Operation equipment for knee surgery, operating room provided with such equipment, assembly kit, and corresponding methods for assembly, operation and use

Abstract

The invention relates to an innovation in the manner of surgically exposing the knee during total or partial knee arthroplasty. Currently, and as has always been the case, the conventional surgical approach for the knee used the anterior route but also the medial route, where it was necessary to sever the whole tissue attachment from the inner bone margin thereof, said tissue attachment comprising the capsule (envelope), the medial patellofemoral ligament and the tendon of the vastus medialis oblique (muscle) of the quadriceps. The present invention relates in particular to operation equipment intended to facilitate and / or implement this new and innovative surgical approach.

Description

[0001] OPERATING EQUIPMENT FOR KNEE SURGERY, OPERATING ROOM PROVIDED WITH SUCH EQUIPMENT, KIT FOR ASSEMBLING, AND CORRESPONDING ASSEMBLY, OPERATION, AND USE METHODS

[0002] Field of invention:

[0003] The present invention relates to the field of surgeries, such as "knee" surgery, for example, and / or any other type of related surgery. More particularly, the present invention relates to operating equipment for innovative knee surgery, for example, and also relates to a system and / or operating room provided with such equipment, as well as a kit for assembling it(them), and corresponding methods of assembly, operation and / or use.

[0004] Description of the prior art:

[0005] According to the reviewed literature, despite rigorous application of all the rules of the art known for this technique, approximately 15% of the results of total knee replacement are unsatisfactory and the causes still remain unknown. These result in chronic pain that is accompanied by limitations in the activities of daily living; particularly those involving going up and down stairs, among others. Despite the acquisition of better mastery in the manufacture of prosthesis models, the design of which has evolved considerably over the last three decades to increasingly respect the anatomy and specific mechanics of the knee; all these elements have not been able to contribute to improving the aforementioned figures.This lack of understanding of the disappointing results has also earned total knee replacement the expression of the "missing link" in contrast to the better results encountered with total hip replacement over the last 30 years, the latter having seen solutions to several identified problems.

[0006] The Applicant / inventor's own understanding of this issue and his beliefs are based on his research, analyses, clinical observations, interpretation of his results, continuous questioning, simulations and personal experience, in particular, as a medical doctor and orthopedic surgeon for 29 years. These led the Applicant / inventor to explain that the origin of these poor results is the result of a change in the behavior of the patella caused by the very surgical approach to the knee, considered universal by the orthopedic community. In the past, this surgical approach had been described and practiced for all kinds of knee surgery, long before the arrival of prosthetic knee replacement surgeries. This was at a time when immobilization of an operated knee was part of the norm.The Applicant / inventor explains this anomaly by the fact that instead of the surgical approach having been adapted to prosthetic knee replacement surgery, the opposite, almost natural, phenomenon would have occurred.

[0007] Indeed, the surgical approach to the knee, which has never in the past been questioned or had an alternative for comparison, has fundamental disadvantages at its core, according to the Applicant / inventor, which are in opposition to the basic principles of knowledge in surgery and tissue healing, in particular:

[0008] 1) This surgical approach, although classical (see diagram #2), creates an irreversible weakening of the capsular wall, ligaments and tendon once cut and following their healing, resulting in a permanent imbalance in the alignment of the patella. This weakening is further maintained, exaggerated and favored by the need for immediate and rapid mobility of the knee postoperatively, well before the end of healing; at best, healing occurs with some elongation of the aforementioned tissues; ) Healing of the soft tissues is complete approximately 42 days after surgery, and its maturation requires even more time, which represents a paradox compared to the need to move the knee immediately after its replacement with a prosthesis.The completion of this healing is theoretically necessary so that the tensile strength of the tissues is large enough to resist the application of a deforming force exerted by the mobilization of the knee, especially beyond 90 degrees of flexion during rehabilitation. On the other hand, we know that in reality, if knee immobilization is imposed to promote quality healing, such a condition can only lead to undesirable and permanent ankylosis of the knee which is incompatible with normal function, the main reason why it is essential to start rehabilitation as early as possible, i.e. the day after the operation and sometimes the same day; ) Also, and by comparison, we know that there are several similar musculoskeletal disorders which normally require immobilization to ensure adequate healing, in order to obtain the desired functional result.Examples include: the finger flexor tendon, the elbow ligaments, the biceps tendon, the shoulder tendon, etc., to name just a few among many others; ) Among the tissues severed in this anterior knee surgical approach, we can also mention, at the microscopic level, the nerve endings specialized in detecting changes in position (proprioceptors), knee pressure (mechanoceptors) and pain (nociceptors), which are distributed at the level of the capsule, tendons and ligaments. These nerve endings, once severed, become pain-producing due to the trauma suffered directly at the level of the micro-nerve endings but also secondary to the surgical remodeling and local edema at the site of the repair.In turn, these specialized nerve endings are excited by the variation in tissue tension induced by the back-and-forth movement of the knee and by the intra-articular pressure increased by the accumulation of excess fluid; would these surgical traumas at the level of the aforementioned specialized endings not be specifically responsible, at least in part, for the inhibition of the myoneural plate of the vastus medialis oblique of the quadriceps observed during the initial four-week period immediately following knee replacement?; ) The immediate postoperative course of a total knee replacement involves the arrival of an increased volume of fluid in the knee capsule caused by bleeding.Since the available intra-articular space is limited; this new fluid volume, the production of synovial fluid and the intense inflammatory reaction in response to the surgical insult, contribute greatly to an increase in intra-articular pressure of the knee. In turn, this hyperpressure is a significant cause of pain by stimulation of mechanoceptors among others at the level of the capsule; ) This mechanism, in parallel with the need to mobilize the knee as quickly as possible and beyond 90 degrees of flexion, becomes one of the most daunting experiences of this surgery for the patient and contributes to significantly limiting flexion.This excess volume cannot be expelled anywhere other than the tightly closed knee cavity; ) The tissue sutures made during closure must therefore and in turn withstand the pressure that will be induced during flexion of the knee in which a surplus volume of reaction liquid has filled. According to observations on cadavers, if the pressure in question exceeds the capacity of the suture threads to resist, or the elasticity of the tissues that the threads assemble, there will be a loss of the tightness of the closure. The latter is initially observed around the suture thread and not between the closely spaced edges, and there is a production of flow of the liquid contents of the knee, leading to the formation of an extra-capsular hematoma, which in turn increases the risk of infection of the knee.All this exacerbates once again the pain experienced by the majority of patients after this surgery, by stimulating the nerve receptors of pressure among others; ) Another type of tissue severed during the classic exposure of the knee are the arterioles of the vascular network that irrigate the tissues. The resulting vascular damage by reduction of the blood supply to the repair area and the closure of the knee is a significant factor and must be taken into consideration. In fact, it is known that a fundamental condition for good healing of cuts is precisely the quality and abundance of vascularization. An area adjacent to the incision can become hypo-vascularized and secondarily contribute to a delay in tissue healing.Another important element that would also influence the vascular flow of the tissues at the incision site itself is the tension applied to the sutures during closure and the reapproximation of the severed elements during the anterior approach to the knee. The fragile paradox that the surgeon faces is the following: on the one hand, a repair with overly tight sutures would result in a reduction of vascularization, creating an ischemic area and consequently poor quality healing, or at least delayed. On the other hand, a closure with loose sutures in order to avoid the aforementioned situation would result in an increased risk of a loss of tightness of the knee capsule (envelope) with the formation of excessive flows, which would increase the risks of infection.Obviously, the exact optimal closure tension for each patient depending on the quality of their tissues, the severity of the correction and their age remains an unknown variable; ) Since the aforementioned soft tissue structures are not always clearly visible and individualized during closure, it is common that perfect symmetry of alignment on both sides of the wound and closure of these elements is not achievable, even if the knee is placed in flexion during closure. This results in an asymmetrical distribution of tension on the tissues during active flexion and extension. This asymmetry may be responsible, at least in part, for joint stiffness; 0) The risk of detachment of the vastus medialis during excessive and early passive flexion of the knee may cause permanent weakening of the vastus medialis oblique (VMO).This can secondarily lead to an imbalance in the alignment of the patella, very often exacerbated during internal rotation of the femur in knee flexion; 11) The exposure of the external compartment, which is still limited in some patients during the procedure, requires widening of the incision in the conventional approach, resection of the fat pad, and 180-degree eversion of the patella. This exerts excessive tension on the surrounding tissues, further increased by the use of retractors during surgery. In addition, this increases the risk of iatrogenic damage to the internal collateral ligament, or the use of the lateral approach if the medical approach proves insufficient; and.

[0009] 12) When closing the knee capsule at the end of the procedure, at the level of its distal tibial attachment, we frequently encounter a tissue deficit due to the lower quality at this precise level of the capsule, which is often stretched and thinned. The leaky closure explains the presence of the flow of intra-articular contents often encountered at the distal end of the wound, typically the day after the procedure. The other factor that contributes to the tissue deficit allowing a leaky closure is the fact that patients, at the time of their knee replacement, have at the same time a correction of the knee axis deformed by osteoarthritis. Thus, the internal deviation of the leg is straightened to reach a normal axis, which creates tension at the level of the medial capsular lip and makes it less mobilizable and available for a quality suture during closure.

[0010] For all the disadvantages of the aforementioned classical surgical approach, and as a consequence, it would therefore be greatly advantageous to find a new surgical technique / approach and / or corresponding operating equipment to intervene surgically, on a knee, for example, and to be able to overcome and / or reduce / minimize, some of the aforementioned disadvantages and drawbacks, if not all, and / or at least, to be able to do it in a faster, simpler, more precise, more efficient, more economical, more reliable, more adjustable, more versatile, more adaptable, more durable, more desirable, and / or in an improved way, than is possible with the current way of doing things.It would be enough to just imagine what it would mean for the patient as well as the third-party payer to be able to initiate easier, less painful, less expensive rehabilitation, and consequently a shorter hospital stay, and a faster return to daily activities, with a higher satisfaction rate.

[0011] The question remains: what is the alternative way to adequately expose the knee to allow the application, according to standards, of the total knee replacement technique, its revision, or others, without compromising the results, and while precisely controlling the return of the normal anatomy of the patella as well as its original mechanical behavior, and this, in all patients without exception? In other words, how can we achieve a predictable and reproducible result in all patients?

[0012] Summary of the invention:

[0013] An object of the present invention is therefore to provide operating equipment (and / or a system and / or an operating room comprising such equipment, etc.) which, thanks to its design and its components, would satisfy some of the aforementioned needs and would therefore be an improvement over other ways of doing things, systems and / or related methods known in the prior art.

[0014] The above-mentioned object is achieved, as will be better understood hereinafter, by an operating equipment (and / or a system and / or an operating room comprising such equipment, etc.) such as that briefly described in the present description, and such as that exemplified in the attached figures. More particularly, an objective of the present invention is to provide an operating equipment comprising at least one piece of equipment being positionable, shaped and dimensioned to cooperate with a joint of a patient intended to be operated on, so as to allow a trans-patellar bone and tendon surgical intervention with longitudinal cutting on the patient's joint, via said at least one piece of equipment of the operating equipment.

