Devices, methods, and kits for preparing bone spaces for joint replacement surgery.

Abstract

Systems and methods for using an instrument to prepare a bone for joint replacement are provided. In various embodiments, the instrument includes a tool frame, a drive interface, a drive shaft, at least one torque interface, and a plurality of coupled bone sculpting tools configured to form at least one continuous loop. Methods and systems for preparing a femur for total hip replacement are also provided.

Description

Technical Field

[0001] Incorporation by reference to priority applications This application claims priority from U.S. Provisional Patent Application 63 / 184451, filed on May 21, 2021, the title of which is Devices, Methods, and Kits for Preparing Bone Voids for Arthroplasty, which is hereby incorporated by reference in its entirety.

[0002] Embodiments of the present invention relate to instruments, methods, and kits for replacing joints. More specifically, the present invention relates to instruments, methods, and kits for preparing a bone void in a patient's femur, for example, during total hip arthroplasty.

Background Art

[0003] Total knee arthroplasty and total hip arthroplasty are durable and reliable treatments for end-stage degenerative joint disease and are two of the most frequently performed orthopedic surgeries worldwide each year. Arthroplasty is a method of treating painful arthritic joints by excising the diseased bone surface and resurfacing the joint with a bearing surface for an artificial joint. In arthroplasty, in addition to excising the painful joint surface, bone surface preparation is also performed to successfully implant artificial joint components designed to rely on bone cement or bone regeneration for the fixation of durable artificial joints. Cementless prosthetic implants as well as cemented prosthetic implants both create voids in the patient's bone that approximate the shape of the implant.

Summary of the Invention

Problems to be Solved by the Invention

[0004] Improved methods for bone preparation in joint replacement surgery reduce the peak stress and decrease the intraoperative fracture rate, can be performed using any anatomical approach to the joint, including the common minimally invasive approach, and create a bone space similar in shape to the prosthetic joint replacements most commonly implanted. [Means for solving the problem]

[0005] As used herein, the term “aspect” may be used interchangeably with the term “embodiment.” Any feature, structure, or step disclosed in the embodiments herein may be replaced by, combined with, or omitted from any other feature, structure, or step disclosed herein. Furthermore, for the purpose of summarizing this disclosure, specific aspects, advantages, and features of the invention are described herein. It should be understood that not all or any of such advantages will be achieved according to any specific embodiment of the invention disclosed herein. Individual aspects of this disclosure are not essential or indispensable.

[0006] According to various aspects of the present invention, bone void sculpting instruments for preparing bone for joint replacement surgery, such as a method for preparing a femur for total hip replacement surgery, and a system for preparing a femur for total hip replacement surgery. Various embodiments of the disclosed instruments, methods, and systems offer the advantage of sculpting irregularly shaped bone voids to precisely match the size and shape of the intended artificial joint implant. The instruments, systems, and methods enable the sculpting of bone voids with irregular cross-sections using a minimally invasive approach that does not provide collinear access to the bone being sculpted, and provide continuous, non-circular cross-sections that do not impose large mechanical stresses on the bone being sculpted. Furthermore, the instruments, methods, and systems disclosed herein can be used to remove bone, expand or form bone cavities, or compress cartilage within bone cavities, thereby improving the degree of match between the artificial joint implant and the bone cavity, better preparing the bone cavity for the final implant shape, and improving the mechanical properties of the bone, such as density, resulting in better clinical outcomes when the implant is placed.

[0007] In various embodiments, a bone sculpting instrument for preparing bone for joint replacement surgery comprises a tool frame including a first side surface, at least one second side surface recessed from the first side surface and having a discontinuous radius, and an internal tool frame cavity; a drive shaft having a proximal and distal end and rotatably fixed in the internal tool frame cavity; a drive interface coupled to the proximal end of the drive shaft; and a plurality of interlocked bone sculpting tools configured to form at least one continuous loop around the at least one second side surface. The system includes the drive shaft and the at least one torque interface coupled to both the drive shaft and the at least one continuous loop of the connected multiple bone carving tools, the at least one continuous loop of the connected multiple bone carving tools having substantially the same cross-sectional shape as the at least one second side surface, the at least one continuous loop of the connected multiple bone carving tools being configured to move along a predetermined path along the at least one second side surface.

[0008] In one embodiment, the bone cavity carving instrument includes a plurality of second sides, a plurality of continuous loops of connected bone carving tools, and a plurality of torque interfaces, wherein the plurality of continuous loops of connected bone carving tools coincide with the corresponding second sides and torque interfaces. In one embodiment, the bone cavity carving instrument has 50 or fewer second sides, 50 or fewer continuous loops of connected bone carving tools, and 50 or fewer torque interfaces. In one embodiment, the main body is formed from a plurality of segments, each having a first side, a second side, and a cavity within the tool frame, and the plurality of segments are firmly connected to each other. In one embodiment, the drive interface is configured to receive torque in a first rotational direction and to transmit the torque to the drive shaft in either the first or second rotational direction. In one embodiment, the drive shaft further has a central channel between the proximal and distal ends of the drive shaft, configured to allow suction or cleaning of the bone cavity. In one embodiment, each of the bone carving tools has a convex surface and a concave surface, the convex surface being configured to contact the bone when the bone carving tool is moving in a first direction along a predetermined path along the second side surface, and the concave surface being configured to contact the bone when the bone carving tool is moving in a second direction along a predetermined path along the second side surface. In one embodiment, the at least one continuous loop of the connected plurality of bone carving tools includes 200 or fewer bone carving tools. In one embodiment, each of the bone carving tools of the connected plurality of bone carving tools is configured to mill the bone when the bone carving tool is moving in a first direction along a predetermined path along the second side surface, and to compress the bone when the bone carving tool is moving in a second direction along a predetermined path along the second side surface.In one embodiment, each of the connected multiple bone carving tools has a first end and a second end, the first end having a substantially spherical protrusion and the second end having a substantially spherical cavity, and the continuous loop of the connected multiple bone carving tools is formed by fitting the substantially spherical protrusion of the first bone carving tool into the substantially spherical cavity of the second bone carving tool. In one embodiment, each of the bone carving tools is configured to move with at least three degrees of freedom relative to adjacent bone carving tools when the connected multiple bone carving tools are formed in the at least one continuous loop of the connected multiple bone carving tools. In one embodiment, the at least one torque interface includes at least one gear. In one embodiment, the at least one torque interface is mechanically coupled to the drive shaft and the continuous loop of the connected multiple bone carving tools. In one embodiment, the tool frame further has a proximal end and a distal end, and the bone cavity reaming instrument further comprises a plurality of conical bone cavity reaming tools firmly connected to the distal end of the tool frame, each of the plurality of conical bone cavity reaming tools comprising an accessory shaft, at least one cutting disc coupled to the accessory shaft, and an accessory linkage connecting the accessory shaft to the drive shaft, and the plurality of conical bone cavity reaming tools are configured to rotate independently of each other and to form a cutting surface with a substantially ovoid cross-sectional shape. In one embodiment, the bone cavity reaming instrument further has markings on the tool frame indicating the coronal axis of the bone cavity reaming instrument.In one embodiment, the bone space preparation instrument further has markings on the tool frame indicating the medial extent of the artificial joint implant used in the joint replacement surgery. In one embodiment, the bone space preparation instrument further has a fiducial marker fixed to the tool frame. In one embodiment, the size and shape of the tool frame match the size and shape of the artificial joint implant used in the joint replacement surgery. In one embodiment, the tool frame further has a neck length, neck angle, stem length, and offset, wherein the neck length is between 7 mm and 60 mm, the neck angle is between 105 and 160 degrees, the stem length is between 75 mm and 145 mm, and the offset is between 10 mm and 70 mm.

