Medical Device and method for treatment of a hip joint

Abstract

A medical device for delivering an action to an area of a hip joint or its surroundings, inside a human body, is provided. The hip joint of a patient comprises a collum femur and a ball shaped caput femur, being the proximal parts of the femoral bone, and an acetabulum, being a bowl shaped part of the pelvic bone. The medical device comprising; an elongated member, having a length axis along its elongated distribution, comprising a first portion, adapted to enter the body of the patient, and a mechanical element, adapted to be used during an operation in the hip joint or its surroundings, inside the body. The first portion of the elongated member comprises a holding member adapted to hold the mechanical element inside the body of the patient, wherein the first portion of the elongated member have a first portion cross-section area substantially perpendicular to the length axis of the elongated member. The first portion is adapted to pass through a hole, in a bone of the patient, the hole having a hole cross-section area. The first portion cross-section area, is adapted to be smaller than said hole cross-section area. The mechanical element have a functional status, ready to deliver said action inside said body, when held by the holding member inside the body of the patient. The mechanical element is adapted to have a mechanical element cross-sectional area substantially perpendicular to the length axis of the elongated member, substantially larger than the first portion cross-sectional area and adapted to be unable to pass through the hole, when the mechanical element is in the functional status.

Claims

1-124. (canceled)

125. A method of performing an action in a hip joint of a human patient, said method comprising creating a first hole in the skin of a patient creating a second hole in the pelvic bone from the abdominal side, inserting a tool through said second hole, performing an action with said tool.

126. The method of claim 125 wherein the tool comprises a drill and the method comprises performing a drilling action.

127. The method of claim 125 wherein the tool comprises a reaming tool and the method comprises performing a reaming action.

128. The method of claim 125, wherein the method further comprises inserting a medical implantable device through said second hole in the pelvic bone.

129. The method of claim 128, wherein the method further comprises positioning the medical implantable device to a desired position in the human patient.

130. The method of claim 125, wherein the method further comprises fixating a fixation element to said area of the hip joint or it's surroundings.

131. The method of claim 128, wherein the method further comprises rotating the medical implantable device.

132. The method of claim 125, wherein the step of inserting the tool in the second hole comprises inserting an elongated member comprising said tool into said second hole.

133. The method of claim 125, wherein the method further comprises the step of injecting a fluid into said area of the hip joint.

134. The method of claim 125, wherein said method further comprises the step of injecting bone cement into said area of the hip joint or it's surroundings.

135. The method of claim 125, wherein said method further comprises dissecting the hip joint preparing for an artificial hip joint surface.

136. method of performing an action in a hip joint of a human patient, said method comprising creating a first hole in the skin of a patient creating a second hole in the pelvic bone from the abdominal side, inserting an elongated member through said second hole, said elongated member comprising a tool, performing an action with said tool.

137. The method of claim 136, wherein the method further comprises inserting a medical implantable device through said second hole in the pelvic bone.

138. The method of claim 135, wherein the method further comprises fixating a fixation element to said area of the hip joint or it's surroundings.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0071] Embodiments will now be described, by way of example, with reference to the accompanying drawings, in which:

[0072] FIG. 1 shows the hip joint in section,

[0073] FIG. 2 shows a frontal view of a human patient when incisions have been performed in a surgical method,

[0074] FIG. 3 shows a frontal view of a human patient when incisions have been performed in a laparoscopic/arthroscopic method,

[0075] FIG. 4 shows the human patient in section when a tool is provided from the abdominal side of the pelvic bone,

[0076] FIG. 5a shows the hip joint in section and different tools,

[0077] FIG. 5b shows the hip joint in section and different tools,

[0078] FIG. 6 shows the hip joint in section when a tool for creating a hole in the pelvic bone is used,

[0079] FIG. 7 shows the hip joint in section when a hole has been created in the pelvic bone,

[0080] FIG. 8 shows a tool adapted to create a hole in the pelvic bone in further detail,

[0081] FIG. 9 shows a tool adapted to create a hole in the pelvic bone in further detail,

[0082] FIG. 10 shows the hip joint in section when a tool adapted to ream is used,

[0083] FIG. 11a-c shows an expandable reamer in further detail,

[0084] FIG. 11d-g shows the hip joint in section when a mechanical element is provided,

[0085] FIG. 12 shows the hip joint in section when an artificial hip joint surface is provided,

[0086] FIG. 13a,b shows a prosthetic part for insertion in a hole in the pelvic bone,

[0087] FIG. 14 shows the hip joint in section when a prosthetic part has been placed in the hole in the pelvic bone,

[0088] FIG. 15 shows the hip joint in section when a bone plug have been placed in the hole in the pelvic bone,

[0089] FIG. 16 shows the placing of an artificial acetabulum concave surface in the collum femur,

[0090] FIG. 17 shows the hip joint in section when a convex surface is placed in the concave surface in the collum femur,

[0091] FIG. 18 shows the placing of a prosthetic part in a hole in the pelvic bone,

[0092] FIG. 19 shows the hip joint in section when the operating of FIGS. 16, 17 and 18 has been concluded,

[0093] FIG. 20 shows the hip joint in section when a liquid is being injected in holes in the femoral bone and the pelvic bone,

[0094] FIGS. 21a and 21b shows the suturing and stapling of the incisions made in the operation.

DETAILED DESCRIPTION

[0095] An action in the hip joint is to be understood as a force, movement or insertion of any tool, prosthesis, prosthetic parts or fluid in the hip joint.

[0096] Force is to be understood as any kind of movement or torque that could be needed to perform a step in the medical treatment of a hip joint of a human patient. The force could be a rotating, reciprocating or oscillating movement, created by an operating device or manual manipulation. It is further conceivable that said force comprises two or more components which could be two or more rotating, reciprocating or oscillating components, or any combination thereof. The operating device could for example be an electrical, hydraulic or pneumatic motor.

[0097] Elongated member is to be understood as any element able to transfer an action or force according to the definition herein. The elongated member could be a stiff or flexible rod, shaft or wire. It is furthermore conceivable that the elongated member could have a part or section adapted to be bent such as a universal joint or at least two gear wheels or worm gears.

[0098] The mechanical element adapted to be fixated to the elongated member is to be understood as a tool or means for fixating a tool or a prosthetic part. A prosthetic part could be an artificial caput femur surface and/or an artificial acetabulum surface.

[0099] Area of the hip joint or its surroundings is to be understood as the immediate area of the hip joint as shown in FIG. 1, together with the abdominal, pelvic and inguinal areas which could be affected in an operation of the hip joint.

[0100] Fixation element is to be understood as a mechanical element which has properties for fixating or assisting in the fixation of prosthesis or a prosthetic part to a human patient.