[0015] According to a possible embodiment of the present invention, the piece of equipment (e.g. a series of tools and / or accessories, etc.) of the operating equipment is selected from a group consisting of a sectioning guide, a sectioning tool, a connection system, a first threaded head, a second threaded head, a connection rod, at least one router bit (e.g. one for each threaded head, etc.), a measuring tool, a retention mechanism, a screwable ring, a rotation tool and a grinding tool, for example.

[0016] According to another possible embodiment of the present invention, it also relates to operating equipment, including a series of corresponding novel tools and / or accessories, including, for example: a patellar cutting guide, as well as a drilling guide for screw or clamp(s), a patella separator, and a choice of implants for patella fixation. This could in particular include an axial compression screw system, a screw system screwed through screwed washers, a double U-shaped clamp system with stops, a wiring system for a crimped cerclage, and / or the use of a screw-in-place ring.

[0017] Indeed, such operating equipment allows in particular, and advantageously, a new surgical approach proposed herein, namely trans-patellar bone and tendon with longitudinal cut, which could potentially remedy all the drawbacks encountered with the conventional surgical approach to knee arthroplasty, and which would most likely be responsible for the poor results of the conventional intervention.

[0018] According to another aspect of the present invention, it also relates to a corresponding system and / or operating room provided with the aforementioned equipment.

[0019] According to another aspect of the present invention, it also provides a kit with corresponding components for assembling the aforementioned equipment, system and / or operating room.

[0020] According to another aspect of the present invention, it also relates to a method of assembling components of the aforementioned equipment, system and / or operating room.

[0021] According to another aspect of the present invention, it also relates to a method of operating the aforementioned equipment, system and / or operating room, and / or certain components thereof.

[0022] According to another aspect of the present invention, it also relates to a method of using the aforementioned equipment, system and / or operating room, and / or certain components thereof.

[0023] According to another aspect of the present invention, it also relates to a set of components to be interchanged on the aforementioned equipment, system and / or operating room). According to another aspect of the present invention, it also relates to a method of manufacturing one or other of the components of the aforementioned equipment, system and / or operating room.

[0024] According to another aspect of the present invention, it also provides a knee having been operated on with the aforementioned equipment, system, operating room, kit, and / or method(s).

[0025] According to another aspect of the present invention, it also provides a method of doing business with the aforementioned equipment, system, operating room, kit, method(s), game and / or product.

[0026] The objects, advantages, and other features of the present invention will become more apparent upon reading the following non-limiting description of preferred embodiments of the invention, shown in the accompanying drawings, and given by way of example only.

[0027] Brief description of the attached drawings:

[0028] Figure 1 is an illustration of the anatomy of a knee with peri-patellar tissue attachments.

[0029] Figure 2 is a representation of a conventional surgical approach in knee arthroplasty.

[0030] Figures 3-61 illustrate various possible components, features, variations and / or combinations of various aspects of the operating equipment of the present invention, according to different possible embodiments. of preferred embodiments of the invention:

[0031] In the following description, the same numerical references refer to similar components. The embodiments (geometries, dimensions, etc.) illustrated in the figures and the characteristics described in the application are preferential only, given for information purposes only.

[0032] Furthermore, although the present invention is primarily designed to surgically intervene on a "knee" (e.g., knee surgery, knee replacement, etc.), for example, the invention could be used with any other type of joints and / or for any other type of application and / or useful purpose, as would be obvious to a person skilled in the art. Therefore, expressions such as "intervention", "surgery", "knee", "operation", "replacement", etc., as used herein, and / or any other reference and / or other expression equivalent or similar thereto, should not be considered as limiting the scope of the present invention and include any other object / substitute and / or any other application with which the present invention may be used and may be useful, as would be obvious to a person skilled in the art.

[0033] Furthermore, although the preferred embodiments of the illustrated system comprise several components, all of these components are not necessarily essential to the invention and consequently should not be taken in their restrictive sense, i.e. should not be considered so as to limit the scope of the present invention. It should be understood, as obvious to a person skilled in the art, that other suitable components and geometries and / or other possible cooperations between them may be used for the system according to the present invention, as will be described below, without departing from the scope of the invention. Furthermore, expressions such as "system", "operating room", "robot", "controller", "program", "software", "retrofit", "control panel", "kit", "device", "assembly", "mechanism", "product", "apparatus", "operator", etc., as well as any other equivalent expression and / or words composed thereof, may be used interchangeably in the context of this description, as obvious to a person skilled in the art. This also applies to other expressions which are mutually equivalent, such as, for example: a) "intervention", "surgery", "operation", "repair", "replacement", "reconstruction", "modification", "inspection", "arthroscopy", "arthroplasty", etc.; b) "knee", "joint", "limb", etc.; c) "cut", "section", "split", "saw", "separate", "fractionate" etc.; d) "bone", "patella", etc.; e) "screw", "nail", "anchor", "crampon", "connector", "fastener", etc.; (f) “controller”, “operator”, “robot”, “control”, “computer”, “circuit”, “hardware”, “software”, “mechanical, electronic, electronic and / or computer component(s)”, etc.; as well as any other mutually equivalent expressions, related to the above-mentioned expressions and / or to any other structural and / or functional aspects of the present invention, as also obvious to a person skilled in the art.

[0034] Furthermore, in the context of the present description, it is to be considered that all elongated objects implicitly have a "longitudinal axis" and / or a "center line", such as the longitudinal axis of a rod, for example, or the center line of a conduit, and that expressions such as "connected" and "connectable", or "pivotable" and "pivotable", may be interchanged and are mutually equivalent, in that the present invention also relates to a kit with corresponding components for assembling a resulting fully assembled and operational equipment and / or system for implementing the present method and / or obtaining any resulting and / or derived product. Furthermore, certain components of the present system and / or steps of the present method (e.g., assembly, operation, etc.) being described in this specification may be modified, simplified, omitted and / or interchanged, without departing from the scope of the present invention, depending on the particular applications for which the present system is designed and / or intended, and also depending on the desired results, as briefly described herein and as also obvious to a person skilled in the art.

[0035] In general, the present invention, as illustrated in the attached figures, relates to medical and / or surgical equipment enabling innovative knee surgery, for example, by reducing the disadvantages associated with other related ways of doing things, systems and / or methods known in the prior art. The present invention also relates to a kit with corresponding components intended for assembly (e.g. of the corresponding equipment, system and / or operating room, etc.), and / or for implementing the resulting equipment, system and / or operating room, as well as corresponding methods of assembly, operation and / or use.

[0036] As will be better understood by referring to the following specification and the corresponding figures attached, the present equipment and / or corresponding operating system allows the proposed new surgical approach to be performed, namely trans-patellar bone and tendon with longitudinal cutting. This innovative approach could potentially overcome all the aforementioned drawbacks and thereby improve the results encountered with the conventional surgical approach to knee arthroplasty.

[0037] Reading the following paragraphs, combined with the drawings, will help you better understand how the announced advantages are linked to this technique. Overview of the new surgical approach proposed herein:

[0038] Since this new approach does not affect the anatomical structures on the medial side of the patella, its functional impairment is avoided because no weakening has been created. For its part, the closure of the innovative approach, which consists of passing through the patella, is done by rigid fixation of the two halves of the patella put under compression using implants, which can withstand very high tensions, and without undergoing deformation or weakening. Furthermore, the closure of the quadriceps tendon and the patellar tendon is done by approximation using continuous threads of their respective fibers which have been separated only vertically and not cut. This results in very little bleeding, almost no tissue tension.This in turn would promote a significant reduction in pain during postoperative knee mobilization, and would allow greater joint range of motion to be achieved more quickly and easily.

[0039] This would represent a major advantage in terms of the length of hospital stay, which in turn would significantly reduce the total costs generated for this type of operation.

[0040] Another major advantage of this proposed new approach is the quality and breadth of surgical exposure provided in the absence of tension applied to the lateral and medial soft tissues during the procedure. Since the patella is split in two, it is no longer necessary to evert the patella, which hinders a large part of the knee exposure, and to exert local pressure due to its abnormal and dislocated position. It would also ensure a perfectly anatomical, symmetrical, and watertight closure while respecting the integrity of all tissues surrounding the patella. These advantages would result in less pain, would allow a superior response to the extreme but non-harmful demands of early mobilization of the freshly operated knee, and thus would guarantee an earlier and faster return to activities of daily living (ADL).Therefore, postoperative patellar alignment control would not be altered compared to the standard surgical approach. The distribution of tensile forces distributed over the soft tissues would also not be affected by either the incision or its closure. In this new approach, the muscle contraction of the vastus medialis would exert its tensile force directly on the patella and not on the tendon that was transected and then repaired during closure in the conventional approach.

[0041] This new technique would obviously require new tools. A patellar cutting guide is provided, as well as a drill guide for screws or clamps, a patella separator, and a choice of implants for patella fixation. This would include an axial compression screw system, a double U-shaped clamp system with stops, and / or the use of a screw-retained ring. If conventional screws would not constitute

[0042] Although it would be possible to achieve adequate assembly of the patella parts with conventional screws, two disadvantages may hinder the desired rapid recovery towards a return to normal knee function:

[0043] 1. The subcutaneous prominence of the screw head, if it is not buried sufficiently under the bone; and

[0044] 2. The subcutaneous prominence of its tip at its exit from the bone, if it is longer than the width of the patella, could constitute a disturbing conflict problem. An exact length of the screw respecting the exact width of the patella, including the cortical bone at the exit of the screw, is mandatory for obtaining an excellent grip in the bone. In the opinion of the present Applicant / inventor, obtaining this degree of precision without compromising the quality of the fixation would be difficult to achieve with certainty each time this is necessary: ​​too short, it would risk loosening or loss of fixation, and too long, it would imply the need for a second intervention after bone union for the removal of the fixation material, which would scrape under the skin.

[0045] In other words, a conventional screw assembly would exert an asymmetrical bone retention force on the two assembled parts. This would imply a significant risk of loosening when this assembly is put under excessive tension, such as when bending beyond 90 degrees with a swollen knee, especially if combined with forced external rotation of the knee. The risk of loosening could also arise from the cumulative effect of deforming forces found in the repetition of movement during rehabilitation. As soon as the pain begins to decrease postoperatively, the repeated tensioning would add up to lead to screw loosening before the start of bone healing, which normally occurs at about 6 weeks.

[0046] In conclusion:

[0047] The tensile forces that the peri-patellar tissues involved in the rehabilitation of a freshly operated knee for replacement must undergo are beyond what their repairs can withstand, without inevitably inducing an irreversible and permanent change at the very site of closure. Since prioritizing early mobilization of the knee in the immediate post-operative period is crucial and essential, it becomes impossible to simultaneously guarantee perfect healing with a return of the histological and anatomical integrity of the involved tissues and secondarily a normal return of function and alignment of the patella.

[0048] Conversely, if the principles of tissue healing (especially with regard to mechanical function) are to be observed and applied according to the rules of the art, and the rehabilitation of the operated knee respects its fundamental principles of healing, joint flexibility would be greatly sacrificed, which would lead to an even greater proportion of poor functional results, due to severe joint ankylosis of the knee.