[0009] In various embodiments, a method for preparing a femur for total hip arthroplasty includes the steps of preparing a femoral cavity to be carved; attaching an attachment configured to transmit torque to a first-size bone space carving instrument; introducing the bone space carving instrument to the proximal femur such that at least one continuous loop of connected bone carving tools, moving along a predetermined non-circular path, contacts the bone; and separating the attachment and attaching a first-size temporary femoral neck prosthesis implant trial to the bone space carving instrument.

[0010] In one embodiment, the method includes selecting a first-size space-creating instrument using pre-operative templating. In one embodiment, the method includes compressing cancellous bone within the intramedullary canal and removing the space-creating instrument from the proximal femur. In one embodiment, the method includes removing the first-size space-creating instrument from the proximal femur, attaching the attachment to a second-size space-creating instrument, introducing the second-size space-creating instrument into the proximal femur such that at least one continuous loop of the connected multiple space-creating tools of the instrument is in contact with the bone, separating the attachment and attaching a second-size temporary femoral neck prosthesis implant trial to the space-creating instrument. In one embodiment, the method includes the steps of compressing the cancellous bone within the medullary duct and removing the bone space milling instrument from the femoral cavity. In one embodiment, the method is introduced into the proximal femur in a direction collinear with the femoral shaft and is lateralized once introduced into the femur. In one embodiment, the step of preparing the milled femoral cavity includes the steps of performing a femoral neck osteotomy to access the femoral canal, optionally opening the apex of the femoral canal and dilating the femoral canal distally.

[0011] In various embodiments, a system for preparing a femur for total hip arthroplasty includes a tool frame comprising a first side surface, at least one second side surface recessed from the first side surface and having a discontinuous radius, and a cavity within the tool frame; a drive shaft having a proximal and distal end and rotatably fixed to the cavity within the tool frame; a drive interface coupled to the proximal end of the drive shaft; a plurality of connected bone carving tools configured to form at least one continuous loop around the at least one second side surface; and the at least one continuous loop formed by the plurality of connected bone carving tools is the minimum A bone void carving instrument includes at least one torque interface coupled to both the drive shaft and the at least one continuous loop of the connected plurality of bone carving tools, the at least one continuous loop of the connected plurality of bone carving tools having substantially the same cross-sectional shape as at least one second side surface, and configured to move along a predetermined path along the at least one second side surface; and an attachment configured to transmit torque to the bone void carving instrument, firmly connected to the tool frame of the bone void carving instrument, and coupled to the drive interface of the bone void carving instrument.

[0012] In one embodiment, the attachment is a surgical drill. In one embodiment, the attachment is an end effector of a surgical robot. In one embodiment, the system includes a provisional femoral neck prosthetic implant trial. In one embodiment, the system includes at least one larger-sized bone space-creating instrument. In one embodiment, the system includes an instrument for performing a femoral neck osteotomy, an instrument for distally expanding the femoral canal, and a plurality of retractors. In one embodiment, the instrument for distally expanding the femoral canal is a flexible reamer. In one embodiment, the system includes a device for opening the apex of the femoral canal, the device being selected from the group consisting of chisels, rasp, and broach.

[0013] In various embodiments, a system for total hip arthroplasty includes a tool frame comprising a first side surface, at least one second side surface recessed from the first side surface and having a discontinuous radius, and a cavity within the tool frame; a drive shaft having a proximal end and a distal end and rotatably fixed to the cavity within the tool frame; a drive interface coupled to the proximal end of the drive shaft; a plurality of connected bone carving tools configured to form at least one continuous loop around the at least one second side surface, and the at least one continuous loop formed by the plurality of connected bone carving tools is connected to the at least one second side surface. A bone void carving instrument includes a drive shaft and at least one torque interface coupled to both the drive shaft and the at least one continuous loop of the connected bone carving tools, the at least one continuous loop of the connected bone carving tools having almost the same cross-sectional shape, and configured to move along a predetermined path along the at least one second side surface; and an attachment configured to transmit torque to the bone void carving instrument, firmly connected to the tool frame of the bone void carving instrument and coupled to the drive interface of the bone void carving instrument; and a prosthetic hip implant.

[0014] Various embodiments are depicted in the accompanying drawings for illustrative purposes, but should not be construed as limiting the scope of the embodiments. Novel features of the present invention are specifically described in the accompanying claims. Furthermore, various features of different disclosed embodiments can be combined to form additional embodiments that are part of this disclosure. A better understanding of the features and advantages of the present invention will be obtained by referring to the following detailed description illustrating exemplary embodiments in which the principles of the present invention are utilized, and to the accompanying drawings: [Brief explanation of the drawing]

[0015] [Figure 1] This is an exploded perspective view of a bone cavity drilling instrument according to one embodiment of the present invention. [Figure 2A]This is a side perspective view of a bone cavity carving instrument assembled according to an embodiment of the present invention. [Figure 2B] This is a schematic side view of a bone void carving instrument according to an embodiment of the present invention, coupled to and separated from an attachment configured to apply torque to the bone void carving instrument. [Figure 3] This is a schematic side view of a specific subassembly of a bone cavity carving instrument according to an embodiment of the present invention. [Figure 4] This is a cross-sectional view of a specific subassembly of a bone cavity carving instrument according to an embodiment of the present invention. [Figure 5] This is a schematic side view of the dimensions and angles of an artificial hip joint implant, corresponding to the dimensions and angles of a suitable bone space carving instrument according to an embodiment of the present invention. [Figure 6A] This is a block diagram of a method for preparing the femur for total hip replacement surgery according to one embodiment of the present invention. [Figure 6B] This is a block diagram of the steps for preparing the femur for total hip replacement according to one embodiment of the present invention. [Figure 6C] This is a block diagram of the steps for preparing the femur for total hip replacement according to one embodiment of the present invention. [Modes for carrying out the invention]

[0016] According to various aspects of the present invention, a bone space preparation instrument for preparing bone for joint replacement surgery, a method for preparing a femur for total hip replacement surgery, and a system for preparing a femur for total hip replacement surgery are provided.

