DE4231101A1 - Motor-driven milling system esp. for hip joint prosthesis - has control system for using measured sound emission from bone, optical and/or acoustic signals and/or automatic interruption of process - Google Patents

Motor-driven milling system esp. for hip joint prosthesis - has control system for using measured sound emission from bone, optical and/or acoustic signals and/or automatic interruption of process

Info

Publication number
DE4231101A1
DE4231101A1 DE4231101A DE4231101A DE4231101A1 DE 4231101 A1 DE4231101 A1 DE 4231101A1 DE 4231101 A DE4231101 A DE 4231101A DE 4231101 A DE4231101 A DE 4231101A DE 4231101 A1 DE4231101 A1 DE 4231101A1
Authority
DE
Germany
Prior art keywords
bone
milling
milling system
cement
motor
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
DE4231101A
Other languages
German (de)
Inventor
Joachim Dr Med Schmidt
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to DE4231101A priority Critical patent/DE4231101A1/en
Publication of DE4231101A1 publication Critical patent/DE4231101A1/en
Withdrawn legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/164Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans intramedullary
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00106Sensing or detecting at the treatment site ultrasonic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00115Electrical control of surgical instruments with audible or visual output
    • A61B2017/00119Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
    • A61B2017/00123Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation and automatic shutdown
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37Surgical systems with images on a monitor during operation
    • A61B2090/378Surgical systems with images on a monitor during operation using ultrasound

Abstract

The milling head (3) is fitted to the end of a sleeve (1) in an opening (2) which may take a variety of forms allowing operation of the head in one direction only. Rising and evacuating devices are installed in the sleeve or connected separately to the head. The operation is controlled by a device which measures acoustic emission from the bone under treatment and may be held, screwed or clamped to the bone. USE/ADVANTAGE - Pref. in replacement of artificial hip joints, and facilitates orthopaedic surgery by milling, flushing and suction. Cement can be removed more quickly from bone marrow cavities or other sites without damage to bone even in unobservable regions.

Description

Gattung des AnwendungsgegenstandesGenus of the object of application

Die Erfindung betrifft ein motorgetriebenes Frässystem, mit dessen Hilfe Knochenzement aus der Knochenmarkshöhle oder aus anderen Knochenteilen entfernt werden kann. Die Entfernung von Knochenzement ist vorzugsweise in der orthopädischen Chirurgie beim Wechsel oder Ausbau von gelockerten oder infizierten Endoprothesen notwendig. Andere Anwendungen sind zusätzlich möglich.The invention relates to a motor-driven milling system, with whose help bone cement from the bone marrow cavity or from other bone parts can be removed. The removal of Bone cement is preferred in orthopedic surgery when changing or removing loosened or infected ones Endoprostheses necessary. Other applications are additional possible.

Stand der TechnikState of the art

Die Zahl der Prothesenwechsel nimmt insbesondere in der Hüft­ endoprothetik stetig zu. Die Entfernung des Knochenzementes bei zementfixierten Prothesen ist mühsam und zeitaufwendig. Bisher wird die Zemententfernung in der Regel mit verschieden geformten Meißeln durchgeführt, deren sichere Anwendung z. B. in der schlecht einsehbaren Tiefe der Markhöhle problematisch ist. Es können neben dem hohen Zeitaufwand Knochenschädigungen resultieren, die die Neuimplantation einer Prothese unmöglich machen oder aber zu einem übergroßen Knochenverlust führen.The number of prosthesis changes increases especially in the hip endoprosthetics steadily. The removal of the bone cement with cement-fixed prostheses is tedious and time-consuming. So far, the cement removal is usually different shaped chisels performed, the safe use of z. B. problematic in the poorly visible depth of the medullary cavity is. In addition to the high expenditure of time, bone damage can occur result in impossible re-implantation of a prosthesis make or lead to excessive bone loss.

Aus der Werkzeugüberwachung bei Zerspanungswerkzeugen ist be­ kannt, daß mittels Schall-Emissions-Aufnehmern (SEA) die Kör­ perschallwellen des Werkstückes oder des Werkzeugs gemessen werden können.From tool monitoring for cutting tools, be knows that by means of sound emission sensors (SEA) the Kör sound waves of the workpiece or tool are measured can be.

Aufgabe der ErfindungObject of the invention

Mit dem dargestellten Frässystem ist zunächst eine Zerkleinerung und Absaugung des am Knochen noch anhaftenden Knochenzementes möglich. Die Konstruktion der Fräsköpfe in Hülsen mit unterschiedlicher Fräsöffnung ermöglicht bereits eine gezieltere Anwendung der Fräsen.With the milling system shown, there is initially one Crushing and suctioning off the bone that still adheres to the bone Bone cement possible. The design of the milling heads in  Sleeves with different milling openings already allow a more targeted application of milling.

