Holder for acetabular cup implant

Abstract

The present invention provides a cover for a medical implant, the cover comprising a body portion and a seal, the body portion having a distal end and a proximal end, the proximal end including a region adapted to connect to an introducer, and the seal having at least one tab extending proximally away from the body portion. Also disclosed are systems incorporating such covers, as well as methods of making and using the same. Also provided are introducers adapted for use with the covers.

Description

Technical Field

[0001] The present invention relates to a holder for a wide acetabular cup implant.

Background Art

[0002] Wide acetabular cup implants having a large-diameter bearing surface, such as hip resurfacing arthroplasty (HRA) cups or large-diameter total hip arthroplasty (THR) cups, are difficult to hold during implantation. The surgeon must force the cup into a prepared slightly smaller-sized wide acetabular socket while ensuring that the cup is implanted at the correct angle and orientation important for function. Furthermore, it is essential to protect the super-finished bearing surface from damage during this pushing process. Many conventional THR cups are composed of an outer shell and a separate bearing liner that is fitted after the metal shell is embedded. Therefore, the inside of the metal shell is used to provide a retaining function portion for an introducer shaft, such as a thread or a bayonet attachment. However, this area cannot be used in HRA cups or THR cups with a pre-attached liner because the inner surface forms the bearing surface. Furthermore, the outer surface is usually completely embedded in the bone socket. In the designs of HRA cups to date, attempts have been made to solve this problem in various ways, but as a result, these methods inevitably result in compromises in the design. That is, compromises are made by reducing the bearing surface or the outer fixation surface, or by including a retaining function portion that catches and deteriorates soft tissues near the cup rim, such as the gluteal tendon.

[0003] New-generation HRA implants and large-diameter THRs using non-metallic support materials such as zirconia-reinforced alumina ceramic (ZTA) and cross-linked ultra-high molecular weight polyethylene (UHMWPE) present greater challenges in cup retention during implantation. In the case of ZTA, manufacturing constraints and material hardness make it technically difficult and costly to add the small retaining parts sometimes found in metal hip cups. In the case of UHMWPE, maintaining the overall wall thickness is crucial for wear properties and material strength, so retaining parts that reduce the wall portion are undesirable. Furthermore, some of the new-generation devices require specific rotational alignment of asymmetrical functional parts on the cup, which also complicates cup retention and positioning. [Overview of the Initiative]

[0004] To solve these problems, the present invention provides a solution for holding a cup, applicable to any hip joint cup having a large diameter support surface, without requiring a special retaining mechanism on the cup. This solution works by establishing a hydraulic seal between the cover assembly and the cup implant, which securely holds both the cover and the cup implant. The cover is connected to an introducer shaft via a separate mechanical connection, which is used to position and forcibly push the cup implant into the prepared acetabulum. After installation, the introducer is removed, and the cover remains attached to the cup implant. The hydraulic seal between the cover and the cup implant is then broken by pulling a release tab on the cover, allowing the cover to be easily removed.

[0005] In Patent Document 1 (UK Patent Application Publication No. 2552173), a similar hydraulic seal is established between three elements: (1) a cup implant, (2) a cover, and (3) an introducer, whereas in the latest invention, it is established between only two elements: (1) a cup implant and (2) a cover. This offers several advantages. Firstly, during implantation, the surgeon can remove and reattach the introducer from the cover without interfering with the hydraulic seal. This allows the surgeon to confirm the position of the cup within the acetabulum and to reattach the introducer to further advance or adjust the position of the cup. Secondly, it is advantageous if the cup implant can be rotated as it approaches the acetabulum to position the asymmetrical functional portion on the cup rim in the desired position and to align with the skeletal structure of the acetabulum. This can be done by rotating the entire assembly around the axis of the shaft when a straight introducer shaft is used, but when an offset shaft is used, it is desirable to rotate the cup independently without affecting the offset position of the shaft. This is because, due to the constraints of surgical access, the offset shaft is positioned within a narrow window of available space at the surgical site. Furthermore, since the optimal position of the offset varies depending on the surgical approach and the surgeon's preference, it is advantageous to position the rotating functional parts of the offset shaft and the cup rim independently of each other. If the hydraulic seal does not depend on the functional parts on the introducer, it is easier to rotate the covered cup independently of the introducer. The mechanism for rotating the cup via the introducer is described below. Thirdly, since the hydraulic seal is contained within two elements, the required fluid volume is reduced, and the possibility of air bubbles remaining in the fluid system, which would reduce the holding force, is reduced. Finally, since the check valve and release mechanism included in the conventional invention are unnecessary for the novel invention, there are fewer components contributing to the hydraulic seal, and therefore fewer failures.

[0006] Patent Document 1 describes means for establishing (or maintaining under suction) low pressure in a fluid. However, experience has shown that this is not essential, as sufficient retention force can be obtained by releasing excess fluid from the sealed cavity and preventing the re-entry of air or fluid. Therefore, the latest invention does not describe similar depressurization means. Furthermore, Patent Document 1 states that it is desirable to use fluid to establish retention force, but that it can also function without fluid. In this case, only air is present in the sealed cavity, and the retention force is reduced. The latest invention also functions without fluid, but the retention force is reduced.