[0101] Manipulating an implantable device is to be understood as the process of positioning a prosthesis or prosthetic part to a desired position in the human patient. For example the process of manipulating can comprise: rotating, turning, bending or attaching.

[0102] In the following a detailed description of embodiments will be given. In the drawing figures, like reference numerals designate identical or corresponding elements throughout the several figures. It will be appreciated that these figures are for illustration only and are not in any way restricting the scope of the invention. Thus, any references to direction, such as up or down, are only referring to the directions shown in the figures. Also, any dimensions etc. shown in the figures are for illustration purposes.

[0103] FIG. 1 shows the hip joint of a human patient in section. The hip joint comprises a caput femur 5 placed at the very top of collum femur 6 which is the top part of the femoral bone 7. The caput femur is in connection with the acetabulum 8, which is a bowl shaped part of the pelvic bone 9. Both the caput femur surface 10 and the acetabulum surface 11 is covered with articular cartilage 13 which acts as a cushion in the hip joint. In patients with hip joint osteoarthritis, this articular cartilage 13 is abnormally worn down due to a low grade inflammation. The hip joint is surrounded by the hip joint capsule 12 which provides support for the joint and hinders luxation. After conventional hip joint surgery, penetrating the hip joint capsule 12, the capsule 12 is dramatically weakened due to the limited healing possibilities of its ligament tissue. By performing hip joint surgery without damaging the hip joint capsule 12 the patient can fully recover and place equal amount of strain on an artificial joint as is possible on a natural one.

[0104] FIG. 2 shows a frontal view of a human patient when an incision for reaching an area of the hip joint through the pelvic bone in a surgical method has been performed. According to one embodiment the incision 1 is made in the abdominal wall of the human patient. The incision 1 passes preferable through the rectus abdominis and through the peritoneum, in to the abdomen of the human patent. In a second embodiment the incision 2 is conducted through the rectus abdominis and in to the pelvic area, below peritoneum. According to a third embodiment the incision 3 is performed just between Illium and the surrounding tissue, an incision 3 which could enable the pelvic bone to be dissected with very little penetration of fascia and muscular tissue. According to a fourth embodiment the incision 4 is made in the inguinal channel. In all of the four embodiments the tissue surrounding the pelvic bone 9 in the area opposite to acetabulum is removed or penetrated which enables the surgeon to reach the pelvic bone 9.

[0105] FIG. 3 shows a frontal view of a human patient when small incisions for reaching an area of the hip joint through the pelvic bone in a laparoscopic/arthroscopic method has been performed. According to a first embodiment the incisions 14 is made in the abdominal wall of the human patient. The small incisions enable the surgeon to insert laparoscopic trocars into the abdomen of the human patient. According to the first embodiment the incisions 14 passes through the rectus abdominis and peritoneum, in to the abdomen of the human patent. According to a second embodiment the small incisions 15 is conducted through the rectus abdominis and in to the pelvic area, below peritoneum. According to a third embodiment the small incisions 16 is performed just between Illium and the surrounding tissue, an incision 16 which could enable the pelvic bone to be dissected with very little penetration of fascia and muscular tissue. According to a fourth embodiment the incision 17 is made in the inguinal channel. In all of the four embodiments the tissue surrounding the pelvic bone 9 in the area opposite to acetabulum 8 is removed or penetrated which enables the surgeon to reach the pelvic bone 9.

[0106] FIG. 4 shows a human patient in section when an incision 1 is made in the abdominal wall of the human patient, and a second incision 200 in made in the lateral part of the left thigh. A drilling member 201 has been introduced through the incision 200 in the thigh, penetrating the fascia lata, and reaching the femoral bone 7. After the drilling member 201 has made contact with the femoral bone 7, a drilling process is started which creates a hole 205 in the cortical bone of the femoral bone 7 and into the cancellous bone of the femoral bone 7, the hole 205 then propagates along a length axis of the collum femur 6 and eventually reaches the caput femur 5, from the inside thereof. The caput femur 5 is penetrated from the inside and the drilling member 201 continues to the acetabulum 8 which is a bowled shaped part of the pelvic bone 9. The drilling member 201 penetrates the pelvic bone 9 and continues into the abdominal area of the human patient. The drilling member 201 is then retracted from the hole 205 which leaves a hole 205 reaching from the lateral side of the thigh, to the area of the hip joint. The drilling member 201 is powered by an operating device 202 which could be an electrically, hydraulically or pneumatically powered operating device 202.

[0107] After the hole 205 has been created along a length axis of the collum femur 6, an elongated member 206 is inserted through the hole 205. The elongated member 206 could be a tubular or solid shaft, or a flexible member 206b such as a wire.

[0108] FIG. 5a shows the hip joint in section when an elongated member 206 has been inserted through the hole 205 in the femoral bone 7. The elongated member 206 comprises a tool fixating member/holding member 218 positioned on the end of the elongated member 206. The tool fixating member/holding member 218 could comprise a screw-thread or a bayonet joint which could be activated to fixate a mechanical element 224, such as a tool 224,225,226, to the elongated member 206, by means of manual manipulation or an operating device 202. The mechanical element is adapted for delivering an action to an area of a hip joint or its surroundings. The elongated member 206 further comprises a mounting portion 251 to which a mechanical element 224 can be mounted. The mechanical element 224 comprises a mounting recess 250 for mounting the mechanical element 224 onto the mounting portion 251 in a direction substantially perpendicular to the elongated member 206.

[0109] The mechanical element 224 could be a tool 224 for creating a hole in the pelvic bone 9, a tool 225 for manipulating an implantable device such as a prosthesis or a prosthetic part, or a tool 226 for reaming the acetabulum 8 and/or the caput femur 5. The tools comprise a fixating member 219 which acts together with the tool fixating member/holding member 218 on the elongated member 206 to fixate the tool 224,225,226 to the elongated member 206. The tools 224,225,226 are inserted through the incision in the abdominal region, as shown in FIG. 4. where a tool 224 for creating a hole in the pelvic bone 9 is inserted through an incision 1 in the abdominal region of the human patient using a tool introducing member 203. The elongated member 206 has a length axis along its elongated distribution having a first portion cross-section area substantially perpendicular to the length axis of the elongated member, the elongated member 206 comprises a holding member 218 adapted to hold said mechanical element inside the body of said patient, and a mounting portion 251. The mechanical element 224,225,226 comprises at least one mounting recess 250 for mounting the mechanical element 224,225,226 onto the mounting portion 251 in a direction substantially perpendicular to the elongated member 206. The mechanical element 224,225,226 is adapted to be used during an operation in the hip joint or its surroundings, when placed inside the body. The elongated member 206 is adapted to pass through a hole in a bone of the patient, the hole having a hole cross-section area. The first portion cross-section area is smaller than the hole cross-section area, and the mechanical element has a functional status, ready to deliver an action inside the body. The mechanical element 224,225,226 cross-sectional area substantially perpendicular to the length axis of the elongated member 206, being substantially larger than the first portion cross-section area and unable to pass through the hole when said mechanical element is in said functional status.

