Acetabular reamer handle and method of reaming acetabulum

Abstract

To provide an acetabular reamer handle and a method for reaming an acetabulum.SOLUTION: An acetabular reamer handle 10 includes a shaft 20 having a distal end 32, a neck part 6 having a longitudinal axis, a drive-line 40 extending through the shaft and the neck part, and a locking mechanism. A distally located head part 42 of the drive-line is mounted for rotation about the longitudinal axis 46 of the neck part and is connectable to a reamer. The distal end of the shaft and a proximal end of the neck part are pivotally attached to allow the shaft to be tilted relative to the longitudinal axis. The tilting can allow a part of the acetabulum and / or reamer that is otherwise obscured to be viewed. The locking mechanism includes an engagement member 50 having an engagement surface 51 located at the distal end of the shaft. The engagement member is moveable distally to urge the engagement surface against the proximal end of the neck part.SELECTED DRAWING: Figure 7

Description

[Technical field]

[0001] The present invention relates to an acetabular reamer handle. The present invention also relates to a method for reaming the acetabulum in a hip replacement procedure. [Background technology]

[0002] A hip replacement is a surgical procedure in which the hip joint is replaced with an artificial joint implant. As part of a hip replacement, the patient's acetabulum may be prepared to receive an acetabular cup implant by reaming the acetabular cup implant to the appropriate size and depth. A surgical tool for reaming the acetabulum may include a reamer having a substantially hemispherical dome that is received within the acetabulum. The reamer may also include features located on an outer surface of the dome for scraping the inner surface of the acetabulum as the reamer rotates. The reamer may be attached to the distal end of a tubular reamer handle to allow the surgeon to manipulate it (e.g., place the dome within the acetabulum and apply a force to press the reamer against the inner surface of the acetabulum as the reamer rotates). A drive system may extend into the reamer handle to transmit torque to the reamer.

[0003] Various types of reamer handles may be used.

[0004] One type of reamer handle is the offset reamer handle, which may include a pair of bends in a tube that form a dog-leg configuration, which may allow the surgeon to more easily work around soft tissue.

[0005] Another type of reamer handle may include a single bend.

[0006] A further type of reamer handle may be substantially straight (ie, containing no bends).

[0007] WO 2003 / 065906 describes a surgical device for holding and rotating an acetabular reaming head. The device comprises a shaft having a length extending from a first end adapted to hold an acetabular reaming head at a second end. At least a portion of the shaft branches off from an axis defined by the first and second ends of the shaft, for example the shaft may include a C-shaped branched portion. Thus, the head held by the device can access the acetabulum in its true anatomical position while avoiding penetration of the shaft over the surrounding body portion.

[0008] Generally, visibility is quite limited during hip replacement surgery. For example, when using a reamer handle, it may be difficult for the surgeon to inspect the dome of the reamer while it is located in the acetabulum (e.g., to assess the reaming depth). In situ, the dome may be at least partially obscured, for example, by soft tissue and / or by the reamer handle. To assess the reaming depth, the surgeon may either remove the reamer handle and reamer from the incision site, or detach the reamer handle from the reamer to view the acetabulum and reamer with the reamer still in situ, which is inconvenient in either case.

[0009] U.S. Patent No. 8,052,690 describes an orthopedic reamer driver including a tubular housing having at least one first positioning feature. A drive shaft within the housing has a drive end. A variable angle cap is pivotally coupled to the housing adjacent the drive end. The variable angle cap includes at least one leg extending along a side of the housing. Each leg has a second positioning feature that selectively engages and disengages a corresponding first positioning feature at a selected one of a plurality of angular positions. Each second positioning feature maintains the variable angle cap at a selected angular position when engaged with a corresponding first positioning feature. A variable angle joint is coupled to the drive end, and a reamer drive head is coupled to the variable angle joint.

[0010] US Patent No. 7,008,430 describes a positioning tool for joint socket cutting instruments or implants designed for use with minimally invasive surgical procedures. The positioning tool has a longitudinally extending drive shaft with a movable joint at a first end and a drive connection for connection to a power source at a second end. A holder for mounting a cutting tool such as a drill or as an acetabular cutting instrument, or a holder for mounting an acetabular implant, is coupled to the movable joint at the first end of the drive shaft for movement relative to the drive shaft. The holder is rotatable about its central axis when the drive shaft is rotated. The drive shaft includes a shaft bearing mounted thereon, the shaft bearing pivotally coupled to the shaft at a fixed longitudinal position and pivotally coupled to a longitudinally extending first arm having a handle. A tracker system that can be utilized by a computer-assisted surgical system is mounted on the first arm. A second arm is provided that is pivotally connected to the holder at a first end and pivotally connected to the first arm at a second end. The resulting four bar connection allows the holder and cutting tool / implant to be manipulated in any position, while the known geometric relationship between the tracker and holder allows the position of the holder relative to the joint to be displayed by computer on a cathode ray tube.

[0011] US 2005 / 159751(A1) describes an orthopedic reamer driver including a tubular housing having at least one first positioning feature. A drive shaft within the housing has a drive end. A variable angle cap is pivotally coupled to the housing adjacent the drive end. The variable angle cap includes at least one leg extending along a side of the housing. Each leg has a second positioning feature that selectively engages and disengages a corresponding first positioning feature at a selected one of a plurality of angular positions. Each second positioning feature maintains the variable angle cap at a selected angular position when engaged with a corresponding first positioning feature. A variable angle joint is coupled to the drive end and a reamer drive head is coupled to the variable angle joint.

