Apparatus for use in surgery

Abstract

The invention provides a targeting device suitable for use in removing a femoral implant from the surrounding tissue, wherein the device comprises: (A) an anterior guide member (1), (B) a posterior guide member (4), (C) an engagement member (7), (D) a first pair of parallel connector rails (509, 510), and (E) an adjustment system (13). When the anterior guide member and the posterior guide member are connected by the first pair of connector rails, via the engagement member, the angled channels of the anterior guide member and the posterior guide member converge in the direction of a distal end, with the convergence angle of the angled channels being in the range of from 2 to 6 degrees, such as from 2 to 5 degrees.

Claims

1. A targeting device suitable for use in removing a femoral implant from the surrounding tissue, wherein the device comprises: an anterior guide member, which comprises a first elongate body provided with a first angled channel therein, running from an entrance at the proximal end of the anterior guide member to an exit at the distal end of the anterior guide member, and where the first elongate body has a first contact element at its distal end for contacting the anterior surface of the shoulder of the femoral implant, and whereby, in use, the exit at the distal end of the anterior guide member is spaced apart from the anterior surface of the shoulder of the implant, a posterior guide member, which comprises a second elongate body provided with a second angled channel therein, running from an entrance at the proximal end of the posterior guide member to an exit at the distal end of the posterior guide member, and where the second elongate body has a second contact element at its distal end for contacting the posterior surface of the shoulder of the implant, and whereby, in use, the exit at the distal end of the posterior guide member is spaced apart from the posterior surface of the shoulder of the implant, an engagement member for locating and engaging the targeting device on the shoulder of the implant, which comprises a third elongate body with an engagement protrusion at its distal end, whereby the engagement protrusion can be received in a recess portion on the shoulder of the implant, and whereby the third elongate body can be located between and aligned with the first elongate body and the second elongate body, such that the elongate axes of the first, second and third elongate bodies are substantially aligned, and with the first and second angled channels converging in the direction of the distal end, a first pair of parallel connector rails, wherein each connector rail can slideably connect the anterior guide member and the posterior guide member via the engagement member, with the connector rails being received in connection bores in the anterior guide member and the posterior guide member, an adjustment system which can adjust the distance between the first elongate body and the third elongate body, so as to move the anterior guide member between a release position and a holding position, and which can adjust the distance between the second elongate body and the third elongate body, so to move the posterior guide member between a release position and a holding position; wherein when the anterior guide member and the posterior guide member are connected by the first pair of connector rails, via the engagement member, the elongate axes of the elongate bodies are substantially aligned and the angled channels converge in the direction of the distal end, with the convergence angle of the angled channels being in the range of from 2 to 6 degrees, such that the engagement protrusion can be located in a recess portion on the shoulder of the implant, with the anterior guide member and the posterior guide member in their release positions, and then the adjustment system can be used to move the anterior guide member towards its holding position until the first contact element contacts the shoulder of the implant, with the exit of the first angled channel lying spaced from the anterior surface of the implant, and to move the posterior guide member towards its holding position until the second contact element contacts the shoulder of the implant, with the exit of the second angled channel lying spaced from the posterior surface of the implant.

2. The targeting device of claim 1, wherein the angled channel in the anterior guide member is an integral part of the anterior guide member and the angled channel in the posterior guide member is an integral part of the posterior guide member.

3. The targeting device of claim 1, wherein the anterior guide member is provided with a recess that extends from its proximal end to its distal end and that can receive an anterior channel providing unit that includes one or more angled channels, wherein the anterior channel providing unit is sized and shaped to slide into and be secured within the recess, extending substantially from the proximal end to the distal end, and wherein the posterior guide member is provided with a recess that extends from its proximal end to its distal end and that can receive a posterior channel providing unit that includes one or more angled channels, wherein the posterior channel providing unit is sized and shaped to slide into and be secured within the recess, extending substantially from the proximal end to the distal end.

4. The targeting device of claim 1, wherein the angle of the (or each) anterior angled channel and the angle of the (or each) posterior angled channel are selected from: 1 degree, 1.5 degrees, 2 degrees, 2.5 degrees and 3 degrees.

5. The targeting device of claim 1, wherein the anterior angled channel(s) and the posterior angled channel(s) have circular cross sections, or square cross sections, or rectangular cross sections, or combinations thereof.

6. The targeting device of claim 1, wherein the first contact element at the distal end of the guide member is a lip or a leg that extends from the distal end of the elongate body, and wherein the second contact element at the distal end of the guide member is a lip or a leg that extends from the distal end of the elongate body.

7. The targeting device of claim 6 wherein each lip or leg is provided with a contact face for contacting the shoulder of the femoral implant.

8. The targeting device of claim 6 wherein each lip or leg is provided with one or more engaging protrusions that can protrude into the cancellous bone anteriorly or posteriorly.

9. The targeting device of claim 1, wherein the first pair of parallel connector rails comprises one proximal rail and one distal rail.

10. The targeting device of claim 9, wherein the proximal rail and the distal rail are located at or near the midpoint between the medial face of the anterior guide member and the posterior guide member and the lateral face of the anterior guide member and the posterior guide member.

11. The targeting device of claim 1, wherein the first pair of parallel connector rails comprises one medial rail and one lateral rail.

12. The targeting device of claim 11, wherein the medial rail and the lateral rail are located at or near the midpoint between the proximal end of the guide members and the distal end of the guide members.

13. The targeting device of claim 1, wherein the adjustment system is a double ended screw.

14. The targeting device of claim 1, wherein the device is made of medical grade stainless steel and/or sterilized plastic.

