according to an embodiment of the present disclosure;
[0114] Figure 2b It is in the second state Figure 2a The head to the liner press;
[0115] Figure 2c It is in the third state Figure 2c The head to the liner press;
[0116] Figure 3 yes Figure 2a to Figure 2c Another view of the head to the liner press; and
[0117] Figure 4 is a schematic diagram of the interaction of the head to liner press with the immediate environment and location of use influencing factors. DETAILED DESCRIPTION
[0118] Although the concepts of the present disclosure are susceptible to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the accompanying drawings and will be described in detail herein. However, it should be understood that it is not intended that the concepts of the present disclosure be limited to the specific forms disclosed herein, but on the contrary, the purpose of the present invention is to cover all modifications, equivalent forms and alternative forms consistent with the present disclosure and the appended claims.
[0119] Throughout the specification, when referring to plastic implants or prostheses and surgical instruments described herein and the natural anatomy of the patient, terms indicating anatomical references may be used, such as anterior, posterior, posterior, medial, lateral, superior, inferior, etc. These terms have well-known meanings in the field of anatomical research and plastic surgery. Unless otherwise specified, these anatomical reference terms used in the written detailed description and claims are intended to be consistent with their well-known meanings.
[0120] During hip replacement surgery, a new femoral head is usually implanted. As part of this procedure, a liner assembly needs to be shrunk onto the head. Control of the forces applied and the orientation of the forces applied is important given the proper head and liner assembly.
[0121] Figure 1 A head to liner press 1 of the type of prior art apparatus is shown. The head to liner press 1 can be used for benchtop or in-situ assembly of a liner and head combination. Figure 1 In the embodiment, an assembly on a table is provided. The head-to-liner press 1 is held vertically on the table in the VV direction, wherein the foot 3 of the press 1 rests on the table. The foot 3 has a fork-shaped section 5 at the end 7. The support cone 9 and the clamping ring 11 are screwed together, wherein the screw thread protrusions on the clamping ring 11 extend upwards between the arms of the fork-shaped section 5.
[0122] The head 13 can then be positioned on the support cone 9 and the liner 15 can be positioned on the head 13. The end plate 19 and cup 19a on the end of the shaft 21 can be shrunk onto the liner 15 by squeezing the handles 17a, 17b of the press 1 together, releasing and repeating, and further movement will shrink the liner 15 onto the head 13. When properly assembled, the liner 15 will rotate freely on the head 13.
[0123] The head to liner press 1 of the type described above can also be used to form the assembly in situ, with the fork section 5 surrounding the neck and under the head of the implant. The liner 15 is then positioned opposite the head and the two are condensed together.
[0124] In either assembly mode, the press 1 requires applying the necessary force while carefully aligning the head 13 and liner 15 before and during loading. Therefore, the stability of the press 1 and the ease with which it can be held in the desired position by the user are important considerations. At the same time, in normal use, the press 1 needs to deliver loads of 800N to 1500N, thus requiring significant effort from the user.
[0125] It would be ideal to make it more comfortable for the user and allow for proper alignment and force application without undue effort or strain. Ergonomic improvements in design and operation are possible and desirable.
[0126] According to one embodiment of the present disclosure, the device 20 is Figure 2a is shown in a first orientation, and therefore in a first state A.
[0127] The instrument 20 has a foot section 22 which terminates in a fork section 24. The fork section 24 allows a projection 26 from a clamping ring 28 to extend upwardly between the arms of the fork section 24.
[0128] The foot section 22 has a first planar base section 30 that provides a first abutment surface to engage, in use, an upper surface 32 of a table 34. As shown, the first planar base section 30 is coplanar with a base portion 36 of the fork section 24. The base portion 36 may be proximally recessed relative to the first planar base section 30 so as to accommodate the clamping ring 28 above the plane of the upper surface 32 of the table 34.
[0129] With the first planar base section 30 on the upper surface 32 of the table 34, the operating axis OO of the instrument 20 is vertically aligned. The planar nature of the base section 30 helps maintain the orientation of the instrument 20 and therefore the orientation of the forces applied during use. The width of the first planar base section 30 resists movement in one plane, and the length resists movement in a perpendicular plane. The instrument 20 does not need to be freestanding in any state, but needs to be stable.
[0130] The foot section 22 also includes a second planar base section 38 toward the middle of the foot section 22. The second planar base section 38 has an angle a of 30° relative to the first planar base section 30. 1 .like Figure 2b As shown, the instrument 20 is in a second orientation and a second state B, wherein the second planar base section 38 rests on the upper surface 32 of the table 34. This places the operating axis OO at an angle of 30° relative to the vertical.
