Bone removal device

Abstract

A bone removal device is disclosed that is configured to improve the efficiency of total ankle arthroplasty by enabling removal of a resected portion of a tibia from a patient. In particular, the bone removal device can enable a resected portion of a bone, such as but not limited to a tibia, to be pulled from the bone. The bone removal device can be configured for use in total ankle arthroplasty of a tibia, resection of carpal bones of the hand or wrist, and other procedures where it is beneficial to assist in removal of a resected portion of a bone. The bone removal device can include one or more wires to remove a resected tibia from a tibia. The bone removal device can include a bone removal device body that supports one or more arms that enable the bone removal device to pull a resected portion of a bone from the bone when the one or more arms are in an open position.

Description

[0001] Cross-reference to related applications This patent application claims the benefit of U.S. Provisional Patent Application No. 63 / 623,161, filed January 19, 2024, which is incorporated herein by reference in its entirety. Background Technology

[0002] This disclosure relates to orthopedic devices, and more specifically, to medical devices that can be used to assist in the removal of bone material during total ankle surgery, carpal resection, and other procedures.

[0003] In a standard total ankle surgery, a saw is used to cut the tibia to remove a portion of it. This removed portion of the tibia is then removed from the patient to allow for the placement of a tibial implant. The removed portion of the tibia is attached to soft tissue on the posterior side of the tibia and is very difficult to remove, partly because the attached soft tissue is difficult to access. Because the soft tissue is difficult to access, removing the removed portion of bone—such as a portion of the tibia—is time-consuming, resulting in unnecessary time being spent attempting to remove the removed portion from the tibia. Summary of the Invention

[0004] A bone removal device is disclosed, configured to improve the efficiency of total ankle surgery by enabling mechanically assisted removal of a resected portion of the tibia from the patient. Specifically, the bone removal device allows a resected portion of bone—such as, but not limited to, the tibia—to be pulled out of the bone. The bone removal device can be configured for use in total ankle surgery of the tibia, carpal resection of the hand or wrist, and other surgeries in which assisted removal of a resected portion of bone is beneficial. In at least one embodiment, the bone removal device may include at least one suture, such as, but not limited to, a suture, configured to be placed under tension to remove the resected portion of bone from the bone. In another embodiment, the bone removal device may include a bone removal device body supporting one or more arms pivotally coupled to the body. These arms are movable between a closed position abutting against the body and an open position configured to abut against the surface of the resected portion of bone once the bone removal device has been inserted into the appropriate position within a hole in the resected portion of bone, so that the bone removal device can pull the resected portion of bone out of the bone.

[0005] In at least one embodiment, the bone removal device may include one or more filaments and one or more button-shaped elements coupled to the filaments. The bone removal device may include a button-shaped element insertion shaft configured to receive and insert the button-shaped element into a hole in the removed portion of the bone. The bone removal device may include one or more button-shaped element removal devices configured to apply adjustable tension to the filaments to allow the removed portion of the bone to be pulled out of the bone. A button-shaped element removal device configured to apply adjustable tension to the filaments may be configured to apply adjustable tension to the filaments while simultaneously applying pressure to the bone, such that the filaments, button-shaped elements, and the removed portion of the bone can be pulled out of the bone.

[0006] In at least one embodiment, the button piece removal device may include one or more rotatable filament capture devices configured to hold the filament and retract it as the rotatable filament capture device rotates. The rotatable filament capture device may include one or more removable filament capture supports configured to be threadedly attached to one or more bone removal device support structures. The removable filament capture support may include a shaft having a threaded portion at one end and one or more rotatable filament tensioner receivers at the other end, the one or more rotatable filament tensioner receivers configured to receive one or more rotatable filament tensioners. The rotatable filament tensioner may be a handle configured to rotate on the rotatable filament tensioner receiver, thereby allowing the filament and the attached button piece to be pulled out of the bone.

[0007] In at least one embodiment, the rotatable suture capture device may include one or more rotatable suture tensioners positioned to rotate about an axis not parallel to the longitudinal axis of the hole in the bone resection portion. The rotatable suture tensioner may be positioned substantially orthogonal to the longitudinal axis of the hole in the bone resection portion. In at least one embodiment, the rotatable suture tensioner may be a rotatable handle.