[0017] Referring to Figure 1, a bone cavity reaming instrument 100, which is one embodiment of a first aspect of the present invention, will be described. The bone cavity reaming instrument comprises a tool frame 110, a drive shaft 120, a drive interface 130 (not shown), at least one continuous loop of a plurality of connected bone reaming tools 140, at least one torque interface 150 (not shown), and, in some embodiments, a plurality of conical bone cavity reaming tools 190. The tool frame 110 has a first side surface, at least one second side surface, and a cavity within the tool frame. Each of the plurality of conical bone cavity reaming tools 190 comprises an auxiliary shaft 360, a cutting disc 370, and an auxiliary connector 380 (not shown).

[0018] The drive shaft 120 is rotatably fixed in the cavity 350 within the tool frame. The drive shaft 120 has a proximal end 121 and a distal end 122. As used in this context, the terms proximal end and distal end refer to the position of the ends of the device relative to the rest of the device, or opposing ends as shown in the drawing. The proximal end can be used to refer to the end that is operated by the user or physician. The distal end can be used to refer to the end of the device that is inserted into the bone and advances, and is furthest from the physician. As will be understood by those skilled in the art, the use of proximal end and distal end may vary in other contexts (for example, in an anatomical context, as proximal end and distal end relative to the patient).

[0019] The proximal end 121 of the drive shaft 120 is mechanically coupled to a drive interface 130 (not shown). The drive shaft 120 is also coupled to at least one torque interface 150 (not shown). Each torque interface is also coupled to at least one continuous loop by a corresponding plurality of interconnected bone carving tools 140. As illustrated in reference to FIG. 2A, each of the continuous loops by the plurality of interconnected bone carving tools 140 surrounds a corresponding at least one second side surface 340. The circumferential length of each of the continuous loops by the plurality of interconnected bone carving tools 140 is selected such that each of the continuous loops by the plurality of interconnected bone carving tools 140 contacts the corresponding second side surface 340 movably. Returning to FIG. 1, in an embodiment having a plurality of conical bone cavity reaming tools 190, the drive shaft 120 is also coupled to an auxiliary shaft 360 via an auxiliary connection 380 (not shown). The cutting disk 370 is coupled to the auxiliary shaft 360.

[0020] In operation, as shown in FIG. 2B, a torque transmitting attachment 200, such as, for example, a conventional surgical drill, an end effector of a conventional surgical robot, or a powered insertion handle specially designed for use with the bone void forming instrument 100, is used. The attachment 200 is firmly fixed to the tool frame 110 and is rotatably coupled to the drive interface 130. The attachment 200 may have an offset direction similar to that of a conventional broach handle and may have a device for releasing the attachment from the bone void forming instrument, such as a release lever. The attachment 200 provides a torque that rotates the drive interface 130 in a first direction. The attachment 200 can provide various torque values to the drive interface at various rotational speeds.

[0021] Returning to FIG. 1, the drive interface 130 transmits torque from the attachment 200 to the drive shaft 120. The drive shaft 120 applies torque to a continuous loop of at least one connected plurality of bone milling tools 140, and transmits torque from the drive shaft 120 to the continuous loop of the connected plurality of bone milling tools 140 via a corresponding torque interface 130, and moves the connected plurality of bone milling tools 140 in a first direction along a preset path along the second side surface 340. When the bone void forming instrument 100 is introduced into a bone void such as a femoral cavity, the continuous loop of the plurality of bone milling tools 140 contacts the bone, and the movement of the plurality of bone milling tools 140 in the first direction mills the bone void. By using a continuous loop of a plurality of bone milling tools 140 that move along a preset path along the second side surface to mill the bone void, advantageously, the bone void can be formed into a non-circular cross-section to conform to the irregular shape of the artificial joint implant. In addition, by using a continuous loop of a plurality of bone milling tools 140 that move along a preset path along the second side surface 340, the physician can introduce the device using a minimally invasive surgical method that does not provide collinear access to the bone void, yet still reduce the peak of the mechanical stress generated in the bone during bone void formation.

[0022] In an embodiment having a conical bone void reaming tool 190, the drive shaft 120 also applies torque to the auxiliary shaft 360 of the conical bone void reaming tool 190 via an auxiliary connection 380 to rotate the auxiliary shaft 360. When the instrument is introduced into the bone void such that the cutting disk 370 contacts the bone, the rotation of the auxiliary shaft 360 rotates the cutting disk 370 to cut the bone. The conical bone void reaming tool 190 advantageously enables reaming the bone void to match the non-circular shape of the artificial joint implant at the distal end of the bone void where the anterior-posterior diameter is too narrow to be cut by the continuous loop of the connected plurality of bone milling tools 140.

[0023] The bone cavity carving instrument 100 may receive torque in a second rotational direction from the attachment 200. In one embodiment, the drive interface 130 receives torque in a first rotational direction, but may include a reversing mechanism such as a reverse gear so that it can provide torque in a second rotational direction to the drive shaft 120. In one embodiment, after receiving torque in a second rotational direction from the attachment 200, the drive interface 130 transmits the torque to the drive shaft 120. The drive shaft 120 applies torque in the second direction to a continuous loop of connected bone carving tools 140, and transmits the torque from the drive shaft 120 to the continuous loop of connected bone carving tools 140 via the torque interface 130, moving the connected bone carving tools 140 in the second direction along a predetermined path along the second side surface 340. When a continuous loop of connected bone carving tools 140 is introduced into a bone cavity such as the medullary duct so that the continuous loop of connected bone carving tools 140 contacts the bone, the movement of the connected bone carving tools 140 in a second direction compresses the soft bone, such as cancellous bone, within the medullary duct in a radial direction away from the centerline of the bone cavity. This compression shapes the bone cavity to the final shape of the artificial joint implant, improving the degree of conformity between the artificial joint implant and the bone cavity, thereby better preparing the bone cavity for the final implant shape, improving the mechanical properties of the bone such as density, and consequently providing the advantage of better clinical outcomes when the implant is placed.