[0131] Due to the different orientation in the second state B, the apparatus 20 is easier to use for shorter users or when a taller work surface 34 is involved. As described in further detail below, the drive mechanism is closer to the edge of the work surface 34, and less inward reaching and less reaching height are required to use the apparatus 20.
[0132] The foot section 22 also includes a third planar base section 40 toward the end of the foot section 22 that is away from the fork-shaped section 24. The third planar base section 40 has an angle a of 15° relative to the second planar base section 38. 2 .like Figure 2c As shown, the instrument 20 is in a third orientation and a third state C, wherein the third planar base section 40 rests on the upper surface 32 of the table 34. This places the operating axis OO at an angle of 45° relative to the vertical.
[0133] Due to the further different orientation in the third state C, the apparatus 20 is even easier to use for shorter users or when a taller work surface 34 is involved. As described in further detail below, the drive mechanism reaches over the edge of the work surface 34, and still less inward reaching and still less reaching height are required to use the apparatus 20.
[0134] Since three stable states A, B and C are provided, the user can select three different orientations of the device. Each of these states and their different orientations also bring different positions and orientations to the drive mechanism employed. Overall, the method enables the user to use the device without putting their wrist and / or shoulder in a tense position.
[0135] The three orientations provided provide a sufficient range of orientations for a sufficiently wide range of users and factors that affect use. Additional orientations and states can be introduced to the three provided above by providing additional planar surfaces or facets at additional different angles. The use of planar surfaces (such as flat facets) is beneficial in optimizing stability in each state.
[0136] There are many possibilities for the manner in which the shaft 21 and end plate 19 are advanced into contact with the liner 15 and then shrunk the liner 15 onto the head 13 . Figure 1 A ratchet mechanism of the type used in the method is one such drive mechanism. This provides a drive mechanism that is aligned orthogonally relative to the driven shaft 21. Rotation of the shaft 21 relative to the fixed body is another option for providing a drive mechanism. This can use a proximal handle extending radially outward on the shaft 21.
[0137] Figure 4 The drive mechanism shown in the figure is a power screw drive 50. It is mounted on the proximal end 52 of the driven shaft 54 and thus extends axially from the instrument 20. This means that a longer configuration is created and greater adjustability is provided for the orientation of the instrument. In addition, the handle 56 for such a drive mechanism is in an optimal position for holding and fully activating and controlling the drive mechanism without requiring a large movement of the user's hand.
[0138] Return to Figure 3 , describing the remaining features of the instrument 20. The handle element 42 links the foot section 22 to the shaft mounting section 44. The contour of the handle element 42 is ergonomically designed to fit the user's left and / or right hand. The handle element 42 is generally perpendicular to the third planar base section 40. The configuration of the handle element 42 allows the user to firmly push the instrument 20 into engagement with the clamping ring 28 or the implant rod [not shown]. The configuration of the handle element 42 also allows the user to bend their wrist and provide fine adjustment of the orientation.
[0139] The shaft mounting section 44 is generally cylindrical. The shaft mounting section 44 extends distally relative to the handle element 42 toward the fork section 24. The shaft mounting section 44 also extends proximally relative to the handle element 42.
[0140] A drive mechanism (e.g., a power screw drive 50) is connected to the distal end 46 of the first driven shaft 48. The driven shaft 48 extends into the shaft mounting section 44 and is connected to the second driven shaft 58. Within the shaft mounting section 44, the rotational drive of the first driven shaft 48 is converted into axial movement of the second driven shaft 58. Driving the first driven shaft 48 in one direction advances the second driven shaft 58 toward the fork section 24. Reversing the drive direction retracts the second driven shaft 58 away from the fork section 24. The distal end 60 of the second driven shaft 58 is provided with a liner receiving cup 62 having an internal distal profile that is adapted to match a portion of the proximal outer profile of the liner [not shown in this figure]. A retaining element 64 is used to retain the liner in the liner receiving cup 62.
[0141] The use position 100 of the instrument 20 and drive mechanism 50 is the position of a user's hand 102 on the user interface of the instrument (typically the handle 104). Figure 4 , various factors may affect the spatial location of the use location 100 within the environment 106 .