[0110] The elongated member 206 is according to this embodiment long enough to pass through a hole in the femoral bone 7, through the hip joint and through a hole in the pelvic bone 9 entering the abdominal cavity.

[0111] FIG. 5b shows the hip joint in section when a elongated member 206b has been inserted through the hole 205. According to this embodiment the elongated member 206b is a flexible elongated member 206b, such as a wire, enabling the elongated member 206b to be bent for simplified handling and/or improved reach. The elongated member 206b comprises a tool fixating member 218 positioned on the end of the elongated member 206b. The tool fixating member 218 could be activated to fixate a tool 224,225,226 to the elongated member 206b, by means of manual manipulation or an operating device 202. The elongated member 206 further comprises a mounting portion 251 to which a mechanical element 224 can be mounted. The mechanical element 224 comprises a mounting recess 250 for mounting the mechanical element 224 onto the mounting portion 251 in a direction substantially perpendicular to the elongated member 206. FIG. 5 further shows a tool for creating a hole 224 in the pelvic bone 9, a tool 225 for manipulating an implantable device such as a prosthesis or a prosthetic part, and a tool 226 for reaming the acetabulum 8 and/or the caput femur 5. The tools comprises a fixating member 219 which acts together with the tool fixating member 218 on the elongated member 206b to fixate the tool 224,225,226 to the elongated member 206. The tools 224,225,226 are inserted through the incision in the abdominal region, as shown in FIG. 4, where a tool 224 for creating a hole in the pelvic bone 9 is inserted through an incision 1 in the abdominal region of the human patient using a tool introducing member 203. The elongated member 206 has a length axis along its elongated distribution having a first portion cross-section area substantially perpendicular to the length axis of the elongated member, the elongated member 206 comprises a holding member 218 adapted to hold said mechanical element inside the body of said patient, and a mounting portion 251. The mechanical element 224,225,226 comprises at least one mounting recess 250 for mounting the mechanical element 224,225,226 onto the mounting portion 251 in a direction substantially perpendicular to the elongated member 206. The mechanical element 224,225,226 is adapted to be used during an operation in the hip joint or its surroundings, when placed inside the body. The elongated member 206 is adapted to pass through a hole in a bone of the patient, the hole having a hole cross-section area. The first portion cross-section area is smaller than the hole cross-section area, and the mechanical element has a functional status, ready to deliver an action inside the body. The mechanical element 224,225,226 cross-sectional area substantially perpendicular to the length axis of the elongated member 206, being substantially larger than the first portion cross-section area and unable to pass through the hole when said mechanical element is in said functional status.

[0112] The elongated member 206 is according to this embodiment long enough to pass through a hole in the femoral bone 7, through the hip joint and through a hole in the pelvic bone 9 entering the abdominal cavity.

[0113] FIG. 6 shows the hip joint in section when a tool 224 for creating a hole 18 in the pelvic bone is fixated to the tool fixating member 219 on the elongated member 206. When the tool 224 for creating a hole in the pelvic bone 9 is applied to the elongated member 206, the elongated member 206 is preferably operated using an operating device 202, which could be an electrical, hydraulic or pneumatic operating device. The tool for creating a hole in the pelvic bone 9 comprises a bone contacting organ 22 which is adapted to create the hole 18 in the pelvic bone 9 through a sawing, drilling or milling process powered by a rotating, vibrating or oscillating movement of the elongated member 206.

[0114] FIG. 7 shows the hip joint in section when the hole 18b in the pelvic bone 9 has been created. According to the embodiment shown the hole 18b is created through the creation of a bone plug 207 which can be adapted to be replaced after the steps of the operation performed through the hole 18b in the pelvic bone 9 has been concluded.

[0115] FIG. 8 shows the tool 224 for creating a hole 18b in the pelvic bone 9 in further detail. The bone contacting organ 22 is according to this embodiment adapted to create a bone plug 207. The tool 204 further comprises two holding members 150 for holding said bone plug 207 in place after it has been removed from the pelvic bone 9 of the human patient.

[0116] FIG. 9 shows the tool 224 for creating a hole 18b in the pelvic bone 9 according to an embodiment wherein said tool further comprises at least one of: at least one camera 163, at least one light source 164, at least one measurement device 162 for measuring the depth of said hole 18b in the pelvic bone 9 and at least one torque meter 165 for sensing the torque exerted on the bone contacting organ 22 from the connection with the elongated member and the operating device 202.

[0117] After the step of creating a hole in the pelvic bone has been concluded the surfaces of the acetabulum 8 and/or the caput femur 5 needs to be prepared.

[0118] FIG. 10 shows the reaming of the acetabulum 8 and/or the caput femur 5 using a reamer 226 comprising reaming blades 40. The reamer 226 is adapted to be introduced through the pelvic bone 9 through an incision as shown in FIG. 2. The reamer 226 is operated through manual manipulation or an operating device 202.

[0119] FIG. 11a shows the reamer 226 according to an embodiment where the reamer 226 is adapted to be expandable. The reaming blades 42 are folded which facilitates the introduction of the reamer 226 through the hole 18b in the pelvic bone 9.

[0120] FIG. 11b shows the expandable reamer in its reaming state with the reaming blades 40 unfolded. The reaming blades 40 comprise an abrasive material which removes material, shapes and smoothens the surface of the acetabulum 8 and/or the caput femur 5. 41a denotes the abrasive material on the outside of the reaming blade 40, adapted to ream the acetabulum 8 surface.

[0121] FIG. 11c shows the expandable reamer from the inside thereof, with the reaming blades 40 and the abrasive material 41b adapted to ream the caput femur 5.

[0122] After the surfaces of the caput femur 5 and/or the acetabulum 8 has been prepared the step of providing the surfaces with an artificial acetabulum surface 65 and/or caput femur surface 65 is performed.

