ORTHOPEDIC REAMER FOR BONE PREPARATION, PARTICULARLY GLENOID PREPARATION
20190247056 ยท 2019-08-15
Inventors
- Matthew J. Purdy (Leesburger, IN, US)
- Lucile Ferrand (Montbonnot, FR)
- Pierric DERANSART (SAINT MARTIN D'URIAGE, FR)
Cpc classification
A61B17/1615
HUMAN NECESSITIES
Y10T408/8953
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
International classification
Abstract
Embodiments of the invention include an orthopedic milling machine for preparing a glenoid bone. The milling machine uses a hub and a sleeve. The hub includes reliefs arranged to cut or mill the bone and the sleeve couples to the hub to transfer rotational motion to the hub. The hub has an axial bore sized to receive an orthopedic guide pin. The hub also has a lateral passage slot that allows the hub to move laterally towards the guide pin in order to place the guide pin within the axial bore.
Claims
1-21. (canceled)
22. A method of preparing bone, the method comprising: positioning a guide pin; placing a burr near the guide pin, the burr comprising: a hub, the burr being configured for rotation about an axis of the hub, the hub comprising a bore adapted to receive the guide pin, wherein the hub comprises a lateral passage slot that extends radially in the hub; and a milling body that extends outwardly and surrounds a periphery of the hub at least in part, the milling body comprising a crown spaced radially from the hub and lugs that connect the hub and the crown in a radial direction, the lugs are distributed around the hub, the milling body further comprising a free volume between two consecutive lugs; laterally moving the burr relative to the guide pin to pass the guide pin through the lateral passage slot in the hub of the burr and into the bore of the hub; and driving the burr around the guide pin.
23. The method of claim 22, wherein a portion of the crown extending along an outer periphery of the burr is eliminated between two of the lugs, and wherein laterally moving the burr comprises passing the guide pin through the eliminated portion of the crown.
24. The method of claim 22, further comprising: advancing a driving mechanism axially along the guide pin; and coupling the driving mechanism to the hub, the driving mechanism configured to drive the burr around the guide pin.
25. The method of claim 24, wherein coupling the drive mechanism to the hub comprises coupling by a threaded connection.
26. The method of claim 22, further comprising releasing the burr by moving the burr laterally away from the guide pin to pass the guide pin back through the lateral passage slot.
27. The method of claim 22, further comprising milling the bone using bone etching reliefs on a distal surface of the milling body.
28. The method of claim 22, wherein driving the burr around the guide pin forms a concave cavity in the bone.
29. The method of claim 22, wherein prior to laterally moving the burr relative to the guide pin, advancing the free volume of the burr axially over a proximal end of the guide pin and toward a bone engaging end of the guide pin.
30. The method of claim 29, wherein when advancing the free volume of the burr, the burr is at an incline.
31. An orthopedic milling machine for bone preparation, comprising: an orthopedic guide pin comprising a bone engaging end and a free end opposite the bone engaging end, a length of the guide pin comprising the bone engaging end; and a burr comprising: a hub, the burr being configured for rotation about an axis of the hub, the hub comprising a bore adapted to receive the orthopedic guide pin, wherein the axis of the hub intersects the bore, wherein the hub comprises a lateral passage slot that extends radially in the hub and that connects a proximal end of the hub to a distal end of the hub, the lateral passage slot extending circumferentially from a first hub edge to a second hub edge, the first hub edge being spaced apart from the second hub edge by the lateral passage slot, a width of the slot measured from the first hub edge to the second hub edge, the width being at least as large as a diameter at any location along the length of the guide pin; and a milling body that extends transversely to the hub and outwardly surrounds a periphery of the hub at least in part, while leaving an opening of the lateral passage slot open, radially opposite the bore, wherein the milling body comprises a crown spaced radially from the hub, and lugs that connect the hub and the crown in a radial direction and that are distributed around the hub, the lugs each including a bone etching relief, the lugs comprising a first lug and a second lug circumferentially adjacent to the second lug; wherein a portion of the crown extending along an outer periphery of the burr is eliminated from the first lug to the second lug, and wherein the milling machine is configured such that the burr can be moved laterally toward the guide pin, at any location along the length of the guide pin until the guide pin is positioned in the bore.
32. The milling machine of claim 31, wherein the eliminated portion and the lateral passage slot are aligned in a direction radial to the axis of the hub.
33. The milling machine of claim 31, wherein two edges of the eliminated portion are inclined by at least 30 relative to a direction radial to the axis of the hub.
34. The milling machine of claim 31, wherein the milling body extends over only a peripheral portion of the hub, and wherein the lateral passage slot is situated outside the peripheral portion of the hub.
35. The milling machine of claim 31, further comprising a sleeve adapted to be simultaneously engaged around the orthopedic guide pin and coupled to the hub in order to drive the burr around the axis of the hub.
36. The milling machine of claim 35, wherein an interior surface of the hub is threaded such that the sleeve can be threadably connected to the hub.
37. The milling machine of claim 35, wherein the sleeve is positioned between the guide pin and the hub when the sleeve is coupled to the hub.