[0008] In at least one embodiment, the bone removal device may include one or more bone removal device bodies and one or more arms having an internal receiver, the arms being rotatably mounted to the bone removal device bodies. The bone removal device may include one or more shafts positioned within the internal receivers and mechanically connected to the arms, whereby linear movement of the shafts in a first direction positions the arms in a first position, in which the arms collapse against the bone removal device bodies, and linear movement of the shafts in a second direction, substantially opposite to the first direction, positions the arms in a second position, in which the arms extend at least partially radially outward from the bone removal device bodies. Pulling the shafts extends the arms to an open position to grasp the removed portion of bone to be pulled from the bone.

[0009] The bone removal device body may include an outer surface configured to engage with the interior of a hole in the bone. The bone removal device body may include an outer surface having a cylindrical shape configured to engage with the interior of a hole in the bone. The bone removal device body may include one or more arm receivers configured to receive an arm in a closed position. The arm and arm receiver may be sized and configured such that, when the arm is in the closed position, the outer surface of the arm is aligned with or radially closer to the longitudinal axis of the bone removal device body than the outer surface of the arm, allowing the bone removal device body with the arm to be inserted into a hole in the resected portion of the bone.

[0010] In at least one embodiment, the bone removal device may include a removable retraction system configured to removably attach the bone removal device body to a bone removal device support structure. The removable retraction system may include a threaded sleeve configured to receive the bone removal device body and allow longitudinal movement of the bone removal device body relative to the sleeve. After the arm has been extended to the open position, the sleeve may rotate to abut against a guide plate, and continued rotation of the sleeve causes the bone removal device body to be pulled away from the guide plate and the bone.

[0011] In at least one embodiment, the arm of the bone removal device may be formed of two or more arms, such as one or more first arms and one or more second arms. One or more second arms may be pivotally coupled to at least one bone removal device body. The first and second arms may be pivotally coupled to the bone removal device body. The first and second arms may be pivotally coupled to the distal end of at least one bone removal device body. The first arm may be configured to rotate to an open position, thereby extending radially from the longitudinal axis of the bone removal device body in a first direction, and the second arm may be configured to rotate to an open position, thereby extending radially from the longitudinal axis of the bone removal device body in a second direction. In at least one embodiment, the second direction may be opposite to the first direction.

[0012] One advantage of the bone removal device is that it enables the rapid removal of the removed portion of bone from the patient's body via a mechanical device configured to pull the removed portion of bone out of the bone, thereby eliminating the time wasted in traditional procedures when removing the removed bone from soft tissues that are difficult to access during surgery.

[0013] Another advantage of the bone removal device is that, through a mechanical device configured to pull the resected portion of the tibia out of the tibia, the resected portion of the tibia can be quickly removed from the patient's tibia, thereby eliminating the time wasted in traditional procedures when removing the resected tibia from soft tissues that are difficult to access during surgery.

[0014] Another advantage of the bone removal device is that it only requires drilling a single hole in the resected portion of the tibia, allowing for rapid removal of the resected portion of the tibia.

[0015] These and other embodiments are described in more detail below. Attached Figure Description

[0016] Figure 1 This is a three-dimensional view of a bone removal device attached to the tibia.

[0017] Figure 2 This is another perspective view of the bone removal device attached to the tibia.

[0018] Figure 3 This is another three-dimensional view of a bone removal device attached to the patient's foot and attached to the tibia.

[0019] Figure 4 This is an exploded view of the support structure of the bone removal device.

[0020] Figure 5 This is a side view of the support structure for the bone removal device attached to the tibia.

[0021] Figure 6 It is a side view of a bone removal device support structure attached to the tibia and a rotatable suture capture device attached to the bone removal device support structure.

[0022] Figure 7 It is a three-dimensional diagram of the tibia, with button-like pieces and silk threads attached to it.

[0023] Figure 8 This is another three-dimensional view of the tibia, with button-like pieces and silk threads attached to it.

[0024] Figure 9 This is a side view of another embodiment of a bone removal device having a bone removal device body, wherein the arm is in the closed position.

[0025] Figure 10This is a side view of the main body of the bone removal device, with the arm positioned between the open and closed positions.

[0026] Figure 11 This is a side view of the main body of the bone removal device, with the arm in the open position.

[0027] Figure 12 This is a perspective view of another embodiment of the bone removal device in the closed position.

[0028] Figure 13 It is in the open position. Figure 12 A perspective view of an embodiment of the bone removal device shown.

[0029] Figure 14 It is a three-dimensional view of the tibial resection portion that has been removed from the tibia by thread.