[0007] This specification focuses on the hydraulic seal between the cup implant and the cover. The description of the third element, the introducer, is included in the context. The cover and introducer are preferably supplied as sterile, disposable instruments. Alternatively, they may be supplied as reusable instruments after decontamination, cleaning, and sterilization before use.

[0008] The primary function is to establish a retaining force between the cup implant and the cover, which can be released after the cup implant is correctly positioned without compromising the fit of the cup within the acetabular socket. While the cup implant is installed into a slightly smaller acetabular socket by striking the introducer with a surgical hammer, the mating surfaces of the cup implant and the cover must be in complete contact with each other in order to transmit the impact force from the introducer to the cup implant. At the same time, the cup implant, especially its super-finished support surface, must be protected.

[0009] The cover comprises a sealing component (preferably silicone rubber) and a cover body. In some preferred configurations, a connector (e.g., in the form of a snap ring) may also be used. The interaction between the cover and the cup implant allows (a) excess fluid to escape and full contact between mating surfaces to be made, (b) a hydraulic seal to be established and the mating surfaces to be held together, and (c) the hydraulic seal to be prevented in order to remove the cover after the cup has been properly implanted.

[0010] During use, the cup implant is filled with fluid (e.g., sterile water), and the cover is rotated and aligned, then pressed against the filled cup implant. The cover and cup may be pressed together separately, or the cover may be attached to the introducer first and then pressed against the cup implant. When both the cover and cup implant are pressed together, excess fluid is drained from around the seal until the mating surfaces make contact. If assembled separately, the cup implant and cover are then attached to the introducer. The cup implant is then moved to the surgical site via the introducer and properly aligned before the end of the introducer is hammered into the acetabular socket. During cup installation, the introducer can be detached from and reattached to the cup with the cover attached for the surgeon to verify and evaluate its position, without affecting the hydraulic seal. Once properly positioned, the cover is removed from the cup by grasping one of the seal tabs protruding upward from the cup rim with a finger or forceps and pulling it. In this case, as explained below, you only need to pull with a small amount of force.

[0011] To maintain the hydraulic seal, several parts of the seal (usually three, but two, four, five, or more are also available), including the area adjacent to the tab and other areas, are compressed between the cover body and the cup support surface. Elsewhere, a small clearance exists for the seal between the cover body and the cup support surface. This allows excess fluid to be discharged during assembly, and in this area, the hydraulic seal is maintained by the seal's edge being pressed against the support surface. In this way, the hydraulic seal is maintained around the entire circumference by the compression of the seal or by the contact of the seal's edge. The seal's edge is biased in the direction of contact with the support surface because the seal portion (e.g., silicone), which is usually cut from a flat sheet, deforms into a spherical shape and then tries to return to its free shape due to its elasticity. As a result, not only the seal edge but also the outer surface of the seal adjacent to the edge contacts the support surface, forming an effective fluid-tight or airtight seal.

[0012] The seal is disrupted by pulling the tab because, as the silicone stretches, it becomes thinner than it compresses, creating a small gap through which air can enter the sealed cavity. Only a small force is needed to stretch the tab, which allows it to be stretched inward (towards the center of the cup), thus avoiding any force that would resist securing the cup.

[0013] In addition to the outer edge of the seal that interacts with the cup, the inner edge also needs to form a seal with the cover body to create a completely sealed cavity. This can be achieved by sandwiching the inner seal edge between the cover body and (if present) the connector (e.g., a snap ring), thereby compressing the silicone to form an effective secondary seal. Other methods for forming a secondary seal are well known to those skilled in the art and may include, for example, bonding the seal element to the cover body (e.g., via thermal bonding, adhesive bonding) or overmolding the seal onto the cover. Alternatively, an effective seal can be made by stretching the smaller diameter central hole of the seal into the larger diameter groove of the cover, similar to how an O-ring is stretched and fitted into the O-ring groove of a shaft.

[0014] Furthermore, the cover incorporates features that allow the introducer to be securely attached via a latching mechanism and a rotational drive mechanism, enabling the cup with the cover to rotate around the introducer axis. This helps to align the features of the cup rim with the skeletal features of the acetabular rim as intended without fully rotating the introducer. Once the introducer is assembled to the cover, a spring-loaded latch automatically engages, allowing it to be rotated via an adjustment knob and locked in a specific rotational position. To remove the introducer from the cup with the cover, the knob is pulled back towards the user to release the latch.

[0015] The following describes a preferred configuration of this disclosure.

[0016] A cover for a medical implant, comprising a body portion and a seal, the body portion having a distal end and a proximal end, the proximal end including a region adapted for connection to an introducer, and the seal having at least one tab extending proximal away from the body portion.

[0017] At least one tab is manipulable to deform the seal.

[0018] The main body preferably has at least one raised portion between its proximal and distal ends, the raised portion assisting in maintaining contact between the cover and the medical implant during use, and preferably, the at least one raised portion is two raised portions.

[0019] In some configurations, at least one additional raised portion is located approximately equidistant from at least one other raised portion.

[0020] In a preferred configuration, the proximal end of the main body portion has at least one slot configured to allow at least one tab to pass through.