[0012] WO 2018 / 033788 A1 describes a surgical reamer driver device that provides a completely closed tube that prevents debris ingress and minimizes soft tissue wear during use. The reamer device includes a minimum number of part assemblies to allow easy replacement and minimize wear. The surgical reamer driver includes a housing assembly in a stand-alone assembly unit, a transmission drive train in a stand-alone assembly unit enclosed within the housing assembly and having at least one double universal joint and a surgical tool connector at its distal end, a motor shaft coupled in the stand-alone assembly unit at its proximal end, and a handle assembly in the stand-alone assembly unit at its proximal end, these four basic components making up a driver that effectively prevents debris from entering the internal workings of the driver. A method for disassembling the reamer driver includes the steps of: a. actuating a slide release sleeve to unlock the handle assembly from the housing assembly, thereby allowing unenclosure of the drive train within the housing assembly; b. sliding the handle assembly from the housing, thereby effectively unenclosing the drive train; c. pulling the motor shaft out of the housing, thereby freeing the drive train from axial constraint at one end; d. detaching the drive train at one end and lifting the one end from the housing assembly, thereby allowing removal of the drive train; and e. pulling the drive train out of the housing assembly, thereby removing the drive train from the housing assembly.

[0013] US 2004 / 097947(A1) describes an orthopedic reamer assembly for minimally invasive surgery that includes a reamer and a driver. The driver includes a shaft having a distal end and a longitudinal axis, and a driver head connected to the distal end. The driver head is pivotable about an axis generally perpendicular to the longitudinal axis. A reamer is connected to the driver head.

[0014] EP 2954860A2 discloses an orthopaedic reamer handle comprising a reamer portion configured to transmit torque to a reamer head, a driver portion connected to the reamer portion and configured to receive and transmit torque from a driver, and a drive train connecting the reamer portion and the driver portion and configured to transmit torque from the driver portion to the reamer portion, the drive train comprising a first drive shaft having a first end and a second end, the first end being connected to the driver portion and the first drive shaft being connected to the first drive shaft. the first intermediate connector having a first intermediate end and a second intermediate end, the first intermediate end being connected to the second end; and an offset member having a third end and a fourth end, the third end being connected to the second intermediate end at an acute angle relative to the first axis, the offset member defining a second axis, the second intermediate connector connecting the fourth end to the reamer portion at an acute angle relative to the second axis. Summary of the Invention [Means for solving the problem]

[0015] Aspects of the invention are set out in the accompanying independent and dependent claims. Combinations of features from the dependent claims may be combined with features of the independent claims as appropriate and are not limited to those explicitly set out in the claims.

[0016] According to an aspect of the present invention, there is provided an acetabular reamer handle comprising: a hollow shaft having a distal end; a hollow neck portion having a longitudinal axis; a drive system extending through the shaft and the neck portion, a head portion distal to the drive system being mounted for rotation about a longitudinal axis of the neck portion and connectable to an acetabular reamer, the distal end of the shaft and the proximal end of the neck portion being pivotally mounted to permit tilting of the shaft relative to the longitudinal axis of the neck portion; and a locking mechanism including an engagement member having an engagement surface located at a distal end of the shaft, the engagement surface being substantially circumferential to a longitudinal axis of the hollow shaft at the distal end of the shaft, the engagement member being distally movable to bias the engagement surface against a proximal end of the neck portion to resist tilting of the shaft relative to the longitudinal axis of the neck portion.

[0017] Tilting the shaft relative to the longitudinal axis of the neck portion may allow for viewing of the acetabulum and / or portions of the reamer that would otherwise be obscured by the reamer handle. This may allow the surgeon better visibility to determine the depth to which the acetabulum has been reamed, for example, without having to remove the reamer and reamer handle from the acetabulum or cut the reamer handle off the reamer. The locking mechanism may function to prevent undesired tilting of the shaft while the reamer is being actuated. The locking mechanism may be simple to operate and may have a compact, robust construction that does not need to include complex parts that would otherwise increase the cost and / or reduce the reliability of the reamer handle.

[0018] The proximal end of the neck portion may include a surface for engaging with the engagement surface of the engagement member. The surface of the proximal end of the neck portion may be contained within a plane.

[0019] The surface of the proximal end of the neck portion may have a surface normal oriented at an angle α relative to the longitudinal axis of the neck portion. Typically, α may be less than 90° to allow for proper operation of the drive system. This angling of the neck portion relative to the shaft allows the surgeon to more easily work around the soft tissue at the incision site. In some embodiments, 30°≦α≦60°. In some embodiments, α is about 30°. In some embodiments, α is about 45°.

[0020] The surface of the proximal end of the neck portion may be contained in a plane having a surface normal oriented parallel to the longitudinal axis of the neck portion, which in some embodiments may allow the acetabular reamer handle to operate as a straight reamer handle (notwithstanding the ability of the reamer handle to tilt, as discussed above).

[0021] The engagement member may be slidably mounted inside the hollow shaft. The engagement member may be configured to protrude from a distal end of the hollow shaft to bias an engagement surface against a proximal end of the neck portion. In this manner, the components of the locking mechanism may be protected by the walls of the shaft, where fluids and / or bone chips at the incision site do not interfere with their actuation.

[0022] The engagement member may be resiliently biased distally to urge the engagement surface against the proximal end of the neck portion. To accomplish this, the locking mechanism may include a helical spring mounted coaxially to the distal end of the hollow shaft and proximally to the engagement member. The helical spring may be mounted inside the hollow shaft. This may also protect the spring from interference with fluids and / or bone chips at the incision site.

[0023] The engagement member may include a handle portion for manually retracting the engagement member proximally to release the engagement surface from the proximal end of the neck portion, allowing the surgeon to selectively release the shaft to tilt it while the shaft remains locked during actuation of the reamer.

[0024] The acetabular reamer may include one or more locking members extending from the engagement surface to be received in one or more corresponding openings in the proximal end of the neck portion. This configuration may enable locking of the engagement surface against the proximal end of the neck portion to resist tilting of the shaft relative to the longitudinal axis of the neck portion. When two or more such locking members are provided, they may be distributed (e.g., evenly) around the circumference formed by the engagement surfaces of the engagement members. For example, the acetabular reamer may include two locking members, each located on either side of a plane that accommodates the longitudinal axis of the hollow shaft and hollow neck portion.

