JP6429845B2 - Orthopedic impact applying electric motor driven instrument - Google Patents

Description

Cross-reference of related applications:
This application claims priority to Patent Document 1 filed on Dec. 28, 2009 based on Section 119 of the U.S. Patent Law, the disclosure of which is incorporated herein by reference. Is incorporated into.

  The present disclosure relates to electric instruments for applying impacts in orthopedic applications, and in particular, electric motor driven instruments for applying orthopedic impacts, with controlled impact on broaches, fleas, or other devices. And an instrument that can provide an opening in a region (e.g., within a bone structure) to reliably receive a prosthetic material in this region.

  In the orthopedic field, prosthetic devices such as prosthetic joints are often implanted or seated in a patient's body by seating the prosthetic device in a bone cavity of the patient. This cavity must be provided before the prosthetic material is seated or implanted, and conventionally, the practitioner is responsible for damaging, extra bone or diseased bone structures from the area forming the cavity. After removing the bone, a hole may be made in the cavity and cut out along the medullary canal of the bone. The prosthetic material typically includes a shaft or other protrusion that serves as a specific portion of the prosthetic material that is inserted into the cavity.

  To provide such a cavity, the practitioner may use a broach that matches the shape of the shaft portion of the prosthetic material. Some measures known in the prior art provide a handle with a broach that allows the practitioner to grip the handle while driving the broach into the implantation area. Unfortunately, this approach is unwieldy and unpredictable due to the specific practitioner's skill. Using this technique, you will almost always fall into a situation where you cannot accurately capture the location and structure of the cavity. Furthermore, this approach carries the risk of damaging the bone structure in areas not intended by the practitioner.

  Another technique for creating a prosthetic cavity is to drive the broach by pneumatic or compressed air. In this method, for example, there is a drawback that the portability of the impact applying device is hindered because there is an air connection line that discharges air from the device to an aseptic surgical site, and that the operator who operates the device becomes tired. is there. Furthermore, in this method, as exemplified in Patent Document 2, the impact force or the impact application frequency cannot be accurately controlled, and on the contrary, it functions like a jack hammer when operating. Also, since there is no precise measure of control, it becomes even more difficult to accurately broach the cavity.

  Another drawback of the devices known in the prior art is that fluid or moisture, such as body fluids, accumulates in the device's hand grip during prolonged use. For example, the difficulty in operating an impact applicator with a broach known in the prior art may increase during the surgical process. This is because the handgrip becomes saturated with body fluid, which may make it practicable for the practitioner to hold such prior art devices.

US Provisional Patent Application No. 61/290336 US Pat. No. 5,057,112

  The present invention addresses the need for an impact applicator that overcomes the various drawbacks found in the prior art.

In view of the shortcomings of the prior art described above, an electric motor driven orthopedic impact applicator is provided that is configured to overcome all the advantages of the prior art and overcome the disadvantages inherent in the prior art.
The instrument can be used by an orthopedic surgeon to apply an orthopedic impact to, for example, the hips, knees, and shoulders. The instrument can hold brooches, fleas, or other devices, control impact impact, and gently drive brooches, fleas, or other devices into cavities, resulting in a prosthesis or implant Fits in shape. Further, the ability to electronically manipulate and control brooches, chisels, or other devices in this manner allows adjustment of impact settings depending on the particular bone type or other patient characteristics. In addition, the device allows the prosthetic material or implant to be properly seated in or properly removed from the implant cavity.

  In one embodiment, an orthopedic impact imparting device driven by an electric motor includes a control unit, a housing, a linear motion converter, at least one reduction gear, an impact imparting element (hereinafter also referred to as a striker), an air chamber, and a compression piston. And force adjustment control means (hereinafter referred to as “control means”). The instrument can further include a motor, an LED, a handle portion having at least one hand grip for comfortably gripping the instrument, a broach adapter, a battery, a feedback system, and a nozzle for the broach adapter. Preferably, at least some of the various components are encased within the housing. The instrument can apply a periodic impact force to a broach, chisel, or other device, or implant, and finely adjust the impact force to multiple impact force levels.

  In one embodiment, the instrument further comprises a control means, the control means having a force adjustment element that controls the impact force to avoid damage caused by uncontrolled impact. be able to. The force can be adjusted electronically or using a mechanical detent. Mechanical detents can increase the impact force without sacrificing control or accuracy of the operation that the broach is machining.