[0021] Preferably, the raised portions are positioned adjacent to each of at least one slot in the main body. In a preferred configuration, the seal extends over at least one of the raised portions.

[0022] The seal may have multiple, preferably two, tabs.

[0023] The seal is preferably removable and attachable to the main body.

[0024] Preferably, the seal is fixedly attached to a fixed mounting area of ​​the main body, and the fixed mounting area forms an airtight and / or watertight seal, or a substantially airtight and / or watertight seal, between the seal and the main body.

[0025] Preferably, the main body is dimensioned to provide clearance between the main body and the seal in an area away from the fixed mounting area, thereby allowing the seal to move toward and away from the longitudinal axis of the cover.

[0026] In some configurations, the cover further comprises a connector that connects the seal to the body portion. The distal end of the body portion can be profiled in a connector region to receive the connector. The connector region can be profiled to hold the connector, and optionally, the connector has protrusions that interact with a rim on the connector region.

[0027] Preferably, the medical implant is a cup implant and the cover is profiled to fit within the cup.

[0028] The body portion has a rim, and optionally, the rim is profiled and optionally, the rim is profiled to match the contour of the rim of the medical implant.

[0029] In some configurations, the seal is profiled to match the contour of the rim of the body portion.

[0030] In some configurations, the rim of the seal is positioned distally from the rim of the body portion, except for at least one tab.

[0031] Further provided is a method of fixing a cover to a medical implant, the method comprising (i) optionally (e.g., when using a liquid instead of air), adding a fluid to the region of the medical implant that receives the cover; (ii) introducing the cover into the region of the medical implant such that the cover displaces the fluid until the cover abuts the surface of the medical implant; and (iii) optionally, applying an additional force to the cover such that the seal is compressed between the body portion and the medical implant.

[0032] The method may further include releasing the cover from the medical implant, and this additional step includes (iv) manipulating one or more tabs on the seal to disrupt the seal between the cover and the medical implant, and (v) removing the cover from the medical implant.

[0033] Furthermore, a system is provided comprising a cover for a medical implant and an introducer, wherein the cover is releasably fixed to the introducer, the introducer having a drive shaft and a connector hub, the introducer having a latching mechanism for fixing the connector hub to the cover, and optionally the connector hub having a rim that engages with a complementary groove within the cover for the medical implant.

[0034] Furthermore, a system is provided comprising a medical implant and a cover, wherein the cover can be removably fixed to the inner surface of the medical implant.

[0035] Furthermore, an introducer comprising a drive shaft and a connector hub is disclosed, the introducer comprising a latching mechanism for securing the connector hub to a cover for a medical implant.

[0036] The connector hub may have a rim that engages with a complementary groove within the cover for a medical implant.

[0037] Preferably, the latching mechanism is movable relative to the drive shaft.

[0038] The drive shaft may be offset from the longitudinal axis of the connector hub. In such a configuration, the introducer includes an impact shaft for transmitting a load from the introducer's handle area to the connector hub, the impact shaft being separate from the drive shaft. Preferably, the drive shaft is movable independently of the impact shaft, so that the drive shaft is rotatable and / or movable toward and away from the connector hub (preferably parallel to the longitudinal axis of the drive shaft). In some configurations, the introducer includes means for biasing the drive shaft toward the connector hub, preferably including a spring. The means for biasing the drive shaft toward the connector hub is independent of the latching means.

[0039] The drive shaft has a distal end (i.e., the end of the connector hub), which preferably has an adapter, such as a ball drive end, that allows the drive shaft to rotate in engagement with a cover for a medical implant at an offset angle, and the ball drive end optionally includes square sides.

[0040] The drive shaft may be parallel to the longitudinal axis of the connector hub. The introducer's drive shaft can function as an impact shaft for transmitting load from the introducer's handle area to the connector hub. In some configurations, the latching mechanism is biased toward the connector hub, and optionally, biasing occurs only when the latching mechanism is moved toward the connector hub. In some configurations, the connector hub has an anti-rotation feature, such as a projection, which preferably interacts with a complementary recess within a cover for a medical implant.

[0041] Hereinafter, an embodiment of the present invention will be described based on the attached drawings. [Brief explanation of the drawing]