[0025] The drive system may include a universal joint located at a pivot point between the distal end of the shaft and the proximal end of the neck portion, which may allow for an angle between the neck portion (within which the head portion rotates) and the housed shaft.

[0026] The acetabular reamer handle may be an offset acetabular reamer handle including a proximal shaft portion and a distal shaft portion, the shaft having a bend located at the interface between the proximal and distal shaft portions. The proximal and distal shaft portions may be formed rigidly such that an angle between a longitudinal axis of the distal shaft portion and a longitudinal axis of the proximal shaft portion is constant.

[0027] The engagement surface may be substantially annular, triangular, rectangular, pentagonal, or hexagonal.

[0028] According to another aspect of the present invention, there is provided a surgical kit including an acetabular reamer handle of the type described above and one or more different sized acetabular reamers connectable to the head portion of the acetabular reamer handle.

[0029] According to a further aspect of the present invention, there is provided a method of reaming an acetabulum of a patient using a reamer connected to a reamer handle, the reamer handle comprising: a hollow shaft having a distal end; a hollow neck portion having a longitudinal axis; a drive system extending through the shaft and the neck portion, a head portion distal to the drive system being mounted for rotation about a longitudinal axis of the neck portion and connected to the reamer, and a distal end of the shaft and a proximal end of the neck portion being pivotally mounted to allow tilting of the shaft relative to the longitudinal axis of the neck portion; The method comprises: Inserting a reamer into the acetabulum; activating the reamer to remove bone from the surface of the acetabulum; With the reamer positioned within the acetabulum, tilting the shaft relative to the longitudinal axis of the neck portion to view a portion of the acetabulum and / or the reamer that would otherwise be obscured by the reamer handle.

[0030] Angling the shaft relative to the longitudinal axis of the neck portion may allow a portion of the acetabulum and / or reamer that would otherwise be obscured by the reamer handle to be viewed without having to remove the reamer and reamer handle from the acetabulum or without having to cut the reamer handle from the reamer.

[0031] The method may further include tilting the reamer handle about a longitudinal axis of the neck portion to view a portion of the acetabulum and / or reamer that would otherwise be obscured by the reamer handle.

[0032] The method may further include viewing a portion of the acetabulum and / or reamer that would otherwise be obscured by the reamer handle to determine the reaming depth.

[0033] The method may further include actuating a locking mechanism on the reamer handle to disengage an engagement member of the locking mechanism from the proximal end of the head portion to allow tilting of the shaft relative to the longitudinal axis of the neck portion.

[0034] The engagement member may be distally movable to bias the engagement surface against the proximal end of the neck portion to resist tilting of the shaft relative to the longitudinal axis of the neck portion.

[0035] The engagement member may be resiliently biased towards the proximal end of the head portion, which may be accomplished by a helical spring, as described above.

[0036] The engaging member may be slidably mounted on or within the shaft. The method may further include manually retracting the engaging member proximally to disengage the engaging member from the proximal end of the neck portion.

[0037] The engagement member may have an engagement surface located at a distal end of the shaft for engaging a proximal end of the neck portion to resist tilting of the shaft relative to the longitudinal axis of the neck portion. The engagement surface may be substantially circumferential relative to the longitudinal axis of the hollow shaft at the distal end of the shaft.

[0038] The engagement surface may be substantially annular, triangular, rectangular, pentagonal, or hexagonal.

[0039] The reamer handle may be an offset reamer handle, where the hollow shaft includes a proximal shaft portion and a distal shaft portion, the shaft having a bend located at the interface between the proximal and distal shaft portions. [Brief description of the drawings]

[0040] Embodiments of the invention will now be described, by way of example only, with reference to the accompanying drawings in which like reference symbols indicate similar elements and in which: [Figure 1A] FIG. 2 shows a side view of an acetabular reamer handle according to an embodiment of the present invention. [Figure 1B] 2 shows a side view of the acetabular reamer handle of FIG. 1 with the acetabular reamer connected to a head portion located distally of the drive train of the acetabular reamer handle; [Diagram 2]1B shows a cross-section of the acetabular reamer handle of FIG. 1A. [Diagram 3] 1B shows an enlarged view of components located toward the distal end of the shaft of the acetabular reamer handle of FIG. 1A. [Figure 4] 1B shows an enlarged cross-section of components located toward the distal end of the shaft of the acetabular reamer handle of FIG. 1A. [Diagram 5] 1B shows another side view of the acetabular reamer handle of FIG. 1A. [Figure 6] 1B shows another cross-section of the acetabular reamer handle of FIG. 1A. [Figure 7] 1B shows an exploded view of the acetabular reamer handle of FIG. 1A. [Figure 8] 13 shows an enlarged view of components located toward the distal end of the shaft of an acetabular reamer handle according to another embodiment of the present invention. [Figure 9] 9 shows another close-up view of the components located toward the distal end of the shaft of the acetabular reamer handle of FIG. 8. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0041] Embodiments of the present invention will now be described with reference to the accompanying drawings.

[0042] 1-7 show various views of an acetabular reamer handle 10 according to one embodiment of the present invention.

[0043] The acetabular reamer handle 10 includes a shaft 20. The shaft 20 has a proximal end 34 and a distal end 32. The shaft 20 is substantially hollow (see, for example, the cross-section of FIG. 2).

[0044] In this embodiment, the shaft 20 includes a distal shaft section 20A and a proximal shaft section 20B. The shaft sections 20A, 20B are fixedly joined together at a bend 28 in the shaft 20, whereby the longitudinal axis 26 of the distal shaft section 20A is oriented at an angle β (see, for example, FIG. 1A ) relative to the longitudinal axis 66 of the proximal shaft section 20B. Each shaft section 20A, 20B may have a distal end and a proximal end. In this embodiment, the proximal end of the distal shaft section 20A is joined to the distal end of the proximal shaft section 20B at said bend 28. The angle β may be in the range of 30°≦β≦60°. In particular, in some embodiments, β=30° or β=45° are envisioned.

[0045] It is also envisioned that shaft 20 may be substantially straight, without bends of the type shown in the figures of this embodiment.