  The instrument further includes an anvil element that has impact points at both the front and rear and a guide that forces the striker to move in a substantially axial direction. In operation, the striker movement along the guide of the anvil element continues in either the forward or backward direction until the striker hits the impact point. As used in this context, the term “forward” includes the movement of the striker toward the brooch or patient, and the term “rearward” includes movement of the striker away from the brooch or chisel or patient. Is included. If the impact point is at the front of the instrument, i.e. in the forward direction, the impact causes the impact impact to be transmitted to the broach or chisel, which is further pushed into the cavity. If the impact point is at the rear of the instrument, the impact impact will try to pull the broach or chisel out of the cavity. The option of bi-directional or unidirectional impact provides the surgeon the flexibility to cut or compress the material in the implant cavity, in which case the material can be removed. The choice of compressing the material is often an important decision in surgery. The impact point can be in the form of a plate disposed at one or each end of the anvil element.

  The instrument can further adjust the frequency of the striker. By adjusting the striker frequency, the instrument can be given a collision impact with a higher overall time weight and maintain the same impact magnitude. This allows the surgeon to control the cutting speed of the broach or flea. For example, the surgeon may choose to cut at a fast rate (high impact frequency) while moving the broach or chisel largely, and then slow down the cutting rate as the broach or chisel approaches the desired depth.

  The user holds the instrument handle firmly and uses an LED light to illuminate the work area to accurately position the broach, chisel, or other device at the desired location on the prosthesis or implant be able to. The reciprocating motion imparted to the broach, chisel, or other device causes the implant and / or broach, chisel, or other device to strike, thereby properly seating the prosthesis or implant within the cavity for the implant Or can be appropriately removed out of the cavity for the implant or controlled by the application of a broach, chisel, or other device to create or shape the cavity for the implant. The instrument has a feedback system that alerts the surgeon if a broach, chisel, or other device-implant interface is detected to bend or deviate beyond a certain degree. May be.

  In line with the various novel features that characterize the present disclosure, these aspects, as well as other aspects of the present disclosure, are pointed out with particularity in the claims appended hereto. And forms part of this disclosure. For a better understanding of the present disclosure, the operational advantages of the present disclosure, and the specific objectives achieved by using the present disclosure, reference is made to the accompanying drawings and the description describing exemplary embodiments of the present disclosure. Should be referenced.

A perspective view of an orthopedic impact applying device according to an exemplary embodiment of the present disclosure. 1 is a perspective view of a compression piston that compresses air against a striker of an orthopedic impact applicator according to an exemplary embodiment of the present disclosure. FIG. 4 is an illustration of a striker that releases and strikes an anvil element according to an exemplary embodiment of the present disclosure. FIG. 5 is an illustration of a compression piston of an orthopedic impact applicator that compresses air back from an anterior position and in front of a striker, according to an exemplary embodiment of the present disclosure. Illustration of a striker of a rear-moving orthopedic impact applicator according to an exemplary embodiment of the present disclosure FIG. 6 is an illustration of an striker of an orthopedic impact applicator that applies an impact to a posterior anvil impact plate, according to an exemplary embodiment of the present disclosure.

  The advantages and features of the present invention may be better understood with reference to the following detailed description and claims, taken in conjunction with the accompanying drawings.

  Like reference numerals refer to like parts throughout the description of the drawings.

  The best mode for carrying out the present disclosure will be described in terms of the preferred embodiments depicted in the accompanying drawings. There are many variations of the preferred embodiments described in detail herein for purposes of illustration. Various omissions and alternatives of equivalents are envisioned depending on circumstances and convenience, but the scope of use and implementation by this omission and alternatives is within the spirit and scope of this disclosure. It is intended to be included in

  The term “a” and “an” does not refer to a quantity limitation but to the presence of at least one item of interest.

  As shown in FIGS. 1-6, the present disclosure provides an orthopedic impact applicator that controls impact impact and is driven by an electric motor. The instrument has the ability to apply single or multiple impacts and to apply impacts with variable speed, force and frequency. The level of the impact force can be adjusted by setting the impact force either electronically or by using a detent. The use of detents tends to create a striking force sufficient to apply a significant impact to the broach, chisel, or other device, or surgical area.

  The instrument has a housing. This housing reliably covers and holds the components of the instrument. In one embodiment, the housing includes a motor, at least one reduction gear, a linear motion conversion device, a compression chamber, an impact applying element (also referred to as a striker), and control means for adjusting force or impact (hereinafter referred to as “control means”). And an anvil element having a front impact plate and a rear impact plate (this impact plate may be part of the anvil, for example).