[0042] [Figure 1] This is an explanatory diagram showing the cover body. [Figure 2]This is an explanatory diagram showing the bottom surface of the cover body. [Figure 3] This is a side view showing the cover body along with a cross-sectional view and a detailed view. [Figure 4] This is an exploded view showing all the components of the cover (cover body, seal, and snap ring). [Figure 5] This is an explanatory diagram showing the cover in its assembled state. [Figure 6] This is an alternative diagram showing the cover in its assembled state. [Figure 7] This is a top view showing the cover along with a cross-sectional view and a detailed view. [Figure 8] This is an explanatory diagram showing an acetabular cup implant. [Figure 9] This is an explanatory diagram showing a cup implant filled with liquid. [Figure 10] This is an explanatory diagram showing the cover as it is provided with the cup implant. [Figure 11] This is an explanatory diagram showing the cover and cup implant in their assembled state. [Figure 12] This is a top view showing the cover and cup implant along with a cross-sectional view and a detailed view. [Figure 13] This is a top view showing the cover and cup implant along with a cross-sectional view and a detailed view. [Figure 13A] This is an explanatory diagram showing the state of excess water being discharged during assembly. [Figure 13B] This is an explanatory diagram showing the fully assembled state with hydraulic seals. [Figure 14] This is an explanatory diagram showing the state of pressing the cup into the acetabulum using an introducer. [Figure 15] This is an explanatory diagram showing the cup and cover installed inside the acetabulum. [Figure 16] This is an explanatory diagram showing the cup with the cover removed. [Figure 17] This is a cross-sectional view showing the cup with the cover removed. [Figure 18]This is a perspective view showing an offset introducer shaft. [Figure 19] This is a partially disassembled perspective view showing the offset introducer shaft. [Figure 20] This is a side view showing the assembled cup implant, cover, and introducer shaft in the latched (locked) position, along with a cross-sectional view and a detailed view. [Figure 21] This is a detailed cross-sectional view showing the assembled cup, cover, and introducer shaft in the latched (released) position. [Figure 22] This is a perspective view showing a straight introducer shaft. [Figure 23] This is a side view showing a straight introducer shaft, along with a cross-sectional view and a detailed view. [Modes for carrying out the invention]

[0043] Figures 1 to 3 show the cover body 1 before assembly. The cover body can be manufactured from a suitable material so as not to damage the cup implant during insertion, and is usually made of polymer material. The cover rim 5 can be profiled to match the contour shape of the cup implant rim 26 (see, for example, Figure 8). Alternatively, the cover rim does not need to be profiled to match the cup implant rim. The recess 4 receives the introducer hubs 44, 58 (see Figures 19 to 23). The central boss 2 may optionally have a rim 13 and / or groove 14 on its outer diameter to receive the introducer latches 50, 62 (see Figures 19 to 23). The central boss 2 may further optionally have a square recess 3 to receive the engaging ball drive end 53 on the introducer 34. The square recess may alternatively be hexagonal, or star-shaped, or any shape that can be driven by an off-axis drive shaft. The cup rim 5 is preferably interrupted by one or more slots 10 that accommodate tabs 17 on the seal 15. The cup has a substantially spherical or spherical diameter that substantially coincides with the spherical bore of the cup implant 25 (see Figure 8). This spherical diameter includes a recessed region 11 and an end region 12. The recessed region 11 has optionally one or more or optionally two raised pads 8 adjacent to the slots 10 and optionally at least one additional raised pad 9 located midway between the slots 10. These pads correspond to the area where the seal is compressed, as will be described below. The cylindrical diameter 6 receives a snap ring 19 held by a raised flange 7. In a preferred configuration, the cover comprises two raised pads (i.e., one raised pad each adjacent to the slots 10) and an additional (third) raised pad between these two.

[0044] Figure 4 shows an exploded view of the arrangement of all three components: the cover 22, the cover body 1, the seal 15, and the snap ring 19. As described above, the snap ring may be optional, and the descriptions of various elements relating to the arrangement of the cover with the snap ring are equally applicable to arrangements without the snap ring. The seal is manufactured from a flexible elastic material such as silicone rubber and is usually die-cut from a flat sheet material, for example, about 1.5 mm thick. Alternatively, the seal can be manufactured from nitrile rubber, thermoplastic elastomer (TPE), polyurethane, or any other elastic material suitable for medical applications, as recognized by those skilled in the art. The seal has a circular central hole 16 smaller than the cylindrical diameter 6 on the cover body, and when stretched during assembly, the flat seal deforms into a cone shape (see Figures 5 and 6). The outer profile 18 is optionally contoured such that when the cover is pressed together with the cup implant, the edge of the seal nearly coincides with but slightly just before the cover rim 5, and the two tabs 17 protrude beyond the cup rim through the slot 10 (see Figures 11-15). If a snap ring 19 is used, its shape is circular and it has a flange 21 and numerous fingers 20 on its inner circumference. Since the snap ring is manufactured from the same polymer material as the cover body, the fingers are semi-flexible. Both the cover body and the snap ring can be 3D printed, molded, or machined from a polymer material such as nylon.

[0045] Figures 5 to 7 show the cover body 22 assembled for use. Figure 7 (cross-sectional and detailed view) shows the seal region 23 adjacent to the central hole 16 and sandwiched between the cover body 1 and the flange 21 on the snap ring 19. In this case, the elastic material remains compressed in region 23, forming a fluid / airtight seal between the seal 15 and the cover body 1. These figures also show the position of the snap ring fingers 20, which hold the snap ring in place and engage with the raised edge 7 of the cover body that maintains the compression of the seal in region 23.

[0046] Figure 8 shows a cup implant typically used in HRA. In this case, the cup 24 is a hemispherical shell and has an inner surface 25 that forms a support surface, the inner surface being extremely smooth and precisely formed to match a femoral head implant (not shown). The outer surface 27 typically has a textured biocompatible surface and / or coating and is pressed directly into the patient's acetabular socket. The rim 26 is contoured in the illustrated embodiment, but may be flat or planar in alternative embodiments. This type of cup implant is typically made of zirconia-reinforced alumina ceramic (ZTA), crosslinked ultra-high molecular weight polyethylene (UHMWPE), or cobalt-chromium-molybdenum alloy. In other embodiments (not shown), the cup implant may consist of an outer shell and an inner support surface pre-assembled using a combination of the materials described above.