[0024] The tool frame 110 supports and guides the components of the bone space preparation instrument, assisting the surgeon in positioning the bone space preparation tool appropriately. The tool frame 110 is a rigid structure formed to match the size and shape of the prosthesis implant used in joint replacement surgery, for example, by a preoperative template method. This size and shape match to the prosthesis implant advantageously provides the bone space preparation instrument with the ability to prepare bone for prosthesis implants with irregular shapes. Referring further to Figure 3, the tool frame 110 has a first side surface 330, at least one second side surface 340, and a cavity 350 within the tool frame. The first side surface 330 has a first side surface of the bone space preparation tool intended to precisely match the size and shape of the prosthesis implant to be introduced. Thus, the first side surface 330 may have various shapes and contours, and in some embodiments, it does not form a continuous surface.

[0025] At least one second side surface 340 is recessed from the first side surface 330, forming a circumferential track around the tool frame 110 that is substantially perpendicular to the proximal-distal axis of the tool frame. The tool frame may have as many as 50 second sides, each of which is substantially parallel to the other second sides. As shown with reference to Figure 4, the second side surface 340 has a radius 410 measured from the central axis 420 of the tool frame. The radius 410 is not constant for all points on the second side surface 340. A continuous loop of connected bone carving tools 140 surrounds each of the second side surfaces 340, and each of the continuous loops of connected bone carving tools 140 has a selected circumferential length such that the continuous loop of connected bone carving tools 140 has substantially the same cross-sectional shape as the corresponding second side surface 340 and is movable in contact with the corresponding second side surface 340. Each of the second sides 340 forms a preset path along which the corresponding connected multiple bone carving tools 140 move when the bone cavity carving instrument is in operation. Because each of the second sides 340 has a non-constant radius 410, the cross-sectional shape 400 of each of the second sides 340 is non-circular, for example, oval, as is the cross-sectional shape of each of the continuous loops of the connected multiple bone carving tools 140. Due to the non-circular cross-sectional shapes of the second sides 340 and the continuous loops of the connected multiple bone carving tools 140, a non-circular cutting surface is formed as the continuous loops of the connected multiple bone carving tools 140 move along the preset path formed by the corresponding second sides 340. This non-circular cutting surface has the advantage of better conforming to the irregular cross-sectional shape of artificial joint implants, reducing the peak of mechanical stress on the bone when cutting bone with a non-circular shape compared to conventional cutting tools, and eliminating the need for collinear access to bone cavities to effectively cut them, thus enabling the use of a minimally invasive surgical approach.

[0026] Returning to Figure 3, the tool frame 110 may have at least one coronal cutout 345, which is a portion of the second side surface 340, such that at least one torque interface 150 (not shown) connects to a continuous loop of the corresponding connected multiple bone carving tools 140. The coronal cutout 345 is positioned such that the continuous loop of the connected multiple bone carving tools 140 does not substantially affect the cross-sectional shape formed by the continuous loop of the connected multiple bone carving tools 140 incorporated into the second side surface 340, or substantially affect the pre-defined path for the continuous loop of the connected multiple bone carving tools 140 formed by the second side surface 340.

[0027] The tool frame 110 has a proximal end 310 and a distal end 320. The tool frame cavity 350 extends from the proximal end 310 to the distal end 320. In some embodiments, the tool frame cavity 350 may extend through the distal end 320 to connect with an auxiliary connector 380. The tool frame cavity 350 may be a centrally located circular channel. Depending on the shape of the tool frame 110, the tool frame cavity 350 can be reoriented along the proximal-distal axis to correspond to the axial profile of the tool frame.

[0028] The tool frame 110 is made of a hard, corrosion-resistant material, such as metal (stainless steel, aluminum, or other corrosion-resistant alloys), ceramic, hard polymer, a combination of such materials, or a natural or artificial composite material having hard and corrosion-resistant properties. The tool frame 110 may consist of a single continuous piece of material or of a plurality of rigidly connected segments 335. In embodiments in which the tool frame 110 consists of a plurality of rigidly connected segments 335, the segments may be fixedly connected or detachably connected. The tool frame 110 may include one or more markings indicating the coronal axis of the bone space carving instrument in order to align the device to the patient's original anteversion angle during stem insertion. The tool frame 110 may include one or more markings indicating the medial range of the intended position of the prosthesis implant, based on a plan for restoring the patient's leg length. Reference markers may be attached to the tool frame to indicate the device's position in a navigation registration system, or to provide a reference location under fluoroscopy or other imaging techniques. The tool frame 110 may be configured to connect with a provisional joint replacement trial.

[0029] Referring further to Figure 5, in some embodiments in which a space-creating instrument is used to prepare the femur for total hip arthroplasty, the tool frame 110 has four dimensions: neck length 510, neck angle 520, stem length 530, and offset 540. The dimensions and angles should be selected to match the shape of the artificial joint implant used in total hip arthroplasty and may be selected based on a preoperative template method. The neck length 510 may range from 7 mm to 60 mm. The neck angle 520 may range from 105 degrees to 160 degrees. The stem length 530 may range from 75 mm to 145 mm. The offset 540 may range from 10 mm to 70 mm. The following table shows exemplary dimensions and angles of various bone space-creating instrument sizes selected to fit the size of a particular commercially available artificial hip implant.

[0030] [Table 1]

[0031] In some embodiments, progressively larger bone cavity preparation instruments 100 can be introduced into the bone to prepare it for joint replacement. In these embodiments, each of the tool frames 110 used may be configured to be between the initial anatomical shape of the bone cavity to be prepared in the patient and the size and shape of the final artificial joint implant to be used in joint replacement.

[0032] Returning to Figure 1, the drive shaft 120 is a rigid shaft for transmitting torque via the bone cavity reaming instrument 100. The size and shape of the drive shaft 120 are selected to fit within the cavity 350 of the tool frame, into which the drive shaft 120 is rotatably fixed. When the tool frame 110 is curved to match the shape of the artificial joint implant used in arthroplasty, the drive shaft 120 may consist of multiple segments coupled to one another to accommodate the shape of the cavity 350 of the tool frame. Such segments may be coupled via a universal joint, a mechanical coupling, or other coupling mechanism for transmitting torque between shaft segments. The proximal end 121 of the drive shaft 120 may be coupled to the drive interface 130, or alternatively, directly to an external torque source such as an attachment 200. In embodiments having a conical bone cavity reaming tool 190, the distal end 122 of the drive shaft 120 may be coupled to an auxiliary coupling 380. The drive shaft 120 may include a gear 124 rigidly coupled to the drive shaft 120 to transmit torque between the drive shaft 120 and the torque interface 150, between the drive interface 130 and the drive shaft 120, or between the drive shaft 120 and the auxiliary coupling 380. Alternatively, the drive shaft 120 may include other structures known in the art to transmit torque. These alternative structures may include mechanical torque couplings such as pulleys or sprockets, or electromagnetic or other torque couplings. The drive shaft 120 may include a central channel (126, not shown) from the proximal end 121 to the distal end 122. The central channel may be configured for aspirating bone marrow when the bone cavity preparation instrument 100 is used to cut bone. When used to prepare bone cavities for joint replacement, such aspiration favorably reduces the incidence of fat embolization. The central channel (not shown) may also be configured for irrigation.Cleaning with a sterile fluid or sterile solution may be advantageous when cutting dense bone to reduce the risk of thermal necrosis, or it may be advantageous when the device is not being used for cutting bone to clean a continuous loop of connected bone carving tools 140. The drive shaft 120 may be configured to connect with a temporary joint replacement trial.