[0046] Shaft 20 (eg, including its constituent shaft sections 20A, 20B) may be generally elongated and cylindrical and may have a substantially circular cross-section.

[0047] One or more handle portions 60 may be provided on the shaft 20 to facilitate holding the acetabular reamer handle 10 and to allow the surgeon to apply axial force to urge a reamer attached to the distal end of the acetabular reamer handle 10 into the inner surface of the patient's acetabulum during reaming. As shown, each handle portion 60 may extend radially outward from a side of one of the shafts 20. The handle portions 60 may be located toward the proximal end of the shaft 20. In this embodiment, the acetabular reamer handle 10 includes a single handle portion 60 extending radially outward from a side of the additional shaft portion 20B.

[0048] The acetabular reamer handle 10 also includes a neck portion 6. The neck portion 6 is substantially hollow. The neck portion 6 may be substantially cylindrical or may have a substantially circular cross-section. The neck portion 6 has a proximal end 62, a distal end 64, and a longitudinal axis 46. As described in more detail below, the proximal end 62 of the neck portion 6 is pivotally connected to the distal end 32 of the shaft 20 to allow the shaft 20 to be tilted relative to the longitudinal axis 46 of the neck portion 6.

[0049] The acetabular reamer handle 10 also includes a drive system 40. The drive system 40 is shown in its entirety in the exploded view of FIG. 7, and portions of the drive system 40 are also visible in FIGs. 1A, 1B, 3, 5, 8, and 9. For clarity, only a head portion 42 (described below) of the drive system 40 is shown in the cross-sectional views of FIGs. 2, 4, and 6. The drive system 40 is elongated and sized to fit within and extend through the hollow shaft 20 and neck portion 6.

[0050] Drive system 40 may include multiple drive system sections. In general, in embodiments in which shaft 20 includes one or more bends, such as bend 28, drive system 40 may include a respective drive system section for each shaft section of hollow shaft 20. In this embodiment, these drive system sections include distal drive system section 40A and proximal drive system section 40B. To accommodate any bends in shaft 20 (and angles between shaft 20 and neck portion 6, described below), drive system 40 may include one or more universal joints positioned along its length. In this embodiment, drive system 40 includes a first universal joint 48A that joins a proximal end of head portion 42 of drive system 40 to a distal end of distal drive system section 40A, and a second universal joint 48B that connects a proximal end of distal drive system section 40A to a distal end of additional drive system section 40B.

[0051] The proximal end 34 of the shaft 20 of the acetabular reamer handle 10 (formed by the additional shaft portion 20B in this embodiment having two shaft portions) may have an opening through which the proximal end 45 of the drive system 40 may protrude. The proximal end 45 of the drive system 40 may include a connection mechanism for connection to a power tool, such as a rotary driver, for applying torque to the drive system 40. In use, the drive system 40 rotates to transmit torque through the hollow shaft 20 and the neck portion 6 to a distally located head portion 42 of the drive system 40. The head portion 42 of the drive system 40 is connectable to a reamer 100. FIG. 1B shows a side view of the acetabular reamer handle 10 of FIG. 1 with the acetabular reamer 100 connected to the head portion 42 of the drive system 40. To effect the connection between the head portion 42 and the acetabular reamer 100, the head portion 42 may include a distally located connection mechanism 44 for connection with a corresponding connection mechanism of the acetabular reamer 100. 1B, the acetabular reamer 100 may include, for example, a hemispherical dome 102 for insertion into a patient's acetabulum. The exterior surface of the dome 102 may include features 104 for scraping bone from the interior surface of the acetabulum as the acetabular reamer 100 rotates with the drivetrain 40.

[0052] The head portion 42 is mounted to rotate about a longitudinal axis 46 of the neck portion 6. The axis of rotation of the head portion 42 may generally be coaxial with the longitudinal axis 46. In this embodiment, the proximal end of the head portion 42 is located inside the neck portion 6. An outer surface of the head portion 42 (e.g., at the proximal end of the head portion in this embodiment) may be formed to fit with an inner surface of the neck portion 6 such that the head portion 42 rests within the neck portion 6 and maintains a coaxial relationship between the axis of rotation of the head portion 42 and the longitudinal axis 46. In this embodiment, the distal end of the head portion 42 projects distally from the distal end 64 of the neck portion 6 and includes the above-described connection mechanism 44 for connecting to an acetabular reamer. The distal end of the head portion 42 may be generally cylindrical and may have a larger diameter than the proximal end of the head portion 42 that rotates within the neck portion 6. In this embodiment, the distal end of the head portion 42 has the same outer diameter as the distal end 62 of the neck portion 6 such that the distal end of the head portion 42 is flush with the outer surface of the distal end 62 of the neck portion 6 .

[0053] In embodiments in which shaft 20 includes one or more bends, the shaft sections may be of different lengths (measured along their longitudinal axes). For example, in this embodiment, distal shaft section 20A is shorter than additional shaft section 20B. Head portion 42 may be shorter than the shaft sections (measured along its longitudinal axis 46).

[0054] As described above, the proximal end 62 of the neck portion 6 is pivotally connected to the distal end 32 of the shaft 20. In this embodiment, the pivot connection 70 is formed by a pair of holes 72 located at the distal end 32 of the shaft 20 and a pair of corresponding holes 7 located on the neck portion 6 through which a bolt 74 passes. The axis of rotation 76 provided by the pivot connection 70 is generally perpendicular to both the longitudinal axis 46 of the neck portion 6 and the longitudinal axis 26 of the distal end 32 of the shaft 20 (e.g., the distal shaft portion 20A). As shown in FIG. 7, the holes 72 may be located at the end of a pair of arms 36 that extend distally from the end of the shaft 20. These arms 36 may provide clearance between the hollow cylindrical portion of the shaft 20 and the proximal end 62 of the neck portion 6 to allow the shaft 20 and the neck portion 6 to rotate relative to each other about the pivot connection 70.