[0047] When in use, the cup 24 is typically removed from its sterile packaging and placed on a flat surface. It is then filled with fluid (e.g., sterile water 28) (see Figure 9). With the cup placed on a flat surface to avoid spillage, the cover 22 is fitted into the cup 24, and the contoured rims 5, 26 (if present) are nearly aligned, as shown in Figure 10. As the cover and cup are pressed together, excess fluid is released from part of the seal until the mating surfaces (cover rim 5 and cup rim 26) make contact with each other. Figure 11 shows the cover fully pressed against the cup, with the mating surfaces in full contact and held together by the hydraulic seal. Alternatively, the cover may be attached to the introducer first and then pressed onto the cup implant. If assembled separately, the cup implant and cover are then attached to the introducer.

[0048] Figure 12 shows a cross-sectional view of the cup and cover held together by a hydraulic seal. As described above, in order to maintain the sealed cavity 27, a portion of the seal is compressed between the cover body and the cup support surface, including the area adjacent to the tab 17. Elsewhere, there is a small clearance with respect to the seal between the cover body and the cup support surface. This small clearance allows the seal to fluctuate between an open position to drain excess fluid and a closed position to maintain a sealed cavity.

[0049] Figure 12B shows a state in which a portion 28 of the seal 15 adjacent to the pull tab 17 is compressed to less than its free thickness between the cover body 1 and the cup support surface 25. When the cover has three raised pads as illustrated in the figure, the compression occurs in three regions, as indicated by arrows 29: the regions adjacent to the two pull tabs 17 and a third position between these pull tabs. These compressed regions correspond to the three raised pads 8, 9 on the cover body 1. The third position 9 is included for a stabilizing effect, ensuring that the compression is maintained, in particular, at the pull tab position 8.

[0050] Figure 12A shows a portion 30 where a small clearance exists with respect to the seal 15 between the cover body 1 and the cup support surface 25. In this case, the seal occupies a gap slightly wider than the thickness of the seal itself, allowing excess fluid to be discharged around the outside of the seal during assembly, and then closing to prevent fluid or air from flowing back into the sealed cavity. Anyone familiar with fluid dynamics will understand that the seal functions similarly to an "umbrella check valve," allowing fluid flow in one direction and preventing backflow in the reverse direction. In the illustrated embodiment, excess fluid from the filled cup implant is allowed to escape because the pressure from the excess fluid pushes the seal inward toward the cover surface, away from the cup support surface, and a small opening is formed. After the excess fluid has been discharged and the pressure normalizes, the seal contacts the cup support surface again, sealing the cavity. The edges of the seal are biased to contact the support surface due to the elastic bias of the material, which tends to return to its free shape. As a result, not only the seal edge but also the outer surface of the seal near the edge makes flush contact with the support surface. In addition, if there is a force that attempts to separate the cover from the cup implant, for example when the cup is manipulated into the acetabulum, the positive pressure on the inner surface of the seal pushes the outer surface that is in flush contact with the support surface, maintaining the seal and resisting separation. This is simulated in Figure 13. In this case, in Figure 13A, the seal 15 is pushed inward in the direction of arrow 31 on the cover body 1 by the pressure of the outflowing excess fluid 32. In Figure 13B, the seal is pushed outward in the direction of arrow 33 by (a) the elastic bias of the material and (b) the positive pressure on the inner surface if there is a force that attempts to separate the cover from the cup.

[0051] If assembled separately, the cup implant and cover are then attached to the introducer. Once the hydraulic seal is established, the cup implant can be moved to the surgical site and manipulated into a pre-prepared acetabular socket 37 in the pelvis 36, as shown in Figure 14. This is done by striking the distal end 35 of the introducer 34 with a surgical hammer (not shown) until the cup is fully seated. As described above, the introducer 34 can be removed from and reattached to the cup with the cover at any stage of insertion for confirmation by the surgeon and / or for final installation, as shown in Figure 15. Depending on the surgical approach, at least one of the tabs 17 is accessible to remove the cover by grasping it with the fingers or using a standard surgical instrument such as forceps 38, as shown in Figure 16. The seal is disrupted by pulling on the tab 17 because, as the elastic material stretches, the tab becomes thinner than the amount it is compressed in area 28, creating a small gap through which air enters the sealed cavity. Because elastic materials are relatively soft and stretchable, less force is required to pull or stretch the tab. Furthermore, since the tab can be stretched inward (towards the center of the cup), it can avoid forces that would otherwise oppose the cup's fixation.

[0052] Figure 17 shows a simulation of the effect of stretching one of the tabs. In this case, tab 17 is grasped between the thumb and index finger and pulled in the direction of arrow 39. As tab 17 is stretched, it becomes thinner until a small gap 41 is created between the seal 15 and the cup support surface 25. This allows air to enter the sealed cavity 27, disrupting the hydraulic seal and making it possible to easily remove the cover. Alternatively, the tab may be pulled toward the center of the cup in the direction of arrow 40, thereby avoiding the force that would pull the cup out of the socket.

