Tool and status for separating a femoral cup from an acetabular ball in an implanted hip prosthesis

This is an application filed under 35 USC 371 based on PCT/US2016/042424 filed 15.Jul.2016, which in turn claims priority to U.S. Ser. No. 62/197188 filed 27.Jul.2015. The present application claims the full priority benefit of these prior applications and herein incorporates by reference the full disclosures of these prior applications as if set forth herein.

The present invention relates to surgical instruments used in connection with a hip prosthesis. More specifically, the invention has to do with surgical tools which are used to separate a femoral cup from an acetabular ball in an implanted hip replacement prosthesis.

The Related Art

A reverse hip prosthesis is described in U.S. Pat. Nos. 8,313,531 B2 and 8,540,779 B2. The prosthesis and a revision surgery method also are described in U.S. Pat. No. 8,992,627 B2. The disclosures of these three patents are incorporated herein in their entireties by reference.

As described in the patents referenced above, a femoral cup articulates on an acetabular ball when the prosthesis is implanted in a patient. The acetabular ball is affixed by means of a Morse taper to a stem which is affixed to and extends from the bottom of the concave surface of an acetabular cup. The surgical tools of the invention enable a surgeon to separate the femoral cup from the acetabular ball without pulling on the acetabular cup or the femoral implant and without disrupting any bone ingrowth. The surgical tool of the invention may be included as a component of a kit containing other surgical instruments and/or implant elements.

FIG. 1 is a top elevation view of a first embodiment of a surgical tool of the invention.

FIG. 1A is a top elevation view of the femoral engagement component 5 of the first embodiment.

FIG. 1B is an end elevation view of FIG. 1A .

FIG. 2 is a side elevation view of the first embodiment of the surgical tool of the invention.

FIG. 2A is a bottom elevation view of an alternate embodiment of the second handle 3 of the first embodiment.

FIG. 2B is the same view as FIG. 2A following movement of the acetabular engagement component 6 a .

FIG. 3 is a side elevation view of the tool of FIG. 2 positioned on a prosthesis just prior to separation of the femoral cup from the acetabular ball.

FIG. 4 is a section view of FIG. 3 with a partial section of a femur as an added element.

FIG. 5 is a side elevation view of a second embodiment of the tool of the invention wherein the handles have been squeezed toward one another.

FIG. 5A is a perspective view of portion A of FIG. 5 .

FIG. 6 is a perspective view of the second embodiment wherein the handles have not been squeezed toward one another.

FIG. 7 is a top elevation view of FIG. 6 .

FIG. 8 is a side elevation view of the second embodiment engaged with a femoral implant/cup and an acetabular cup before the femoral cup and acetabular cup are separated from one another.

FIG. 8A is a section view of FIG. 8 .

FIG. 9 is a side elevation view of the second embodiment engaged with a femoral implant/cup and an acetabular cup after the femoral cup and acetabular cup have been separated from one another.

FIG. 9A is a section view of FIG. 9 .

Referring to the first embodiment, the surgical tool 1 of the invention, also referred to herein as a surgical instrument, is illustrated in a top elevation view in FIG. 1 and a side elevation view in FIG. 2 . The tool has a first handle 2 and a second handle 3 . Springs 4 tend to bias the handles apart from one another as illustrated in FIG. 2 . The distal end of the first handle 2 has a femoral engagement component 5 attached thereto and the distal end of the second handle 3 has an acetabular engagement component 6 attached thereto. Fulcrum pin 7 hinges the first handle 2 to the second handle 3 so that when the handles are squeezed toward one another the femoral engagement component 5 and the acetabular engagement component 6 are moved away from one another. The pin 7 thus provides a fulcrum between the first and second handles.

The femoral engagement component 5 illustrated in FIG. 1A is viewed from the direction of arrow A in FIG. 2 . Femoral engagement component 5 may be rotatably connected to first handle 2 by means of axis pin 5 a . Axis pin 5 a allows a femoral engagement component 5 to rotate axially about the central axis of the first handle 2 . In FIG. 1B , an end view of femoral engagement component 5 is illustrated as taken from the direction of arrow B in FIG. 1A . Arrow C in FIG. 1B illustrates the directions in which femoral engagement component 5 can be rotated.

FIGS. 2A and 2B illustrate a bottom elevation view of an alternate embodiment of the second handle which is designated as 3 a . A hinge 3 b is provided on handle 3 a to allow lateral pivoting of a portion of the handle located between pin 7 (see FIG. 2 ) and acetabular engagement component 6 a . Hinge 3 b allows lateral movement in the directions of arrow D of FIG. 2A . FIG. 2B provides an example of a hinged handle 3 a having an acetabular engagement component 6 a at the distal end thereof.