[0030] Figure 15 This is a side view of the button insert shaft. Detailed Implementation

[0031] like Figures 1 to 15 As shown, a bone removal device 10 is disclosed, configured to improve efficiency by enabling the mechanically assisted removal of a resected portion 12 of bone 14 from the patient's body. Specifically, the bone removal device 10 allows the resected portion 12 of bone 14—such as, but not limited to, the tibia—to be pulled out of bone 14. The bone removal device 10 can be configured for use in total ankle surgery of the tibia, carpal resection of the hand or wrist, and other surgeries in which the assisted removal of the resected portion of bone is beneficial. In at least one embodiment, the bone removal device 10 may include at least one suture 16, such as, but not limited to, a suture 18, configured to be placed under tension to remove the resected portion 12 of bone 14 from bone 14. In another embodiment, the bone removal device 10 may include a bone removal device body 20 supporting one or more arms 22 pivotally coupled to the body 20. Arm 22 is movable between a closed position 24 and an open position 26, in which it abuts against the body 20 and in which it is configured to abut against the surface 28 of the removed portion of bone 14 in the open position, so that the bone removal device 10 can pull the removed portion 12 of bone 14 out of bone 14.

[0032] In at least one embodiment, such as Figures 1 to 6As shown, the bone removal device 10 may include one or more sutures 16, such as, but not limited to, sutures 18, configured to be placed under tension to remove a resected portion 12 of the bone 14 from the bone 14. In at least one embodiment, the sutures 16 may have any suitable length to function as described herein. The sutures 26 may be formed of any material capable of withstanding the forces applied thereto during the removal of the resected portion 12 of the bone 14 from the bone 14.

[0033] The bone removal device 10 may include one or more button-shaped elements 30, which are coupled to the filament 16. The button-shaped elements 30 may have any suitable shape and configuration. In at least one embodiment, the button-shaped element 30 may have a generally elongated oval shape with a relatively thin, flat profile. The button-shaped element 30 should be sized to pass through a hole 36 drilled in the resection portion 12 of the bone 14, and sized such that when the filament 16 attached to the button-shaped element 30 is pulled, the button-shaped element 30 engages a portion of the resection portion of the bone 14 and is not pulled back through the hole 36 in the resection portion of the bone 14. In this configuration, the button-shaped element 30 may have a dimension smaller than the diameter of the hole 36 in the resection portion of the bone 14 along two axes orthogonal to each other, and the button-shaped element may have a dimension larger than the diameter of the hole 36 in the resection portion of the bone 14 along a third axis orthogonal to both the first and second axes. Thus, the button-shaped element 30 may be positioned in a first orientation and pushed through the hole 36. In the second orientation, the button-type member 30 is prevented from being pulled through the hole 36. The button-type member 30 may include one or more thread attachment systems 32 configured to removably attach threads 16 to the button-type member 30. In at least one embodiment, the thread attachment system 32 may be one or more holes 34 located in the button-type member 30 such that one or more threads 16 can be attached to the button-type member 30.

[0034] Bone removal device 10 may include a button-type insert shaft 40, such as Figure 15 As shown, the button insert shaft 40 is configured to receive the button 30 and insert it into a hole 36 in the bone 14. The button insert shaft 40 can include any suitable shape and configuration such that it can be used to push the button 30 and the portion of the suture 16 attached to the button through the hole 36 in the bone 14. The outer diameter of the button insert shaft 40 can be smaller than the diameter of the hole 36 in the resected portion 12 of the bone 14. The button insert shaft 40 can be formed of a material such as, but not limited to, metal, including, but not limited to, stainless steel.

[0035] The bone removal device 10 may include one or more button-type removal devices 42 configured to apply adjustable tension to the suture 16 so that the resected portion 12 of the bone 14 can be pulled out of the bone 14. The button-type removal device 42 may be configured to apply adjustable tension to the suture 16 while simultaneously applying pressure to the bone 14, such that the suture 16, the button 30, and the resected portion 12 of the bone 14 can be pulled out of the bone 14. The button-type removal device 42 may include one or more rotatable suture capture devices 44 configured to hold the suture 16 and retract the suture 16 as the rotatable suture capture device 42 rotates.