[0053] Embodiments of the introducer 34 shown in Figures 14 and 18-21 feature an offset shaft, which is preferred by many surgeons. The offset shaft is preferred because, particularly in anterior surgical approaches and / or when minimizing surgical access to reduce incision size, there may be obstacles that prevent direct access to the acetabulum with a straight introducer shaft. The introducer comprises a handle 42, an offset shaft 43, a connector hub 44, a latch subassembly 45, a spring holder 46, and a spring 47. The illustrated offset shaft consists of two plates, and the entire assembly is secured by a number of rivet nuts 48. However, it will be understood that the offset shaft may consist of a single piece or multiple pieces, and the means of securing the assembly together are not limited to rivet nuts, but may be any suitable fastening means known to those skilled in the art.

[0054] The latch subassembly 45 incorporates a housing 49 having a latch 50 for holding the cover, a rotary drive shaft 51 for rotating the cover around the longitudinal axis of the introducer, and latching means such as a cam lever 52 for locking the rotary drive shaft in a specific position. The drive shaft has an adapter at its distal end, which allows the drive shaft to rotate the cover in an offset position. In the illustrated configuration, this adapter is represented as a ball drive end 53 having square sides, which engage with a square recess drive function 3 on the cover. The ball drive end 53 is similar to a standard ball-end Allen key that allows the tool to be used at an off-axis angle to the screw, but the Allen key ball drive has hexagonal sides, whereas the illustrated ball drive end has square sides. In this case, the ball drive end allows the rotary drive shaft to be off-axis with respect to the cover rotation axis. This is necessary because the shape of the introducer shaft is offset. Alternatively, the ball drive end 53 and the fitting recess 3 on the cover body 1 may be hexagonal, star-shaped, or any other shape that allows rotation via an off-axis drive shaft.

[0055] The latch subassembly 45 can slide freely for a short distance in a direction parallel to the drive shaft axis, but the position of the spring holder 46 is fixed (for example by a rivet nut), so that the spring 47 biases the latch subassembly toward the hub 44. This allows the latch 50 and ball drive unit 53 to engage with and disengage from the cover. When the cover is assembled with the introducer, the hub 44 engages with the cover recess 4. The latch and ball drive unit are pushed back by the cover boss rim 13 in the direction of arrow 54 until the latch and ball drive unit fall into their respective engagement parts. This occurs automatically by spring force when the user pushes them together. To disengage and release the cover, the user must first pull the latch assembly against the spring force for a certain distance (e.g., 3-4 millimeters) in the direction of arrow 54 shown in Figure 21 via the knob on the drive shaft 51. The latching means (e.g., cam lever 52) that locks the rotation of the drive shaft is independent of the operation of the latch subassembly and can be engaged or disengaged at any time.

[0056] Figure 20 shows the latch and ball drive in the engaged position, and Figure 21 shows the latch and ball drive in the disengaged position with the latch assembly pulled back in the direction of arrow 54.

[0057] Figures 22 and 23 show an alternative configuration of an introducer with a straight shaft 55. This straight introducer comprises a handle 56, a shaft 57, a connector hub 58, and a carriage 59, which are fastened together (for example, by a number of rivet nuts 48). In the case of a straight shaft, there is no need to include a mechanism for rotating the cover, because the entire introducer can be rotated to align the cup implant in the appropriate direction of rotation. The straight introducer connector hub optionally incorporates an anti-rotation pin 60 that engages with a complementary slot 61 in the cover body 1, so that the cover and introducer rotate together (offset introducers do not need to include such a pin, but may be provided in some configurations). The straight introducer comprises a carriage that is freely movable in a direction parallel to the shaft axis. The carriage incorporates (optionally two) latches 62 that engage with recesses in the cover boss 14. The latch is located on a semi-flexible finger / prong 63 that engages with a (optionally triangular) portion 64 of the hub 58. As the carriage moves in the direction of arrow 65, the latch prong moves along the (triangular) portion 64, so that the latch moves out of the cover boss recess 14 in the direction of arrow 66 and the cover is released. Those skilled in the art will recognize that other suitable shapes are available to achieve a similar effect in which the latch finger is forced outward as the carriage moves away from the connector hub. Instead of a spring, the carriage includes a slot 67 having a constriction 68 (two in the illustrated configuration) located adjacent to one of the three rivet nuts 48. As the carriage returns in the direction of arrow 65, the constriction 68 moves upward beyond the diameter of the rivet nut (or other similar pin), thereby biasing the carriage toward the hub 58 and acting like a spring. Those skilled in the art will recognize other biasing means (e.g., the use of a spring) available to achieve a similar effect. The carriage further includes a flange 69 that forms a finger grip for releasing the latch.