[0049] It is for all these reasons that the proposed new surgical approach, namely trans-patellar bone and tendon with longitudinal cut through the patella, could potentially remedy all the disadvantages encountered with the conventional surgical approach to knee arthroplasty; as mentioned above.

[0050] Namely, that interosseous healing is completed in a significantly shorter time, that it can also be completed with significantly greater precision to restore the integrity of the anatomy, and achieve a far stronger resistance force than that generated by early mobilization of the knee. This can be explained firstly by the richness of the vascular network around the patella from which its bone tissue benefits and secondly by the achievement of a highly rigid assembly force offered by the compression between the two bone fragments via the instrumentation described and the various implants proposed.

[0051] List of references and / or corn illustrated in the figures below and / or being THE

[0052] 1. operating equipment (and corresponding tool(s) and / or accessory(ies)) . sectioning guide (e.g. "patellar cutting guide") . groove (of the sectioning guide) a. first segment of the groove (e.g. distal segment, straight) b. second segment of the groove (e.g. distal segment, straight) c. other segment (e.g. intermediate segment) d. transition segment (e.g. between 2 neighboring segments) . main body (of the sectioning guide) . hollow (of the sectioning guide) c. contour (of the sectioning guide) 1 . passage (e.g. side and / or other) la. first side passage (e.g. lateral side, outer side, etc.) l b. second side pass (e.g. medial side, inner side, etc.) 3. corner (of sectioning guide) 5. thickness (e.g. height - of sectioning guide) 7. sectioning tool (e.g. patella separator) 7a. first edge (e.g. sharp - of sectioning tool)7b. second edge (e.g. non-sharp - of sectioning tool)7c.lateral groove (of the sectioning tool) 9. connection system (which can take various embodiments)9. connection system (e.g. "double U-shaped clamps with stops") 9. connection system (e.g. "axial compression screw system")9. connection system (e.g. "cerclage and / or winding") 9. connection system (e.g. "headless interfragmentary screw") 9 connection system (e.g. "screwable ring") 1 . fastener (e.g. "U-shaped") 1a. first fastener 1 b. second fastener 3. male part (of the fastener) 5. female part (of the fastener) . section (of the fastener) . first threaded head (e.g. first "implant") a. anchoring surface (of the 1. ère threaded head) b. tip (of the 1 ère threaded head) c. hole (of the 1 ère threaded head) d. peripheral contour (of the 1 ère threaded head) e. axial hole (of the 1 ère threaded head) . second threaded head (e.g. second "implant") a. anchoring surface (of the 2 ethreaded head) b. tip (of the 2 e threaded head) c. hole (of the 2 e threaded head) d. peripheral contour (of the 2 e threaded head) e. axial hole (of the 2 e threaded head) . connecting rod a. first end (of the connecting rod) b. second end (of the connecting rod) c. main rod (of the connecting rod) d. head (of the connecting rod) . thread . component(s) (e.g. miscellaneous, etc.) . first router bit (for 1 ère threaded head). second router bit (for 2 ethreaded head) . measuring tool (and / or "drill guide") a. first main section (of the measuring tool)b. second main section (of the measuring tool)c. first complementary section (of the measuring tool)d. second complementary section (of the measuring tool)e. longitudinal axis (of the measuring tool) . measuring end (of the measuring tool) a. first measuring end (on first main section)b. second measuring end (on second main section). measuring scale . reading line (for measuring scale) . clamping component a. first main clamping component b. second main clamping component c. first complementary clamping component d. second complementary clamping component . handle (e.g. rounded and / or knurled - of clamping component)a. first handle (of 1 ère main clamping component)b. second handle (of 2 e main clamping component)c. first handle (of 1ère additional clamping component)c. second handle (of 2 e complementary tightening component). wire (e.g., of the cerclage system) . hole (e.g., for wire) . retention mechanism . interfragmentary screw a. first opposing part (of interfragmentary screw) a. second opposing part (of interfragmentary screw) c. longitudinal part (of interfragmentary screw) d. distal cavity (of interfragmentary screw) 1. longitudinal groove (of interfragmentary screw) . screwable ring a. inner peripheral part (of the screwable ring) b. outer peripheral part (of the screwable ring) c. main body (of the screwable ring) d. distal portion (of the screwable ring) e. distal rim (of the screwable ring) 65. cavity (of the screwable ring)

[0053] 67. turning tool (e.g. for screw ring)

[0054] 69. protruding element (of the rotating tool)

[0055] 71. reinforcement part(s) (of the rotation tool)

[0056] 73. common shank (of the turning tool)

[0057] 75. close part of manipulation (of the rotation tool)

[0058] 75a. first opposite handle (of the handling part)

[0059] 75b. second opposite handle (of the manipulation part)

[0060] 77. grinding tool (and / or drilling, digging, tracing, etc.)

[0061] The present operating equipment system (and the various inventive aspects thereof) may be embodied in different forms and / or expressions, comprising one and / or more of the following components and features (and / or different combination(s) and / or permutation(s) thereof), given as preferred and / or optional embodiment(s) only: i.) An operating equipment (1) comprising a series of tools and / or accessories (in order to enable, in particular, a new surgical approach proposed herein, namely trans-patellar bone and tendon with longitudinal cutting, which could potentially overcome all the drawbacks encountered with the conventional surgical approach to knee arthroplasty, and which would most likely be responsible for the poor results of this conventional intervention). ii.) An operating equipment (1) according to any of the preceding combinations, wherein the set of tools and / or accessories comprises a sectioning guide (3) (e.g. sawing, splitting, cracking, separating, etc.) for sectioning a bony part (e.g. patella) of the joint (e.g. knee) into two sub-parts. iii.) An operating equipment (1) according to any of the preceding combinations, wherein the sectioning guide (3) comprises a groove (5) extending through a main body (7) of the sectioning guide (3) (e.g. in a central part of the main body (7), for example), and defining a shape being intended to be used for sectioning the bony part (e.g. patella) of the joint (e.g. knee). iv.) An operating equipment (1) according to any of the preceding combinations, in which the groove (5) of the sectioning guide (3) is segmented, and comprises at least two different segments (5a, 5b). v.) An operating equipment (1) according to any of the preceding combinations, in which the groove (5) of the sectioning guide (3) is segmented, and comprises at least three different segments (5a, 5b, 5c). vi.) An operating equipment (1) according to any of the preceding combinations, in which each different segment (5a, 5b, 5c) of the groove (5) of the sectioning guide (3) is substantially rectilinear. vii.) An operating equipment (1) according to any of the preceding combinations, in which each different rectilinear segment (5a, 5b, 5c) is connected to an adjacent rectilinear segment (5a, 5b, 5c) via a transition segment (5d). viii.) An operating equipment (1) according to any of the preceding combinations, in which the groove (5) of the sectioning guide (3) has first and second distal segments (5a, 5b). ix.) An operating equipment (1) according to any of the preceding combinations, wherein the groove (5) of the sectioning guide (3) comprises at least one intermediate segment (5c). x.) An operating equipment (1) according to any of the preceding combinations, wherein the different segments (5a, 5b, 5c, 5d) define the groove (5) of the sectioning guide (3). xi.) An operating equipment (1) according to any of the preceding combinations, wherein the groove (5) of the sectioning guide (3) defines a zigzag path. xii.) An operating equipment (1) according to any of the preceding combinations, wherein the sectioning guide (3) comprises a hollow (9) being positioned, shaped and dimensioned in order to receive a frontal portion of the bony part (e.g. patella) of the joint (e.g. knee). xiii.) An operating equipment (1) according to any of the preceding combinations, wherein the recess (9) has a substantially elliptical contour (9c). xiv.) An operating equipment (1) according to any of the preceding combinations, wherein the sectioning guide (3) has at least one passage (11) (e.g., sideways and / or otherwise) for receiving a mounting means (e.g., a nail, a screw, an anchor, a clamp, etc.) for selectively and temporarily mounting the sectioning guide (3) on the frontal portion of the bony part (e.g., patella) of the joint (e.g., knee) to be surgically operated on. xv.) An operating equipment (1) according to any of the preceding combinations, wherein the sectioning guide (3) comprises at least one first side passage (11 a) in a first side of the sectioning guide (3) for connecting the sectioning guide (3) selectively and temporarily on a first side (e.g.xvi.) An operating equipment (1) according to any of the preceding combinations, wherein the sectioning guide (3) comprises at least one pair of first side passages (11a) and at least one pair of second side passages (11b), in order to provide the sectioning guide (3) with a minimum of four side passages (11a, 11b). xvii.) An operating equipment (1 ) according to any of the preceding combinations, wherein each passage (11 , 11 a, 11 b) (e.g. sideways and / or otherwise) is substantially cylindrical. xviii.) An operating equipment (1 ) according to any of the preceding combinations, wherein each passage (11 , 11 a, 11 b) extends at an angle through the main body (7) of the sectioning guide (3). xix.) An operating equipment (1 ) according to any of the preceding combinations, wherein each passage (11 , 11 a, 11 b) is provided with a first end on the surface of the sectioning guide (3) and a second end in an internal part of the sectioning guide (3). xx.) An operating equipment (1) according to any of the preceding combinations, in which the first end of each passage (11, 11a, 11b) comes from a different corner (13) of the sectioning guide (3). xxi.) An operating equipment (1 ) according to any of the preceding combinations, wherein each corner (13) of the sectioning guide (3) is beveled (e.g. at an angle, relative to lateral sides, etc.). xxii.) An operating equipment (1 ) according to any of the preceding combinations, wherein the second end of each passage (11 , 11 a, 11 b) is directed (e.g. oriented, converges, etc.) towards a central portion of the sectioning guide (3). xxiii.) An operating equipment (1 ) according to any of the preceding combinations, wherein the second end of each passage (11 , 11 a, 11 b) opens into an internal portion of the sectioning guide (3). xxiv.) An operating equipment (1) according to any of the preceding combinations, in which the second end of each passage (11, 11a, 11b) terminates in the hollow (9) of the sectioning guide (3) being adapted to receive a front portion of the bone part (eg.patella) of the joint (e.g. knee) intended to be surgically operated. xxv.) An operating equipment (1) according to any of the preceding combinations, in which the sectioning guide (3) comprises a main body (7) being substantially rectangular. xxvi.) An operating equipment (1) according to any of the preceding combinations, in which the main body (7) of the sectioning guide (3) has a given thickness (15) (e.g. a given height, etc.). xxvii.) An operating equipment (1) according to any of the preceding combinations, in which the hollow (9) being designed to receive a frontal portion of the bony part (e.g. patella) of the joint (e.g. knee) intended to be surgically operated is housed inside the given thickness (15) (e.g. a given height, etc.) of the main body (7) of the sectioning guide (3) has a thickness (15). xxviii.) An operating equipment (1) according to any of the preceding combinations, wherein the series of tools and / or accessories comprises a sectioning tool (17) having a geometric profile complementary to the groove (5) of the sectioning guide (3), in order to allow an insertion of said sectioning tool (17) through said groove (5) of the sectioning guide (3). xxix.) An operating equipment (1) according to any of the preceding combinations, wherein the sectioning tool (17) comprises a first edge (17a) (e.g. a distal edge) which is sharp in order to allow a sectioning of the bony part (e.g. patella) of the joint (e.g. knee) into two corresponding sub-parts. xxx.) An operating equipment (1) according to any of the preceding combinations, in which the sectioning tool (17) has a second edge (17b) (e.g. a near edge) which is not sharp in order to receive a tool (e.g. a hammer, etc.) to strike the sectioning tool (17) and thus enable the first edge (17a) (e.g. a distal edge) thereof to section the bony part (e.g. patella) of the joint (e.g. knee) into two corresponding sub-parts. xxxi.) An operating equipment (1) according to any of the preceding combinations, wherein the sectioning tool (17) comprises at least one lateral groove (17c). xxxii.) An operating equipment (1) according to any of the preceding combinations, wherein the sectioning tool (17) comprises a pair of lateral grooves (5) (17c). xxxiii.) An operating equipment (1) according to any of the preceding combinations, wherein the series of tools and / or accessories comprises a connection system (19) for reconnecting again and together the bony part (e.g. patella) of the joint (e.g. knee) having been sectioned into two sub-parts with the guide and / or sectioning tool (17).xxxiv.) An operating equipment (1) according to any of the preceding combinations, wherein the connection system (19) comprises at least one fastener (21) being insertable into a corresponding hole having been defined (e.g., perforated, etc.) in the two corresponding sub-parts of the bony part (e.g., patella) of the joint (e.g., knee) having been severed, the fastener (21) being adapted to be adjusted and tightened in order to bring the two sub-parts of the bony part (e.g., patella) of the joint (e.g., knee) together after the surgical intervention. xxxv.) An operating equipment (1 ) according to any one of the preceding combinations, wherein said at least one fastener (21 ) comprises first and second fasteners (21 a, 21 b), at least one of these fasteners (21 a, 21 b) comprising at least one male part (23) intended to cooperate with at least one corresponding female part (25) of the other fastener (21 b, 21 a), to allow corresponding interconnection and self-locking between said fasteners (21 a, 21 b). xxxvi.) An operating equipment (1 ) according to any one of the preceding combinations, wherein the first and second fasteners (21 a, 21 b) each comprise a series of male (23) and female (25) parts intended to cooperate with the corresponding female (25) and male (23) parts of the other fastener (21 b, 21 a). xxxvii.) An operating equipment (1 ) according to any of the preceding combinations, in which each fastener (21 a, 21 b) is substantially "U" shaped, and has two sections (27) each provided with a series of male (23) and female (25) parts for cooperating with the corresponding female (25) and male (23) parts of the other fastener (21 b, 21 b). xxxviii.) An operating equipment (1 ) according to any of the preceding combinations, in which each section (27) of each fastener (21 a, 21 b) is provided with a series of male (23) and female (25) parts being defined by alternating peaks and depressions. xxxix.) An operating equipment (1) according to any of the preceding combinations, wherein each section (27) of each attachment (21 a, 21 b) has a cross-section which tapers towards a distal end of said each section. xl.) An operating equipment (1) according to any of the preceding combinations, in which the connection system (19) comprises a first threaded head (29) (e.g. first "implant") being insertable into a first sub-part of the two sub-parts of the bone part (e.g. patella) of the joint (e.g. knee) having been severed with the guide and / or the sectioning tool (17), a second threaded head (31) (e.g. second "implant") being insertable into a second sub-part of the two sub-parts of the bone part (e.g. patella) of the joint (e.g. knee) having been severed, and a connection rod (33) cooperating with the two threaded heads (29, 31), the connection system (19) being adapted to be adjusted and tightened by means of a rotation of the connection rod (33) in order to bring the two sub-parts of the bone part (e.g. patella) of the joint (e.g. knee) together after surgery. xli.) An operating equipment (1) according to any of the preceding combinations, wherein the first threaded head (29) has an anchoring surface (29a) provided with threads (35) for anchoring (e.g. inserting, penetrating, aiming, etc.) this first threaded head (29) in the first sub-part of the two sub-parts of the bony part (e.g. patella) of the joint (e.g. knee). xlii.) An operating equipment (1) according to any of the preceding combinations, wherein the anchoring surface (29a) of the first threaded head (29) is tapered (e.g. angled, etc.). xliii.) An operating equipment (1) according to any of the preceding combinations, in which the first threaded head (29) is provided with a tip (29b) having at least one hole (29c) for receiving a rotation and / or fixing tool for fixing in rotation (e.g. aiming, engaging, inserting, etc.) and hold the first threaded head (29) in place in the first sub-part of the two sub-parts of the bony part (e.g. patella) of the joint (e.g. knee) (e.g. before, and / or during adjustment and / or tightening of the connection system (19)). xliv.) An operating equipment (1) according to any of the preceding combinations, in which the tip (29b) of the first threaded head (29) has n corresponding holes (29c), n being an integer greater than 1 (e.g. n=2, 3, 4, 5, etc.). xlv.) An operating equipment (1) according to any of the preceding combinations, in which the n holes (29c) of the tip (29b) of the first threaded head (29) are identical to each other. xlvi.) An operating equipment (1) according to any of the preceding combinations, in which the n holes (29c) of the tip (29b) of the first threaded head (29) are equidistant from each other. xlvii.) An operating equipment (1) according to any of the preceding combinations, wherein the tip (29b) of the first threaded head (29) has 3 corresponding holes (29c). xlviii.) An operating equipment (1) according to any of the preceding combinations, wherein the tip (29b) of the first threaded head (29) has rounded peripheral contours (29d). xlix.) An operating equipment (1) according to any of the preceding combinations, wherein the tip (29b) of the first threaded head (29) has an axial hole (29e) (e.g., longitudinal, etc.) being configured to receive a first end (33a) of the connecting rod (33).