[0055] The pivot connection 70 between the neck portion 6 and the shaft 20 can allow the shaft 20 to be tilted relative to the longitudinal axis 46 of the neck portion 6. This tilt of the shaft 20 relative to the longitudinal axis 46 of the neck portion 6 can allow portions of the acetabulum and / or reamer 100 that would otherwise be obscured by the reamer handle 10 to be viewed. This can allow the surgeon better visibility to determine the depth to which the acetabulum has been reamed, for example, without having to remove the reamer 100 and reamer handle 10 from the acetabulum or without having to separate the reamer handle 10 from the reamer. Figures 1-4 show the acetabular reamer handle 10 of this embodiment in a non-tilted state. Figures 5 and 6 show the shaft 20 tilted (in a counterclockwise direction as viewed in these figures) such that the angle between the longitudinal axis 46 of the neck portion 6 and the longitudinal axis 26 of the distal shaft portion 20A is increased. It will be appreciated from a comparison of Figures 1-4 with Figures 5 and 6 that such inclination of the shaft 20 may allow portions of the acetabulum and / or reamer 100 located beneath the shaft 20 to be revealed.

[0056] It is noted that the universal joint 48A of the driveline 40 is positioned to coincide with the pivot connection 70 between the distal end 32 of the shaft 20 and the proximal end 62 of the neck portion 6. This may allow for angling of the shaft 20 relative to the longitudinal axis 46 of the neck portion 6 to be accommodated. As described herein, this angling of the shaft 20 relative to the longitudinal axis of the neck portion 6 may be possible in the untilted condition of the acetabular reamer handle 10 (e.g., due to the angle of the engagement surface 8, described below). The universal joint 48A may also accommodate relative rotation of the shaft 20 and neck portion 6 about the pivot connection 70 to tilt the shaft, as described above.

[0057] In addition to the shaft 20 being tilted as shown in Figures 5 and 6, it is envisioned that the shaft 20 is also tilted about the longitudinal axis 46 of the neck portion 6 (i.e., in either a clockwise or counterclockwise direction when viewing along the longitudinal axis 46 from the surgeon's viewing point) to view the acetabulum and / or portions of the reamer that would otherwise be obscured by the reamer handle 10.

[0058] The pivot connection 70 between the neck portion 6 and the distal end 32 of the shaft 20 may include a locking mechanism. The locking mechanism may function to resist undesired tilting of the shaft 20 relative to the longitudinal axis 46 of the neck portion 6. In this manner, the relative orientation of the neck portion 6 and the shaft 20 may be fixed in place while the patient's acetabulum is being reamed. As described below, the locking mechanism may be simple to operate and may have a compact, robust construction that does not require the inclusion of complex parts that would otherwise increase the cost of the reamer handle 10 and / or reduce its reliability.

[0059] In this embodiment, the locking mechanism includes an engagement member 50 having an engagement surface 51. As can be seen, for example, from a comparison of Figures 1 and 7, the engagement surface 51 is substantially circumferential to the longitudinal axis of the hollow shaft at the distal end of the shaft (which in this embodiment corresponds to the longitudinal axis 26 of the distal shaft portion 20A). The engagement member 50 is located at the distal end 32 of the shaft 20. The engagement surface 51 in this embodiment is substantially ring-shaped. It is also envisioned that the engagement surface may have different shapes (e.g., triangular, rectangular, pentagonal, or hexagonal). The engagement member 50 may be substantially tubular and may have a cross-sectional shape corresponding to the shape of the engagement surface 51.

[0060] The drive system 40 may pass through the center of the engagement member 50. The engagement member 50 may be mounted on the inside or outside of the shaft 20. In one embodiment, the engagement member 50 may be mounted as a sleeve on the outer surface of the distal shaft portion 20A.

[0061] In this embodiment, the engagement member 50 is slidably mounted inside the shaft 20 and projects from the distal end 32 of the shaft 20 to engage the proximal end 62 of the neck portion 6 .

[0062] Engagement member 50 is movable distally to bias engagement surface 51 against the proximal end of neck portion 6 to resist tilting of shaft 20 relative to longitudinal axis 46 of neck portion 6 .

[0063] In one embodiment, the engagement member 50 may be mounted on the threads (including a first thread located on the shaft and a second thread located on the engagement member 50) to allow the engagement member to be moved distally (by rotation of the engagement member 50 about the threads in a first direction) to bias the engagement surface 51 against the proximal end of the neck portion 6. The engagement member 50 may be moved proximally to disengage the engagement surface 51 from the proximal end of the neck portion 6 by rotating the engagement member 50 in a second direction opposite the first direction.

[0064] In other embodiments, the engagement member 50 may be elastically biased distally to bias the engagement surface 51 against the proximal end of the neck portion 6. For example, in this embodiment, the locking mechanism includes a spring, such as a helical spring 80. The helical spring 80 may be mounted coaxially with the distal end 32 of the shaft 20 and proximally with respect to the engagement member 50. In an embodiment in which the engagement member 50 is mounted as a sleeve on the outside of the shaft 20, the helical spring 80 may also be mounted on the outside of the shaft 20. In this embodiment, the helical spring 80 is located on the inside of the shaft 20 along with the engagement member 50. As shown, the helical spring 80 in this embodiment is located between the engagement member 50 and a circumferential lip 56 (e.g., FIG. 4) provided on the inner surface of the shaft 20. The helical spring 80 is thus positioned to bias the engagement member 50 distally to protrude from the distal end 32 of the shaft 20, as described above.

[0065] In use, the engagement surface 51 of the engagement member 50 is biased (e.g., by a spring in a locking mechanism) against the proximal end 62 of the neck portion 6. This resists any pivotal movement of the neck portion 6 relative to the shaft 20 (including tilting of the shaft 20 as described above).

[0066] In this embodiment, the proximal end 62 of the neck portion 6 is provided with an engagement surface 8 against which an engagement surface 51 of the engagement member 50 may be biased to resist the above-mentioned tilting of the shaft 20. The engagement surfaces 8 and 51 may also be substantially flat to provide a stable and secure contact therebetween.