[0033] The drive interface 130 has a coupling between the drive shaft 120 and an external torque source (e.g., attachment 200). The coupling may be a shaft coupling, a collar, a chuck, a collet, or other mechanical coupling, or any other coupling sufficient to transmit an acceptable portion of the torque provided by the external torque source to the drive shaft 120. The drive interface 130 may be fixedly or detachably connected to the drive shaft 120. The drive interface 130 may also be fixedly or detachably connected to the tool frame 120. The drive interface 130 may be configured to couple with a temporary joint replacement trial.

[0034] Figure 4 illustrates in more detail an embodiment of a plurality of connected bone carving tools 140. Each bone carving tool 430 includes a first surface 440 having a shape for cutting bone and a second surface 450 having a shape for compressing bone. The first surface 440 may have a convex outer shape for cutting bone. The second surface 450 may have a concave outer shape for compressing bone. The outer shape of each bone carving tool may further have a shape that forms a cutting angle that mimics the contour of the final artificial joint implant used in joint replacement surgery. The cutting angle may be in the range of 90 to 180 degrees from the proximal-distal axis of the bone carving instrument, more preferably 120 to 160 degrees.

[0035] To connect with each other, each bone carving tool 430 has a first end 460 and a second end 480. The first end 460 may have a substantially spherical projection 470. The second end 480 may have a substantially spherical cavity 490. As shown in the embodiment of Figure 4, to connect the bone carving tools, the substantially spherical projection 470 of one bone carving tool is fixed into the substantially spherical cavity 490 of an adjacent bone carving tool. In various embodiments, as many as 300, 200, 150, 100, 75, 50, or 25 bone carving tools can be connected to form a plurality of connected bone carving tools 140. The number and size of the connected bone carving tools should be selected so as to have sufficient tension to maintain a continuous loop of connected bone carving tools 140 that remains in movably contact with the corresponding torque interface 130 and maintains a cross-sectional shape 400 substantially similar to the corresponding second side surface 340, along which the continuous loop of connected bone carving tools 140 moves along a predetermined path. The bone carving tool connection design of the embodiment shown in Figure 4 has the advantage of giving the bone carving tools three degrees of freedom relative to their adjacent bone carving tools when formed into a continuous loop of connected bone carving tools 140, and giving the continuous loop of connected bone carving tools 140 the ability to move along a predetermined path along a second side surface 340 of various shapes. However, other designs for connecting bone carving tools that provide at least one degree of freedom for the bone carving tools relative to adjacent bone carving tools may be used to form a continuous loop of connected bone carving tools 140.

[0036] The inner surface 405 of a continuous loop formed by multiple interconnected bone carving tools 140 is configured to connect to a torque interface 150. For example, when the bone carving tools are interconnected to form a continuous loop, the inner surface 405 may have an external shape consisting of repeating patterns such as serrations, teeth, or notches that can mesh with one or more gears or sprockets. Each of the bone carving tools 430 is made of a hard, corrosion-resistant material, such as metal (stainless steel, aluminum, or other corrosion-resistant alloys), ceramic, hard polymer, a combination of such materials, or a natural or artificial composite material having hard and corrosion-resistant properties.

[0037] The torque interface 150 receives torque from the drive shaft 120 and transmits it to a continuous loop of interconnected bone carving tools 140. The torque interface 150 can be configured with any suitable mechanism for transmitting torque from the drive shaft 120 to the continuous loop of interconnected bone carving tools 140. For example, the torque interface 150 may include one or more gears. In such an embodiment, each of the one or more gears of the torque interface meshes with a gear on the drive shaft 120 to receive torque from the drive shaft 120 and meshes with the outer shape of the inner surface 405 of the continuous loop of interconnected bone carving tools 140 to transmit torque from the drive shaft 120 to the continuous loop of interconnected bone carving tools 140. When coupled in this manner to the drive shaft 120 and the continuous loop of connected bone carving tools 140, each torque interface 150 transmits an allowable portion of the torque received from the drive shaft 120 to the continuous loop of connected bone carving tools 140, causing the continuous loop of connected bone carving tools 140 to move along a predetermined path along the second side surface 340. The torque interface may be rotatably fixed to the tool frame 110.

[0038] In some joint replacement surgeries, the anterior-posterior diameter of the distal end of the final artificial joint implant, and therefore the anterior-posterior diameter of the cavity to fit the artificial joint implant, is smaller than the diameter that can be accommodated using a continuous loop of multiple connected bone reaming tools 140. To ream a narrow-diameter bone cavity for the distal end of the artificial joint implant, the bone cavity reaming instrument 100 may include multiple conical bone cavity reaming tools 190. Each conical bone cavity reaming tool 190 has an auxiliary shaft 360, a cutting disc 370, and an auxiliary connector 380. The auxiliary connector 380 connects the drive shaft 120 to the auxiliary shaft 360. The auxiliary connector 380 may consist of gears, pulleys and belts, chains and sprockets, or other mechanical linkages or couplings. For example, the auxiliary connector 380 may consist of a gear fixed to the auxiliary shaft 360 that meshes with the gear 124 of the drive shaft 120. The auxiliary shaft 360 is rotatably attached to the distal end 320 of the tool frame 110 and extends from the distal end 320. The auxiliary shaft 360 has a length selected to match the length of the artificial joint implant used in arthroplasty and a diameter sufficient to prevent harmful vibrations or chatter of the cutting disc 370 when reaming the bone cavity. The cutting disc 370 is coupled to the auxiliary shaft 360. The cutting disc 370 consists of a circular cutting tool with a diameter, cutting edge, and cutting angle selected to match the contour of the artificial joint implant used in arthroplasty. Multiple conical bone cavity reaming tools 190 are configured so that the cutting disc 370 forms a cutting surface having a desired cross-sectional shape, for example, an oval cross-sectional shape. Each cutting disc 370 of the conical cavity reaming tool 190 is offset along the proximal-distal axis relative to the cutting discs of other conical cavity reaming tools, so that each auxiliary shaft 360 of the conical cavity reaming tool 190 rotates independently and the cutting discs 370 of the conical cavity reaming tool 190 do not interfere with each other.