[0036] In at least one embodiment, such as Figure 6 As shown, the rotatable filament capture device 44 may include one or more removable filament capture supports 46 configured to be threadedly attached to one or more bone removal device support structures 48. The removable filament capture support 46 may include a shaft 50 having a threaded portion 52 at one end 54 and one or more rotatable filament tensioner receivers 56 at the other end 58, the one or more rotatable filament tensioner receivers configured to receive at least one rotatable filament tensioner 60. In at least one embodiment, the at least one rotatable filament tensioner 60 may be a handle 62 configured to rotate on the rotatable filament tensioner receiver 56, thereby allowing the filament 16, the attached button-type piece 30, and the resected portion 12 of the bone 14 to be pulled out of the bone 14.

[0037] In at least one embodiment, such as Figure 1 and Figure 3 As shown, the rotatable filament trapping device 44 may include one or more rotatable filament tensioners 60, which are positioned to rotate about an axis 64 that is not parallel to the longitudinal axis 66 of the hole 36 in the resected portion 12 of the bone 14. In at least one embodiment, the rotatable filament tensioner 60 may be positioned substantially orthogonal to the longitudinal axis 66 of the hole 36 in the bone 14. In at least one embodiment, the rotatable filament tensioner 60 may be a rotatable handle 62.

[0038] The bone removal device support structure 48 can be configured to apply force directly or indirectly to the bone 14, thereby allowing the removed portion 12 of the bone 14 to be pulled out of the bone 14 using the suture 16. In at least one embodiment, the bone removal device support structure 48 can be a tube 70 having a guide plate 72. The tube 70 can have any suitable shape, such as, but not limited to, square, rectangular, cylindrical, etc.

[0039] During use, Figures 1 to 8 The illustrated embodiment can be used to pull the cut portion 12 of bone 14 out of bone 14. Once bone 14 has been cut to form the cut portion 12 of bone 14, a hole 36 can be drilled in the cut portion 12 of bone 14. In at least one embodiment, the hole 36 can extend completely through the cut portion 12 of bone 14. A button insert shaft 40 can be used to insert a button 30 and a portion of the thread 16 attached to the button 30 via a thread attachment system 32. The button insert shaft 40 can be used to push the button 30 completely through the hole 36 in the cut portion 12 of bone 14. The button insert shaft 40 can be retracted, leaving the button 30 in place. The button insert shaft 40 can be used to at least partially rotate the button 30 so that when the thread 16 is pulled toward the inlet 38 in the hole 36, the button 30 abuts against the bone 14 and is locked, preventing the button 30 from being pulled back through the hole 36 and the inlet 38. The bone removal device support structure 48 can be positioned around the inlet 38. A removable thread-catching support 46 can be threadedly attached to the bone removal device support structure 48. A rotatable thread tensioner 60 can be attached to the removable thread-catching support 46. The thread 16 can be attached to the rotatable thread tensioner 60. Depending on the embodiment used, the rotatable thread tensioner 60 can be positioned in different locations. The rotatable thread tensioner 60 can rotate to tighten the thread 16. The rotatable wire tensioner 60 can continue to rotate to break the attachment of the resected portion 12 of bone 14 to the soft tissue, thereby removing the resected portion 12 of bone 14 from bone 14.

[0040] In another embodiment, such as Figures 9 to 11 As shown, the bone removal device 10 may include a bone removal device body 20 configured to be inserted into a hole 36 in a resected portion 12 of bone 14 to remove the resected portion 12 from bone 14. The bone removal device body 20 of the bone removal device 10 may support one or more arms 22, which are pivotally coupled to the body 20 and capable of, for example... Figure 9 The closed position 24 shown and as Figure 11 The device moves between the open positions 26 shown, where it abuts against the body 20 in the closed position and is configured to abut against the surface 28 of the cut portion 12 of the bone 14 in the open position, so that the bone removal device 10 can pull the cut portion 12 of the bone 14 out of the bone 14.

[0041] The bone removal device body 20 may have an internal receiver 80 configured to receive one or more shafts 82. The internal receiver 80 may have any shape configured to hold and guide at least one shaft 82. The bone removal device body 20 may include one or more arms 22 rotatably mounted to the bone removal device body 20. The bone removal device 10 may include one or more shafts 82 positioned within the internal receiver 80 and mechanically connected to one or more arms 22, whereby a linear movement in a first direction 84 places the arm 22 in a first position 86, in which the arm 22 is folded against the bone removal device body 20, and a linear movement in a second direction 88, substantially opposite to the first direction 84, places the arm 22 in a second position 89, in which the arm 22 extends at least partially radially outward from the bone removal device body 20. Pulling the shaft 82 causes the arm 22 to unfold to an open position 26 to grasp the resected portion 12 of the bone 14 to be pulled out from the bone 14.