38. The milling machine of claim 31, wherein the lugs are distributed substantially uniformly around the hub.
39. The milling machine of claim 31, wherein each lug has a lengthwise curvature.
40. The milling machine of claim 31, wherein each bone etching relief extends over an entire length of a distal edge of a corresponding lug.
41. The milling machine of claim 31, wherein each bone etching relief comprises a curvature such that the lugs are able to hollow out a bowl-shaped cavity.
42. The milling machine of claim 31, wherein the first hub edge and the second hub edge form parallel planes.
43. An orthopedic milling machine for bone preparation, comprising: a burr comprising: a hub, the burr being configured for rotation about an axis of the hub, the hub comprising a bore adapted to receive the orthopedic guide pin, wherein the axis of the hub intersects the bore; and a milling body that extends transversely to the hub and outwardly surrounds a periphery of the hub at least in part, wherein the milling body comprises a crown spaced radially from the hub and a plurality of lugs that connect the hub and the crown in a radial direction, the plurality of lugs are distributed around the hub, each of the plurality of lugs comprising a bone etching relief; and means for moving the burr laterally toward an intermediate portion of a guide pin until the guide pin is positioned in the bore.
44. The milling machine of claim 43, further comprising a sleeve adapted to drive the burr around the axis of the hub.
45. The milling machine of claim 44, wherein the sleeve comprises means for coupling to the hub.
46. The milling machine of claim 43, wherein the plurality of lugs are distributed substantially uniformly around the hub.
47. The milling machine of claim 43, wherein each of the plurality of lugs comprises a lengthwise curvature.
48. The milling machine of claim 43, wherein each bone etching relief extends over an entire length of a distal edge of a corresponding lug.
49. The milling machine of claim 43, wherein each bone etching relief comprises a curvature such that the plurality of lugs are able to hollow out a bowl-shaped cavity.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0028]
[0029]
[0030]
[0031]
[0032]
[0033]
[0034]
[0035]
[0036]
[0037]
[0038]
[0039]
[0040] While the invention is amenable to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and are described in detail below. The intention, however, is not to limit the invention to the particular embodiments described. On the contrary, the invention is intended to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the appended claims.
DETAILED DESCRIPTION
[0041]
[0042] According to the embodiments shown in
[0043] On their distal surface, e.g., the surface facing the reader looking at
[0044] Bone etching reliefs may include components other than the blades 14, such as spurs, teeth, tips, and the like. Furthermore, by way of one alternative not illustrated, such bone etching reliefs can be provided on all or part of the distal surface of the crown 12, as well as on all or part of the distal surface of the hub 11. In other words, more generally, the crown 12 and the lugs 13 form, at least in part, a milling body that is arranged coaxially and transversely to the hub 11 and that can assume various forms.
[0045] Given its angular shape, the hub 11 inwardly delimits a bore 15 that is centered on the axis X-X and passes axially all the way through the hub 11, thereby emerging on the distal surface of the hub 11, as shown in
[0046] As shown in
[0047] As illustrated in
[0048] The opposite edges 60, 62 of the passage 17 are separated from one another in a plane perpendicular to axis X-X, with a relative spacing substantially equal to the spacing e between the edges of the slot 16.
[0049] One example of the use of the burr 10 will now be presented in light of
[0050] As shown in
[0051] As shown in
[0052] As visible by comparing
[0053] For the guide pin 30 to be able to pass through the crown 12 via the passage 17, the spacing between the edges 60, 62 of said passage 17 are at least equal to, or slightly larger than the diameter of the guide pin 30, according to embodiments of the present invention. After crossing the passage 17, the guide pin 30 is positioned inside the crown 12, extending axially through the free volume V.
[0054] Still while continuing the lateral approach to the guide pin 30 with the burr 10, the surgeon brings the hub 11 closer to the intermediate portion 64 of said guide pin 30, until said intermediate portion 64 of the guide pin 30 is engaged through the slot 16, as indicated by arrow F3 in
[0055] As shown in
[0056] During coupling operations, the surgeon may manipulate the burr 10 by gripping it by the proximal end of the hub 11. For example, as shown in
[0057] Once the sleeve 21 is secured to the burr 10, as shown in
[0058] The milling of the glenoid G by the burr 10 is thus guided by the guide pin 30, inasmuch as said guide pin constitutes the application axis of the burr 10 on the glenoid G. Once the milling of the glenoid G is finished, the sleeve 21 is, after separating the sleeve 21 and the hub 11, released by sliding the sleeve 21 along the guide pin 30 toward the proximal end of said pin. The surgeon then releases the burr 10 laterally from the guide pin 30, making the intermediate portion of said guide pin successively pass through the slot 16 and the passage 17, following a lateral movement opposite to that described in reference to
[0059]
[0060] It will be noted that the incline of the passage 17 relative to the direction radial to axis X-X means that its opening on the outside is offset, in a peripheral direction of the crown 12, relative to its opening on the free volume V. Consequently, to place the burr 10 on the glenoid G, the burr must be moved in a different manner than the burr described in
[0061]
[0062]
[0063] Similar to the burr 10, the burr 110 includes an inner annular hub 111, which is centered on axis X-X and inwardly delimits a through bore 115, and a milling body that extends transversely around the hub 111. This milling body includes an outer crown 112 and five lugs 113. The lugs 113 connect the hub 111 and the crown 112 in a direction substantially radial to axis X-X and are distributed around that axis along the periphery of the hub 111. Similarly to the lugs 13 of the burr 10, the lugs 113 of the burr 110 include cutting blades 114 on their distal surfaces.