15. A kit comprising the targeting device as defined in claim 1, together with one or more of: (a) an osteotome device that can remove bony ingrowth located adjacent to the anterior access tunnel, and remove bony ingrowth located adjacent to the posterior access tunnel and the posterior surface of the implant; (b) a curette device that can remove bony ingrowth located between the implant and the femur in the anterior aspect, and remove bony ingrowth located between the implant and the femur in the posterior aspect; (c) a medial-lateral clearance device that can clear the medial surface of the implant of bony ingrowth at or near to where it adjoins the anterior surface of the implant and at or near to where it adjoins the posterior surface of the implant, and that can clear the lateral surface of the implant of bony ingrowth at or near to where it adjoins the anterior surface of the implant and at or near to where it adjoins the posterior surface of the implant; (d) a wire delivery device that can be used for clearing the medial aspect of a collared implant of bony ingrowth.

16. The kit of claim 15, further comprising a chevron chisel which comprises: an elongate body in the form of a flat plate having an upper face and a lower face, wherein the elongate body extends from a first elongate edge to a second elongate edge and having a proximal end that can be provided with a handle and having a distal end; and a cutting portion located at the distal end which comprises a first cutting face and a second cutting face which meet at an angled cutting point, wherein the first cutting face extends at an angle of from 30 to 60 degrees from the first elongate edge when measured with respect to the elongate axis of the elongate body, and the second cutting face extends at an angle of from 30 to 60 degrees from the second elongate edge when measured with respect to the elongate axis of the elongate body, and wherein the first cutting face extends at an angle of from 30 to 60 degrees from the lower face to the upper face, and wherein the second cutting face extends at an angle of from 30 to 60 degrees from the lower face to the upper face.

17. The kit of claim 16, wherein the first cutting face extends at an angle of from 40 to 50 degrees from the first elongate edge when measured with respect to the elongate axis of the elongate body, and the second cutting face extends at an angle of from 40 to 50 degrees from the second elongate edge when measured with respect to the elongate axis of the elongate body, and wherein the first cutting face extends at an angle of from 40 to 50 degrees from the lower face to the upper face, and wherein the second cutting face extends at an angle of from 40 to 50 degrees from the lower face to the upper face.

18. The targeting device of claim 1, wherein the convergence angle of the angled channels is in the range of from 2 to 5 degrees.

Description

DESCRIPTION OF THE DRAWINGS

(1) The invention will now be further described with reference to the drawings, which are exemplary of the invention rather than limiting, and in which:

(2) FIG. 1a is a side (lateral) view of a targeting device of the invention, located on a femoral implant

(3) FIG. 1b is a front view of a targeting device of the invention, located on a femoral implant FIG. 1c is a top view of a targeting device of the invention

(4) FIG. 1d is a perspective view of a channel providing unit for use in the targeting device of the invention

(5) FIG. 1e is a side (lateral) view of a targeting device of the invention, located on a larger sized femoral implant than shown in FIG. 1a

(6) FIG. 1f is a front view of the engagement member of a targeting device of the invention

(7) FIG. 1g is a side view of the engagement member of a targeting device of the invention

(8) FIG. 1h is a cross sectional view of the engagement member of a targeting device of the invention

(9) FIG. 2a is a front perspective view of the anterior guide member of a targeting device of the invention

(10) FIG. 2b is a front perspective view of the engagement member of a targeting device of the invention

(11) FIG. 2c is a front perspective view of the posterior guide member of a targeting device of the invention

(12) FIG. 2d is a side perspective view of the anterior guide member of a targeting device of the invention

(13) FIG. 2e is a cross section of the anterior guide member of a targeting device of the invention, showing the angled channel

(14) FIG. 2f is a cross section of the posterior guide member of a targeting device of the invention, showing the angled channel

(15) FIG. 2g is a side perspective view of the posterior guide member of a targeting device of the invention

(16) FIG. 3a is a perspective view of the osteotome device of the invention

(17) FIG. 3b is a side view of an osteotome device of the invention

(18) FIG. 3c is a plan view of an osteotome device of the invention

(19) FIG. 3d is a detailed view of the osteotome device shown in FIG. 3c

(20) FIG. 3e is a plan view of an alternative osteotome device of the invention

(21) FIG. 4a is a side view of a curette device of the invention

(22) FIG. 4b is a plan view of a curette device of the invention

(23) FIG. 4c is a detailed view of the curette device shown in FIG. 4b

(24) FIG. 4d is a plan view of an alternative curette device of the invention

(25) FIG. 5a is a side view of a medial-lateral clearance device of the invention

(26) FIG. 5b is a plan view of the medial-lateral clearance device of the invention

(27) FIG. 5c is a cross sectional view of the distal end of the medial-lateral clearance device of FIG. 5a

(28) FIG. 5d is a perspective side view of the medial-lateral clearance device, without the handle included

(29) FIG. 5e is another perspective side view of the medial-lateral clearance device, without the handle included

(30) FIG. 6a is a side view of a wire delivery device of the invention

(31) FIG. 6b is a front view of a wire delivery device of the invention

(32) FIG. 7a is a perspective view of a targeting device of the invention, together with a medial targeting device

(33) FIG. 7b is a side view of a targeting device of the invention

(34) FIG. 7c is a cut through view of a targeting device of the invention

(35) FIG. 7d is a perspective view of a targeting device of the invention, together with a medial targeting device and a key

(36) FIG. 8a is a side view of a targeting device of the invention, located on a femoral implant, and together with a medial targeting device

(37) FIG. 8b is a perspective view of a targeting device of the invention, located on a femoral implant, and together with a medial targeting device

(38) FIG. 8c is a front view of a targeting device of the invention, located on a femoral implant, and together with a medial targeting device

(39) FIG. 9a is a perspective view of a targeting device of the invention, together with a medial targeting device and a key