[0039] Further aspects of the present invention are methods for preparing the femur for total hip arthroplasty, as will be described with reference to Figures 6A, 6B, and 6C. First, referring to Figure 6A, one of the various available surgical approaches is used to access the hip joint (600). Before carving out the bone cavity, the physician must prepare the femoral cavity (605). Preparation of the femoral cavity is performed at various points in the surgical workflow, depending on the surgeon's choice, and may or may not be performed before surgical hip dislocation, or after the surgical preparation of the acetabulum to receive the artificial acetabular cup. As shown with reference to Figure 6B, preparation of the proximal femur is typically initiated by performing a femoral neck osteotomy to access the femoral canal (606) and planning the restoration of the patient's leg length based on the height of the neck osteotomy. The apex of the femoral canal can then be optionally opened using a tool such as a rasp, chisel, or broach (607). Next, the femoral canal may be dilated distally using a temporary flexible reamer (608), and a retractor may be applied. Subsequently, the retractor may be applied to obtain optimal exposure of the proximal femur. Based on the preoperative template method, a first size of the bone space-creating instrument is selected (609).

[0040] Returning to Figure 6A, the bone voiding instrument is connected to an attachment configured to apply torque (610). Next, the bone voiding instrument is introduced into the proximal femur (615). Then, the attachment is powered on, and torque is applied to the bone voiding instrument in a first direction, and to the continuous loop of connected bone voiding tools so that it begins to move along a predetermined path on the second side. This slowly introduces the bone voiding instrument into the proximal femur (615).

[0041] As illustrated with reference to Figure 6C, the bone space carving instrument can be introduced into the proximal femur in a direction collinear with the femoral shaft (616) before it is slowly laterally positioned to prevent the stem from becoming varus (617), without the need to remove excess bone from the femur as is commonly done before initiating the preparation process. Once the continuous loop of the bone carving tool contacts the bone of the femoral cavity, the bone space carving instrument slowly begins to carve the cancellous bone of the proximal femur as it is introduced to highly conform to the shape of the final implant under conditions of extremely low peak stress on the patient's bone. The device is introduced in a proximal-distal direction of the femur until resistance is encountered as the stem moves as distally as possible, based on the patient's anatomy and stem shape.

[0042] The surgeon may optionally attach a first-size temporary femoral neck prosthesis implant trial to a bone spacer (620) and introduce a temporary femoral head to test hip joint stability. Alternatively, the physician may assess the size of the stem needed to restore the patient's specific anatomical structure and decide to change the size of the prosthesis implant stem based on the relationship between the bone spacer and the femoral neck cutting. If a different-sized stem is selected, the first-size bone spacer is removed from the proximal femur (625). The attachment is then attached to a second-size bone spacer that fits the new stem size (630) and introduced into the proximal femur in a similar manner (635).

[0043] Once the size of the current femoral stem is satisfactory, the occlusion device can be removed from the attachment and secured to the proximal femur. Next, the physician can attach a temporary femoral neck trial to the occlusion device, followed by the temporary femoral head (645). The hip joint is then shortened and the stability of the artificial hip joint is tested in a standard manner. Once the stability of the hip joint is satisfactory, the physician can reattach the attachment to the occlusion device and optionally turn on the attachment to apply torque in a second direction to the occlusion device, compressing the cancellous bone within the intramedullary canal with the occlusion device (645). The physician can then remove the occlusion device from the proximal femur (650) and implant the final femoral stem to complete the surgery.

[0044] A further aspect of the present invention is a system for preparing the femur for total hip arthroplasty. This system comprises a bone space drilling instrument 100 as described in other aspects of the present invention and an attachment 200 configured to apply torque to the bone space drilling instrument. The attachment 200 may be a conventional surgical drill, an end effector of a conventional surgical robot, or a powered insertion handle specifically designed for use with the bone space drilling instrument. The attachment 200 may have an offset direction similar to that of a conventional broach handle and may have a device for releasing the attachment from the bone space drilling instrument, such as a release lever. The attachment 200 provides torque to rotate the drive interface 130 in a first direction. The attachment 200 can apply various torque values ​​to the drive interface at various rotational speeds. The system may further comprise a temporary femoral neck prosthesis implant trial, which can be coupled to the bone space drilling instrument, for testing hip joint stability and evaluating the size of the femoral stem required to restore patient-specific anatomical structures. The system may further include at least one larger bone space-creating instrument. The system may further include instruments for performing femoral neck osteotomy. The system may further include instruments for opening the upper part of the femoral canal, such as a chisel, rasp, or broach. The system may further include instruments for distally expanding the femoral canal, such as a temporary flexible reamer. The system may further include multiple retractors for obtaining optimal exposure of the proximal femur.

[0045] A further aspect of the present invention is a system for total hip replacement. This system comprises a bone space carving instrument 100 as described in another aspect of the present invention, an attachment 200 configured to apply torque to the bone space carving instrument, and a hip replacement implant.

[0046] While this disclosure has been described in the context of specific embodiments and examples, it will be understood by those skilled in the art that this disclosure extends beyond the specifically disclosed embodiments to other alternative embodiments and / or uses, as well as their apparent modifications and equivalents. In addition, while some modifications of the embodiments of this disclosure have been shown and described in detail, other modifications that are within the scope of this disclosure will be readily apparent to those skilled in the art. Furthermore, various combinations or subcombinations of specific features and aspects of the embodiments are intended to be made and still fall within the scope of this disclosure. For example, a feature described above in relation to one embodiment can be used with a different embodiment described herein, and such combination remains within the scope of this disclosure. It should be understood that various features and aspects of the disclosed embodiments can be combined with or substituted for each other to form various aspects of the embodiments of this disclosure. Accordingly, it is intended that the scope of the disclosure herein should not be limited by the specific embodiments described above. Accordingly, unless otherwise stated or unless obviously incompatible, each embodiment of the present invention may include, in addition to its essential features described herein, one or more features from other embodiments of the present invention disclosed herein, as described herein.

[0047] Any features, materials, characteristics, or groups described in connection with a particular aspect, embodiment, or example are understood to be applicable to other aspects, embodiments, or examples described in this section or elsewhere in this specification, unless they are incompatible. All features and / or all steps of a method or process disclosed herein (including the appended claims, abstract, and drawings) may be combined in any combination, except for any combination in which at least some of such features and / or steps are mutually exclusive. Protection is not limited to the details of the embodiments described above. Protection extends to novel or novel combinations of features or steps of a method or process disclosed herein (including the appended claims, abstract, and drawings).

[0048] Furthermore, certain features described in this disclosure in the context of separate implementations may be implemented in combination in a single implementation. Conversely, various features described in the context of a single implementation may be implemented separately in multiple implementations or in any appropriate subcombination. Furthermore, while features may be described above as acting in a particular combination, in some cases one or more features may be excluded from the claimed combination, and that combination may be claimed as a subcombination or a variation of a subcombination.