[0123] FIG. 11d shows the medical device for delivering an action to an area of a hip joint or its surroundings, inside a human body. The hip joint of a patient comprises a collum femur 6 and a ball shaped caput femur 5, being the proximal parts of the femoral bone 7, and an acetabulum 8, being a bowl shaped part of the pelvic bone 9. The medical device according to the embodiment shown comprises an elongated member 206, having a length axis along its elongated distribution, comprising a first portion 206, adapted to enter the body of the patient, and a mechanical element 226, such as a reaming tool 226, adapted to be used during an operation in the hip joint or its surroundings, inside the body. The first portion 206 of the elongated member comprises a holding member 218, such as a tool fixating member 218, adapted to hold the mechanical element 226 inside the body of the patient, wherein the first portion of the elongated member 206 have a first portion cross-section area 247, shown in the section A-A, substantially perpendicular to the length axis of the elongated member 206. The first portion 206 is adapted to pass through a hole 205, in a bone of the patient, the hole 205 having a hole cross-section area 248, shown in section A-A. The first portion cross-section area 248, is adapted to be smaller than said hole cross-section area 247. The mechanical element 226 is in FIG. 11d shown in its functional status, ready to deliver an action inside the body, when held by the holding member 246 inside the body of the patient. The mechanical element 226 is adapted to have a mechanical element cross-sectional area 249, shown in section B-B, substantially perpendicular to the length axis of the elongated member 206, substantially larger than the first portion 206 cross-sectional area 247 and adapted to be unable to pass through the hole 205, when the mechanical element 226 is in the functional status. FIG. 11d furthermore shows the second portion 206 of the elongated member 206 adapted to remain outside of the body of the patient when the medical device is in use. The second portion 206 of the elongated member 206 could be adapted to be connected to an operating device 202 for operating the medical device. The mechanical element shown in FIG. 11d is a reaming tool, however the mechanical element could be any mechanical element for delivering any action, such as drilling, reaming, placing, connecting attaching, fixating, delivering an object, delivering a fluid or providing an optical view of the hip joint.

[0124] FIG. 11e shows the medical device according to an embodiment in which the first portion of the elongated member 240 is adapted to pass through the skin of the patient, through the pelvic bone 9, through the abdominal cavity, through the pelvic bone 9 on the opposite side, and into the hip joint.

[0125] FIG. 11f shows the elongated member 240 further detail, first in a state in which a protective sleeve is advanced for covering the drilling member 201 and thereby protecting the organs and tissue of the human body from the drilling member. Below, the drilling member is shown in a second state, in which the protective sleeve is retracted and thereby exposing the drilling member 201 and enabling the drilling member 201 to create a hole in bone.

[0126] FIG. 11g shows the medical device according to an embodiment in which the first portion of the elongated member 240 is adapted to enter the body of the patient is long enough to pass through a hole in the femoral bone 7, through the hip joint and through a hole in the pelvic bone 9 entering the abdominal cavity and through the pelvic bone 9 on the opposite side and further out through the skin of the patient. The arrow shows the mounting direction of a mechanical element comprising at least one mounting recess for mounting the mechanical element onto the mounting portion of the elongated member in a direction substantially perpendicular to the elongated member.

[0127] FIG. 12 shows the step of providing an artificial caput femur surface 45 which is inserted through the incision according to FIG. 2 or FIG. 3. The artificial caput femur surface 45 is then mounted on to the elongated member 206 which acts a guide for the surface 45, facilitating the introduction and fixation of said surface 45. However it is furthermore conceivable that the elongated member is replaced by a guiding rod (not shown) adapted to guide the artificial caput femur surface 45 on to the caput femur 5.

[0128] FIG. 13a shows, schematically how a prosthetic part 98 is inserted in a hole 18b in the pelvic bone 9. The prosthetic part 98 comprises supporting members 99, which are adapted to support the weight of the human patient through the connection with the pelvic bone 9. The prosthetic part 98 is guided by the elongated member 900 through a guiding hole 910 being placed centrally in the prosthetic part 98. The supporting members 99 corresponds to sections in the hole 18b in the pelvic bone 9, which enables the insertion of the prosthetic part 98 through the hole 18b in the pelvic bone 9, and enables the prosthetic part 98 to carry the load from the human patient through the connection with the pelvic bone 9. The artificial acetabulum surface 65 could be a part of the prosthetic part 98 or a part adapted to be placed in the hip joint before the prosthetic part 98.

[0129] FIG. 13b shows the prosthetic part 98 when inserted and rotated to carry the load placed on the acetabulum surface 65 through the connection with the pelvic bone 9.

[0130] FIG. 14 shows the hip joint in section when a prosthetic part 98 has been provided. The supporting members 99 are placed in connection with the pelvic bone 9. The artificial acetabulum surface 65 is herein integrated with the prosthetic part 98.

[0131] FIG. 15 shows the hip joint in section when the bone plug 207 has been replaced after an artificial caput femur surface 45 and an artificial acetabulum surface 65 has been provided. The bone plug 207 is fixated to the pelvic bone by means of screws 208a, 208b which can be placed from the pelvic bone 9 and into the bone plug 207, denoted 208b, and from the bone plug 207 and into the pelvic bone 9, denoted 208a. The elongated member 900 has been removed from the hole 902 in the femoral bone 7 and the pelvic bone 9.

[0132] FIG. 16 shows the placing of a concave acetabulum surface 110 in the collum femur 6 from the abdominal side of the pelvic bone 9. The concave acetabulum surface 110 is guided by the elongated member 206 placed in a hole 205 in the femoral bone 7.

[0133] FIG. 17 shows a convex caput femur surface being placed in the concave acetabulum surface 110 in the collum femur 6 from the abdominal side of the pelvic bone 9. The convex caput femur surface 112 is guided by the elongated member 900 and placed in the concave acetabulum surface 110, thus creating an opposite embodiment.

[0134] FIG. 18 shows the placing of a prosthetic part 118 in the pelvic bone 9 from the abdominal side of acetabulum 9. The prosthetic part comprising a hole in which the convex caput femur surface is placed and fixated by means of the screw threads 130 on the convex caput femur surface and the nut placed from the abdominal side of the pelvic bone 9.

[0135] FIG. 19 shows the hip joint in section after the operation shown in FIGS. 16, 17 and 18 has been concluded. The prosthetic part 118 has been fixated to the pelvic bone 9 using screws 121 placed in the pelvic bone 9 from the abdominal side of the pelvic bone 9, and the elongated member placed in the hole 902 in the femoral bone has been removed. The instant operation creates a hip joint in an opposite embodiment.

[0136] FIG. 20 shows the step of filling the holes 205, 18 created by the drilling member 201. The injecting members 214 is adapted to inject a fluid 213 into said hole 205, said fluid could be bone cement or another biocompatible fluid adapted to harden. The injecting members 214 comprises a piston 216 which transfers force through an injecting member 215 which could be flexible for facilitating the surgeon reaching the area where the hole 205 is located. The injecting members 215 comprises a piston 216 adapted to press the fluid 213 to be injected.