(40) FIG. 9b is a top view of a targeting device of the invention, together with a medial targeting device

(41) FIG. 9c is a side view of a targeting device of the invention

(42) FIG. 9d is a perspective view of the engagement member of a targeting device of the invention

(43) FIG. 10a is a perspective view of an external targeting device of the invention

(44) FIG. 10b is a side view of an external targeting device of the invention

(45) FIG. 11a is a plan view of a medial-lateral clearance device of the invention

(46) FIG. 11b is a side view of the medial-lateral clearance device of the invention

(47) FIG. 11c is a cross sectional view of the distal end of the medial-lateral clearance device of FIG. 11b

(48) FIG. 11d is a perspective view of the distal end medial-lateral clearance device

(49) FIG. 12 is a perspective view of a brace sleeve of the invention

(50) FIG. 13a is a perspective view of a universal handle of the invention

(51) FIG. 13b is an exploded perspective view of a universal handle of the invention

(52) FIG. 13c is a top view of a universal handle of the invention

(53) FIG. 14a is a side view of a wire delivery device of the invention

(54) FIG. 14b a plan view of a wire delivery device of the invention

(55) FIG. 14c is a side view of a wire delivery device of the invention

(56) FIG. 15a is a plan view of a chevron chisel of the invention

(57) FIG. 15b is a side view of a chevron chisel of the invention

(58) FIG. 15c is a perspective view of the distal end of a chevron chisel of the invention.

(59) Embodiments of the targeting device of the invention are shown in FIGS. 1a-h, FIGS. 2a-g, FIGS. 7a-d, FIGS. 8a-c and FIGS. 9a-d.

(60) The targeting device comprises an anterior guide member 1. This comprises a first elongate body provided with a first angled channel 2 therein, running from an entrance 2a at the proximal end of the guide member to an exit 2b at the distal end of the guide member. The first angled channel is at an angle in the range of from 1 to 3 degrees (e.g. 1 to 2.5 degrees) to the elongate axis of the elongate body, ideally 2 degrees or 2.5 degrees or 3 degrees.

(61) The first elongate body also has a first contact element in the form of a leg 3 at its distal end for contacting the shoulder of the femoral implant and for distancing the exit from the shoulder of the implant. In some embodiments (see FIG. 1e) the leg can include perpendicularly extending prongs 3a which can contact and protrude into the surface of the shoulder of the femoral implant, to provide a secure engagement.

(62) The targeting device also comprises a posterior guide member 4, which comprises a second elongate body provided with a second angled channel 5 therein, running from an entrance 5a at the proximal end of the guide member to an exit 5b at the distal end of the guide member. The second angled channel is at an angle in the range of from 1 to 3 degrees (e.g. 1 to 2.5 degrees) to the elongate axis of the elongate body, ideally 2 degrees or 2.5 degrees or 3 degrees.

(63) The posterior elongate body also has a second contact element in the form of a leg 6 at its distal end for contacting the surface of the shoulder of the implant and for distancing the exit from the shoulder of the implant. In some embodiments (see FIG. 1e) the leg can include perpendicularly extending prongs 6a which can contact and protrude into the surface of the shoulder of the femoral implant, to provide a secure engagement.

(64) Different designs of targeting device can be envisaged in terms of the number and location of the angled channels. FIGS. 1a, 2e and 2f show one design. FIG. 1d shows another design. FIGS. 7a-d and 8a-c show yet another design. FIGS. 9a-d shows a yet further design. The invention is also not limited to these illustrated designs.

(65) In some embodiments, there is a single angled channel 2 with entrance 2a in the anterior guide member and a single angled channel 5 with entrance 5a in the posterior guide member. For example, the angled channels may each have a circular cross section. This is shown in FIGS. 1a, 2e and 2f.

(66) In some embodiments, there are two angled channels 2 with entrance 2a in the anterior guide member and two angled channels 5 with entrance 5a in the posterior guide member. For example, the angled channels may each have a circular cross section. The angled channels in the anterior guide member may be co-joined and the angled channels in the posterior guide member may be co-joined. This is shown in FIGS. 9a and 9b.

(67) In some embodiments, there are three angled channels 2 with entrance 2a in the anterior guide member and three angled channels 5 with entrance 5a in the posterior guide member. For example, there may be one channel having a rectangular cross section and two having a circular cross section in each of the anterior guide member and the posterior guide member. The angled channels in the anterior guide member may be co-joined and the angled channels in the posterior guide member may be co-joined. This is shown in FIGS. 7a, 7d and 8b.

(68) The targeting device may optionally also include receiving channels 2c, 5c, for receiving the anterior guide member interlocking component 705 and the posterior guide member interlocking component 706 of the external targeting device as shown in FIGS. 10a-b and described below.

(69) In this embodiment, the targeting device includes a first receiving channel 2c adjacent to the first angled channel 2 and aligned therewith and includes a second receiving channel 5c adjacent to the second angled channel 5 and aligned therewith. The anterior guide member interlocking component 705 and the posterior guide member interlocking component 706 are then received in these channels respectively. The first and second receiving channels 2c, 5c are shown as circular in cross section and these may each have a diameter of from 2 to 4 mm, such as about 3 mm. However, other shapes could be envisaged, e.g. they could have a square cross section, and likewise other sizes could be envisaged. The first and second receiving channels 2c, 5c may be blind channels and may, for example, extend for a depth of from 25 to 40 mm, such as about 30 mm.