[0042] One or more arms 22 of the bone removal device 10 may be a first arm 90 and a second arm 92. The first arm 90 and the second arm 92 may be pivotally coupled to the bone removal device body 20, for example, to the distal end 94 of the bone removal device body 20 or other locations. The first arm 90 may be configured to rotate to an open position 26, thereby extending radially from the longitudinal axis 96 of the bone removal device body 20 in a first direction 98, and as... Figure 11 As shown, the second arm 92 can be configured to rotate to an open position 26, thereby extending radially from the longitudinal axis 96 of the bone removal device body 20 in a second direction 100. In at least one embodiment, the second direction 100 may be opposite to the first direction 98. The second arm 92 may be pivotally coupled to the bone removal device body 20.

[0043] The bone removal device body 20 may include an outer surface 110 configured to engage within a hole 12 in the resection portion 12 of the bone 14. The outer surface 110 may have a cylindrical shape configured to engage within the hole 12 in the resection portion 12 of the bone 14. The bone removal device body 20 may include one or more arm receivers 112 configured to receive an arm 22 in a closed position 24, such as... Figure 9 As shown. Arm 22 and arm receiver 112 can be sized and configured such that when arm 22 is in closed position 24, the outer surface 114 of arm 22 can be aligned with the outer surface 110 of bone removal device body 20, or be radially closer to the longitudinal axis 96 of bone removal device body 20 than the outer surface 114 of at least one arm 22.

[0044] like Figure 12 and Figure 13As shown, the bone removal device 10 may further include a removable retraction system 116 configured to removably attach the bone removal device body 20 to the bone removal device support structure 48. The removable retraction system 116 may include a sleeve 120 configured to receive the bone removal device body 20 and allow longitudinal movement of the bone removal device body 20 relative to the sleeve 120. In at least one embodiment, the sleeve 120 may be a cylindrical tube, a nut, or the like. The inner surface 122 of the sleeve 120 may include threads 124, allowing the sleeve 120 to be threadedly attached to the bone removal device body 20. The sleeve 120 may contact the guide plate 72 and is configured such that when the sleeve 120 rotates and abuts against the guide plate 72, the bone removal device body 20 is pulled away from the bone 14, thereby allowing the resected portion 12 of the bone 14 to be pulled out from the bone 14 along with the arm 22.

[0045] During use, Figures 9 to 13 The illustrated embodiment can be used to pull the resected portion 12 of bone 14 out of bone 14. One or more arms 22 can be placed in a closed position 24 by moving shaft 82 in a first direction 84, and then the bone removal device body 20 is inserted into a hole 36 in the resected portion 12 of bone 14 until the arm 22 is completely through the hole 36 in the resected portion 12 of bone 14. One or more arms 22 can be moved to an open position 26, whereby the total width of the arm 22 from the distal end of the first arm 90 to the distal end of the second arm 92 is greater than the diameter of the hole 36 in the resected portion 36 of bone 14. Shaft 82 can be pulled away from bone 14 to break the attachment of the resected portion 12 of bone 14 to soft tissue, thereby allowing the resected portion 12 of bone 14 to be removed from bone 14. Sleeve 120 can be attached to bone removal device body 20. Sleeve 120 can be rotated such that sleeve 120 contacts guide plate 72 and pushes bone removal device body 20 and resected portion 12 of bone 14 away from bone 14 as sleeve 120 continues to rotate.

[0046] The above content is provided for the purpose of illustrating, explaining, and describing the embodiments. Modifications and adaptations to these embodiments will be readily apparent to those skilled in the art.

Claims

1. A bone removal device, comprising: At least one thread; At least one button-shaped component, said at least one button-shaped component being connected to said at least one thread; At least one button insert shaft, the at least one button insert shaft being configured to receive the at least one button and insert the at least one button into a hole in the bone; as well as At least one button-type removal device, the at least one button-type removal device being configured to apply adjustable tension to the at least one thread so that the resected portion of the bone can be removed from the bone.