[0137] After the step of injecting a fluid 213 adapted to harden into the hole 205 is concluded the instruments used in the surgical or laparoscopic/arthroscopic method is retracted and the tissue is closed in layers.

[0138] FIG. 21a shows the step of suturing 111 or stapling 110 the incisions made in the surgical method, whereas FIG. 21b shows the suturing 111 or stapling of the small incisions made in the laparoscopic/arthroscopic method. [0139] 1. A medical device for delivering an action to an area of a hip joint or its surroundings, inside a human body of a patient, the hip joint comprising a collum femur and a ball shaped caput femur, being the proximal parts of the femoral bone, and an acetabulum, being a bowl shaped part of the pelvic bone, said medical device comprising; [0140] an elongated member, having a length axis along its elongated distribution, and a first portion being adapted to enter the body of the patient, said first portion of said elongated member having a first portion cross-section area substantially perpendicular to the length axis of the elongated member, the first portion comprising: [0141] i. a mounting portion, and [0142] ii. a holding member adapted to hold a mechanical element inside the body of said patient, [0143] a mechanical element comprising at least one mounting recess or hole for mounting the mechanical element onto the mounting portion in a direction substantially perpendicular to the elongated member, wherein said mechanical element is adapted to be used during an operation in the hip joint or its surroundings, when placed inside the body, wherein; [0144] said first portion is adapted to pass through a hole in a bone of the patient, the hole having a hole cross-section area, wherein said first portion cross-section area is smaller than said hole cross-section area, and said mechanical element, having a functional status ready to deliver an action inside the body when held by said holding member inside the body of the patient, has a mechanical element cross-sectional area substantially perpendicular to the length axis of the elongated member, being substantially larger than said first portion cross-section area and unable to pass through the hole when said mechanical element is in said functional status. [0145] 2. The medical device according to embodiment 1, wherein said mechanical element cross-sectional area is in the interval 1.2-2 times larger than said first portion cross-sectional area more than 2 times larger than said first portion cross-sectional area. [0146] 3. The medical device according to any one of embodiments 1 and 2, wherein the first portion of the elongated member is long enough to pass through a hole in the femoral bone, through the hip joint and through a hole in the pelvic bone entering the abdominal cavity. [0147] 4. The medical device according to any one of embodiments 1-3, wherein the first portion of the elongated member is long enough to pass through a hole in the femoral bone, through the hip joint and through a hole in the pelvic bone, entering the abdominal cavity and through the pelvic bone on the opposite side and further out through the skin of the patient, or through the skin of the patient, through the pelvic bone, through the abdominal cavity, through the pelvic bone on the opposite side, and into the hip joint. [0148] 5. The medical device according to any one of embodiments 1-4, wherein said holding member is adapted to transfer a force from said elongated member to said mechanical element, for delivering said action during the operation. [0149] 6. The medical device according to any one of embodiments 1-5, wherein said mechanical element comprises at least one drilling tool. [0150] 7. The medical device according to embodiment 6, wherein said drilling tool is adapted to create a hole in the pelvic bone by creating a bone plug. [0151] 8. The medical device according to embodiment 7, wherein said drilling tool is adapted to create a hole in the pelvic bone from the abdominal side of the pelvic bone. [0152] 9. The medical device according to any one of embodiments 1-4, wherein said mechanical element comprises at least one reaming tool. [0153] 10. The medical device according to embodiment 9, wherein said reaming tool is adapted to ream the acetabulum of the human patient. [0154] 11. The medical device according to embodiment 9, wherein said reaming tool is adapted to ream the caput femur of the human patient. [0155] 12. The medical device according to any one of embodiments 1-4, wherein said mechanical element comprises at least one tool for fixating a fixation element to the area of the hip joint. [0156] 13. The medical device according to embodiment 12, wherein said fixation element comprises at least one fixation element selected from a group consisting of: [0157] a. at least one screw, [0158] b. at least one pin, [0159] c. at least one portion of at least one of the parts adapted to be introduced into the other part, [0160] d. the parts being adapted to be sliding into the other part, [0161] e. form fitting, [0162] f. welding, [0163] g. adhesive, [0164] h. pin, [0165] i. wire, [0166] j. a ball mounted into a bowl being portions of said parts, [0167] k. a male portion of one part mounted into a female portion of the other part, [0168] l. a key introduced into a lock being portions of said parts, [0169] m. band, and [0170] n. other mechanical connecting members. [0171] 14. The medical device according to any one of embodiments 1-4, wherein said mechanical element comprises at least one fluid injecting tool. [0172] 15. The medical device according to embodiment 14, wherein said fluid injecting tool is adapted to inject adhesive. [0173] 16. The medical device according to embodiment 14, wherein said fluid injecting tool is adapted to inject bone cement. [0174] 17. The medical device according to embodiment 14, wherein said fluid injecting tool is adapted to inject a lubricating fluid. [0175] 18. The medical device according to any one of embodiments 1-4, wherein said tool comprises at least one tool for manipulating an implantable device. [0176] 19. The medical device according to embodiment 18, wherein said implantable device comprises an artificial acetabulum surface. [0177] 20. The medical device according to embodiment 18, wherein said implantable device comprises an artificial caput femur surface. [0178] 21. The medical device according to any one of embodiments 1-4, wherein said medical device further comprises at least one tool adapted to connect to said mechanical element for delivering said action during said operation of said hip joint. [0179] 22. The medical device according to embodiment 21, wherein said tool comprises at least one drilling tool. [0180] 23. The medical device according to embodiment 22, wherein said drilling tool is adapted to create a hole in the pelvic bone. [0181] 24. The medical device according to embodiment 23, wherein said drilling tool is adapted to create a hole in the pelvic bone from the abdominal side of the pelvic bone. [0182] 25. The medical device according to embodiment 21, wherein said tool comprises at least one reaming tool. [0183] 26. The medical device according to embodiment 25, wherein said reaming tool is adapted to ream the acetabulum of the human patient. [0184] 27. The medical device according to embodiment 25, wherein said reaming tool is adapted to ream the caput femur of the human patient. [0185] 28. The medical device according to embodiment 21, wherein said tool comprises at least one tool for fixating a fixation element to said area of the hip joint. [0186] 29. The medical device according to embodiment 28, wherein said fixation element comprises at least one fixation element selected from a group consisting of: [0187] a. at least one screw, [0188] b. at least one pin, [0189] c. at least one portion of at least one of the parts adapted to be introduced into the other part, [0190] d. the parts being adapted to be sliding into the other part, [0191] e. form fitting, [0192] f. welding, [0193] g. adhesive, [0194] h. pin, [0195] i. wire, [0196] j. a ball mounted into a bowl being portions of said parts, [0197] k. a male portion of one part mounted into a female portion of the other part, [0198] l. a key introduced into a lock being portions of said parts, [0199] m. band, and [0200] n. other mechanical connecting members. [0201] 30. The medical device according to embodiment 21, wherein said tool comprises at least one fluid injecting tool. [0202] 31. The medical device according to embodiment 30, wherein said fluid injecting tool is adapted to inject adhesive. [0203] 32. The medical device according to embodiment 30, wherein said fluid injecting tool is adapted to inject bone cement. [0204] 33. The medical device according to embodiment 30, wherein said fluid injecting tool is adapted to inject a lubricating fluid. [0205] 34. The medical device according to embodiment 21, wherein said tool comprises at least one tool for manipulating an implantable device. [0206] 35. The medical device according to embodiment 1, wherein said mechanical element comprises an artificial acetabulum or an artificial acetabulum surface, and wherein said holding member is adapted to hold said artificial acetabulum or said artificial acetabulum surface, for delivering the action to mount the artificial acetabulum or the artificial acetabulum surface in the hip joint, during said operation. [0207] 36. The medical device according to embodiment 1, wherein said mechanical element comprises an artificial caput femur or an artificial caput femur surface, and wherein said holding member is adapted to hold the artificial caput femur or the artificial caput femur surface, for delivering the action to mount the artificial caput femur or the artificial caput femur surface in the hip joint, during said operation. [0208] 37. The medical device according to embodiment 1, wherein said mechanical element comprises an intermediate part adapted to be placed between the acetabulum, or an artificial replacement therefore, and the caput femur, or an artificial replacement therefore.