(70) The targeting device also comprises an engagement member 7 for locating and engaging the targeting device on the shoulder of the implant. This comprises an elongate body with an engagement protrusion 8 at its distal end. The engagement protrusion 8 can be received in a recess portion R on the shoulder of the implant. The elongate body of the engagement member can be located between and aligned with the elongate body of the anterior guide member 1 and the elongate body of the posterior guide member 4, such that the elongate axes of the elongate bodies are substantially aligned, and with the angled channels 2, 5 converging in the direction of the distal end, ideally at a convergence angle of 4 to 6 degrees, e.g. 4 degrees.

(71) The elongate body of the engagement member may, in one embodiment, comprise a central locking rod 7a, a medial elongate wing 7b and a lateral elongate wing 7c (see FIGS. 1f, 1g, 1h).

(72) In another embodiment the elongate body of the engagement member 7 may be substantially block-shaped. It may be that the block includes a rod 14 extending therethrough, with the distal end of the rod providing the engagement protrusion 8 (see FIG. 2b and FIGS. 7b, 7d and 9a, 9c).

(73) Different designs of targeting device can be envisaged in terms of the number and location of the connector rails. FIGS. 1a-h and 2a-g show one design. FIGS. 7a-d and 8a-c show another design. FIGS. 9a-d show a yet further design. The invention is also not limited to these illustrated designs.

(74) In one embodiment (as shown in FIGS. 1a-h and 2a-g) the targeting device comprises a pair of parallel proximal connector rails 9, 10 and a pair of parallel distal connector rails 11, 12 (see FIGS. 1a-h). Each proximal connector rail can slideably connect the anterior guide member and the posterior guide member via the engagement member, with the connector rails being received in proximal connection bores 9a, 10a in the anterior guide member and the posterior guide member (see FIGS. 2a-g). Each distal connector rail can slideably connect the anterior guide member and the posterior guide member via the engagement member, with the connector rails being received in distal connection bores 11a, 12a, in the anterior guide member and the posterior guide member (see FIGS. 2a-g).

(75) The pair of parallel proximal connector rails 9, 10 and the pair of parallel distal connector rails 11, 12 are fixedly secured to the engagement member 7.

(76) In the embodiment shown in FIG. 1e, one of the pair of parallel proximal connector rails 9 is attached to, or integral with medial elongate wing 7b and the other one of the pair of parallel proximal connector rails 10 is attached to, or integral with lateral elongate wing 7c, whilst one of the pair of parallel distal connector rails 11 is attached to, or integral with medial elongate wing 7b and the other one of the pair of parallel distal connector rails 12 is attached to, or integral with lateral elongate wing 7c.

(77) In another embodiment, the targeting device comprises a first pair of parallel connector rails 509, 510, which comprises one proximal rail 509 and one distal rail 510 (see FIGS. 7a-d).

(78) The pair of parallel connector rails 509, 510 is located at or near the midpoint between the medial face of the guide members and the lateral face of the guide members.

(79) The connector rails are slidably secured to the engagement member. Therefore the proximal connector rail 509 is received in proximal connection bores in the anterior guide member, in the engagement member, and in the posterior guide member, whilst the distal connector rail 510 is received in distal connection bores in the anterior guide member, in the engagement member, and in the posterior guide member (see FIGS. 7b, 7c).

(80) In yet another embodiment, the targeting device comprises a first pair of parallel connector rails 609, 610, which comprises one proximal rail 609 and one distal rail 610, and a second pair of parallel connector rails 611, 612, which comprises one medial rail 611 and one lateral rail 612 (see FIGS. 9a-d).

(81) The first pair of parallel connector rails 609, 610 is located at or near the midpoint between the medial face of the guide members and the lateral face of the guide members. The second pair of parallel connector rails 611, 612 is located at or near the midpoint between the proximal end of the guide members and the distal end of the guide members.

(82) The connector rails are slidably secured to the engagement member. Therefore the proximal connector rail 609 is received in proximal connection bores in the anterior guide member, in the engagement member, and in the posterior guide member, whilst the distal connector rail 610 is received in distal connection bores in the anterior guide member, in the engagement member, and in the posterior guide member (see FIG. 9c). The medial connector rail 611 is received in medial connection bores provided on the anterior guide member, on the engagement member, and on the posterior guide member, whilst the lateral connector rail 612 is received in lateral connection bores provided on the anterior guide member, on the engagement member, and on the posterior guide member (see FIG. 9a, 9b).

(83) As shown in FIGS. 8a and 9b each connector rail may be provided with a spring 550 around its outer circumference that serves to bias the anterior guide member 1 and the posterior guide member 4 into their release positions. The biasing force of the spring 550 can be overcome by use of the adjustment system 13 (as described further below) to move the anterior guide member and the posterior guide member into their holding positions.

(84) The targeting device also comprises an adjustment system, which may be a double ended screw 13 that can adjust the distance between the elongate body of the anterior guide member 1 and the elongate body of the engagement member 7, so as to move the anterior guide member between a release position and a holding position and can simultaneously adjust the distance between the elongate body of the posterior guide member 4 and the elongate body of the engagement member 7, so as to move the posterior guide member between a release position and a holding position.

(85) The double ended screw 13 can be received in a first engaging bore 13a in the anterior guide member, a second engaging bore 13c in the posterior guide member and a non-engaging bore 13b in the engagement member.

(86) In the embodiment shown in FIGS. 1a-h and 2a-g, this series of bores 13a, 13b, 13c is parallel to the connection bores 9a, 10a, 11a, 12a. Therefore in use the anterior guide member, the engagement member and posterior guide member are connected and aligned using the pair of proximal connector rails 9, 10 and the pair of distal connector rails 11, 12 and the double ended screw 13.

(87) In the embodiment shown in FIGS. 7a-d, this series of bores is parallel to the connection bores for the proximal rail 509 and the distal rail 510. Therefore in use the anterior guide member 1, the engagement member 7 and the posterior guide member 4 are connected and aligned using the proximal rail 509 and the distal rail 510 and the double ended screw 13, which are parallel to one another.