2. The bone-removal device of claim 1, wherein, The at least one button piece removal device configured to apply adjustable tension to the at least one thread is a device configured to apply adjustable tension to the at least one thread while applying pressure to the bone, such that the at least one thread, the at least one button piece, and the removed portion of the bone can be pulled out of the bone.

3. The bone-removal device of claim 1, wherein, The at least one button removal device includes at least one rotatable thread catcher configured to hold the at least one thread and retract the at least one thread when the at least one rotatable thread catcher rotates.

4. The bone-removal device of claim 3, wherein, The at least one rotatable filament capture device includes at least one removable filament capture support configured to be threadedly attached to at least one bone removal device support structure.

5. The bone-removal device of claim 4, wherein, The at least one removable wire capture support includes a shaft having a threaded portion at one end and at least one rotatable wire tensioner receiver at the other end, the at least one rotatable wire tensioner receiver being configured to receive at least one rotatable wire tensioner.

6. The bone-removal device of claim 5, wherein, The at least one rotatable wire tensioner is a handle configured to rotate on the at least one rotatable wire tensioner receiver, thereby allowing the wire, the at least one attached button, and the removed bone portion to be pulled out of the bone.

7. The bone-removal device of claim 1, wherein, The at least one rotatable thread-catching device includes at least one rotatable thread tensioner, which is positioned to rotate about an axis that is not parallel to the longitudinal axis of the hole in the bone.

8. The bone removal device according to claim 7, wherein, The at least one rotatable wire tensioner is positioned approximately orthogonal to the longitudinal axis of the hole in the bone.

9. The bone removal device according to claim 7, wherein, The at least one rotatable wire tensioner is a rotatable handle.

10. A bone removal device, comprising: At least one bone removal device body, the at least one bone removal device body having an internal receiver; At least one arm, the at least one arm being rotatably mounted to the body of the at least one bone removal device; At least one axis is positioned within the internal receiver and mechanically connected to the at least one arm, whereby a linear movement in a first direction places the at least one arm in a first position, in which the at least one arm is folded against the at least one bone removal device body, and a linear movement in a second direction substantially opposite to the first direction places the at least one arm in a second position, in which the arm extends at least partially radially outward from the at least one bone removal device body.

11. The bone removal device according to claim 10, wherein, The body of the at least one bone removal device includes an outer surface configured to engage with the interior of the hole in the bone.

12. The bone removal device according to claim 11, wherein, The body of the at least one bone removal device includes an outer surface having a cylindrical shape configured to fit into the interior of the hole in the bone.

13. The bone removal device according to claim 10, wherein, The at least one bone removal device body includes at least one arm receiver configured to receive the at least one arm in a closed position.

14. The bone removal device according to claim 13, wherein, The at least one arm and the at least one arm receiver are sized and configured such that when the at least one arm is in the closed position, the outer surface of the at least one arm is aligned with the outer surface of the at least one bone removal device body, or is radially closer to the longitudinal axis of the at least one bone removal device body than the outer surface of the at least one arm.

15. The bone removal device of claim 10, further comprising a removable retraction system configured to removably attach the at least one bone removal device body to a bone removal device support structure.

16. The bone removal device according to claim 15, wherein, The removable return system includes a sleeve configured to receive the at least one bone removal device body and allow longitudinal movement of the at least one bone removal device body relative to the sleeve.

17. The bone removal device according to claim 10, wherein, The at least one arm includes at least one first arm and at least one second arm.

18. The bone removal device according to claim 17, wherein, The at least one first arm and the at least one second arm are pivotally connected to the at least one bone removal device body.

19. The bone removal device according to claim 17, wherein, The at least one first arm and the at least one second arm are pivotally connected to the distal end of the at least one bone removal device body.

20. The bone removal device according to claim 17, wherein, The at least one first arm is configured to rotate to an open position, thereby extending radially from the longitudinal axis of the at least one bone removal device body in a first direction, and the at least one second arm is configured to rotate to an open position, thereby extending radially from the longitudinal axis of the at least one bone removal device body in a second direction.

21. The bone removal device according to claim 19, wherein, The second direction is opposite to the first direction.

22. A tibial removal device, comprising: At least one thread; At least one button-shaped component, said at least one button-shaped component being connected to said at least one thread; At least one button insert shaft, the at least one button insert shaft being configured to receive the button and insert the button into a hole in the tibia; as well as At least one button-type removal device, the at least one button-type removal device being configured to apply adjustable tension to the at least one thread so that the resected portion of the tibia can be removed from the tibia.

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