[0049] Furthermore, while operations may be depicted in a specific order in the drawings or described in the specification, such operations do not need to be performed in the specific order shown or in a sequential order to achieve the desired result, nor do all operations need to be performed. Other operations not shown or described may also be incorporated into the exemplary methods and processes. For example, one or more additional operations may be performed before, after, simultaneously with, or between the described operations. Furthermore, operations may be rearranged or reordered in other implementations. Those skilled in the art will understand that in some embodiments, the steps actually performed in the illustrated and / or disclosed processes may differ from those shown. In some embodiments, some of the steps described above may be omitted and other steps may be added. Furthermore, the features and attributes of the particular embodiments disclosed above may be combined in different ways to form additional embodiments, all of which are within the scope of this disclosure. Furthermore, the separation of various system components in the implementation described above should not be understood as requiring such separation in all implementations. The components and systems described may generally be integrated together in a single product or packaged across multiple products.

[0050] For the purposes of this disclosure, certain aspects, advantages, and novel features are described herein. Not all such advantages are necessarily achieved according to any particular embodiment. Therefore, for example, a person skilled in the art will recognize that this disclosure may be embodied or implemented in a manner that achieves one or a group of advantages as taught herein, without necessarily achieving other advantages as taught or suggested herein.

[0051] As used herein, conditional language such as “can,” “could,” “might,” “may,” and “eg” is generally intended to convey that a particular embodiment includes certain features, elements, and / or steps, while other embodiments do not, unless otherwise stated or understood in the context in which they are used. Therefore, such conditional language is not generally intended to mean that features, elements, and / or steps are required in any way to one or more embodiments, or that one or more embodiments necessarily include logic for determining whether these features, elements, and / or steps are included in or performed in any particular embodiment, with or without other inputs or prompts. Terms such as “comprising,” “including,” and “having” are synonymous and are used in a comprehensive, open-ended manner, not excluding additional elements, features, actions, operations, etc. Furthermore, the term "or" is used in an inclusive sense (rather than an exclusive sense), so for example, when used to connect a list of elements, the term "or" can mean one, some, or all of the elements in the list.

[0052] Conjunctions such as "at least one of X, Y, and Z" are generally used, in context, to indicate that an item, term, etc., may be X, Y, or Z, unless otherwise specified. Therefore, such conjunctions do not generally imply that a particular embodiment requires the presence of at least one X, at least one Y, and at least one Z.

[0053] The degree of language used herein, such as the terms “approximately,” “about,” “generally,” and “substantially,” describes values, quantities, or characteristics that are close to the stated values, quantities, or characteristics that still perform the desired function or achieve the desired result. For example, the terms “approximately,” “about,” “generally,” and “substantially” may refer to quantities that are within the range of less than 10%, less than 5%, less than 1%, less than 0.1%, and less than 0.01% of the stated quantities. As another example, in certain embodiments, the terms “generally parallel” and “substantially parallel” refer to values, quantities, or characteristics that deviate from perfect parallel by 15 degrees or less, 10 degrees or less, 5 degrees or less, 3 degrees or less, 1 degree or less, 0.1 degrees or less, or otherwise.

[0054] The methods disclosed herein do not need to be performed in the order described. The methods disclosed herein include specific actions performed by a practitioner, but may also include instructions, explicitly or implicitly, from any third party to perform such actions. For example, the action of "controlling the motor speed" may also include "instructing to control the motor speed."

[0055] The scope of this disclosure is not intended to be limited by any specific disclosure of preferred embodiments in this section or elsewhere in this specification, but may be defined by claims presented or hereafter presented in this section or elsewhere in this specification. The language of the claims should be interpreted broadly based on the language adopted in the claims, and should not be limited to the examples described herein or in the specification of this application, and these examples should be interpreted as non-exclusive.

[0056] Since many modifications, variations, and changes in detail are possible in the preferred embodiments of the invention described herein, all matters shown in the foregoing description and accompanying drawings are intended to be illustrative and not restrictive. Accordingly, the scope of the invention should be determined by the appended claims and their legal equivalents.

Claims

1. A bone space preparation instrument for preparing bone for joint replacement surgery, A tool frame having a proximal end and a distal end, a first side surface, at least one second side surface recessed from the first side surface, and a cavity within the tool frame, wherein the at least one second side surface has a static and non-constant radius with respect to a plurality of points located on the periphery of the at least one second side surface, the radius being measured from the central axis of the tool frame, and the cavity within the tool frame extends from the proximal end to the distal end of the tool frame. A drive shaft having a proximal end and a distal end, located within the cavity of the tool frame and rotatably fixed, A drive interface coupled to the proximal end of the drive shaft, A plurality of interconnected bone carving tools configured to form at least one continuous loop located around the at least one second side surface, wherein the at least one continuous loop formed by the interconnected bone carving tools has substantially the same cross-sectional shape as the at least one second side surface, and the at least one continuous loop formed by the interconnected bone carving tools is configured to move along a predetermined path along the at least one second side surface, A torque interface coupled to both the drive shaft and the at least one continuous loop of the connected plurality of bone carving tools, A bone cavity carving tool characterized by comprising the following features.

2. The at least one second surface includes a plurality of second surfaces, The at least one continuous loop of the connected multiple bone carving tools includes multiple continuous loops of the connected multiple bone carving tools, The aforementioned at least one torque interface includes a plurality of torque interfaces, Each of the multiple continuous loops formed by the multiple connected bone carving tools is positioned around a corresponding second side of the multiple second sides and coupled to a corresponding torque interface of the multiple torque interfaces. The bone cavity carving instrument according to feature 1.

3. The at least one second surface includes 50 or fewer of the second surfaces, The at least one continuous loop of the connected multiple bone carving tools includes 50 or fewer continuous loops of the connected multiple bone carving tools. The at least one torque interface includes 50 or fewer torque interfaces. The bone cavity carving instrument according to feature 1.

4. The main body of the tool frame is formed from a plurality of segments, each of which has a first side surface, a second side surface, and a cavity inside the tool frame. The aforementioned multiple segments are strongly connected to one another. The bone cavity carving instrument according to feature 2.

5. The drive interface is configured to receive torque in a first rotational direction and transmit the torque to the drive shaft in either the first rotational direction or a second rotational direction opposite to the first rotational direction. The bone cavity carving instrument according to feature 1.

6. The drive shaft further has a central channel between the proximal and distal ends of the drive shaft, configured to allow suction or irrigation of bone cavities. The bone cavity carving instrument according to feature 1.