[0062] I.) An operating equipment (1) according to any of the preceding combinations, wherein the axial hole (29e) (e.g. longitudinal, etc.) of the first threaded head (29) is provided with an internal thread (35) configured to receive a corresponding external thread (35) of the first end (33a) of the connecting rod (33). li.) An operating equipment (1) according to any of the preceding combinations, wherein the second threaded head (31) has an anchoring surface (31a) being provided with threads (35) for anchoring (e.g. inserting, penetrating, aiming, etc.) this second threaded head (31) in the second sub-part of the two sub-parts of the bony part (e.g. patella) of the joint (e.g. knee). lii.) An operating equipment (1) according to any of the preceding combinations, in which the anchoring surface (31a) of the second threaded head (31) is curved. liii.) An operating equipment (1) according to any of the preceding combinations, wherein the second threaded head (31) is provided with a tip (31b) having at least one orifice (31c) for receiving a rotation and / or fixing tool for fixing in rotation (e.g. aiming, etc.) and holding in place the second threaded head (31) in the second sub-part of the two sub-parts of the bony part (e.g. patella) of the joint (e.g. knee) (e.g. before, and / or during adjustment and / or tightening of the connection system (19)). liv.) An operating equipment (1) according to any of the preceding combinations, wherein the tip (31b) of the second threaded head (31) has n corresponding orifices (31c), n being an integer greater than 1 (e.g. n=2, 3, 4, 5, etc.).

[0063] Iv.) An operating equipment (1) according to any of the preceding combinations, in which the n holes (31 c) of the tip (31 b) of the second threaded head (31 ) are identical to each other.

[0064] Ivi.) An operating equipment (1 ) according to any of the preceding combinations, in which the n holes (31 c) of the tip (31 b) of the second threaded head (31 ) are equidistant from each other. Ivii.) An operating equipment (1 ) according to any of the preceding combinations, in which the tip (31 b) of the second threaded head (31 ) has 4 corresponding holes (29c).

[0065] Iviii.) An operating equipment (1) according to any of the preceding combinations, wherein the tip (31 b) of the second threaded head (31 ) has rounded peripheral contours (31 d). lix.) An operating equipment (1) according to any of the preceding combinations, wherein the tip (31 b) of the second threaded head (31 ) has an axial hole (31 e) (e.g., longitudinal, etc.) being configured to receive a second end (33b) of the connecting rod (33).

[0066] Ix.) An operating equipment (1) according to any of the preceding combinations, in which the axial hole (31e) (e.g. longitudinal, etc.) of the second threaded head (31) is configured to leave a passage of the first end (33a) of the connecting rod (33), beforehand, so that this first end (33a) of the connecting rod (33) is connected (e.g. mounted, inserted, screwed, etc.) on the first threaded head (29).

[0067] Ixi.) An operating equipment (1) according to any of the preceding combinations, wherein the connecting rod (33) comprises a main rod (33c), a first end (33a) provided with an external thread (35) being complementary to a corresponding internal thread (35) of the axial hole (29e) (e.g. longitudinal) of the first threaded head (29), and a second end (33b) provided with a corresponding head (33d) provided with a cavity (e.g. socket) for receiving a corresponding turning tool (e.g. screwdriver, etc.).

[0068] Ixii.) An operating equipment (1) according to any of the preceding combinations, wherein the set of tools and / or accessories comprises a corresponding first router bit (39) (e.g. drill bit, etc.) having a geometric profile being substantially complementary to that of the main body of the first threaded head (29), the first router bit (39) being used to drill a corresponding hole in the first sub-part of the two sub-parts of the bony part (e.g. patella) of the joint (e.g. knee) intended to receive the first threaded head (29).

[0069] Ixiii.) An operating equipment (1) according to any of the preceding combinations, wherein the set of tools and / or accessories comprises a corresponding second router bit (41) (e.g. drill bit, etc.) having a geometric profile being substantially complementary to that of the main body of the second threaded head (31), the second router bit (41) being used to drill a corresponding hole in the second sub-part of the two sub-parts of the bony part (e.g. patella) of the joint (e.g. knee) intended to receive the second threaded head (31).

[0070] Ixiv.) An operating equipment (1) according to any of the preceding combinations, wherein the set of tools and / or accessories comprises a measuring tool (43) (and / or "drill guide") for measuring a distance relative to the corresponding hole to be defined (e.g., perforated, etc.) in the two corresponding sub-parts of the bony part (e.g., patella) of the joint (e.g., knee) to be severed, in order to be able to carry out the surgical intervention and subsequently to be able to better bring the two sub-parts of the bony part (e.g., patella) of the joint (e.g., knee) together after the surgical intervention.

[0071] Ixv.) An operating equipment (1) according to any of the preceding combinations, wherein the measuring tool (43) has two main sections (43a, 43b) being movable (e.g. sliding, etc.) relative to each other. Ixvi.) An operating equipment (1) according to any of the preceding combinations, wherein the measuring tool (43) has two measuring ends (45a, 45b) being movable (e.g. sliding, etc.) relative to each other by means of a relative movement between the two main sections (43a, 43b) of the measuring tool (43).

[0072] Ixvii.) An operating equipment (1) according to any of the preceding combinations, wherein at least one main section (43a, 43b) of the measuring tool (43) has a measuring scale (47) and a corresponding reading line (49), in order to be able to measure a distance between the two measuring ends (45a, 45b) of the measuring tool (43).