[0142] The three different states A, B, C of the apparatus 20 described above allow the apparatus 20 to be successfully and comfortably operated for its intended purpose in a variety of situations. The various situations can be considered to cover different situations where various factors that have an impact on the use environment appear at different values. Such factors are at least partially in Figure 4 , but for clarity reference is made to a single state instrument 20. Various factors include those that influence the use position 100 of the instrument 20 and the alternate possible use positions [not shown] having different states.
[0143] A set of key factors are all factors that have an impact on the height of the use location 100 relative to the floor 108 of the environment 106 in which the machine 20 is used. The overall bottom-to-top height can include many different factors. These factors include:
[0144] • The floor 108 to surgical table 32 factor, defined herein as the floor to table length 110, contributes significantly to this height variation. A wide range of values may be encountered between different tables 32, for example heights of 900mm to 1200mm are common.
[0145] Head length 112 is the next factor encountered. It will vary with the head design adopted and therefore the physical size of the head. Typical values for this factor may be centered around 25 mm, or a maximum of 25 mm.
[0146] The next factor moving up is the liner length 114. This will vary with the type of liner chosen to be used and the different sizes that come with it and the different separations required to introduce the liner into the head.
[0147] • Stroke length 116 is the next factor and relates to the separation required to align the liner with the head and then collapse towards each other. It will vary with the head and liner design but can be around 80mm.
[0148] • Finally, the drive mechanism configuration (identified herein as gun width 118 ) will further impact where the use position 100 is located.
[0149] If the instrument 20 is in state A, the use position 100 will move inwardly and upwardly on the workbench 34, as indicated by arrow A. If the instrument is in state C, the use position 100 will move outwardly and downwardly from the workbench 34, as indicated by arrow C.
[0150] While the present disclosure has been illustrated and described in detail in the drawings and foregoing description, such illustration and description should be regarded as illustrative rather than restrictive in nature, and it should be understood that only illustrative embodiments have been shown and described and that all changes and modifications made within the spirit of the present disclosure should be protected.
[0151] The present disclosure has a number of advantages arising from the various features of the devices, systems and methods described herein. It should be noted that alternative embodiments of the devices, systems and methods of the present disclosure may not include all of the features described, but may still benefit from at least some of the advantages of these features. Those of ordinary skill in the art can easily design their own implementations of the devices, systems and methods that can incorporate one or more of the features of the present invention and fall within the spirit and scope of the present disclosure.
Claims
1. A surgical instrument, the surgical instrument include: handle element; a driven element mounting section connected to the handle element; one or more driven elements, the one or more driven elements including a driven element providing a proximal driver attachment location, the one or more driven elements including a driven element providing a proximal implant component contactor; and an instrument support section comprising a first abutment surface and at least a second abutment surface; wherein the instrument has a driven axis corresponding to a driven element axis extending from distally to proximally through one or more of the driven elements; A first intersection defined between the driven axis and the first abutment surface forms a first angle, and a second intersection defined between the driven axis and the second abutment surface forms a second angle, the second angle being different from the first angle.
2. An instrument according to claim 1, wherein the instrument has a first state, in which the first adjacent surface is suitable for contacting an instrument support position, such as an instrument support table surface, and the instrument has a second state, in which the second adjacent surface is suitable for contacting the instrument support position.
3. An apparatus according to claim 1 or claim 2, wherein the apparatus has a first state, in which the driven axis has a first angular orientation relative to a vertical line, and the apparatus has a second state, in which the driven axis has a different second angular orientation relative to the vertical line.
4. An instrument according to any one of the preceding claims, wherein the instrument has a third state in which the third abutment surface is adapted to contact an instrument support location.
5. An instrument according to any one of the preceding claims, wherein the instrument has a third state in which the driven axis has a different third angular orientation relative to the vertical.
6. An instrument according to any one of the preceding claims, wherein the instrument has a first state and / or a second state and / or a third state and / or another state, in which the driven axis is + / -5° from the vertical, in the second state, the driven axis is 30° from the vertical + / -5°, in the third state, the driven axis is 45° from the vertical + / -5°, and in the other state, the driven axis is offset from the vertical by more than 55° from the vertical by + / -5°.
7. An instrument according to any one of the preceding claims, wherein the instrument supporting section comprises a first abutment surface, a second abutment surface and a third abutment surface.
8. An instrument according to claim 7, wherein, within the instrument supporting section, the first abutting surface is farther away from the handle element than the second abutting surface and / or the third abutting surface, and / or wherein within the instrument supporting section, the second abutting surface is farther away from the handle element than the third abutting surface and / or is closer to the handle element than the first abutting surface.