In FIGS. 3 and 4 the surgical tool 1 is positioned on a prosthesis just prior to separation of the femoral cup 20 from the acetabular ball 21 . The acetabular engagement component 6 is engaged with the circumferential edge 22 of acetabular cup 23 and the femoral engagement component 5 is engaged with the neck 24 of femoral cup 20 , or the outer hemispherical surface of femoral cup 20 , or both the neck 24 and the outer hemispherical surface of femoral cup 20 . And the femoral engagement component 5 may also engage the top (i.e., the proximal end) of femoral implant 25 which is implanted in femur 26 , shown in partial section. A liner 27 is illustrated in femoral cup 20 . The acetabular ball 21 is affixed to stem 28 of the acetabular cup.

When handles 2 and 3 or 2 and 3 a are squeezed toward one another, the femoral cup is separated from the acetabular ball.

The second embodiment of the surgical tool of the invention is very similar to the first embodiment except for the acetabular engagement element. This embodiment is illustrated in FIGS. 5-9A and it is designated as tool 31 . A pivotable partial ring, referred to herein as acetabular engagement ring 36 , is employed to engage the acetabular cup in the second embodiment as distinguished from acetabular engagement component 6 in the first embodiment. The term “acetabular engagement element” may be used herein to refer to both the acetabular engagement component 6 and the acetabular engagement ring 36 .

FIG. 5 is a side elevation view of tool 31 . The tool has a first handle 32 and a second handle 33 . Springs 34 , affixed to the handles with screws 41 , tend to bias the handles apart from one another. And in FIG. 5 , the handles have been squeezed toward one another to an intermediate position between fully open as shown in FIG. 6 and fully closed as shown in FIG. 9 . The distal end of first handle 32 has a femoral engagement component 35 attached thereto. The distal end of second handle 33 has an acetabular engagement ring 36 pivotably attached thereto by means of ring pins 40 . (See also FIG. 5A .) As can be seen from the drawings, ring 36 is pivotable about an axis which is perpendicular to the central axis of the distal portion of handle 33 . Fulcrum pin 37 hinges the first handle 32 to the second handle 33 so that when the handles are squeezed toward one another the femoral engagement component 35 and the acetabular engagement ring 36 are moved away from one another. The pin 37 thus provides a fulcrum between the first and second handles.

As in the first embodiment, the femoral engagement component 35 of the second embodiment may be rotatably connected to first handle 32 by means of axis pin 35 a . Axis pin 35 a allows the femoral engagement component 35 to rotate axially about the central axis of the first handle 32 in the same manner as femoral engagement component 5 is allowed to rotate axially about the central axis of first handle 2 in the first embodiment. The alternate embodiment of second handle 3 a which has a hinge 3 b as described above (See FIG. 2B ) can also be used with the second embodiment of the tool of the invention.

Referring to FIGS. 5A, 7, 8A and 9A , acetabular engagement ring 36 has a beveled edge 36 b which engages beveled edge 22 a of acetabular cup 23 . Ring 36 also has a tab 36 a which is seated in indent 33 a to prevent downward rotation of ring 36 below the horizontal central plane of the distal end of handle 33 . Thus, as can be seen in FIGS. 6 and 7 wherein the handles are in the fully open position, tab 36 a is seated in indent 33 a and ring 36 is prevented from downward rotation in that position.

In FIGS. 8 and 8A the surgical tool 31 is positioned on a prosthesis just prior to separation of the femoral cup 20 from the acetabular ball 21 . The beveled edge 36 b of acetabular engagement ring 36 is engaged with the circumferential beveled edge 22 a of acetabular cup 23 and the femoral engagement component 35 is engaged with the neck 24 of femoral cup 20 or the outer hemispherical surface of femoral cup 20 , or both the neck 24 and the outer hemispherical surface of femoral cup 20 . A femoral implant 25 is also illustrated and the femoral engagement component 35 may also engage the top (i.e., the proximal end) of implant 25 . A liner 27 is illustrated in femoral cup 20 . The acetabular ball 21 is affixed to stem 28 of the acetabular cup.

When handles 32 and 33 are squeezed toward one another the femoral cup is separated from the acetabular ball as shown in FIGS. 9 and 9 a .

In the surgical method of the invention, femoral engagement component 5 or 35 is engaged with the neck of the femoral cup, or an outer hemispherical surface of the femoral cup or both the neck and the outer hemispherical surface of the femoral cup and/or the upper surface (i.e. the proximal end) of a femoral implant. Simultaneously, the acetabular engagement component 6 is engaged with the circumferential edge 22 of the acetabular cup 23 , or the circumferential beveled edge 36 b of femoral engagement ring 36 is engaged with the circumferential beveled edge 22 a of acetabular cup 23 , and then the first and second handles are squeezed toward one another thereby causing the femoral cup and the acetabular ball to be separated from one another.