Elongated Member

[0209] 38. The medical device according to embodiment 1, wherein said elongated member is adapted for rotational movement. [0210] 39. The medical device according to embodiment 1, wherein said elongated member elongated member is adapted for reciprocating movement. [0211] 40. The medical device according to embodiment 1, wherein said elongated member is elongated member adapted for oscillating movement. [0212] 41. The medical device according any one of embodiments 38, 39 and 40, wherein said elongated member comprises a rod. [0213] 42. The medical device according any one of embodiments 38, 39 and 40, wherein said elongated member comprises a wire. [0214] 43. The medical device according any one of embodiments 38, 39 and 40, wherein said elongated member comprises a part or section adapted to be bent. [0215] 44. The medical device according to embodiment 1, wherein said elongated member is adapted to be supported in at least a first and a second supporting points, wherein said first and said second supporting point are separated from each other. [0216] 45. The medical device according to embodiment 44, wherein said first supporting point is a supporting point in the femoral bone and wherein said second supporting point is a supporting point in the pelvic bone. [0217] 46. The medical device according to embodiment 1, wherein the medical device is adapted to control the placing of at least one prosthetic part in said hip joint.

Operating Device

[0218] 47. The medical device according to embodiment 1, wherein the medical device further comprises an operation device adapted to create force. [0219] 48. The medical device according to embodiment 47, wherein said operation device is connected to said elongated member. [0220] 49. The medical device according to embodiment 47, wherein said operation device comprises a motor. [0221] 50. The medical device according to embodiment 49, wherein said motor is an electrical motor. [0222] 51. The medical device according to embodiment 49, wherein said motor is a hydraulic motor. [0223] 52. The medical device according to embodiment 49, wherein said motor is a pneumatic motor. [0224] 53. The medical device according to embodiment 47, wherein said operation device is an operation device adapted for manual manipulation. [0225] 54. The medical device according to embodiment 47, wherein said operation device is adapted to connect to said elongated member in the abdomen of the body. [0226] 55. The medical device according to embodiment 47, wherein said operation device is adapted to connect to said elongated member outside the body lateral of the proximal femoral bone. [0227] 56. The medical device according to embodiment 47, wherein said operation device is connected to said force elongated member outside the body, lateral on the opposite side of said hip joint of said body outside the ilium pelvic bone. [0228] 57. The medical device according to embodiment 1, wherein said elongated member is adapted to receive said force from an operation device in the abdomen. [0229] 58. The medical device according to embodiment 1, wherein said elongated member is adapted to receive said force from an operation device outside the body, lateral of the proximal femoral bone. [0230] 59. The medical device according to embodiment 1, wherein said elongated member is adapted to receive said force from an operation device outside the body, lateral on the opposite side of the hip joint the body outside the ilium pelvic bone.