9. The instrument according to any of the preceding claims, wherein the first abutment surface and / or the second abutment surface and / or the third abutment surface comprises a substantially planar surface section.
10. An instrument according to any of the preceding claims, wherein the first abutment surface is inclined at an angle of 30° + / - 10° relative to the second abutment surface and / or the first abutment surface is inclined at an angle of 45° + / - 10° relative to the third abutment surface.
11. An instrument according to any one of the preceding claims, wherein the driven element mounting section is provided integrally with the handle element and integrally with the instrument supporting section.
12. An instrument according to any of the preceding claims, wherein the distal implant component contact is adapted to receive a prosthetic component, such as a liner, and / or wherein the instrument support section is connected to a second implant component contact, which is adapted to receive a second prosthetic component, such as a head.
13. A kit, the kit comprising: include: Surgical instruments; Actuator device; The surgical instrument comprises: handle element; a driven element mounting section connected to the handle element; one or more driven elements, the one or more driven elements including a driven element providing a proximal driver attachment location, the one or more driven elements including a driven element providing a proximal implant component contactor; and an instrument support section including a first abutment surface and at least a second abutment surface; wherein the instrument has a driven axis corresponding to a driven element axis extending from distally to proximally through one or more of the driven elements; A first intersection defined between the driven axis and the first abutment surface forms a first angle, and a second intersection defined between the driven axis and the second abutment surface forms a second angle, the second angle being different from the first angle.
14. A kit according to claim 13, wherein the actuator means is a rotary actuator means or a ratchet.
15. A method of assembling a multi-component surgical implant, the method include: a) providing at least two components of the multi-component surgical implant; b) providing a surgical instrument, the surgical instrument comprising: i. handle element; ii. a driven element mounting section connected to the handle element; iii. one or more driven elements, the one or more driven elements including a driven element providing a proximal driver attachment location, the one or more driven elements including a driven element providing a proximal implant component contactor; and iv. an instrument support section comprising a first abutment surface and at least a second abutment surface; v. wherein the instrument has a driven axis corresponding to a driven element axis extending from distally to proximally through one or more of the driven elements; vi. wherein a first intersection defined between the driven axis and the first abutment surface forms a first angle, and a second intersection defined between the driven axis and the second abutment surface forms a second angle, the second angle being different from the first angle; c) providing a first component of the surgical implant on the instrument supporting section; d) providing a second component of the surgical implant on the proximal implant component contactor; e) abutting selected ones of the abutment surfaces with a non-instrument surface; f) driving a driven element to reduce the separation of the second component relative to the first component and to urge the second component and the first component into an assembled form.
16. The method of claim 15, wherein the instrument support section supports the instrument in cooperation with the non-instrument surface, such as a work surface.
17. A method according to claim 15 or claim 16, wherein the method comprises moving the instrument to change the abutment surface abutting the non-instrument surface.
18. A method according to any one of claims 15 to 17, wherein the method comprises connecting a driver device to the proximal driver attachment location and / or activating a driver device to drive a driven element.
19. A method according to any one of claims 15 to 18, wherein a driver device is provided and includes a driver handle section, which defines a user position in the environment of the instrument, and the method includes changing an adjacent position for changing the user position in the environment of the instrument.
20. A method according to claim 19, wherein the method comprises varying the abutment position for varying the inclination of the driven axis.
21. A surgical method using a multi-component surgical implant, the method include: a) providing at least two components of the multi-component surgical implant; b) providing a surgical instrument, the surgical instrument comprising: i. handle element; ii. a driven element mounting section connected to the handle element; iii. one or more driven elements, the one or more driven elements including a driven element providing a proximal driver attachment location, the one or more driven elements including a driven element providing a proximal implant component contactor; and iv. an instrument support section comprising a first abutment surface and at least a second abutment surface; v. wherein the instrument has a driven axis corresponding to a driven element axis extending from distally to proximally through one or more of the driven elements; vi. wherein a first intersection defined between the driven axis and the first abutment surface forms a first angle, and a second intersection defined between the driven axis and the second abutment surface forms a second angle, the second angle being different from the first angle; c) providing a first component of the surgical implant on the instrument supporting section; d) providing a second component of the surgical implant on the proximal implant component contactor; e) abutting selected ones of the abutment surfaces with a non-instrument surface; f) driving a driven element to reduce the separation of the second component relative to the first component and to urge the second component and the first component into an assembled form.