(88) In the embodiment shown in FIGS. 9a-d, this series of bores is parallel to the connection bores for the proximal rail 609, the distal rail 610, the medial rail 611 and the lateral rail 612. Therefore in use the anterior guide member 1, the engagement member 7 and posterior guide member 4 are connected and aligned using the proximal rail 609, the distal rail 610, the medial rail 611 and the lateral rail 612, and the double ended screw 13.

(89) The double ended screw 13 does not engage with the non-engaging bore 13b in the engagement member. The non-threaded section in the middle of the double ended screw will be located in the non-engaging bore. Therefore the double ended screw extends through the engagement member but is not attached to the engagement member.

(90) The double ended screw 13 does engage with the engaging bore 13a in the posterior guide member and does engage with the engaging bore 13c in the anterior guide member. The threaded portions at the two ends of the double ended screw are received in and engage with these engaging bores 13a, 13c. Therefore in use the double ended screw is attached to the anterior guide member and to the posterior guide member.

(91) A key 600 may be provided that has a distal end 600a which engages with and rotates the double ended screw 13 (see FIGS. 7d and 9a).

(92) The use of a double ended screw means that the anterior guide member 1 and the posterior guide member 4 can be simultaneously moved closer to or away from the engagement member 7 by the same distance.

(93) Therefore when the anterior guide member and the posterior guide member are connected by the connector rails, via the engagement member, the elongate axes of the elongate bodies are substantially aligned and the angled channels converge in the direction of the distal end, such that the engagement protrusion can be located in a recess portion on the shoulder of the implant, with the anterior guide member and the posterior guide member in their release positions, and then the adjustment member can be used to move the anterior guide member towards its holding position until the first contact element contacts the surface of the shoulder of the implant, with the exit of the first angled channel lying spaced from the implant, and to simultaneously move the posterior guide member towards its holding position until the second contact element contacts the surface of the shoulder of the implant, with the exit of the second angled channel lying spaced from the implant.

(94) The angled channel in the anterior guide member may be an integral part of the guide member. In other words, the angled channel is fixed within the anterior guide member. Likewise, the angled channel in the posterior guide member may be an integral part of the guide member. In other words, the angled channel is fixed within the posterior guide member.

(95) However, the anterior guide member and the posterior guide member can each be provided with a recess that extends from its proximal end to its distal end and that can receive a channel providing unit 15 (see FIG. 1d). The channel providing unit is sized and shaped to slide into and be secured within the recess, extending substantially from the proximal end to the distal end. The channel providing unit includes one or more angled channel. The channel providing unit can be located and secured in the recess and when in this position it provides the guide member with an angled channel therein, running from an entrance at the proximal end of the guide member to an exit at the distal end of the guide member, wherein the channel is at an angle in the range of from 1 to 2.5 degrees, ideally 2 degrees, to the elongate axis of the elongate body.

(96) As shown in FIG. 1d, the channel providing unit 15 can include multiple channels. However, this is optional rather than essential.

(97) The targeting device may be used in combination with a medial targeting device 700, as shown in FIGS. 7a, 7d and 8b. This device can be used to double check the alignment of the targeting kit in the antero-posterior plane before the tunnels are drilled.

(98) When a medial targeting device 700 is used, the targeting device is provided with an alignment slot 517 located at the proximal end of the engagement member 7 (See FIG. 9d). This alignment slot is in longitudinal alignment with the engagement protrusion 8 of the engagement member 7 as shown in FIG. 9c.

(99) The medial targeting device 700 is in the form of a plate, which has an enlarged head 700a at the proximal end and an elongate body 700b that extends to the distal end. The enlarged head 700a is circular and is sized and shaped to be received in the alignment slot 517 of the engagement member 7 (see FIG. 7d). The elongate body 700b has a length greater than the distance from the alignment slot 517 to the engagement protrusion of the engagement member.

(100) In use (see FIGS. 8a, 8b, 8c), the enlarged head 700a is received in the alignment slot 517 of the engagement member and the elongate body 700b of the medial targeting device is then pivoted until it contacts the proximal end of the neck 120 of the femoral implant. An assessment can be made as to whether the elongate plate is bisecting the neck centrally in the antero-posterior plane. If it is not, the location of the targeting device can be adjusted until the elongate plate of the medial targeting device does bisect the neck centrally in the antero-posterior plane.

(101) An external targeting device of the invention is shown in FIGS. 10a-b. This can be used with the targeting device of the invention.

(102) The external targeting device comprises a targeting device interlocking portion 701, an alignment portion 702, and a holding arrangement 703 for holding and pivoting the alignment portion 702 relative to the targeting device interlocking portion 701.

(103) The targeting device interlocking portion 701 comprises a planar support body 704 provided with an anterior guide member interlocking component 705 and a posterior guide member interlocking component 706.

(104) The anterior guide member interlocking component 705 comprises a first locking pin that extends from the planar support body in the same plane and can be received in the first angled channel. The posterior guide member interlocking component 706 comprises a second locking pin that extends from the planar support body in the same plane and can be received in the second angled channel. The location of the posterior guide member interlocking component 706 is fixed. A channel 707 is provided in the planar support body and the anterior guide member interlocking component 705 is provided with an engaging pin 708 that engages with and can slideably move along the channel and can be secured at any location therein. Thus the distance between the anterior guide member interlocking component 705 and the posterior guide member interlocking component 706 can be varied.

(105) The alignment portion 702 comprises a planar elongate body 702a having an angled tip 702b at the distal end.