Beim motorgetriebenen Fräsen von Knochen bzw. Knochenzement werden ebenfalls Körperschallwellen erzeugt. Diese Körper- Schallwellen zeigen für Knochen und Knochenzement eine un­ terschiedliche Intensität, die bereits mit handelsüblichen SEA meßtechnisch erfaßt werden können.For motor-driven milling of bones or bone cement structure-borne sound waves are also generated. This body Sound waves show an un for bones and bone cement different intensity, which is already available with commercially available SEA can be measured.

Durch die Steuerung über den meßbaren Körperschall kann beim Fräsen, z. B. auch in der schlecht einsehbaren Tiefe des Mark­ raumes, sicher zwischen dem Fräsen am Knochen oder am Knochen­ zement unterschieden werden. Durch geeignete Sichtbarmachung der Schallintensität und/oder akustische Warnsignale und/oder automatische Abstellung des motorgetriebenen Frässystems beim Knochenkontakt ist eine sichere Entfernung des Zementes möglich.By controlling the measurable structure-borne noise, the Milling, e.g. B. also in the poorly visible depth of the marrow space between the milling on the bone or on the bone cement can be distinguished. Through suitable visualization the sound intensity and / or acoustic warning signals and / or automatic shutdown of the motorized milling system at Bone contact is a safe removal of the cement possible.

Vorteilebenefits

Der Zeitaufwand zur Zemententfernung, vorzugsweise am Beispiel des Prothesenwechsels, wird deutlich reduziert. Eine Zemententfernung ist ohne wesentliche Schädigung des Knochens auch im nicht einsehbaren Bereich möglich.The time required for cement removal, preferably using the example prosthesis change is significantly reduced. A Cement removal is without significant damage to the bone also possible in the non-visible area.

Gewerbliche AnwendungCommercial application

Das in der Erfindung beschriebene Frässystem ist jedesmal anwendbar, wenn am Knochen anhaftender Knochenzement entfernt werden muß. Die Anwendung dieses Systems ist daher in allen orthopädisch-chirurgischen Abteilungen denkbar.The milling system described in the invention is every time applicable when bone cement adhering to the bone is removed must become. The application of this system is therefore in all orthopedic-surgical departments conceivable.

AusführungsbeispielEmbodiment

Ein Ausführungsbeispiel ist in den Abbildungen dargestellt und wird im folgenden näher beschrieben:An embodiment is shown in the figures and is described in more detail below:

Abb. 1 zeigt Ausführungsbeispiele unterschiedlich ge­ stalteter Fräsen, die bereits ein gezielteres Fräsen von Knochenzement unter Schonung von Knochen ermöglichen. Eine Führungshülse 1 ist in unterschiedlicher Weise derart geöffnet 2 daß der Fräskopf 3 nur in eine bestimmte Richtung fräsen kann. In der Führungshülse 1 der Fräse ist eine Absaugvorrichtung in geeigneter Weise installiert, ggf. auch eine Spülvorrichtung. Die Spülflüssigkeit kann jedoch auch über eine getrennte Vorrichtung an den Fräskopf herangeführt werden. Auch ein Einsatz des Fräskopfes ohne integrierte Saug-Spülvorrichtung ist denkbar. Fig. 1 shows exemplary embodiments of differently designed milling cutters, which already enable a more targeted milling of bone cement while protecting bones. A guide sleeve 1 is opened in different ways 2 such that the milling head 3 can only mill in a certain direction. A suction device is suitably installed in the guide sleeve 1 of the milling machine, and possibly also a flushing device. However, the rinsing liquid can also be brought to the milling head via a separate device. It is also conceivable to use the milling head without an integrated suction-flushing device.

Abb. 2 zeigt ein Ausführungsbeispiel für die Halterung 4 eines handelsüblichen Schall-Emissions-Aufnehmers 5, der von Hand am intraoperativ sichtbaren körpernahen Knochenanteil fixiert werden kann. Andere Fixationsmöglichkeiten des SEA am Knochen, z. B. durch Schraube oder Cerclage sind möglich. Fig. 2 shows an embodiment for the holder 4 of a commercially available sound emission transducer 5 , which can be fixed by hand on the intraoperatively visible body part of the bone. Other fixation options of the SEA on the bone, e.g. B. by screw or cerclage are possible.