  The instrument may further include a handle portion having at least one handgrip for holding the instrument comfortably and securely during use, a broach adapter, a battery, and a position sensor, a direction sensor, and / or a twist sensor. it can. The instrument can further comprise a lighting element such as an LED that provides light to a work area where the user uses the instrument. The broach adapter can be connected to the anvil of the anvil element, for example, via a quick connect mechanism at the end of the instrument that faces the patient when using the instrument.

  Referring now to FIG. 1, in one embodiment, the linear motion conversion device includes a slider crank mechanism 12 that is operatively coupled to a motor 8 and reduction gears 7 and 9. The instrument further comprises an air chamber 5, 17 for receiving a compression piston 6 having a first end and a second end, the compression piston 6 being actuated via a linear motion conversion device 12. It will be appreciated that there is an air mass at one end of the compression piston while the compression piston is in the air chamber because the longitudinal dimension of the compression piston is smaller than the air chamber containing the piston. . Hereinafter, the air mass between the head portion of the compression piston and the striker is referred to as “front air chamber portion” or “front air chamber” 5 and is the end portion of the compression piston closer to the linear motion conversion device. The air mass between the device and the motor of the instrument is called “rear air chamber” or “rear air chamber” 17.

  In one embodiment of the present disclosure, the appliance motor is compressed by a linear motion converter until sufficient pressure is applied to the front air chamber 5 between the front end of the compression piston and the rear end of the striker 4. The piston is moved to overcome the detent 10 that keeps the striker in the rear position and / or the inertial and frictional forces that hold the striker 4 in position. When this sufficient pressure is reached, the pneumatic force accelerates the striker 4, which slides down along the axis toward the cavity inside the instrument housing and strikes the front anvil impact plate 15. The force thus generated is transmitted through the anvil 14 adjacent to the impact plate 15 and optionally through the broach adapter 1 (which will be described in more detail below). May be fitted with a broach, chisel, or other device for seating or removing the implant or prosthesis.

  Since the compression piston 6 continues to move due to the impact, the compression piston 6 moves rearward and compresses the air mass in the rear air chamber 17. This air mass can be passed to the front side of the striker 4 via the air passage 19 and generates a return force to the striker 4, and the striker 4 moves rearward by the return force, that is, the impact point of the striker. , Move away from the front anvil impact plate 15. The striker continues to move until the rear anvil impact plate 16 is impacted. When the rear impact plate is struck, a backward force is generated on the anvil 14. When the broach adapter 1 is attached to the anvil 14, the force is transmitted to the broach adapter 1, to which a broach, chisel, or other device for seating or removing the implant or prosthesis is attached. In this way, an anterior and posterior impact force can be applied to a broach, chisel, or other device, or implant / prosthesis in one complete cycle.

  In one embodiment, the compression piston preferably has a cavity in the head of the piston, which creates pressure during the return stroke of the piston, which causes the front end of the striker to move forward. An impact is applied to the rear impact point of the anvil element away from the anvil impact plate. A striker that applies an impact to the rear anvil impact plate transmits a negative force in front of the anvil (and broach, chisel, or other device), and this negative force forces the broach, chisel, or other device to the surgical area. It turns out that it keeps away from the impact application location inside.

  Embodiments of the slider crank of the instrument facilitate control of the continuous impact application of the striker and anvil. In order to continuously apply an impact in this way, the slider crank returns to the bottom of the striking motion after being compressed by the compression piston, and this return releases the pressure applied to the striker, and the piston moves to the head. In the above embodiment with a cavity, this return can apply pressure in front of the striker, thereby returning the striker to its original rest position.

  In order to strike once, a linear motion converter (such as a slider crank described herein) stops at or near the rear position and releases the forward pressure on the striker, thereby causing the striker You can go back to the starting position and prepare for another blow. In this mode of operation, the user can selectively impact using the instrument (as opposed to repeatedly impacting), so that the impact can be further controlled to create, for example, a surgical area or Shape processing will be possible.

  A position sensor operatively connected to the controller may be provided to assist in adjusting the periodic operation of the linear motion converter at a preferred position. For example, when the control unit moves the slider crank so that it stops at the position where the slider crank is completely returned or close to this position and receives a signal from the position sensor that the slider crank has reached the center position which is the bottom dead center. The pressure for the next impact can be generated. In another embodiment, the control unit can be directly connected to the linear motion conversion device to start and stop the operation of the linear motion conversion device.

  The controller can further operate force control means for selectively adjusting the amount of impact force per cycle. By controlling the impact force, the instrument can avoid damage caused by uncontrolled or excessive force impact. For example, the user can reduce the impact setting for an elderly patient suffering from osteoporosis, or the impact setting if the bone structure is stronger than normal or healthy and strong. Can be strengthened.