[0067] As can be seen, in this embodiment, the engagement surface 8 of the neck portion 6 may be set at an angle relative to the longitudinal axis 46. In particular, the engagement surface 8 may be contained within a plane having a surface normal oriented at a non-zero angle α relative to the longitudinal axis 46 of the neck portion 6. Typically, α may be less than 90° to allow for proper actuation of the universal joint 48A of the drive train 40. This angling of the neck portion 6 relative to the shaft 20 may allow the surgeon to more easily work around the soft tissue at the incision site. In its non-angled position (e.g., FIG. 1A), the longitudinal axis 26 of the distal end 32 of the shaft 20 may be parallel to the surface normal of the engagement surface 8.

[0068] In some embodiments, 30°≦α≦60°. In some embodiments, α is about 30°. In some embodiments, α is about 45°.

[0069] It should be noted that in embodiments in which shaft 20 includes a bend, such as bend 28, the (non-tilted) angling of neck portion 6 relative to shaft 20 and bend 28 may be combined to configure acetabular reamer handle 10 as an offset reamer handle. It is contemplated that angles α and β may be equal in magnitude and opposite in direction to form a dogleg arrangement in which longitudinal axis 46 of neck portion 6 is substantially parallel to longitudinal axis 66 of proximal shaft portion 20B.

[0070] According to an alternative embodiment, it is envisioned that the engagement surface 8 of the neck portion 6 may be contained in a plane having a surface normal oriented parallel to the longitudinal axis 46 of the neck portion 6. This may allow the acetabular reamer handle 10 to operate as a straight reamer handle (notwithstanding the ability of the reamer handle to tilt as discussed herein).

[0071] To release the engagement surface 51 from the proximal end 62 of the neck portion 6, the engagement member 50 may be retracted in a proximal axial direction against the bias provided by the spring 80. The engagement member 50 may include or be connected to a handle 52, which may include one or more gripping surfaces. The handle 52 may be grasped by a surgeon and retracted in a proximal direction to retract the engagement member 50. In this embodiment, the handle 52 is connected to the engagement member 50 by a pair of arms 54 that extend substantially parallel to the distal end 32 of the shaft 20. The arms 54 extend through respective holes 55 located in the wall of the shaft 20 such that the handle 52 may be located outside the shaft 20 for manipulation by the surgeon.

[0072] Retraction of engagement member 50 disengages proximal end 62 (e.g., engagement surface 8) from engagement surface 51, allowing neck portion 6 and shaft 20 to pivot freely about pivot connection 70, thereby allowing shaft 20 to be free to tilt, as described herein, to view the acetabulum and / or portions of reamer 100 that may otherwise be obscured. After viewing the acetabulum and / or reamer, the surgeon may return shaft 20 to its original position (e.g., with the longitudinal axis 26 of distal end 32 of shaft 20 lying parallel to the surface normal of engagement surface 8) and release handle 52, such that engagement surface 51 re-engages and biases against proximal end 62 of neck portion 6. In this manner, the surgeon may resume reaming, with shaft 20 locked to prevent undesired tilting.

[0073] Figures 8 and 9 show components located toward the distal end 32 of the shaft 20 of an acetabular reamer handle 10 according to another embodiment of the present invention. The embodiment of Figures 8 and 9 is similar in many respects to the embodiment of Figures 1-7, with only the differences being described in detail below. Similar to Figures 3 and 4 and 5 and 6, Figures 8 and 9 show the acetabular reamer handle 10 in a non-angled configuration for reaming (Figure 8), and in an angled configuration (Figure 9) for viewing portions of the acetabulum and / or reamer 100 that would otherwise be obscured by the acetabular reamer handle 10.

[0074] In this embodiment, the acetabular reamer handle 10 includes one or more locking members 58. The locking member(s) 58 extend distally from the substantially annular shaped engagement surface 51 of the engagement member 50. As shown in FIG. 8 , the locking member(s) 58 may be received within corresponding respective aperture(s) 88 located at the proximal end 62 (e.g., engagement surface 8) of the neck portion 6. The locking members 58 and apertures 88 may cooperate to lock the engagement surface 51 relative to the proximal end 62 of the neck portion 6. In particular, because of the distally projecting orientation of the locking member(s) 58, when the locking member(s) 58 are located within their corresponding aperture(s) 88, any attempt to tilt the shaft 20 relative to the longitudinal axis 46 of the neck portion 6 will bias the locking member(s) 58 laterally against the sidewalls of their corresponding aperture(s) 88. Thus, the locking members 58 can resist tilting of the shaft 20 when they are received within their corresponding openings 88. Conversely, when the engaging member 50 is retracted proximally, as described above, the locking member(s) 58 are withdrawn from the corresponding opening(s) 88, thereby allowing the shaft 20 to be tilted, as shown in FIG.

[0075] The locking member(s) 58 may be triangular in cross section with the apex of the triangle facing distally. In this embodiment, the apex of the substantially triangular locking member(s) 58 faces distally along the longitudinal axis 26 of the distal shaft portion 20A. The opening(s) 88 may have an inner surface that matches the shape of its corresponding locking member(s) 58.

[0076] When two or more such locking members 58 are provided, the locking members 58 may be distributed (e.g., evenly) around the circumference formed by the engagement surfaces 51 of the engagement members 50. For example, the acetabular reamer 10 may include two locking members 58 located on either side of a plane that includes the longitudinal axis 46 of the hollow shaft 20 and hollow neck portion 6.

[0077] The acetabular reamer handle 10 according to one embodiment of the present invention may be included in a surgical kit. The kit may also include one or more different sized acetabular reamers 100 connectable to the head portion of the drive train of the acetabular reamer handle.