Claims (5)

1. Motorgetriebenes Frässystem für die Entfernung von Knochen­ zement aus der Knochenmarkshöhle oder anderen Knochenanteilen, dadurch gekennzeichnet, daß das Frässystem über eine Meßein­ richtung zur Körperschallmessung des bearbeiteten Knochens ge­ steuert wird.1. Motor-driven milling system for the removal of bone cement from the bone marrow cavity or other bone parts, characterized in that the milling system is controlled via a measuring device for structure-borne noise measurement of the processed bone. 2. Motorgetriebenes Frässystem für die Entfernung von Knochen­ zement nach Anspruch 1, dadurch gekennzeichnet, daß die Fräsen in Hülsen laufen, die im Bereich des Fräskopfes in geeigneter Weise nach vorne, schräg oder seitlich geöffnet sind, um ein kontrolliertes Fräsen zu ermöglichen.2. Motorized milling system for bone removal Cement according to claim 1, characterized in that the milling run in sleeves that are suitable in the area of the milling head Way forward, diagonally or sideways open to one to enable controlled milling. 3. Motorgetriebenes Frässystem für die Entfernung von Knochen­ zement nach einem der vorangehenden Ansprüche, dadurch ge­ kennzeichnet, daß die Steuerung über optische und/oder akusti­ sche Signale und/oder eine automatische Unterbrechung des Fräsvorganges erfolgt.3. Motorized milling system for bone removal cement according to one of the preceding claims, characterized ge indicates that the control via optical and / or acousti cal signals and / or an automatic interruption of the Milling process takes place. 4. Motorgetriebenes Frässystem für die Entfernung von Knochen­ zement nach einem der vorangehenden Ansprüche, dadurch ge­ kennzeichnet, daß die Hülsen des Frässystems gleichzeitig als Saug-Spülvorrichtung zur Entfernung des zerkleinerten Zementes konstruiert sind.4. Motorized milling system for bone removal cement according to one of the preceding claims, characterized ge indicates that the sleeves of the milling system simultaneously as Suction-rinsing device to remove the crushed cement are constructed. 5. Motorgetriebenes Frässystem für die Entfernung von Knochen­ zement nach einem der vorangehenden Ansprüche, dadurch ge­ kennzeichnet, daß der Schall-Emissions-Aufnehmer in einer ge­ eigneten Vorrichtung plaziert wird, die eine manuelle oder andere Fixierung am zu bearbeitenden Knochen ermöglicht.5. Motorized milling system for bone removal cement according to one of the preceding claims, characterized ge indicates that the sound emission sensor in a ge suitable device is placed, the manual or allows other fixation on the bone to be processed.
DE4231101A 1992-09-17 1992-09-17 Motor-driven milling system esp. for hip joint prosthesis - has control system for using measured sound emission from bone, optical and/or acoustic signals and/or automatic interruption of process Withdrawn DE4231101A1 (en)

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DE4231101A DE4231101A1 (en) 1992-09-17 1992-09-17 Motor-driven milling system esp. for hip joint prosthesis - has control system for using measured sound emission from bone, optical and/or acoustic signals and/or automatic interruption of process

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Cited By (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102006031356A1 (en) * 2006-07-06 2008-01-10 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. In situ removal of human or animal bone material device, has removing tool, which is reciprocally transferred by tool activating device, from passive position to active position, and which is guided to impact area of bone to be removed
US7938777B2 (en) 2006-07-21 2011-05-10 Orthosoft Inc. Non-invasive tracking of bones for surgery
US8439947B2 (en) 2009-07-16 2013-05-14 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US8821494B2 (en) 2012-08-03 2014-09-02 Howmedica Osteonics Corp. Surgical instruments and methods of use
US9078740B2 (en) 2013-01-21 2015-07-14 Howmedica Osteonics Corp. Instrumentation and method for positioning and securing a graft
US9232954B2 (en) 2009-08-20 2016-01-12 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US9402620B2 (en) 2013-03-04 2016-08-02 Howmedica Osteonics Corp. Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use
US9463013B2 (en) 2013-03-13 2016-10-11 Stryker Corporation Adjustable continuous filament structure and method of manufacture and use
US9788826B2 (en) 2013-03-11 2017-10-17 Howmedica Osteonics Corp. Filamentary fixation device and assembly and method of assembly, manufacture and use
US9795398B2 (en) 2011-04-13 2017-10-24 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US9808242B2 (en) 2012-04-06 2017-11-07 Howmedica Osteonics Corp. Knotless filament anchor for soft tissue repair
US9986992B2 (en) 2014-10-28 2018-06-05 Stryker Corporation Suture anchor and associated methods of use
US10448944B2 (en) 2011-11-23 2019-10-22 Howmedica Osteonics Corp. Filamentary fixation device
US10568616B2 (en) 2014-12-17 2020-02-25 Howmedica Osteonics Corp. Instruments and methods of soft tissue fixation
US10610211B2 (en) 2013-12-12 2020-04-07 Howmedica Osteonics Corp. Filament engagement system and methods of use
USD902405S1 (en) 2018-02-22 2020-11-17 Stryker Corporation Self-punching bone anchor inserter
US11331094B2 (en) 2013-04-22 2022-05-17 Stryker Corporation Method and apparatus for attaching tissue to bone
US11446090B2 (en) 2017-04-07 2022-09-20 Orthosoft Ulc Non-invasive system and method for tracking bones
US11684426B2 (en) 2018-08-31 2023-06-27 Orthosoft Ulc System and method for tracking bones