Centering Device

[0231] 60. A medical device system including the medical device according to embodiment 1, comprising an artificial acetabulum or an artificial acetabulum surface, wherein said elongated member is adapted to center and hold said artificial acetabulum or said artificial acetabulum surface during fixation thereof in the hip joint. [0232] 61. A medical device system including the medical device according to embodiment 1, comprising an artificial caput femur or an artificial caput femur surface, wherein said elongated member is adapted to center and hold said artificial caput femur or said artificial caput femur surface during fixation thereof in the hip joint. [0233] 62. The medical device system according to embodiment 61, further comprising an artificial acetabulum or an artificial acetabulum surface, wherein said elongated member is adapted to center and hold both said artificial caput femur or said artificial caput femur and said artificial acetabulum or said artificial acetabulum surface during fixation thereof in said hip joint. [0234] 63. The medical device system according to embodiment 62, wherein said artificial caput femur surface comprising a convex form towards the center of the hip joint, and said artificial acetabulum surface comprising a concave form towards the center of the hip joint, and wherein said artificial caput femur surface and said artificial acetabulum surface are constructed to be placed in the hip joint in a opposite position towards each other, thus; [0235] said artificial convex caput femur surface is adapted to be fixated to the pelvic bone of the human patient, and said artificial concave acetabulum surface is adapted to be fixated to the femoral bone of the human patient. [0236] 64. A medical device system including the medical device according to embodiment 1, wherein said mechanical element comprises an artificial acetabulum or an artificial acetabulum surface, wherein said elongated member is adapted to center and hold said artificial acetabulum or an artificial acetabulum surface during fixation thereof in said hip joint. [0237] 65. A medical device system including the medical device according to embodiment 1, said mechanical element comprising an artificial caput femur or an artificial caput femur surface, wherein said elongated member is adapted to center and hold said artificial caput femur or said artificial caput femur during fixation thereof in said hip joint. [0238] 66. The medical device system according to embodiment 65, wherein said mechanical element further comprises an artificial acetabulum or an artificial acetabulum surface, wherein said elongated member is adapted to center and hold both said artificial caput femur or said artificial caput femur surface and said artificial acetabulum or said artificial acetabulum surface during fixation thereof in said hip joint. [0239] 67. The medical device system according to embodiment 66, wherein said artificial caput femur surface comprises a convex form towards the center of the hip joint, and said artificial acetabulum surface comprising a concave form towards the center of the hip joint, and wherein said artificial caput femur surface and said artificial acetabulum surface are constructed to be placed in the hip joint in a opposite position towards each other, thus; [0240] said artificial convex caput femur surface is adapted to be fixated to the pelvic bone of the human patient, and said artificial concave acetabulum surface is adapted to be fixated to the femoral bone of the human patient. [0241] 68. A medical device for treating hip joint osteoarthritis in a human patient by providing at least one artificial hip joint surface, said hip joint having a ball shaped caput femur as the proximal part of the femoral bone with a convex hip joint surface towards the center of said hip joint and a bowl shaped acetabulum as part of the pelvic bone with a concave hip joint surface towards the center of said hip joint, the medical device comprising; [0242] an artificial caput femur or an artificial caput femur surface, comprising a convex form towards the center of the hip joint, and/or an artificial acetabulum or an artificial acetabulum surface, comprising a concave form towards the center of the hip joint, wherein said artificial caput femur or said artificial caput femur surface and said artificial acetabulum or said artificial acetabulum surface are constructed to be centered in the hip joint by an elongated member, thus; [0243] said artificial convex caput femur or said artificial convex caput femur surface have a hole in the center of said convex part, for enabling the elongated member to pass through said hole, and/or [0244] said artificial concave acetabulum or said artificial concave acetabulum surface have a hole in the center of said concave part, for enabling the elongated member to pass through said hole. [0245] 69. The artficial hip joint surface according to embodiment 1, wherein said first portion of said elongated member is adapted to be introduced into at least one of the femoral bone and the pelvic bone and wherein said elongated member is further adapted to be introduced into a hole in an artificial hip joint surface, when said artificial hip joint surface is placed inside the human body. [0246] 70. The elongated member according to embodiment 69, wherein said elongated member introduced into said hole in said artificial hip joint surface is adapted to guide said artificial hip joint surface to a correct position inside the human body. [0247] 71. The elongated member according to embodiment 70, wherein said elongated member further is adapted to be fixated to at least one of the femoral bone and the pelvic bone during, when said artificial hip joint surface is placed inside the human body. [0248] 72. The elongated member according to embodiment 69, wherein said elongated member is adapted to be removed from at least one of the femoral bone and the pelvic bone when said artificial hip joint surface is placed inside the hip joint. [0249] 73. The elongated member according to embodiment 70, wherein said elongated member is adapted to be removed from said artificial hip joint surface when said artificial hip joint surface is placed in said correct position inside the hip joint. [0250] 74. The elongated member according to embodiment 69, wherein said elongated member is adapted to have a first and second state, wherein in said first state said elongated member is flexible, and wherein in said second state said elongated member is adapted to be less flexible than in said first state. [0251] 75. The elongated member according to embodiment 70, wherein said elongated member is adapted to guide said artificial hip joint surface in at least one axis. [0252] 76. The elongated member according to embodiment 70, wherein said elongated member is adapted to guide said artificial hip joint surface in at least two axis. [0253] 77. The elongated member according to embodiment 70, wherein said elongated member is adapted to guide said artificial hip joint surface in at least three axis. [0254] 78. The elongated member according to embodiment 70, wherein said elongated member is adapted to guide said artificial hip joint surface in at least one plane. [0255] 79. The elongated member according to embodiment 1, wherein said elongated member is adapted to be placed in a positioning hole of said artificial hip joint surface. [0256] 80. The elongated member according to embodiment 79, wherein said artficial hip joint surface comprises at least two artificial hip joint surface parts, and wherein said elongated member is adapted to be placed in a positioning hole in at least one of said at least two artficial hip joint surface parts. [0257] 81. The elongated member according to embodiment 79, wherein said elongated member, having an area substantially perpendicular to its elongated distribution, is adapted to be positioned in said positioning hole, being substantially circular. [0258] 82. The elongated member according to embodiment 79, wherein said elongated member, having an area substantially perpendicular to its elongated distribution, is adapted to be positioned in said positioning hole being substantially non-circular. [0259] 83. The elongated member according to embodiment 79, wherein said elongated member is adapted to be positioned in said positioning hole, said hole having a cut circumference. [0260] 84. The elongated member according to embodiment 79, wherein said elongated member is adapted to receive said artificial hip joint surface inserted into the hip joint through the hip joint capsule. [0261] 85. The elongated member according to embodiment 79, wherein said elongated member is adapted to receive said artificial hip joint surface inserted into the hip joint through the pelvic bone. [0262] 86. The elongated member according to embodiment 69, wherein said elongated member is adapted to receive said artificial hip joint surface to be mounted onto said elongated member inside of the hip joint.