[0073] Ixviii.) An operating equipment (1) according to any of the preceding combinations, wherein each main section (43a, 43b) (e.g., both main sections) of the measuring tool (43) has a measuring scale (47) and a corresponding reading line (49), so as to be able to measure a distance between the two measuring ends (45a, 45b) of the measuring tool (43).

[0074] Ixix.) An operating equipment (1) according to any of the preceding combinations, in which the measuring tool (43) comprises at least one main clamping component (51) (e.g., blocking, etc.) in order to hold in place in a fixed manner, the two main sections (43a, 43b), and therefore, the two corresponding measuring ends (45a, 45b), of the measuring tool (43), one relative to the other.

[0075] Ixx.) An operating equipment (1) according to any of the preceding combinations, wherein said at least one main clamping component (51) (e.g., blocking, etc.) comprises a handle (53, 53a, 53b). Ixxi.) An operating equipment (1) according to any of the preceding combinations, wherein the handle (53, 53a, 53b) of said at least one main clamping component (51) (e.g., blocking, etc.) is rounded.

[0076] Ixxii.) An operating equipment (1) according to any of the preceding combinations, wherein the handle (53, 53a, 53b) of said at least one main clamping component (51) (e.g., locking, etc.) has a knurled peripheral surface to allow increased manual grip by a user of the measuring tool (43).

[0077] Ixxiii.) An operating equipment (1) according to any of the preceding combinations, wherein said at least one main clamping component (51) (e.g., blocking, etc.) comprises two main clamping components (51a, 51b) (e.g., blocking, etc.), one for each main section (43a, 43b) of the measuring tool (43), in order to hold in place in a fixed manner, the two main sections (43a, 43b), and thus, the two corresponding measuring ends (45a, 45b), of the measuring tool (43), one relative to the other.

[0078] Ixxiv.) An operating equipment (1) according to any of the preceding combinations, wherein the measuring tool (43) comprises at least one complementary section (43c, 43d) being movable (e.g. sliding, etc.) relative to a main body of the measuring tool (43), a measuring end (45, 45a, 45b) of the measuring tool (43) being mounted on said complementary section (43c, 43d).

[0079] Ixxv.) An operating equipment (1) according to any of the preceding combinations, wherein the measuring tool (43) comprises two complementary sections (43c, 43d) each being movable (e.g. sliding, etc.) relative to a main body of the measuring tool (43), a measuring end (45, 45a, 45b) of the measuring tool (43) being mounted on each of said complementary sections (43c, 43d). Ixxvi.) An operating equipment (1) according to any of the preceding combinations, in which at least one complementary section (43c, 43d) of the measuring tool (43) comprises a measuring scale (47) and a corresponding reading line (49), in order to be able to measure a distance between a longitudinal axis (43e) of the measuring tool (43) and a corresponding measuring end (45, 45a, 45b).

[0080] Ixxvii.) An operating equipment (1) according to any of the preceding combinations, in which each complementary section (43c, 43d) (e.g. the two complementary sections) of the measuring tool (43) has a measuring scale (47) and a corresponding reading line (49), in order to be able to measure a distance between a longitudinal axis (43e) of the measuring tool (43) and a corresponding measuring end (45, 45a, 45b) associated with a given complementary section (43c, 43d).

[0081] Ixxviii.) An operating equipment (1) according to any of the preceding combinations, in which the measuring tool (43) comprises at least one complementary clamping (e.g., locking, etc.) component (51 c, 51 d) in order to hold in place, at least one complementary section (43 c, 43 d) and a corresponding measuring end (45, 45 a, 45 b), fixedly relative to a main body of the measuring tool (43).

[0082] Ixxix.) An operating equipment (1) according to any of the preceding combinations, wherein said at least one complementary clamping (e.g., locking, etc.) component (51 c, 51 d) comprises a handle (53, 53c, 53d).

[0083] Ixxx.) An operating equipment (1) according to any of the preceding combinations, in which the handle (53,53c,53d) of said at least one complementary clamping (e.g. locking, etc.) component (51 c,51 d) is rounded.

[0084] Ixxxi.) An operating equipment (1) according to any of the preceding combinations, wherein the handle (53,53c,53d) of said at least one complementary clamping (e.g., locking, etc.) component (51c,51d) has a knurled peripheral surface in order to allow an increased manual grip by a user of the measuring tool (43).

[0085] Ixxxii.) An operating equipment (1) according to any of the preceding combinations, wherein said at least one complementary clamping (e.g., blocking, etc.) component (51 c, 51 d) comprises two complementary clamping (e.g., blocking, etc.) components (51 c, 51 d), one for each complementary section (43c, 43d) of the measuring tool (43), in order to hold in place, each complementary section (43c, 43d) and a corresponding measuring end (45, 45a, 45b), fixedly relative to a main body of the measuring tool (43).

[0086] Ixxxiii.) An operating equipment (1) according to any of the preceding combinations, in which the connection system (19) comprises a strapping system (e.g. winding, etc.).

[0087] Ixxxiv.) An operating equipment (1) according to any of the preceding combinations, in which the strapping system is selectively tensioned by means of a tensioner.

[0088] Ixxxv.) An operating equipment (1) according to any of the preceding combinations, wherein the strapping system comprises at least one wire (55). Ixxxvi.) An operating equipment (1) according to any of the preceding combinations, wherein said at least one wire (55) of the strapping system comprises at least one high-tension wire (55).

[0089] Ixxxvii.) An operating equipment (1) according to any of the preceding combinations, wherein said at least one wire (55) of the strapping system comprises at least one wire (55) (e.g. filament, etc.) of metal.

[0090] Ixxxviii.) An operating equipment (1) according to any of the preceding combinations, wherein said at least one wire (55) of the strapping system comprises a plurality of metal filaments being braided together.

[0091] Ixxxix.) An operating equipment (1) according to any of the preceding combinations, wherein said at least one wire (55) of the strapping system is insertable into at least one corresponding hole (57) of the ball joint. xc.) An operating equipment (1) according to any of the preceding combinations, wherein said at least one wire (55) of the strapping system is adapted to be fixed in place by a retention mechanism (59) (e.g. a knot being closed and hidden in a recess and / or in a hollow (9), for example). xci.) An operating equipment (1) according to any of the preceding combinations, wherein the connection system (19) comprises a headless interfragmentary screw system (61), having a longitudinal part (61c), and first and second opposing parts (61a, 61b) with external threaded surfaces, these first and second parts (61a, 61b) being mountable and movable along said longitudinal part portion (61c). xcii.) An operating equipment (1 ) according to any of the preceding combinations, wherein geometric arrangements (e.g. thread type, thread pitch, thread shape, etc.) of the first and second opposing parts (61 a, 6b) are different from each other. xciii.) An operating equipment (1 ) according to any of the preceding combinations, wherein each opposing part (61 a, 61 b) has a distal cavity (61 d) being positioned, shaped and dimensioned to receive a corresponding tool for screwing (e.g. tightening, etc.) and / or unscrewing the first and second opposing parts (61 a, 61 b) in movement relative to each other along the longitudinal part (61 c) of the headless interfragmentary screw system (61 ). xciv.) An operating equipment (1 ) according to any of the preceding combinations, wherein the longitudinal part (61 c) of the headless interfragmentary screw system (61 ) comprises at least one longitudinal groove (611). xcv.) An operating equipment (1 ) according to any of the preceding combinations, wherein the longitudinal part (61 c) of the headless interfragmentary screw system (61 ) comprises at least one peripheral longitudinal groove (611) and / or at least one axial longitudinal groove (611). xcvi.) An operating equipment (1 ) according to any of the preceding combinations, wherein the connection system (19) comprises a screwable ring (63). xcvii.) An operating equipment (1 ) according to any of the preceding combinations, wherein the screwable ring (63) comprises an inner peripheral part (63a) and an outer peripheral part (63b). xcviii.) An operating equipment (1) according to any of the preceding combinations, wherein at least one peripheral portion of the screwable ring (63) is provided with a threaded surface. xcix.) An operating equipment (1) according to any of the preceding combinations, wherein both peripheral portions of the screwable ring (63) (i.e., inner and outer portions) are provided with respective threaded surfaces. c.) An operating equipment (1) according to any of the preceding combinations, wherein the screwable ring (63) comprises a main body (63c) being substantially circular (e.g., in order to allow rotation and corresponding screwing / unscrewing of the ring, etc.). ci.) An operating equipment (1) according to any of the preceding combinations, wherein the main body (63c) of the screwable ring (63) has a cross-section being profiled (e.g. angled, converging downwards, etc.). cii.) An operating equipment (1) according to any of the preceding combinations, wherein the cross-section of the main body (63c) of the screwable ring (63) has a distal portion (63d). ciii.) An operating equipment (1) according to any of the preceding combinations, wherein the distal portion (63d) of the cross-section of the main body (63c) of the screwable ring (63) is substantially pointed (e.g., triangular-shaped, etc.). civ.) An operating equipment (1) according to any of the preceding combinations, wherein the distal portion (63d) of the cross-section of the main body (63c) of the screwable ring (63) has a distal edge (63e). cv.) An operating equipment (1) according to any of the preceding combinations, wherein the distal edge (63e) of the cross-section of the main body (63c) of the screw ring (63) is substantially sharp (e.g. penetrating, etc.). cvi.) An operating equipment (1 ) according to any of the preceding combinations, wherein an upper part of the main body (63c) of the screwable ring (63) is provided with at least one corresponding cavity (65) for receiving a corresponding rotation tool (67) (e.g. for screwing / unscrewing, etc.). cvii.) An operating equipment (1 ) according to any of the preceding combinations, wherein the upper part of the main body (63c) of the screwable ring (63) is provided with 2n corresponding cavities (65) for receiving the corresponding rotation tool (67), n being an integer being equal to and / or greater than 1 (e.g. n=1, 2, 3, 4, 5, etc.). cviii.) An operating equipment (1) according to any of the preceding combinations, in which each corresponding cavity (65) of the screwable ring (63) is adapted to receive a corresponding projecting element (69) of the corresponding rotation tool (67). cix.) An operating equipment (1) according to any of the preceding combinations, wherein each corresponding cavity (65) of the screwable ring (63) is arranged around the main body (63c) of the screwable ring (63). ex.) An operating equipment (1) according to any of the preceding combinations, wherein each corresponding cavity (65) of the screwable ring (63) is arranged equidistant from each other around the main body (63c) of the screwable ring (63). cxi.) An operating equipment (1) according to any of the preceding combinations, in which the upper part of the main body (63c) of the screwable ring (63) is provided with at least two corresponding cavities (65) (e.g. n=1, and therefore, 2n=2) for receiving projecting elements (69) of the corresponding rotation tool (67). cxii.) An operating equipment (1) according to any of the preceding combinations, wherein the upper part of the main body (63c) of the screwable ring (63) is provided with at least four corresponding cavities (65) (e.g. n=2, and therefore, 2n=4) for receiving projecting elements (69) of the corresponding rotation tool (67). cxiii.) An operating equipment (1) according to any of the preceding combinations, wherein the upper part of the main body (63c) of the screwable ring (63) is provided with at least six corresponding cavities (65) (e.g. n=3, and therefore, 2n=3) for receiving projecting elements (69) of the corresponding rotation tool (67). cxiv.) An operating equipment (1) according to any of the preceding combinations, in which the upper part of the main body (63c) of the screwable ring (63) is provided with at least eight cavities (65) (eg.n=4, and therefore, 2n=8) corresponding to receive projecting elements (69) of the corresponding rotation tool (67). cxv.) An operating equipment (1) according to any of the preceding combinations, in which the corresponding rotation tool (67) (e.g. for screwing / unscrewing, etc.) comprises a number of projecting elements (69) being complementary (and / or compatible, etc.) with the number of corresponding cavities (65) provided on the screwable ring (63). cxvi.) An operating equipment (1) according to any of the preceding combinations, in which each projecting element (69) of the rotation tool (67) (e.g. for screwing / unscrewing, etc.) is complementary (e.g. in shape and / or in size) to at least one corresponding cavity (65) of the screwable ring (63). cxvii.) An operating equipment (1) according to any of the preceding combinations, in which each projecting element (69) of the rotation tool (67) (e.g. screwing / unscrewing, etc.) is complementary (e.g. in shape and / or dimension) to each corresponding cavity (65) of the screwable ring (63). cxviii.) An operating equipment (1) according to any of the preceding combinations, in which each corresponding cavity (65) of the screwable ring (63) is substantially cylindrical, and therefore, in which each projecting element (69) of the corresponding rotation tool (67) (e.g. for screwing / unscrewing, etc.) is also substantially cylindrical. cxix.) An operating equipment (1) according to any of the preceding combinations, in which each projecting element (69) of the rotation tool (67) (e.g. for screwing / unscrewing, etc.) is arranged on a distal part of the rotation tool (67) (e.g. for screwing / unscrewing, etc.). cxx.) An operating equipment (1) according to any of the preceding combinations, in which the distal part of the rotation tool (67) (e.g. screwing / unscrewing, etc.) is substantially circular and complementary to the upper part of the screwable ring (63). cxxi.) An operating equipment (1 ) according to any of the preceding combinations, in which the distal part of the rotation tool (67) is provided with parts (e.g. bars and / or the like) of reinforcement (71 ) converging into a common rod (73). cxxii.) An operating equipment (1 ) according to any of the preceding combinations, in which the rotation tool (67) (e.g. screwing / unscrewing, etc.) is provided with a close manipulation part (75) (e.g. manual and / or the like). cxxiii.) An operating equipment (1) according to any of the preceding combinations, in which the close manipulation part (75) (e.g. manual and / or other) is provided on a common rod (73) of the rotation tool (67) (e.g. screwing / unscrewing, etc.). cxxiv.) An operating equipment (1) according to any of the preceding combinations, wherein the close handling portion (75) comprises a pair of opposed handles (75a, 75b) (e.g. to enable a user of the tool to transmit greater torque to the tool and, consequently, to the screw ring (63), etc.). cxxv.) An operating equipment (1) according to any of the preceding combinations, wherein the operating equipment (1) a tool (e.g. a drill bit, a bell, a saw, etc.) for grinding (77) (and / or drilling, etc.) having a geometric profile substantially complementary (e.g. substantially similar and / or smaller, etc.) to that of the main body (63c) of the screw ring (63), to enable a corresponding circular depression to be dug beforehand in the ball joint, being intended to receive said screw ring (63). cxxvi.) An operating system provided with operating equipment (1) in any of the preceding combinations. cxxvii.) A use of a tool and / or accessory (and / or part and / or component thereof) of the operating equipment (1), in any of the preceding combinations. cxxviii.) A method of operation (e.g., a surgical procedure) using an aspect of the operating equipment (1) in any of the preceding combinations.