  It is preferable that a setting for selectively releasing the force with respect to the mechanical detent that holds the striker is included for each force control. It will be appreciated that if the pressure required to remove the striker from the detent is increased, the striker will impact the anvil with a stronger force. In another embodiment, the detent comprises a solenoid, which can be activated by increasing the pressure in a predetermined manner, after which the striker 4 is released, causing the striker to impact the anvil. Give.

  The control unit can also control the impact force by adjusting the forward (forward movement) speed and / or the reverse (backward movement) speed of the compression piston. It will be appreciated that the speed adjustment of the compression piston affects the pressure buildup for the striker to move forward and backward. For example, if the piston's forward speed is relatively high and the piston's backward speed is relatively low, the striker speed in the forward direction will be much higher, which gives the impact impact given by the striker. Is larger when traveling forward of the piston and striker. By adjusting the forward and backward speed of the piston in this way, the user can create a greater impact force if desired (eg, to create a surgical area) or backwards. A greater force can be created to facilitate removal of, for example, a broach, chisel, or other device from the surgical area. If the forward and backward speeds are the same, the instrument can move a broach, chisel, or other device in the direction of operation, creating a very effective technique for machining the cavity.

  The motor of the instrument can be particularly configured to assist in applying such multi-directional impacts. In one embodiment, the motor can operate with pulse width modulation to strike backwards and can operate at full speed or continuous speed to strike the striker forward. When operated in this manner, a broach, chisel, or other device attached to the instrument can only receive approximately forward movement, which facilitates making a seat for the implant. Alternatively, the motor may operate with pulse width modulation to strike forward and operate at full speed or continuous speed to impact backwards, which allows the stabbed broach, Pulling movements can be created that are beneficial for removing fleas, or other devices, or for removing implants.

  In yet another embodiment, the instrument comprises a position sensor, such as an anvil position sensor, that can be operatively coupled to the striker control of the instrument. This position sensor can determine whether the operator is pushing or pulling the instrument. For example, the sensor can determine whether this is pushing or pulling based on the position of the adapter or anvil holding the broach. By this determination, when the user is applying force to the instrument in a specific direction, the striker's impact can be adjusted accordingly. For example, if the sensor determines that the user is pushing the instrument or pushing the instrument against the object, the sensor can cause the striker to apply a forward impact. If the sensor determines that the user is pulling the instrument, the sensor can cause the striker to apply an impact in the rearward direction or cause a pulling force to be applied to the striker by turning the slider crank.

  The appliance can further comprise a lighting element, and in one embodiment, the lighting element can comprise an LED array, which can illuminate a user's work area. In one embodiment, the LED can be placed in the housing of the instrument and can be directed to the patient's body or a cavity to be operated on.

  The instrument can further include a plate or other flat surface at the instrument end distal from the surgical area, which allows the user to use the broach, as specified by the surgical or physical condition, Selective manual pressure can be applied to the chisel or other device or surgical implant. For example, if the broach is firmly seated in the cavity so that the instrument will not operate and the broach is not removed, the user can manually tap the plate to remove the broach.

  The instrument can further comprise a torsion sensor, which can determine whether the force or movement of the instrument is lateral or warped, so that the instrument has a broach and an implant. If it is sensed that the warpage has deviated from a predetermined scale, a signal can be transmitted to inform the user of the warpage. In this and other ways, the instrument facilitates constant broaching and implant placement along the axis.

  In yet another embodiment, the broach adapter may comprise a parallel four bar configuration. In this embodiment, the adapter can accept a broach to replace the front or rear joint. A mechanism consisting of four parallel bars of the adapter can facilitate receiving the broach and directing it to various positions, such as a center position or a left or right offset position. The adapter holds the broach in a direction parallel to or collinear with the instrument and striker body. The broach adapter may comprise a clamp, vise, or any other fastener that can securely hold the broach, chisel, or other device during operation of the instrument.

  The device can further comprise a hand grip disposed on the housing of the device, the hand grip can have a rubber coating or other adhesive coating disposed so as to be removable. . Such a coating facilitates comfortable operation of the instrument, improves the user's instrument retention, increases instrument controllability, and reduces fatigue during instrument operation.