Method

[0263] 87. A method of delivering an action using the medical device according to any one of embodiments 1-86, to an area of a hip joint of a human patient, the hip joint comprising a collum femur, being the proximal part of the femoral bone, a caput femur, being the upper ball shaped extremity of the femoral bone, and an acetabulum, being a bowl shaped part of the pelvic bone, said method comprising the steps of: [0264] a. penetrating the skin of the human patient, [0265] b. penetrating a bone of the human patient, on a first side thereof, [0266] c. creating a hole in said bone, reaching the area of the hip joint or its surroundings, on a second side of said bone, [0267] d. placing a first portion of said elongated member through said hole, into the human patient, [0268] e. connecting said mechanical element to said elongated member substantially perpendicular to the length axis of the elongated member, on said second side of said bone, [0269] f. holding said mechanical element using said holding member inside of the human patient, [0270] g. delivering an action to said area of the hip joint using said mechanical element, [0271] 88. The method according to embodiment 87, wherein the step of connecting said elongated member to said mechanical element comprises the step of fixating a tool to said elongated member. [0272] 89. The method according to embodiment 88, wherein said method further comprises the step of creating a hole in the pelvic bone using said tool. [0273] 90. The method according to embodiment 88, wherein said method further comprises the step of reaming the acetabulum using said tool. [0274] 91. The method according to embodiment 88, wherein said method further comprises the step of reaming the caput femur, using said tool. [0275] 92. The method according to embodiment 88, wherein the step of fixating said tool to said elongated member comprises fixating said tool to said elongated member from the abdominal side of the pelvic bone. [0276] 93. The method according to embodiment 87, wherein said method further comprises the step of fixating a fixation element to said area of the hip joint or it's surroundings. [0277] 94. The method according to embodiment 87, wherein said method further comprises the step of injecting a fluid into said area of the hip joint. [0278] 95. The method according to embodiment 94, wherein said method further comprises the step of injecting adhesive into said area of the hip joint or it's surroundings. [0279] 96. The method according to embodiment 94, wherein said method further comprises the step of injecting bone cement into said area of the hip joint or it's surroundings. [0280] 97. The method according to embodiment 94, wherein said method further comprises the step of injecting a lubricating fluid into said area of the hip joint. [0281] 98. The method according to embodiment 94, wherein the step of delivering an action to said area of the hip joint comprises the step of manipulating an implantable device in said area of the hip joint or it's surroundings. [0282] 99. The method according to embodiment 98, wherein the step of manipulating an implantable device comprises the step of fixating an artificial acetabulum surface to the pelvic bone. [0283] 100. The method according to embodiment 98, wherein the step of manipulating an implantable device comprises the step of fixating an artificial caput femur surface to the femoral bone. [0284] 101. The method according to embodiment 98, wherein the step of manipulating an implantable device comprises the step of centering an artificial acetabulum surface using said elongated member and the step of fixating said artificial acetabulum surface to the pelvic bone. [0285] 102. The method according to embodiment 98, wherein the step of manipulating an implantable device comprises the step of centering an artificial caput femur surface using said elongated member and the step of fixating said artificial caput femur surface to the pelvic bone. [0286] 103. The method according to embodiment 87, wherein said medical device comprises an artificial acetabulum or an artificial acetabulum surface adapted to be centered and held by said elongated member, during fixation in said hip joint, and wherein said method comprises the step of centering said artificial acetabulum or said artificial acetabulum surface using said elongated member. [0287] 104. The method according to embodiment 87, wherein said medical device comprises an artificial caput femur or an artificial caput femur surface adapted to be centered and held by said elongated member, during fixation in said hip joint, and wherein said method comprises the step of centering said artificial caput femur or said artificial caput femur surface using said elongated member. [0288] 105. The method according to embodiment 87, wherein the step of penetrating the skin is performed at a lateral portion of the thigh. [0289] 106. The method according to embodiment 87, wherein the step of creating a hole in bone comprises creating a hole along the length axis of the collum femur. [0290] 107. The method according to embodiment 87, wherein the step of penetrating the skin is performed lateral and outside the proximal part of the hip bone of the pelvic bone on the opposite said of the hip joint. [0291] 108. The method according to embodiment 87, wherein the step of creating a hole in bone comprises creating a hole in the pelvic hip bone on one side of the human body and a further hole in the pelvic bone on the opposite side of the acetabulum on the other side of the human body. [0292] 109. The method according to embodiment 98, wherein the step of manipulating an implantable device comprises the step of fixating an artificial acetabulum surface to the femoral bone. [0293] 110. The method according to embodiment 98, wherein the step of manipulating an implantable device comprises the step of fixating an artificial caput femur surface to the pelvic bone. [0294] 111. The method according to embodiment 98, wherein the step of manipulating an implantable device comprises the step of centering an artificial acetabulum surface using said elongated member and the step of fixating said artificial acetabulum surface to the femoral bone. [0295] 112. The method according to embodiment 98, wherein the step of manipulating an implantable device comprises the step of centering an artificial caput femur surface using said elongated member and the step of fixating said artificial caput femur surface to the pelvic bone. [0296] 113. A method of centering an artificial hip joint surface in a hip joint of a human patient, said hip joint comprising a collum femur, being the proximal part of the femoral bone, a caput femur, being the upper extremity of the femoral bone, and an acetabulum, being a bowl shaped part of the pelvic bone, said method comprising the steps of: [0297] a. penetrating the skin of a lateral section of the thigh, [0298] b. creating a hole in the collum femur, along a length axis thereof, reaching an area of the hip joint or it's surroundings, [0299] c. placing an elongated member in said hole, [0300] d. dissecting the hip joint preparing for an artificial hip joint surface, [0301] e. placing an artificial hip joint surface in said hip joint, wherein said artificial hip joint surface having a guiding hole adapted to receive said elongated member, [0302] f. introducing said elongated member in said hole of said artificial hip joint surface, [0303] g. guiding said artificial hip joint surface using said elongated member, [0304] h. fixating said artificial hip joint surface in a functional position in said hip joint. [0305] 114. The method according to embodiment 113, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial convex caput femur or an artificial convex caput femur surface. [0306] 115. The method according to embodiment 113, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial concave acetabulum or an artificial concave acetabulum surface. [0307] 116. The method according to embodiment 113, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial concave acetabulum or an artificial concave acetabulum surface, and the step of placing an artificial convex caput femur or an artificial convex caput femur surface. [0308] 117. The method according to embodiment 113, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial convex caput femur or an artificial convex caput femur surface onto the pelvic bone. [0309] 118. The method according to embodiment 113, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial concave acetabulum or an artificial concave acetabulum surface onto the femoral bone. [0310] 119. A method of centering an artificial hip joint surface in a hip joint of a human patient, said hip joint comprising a collum femur, being the proximal part of the femoral bone, a caput femur, being the upper extremity of the femoral bone, and an acetabulum, being a bowl shaped part of the pelvic bone, said method comprising the steps of: [0311] a. performing an abdominal operation, [0312] b. creating a hole in the pelvic bone from the abdominal side opposite the acetabulum, reaching an area of the hip joint, [0313] c. placing an elongated member in said hole passing into said femoral bone, [0314] d. dissecting the hip joint preparing for an artificial hip joint surface, [0315] e. placing an artificial hip joint surface in said hip joint, wherein said artificial hip joint surface having a guiding hole adapted to receive said elongated member, [0316] f. introducing said elongated member in said hole of said artificial hip joint surface, [0317] g. guiding said artificial hip joint surface using said elongated member, [0318] h. fixating said artificial hip joint surface in a functional position in said hip joint. [0319] 120. The method according to embodiment 119, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial convex caput femur or an artificial convex caput femur surface. [0320] 121. The method according to embodiment 119, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial concave acetabulum or an artificial concave acetabulum surface. [0321] 122. The method according to embodiment 119, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial concave acetabulum or an artificial concave acetabulum surface, and the step of placing an artificial convex caput femur or an artificial convex caput femur surface. [0322] 123. The method according to embodiment 119, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial convex caput femur or an artificial convex caput femur surface onto the pelvic bone. [0323] 124. The method according to embodiment 119, wherein the step of placing an artificial hip joint surface comprises the step of placing an artificial concave acetabulum or an artificial concave acetabulum surface onto the femoral bone.