[0092] Of course, several modifications and / or other alternatives and / or other technical / mechanical equivalents could be made to the present system and / or to the components and / or to the corresponding steps thereof, without departing from the present invention, as obvious to a person skilled in the art.

[0093] Therefore, for the connection system (e.g. "axial compression screw system") previously explained, instead of using an embodiment such as the one(s) described above and / or illustrated in Figures 12-26, for example, one could use a "headless interfragmentary screw" system allowing to generate a compressive force at the exact site between two (2) elements which are to be assembled, such as the one exemplified in Figures 43-49, for example.

[0094] In this case, after being cut vertically, the two (2) halves of the patella will be able to benefit from the advantages of this system. Indeed, the patella is a superficial bone lying underneath and in direct contact with the skin, with solid tendinous attachments on either side of the medial and lateral edges. These characteristics require the particularity that the implant used does not have a head because it would be bothersome, visible and most likely painful due to its prominence under the skin.

[0095] The principle of this "headless interfragmentary screw" is that in the absence of a screw head, the desired compression is generated by the difference in the grip in the bone between the two (2) halves of the patella. Thus, the side or the contact surface between the screw and the bone is smaller, slides towards the side where the contact surface of the screw with the bone is larger. This is achieved by the presence of two (2) different types of threading on each end of this screw - in other words, it is this difference between the two (2) threads which makes it possible to obtain two (2) grip forces in the bone, being "different". All this allows the user (e.g. operator, surgeon, etc.) to achieve a total erasure of the free space between the two (2) fragments of the patella. It goes without saying that the orientation of the screw is as perpendicular as possible in relation to the cutting plane of the patella, and this, in the two (2) axes.

[0096] The central tunnel of this "headless interfragmentary screw" is present for the same reason as already described in the first screw system where a pin of diameter equal to that of the inner tunnel of the drill bit and the screw is positioned prior to cutting. During the final assembly, this same pin will be returned exactly to the initial location which facilitates the guidance of the screw through the drilled hole in question. This allows us to assemble the ball joint as perfectly as possible compared to its initial condition, which is advantageous for various reasons which go without saying.

[0097] Alternatively, for the connection system (e.g. "system for fixing the ball joint after cutting it"), one could also use a system (and / or principle and / or technique) of "strapping" (e.g. with tensioning by a tensioner and / or the like), such as that exemplified in Figures 38-42, for example. According to this particular embodiment being possible for the present system as well, the technique of strapping (and / or winding, etc.) could use a high-tension resistant engineering wire (and / or band, tie, etc.), being braided with metal filaments (for example), and being insertable into a corresponding hole(s) and being fixed in place, by a retention mechanism, such as a knot being closed and hidden (e.g. recessed and / or in a hollow, etc.), for example, as illustrated in the corresponding figures attached hereto.

[0098] As can now be better appreciated in view of the foregoing, the present invention is particularly advantageous insofar as it makes it possible to provide operating equipment comprising a series of new tools and / or accessories, in order to allow, in particular, a new surgical approach proposed by the present invention, namely trans-patellar bone and tendon with longitudinal cutting, which could potentially remedy all the drawbacks encountered with the conventional surgical approach to knee arthroplasty, and which would very likely be responsible for the poor results of this conventional intervention.

[0099] As can now also be better appreciated, the present invention is also advantageous in that it allows surgical intervention on a joint, such as a knee, for example, and to be able to do so in a faster, simpler, more precise, more efficient, more economical, more reliable, more adjustable, more versatile, more adaptable, more durable, more desirable, and / or improved manner than is possible with the current way of doing things.

[0100] The present invention is also advantageous for all the different stakeholders in the process (e.g., patients, surgeons, operating teams, rehabilitation teams, insurance companies, healthcare system, etc.). Finally, and according to the present invention, the operating equipment (and / or resulting system, etc.) and its corresponding components are preferably made of substantially rigid materials, such as metallic materials (stainless steel, titanium, etc.), hardened polymers, composite materials, and / or any other suitable material, while the other components of the system according to the present invention, in order to obtain the advantages discussed above, can be made of any other suitable material, such as polymeric materials (plastic, rubber, etc.), and / or any other suitable material, depending on the particular applications for which the system is designed and the various parameters involved, as obvious to a person skilled in the art.

[0101] Although the present invention has been previously explained by way of preferred embodiments thereof, it should be made clear that any modification to these preferred embodiments is not considered to change or alter the nature and scope of the present invention. Indeed, the appended claim(s) should not be limited in its scope by the preferred embodiments illustrated in the examples, but should be given the broadest interpretation consistent with the description as a whole.

Claims

CLAIMS:

1. An operating equipment (1) comprising at least one piece of equipment being positionable, formed and dimensioned to cooperate with a joint of a patient intended to be operated on, so as to permit a transpatellar bone and tendon surgical intervention with longitudinal cut on the joint of the patient, via said at least one piece of equipment of the operating equipment 2. An operating equipment (1) according to claim 1, wherein the operating equipment (1) comprises a sectioning guide (3) for sectioning into two sub-parts a bony part of the joint.

3. An operating device (1) according to claim 2, wherein the sectioning guide (3) comprises a groove (5) extending through a main body (7) of the sectioning guide (3), and defining a shape intended to be used for sectioning the bony part of the joint.

4. An operating equipment (1) according to claim 3, in which the groove (5) of the sectioning guide (3) is segmented, and comprises at least two different segments (5a, 5b).

5. An operating equipment (1) according to claim 3, in which the groove (5) of the sectioning guide (3) is segmented, and comprises at least three different segments (5a, 5b, 5c).

6. An operating equipment (1) according to claim 4 or 5, wherein each segment (5a, 5b, 5c) different from the groove (5) of the sectioning guide (3) is substantially straight.

7. An operating equipment (1) according to claim 6, in which each different straight segment (5a, 5b, 5c) is connected to an adjacent straight segment (5a, 5b, 5c) via a transition segment (5d).

8. An operating equipment (1) according to any one of claims 3-7, wherein the groove (5) of the sectioning guide (3) comprises first and second distal segments (5a, 5b).

9. An operating equipment (1) according to claim 8, in which the groove (5) of the sectioning guide (3) comprises at least one intermediate segment (5c).

10. An operating equipment (1) according to any one of claims 4-9, wherein the various segments (5a, 5b, 5c, 5d) define the groove (5) of the sectioning guide (3).

11. An operating equipment (1) according to any one of claims 3-10, wherein the groove (5) of the sectioning guide (3) defines a zigzag path.

12. An operating equipment (1) according to any one of claims 2-11, in which the sectioning guide (3) has a hollow (9) being positioned, formed and dimensioned to receive a frontal portion of the bony part of the joint.

13. An operating equipment (1) according to claim 12, in which the hollow (9) has a substantially elliptical contour (9c).

14. An operating device (1) according to any one of claims 2-13, wherein the sectioning guide (3) has at least one passage (11) for receiving a mounting means for mounting the guide sectioning (3) selectively and temporarily on the frontal portion of the bony part of the joint intended to be surgically intervened.

15. An operating device (1) according to any one of claims 2-14, wherein the sectioning guide (3) has at least one first side passage (11a) in a first side of the sectioning guide (3) for selectively and temporarily connecting the sectioning guide (3) to a first side of the front portion of the bony part of the joint intended to be surgically operated on, and wherein the sectioning guide (3) has at least one second side passage (11b) in a second side of the sectioning guide (3) for selectively and temporarily connecting the sectioning guide (3) to a second side of the front portion of the bony part of the joint intended to be surgically operated on.

