Methods and instruments for performing radial impacting
AssigneeSmith & Nephew, Inc.
InventorS. David Stulberg
Life of this patent
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Abstract
A radial impacting technique involves using a set of progressively larger radial impactors to pack a medullary canal in a radial direction toward the cortex. For revision cases, graft material, which may be either synthetic or bone graft material, is added into the medullary canal after the previously installed implant has been removed. Packing the medullary canal in the radial direction, as opposed to the conventional approach of packing in a distal direction, provides superior results. The radial impactors are preferably cannulated and may also have holes to assist in the removal of fluids from within the medullary canal. The profile impactors may be either cannulated or non-cannulated and prepare the medullary canal for receipt of the implant.
Claims82
A method of preparing a medullary canal of a bone for receipt of a prosthetic implant by packing, graft material, comprising:
- inserting a first packer into the medullary canal to pack said graft material, the first packer comprising:
- (a) a first outer periphery at a reference position within the medullary canal and
- (b) a working surface having a substantially circular cross-section throughout its entire length;
- inserting at least a second packer into the medullary canal to pack said graft material, the second packer comprising:
- (a) a second outer periphery at the reference position and
- (b) a working surface having a substantially circular cross-section throughout its entire length, the second outer periphery being greater than the first outer periphery;
- wherein inserting the second packer occurs after inserting the first packer so as to pack the medullary canal in a radial direction toward the cortex of the bone.
A method of preparing a medullary canal of a bone for receipt of a prosthetic implant by packing graft material, comprising:
- inserting a first packer having an insertion end and working surface into the medullary canal, the working surface having a substantially circular cross-section throughout its entire length with the working surface generally decreasing in cross-section in a direction toward the insertion end;
- inserting at least a second packer having an insertion end and working surface into the medullary canal, the working surface of the second packer having a substantially circular cross-section throughout its entire length and generally decreasing in cross-section in a direction toward the insertion end, diameters of the second packer being larger than the diameters of the first packer at corresponding positions along lengths of the first and second packers;
- wherein inserting the first and second packers pack the medullary canal in a radial direction toward the cortex of the bone.
A radial packer in combination with graft material for preparing a medullary canal for receipt of a prosthetic implant, comprising:
- a radial packer having a smooth working surface, the working surface having a substantially circular cross-section throughout its entire length that generally decreases in diameter at an insertion end, the insertion end adapted to be inserted into the medullary canal;
- and
- graft material for being inserted into the medullary canal, the graft material adapted to be packed by the packer in a radial direction relative to the medullary canal toward a cortex of the bone;
- and
- an instrument for being coupled to the radial packer for rotating the radial packer after the packer is inserted into the medullary canal in order to pack the graft material in the medullary canal.
A collection of instruments for preparing a bone for receipt of a prosthetic implant, comprising:
- a plurality of radial packers each having a smooth working surface adapted to pack the medullary canal in a radial direction toward the cortex of the bone, the radial packers being sized to have progressively larger outer peripheries at corresponding positions along the lengths of the radial packers and the radial packers each having a working surface having a substantially circular cross-section throughout its entire length;
- at least one profile packer adapted to pack the medullary canal to define an aperture within the medullary canal bone of an approximate size and shape to receive at least part of the prosthetic implant, and
- an instrument for being coupled to the radial packer for rotating the radial packer after the radial packer is inserted into the medullary canal in order to pack the graft material in the medullary canal.
A method of preparing a medullary canal for arthroplasty by packing graft material, comprising:
- inserting a guide wire into the medullary canal;
- inserting at least one cannulated radial packer to pack said graft material, the radial packer having an insertion end and working surface into the medullary canal, the working surface having a substantially circular cross-section throughout its entire length and generally decreasing in cross-section in a direction toward the insertion end;
- and
- inserting at least one profile packer into the medullary canal, a portion of the profile packer having a shape that approximates a shape of a prosthetic implant.
A method of preparing a medullary canal for arthroplasty by packing graft material, comprising:
- inserting at least one radial packer to pack the graft material, the radial packer having an insertion end and working surface into the medullary canal, the working surface having a substantially circular cross-section throughout its entire length and generally decreasing in cross-section in a direction toward the insertion end;
- inserting at least one profile packer into the medullary canal, a portion of the profile packer having a shape that approximates a shape of a prosthetic implant;
- and
- inserting a prosthetic implant into the medullary canal.
A collection of instruments for use in performing arthroplasty, comprising:
- at least one radial packer adapted to be inserted into a medullary canal for packing graft material, each radial packer having a working surface that is generally tapered and having a substantially circular cross-section throughout its entire length, an insertion end of the radial packer having a smaller outer periphery than an outer periphery of a more distal position along a length of the radial packer;
- a stem implant having a portion adapted to be inserted into the medullary canal;
- and
- an instrument for being coupled to the radial packer for rotating the radial packer after the radial packer is inserted into the medullary canal in order to pack the graft material in the medullary canal;
- wherein outer peripheries of the at least one radial packer are smaller than outer peripheries of the stem implant at corresponding positions along lengths of the at least one radial packer and stem implant.
A radial packer in combination with graft material for preparing a medullary canal for receipt of a prosthetic implant, comprising:
- a radial packer having a smooth working surface, the working surface having a substantially circular cross-section throughout its entire length that generally decreases in diameter at an insertion end, the insertion end adapted to be inserted into the medullary canal;
- graft material for being inserted into the medullary canal, the graft material adapted to be packed by the packer in a radial direction relative to the medullary canal toward the cortex;
- and
- a torque wrench for measuring the stability of an implant.
A collection of instruments for preparing a bone for receipt of a prosthetic implant, comprising:
- a plurality of radial packers each having a smooth working surface adapted to pack the medullary canal in a radial direction toward the cortex of the bone, the radial packers being sized to have progressively larger outer peripheries at corresponding positions along the lengths of the radial packers and the radial packers each having a working surface having a substantially circular cross-section throughout its entire length;
- at least one profile packer adapted to pack the medullary canal to define an aperture within the medullary canal bone of an approximate size and shape to receive at least part of the prosthetic implant;
- and
- a torque wrench for measuring the stability of an implant.
A method of preparing a medullary canal of a bone for receipt of a prosthetic implant by packing graft material, comprising:
- inserting a packer having a working surface into the medullary canal to pack said graft material, the working surface of the packer having a substantially circular cross-section throughout its entire length, and
- rotating the radial packer for a continuous period of time in one direction,
- wherein the inserting the packer packs the medullary canal in a radial direction toward the cortex of the bone.
Dependencies are inferred from the claim text.