[0078] In one embodiment, a method of reaming a patient's acetabulum may include connecting an acetabular reamer 100 to a reamer handle 10 of the type described above. The method may also include inserting the acetabular reamer 100 into the patient's acetabulum. The method may also include actuating the acetabular reamer 100 to remove bone from a surface of the acetabulum. The method may further include, with the acetabular reamer 100 positioned within the acetabulum, tilting the shaft 20 relative to the longitudinal axis 46 of the neck portion 6 to view the acetabulum and / or a portion of the acetabular reamer 100 that would otherwise be obscured by the reamer handle 10. The method may also include tilting the reamer handle 10 about the longitudinal axis 46 of the neck portion to view the acetabulum and / or a portion of the acetabular reamer 100 that would otherwise be obscured by the reamer handle 10. By visually examining the portion of the acetabulum and / or acetabular reamer 100 that would otherwise be obscured by the reamer handle 10, the reaming depth may be determined.

[0079] The method may also include actuating the locking mechanism of the reamer handle 10 to disengage an engagement member 50 of the locking mechanism from the proximal end of the head portion 42 to allow tilting of the shaft 20 relative to the longitudinal axis 46 of the neck portion described above.

[0080] The method may further include manually retracting the engagement member 50 in a proximal direction to release the engagement member 50 from the proximal end 62 of the neck portion 6, as described in more detail above.

[0081] Thus, an acetabular reamer handle is described that includes a shaft having a distal end, a neck portion having a longitudinal axis, a drive system extending through the shaft and the neck portion, and a shaft having a locking mechanism. A head portion distal to the drive system is mounted for rotation about the longitudinal axis of the neck portion and connectable to the reamer. The distal end of the shaft and the proximal end of the neck portion are pivotally mounted to allow the shaft to tilt relative to the longitudinal axis. The tilt may allow portions of the acetabulum and / or reamer that would otherwise be obscured to be viewed. The locking mechanism includes an engagement member having an engagement surface located at the distal end of the shaft. The engagement member is movable distally to bias the engagement surface against the proximal end of the neck portion.

[0082] Although specific embodiments of the present invention have been described above, it will be appreciated that many modifications / additions and / or substitutions can be made within the scope of the invention as claimed.

[0083] [Embodiment] (1) An acetabular reamer handle, a hollow shaft having a distal end; a hollow neck portion having a longitudinal axis; a drive system extending through the shaft and neck portion, a head portion distal to the drive system mounted for rotation about the longitudinal axis of the neck portion and connectable to an acetabular reamer, the distal end of the shaft and the proximal end of the neck portion being pivotally mounted to permit tilting of the shaft relative to the longitudinal axis of the neck portion; 1. An acetabular reamer handle comprising: a locking mechanism including an engagement member having an engagement surface located at the distal end of the shaft, the engagement surface being substantially circumferential about a longitudinal axis of the hollow shaft at the distal end of the shaft, the engagement member being movable in a distal direction to urge the engagement surface against the proximal end of the neck portion to resist the tilting of the shaft relative to the longitudinal axis of the neck portion. (2) An acetabular reamer handle as described in embodiment 1, wherein the proximal end of the neck portion includes a surface for engaging with the engagement surface of the engagement member, and the surface of the proximal end of the neck portion is contained within a plane. (3) An acetabular reamer handle as described in embodiment 1, wherein the surface of the proximal end of the neck portion is contained within a plane having a surface normal oriented at a non-zero angle α relative to the longitudinal axis of the neck portion, where α<90°. (4) An acetabular reamer handle as described in embodiment 3, wherein 30°≦α≦60°. (5) An acetabular reamer handle as described in embodiment 4, wherein α is approximately 30°.

[0084] (6) An acetabular reamer handle as described in embodiment 4, wherein α is approximately 45°. (7) An acetabular reamer handle as described in embodiment 2, wherein the surface of the proximal end of the neck portion is contained in a plane having a surface normal oriented parallel to the longitudinal axis of the neck portion. (8) An acetabular reamer handle as described in any one of embodiments 1 to 7, wherein the engagement member is slidably mounted inside the hollow shaft and configured to protrude from the distal end of the hollow shaft and urge the engagement surface against the proximal end of the neck portion. (9) An acetabular reamer handle as described in any one of claims 1 to 8, wherein the engagement member is resiliently biased distally to urge the engagement surface against the proximal end of the neck portion. (10) The acetabular reamer handle of embodiment 9, wherein the locking mechanism includes a helical spring mounted coaxially to the distal end of the hollow shaft and proximal to the engagement member.

[0085] (11) The acetabular reamer handle of embodiment 10, wherein the helical spring is attached inside the hollow shaft. (12) An acetabular reamer handle according to any one of embodiments 1 to 11, wherein the engagement member includes a handle portion for manually retracting the engagement member in a proximal direction to disengage the engagement surface from the proximal end of the neck portion. (13) An acetabular reamer handle as described in any one of embodiments 1 to 12, comprising one or more locking members extending from the engagement surface to be received within one or more corresponding openings in the proximal end of the neck portion to lock the engagement surface against the proximal end of the neck portion and resist tilting of the shaft relative to the longitudinal axis of the neck portion. (14) An acetabular reamer handle as described in any one of embodiments 1 to 13, wherein the drive system includes a universal joint located at a pivot point between the distal end of the shaft and the proximal end of the neck portion. (15) The acetabular reamer handle according to any one of embodiments 1 to 14, wherein the hollow shaft is an offset acetabular reamer handle including a proximal shaft portion and a distal shaft portion, and the shaft has a bend portion located at the interface between the proximal shaft portion and the distal shaft portion.