16. An operating equipment (1) according to any one of claims 2-15, wherein the sectioning guide (3) has at least one pair of first side passages (11a) and at least one pair of second side passages (11b), so as to equip the sectioning guide (3) with a minimum of four side passages (11a, 11b).

17. An operating equipment (1) according to any one of claims 14-16, in which each passage (11,11a,11b) is substantially cylindrical.

18. An operating equipment (1) according to any one of claims 14-17, wherein each passage (11, 11a, 11b) extends at an angle through the main body (7) of the sectioning guide (3).

19. An operating device (1) according to any one of claims 14-18, wherein each passage (11, 11a, 11b) is equipped with a first end on the surface of the sectioning guide (3) and a second end in an internal part of the sectioning guide (3).

20. An operating equipment (1) according to claim 19, in which the first end of each passage (11, 11a, 11b) comes from a different corner (13) of the sectioning guide (3).

21. An operating equipment (1) according to claim 20, wherein each corner (13) of the sectioning guide (3) is beveled.

22. An operating equipment (1) according to any one of claims 19-21, wherein the second end of each passage (11, 11a, 11b) is directed towards a central part of the sectioning guide (3).

23. An operating equipment (1) according to any one of claims 19-22, wherein the second end of each passage (11, 11a, 11b) opens into an internal part of the sectioning guide (3).

24. An operating device (1) according to any one of claims 19-23, wherein the second end of each passage (11, 11a, 11b) terminates in a hollow (9) of the sectioning guide (3) being designed to receive a frontal portion of the bony part of the joint intended to be surgically intervened.

25. An operating equipment (1) according to any one of claims 2-24, wherein the sectioning guide (3) comprises a main body (7) being substantially rectangular.

26. An operating equipment (1) according to claim 25, in which the main body (7) of the sectioning guide (3) has a given thickness (15).

27. An operating equipment (1) according to claim 26, in which the hollow (9) being designed to receive a frontal portion of the bony part of the joint intended to be surgically operated on is housed within the given thickness (15) of the main body (7) of the sectioning guide (3) has a thickness (15).

28. An operating equipment (1) according to any one of claims 2-27, wherein the operating equipment (1) comprises a sectioning tool (17) having a geometric profile complementary to a groove (5) of the sectioning guide (3), in order to permit insertion of said sectioning tool (17) through said groove (5) of the sectioning guide (3).

29. An operating equipment (1) according to claim 28, in which the cutting tool (17) has a first sharp edge (17a) to allow sectioning of the bony part of the joint into two corresponding sub-parts.

30. An operating equipment (1) according to claim 29, in which the cutting tool (17) has a second non-cutting edge (17b) to receive a tool to strike the cutting tool (17) and thus allow the first cutting edge (17a) thereof to cut the bony part of the joint into two corresponding sub-parts.

31. An operating equipment (1) according to any one of claims 28-30, wherein the cutting tool (17) has at least one lateral groove (17c).

32. An operating equipment (1) according to any one of claims 28-31, in which the sectioning tool (17) has a pair of lateral grooves (5) (17c).

33. An operating equipment (1) according to any one of claims 2-32, wherein the operating equipment (1) comprises a connection system (19) for reconnecting the bony part of the joint which has been sectioned into two sub-parts with the sectioning guide (3).

34. An operating device (1) according to claim 33, wherein the connection system (19) comprises at least one fastener (21) being insertable into a corresponding hole having been defined in the two corresponding sub-parts of the bony part of the joint having been sectioned, the fastener (21) being able to be adjusted and tightened in order to bring the two sub-parts of the bony part of the joint back together after the surgical procedure.

35. An operating equipment (1) according to claim 34, wherein said at least one attachment (21) comprises first and second attachments (21a, 21b), at least one of these attachments (21a, 21b) comprising at least one male part (23) intended to cooperate with at least one corresponding female part (25) of the other attachment (21b, 21a), to permit corresponding interconnection and self-locking between said attachments (21a, 21b).

36. An operating equipment (1) according to claim 35, in which the first and second attachments (21a, 21b) each comprise a series of male (23) and female (25) parts intended to cooperate with the corresponding female (25) and male (23) parts of the other attachment (21b, 21a).

37. An operating device (1) according to claim 35 or 36, wherein each attachment (21a, 21b) is substantially U-shaped and comprises two sections (27), each having a series of male (23) and female parts (25) intended to cooperate with the corresponding female (25) and male (23) parts of the other attachment (21 b, 21 b).

38. An operating equipment (1) according to any one of claims 35-37, wherein each section (27) of each attachment (21 a, 21 b) is provided with a series of male (23) and female (25) parts being defined by alternating peaks and depressions.

39. An operating equipment (1) according to any one of claims 35-38, wherein each section (27) of each attachment (21 a, 21 b) has a cross-section that decreases towards a distal end of said each section.

40. An operating device (1) according to any one of claims 33-39, wherein the connection system (19) comprises a first threaded head (29) being insertable into a first sub-part of the two sub-parts of the bony part of the joint having been sectioned with the sectioning guide (3), a second threaded head (31) being insertable into a second sub-part of the two sub-parts of the bony part of the joint having been sectioned, and a connecting rod (33) cooperating with the two threaded heads (29,31), the connection system (19) being able to be adjusted and tightened by means of a rotation of the connecting rod (33) in order to bring the two sub-parts of the bony part of the joint back together after the surgical intervention.

41. An operating equipment (1) according to claim 40, in which the first threaded head (29) has an anchoring surface (29a) having threads (35) to anchor this first threaded head (29) in the first sub-part of the two sub-parts of the bony part of the joint.

42. An operating equipment (1) according to claim 41, in which the anchoring surface (29a) of the first threaded head (29) is tapered.

43. An operating equipment (1) according to any one of claims 40-42, wherein the first threaded head (29) is provided with an end (29b) having at least one orifice (29c) for receiving a rotation and / or fixing tool for fixing in rotation and holding in place the first threaded head (29) in the first sub-part of the two sub-parts of the bony part of the joint.

44. An operating equipment (1) according to claim 43, in which the tip (29b) of the first threaded head (29) has n corresponding orifices (29c), n being an integer greater than 1.

45. An operating equipment (1) according to claim 44, in which the n orifices (29c) of the tip (29b) of the first threaded head (29) are identical to each other.

46. ​​An operating equipment (1) according to claim 44 or 45, wherein the n orifices (29c) of the tip (29b) of the first threaded head (29) are equidistant from each other.

47. An operating equipment (1) according to any one of claims 43-46, wherein the tip (29b) of the first threaded head (29) has 3 corresponding orifices (29c).

48. An operating equipment (1) according to any one of claims 43-47, wherein the tip (29b) of the first threaded head (29) has rounded peripheral contours (29d).

49. An operating device (1) according to any one of claims 43-48, wherein the tip (29b) of the first threaded head (29) includes an axial hole (29e) being configured to receive a first end (33a) of the connecting rod (33).

50. An operating equipment (1) according to claim 49, in which the axial hole (29e) of the first threaded head (29) is provided with an internal thread (35) configured to receive a corresponding external thread (35) of the first end (33a) of the connecting rod (33).

51. An operating equipment (1) according to any one of claims 40-50, wherein the second threaded head (31) has an anchoring surface (31a) having threads (35) to anchor this second threaded head (31) in the second sub-part of the two sub-parts of the bony part of the joint.

52. An operating equipment (1) according to claim 50, in which the anchoring surface (31a) of the second threaded head (31) is curved.

53. An operating equipment (1) according to any one of claims 40-52, wherein the second threaded head (31) is provided with an end (31b) having at least one orifice (31c) for receiving a rotation and / or fixing tool for fixing in rotation and holding in place the second threaded head (31) in the second subpart of the two subparts of the bony part of the joint.

54. An operating equipment (1) according to claim 53, in which the tip (31b) of the second threaded head (31) has n corresponding orifices (31c), n being an integer greater than 1.

55. An operating equipment (1) according to claim 54, in which the n orifices (31c) of the tip (31b) of the second threaded head (31) are identical to each other.

56. An operating equipment (1) according to claim 54 or 55, in which the n orifices (31c) of the tip (31b) of the second threaded head (31) are equidistant from each other.

57. An operating equipment (1) according to any one of claims 53-56, wherein the tip (31b) of the second threaded head (31) has 4 corresponding orifices (29c).

58. An operating equipment (1) according to any one of claims 53-57, wherein the tip (31b) of the second threaded head (31) has rounded peripheral contours (31d).

59. An operating equipment (1) according to any one of claims 53-58, wherein the tip (31b) of the second threaded head (31) has an axial hole (31e) configured to receive a second end (33b) of the connecting rod (33).

60. An operating equipment (1) according to claim 59, wherein the axial hole (31e) of the second threaded head (31) is configured to allow a passage of the first end (33a) of the connecting rod (33), beforehand, so that this first end (33a) of the connecting rod (33) is connected to the first threaded head (29).

61. An operating equipment (1) according to any one of claims 40-60, wherein the connecting rod (33) comprises a main rod (33c), a first end (33a) having an external thread (35) complementary to a corresponding internal thread (35) of the axial hole (29e) of the first threaded head (29), and a second end (33b) having a corresponding head (33d) having a cavity for receiving a corresponding rotary tool. 60 62. An operating equipment (1) according to any one of claims 40-61, wherein the operating equipment (1) comprises a corresponding first router bit (39) having a geometric profile being substantially complementary to that of the main body of the first threaded head (29), the first router bit (39) being used to drill a corresponding hole in the first sub-part of the two sub-parts of the bony part of the joint intended to receive the first threaded head (29).

63. An operating equipment (1) according to claim 62, wherein the operating equipment (1) comprises a corresponding second router bit (41) having a geometric profile being substantially complementary to that of the main body of the second threaded head (31), the second router bit (41) being used to drill a corresponding hole in the second sub-part of the two sub-parts of the bony part of the joint intended to receive the second threaded head (31).

64. An operating equipment (1) according to any one of claims 1-63, wherein the operating equipment (1) comprises a measuring tool (43) for measuring a distance relative to the corresponding hole to be defined in the two corresponding sub-parts of the bony part of the joint to be sectioned, in order to be able to carry out the surgical intervention and to be able subsequently to better bring the two sub-parts of the bony part of the joint together after the surgical intervention.

65. An operating equipment (1) according to claim 64, in which the measuring tool (43) comprises two main sections (43a, 43b) being movable relative to each other.

66. An operating device (1) according to claim 64 or 65, wherein the measuring tool (43) has two measuring ends (45a, 45b) being 61 movable relative to each other by means of a relative displacement between the two main sections (43a, 43b) of the measuring tool (43).

67. An operating equipment (1) according to any one of claims 64-66, wherein at least one main section (43a, 43b) of the measuring tool (43) has a measuring scale (47) and a corresponding reading line (49), so as to be able to measure a distance between the two measuring ends (45a, 45b) of the measuring tool (43).

68. An operating equipment (1) according to any one of claims 64-67, wherein each main section (43a, 43b) of the measuring tool (43) has a measuring scale (47) and a corresponding reading line (49), so as to be able to measure a distance between the two measuring ends (45a, 45b) of the measuring tool (43).

