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WO1999058067A1 - Dispositif pour preparer un os tubulaire humain en vue de l'implantation d'un implant osseux et procede pour actionner ledit dispositif - Google Patents

Dispositif pour preparer un os tubulaire humain en vue de l'implantation d'un implant osseux et procede pour actionner ledit dispositif Download PDF

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Publication number
WO1999058067A1
WO1999058067A1 PCT/EP1999/002876 EP9902876W WO9958067A1 WO 1999058067 A1 WO1999058067 A1 WO 1999058067A1 EP 9902876 W EP9902876 W EP 9902876W WO 9958067 A1 WO9958067 A1 WO 9958067A1
Authority
WO
WIPO (PCT)
Prior art keywords
bone
implant
rasp
cavity
robot
Prior art date
Application number
PCT/EP1999/002876
Other languages
German (de)
English (en)
Inventor
Hans Grundei
Original Assignee
Eska Implants Gmbh & Co.
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 Eska Implants Gmbh & Co. filed Critical Eska Implants Gmbh & Co.
Priority to EP99923482A priority Critical patent/EP1079742A1/fr
Publication of WO1999058067A1 publication Critical patent/WO1999058067A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/1659—Surgical rasps, files, planes, or scrapers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1742—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip
    • A61B17/175—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip for preparing the femur for hip prosthesis insertion

Definitions

  • the invention relates to a device for preparing a long bone for the implantation of a bone implant.
  • a (stem-shaped) endoprosthesis Before the implantation of a (stem-shaped) endoprosthesis in a long bone, for example in the human femur, the end of the joint is resected and the cancellous bone is usually milled and removed from the bone marrow.
  • the stem of the endoprosthesis can then be introduced into the milled space, which can be provided with a correspondingly open-meshed three-dimensional network structure through which bone trapezoids can grow for secondary fixation of the implant.
  • a typical example of such a stem-shaped endoprosthesis is the hip stem of an artificial hip joint.
  • Such millings are carried out with appropriate tools, i.e. milling cutters.
  • the milling has the disadvantage that the inner wall of the milling or the cavity created in the bone marrow space is tension-free. This means that after using the bone implant in the created cavity no area-wide pressure is exerted by the remaining cancellous bone on the inserted implant, so that practically no force or frictional connection between the implant and Residual cancellous bone works. This not only affects the primary fixation of the implant in situ, but also delays the ingrowth behavior of the bone trapezoids due to the open-mesh spatial network structure of the implant.
  • Another method for clearing the bone marrow space is to use a bone rasp, as is known for example from DE 43 23 873 C2 or DE 39 07 256 AI.
  • a bone rasp As is known for example from DE 43 23 873 C2 or DE 39 07 256 AI.
  • the surgeon pushes them in preparation for the implantation in the longitudinal direction of the bone marrow space, the surface of the rasps being provided with a scraping profile, which, depending on the design of the profile when the rasps are pushed into the bone marrow space, cuts through and if necessary. also when pulling out the bone marrow rasp from the bone marrow space.
  • the use of a rasp has a considerably different effect compared to the milling cutter mentioned at the beginning: when the cavity is rasped out, the side wall of the cavity is compressed when the rasp is driven into it.
  • the inner wall of the created cavity is not stress-free - as in the case of milling - but the bone material compressed in the area of the inner wall tends to relax again after removing the rasp from the cavity.
  • this leads to an increasingly force-fitting fit of the implant in the cavity and - if the implant is provided with an open-meshed three-dimensional network structure - that is, the separated, relaxing bone trapezoids reach directly into the 3D-open-mesh structure and subsequently a much faster growth of the implant.
  • the device consists of a programmable industrial robot which carries on its robot hand a machine tool with a tool head which operates in the manner of a rotary hammer.
  • the tool head performs an oscillating stroke movement in the direction of its longitudinal axis during operation of the machine tool and carries a rasp bone. This is used to clear out a cavity in the long bone in the form of the bone implant to be inserted.
  • the core of the invention is accordingly the combination of a programmable industrial robot with a machine tool which drives a bone rasp known per se into the tubular bones.
  • the combination of the components according to the invention enables extremely precise rasping of the cavity in the bone marrow space, in which the implant of the same shape is then inserted. Due to the high precision it is achieved that the surface pressure from the inner wall of the rasped cavity to the greatest possible extent on the implant surface is evenly distributed, so that a high stable primary fixation is guaranteed. If the implant has an open-meshed three-dimensional network structure on its surface, bony trapezoids are pressed from the inner wall of the cavity into the surface of the implant due to the relaxation after compression by using the rasp. This creates an excellent basis for organizing bone material through the surface of the implant.
  • the advancement of the robot arm is preferably program-controlled.
  • the software depicts the X-ray slices of this medullary bone that have been taken preoperatively. This increases the precision of the rasping of the cavity.
  • the robot head advances the bone rasp without pressure. This ensures that the cavity does not break out of bone material at places where this is not intended due to high loads.
  • the drawing shows a patient lying on an operating table 9, whose hip area has already been opened so that a cavity can be rasped into the femur bone 7, in which a hip stem of an artificial hip joint can then be inserted.
  • a bone rasp 6 is used to create the cavity, which is introduced into the bone marrow space in an oscillating manner in the direction of the longitudinal axis of the femoral bone 7 and is pulled out again.
  • the bone rasp 6 is coupled to an industrial robot 2 of a known type.
  • the coupling of the bone rasp 6 the robot 2 takes place via a machine tool 4, which essentially works in the manner of a rotary hammer.
  • the machine tool 4 is fastened to the robot hand 3, which in turn sits on the front of the robot arm 8.
  • the robot 2 is operated in a software-controlled manner in such a way that the software images the x-ray slice images of the bone marrow space of the femur 7 so that the bone rasp 6 can grate the respective cavity individually adapted to the patient's requirements.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Robotics (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un dispositif permettant de préparer un os tubulaire humain en vue de l'implantation d'un implant osseux. Ce dispositif comprend un robot industriel (2) programmable qui porte sur sa main (3), une machine-outil (4) munie d'une tête d'outil (5) et fonctionnant comme un marteau-perforateur. La tête d'outil guide pendant que la machine (4) est en marche, une râpe osseuse (6) avec laquelle une cavité est ménagée dans l'os tubulaire (7), ayant la forme de l'implant osseux à introduire.
PCT/EP1999/002876 1998-05-08 1999-04-28 Dispositif pour preparer un os tubulaire humain en vue de l'implantation d'un implant osseux et procede pour actionner ledit dispositif WO1999058067A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP99923482A EP1079742A1 (fr) 1998-05-08 1999-04-28 Dispositif pour preparer un os tubulaire humain en vue de l'implantation d'un implant osseux et procede pour actionner ledit dispositif