[0086] (16) An acetabular reamer handle as described in embodiment 15, wherein the proximal shaft portion and the distal shaft portion are rigidly formed such that the angle between the longitudinal axis of the distal shaft portion and the longitudinal axis of the proximal shaft portion is constant. (17) An acetabular reamer handle according to any one of embodiments 1 to 16, wherein the engagement surface is substantially annular, triangular, rectangular, pentagonal, or hexagonal. (18) A surgical kit comprising an acetabular reamer handle described in any one of embodiments 1 to 17, and one or more acetabular reamers of different sizes connectable to the head portion of the acetabular reamer handle. (19) A method of reaming an acetabulum of a patient using a reamer connected to a reamer handle, the reamer handle comprising: a hollow shaft having a distal end; a hollow neck portion having a longitudinal axis; a drive system extending through the shaft and the neck portion, a head portion distal to the drive system being mounted for rotation about the longitudinal axis of the neck portion and connected to the reamer, the distal end of the shaft and the proximal end of the neck portion being pivotally mounted to allow tilting of the shaft relative to the longitudinal axis of the neck portion; The method further comprising: Inserting the reamer into the acetabulum; Operate the reamer to remove bone from a surface of the acetabulum; With the reamer positioned within the acetabulum, tilting the shaft relative to the longitudinal axis of the neck portion to view portions of the acetabulum and / or reamer that would otherwise be obscured by the reamer handle. (20) The method of claim 19, further comprising tilting the reamer handle about the longitudinal axis of the neck portion to view portions of the acetabulum and / or reamer that would otherwise be obscured by the reamer handle.

[0087] (21) The method of any one of claims 19 to 20, further comprising visually inspecting the portions of the acetabulum and / or reamer that would otherwise be obscured by the reamer handle to determine the reaming depth. (22) The method of any of claims 19 to 21, further comprising actuating a locking mechanism of the reamer handle to disengage an engagement member of the locking mechanism from the proximal end of the head portion to allow the tilting of the shaft relative to the longitudinal axis of the neck portion. (23) The method of embodiment 22, wherein the engagement member is movable distally to bias the engagement surface against the proximal end of the neck portion to resist the tilt of the shaft relative to the longitudinal axis of the neck portion. (24) The method of claim 23, wherein the engagement member is resiliently biased toward the proximal end of the head portion. (25) The method of any one of embodiments 22 to 24, wherein the engagement member is slidably mounted on or within the shaft, and the method further comprises manually retracting the engagement member in a proximal direction to release the engagement member from the proximal end of the neck portion.

[0088] (26) The method of any one of embodiments 22 to 25, wherein the engagement member has an engagement surface located at the distal end of the shaft for engaging the proximal end of the neck portion to resist the tilting of the shaft relative to the longitudinal axis of the neck portion, the engagement surface being substantially circumferential about the longitudinal axis of the hollow shaft at the distal end of the shaft. 27. The method of claim 26, wherein the engagement surface is substantially annular, triangular, rectangular, pentagonal, or hexagonal. (28) A method according to any of embodiments 19 to 27, wherein the reamer handle is an offset reamer handle, the hollow shaft including a proximal shaft portion and a distal shaft portion, the shaft having a bend located at the interface between the proximal shaft portion and the distal shaft portion.

Claims

1. 1. An acetabular reamer handle, comprising: a hollow shaft having a distal end; a hollow neck portion having a longitudinal axis; a drive system extending through the shaft and neck portion, a head portion distal to the drive system mounted for rotation about the longitudinal axis of the neck portion and connectable to an acetabular reamer, the distal end of the shaft and the proximal end of the neck portion being pivotally mounted to permit tilting of the shaft relative to the longitudinal axis of the neck portion; a locking mechanism including an engagement member having an engagement surface located at the distal end of the shaft, the engagement surface being annular in shape circumferentially about a longitudinal axis of the shaft at the distal end of the shaft, the engagement member being movable in a distal direction to bias the engagement surface against the proximal end of the neck portion to resist the tilting of the shaft relative to the longitudinal axis of the neck portion; An acetabular reamer handle, wherein the proximal end of the neck portion includes a flat surface for engaging the annular engagement surface of the engagement member.

2. The acetabular reamer handle of claim 1 , wherein said surface of said proximal end of said neck portion is contained within a plane.

3. 2. The acetabular reamer handle of claim 1, wherein the proximal end of the neck portion comprises a surface, the surface being contained in a plane having a surface normal oriented at a non-zero angle α relative to the longitudinal axis of the neck portion, where α<90°.

4. 4. The acetabular reamer handle of claim 3, wherein 30°≦α≦60°.

5. 5. The acetabular reamer handle of claim 4, wherein α is approximately 30°.

6. 5. The acetabular reamer handle of claim 4, wherein α is approximately 45°.

7. The acetabular reamer handle of claim 2 , wherein the surface of the proximal end of the neck portion is contained in a plane having a surface normal oriented parallel to the longitudinal axis of the neck portion.

8. 8. The acetabular reamer handle of claim 1, wherein the engagement member is slidably mounted inside the shaft and projects from the distal end of the shaft and is configured to bias the engagement surface against the proximal end of the neck portion.

9. An acetabular reamer handle according to any preceding claim, wherein the engagement member is resiliently biased distally to urge the engagement surface against the proximal end of the neck portion.

10. The acetabular reamer handle of claim 9 , wherein the locking mechanism includes a helical spring mounted coaxially to the distal end of the shaft and proximally to the engagement member.

11. The acetabular reamer handle of claim 10 , wherein the helical spring is mounted inside the shaft.

12. 12. The acetabular reamer handle of claim 1, wherein the engagement member includes a handle portion for manually retracting the engagement member in a proximal direction to disengage the engagement surface from the proximal end of the neck portion.

13. An acetabular reamer handle according to any preceding claim, wherein the drive system includes a universal joint located at a pivot point between the distal end of the shaft and the proximal end of the neck portion.

14. The acetabular reamer handle of any one of claims 1 to 13, wherein the shaft is an offset acetabular reamer handle including a proximal shaft portion and a distal shaft portion, the shaft having a bend located at the interface between the proximal shaft portion and the distal shaft portion.

15. The acetabular reamer handle of claim 14 , wherein the angle between the longitudinal axis of the distal shaft portion and the longitudinal axis of the proximal shaft portion is constant.

16. A surgical kit comprising an acetabular reamer handle according to any one of claims 1 to 15, and one or more different sized acetabular reamers connectable to the head portion of the acetabular reamer handle.

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