(106) The holding arrangement comprises a pivot nut, a pivot washer, and a locking screw that can be rotated from an open position where pivoting can occur to a locked position where pivoting is prevented. The holding arrangement therefore holds the planar elongate body and the planar support body in the same plane, but permits the pivotal movement of the planar elongate body relative to the planar support body within that plane.

(107) In use, the first locking pin can be received in the first angled channel of the targeting device, and the second locking pin can be received in second angled channel of the targeting device, such that the planar support body is aligned with the anterior-posterior plane in which the first and second angled channels lie, and such that the planar elongate body is consequently also aligned with the anterior-posterior plane in which the first and second angled channels lie, such that the planar elongate body can be pivoted relative to the planar support body until the angled tip is alongside the implant and the plane of the angled tip can be compared to the centreline in the anterior-posterior plane, as determined via x-ray.

(108) If the plane of the angled tip is not aligned with the centreline in the anterior-posterior plane, the location of the targeting device can be adjusted until the angled tip does align with the centreline in the anterior-posterior plane.

(109) The osteotome device of the invention is shown in FIGS. 3a-e.

(110) The chevron osteotome device of the invention comprises an elongate body 100 having a proximal end 101 that can be provided with a handle 101a and a distal end 102 that can be blunt or may be sharp. The handle 101a can be understood to have an enlarged head portion extending from a neck.

(111) The elongate body includes a distal section extending from the distal end to a shoulder point 103, wherein the shoulder point is located closer to the distal end than the proximal end.

(112) The osteotome device also includes a cutting portion 104 extending outwardly from both sides of the elongate body at the shoulder point 103. The cutting portion has a first angled cutting side 104a that extends outwardly from one side of the elongate body at the shoulder point, and a second angled cutting side 104b that extends outwardly from the opposite side of the elongate body at the shoulder point.

(113) The cutting portion 104 has a front face and a back face which are connected by the first angled cutting side and the second angled cutting side, the front face being aligned with and a continuation of the elongate body, and the back face being aligned with and a continuation of the elongate body, such that the cutting portion has the same depth as the elongate body. The front face and the back face are blunt.

(114) Therefore the distal end of the chevron osteotome device can be located in an access tunnel and chevron osteotome device can be pushed in the direction of the distal end of the implant so as to cut away bony ingrowth on both sides of the access tunnel with the first angled cutting side and the second angled cutting side.

(115) The elongate body has an upper face that is substantially planar and a lower face that is substantially planar. The distal end of the elongate body may optionally be rounded, as shown in the Figures.

(116) The first angled cutting side and the second angled cutting side are located towards and face towards the distal end of the cutting portion, i.e. such that cutting occurs as the chevron osteotome device is pushed into the tunnel.

(117) The cutting portion is a rhombus shape, with two sides of the rhombus being the first cutting side and the second cutting side (with these sides facing towards the distal end of the cutting portion). The third and fourth side of the rhombus (which face away from the distal end of the cutting portion) are blunt.

(118) FIG. 3e shows a different shape for the handle 101a. In this shape there are no indents in the side edges of the handle, as compared to the handle shape shown in FIG. 3c. The handle 101a is essentially a square or rectangular protrusion from the elongate body. It can be understood to have an enlarged head portion extending from a neck.

(119) In the embodiment of FIG. 3e the distal end 102 is also shown as sharp. The end may be chisel like, e.g. with a 45 degree angled sharp end. This compares with the embodiment of FIG. 3c where the distal end 102 is shown as blunt.

(120) The curette device of the invention is shown in FIGS. 4a-d.

(121) The curette device of the invention comprises an elongate body 200 in the form of a flat plate that extends from a first elongate edge 201 to a second elongate edge 202 and having a proximal end 203 that can be provided with a handle 203a and having a distal end 204 that is blunt. The handle 203a can be understood to have an enlarged head portion extending from a neck.

(122) The curette device of the invention also comprises a first cutting portion 205 located at or near the distal end 204. This extends outwardly from the first elongate edge 201 of the elongate body. The cutting portion has a blunt edge 206 and a cutting edge 207 which meet at an angled cutting point 208. The blunt edge extends from a first location on the elongate body to the cutting point and the cutting edge extends from a second location on the elongate body to the cutting point, wherein the first location is closer to the distal end than the second location. Furthermore, the cutting edge is at an angle to the elongate axis of the curette device of from 50 to 85 degrees.

(123) The curette device further comprises a second cutting portion 209, located between the second elongate edge 202 and the distal end 204 of the elongate body. In the embodiment illustrated, the second cutting portion 209 is provided on a curved edge that extends between the second elongate edge 202 and the distal end 204 of the elongate body. The second cutting portion is shown as comprising teeth, but alternatively or additionally, the second cutting portion may comprise a sharp edge.

(124) Thus the curette device can be located in an access tunnel, with its elongate axis substantially aligned with the central axis running along the length of the tunnel, and with the distal end located at or near the distal (closed) end of the access tunnel, and then can be moved such that its elongate axis is angled with respect to the central axis running along the length of the tunnel, until the cutting edge contacts bony ingrowth located between the implant and the femoral cortex, and such that the curette device can then be withdrawn from the access tunnel whilst being retained in an angled position, such that as the device is withdrawn the cutting edge cuts away bony ingrowth located between the implant and the femoral cortex.

(125) FIG. 4d shows a different shape for the handle 203a. In this shape there are no indents in the side edges of the handle, as compared to the handle shape shown in FIG. 4b. The handle 203a is essentially a square or rectangular protrusion from the elongate body 200. It can be understood to have an enlarged head portion extending from a neck.

(126) In the embodiment of FIG. 4d the second cutting portion 209 is shown as comprising a sharp edge. The end may be chisel like, e.g. with a 45 degree angled sharp end. This compares with the embodiment of FIG. 4c where the second cutting portion 209 is shown as comprising teeth.