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19820506.6 1998-05-08
DE19820506A DE19820506C1 (de) 1998-05-08 1998-05-08 Vorrichtung zur Präparation eines menschlichen Röhrenknochens für die Implantation eines Knochenimplantates sowie Verfahren zum Betreiben dieser Vorrichtung

Publications (1)

Publication Number Publication Date
WO1999058067A1 true WO1999058067A1 (fr) 1999-11-18

Family

ID=7867021

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1999/002876 WO1999058067A1 (fr) 1998-05-08 1999-04-28 Dispositif pour preparer un os tubulaire humain en vue de l'implantation d'un implant osseux et procede pour actionner ledit dispositif

Country Status (3)

Country Link
EP (1) EP1079742A1 (fr)
DE (1) DE19820506C1 (fr)
WO (1) WO1999058067A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002007631A1 (fr) * 2000-07-21 2002-01-31 U.R.S. Universal Robot Systems Gmbh & Co. Kg Instrument chirurgical permettant de façonner une structure osseuse

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10146042A1 (de) * 2001-09-18 2003-05-08 Urs Universal Robot Systems Gm Chirurgisches Instrument zum Bearbeiten einer knöchernen Struktur

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4651833A (en) * 1983-12-01 1987-03-24 Emil Schenker Ag Pneumatic impact tool
US5152352A (en) * 1990-04-20 1992-10-06 Imt Integral Medizintechnik Ag Pneumatic percussion tool, especially for the preparation of bones
US5408409A (en) * 1990-05-11 1995-04-18 International Business Machines Corporation Image-directed robotic system for precise robotic surgery including redundant consistency checking
EP0755660A2 (fr) * 1995-07-28 1997-01-29 Armstrong Healthcare Limited Dispositif d'alignement
WO1997030652A1 (fr) * 1996-02-22 1997-08-28 Integrated Surgical Systems, Inc. Dispositif assiste par ordinateur pour la revision d'une chirurgie d'arthroplastie totale de hanche
WO1998014127A1 (fr) * 1996-09-30 1998-04-09 Integrated Surgical Systems, Inc. Procede et systeme servant a un alesage de finition de cavites osseuses

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4979949A (en) * 1988-04-26 1990-12-25 The Board Of Regents Of The University Of Washington Robot-aided system for surgery
DE3907256A1 (de) * 1989-03-07 1990-09-20 Orthoplant Endoprothetik Knochenraspel
DE4323873C2 (de) * 1993-07-16 1996-07-18 Eska Medical Gmbh & Co Hohlschaftraspel

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4651833A (en) * 1983-12-01 1987-03-24 Emil Schenker Ag Pneumatic impact tool
US5152352A (en) * 1990-04-20 1992-10-06 Imt Integral Medizintechnik Ag Pneumatic percussion tool, especially for the preparation of bones
US5408409A (en) * 1990-05-11 1995-04-18 International Business Machines Corporation Image-directed robotic system for precise robotic surgery including redundant consistency checking
EP0755660A2 (fr) * 1995-07-28 1997-01-29 Armstrong Healthcare Limited Dispositif d'alignement
WO1997030652A1 (fr) * 1996-02-22 1997-08-28 Integrated Surgical Systems, Inc. Dispositif assiste par ordinateur pour la revision d'une chirurgie d'arthroplastie totale de hanche
WO1998014127A1 (fr) * 1996-09-30 1998-04-09 Integrated Surgical Systems, Inc. Procede et systeme servant a un alesage de finition de cavites osseuses

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
"ROBOT ASSISTS WITH HIP REPLACEMENT SURGERY", MACHINE DESIGN, vol. 65, no. 4, 26 February 1993 (1993-02-26), pages 12, XP000355849, ISSN: 0024-9114 *

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002007631A1 (fr) * 2000-07-21 2002-01-31 U.R.S. Universal Robot Systems Gmbh & Co. Kg Instrument chirurgical permettant de façonner une structure osseuse

Also Published As

Publication number Publication date
DE19820506C1 (de) 2000-01-05
EP1079742A1 (fr) 2001-03-07

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