7. Each of the aforementioned bone carving tools has a convex surface and a concave surface, The convex surface is configured to contact the bone when the bone carving tool is moving along a predetermined path along the second side in a first direction, The concave surface is configured to contact the bone when the bone carving tool is moving along a predetermined path along the second side surface in a second direction opposite to the first direction. The bone cavity carving instrument according to feature 1.

8. The at least one continuous loop of the connected multiple bone carving tools includes 200 or fewer bone carving tools. The bone cavity carving instrument according to feature 7.

9. Each of the connected plurality of bone carving tools is configured to cut the bone when the bone carving tool is moving along a predetermined path along the second side in a first direction, and to compress the bone when the bone carving tool is moving along a predetermined path along the second side in a second direction opposite to the first direction. A bone cavity carving instrument according to any one of claims 1 to 8.

10. Each of the connected plurality of bone carving tools has a first end and a second end. The first end has a substantially spherical projection, The second end portion has a substantially spherical cavity, The continuous loop formed by the connected multiple bone carving tools is created by fitting the substantially spherical projection of the first bone carving tool into the substantially spherical cavity of the second bone carving tool. A bone cavity carving instrument according to any one of claims 1 to 8.

11. Each of the bone carving tools is configured to move with at least three degrees of freedom relative to an adjacent bone carving tool when the connected plurality of bone carving tools form the at least one continuous loop of the connected plurality of bone carving tools. A bone cavity carving instrument according to any one of claims 1 to 8.

12. The aforementioned at least one torque interface includes at least one gear, The at least one gear mechanically engages with the drive shaft. A bone cavity carving instrument according to any one of claims 1 to 8.

13. The at least one torque interface is mechanically coupled to the drive shaft and the continuous loop of the connected multiple bone carving tools. A bone cavity carving instrument according to any one of claims 1 to 8.

14. The bone cavity reaming instrument further comprises a plurality of conical bone cavity reaming tools firmly connected to the distal end of the tool frame, Each of the aforementioned multiple conical bone cavity reaming tools is, Auxiliary shaft and At least one cutting disc coupled to the auxiliary shaft, The auxiliary shaft is connected to the drive shaft by an auxiliary connector, The plurality of conical bone cavity reaming tools are configured to rotate independently of each other and to form a cutting surface with a roughly oval cross-sectional shape. A bone cavity carving instrument according to any one of claims 1 to 8.

15. The tool frame further has markings indicating the coronal axis of the bone cavity carving instrument. A bone cavity carving instrument according to any one of claims 1 to 8.

16. The tool frame further has markings indicating the medial range of the artificial joint implant used in the aforementioned joint replacement surgery. A bone cavity carving instrument according to any one of claims 1 to 8.

17. The tool frame further has fixed reference marks. A bone cavity carving instrument according to any one of claims 1 to 8.

18. The length and width of the tool frame match the length and width of the artificial joint implant used in the joint replacement surgery. A bone cavity carving instrument according to any one of claims 1 to 8.

19. The tool frame further has a neck length, neck angle, stem length, and offset, wherein the neck length is between 7 mm and 60 mm, the neck angle is between 105 degrees and 160 degrees, the stem length is between 75 mm and 145 mm, and the offset is between 10 mm and 70 mm. A bone cavity carving instrument according to any one of claims 1 to 8.

20. A system for preparing the femur for total hip replacement surgery. It comprises a bone cavity carving instrument and an attachment, The aforementioned bone cavity carving instrument is A tool frame having a proximal end and a distal end, a first side surface, at least one second side surface recessed from the first side surface, and a cavity within the tool frame, wherein the at least one second side surface has a static and non-constant radius with respect to a plurality of points located on the periphery of the at least one second side surface, the radius being measured from the central axis of the tool frame, and the cavity within the tool frame extends from the proximal end to the distal end of the tool frame. A drive shaft having a proximal end and a distal end, located within the cavity of the tool frame and rotatably fixed, A drive interface coupled to the proximal end of the drive shaft, A plurality of interconnected bone carving tools configured to form at least one continuous loop located around the at least one second side surface, wherein the at least one continuous loop formed by the interconnected bone carving tools has substantially the same cross-sectional shape as the at least one second side surface, and the at least one continuous loop formed by the interconnected bone carving tools is configured to move along a predetermined path along the at least one second side surface, A torque interface coupled to both the drive shaft and the at least one continuous loop of the connected plurality of bone carving tools, Equipped with, The attachment is configured to transmit torque to the bone void drilling instrument, is firmly connected to the tool frame of the bone void drilling instrument, and is coupled to the drive interface of the bone void drilling instrument. A system characterized by the following features.

21. The attachment is a surgical drill. The system according to claim 20, characterized in that it is as described above.

22. The aforementioned attachment is an end effector for a surgical robot. The system according to claim 20, characterized in that it is as described above.

23. Further including a trial of a provisional femoral neck prosthesis implant. The system according to claim 20, characterized in that it is as described above.

24. Further includes at least one larger bone cavity carving instrument. The system according to claim 20, characterized in that it is as described above.

25. Instruments for performing femoral neck osteotomy, A device for distally dilating the femoral canal, Includes multiple retractors The system according to any one of claims 20 to 24, characterized in that it is the system described in any one of claims 20 to 24.

26. The instrument for dilating the femoral canal distally is a flexible reamer. The system according to claim 25, characterized in that it is the same as described above.

27. The device further includes a device for opening the top of the femoral canal, The device is selected from the group consisting of chisels, rasp, and broach. The system according to claim 25, characterized in that it is the same as described above.

28. A system for total hip replacement surgery, It comprises a bone space carving instrument, an attachment, and an artificial hip joint implant. The aforementioned bone cavity carving instrument is A tool frame having a proximal end and a distal end, a first side surface, at least one second side surface recessed from the first side surface, and a cavity within the tool frame, wherein the at least one second side surface has a static and non-constant radius with respect to a plurality of points located on the periphery of the at least one second side surface, the radius being measured from the central axis of the tool frame, and the cavity within the tool frame extends from the proximal end to the distal end of the tool frame. A drive shaft having a proximal end and a distal end, located within the cavity of the tool frame and rotatably fixed, A drive interface coupled to the proximal end of the drive shaft, A plurality of interconnected bone carving tools configured to form at least one continuous loop located around the at least one second side surface, wherein the at least one continuous loop formed by the interconnected bone carving tools has substantially the same cross-sectional shape as the at least one second side surface, and the at least one continuous loop formed by the interconnected bone carving tools is configured to move along a predetermined path along the at least one second side surface, A torque interface coupled to both the drive shaft and the at least one continuous loop of the connected plurality of bone carving tools, Equipped with, The attachment is configured to transmit torque to the bone void drilling instrument, is firmly connected to the tool frame of the bone void drilling instrument, and is coupled to the drive interface of the bone void drilling instrument. A system characterized by the following features.

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