(127) The medial-lateral clearance device of the invention is shown in FIGS. 5a-e. An alternative design is shown in FIGS. 11a-d.

(128) The medial-lateral clearance device of the invention comprises an elongate body 300 having a proximal end 301 that can be provided with a handle 301a and having a distal end 302 that is blunt or may be sharp. The elongate body is in the shape of a flat plate that extends from a first elongate edge 303 to a second elongate edge 304. The handle 301a can be understood to have an enlarged head portion extending from a neck.

(129) In the embodiment of FIGS. 11a-d the distal end 302 is shown as sharp. The end may be chisel like, e.g. with a 45 degree angled sharp end. This compares with the embodiment of FIGS. 4a-d where the distal end 302 is shown as blunt.

(130) The medial-lateral clearance device of the invention also comprises a cutting portion 305 extending outwardly from the elongate body and located at or near the distal end 302. The cutting portion has an inner surface 306 that is flat and which connects with the first elongate edge of the elongate body at a substantially 90 degree angle. In FIGS. 5a-e the angle is 90 degrees. In FIGS. 11a-d the angle is 100 degrees.

(131) The cutting portion has an outer surface 307 that comprises an angled cutting face 308 that is located towards the distal end of the elongate body. The inner surface meets the angled cutting face at a cutting edge 309, at an angle of from 20 to 70 degrees. This provides a sharp and chisel shaped end.

(132) Thus the distal end of the flat plate elongate body can be located in a space at the bone-implant interface, at or near to the shoulder portion of the implant, with the flat plate being parallel to either the anterior surface or the posterior surface, and with the flat inner surface of the cutting portion aligned with either the medial or lateral surface of the implant, such that the medial-lateral clearance device can then be pushed in the direction of the distal end of the implant, with the flat plate elongate body remaining alongside the respective anterior or posterior surface, in the space at the bone-implant interface, whilst the angled cutting face cuts away bony ingrowth located at said medial or lateral surface of the implant as the device is pushed towards the distal end of the implant.

(133) In another embodiment the cutting portion is not replaceable and therefore the medial-lateral clearance device is simply disposed of once the cutting edge is not sharp enough for continued use.

(134) It will be appreciated that a pair of such medial-lateral clearance devices should be provided: one where the flat plate cutting portion is 90 to 110 degrees clockwise from the flat plate elongate body and one where the flat plate cutting portion is 90 to 100 degrees anticlockwise from the flat plate elongate body.

(135) In addition, for both the “left handed” version and the “right handed” version, two or more different sizes may be provided.

(136) A wire delivery device of the invention is shown in FIGS. 6a-b.

(137) The wire delivery device of the invention comprises a first elongate body 401 in the form of a flat plate that extends from a first elongate edge 402 to a second elongate edge 403.

(138) The elongate body has a proximal end 404. A handle receiving portion 407 extends from the proximal end; this is shown as being circular in shape. The handle receiving portion 407 has a handle 408 extending outwardly therefrom, at 90 degrees to the flat plate elongate body 401.

(139) The elongate body has a distal end 405 that is blunt. The distal end 405 slopes down from the first elongate edge 402 to the second elongate edge 403, at an angle to the elongate axis of the body of from 120 to 140 degrees, ideally about 135 degrees.

(140) There is also a first wire guidance slot 406 provided in a spaced relationship with the distal end 405, the wire guidance slot running substantially parallel to this sloped distal end.

(141) The wire delivery device of the invention further comprises a second elongate body 411 in the form of a flat plate that extends from a first elongate edge 412 to a second elongate edge 413.

(142) The elongate body has a proximal end 414. A handle receiving portion 417 extends from the proximal end; this is shown as being circular in shape. The handle receiving portion 417 has a handle 418 extending outwardly therefrom, at 90 degrees to the flat plate elongate body 411.

(143) The elongate body has a distal end 415 that is blunt. The distal end 415 slopes down from the first elongate edge 412 to the second elongate edge 413, at an angle to the elongate axis of the body of from 120 to 140 degrees, ideally about 135 degrees.

(144) There is also a second wire guidance slot 416 provided in a spaced relationship with the distal end 415, the wire guidance slot running substantially parallel to this sloped distal end.

(145) As shown in FIGS. 6a and 6b, a wire 420, such as a gigli wire, can be fed through and extend between the first wire guidance slot 406 and the second wire guidance slot 416. It can be secured in place by welding. The elongate bodies 401, 411 can be positioned in a spaced apart but aligned configuration with their second elongate edges 403, 413 closest to one another, so that the wire 420 extends into the space between the elongate bodies at an angle of from 120 to 140 degrees, especially 135 degrees.

(146) When the device is ready to be used, the wire 420 can be pulled taught between the two elongate bodies 401, 411 and can then be used to cut the bone-implant interface by pulling the first and second elongate bodies in an alternating motion or by pushing the first and second elongate bodies in an alternating motion.

(147) The wire delivery device can be operated manually or the first and second elongate bodies can be attached to a reciprocating saw or another reciprocating mechanism that automatically moves the device forwards and backwards in a linear fashion.

(148) An alternative design for the wire delivery device of the invention is shown in FIGS. 14a-c.

(149) The wire delivery device of the invention uses an elongate body 901 in the form of a flat plate that extends from a first elongate edge 902 to a second elongate edge 903.

(150) The elongate body has a proximal end 904 with a handle 907. The handle 907 can be understood to have an enlarged head portion extending from a neck.

(151) The elongate body has a distal end 905 that is blunt.