Cited By (37)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102006031356A1 (en) * 2006-07-06 2008-01-10 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. In situ removal of human or animal bone material device, has removing tool, which is reciprocally transferred by tool activating device, from passive position to active position, and which is guided to impact area of bone to be removed
DE102006031356B4 (en) * 2006-07-06 2012-02-16 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Device for the local removal of human or animal bone material
US7938777B2 (en) 2006-07-21 2011-05-10 Orthosoft Inc. Non-invasive tracking of bones for surgery
US8152726B2 (en) 2006-07-21 2012-04-10 Orthosoft Inc. Non-invasive tracking of bones for surgery
US8439947B2 (en) 2009-07-16 2013-05-14 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US11304690B2 (en) 2009-07-16 2022-04-19 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US8911474B2 (en) 2009-07-16 2014-12-16 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US10159478B2 (en) 2009-07-16 2018-12-25 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US9545252B2 (en) 2009-07-16 2017-01-17 Howmedica Osteonics Corp. Suture anchor implantation instrumentation system
US9232954B2 (en) 2009-08-20 2016-01-12 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US10231744B2 (en) 2009-08-20 2019-03-19 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US11364041B2 (en) 2009-08-20 2022-06-21 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US10238404B2 (en) 2009-08-20 2019-03-26 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US9795398B2 (en) 2011-04-13 2017-10-24 Howmedica Osteonics Corp. Flexible ACL instrumentation, kit and method
US11844508B2 (en) 2011-11-23 2023-12-19 Howmedica Osteonics Corp. Filamentary fixation device
US10448944B2 (en) 2011-11-23 2019-10-22 Howmedica Osteonics Corp. Filamentary fixation device
US11076865B2 (en) 2012-04-06 2021-08-03 Howmedica Osteonics Corp. Knotless filament anchor for soft tissue repair
US9808242B2 (en) 2012-04-06 2017-11-07 Howmedica Osteonics Corp. Knotless filament anchor for soft tissue repair
US8821494B2 (en) 2012-08-03 2014-09-02 Howmedica Osteonics Corp. Surgical instruments and methods of use
US9226744B2 (en) 2012-08-03 2016-01-05 Howmedica Osteonics Corp. Surgical instruments and methods of use
US10653410B2 (en) 2012-08-03 2020-05-19 Howmedica Osteonics Corp. Soft tissue fixation devices and methods
US10123792B2 (en) 2012-08-03 2018-11-13 Howmedica Osteonics Corp. Soft tissue fixation devices and methods
US9078740B2 (en) 2013-01-21 2015-07-14 Howmedica Osteonics Corp. Instrumentation and method for positioning and securing a graft
US10285685B2 (en) 2013-03-04 2019-05-14 Howmedica Osteonics Corp. Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use
US9402620B2 (en) 2013-03-04 2016-08-02 Howmedica Osteonics Corp. Knotless filamentary fixation devices, assemblies and systems and methods of assembly and use
US9788826B2 (en) 2013-03-11 2017-10-17 Howmedica Osteonics Corp. Filamentary fixation device and assembly and method of assembly, manufacture and use
US9463013B2 (en) 2013-03-13 2016-10-11 Stryker Corporation Adjustable continuous filament structure and method of manufacture and use
US11331094B2 (en) 2013-04-22 2022-05-17 Stryker Corporation Method and apparatus for attaching tissue to bone
US10610211B2 (en) 2013-12-12 2020-04-07 Howmedica Osteonics Corp. Filament engagement system and methods of use
US11006945B2 (en) 2014-10-28 2021-05-18 Stryker Corporation Suture anchor and associated methods of use
US9986992B2 (en) 2014-10-28 2018-06-05 Stryker Corporation Suture anchor and associated methods of use
US10568616B2 (en) 2014-12-17 2020-02-25 Howmedica Osteonics Corp. Instruments and methods of soft tissue fixation
US11446090B2 (en) 2017-04-07 2022-09-20 Orthosoft Ulc Non-invasive system and method for tracking bones
USD902405S1 (en) 2018-02-22 2020-11-17 Stryker Corporation Self-punching bone anchor inserter
USD958989S1 (en) 2018-02-22 2022-07-26 Stryker Corporation Self-punching bone anchor inserter
USD976405S1 (en) 2018-02-22 2023-01-24 Stryker Corporation Self-punching bone anchor inserter
US11684426B2 (en) 2018-08-31 2023-06-27 Orthosoft Ulc System and method for tracking bones

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