69. An operating equipment (1) according to any one of claims 64-68, in which the measuring tool (43) comprises at least one main clamping component (51) in order to hold in fixed position the two main sections (43a, 43b), and therefore the two corresponding measuring ends (45a, 45b), of the measuring tool (43), relative to each other.

70. An operating equipment (1) according to claim 69, wherein said at least one main clamping component (51) comprises a handle (53, 53a, 53b).

71. An operating equipment (1) according to claim 70, wherein the handle (53, 53a, 53b) of said at least one main clamping component (51) is rounded. 62 72. An operating equipment (1) according to claim 70 or 71, wherein the handle (53, 53a, 53b) of said at least one main clamping component (51) has a knurled peripheral surface to permit increased manual grip by a user of the measuring tool (43).

73. An operating equipment (1) according to any one of claims 69-72, wherein said at least one main clamping component (51) comprises two main clamping components (51a, 51b), one for each main section (43a, 43b) of the measuring tool (43), in order to hold in fixed position the two main sections (43a, 43b), and therefore the two corresponding measuring ends (45a, 45b), of the measuring tool (43), relative to each other.

74. An operating equipment (1) according to any one of claims 64-73, wherein the measuring tool (43) comprises at least one complementary section (43c, 43d) being movable relative to a main body of the measuring tool (43), a measuring end (45, 45a, 45b) of the measuring tool (43) being mounted on said complementary section (43c, 43d).

75. An operating equipment (1) according to any one of claims 64-74, in which the measuring tool (43) comprises two complementary sections (43c, 43d) each being movable relative to a main body of the measuring tool (43), a measuring end (45, 45a, 45b) of the measuring tool (43) being mounted on each of said complementary sections (43c, 43d).

76. An operating equipment (1) according to claim 75, in which at least one additional section (43c, 43d) of the measuring tool (43) has a measuring scale (47) and a corresponding reading line (49), so as to be able to measure a distance between a longitudinal axis (43e) of the measuring tool (43) and a corresponding measuring end (45, 45a, 45b). 63 77. An operating equipment (1) according to claim 75 or 76, wherein each additional section (43c, 43d) of the measuring tool (43) has a measuring scale (47) and a corresponding reading line (49), so as to be able to measure a distance between a longitudinal axis (43e) of the measuring tool (43) and a corresponding measuring end (45, 45a, 45b) associated with a given additional section (43c, 43d).

78. An operating equipment (1) according to any one of claims 64-77, wherein the measuring tool (43) comprises at least one additional clamping component (51c, 51d) in order to hold in place, at least one additional section (43c, 43d) and a corresponding measuring end (45, 45a, 45b), fixedly relative to a main body of the measuring tool (43).

79. An operating equipment (1) according to claim 78, wherein said at least one additional clamping component (51c,51d) comprises a handle (53,53c,53d).

80. An operating equipment (1) according to claim 79, wherein the handle (53,53c,53d) of said at least one additional clamping component (51c,51d) is rounded.

81. An operating equipment (1) according to claim 79 or 80, wherein the handle (53,53c,53d) of said at least one additional clamping component (51c,51d) has a knurled peripheral surface to permit increased manual grip by a user of the measuring tool (43).

82. An operating device (1) according to any one of claims 79-81, wherein said at least one additional clamping component (51c, 51d) comprises two additional clamping components 64 (51c, 51d), one for each complementary section (43c, 43d) of the measuring tool (43), in order to hold in place, each complementary section (43c, 43d) and a corresponding measuring end (45, 45a, 45b), fixedly relative to a main body of the measuring tool (43).

83. An operating equipment (1) according to any one of claims 33-82, wherein the connection system (19) comprises a strapping system.

84. An operating equipment (1) according to claim 83, in which the strapping system is selectively tensioned by means of a tensioner.

85. An operating equipment (1) according to claim 83 or 84, wherein the strapping system comprises at least one wire (55).

86. An operating equipment (1) according to claim 85, wherein said at least one wire (55) of the strapping system comprises at least one high-voltage wire (55).

87. An operating equipment (1) according to claim 85 or 86, wherein said at least one wire (55) of the strapping system comprises at least one metallic wire (55).

88. An operating equipment (1) according to any one of claims 85-87, wherein said at least one wire (55) of the strapping system comprises a plurality of metallic filaments being braided together.

89. An operating equipment (1) according to any one of claims 85-88, in which said at least one wire (55) of the strapping system is insertable into at least one corresponding hole (57) of the ball joint. 65 90. An operating equipment (1) according to any one of claims 85-89, wherein said at least one wire (55) of the strapping system is capable of being fixed in place by a retention mechanism (59).

91. An operating equipment (1) according to any one of claims 33-90, in which the connection system (19) comprises a headless interfragmentary screw system (61), having a longitudinal part (61c), and first and second opposing parts (61a, 61b) with external threaded surfaces, these first and second parts (61a, 61b) being mountable and movable along said longitudinal part (61c).

92. An operating equipment (1) according to claim 91, in which geometric arrangements of the first and second opposing parts (61 a, 6b) are different from each other.

93. An operating equipment (1) according to claim 91 or 92, in which each opposing part (61 a, 61 b) has a distal cavity (61 d) being positioned, formed and dimensioned to receive a corresponding tool for screwing and / or unscrewing the first and second opposing parts (61 a, 61 b) moving relative to each other along the longitudinal part (61 c) of the headless interfragmentary screw system (61 ).

94. An operating equipment (1) according to any one of claims 91-93, wherein the longitudinal part (61c) of the headless interfragmentary screw system (61) has at least one longitudinal groove (611).

95. An operating equipment (1) according to any one of claims 91-94, wherein the longitudinal part (61c) of the headless interfragmentary screw system (61) has at least one peripheral longitudinal groove (611) and / or at least one axial longitudinal groove (611). 66 96. An operating equipment (1) according to any one of claims 33-95, wherein the connection system (19) comprises a screw-on ring (63).

97. An operating equipment (1) according to claim 96, in which the screw-on ring (63) comprises an internal peripheral part (63a) and an external peripheral part (63b).

98. An operating equipment (1) according to claim 96 or 97, in which at least a peripheral part (63a, 63b) of the screwable ring (63) is provided with a threaded surface.

99. An operating equipment (1) according to claim 97 or 98, in which the two peripheral parts (63a, 63b) of the screwable ring (63) are provided with respective threaded surfaces.

100. An operating equipment (1) according to any one of claims 96-99, in which the screw-on ring (63) comprises a main body (63c) being substantially circular.

101. An operating equipment (1) according to claim 100, in which the main body (63c) of the screwable ring (63) has a cross-section being profiled.

102. An operating equipment (1) according to claim 100 or 101, wherein the cross-section of the main body (63c) of the screw-on ring (63) comprises a distal portion (63d). 67 103. An operating equipment (1) according to claim 102, wherein the distal portion (63d) of the cross-section of the main body (63c) of the screw-on ring (63) is substantially pointed.

104. An operating equipment (1) according to claim 102 or 103, wherein the distal portion (63d) of the cross-section of the main body (63c) of the screw-on ring (63) has a distal border (63e).

105. An operating device (1) according to any one of claims 102-104, wherein the distal edge (63e) of the cross-section of the main body (63c) of the screw-on ring (63) is substantially sharp.

106. An operating equipment (1) according to any one of claims 100-105, in which an upper part of the main body (63c) of the screw-on ring (63) is provided with at least one corresponding cavity (65) for receiving a rotating tool (67).

107. An operating equipment (1) according to claim 106, in which the upper part of the main body (63c) of the screw-on ring (63) is provided with 2n corresponding cavities (65) for receiving the corresponding rotating tool (67), n being an integer equal to and / or greater than 1.

108. An operating equipment (1) according to claim 107, in which each corresponding cavity (65) of the screwable ring (63) is suitable for receiving a corresponding protruding element (69) of the corresponding rotating tool (67).

109. An operating equipment (1) according to claim 107 or 108, in which each corresponding cavity (65) of the screw-on ring (63) is arranged around the main body (63c) of the screw-on ring (63). 68 110. An operating equipment (1) according to any one of claims 107-109, in which each corresponding cavity (65) of the screw ring (63) is arranged equidistant from each other around the main body (63c) of the screw ring (63).

111. An operating equipment (1) according to any one of claims 107-110, wherein the upper part of the main body (63c) of the screw-on ring (63) is provided with at least two corresponding cavities (65) for receiving protruding elements (69) of the corresponding rotating tool (67).

112. An operating equipment (1) according to any one of claims 107-111, in which the upper part of the main body (63c) of the screw-on ring (63) is provided with at least four corresponding cavities (65) for receiving protruding elements (69) of the corresponding rotating tool (67).

113. An operating equipment (1) according to any one of claims 107-112, wherein the upper part of the main body (63c) of the screw-on ring (63) is provided with at least six corresponding cavities (65) for receiving protruding elements (69) of the corresponding rotating tool (67).

114. An operating equipment (1) according to any one of claims 107-113, in which the upper part of the main body (63c) of the screw-on ring (63) is provided with at least eight corresponding cavities (65) for receiving protruding elements (69) of the corresponding rotating tool (67).

115. An operating equipment (1) according to any one of claims 106-114, wherein the corresponding rotating tool (67) comprises a number of protruding elements (69) being complementary with the number of corresponding cavities (65) provided on the screwable ring (63). 69 116. An operating equipment (1) according to claim 115, wherein each protruding element (69) of the rotating tool (67) is complementary to at least one corresponding cavity (65) of the screw-on ring (63).

117. An operating equipment (1) according to claim 115 or 116, wherein each protruding element (69) of the rotating tool (67) is complementary to each corresponding cavity (65) of the screw-on ring (63).

118. An operating equipment (1) according to any one of claims 115-117, wherein each corresponding cavity (65) of the screw-on ring (63) is substantially cylindrical, and therefore, wherein each protruding element (69) of the corresponding rotating tool (67) is also substantially cylindrical.

119. An operating equipment (1) according to any one of claims 115-118, wherein each protruding element (69) of the rotating tool (67) is disposed on a distal part of the rotating tool (67).

120. An operating equipment (1) according to claim 119, wherein the distal part of the rotating tool (67) is substantially circular and complementary to the upper part of the screwable ring (63).

121. An operating equipment (1) according to claim 119 or 120, wherein the distal part of the rotating tool (67) is provided with reinforcing parts (71) converging into a common rod (73).

122. An operating equipment (1) according to any one of claims 106-121, in which the rotating tool (67) is provided with a close handling part (75). 70 123. An operating device (1) according to claim 122, wherein the close-grip handling portion (75) is provided on a common shaft (73) for the rotating tool (67).

124. An operating device (1) according to claim 122 or 123, wherein the close-grip handling portion (75) comprises a pair of opposing handles (75a, 75b).

125. An operating equipment (1) according to any one of claims 96-124, wherein the operating equipment (1) comprises a grinding tool (77) having a geometric profile substantially complementary to that of the main body (63c) of the screw-on ring (63), to allow a corresponding circular depression to be cut beforehand in the ball joint, being intended to receive said screw-on ring (63).

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