  In use, a user, such as a surgeon, holds the instrument's handle grip (grip or grips) firmly, uses an LED light to illuminate the work area, and uses a broach, chisel or other attached to the instrument Is accurately positioned at a desired position on the prosthesis or implant. The reciprocating motion that the instrument imparts to the broach, chisel or other device causes the implant to strike and thereby properly seats the prosthetic or implant within the implant cavity or properly out of the implant cavity It becomes possible to take out. The warning system can alert the user when a bending moment greater than a certain magnitude is detected at the interface between the broach (or flea or other device) and the implant.

  The devices disclosed herein provide various advantages over the prior art. The instrument makes it easier to control the impact on the surgical point, minimizes wasteful damage to the patient's body, and allows the implant or prosthesis seat to be machined into an accurate shape. The instrument also allows the user to adjust the direction and force of the impact, thereby improving the ability of the user to operate the instrument. By controlling and adjusting the impact setting force, the user can set the impact force depending on the particular bone type or other characteristics of the patient. Thus, the instrument allows the prosthetic material or implant to be properly seated within the implant cavity or properly removed from the implant cavity.

  The foregoing descriptions of specific embodiments of the present disclosure have been written for purposes of illustration and description. They are not intended to be exhaustive or to limit the disclosure to the precise form disclosed, and, of course, many modifications and variations are possible in light of the above teaching. The illustrative embodiments have been chosen and described in order to best illustrate the principles of the present disclosure and their practical application, and based on this, other persons skilled in the art will envision specific uses. As such, the disclosure and various embodiments can be modified and used in an optimal manner.

1 Brooch adapter
2 Anvil rotation prevention element
4 Striker
5 Front air chamber
6 Compression piston
7 Gear reducer
8 Motor
9 Gear reducer 10 Detent
11 Front striker air chamber
12 Linear motion converter
13 Brooch Quick Connect
14 Anvil
15 Forward anvil impact plate
16 Rear anvil impact plate
17 Rear air chamber
19 Air passage

Claims (13)

In a portable, battery-operated surgical impact device for striking an object with a repeatable and controlled striking force to bias the operation of the surgical tool in the opposite direction,
A drive mechanism;
An integrated battery power supply for supplying power to the drive mechanism of the portable impact device;
A control circuit that controls the storage and release of energy to the energy storage mechanism in response to the drive mechanism to generate the repeatable and controlled striking force;
An adapter configured to releasably receive a surgical tool for interfacing with the object;
A striker providing selectively an impact into two separate impact surface even without least in accordance with the release of energy from said energy storage mechanism,
With
Providing the impact to the front impact surface of the at least two separate impact surfaces biases the adapter forward;
Providing the impact to a rear impact surface of the at least two separate impact surfaces biases the adapter in a rearward direction;
Impact device.   The impact device of claim 1, wherein the selection of the at least two separate impact surfaces is based on a user bias force applied to the impact device.   The impact device according to claim 2, wherein the user bias force in the direction of the object causes the striker to collide with the front impact surface.   The impact device according to claim 2, wherein the user bias force in a direction away from the object causes the striker to collide with the rear impact surface.   The impact device of claim 1, further comprising a detent mechanism that holds the striker until the detent mechanism is released to allow the energy storage mechanism to release energy to the striker.   The impact device according to claim 1, wherein the energy storage mechanism is a compressed air storage chamber.   The impact device of claim 1, further comprising an energy adjustment mechanism for adjusting the impact energy that the striker supplies to the adapter according to a patient profile.   The impact device according to claim 1, further comprising a linear motion conversion mechanism that converts an output of the drive mechanism into a linear motion.   The impact device of claim 1, wherein the striker is operably coupled to the adapter by an anvil having the at least two impact surfaces.   The impact device according to claim 1, wherein the striker is guided along a guide portion having an opening for discharging air during operation.   The impact device of claim 1, further comprising a sensor operably coupled to the control circuit to adjust the linear motion transformation to a preferred periodic motion. In a portable, battery-operated surgical impact device for striking an object with a repeatable and controlled striking force to bias the operation of the surgical tool in the opposite direction,
Means for driving the impact device;
An integrated battery power supply for supplying power to the drive means of the portable impact device;
A control circuit that controls the storage and release of energy of the drive means to the energy storage device to generate a repeatable and controlled striking force;
An instrument mount for receiving the surgical tool;
A striker providing selectively an impact into two separate impact surface even without least in accordance with the release of energy from said energy storage device,
With
Providing the impact to the front impact surface of the at least two separate impact surfaces biases the instrument mount forward;
Providing the impact to a rear impact surface of the at least two separate impact surfaces biases the instrument mount in a rearward direction;
Impact device. The impact device according to claim 12, wherein a user bias force in a direction away from the object causes the striker to collide with the rear impact surface.

Images