[0064] The lugs 113 differ from the lugs 13 in that, in a cutting plane perpendicular to axis X-X, they have a substantially rectilinear profile. Furthermore, unlike the lugs 13 that are all individually identical, the lugs 113 are broken down into a group of four identical lugs 113. The remaining lug 113 differs from the other lugs 113 by the presence of an opening 119 that passes all the way through the lug 113 in the direction of axis X-X, thereby connecting the distal and proximal surfaces of said lug, and running over the entire radial dimension of the lug 113, thereby connecting the inner and outer ends of said lug. More specifically, at the outer end of the aforementioned lug 113, an opening 119 emerges on the outer peripheral surface of the crown 112, while, at the inner end of said lug 113, the opening 119 is extended by a slot 116, functionally similar to the slot 16, delimited through the annular wall of the hub 111. As visible in
[0065] The burr 110 is used in substantially the same way as the burr 10: before coupling the hub 111 to the sleeve 21 that slides along the guide pin 30, the burr 110 is brought closer to said guide pin 30 laterally to the intermediate portion thereof, so as to radially engage said intermediate portion of the guide pin 30 through the opening 119 and the slot 116 successively, until reaching the inside the bore 115.
[0066]
[0067] The burr 210 includes an annular hub 211, centered on an axis X-X and functionally similar to the hub 11 or 111 of the burrs 10 or 110.
[0068] The bur 210 differs from the burrs 10 and 110, for example, by the overall shape of its milling body; in fact, this body extends over a peripheral portion of the hub 211 and consists of a crown portion 212 connected to the hub 211 by one or more radial lugs 213. On its distal surface, the crown portion 212 is provided with an etching or toothing 214 for milling the glenoid bone matter. In some embodiments, the milling body of the burr 210 has a bulk that is globally much smaller than that of the milling body of the burrs 10 and 110. It is thus understood that the burr 210 may be used to produce bone preparations on a smaller scale.
[0069] For balancing reasons, the burr 210 advantageously includes a counterweight 212, which extends transversely from the hub 211 and which is arranged diametrically opposite the crown portion 212.
[0070] Similarly to the hub 11 or 111 of the burrs 10 and 110, the hub 211 of the burr 210 simultaneously delimits an inner bore 215, centered on axis X-X, and a lateral slot 216, which connects the inside of the bore 215 and the outside of the hub 211 in a direction radial to axis X-X. As visible in
[0071] The use of the burr 210 is similar to that described above for the burrs 10 and 110, in that the placement of the burr 210 on a glenoid to be milled, provided beforehand with the guide pin 30, consists of bringing the burr 210 closer to said guide pin 30 laterally to the intermediate portion of said guide pin 30 so as to radially engage said intermediate portion of the guide pin through the slot 216 until it reaches the inside of the bore 215.
[0072] Various arrangements and alternatives to the milling machine described above, in particular the burrs 10, 110 and 210, can also be included alone or in combination, including but not limited to one or more of the following characteristics and/or features: [0073] by way of non-illustrated alternatives for the burrs 10 and 110, their crown 12, 12, or 112 can be eliminated at one or more portions along their periphery, or over the entire periphery thereof, in particular for small burrs; [0074] by way of non-illustrated alternatives for the burr 210, the counterweight 212 can be replaced by a toothed crown portion, symmetrical to the crown portion 212 relative to axis X-X; [0075] rather than having a circular base, the milling body of the burrs 10, 110 and 210 can be centered on axis X-X while having an oval or ovoid or multi-lobed base; [0076] as mentioned above, the geometry of the cavity hollowed out by the burrs 10, 110 and 210 in the bone material is not a necessary limitation of those embodiments; thus, in return for ad hoc arrangements of the distal surface of their milling body, these burrs can perform both a concave spherical activity as described above, or a convex spherical relief, a planar resection, a cavity with a spherical central region and a flat peripheral edge, and the like; and/or [0077] embodiments of the invention can be applied to orthopedic milling machines intended to be used on bones other than the glenoid of a shoulder blade; thus, embodiments of the invention are for example applicable to milling the humerus or the bones of the hand or foot.
[0078] Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the present invention. For example, while the embodiments described above refer to particular features, the scope of this invention also includes embodiments having different combinations of features and embodiments that do not include all of the described features. Accordingly, the scope of the present invention is intended to embrace all such alternatives, modifications, and variations as fall within the scope of the claims, together with all equivalents thereof.