[0058] The cover is universal and accommodates either a straight introducer or an offset introducer, depending on the surgeon's preference. Preferably, the cover is supplied sterile for single use or can be washed, re-sterilized, and reused multiple times. Those skilled in the art will understand that it is advantageous to have a cover designed in common to fit both straight introducers and offset introducers in order to increase compatibility and reduce instrument inventory. According to embodiment (1), a cover for a medical implant, the cover comprising a body portion and a seal, the body portion having a distal end and a proximal end, the proximal end including a region adapted for connection to an introducer, and the seal having at least one tab extending proximal away from the body portion. According to embodiment (2), the at least one tab is operable to deform the seal. According to embodiment (3), the main body portion has at least one raised portion between the proximal end and the distal end, the raised portion assists in maintaining contact between the cover and the medical implant during use, and preferably the at least one raised portion is two raised portions. According to embodiment (4), at least one further raised portion is arranged at approximately equidistant from the at least one raised portion. According to embodiment (5), the proximal end of the main body portion has at least one slot configured to allow each of the at least one tab to pass through. According to embodiment (6), the raised portion is arranged adjacent to each of the at least one slots in the main body portion. According to embodiment (7), the seal extends over the at least one raised portion. According to embodiment (8), the seal has a plurality, preferably two, tabs. According to embodiment (9), the seal is detachably attached to the main body portion. According to embodiment (10), the seal is fixedly attached to the fixed mounting area of ​​the main body portion, and the fixed mounting area forms an airtight and / or watertight seal, or a substantially airtight and / or watertight seal, between the seal and the main body portion. According to embodiment (11), the main body portion is sized to provide a clearance between the main body portion and the seal in a region away from the fixed mounting area, thereby allowing the seal to move toward and away from the longitudinal axis of the cover. According to embodiment (12), the cover further comprises a connector for connecting the seal to the main body portion. According to embodiment (13), the distal end of the main body portion is profiled in the connector area to receive the connector. According to embodiment (14), the connector region is profiled to hold the connector, and optionally the connector has projections that interact with a rim on the connector region. According to embodiment (15), the medical implant is a cup implant, and the cover is profiled to fit inside the cup. According to embodiment (16), the main body portion has a rim, which is optionally contoured, and optionally contoured to match the contour of the rim of the medical implant. According to embodiment (17), the seal is contoured to match the contour of the rim of the main body portion. According to embodiment (18), the rim of the seal is located distal to the rim of the main body portion, except for the at least one tab. According to embodiment (19), a method for fixing one of the covers of embodiments 1 to 18 to a medical implant, wherein the method is (i) optionally, the step of adding fluid to the area of ​​the medical implant that receives the cover, (ii) The step of introducing the cover into the area of ​​the medical implant until the cover contacts the surface of the medical implant, thereby causing the cover to displace the fluid, (iii) optionally, the seal is compressed between the main body portion and the medical implant by applying an additional force to the cover, This method includes [something]. According to embodiment (20), the method further includes releasing the cover from the medical implant, the additional step being (iv) The step of manipulating one or more tabs on the seal in order to obstruct the seal between the cover and the medical implant, (v) The step of removing the cover from the medical implant, Includes. According to embodiment (21), a system comprising a cover of any one of embodiments 1 to 18 and an introducer, wherein the cover is releasably fixed to the introducer, the introducer has a drive shaft and a connector hub, the introducer has a latching means for fixing the connector hub to the cover, and optionally the connector hub has a rim that engages with a complementary groove in the cover for a medical implant. According to embodiment (22), the system comprises a medical implant and one cover from embodiments 1 to 18, wherein the cover can be removably fixed to the inner surface of the medical implant. According to embodiment (23), an introducer comprising a drive shaft and a connector hub, wherein the introducer comprises a latching means for securing the connector hub to a cover for a medical implant, and optionally the cover is one of the covers of embodiments 1 to 18. According to embodiment (24), the connector hub is an introducer having a rim that engages with a complementary valley within a cover for a medical implant. According to embodiment (25), the latching means is an introducer that is movable relative to the drive shaft. According to embodiment (26), the drive shaft is an introducer that is offset from the longitudinal axis of the connector hub. According to embodiment (27), the introducer is an introducer comprising an impact shaft for transmitting a load from the handle area of ​​the introducer to the connector hub, wherein the impact shaft is different from the drive shaft. According to embodiment (28), the drive shaft is an introducer that is movable independently of the impact shaft, so that the drive shaft is rotatable and / or movable toward and away from the connector hub (preferably parallel to the longitudinal axis of the drive shaft). According to embodiment (29), the introducer is an introducer comprising means for biasing the drive shaft toward the connector hub, preferably the biasing means including a spring. According to embodiment (30), the means for biasing the drive shaft toward the connector hub is an introducer that is independent of the latching means. According to embodiment (31), the drive shaft has a distal end (i.e., the end of the connector hub) the distal end has an adapter, such as a ball drive end, which allows the drive shaft to be rotated in engagement with a cover for a medical implant at an offset angle, and the ball drive end is optionally an introducer including a square side. According to embodiment (32), the introducer is an introducer in which the drive shaft functions as an impact shaft for transmitting a load from the handle area of ​​the introducer to the connector hub. According to embodiment (33), the latching means is an introducer that is biased toward the connector hub, and biasing occurs only when the latching means is optionally moved away from the connector hub. According to embodiment (34), the connector hub is an introducer having an anti-rotation function, for example, a projection, which preferably interacts with a complementary recess in the cover for a medical implant. Related Patent Documents

[0059] [Patent Document 1] UK Patent Application Publication No. 2552173

Claims

1. A cover for a medical implant, the cover comprising a body portion and a seal, the body portion having a distal end and a proximal end, the proximal end including a region adapted for connection to an introducer, and the seal having at least one tab extending proximal away from the body portion. The proximal end of the main body portion is a cover having at least one slot configured to allow each of the at least one of the tabs to pass through.