(152) There is a wire guidance slot 906 provided in a spaced relationship with the distal end 905 and located within the first elongate body, wherein the wire guidance slot runs from an entrance 906a at the first elongate edge to an exit 906b at the second elongate edge, wherein the distance between the entrance 906a and the distal end 905 is greater than the distance between the exit 906b and the distal end 905, such that the wire guidance slot is at an angle to the elongate axis of the body of from 120 to 140 degrees, ideally about 135 degrees.

(153) To use the wire delivery device of the invention, two of these elongate body devices 901 are used.

(154) A wire, such as a Gigli wire, can be fed through and extend between the wire guidance slots of the two elongate body devices. It can be secured in place by welding. The elongate body devices can be positioned in a spaced apart but aligned configuration with their second elongate edges closest to one another, so that the wire extends into the space between the elongate bodies at an angle of from 120 to 140 degrees, especially 135 degrees.

(155) When the device is ready to be used, the wire can be pulled taught between the two elongate body devices and can then be used to cut the bone-implant interface by pulling the first and second elongate bodies in an alternating motion or by pushing the first and second elongate bodies in an alternating motion.

(156) The wire delivery device can be operated manually or the first and second elongate bodies can be attached to a reciprocating saw or another reciprocating mechanism that automatically moves the device forwards and backwards in a linear fashion.

(157) The brace sleeve 750 of the invention is shown in FIG. 12. The brace sleeve 750 can be used to provide structural support for the elongate body of any of the devices described above and shown in the preceding drawings, except for the targeting device which it will be appreciated does not have an elongate body.

(158) The brace sleeve 750 comprises two elongate faces 751, 752 which are joined at one elongate edge 753 and are open at the opposite elongate edge and at both the two ends, so as to create an elongate cavity between the two faces within which an elongate body can be slidably received. The brace sleeve can slide onto and over an elongate body to provide additional strength and resistance to bending during use. The brace sleeve can cover some, most or all of the length of an elongate body of any of the devices described above.

(159) The two elongate faces may be flat and parallel to one another. However, in the illustrated embodiment, one of the elongate faces 752 flares outwardly towards the open elongate edge. This can assist with ease of placing the brace sleeve onto the elongate body, because it means that the open “mouth” of the brace sleeve is larger than the closed edge.

(160) The universal handle 800 of the invention is shown in FIGS. 13a-c. The universal handle 800 can be used as a handle for two or more of the devices described above, except for the targeting device which it will be appreciated does not require a handle. The universal handle 800 comprises a body 801 having two grip portions 802 at its proximal end and an engagement recess 803 in the form of a slot, at its distal end. The engagement recess is sized and shaped to receive the proximal end (handle) of the devices described above, except for the targeting device. As shown in the drawings, the handle of the devices described above comprises a neck and an enlarged head.

(161) The universal handle 800 is provided with a locking cap 804 which fits over the distal end of the body 801 and permits the enlarged head of the handle to be locked in place in the engagement recess 803. The locking cap 804 is provided with a dual slot 805, comprising a first elongate shaped slot 805a that can receive the enlarged head and allow it to pass therethrough, and a second elongate shaped slot 805b that can receive the neck and allow it to pass therethrough but that is too small to allow the enlarged head to pass therethrough. The first elongate shaped slot and the second elongate shaped slot overlap, with the elongate axis of the first elongate shaped slot being at an angle to the elongate axis of the second elongate shaped slot. Therefore the locking cap 804 can be placed over the distal end of the body with the first elongate shaped slot 805a aligned with the engagement recess and the enlarged head can pass through the first elongate shaped slot and into the engagement recess. Then the locking cap can be rotated such that the second elongate shaped slot 805b is aligned with the engagement recess, meaning that the enlarged head is locked into the engagement recess because it is too big to pass through the second elongate shaped slot. When it is desired to release the universal handle from the device, the locking cap can be rotated until the first elongate shaped slot is aligned with the engagement recess again.

(162) The locking cap is spring loaded to assist with release. Therefore a torsion spring 806 is provided between the body 801 and the locking cap 804, which biases the locking cap away from the body. The user can overcome that biasing force by pushing the locking cap onto the body. The locking cap can be held in place by the use of a securing means 807 (e.g. a locking pin and corresponding aperture) that connects the locking cap and the body.

(163) FIGS. 15a-c show a chevron chisel according to the invention. The chevron chisel comprises an elongate body 950 in the form of a flat plate having an upper face 950a and a lower face 950b. The elongate body 950 extends from a first elongate edge 951 to a second elongate edge 952.

(164) The elongate body 950 has a proximal end 953 that can be provided with a handle 954. The handle 954 can be understood to have an enlarged head portion extending from a neck.

(165) The elongate body 950 has a distal end 955. A cutting portion is located at the distal end 955. The cutting portion comprises a first cutting face 956 and a second cutting face 957 which meet at an angled cutting point 958. The angled cutting point is located substantially centrally between the first elongate edge and the second elongate edge.

(166) The first cutting face 956 extends at an angle of about 45 degrees from the first elongate edge 951 when measured with respect to the elongate axis of the elongate body, and the second cutting face 957 extends at an angle of about 45 degrees from the second elongate edge 952 when measured with respect to the elongate axis of the elongate body. In addition, the first cutting face 956 extends at an angle of about 45 degrees from the lower face to the upper face, and the second cutting face 957 extends at an angle of about 45 degrees from the lower face to the upper face.

(167) The chevron chisel may optionally have a depth (the lower face to the upper face) of from 0.5 to 3 mm, e.g. 1 to 2 mm; it may be about 1 mm deep. The chevron chisel may optionally have a width (first elongate edge to a second elongate edge) of from 4 to 10 mm, e.g. 5 to 9 mm; it may be about 7 to 8 mm wide.