Prosthetic element removal apparatus and methods

Details Prosthetic element removal apparatus and methods Prosthetic element removal apparatus and methods

1999-07-08

2001-02-13

Buiz, Michael (Department: 3731)

Surgery

Instruments

Orthopedic instrumentation

Reexamination Certificate

active

06187012

ABSTRACT:

FIELD OF THE INVENTION
This invention relates generally to prosthetic elements and, more particularly, to apparatus and methods for removing previously implanted orthopaedic appliances, including those associated with joint-replacement surgery.
BACKGROUND OF THE INVENTION
Porous or bony ingrowth surfaces are now commonly used on a wide variety of prosthetic elements, including joint-replacement components associated with the hip and knee, as well as other orthopaedic devices.
Although there is some debate as to the advantages of cementless fixation in terms of longevity and conservation of host bone, such devices are often very difficult to remove due to the tenacious invasion of surrounding bone. Removal for various purposes such as revision arthroplasty can therefore be unpredictable and problematic.
The need therefore exists for tools and techniques to aid in the removal of such devices. Such tools and techniques would preferably be applicable to both cemented as well as cementless fixation styles.
SUMMARY OF THE INVENTION
The present invention helps to minimize problems associated with the removal of prosthetic elements, both cemented and cementless, by providing guide means to direct a cutting tool into the interface between the prosthesis and the bone to effectuate a more controlled separation. In a preferred embodiment, such guide means are placed on the prosthetic element itself whereas, according to an alternative embodiment, the guide means are provided on a separate component which is then aligned with the prosthesis.
In the particular case of a stemmed prosthesis such as a proximal femoral component, the invention preferably provides one or more tracks, grooves, channels, slots or the like disposed longitudinally along the stem of the implant. Such guide means allows cutting tool such as an osteotome, for example, to be inserted thereinto and tapped down along the side of the implant between the prosthesis and the surrounding bone to bring about a cleaner and more controlled separation. Preferably, sufficient guide means are provided around the body of the implant so that as the cutting tool is inserted along the plurality of tracks, very little fusion remains between the implant and the surrounding bone, thereby enabling the prosthesis to be readily removed.
Although different cutting tools may be provided for use as part of the invention, standard osteotomes are preferably used due to their widespread availability. In particular, osteotomes having blades which are somewhat flexible are preferred in some applications, particularly when the stem to be released from the surrounding bone has a curved outer surface. As an alternative, however, specialized osteotomes or other cutting tools may be provided as discussed elsewhere herein to avoid binding or to cooperate with the guide means provided according to the invention.
The guide means according to the invention may be associated with any type of implanted device, including joint-replacement components, nails, stems or other components. In each case, however, at least a portion of the guide means are preferably left exposed following initial fixation of the implant, enabling the surgeon to readily ascertain where the cutting tool needs to be inserted to sever the interface.
The invention is applicable to both cemented and non-cemented interfaces incorporating porous or bony ingrowth surfaces. In the case of the latter, the interface may be severed between the ingrowth region and surrounding bone, or between the ingrowth region and the body of the implant.


REFERENCES:
patent: 4702236 (1987-10-01), Tarabichy et al.
patent: 4846161 (1989-07-01), Roger
patent: 5019083 (1991-05-01), Klapper et al.
patent: 5290291 (1994-03-01), Linden
patent: 5456686 (1995-10-01), Klapper et al.
patent: 5571109 (1996-11-01), Bertagnoli

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