2. A cover according to claim 1, wherein at least one of the tabs is operable to deform the seal.

3. A cover according to claim 1 or 2, wherein the main body portion has at least one raised portion between the proximal end and the distal end, the raised portion assists in maintaining contact between the cover and the medical implant during use.

4. The cover according to claim 3, wherein at least one of the raised portions is two of the raised portions, and an additional raised portion is arranged between the two of the raised portions at an equidistant distance along the circumferential direction of the cover.

5. The cover according to claim 1, wherein at least one raised portion is arranged adjacent to each of the at least one slots in the main body portion.

6. The cover according to claim 3 or 5, wherein the seal extends over at least one of the raised portions.

7. A cover according to any one of claims 1 to 6, wherein the seal is: (i) having a plurality of the aforementioned tabs; and / or, (ii) It is removablely attachable to the main body portion; and / or, (iii) A cover fixedly attached to a fixed mounting area of ​​the main body portion, wherein the fixed mounting area forms an airtight and / or watertight seal, or substantially airtight and / or watertight seal, between the seal and the main body portion.

8. A cover according to claim 7, wherein the main body portion is dimensioned to provide a clearance between the main body portion and the seal in a region away from the fixed mounting area, thereby allowing the seal to move toward and away from the longitudinal axis of the cover.

9. A cover according to any one of claims 1 to 8, wherein the cover further comprises a connector for connecting the seal to the main body portion.

10. A cover according to claim 9, wherein the distal end of the main body portion is profiled in a connector region to receive the connector, the connector region is profiled to hold the connector, and the connector has projections that interact with a rim on the connector region.

11. A method for fixing the cover according to any one of claims 1 to 10 to the medical implant, wherein the method is: (i) the step of adding fluid to the area of ​​the medical implant that receives the cover, (ii) The step of introducing the cover into the area of ​​the medical implant until the cover contacts the surface of the medical implant, thereby causing the cover to displace the fluid, (iii) The step of compressing the seal between the main body portion and the medical implant by applying an additional force to the cover, Methods that include...

12. The method according to claim 11, further comprising releasing the cover from the medical implant and applying an additional force to the cover. (iv) The step of manipulating one or more tabs on the seal in order to obstruct the seal between the cover and the medical implant, (v) The step of removing the cover from the medical implant, Methods that include...

13. A system for a medical implant comprising a cover according to any one of claims 1 to 9 and an introducer, wherein the cover is releasably fixed to the introducer, the introducer has a drive shaft and a connector hub, and the introducer has a latching means for fixing the connector hub to the cover.

14. The system according to claim 13, wherein the connector hub has a rim that engages with a complementary valley within the cover for the medical implant.

15. A system comprising the medical implant and a cover according to any one of claims 1 to 9, wherein the cover is releasably fixed to the inner surface of the medical implant.

16. An introducer comprising a drive shaft and a connector hub, wherein the introducer comprises a latching means for securing the connector hub to a cover for the medical implant, the cover being the cover according to any one of claims 1 to 9.

17. An introducer according to claim 16, wherein the connector hub has a rim that engages with a complementary valley within the cover for the medical implant.

18. An introducer according to claim 16, wherein the latching means is movable relative to the drive shaft.

19. An introducer according to any one of claims 16 to 18, wherein the drive shaft is offset from the longitudinal axis of the connector hub.

20. An introducer according to any one of claims 16 to 19, wherein the introducer is (i) comprising an impact shaft for transmitting a load from the handle area of ​​the introducer to the connector hub, wherein the impact shaft differs from the drive shaft, ; and / or, (ii) The introducer comprises means for biasing the drive shaft toward the connector hub, the means including a spring.

21. An introducer according to claim 20, wherein the drive shaft is movable independently of the impact shaft, so that the drive shaft is rotatable and / or movable toward and toward the connector hub parallel to the longitudinal axis of the drive shaft.

22. An introducer according to claim 20, wherein the means for biasing the drive shaft toward the connector hub is independent of the latching means.

23. An introducer according to any one of claims 16 to 20, wherein the drive shaft has a distal end as the end of the connector hub, the distal end comprises an adapter including a ball drive end having a square side, which allows the drive shaft to be rotated in engagement with the cover for the medical implant at an offset angle.

24. An introducer according to any one of claims 16 to 18, wherein the drive shaft of the introducer functions as an impact shaft for transmitting a load from the handle area of ​​the introducer to the connector hub.

25. An introducer according to claim 24, wherein the latching means is biased toward the connector hub, and / or the connector hub has an anti-rotation function portion including a projection.

26. An introducer according to claim 25, wherein biasing occurs only when the latching means is moved away from the connector hub.

27. ​​An introducer according to claim 25, wherein the projection interacts with a complementary recess within the cover for the medical implant.

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