JP7797408B2 - Prosthetic implant removal tools and tool sets - Google Patents

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to Provisional Application No. 63/199,654, filed January 14, 2021, entitled "Prosthetic Implant Removal Tool and Related Method," and Provisional Application No. 63/202,053, filed May 25, 2021, entitled "Implant Removal Tool Set," and Non-Provisional Application No. 17/387,805, filed July 28, 2021, entitled "Prosthetic Implant Removal Tool and Tool Set."

TECHNICAL FIELD The present disclosure relates to a tool set for removing prosthetic implants. More particularly, the present disclosure relates to tools and related methods for minimizing bone loss during prosthesis removal.

Arthroplasty is becoming increasingly common in the United States and around the world. Arthroplasty includes complete or partial replacement of the hip, knee, or shoulder. Of these, hip replacement is the most common procedure. In a hip replacement, the surgeon replaces the socket of the hip bone, known as the acetabulum, with an acetabular cup. The femoral head is also replaced with a femoral implant. A femoral implant includes a stem that is inserted into the top end of the femur and an angled neck that extends upward. The neck mimics the original neck of the femur and provides an attachment point for the head. These implants contain coatings and texturing to promote bone growth and secure the implant to the femur and hip socket.

Most hip replacements last approximately 25 years. After this time, the acetabular cup and femoral implant may fail and require repair or replacement. As lifespans generally increase, people are living with artificial hip joints for longer periods of time. As a result, hip revision surgeries are on the rise. Revision hip replacements can be complex and often carry higher risks than the original hip replacement. During revision surgery, surgeons attempt to remove the existing implant while minimizing damage to the surrounding bone and tissue. This is often a difficult task, as implants are designed to bond with the surrounding bone over time. Minimizing this bone loss during revision surgery allows for proper fixation of the new implant. This also reduces the duration and cost of revision surgery, further shortening recovery time. Efforts have been made over the years to provide tools to aid in the efficient removal of prostheses.

One example of this is disclosed in U.S. Patent No. 5,999,499 to Macke. Macke describes a method for extracting a medical implant. According to this method, a surgical cutting guide is attached to an implanted prosthesis. An osteotome is guided through a slot in the surgical cutting guide to a specific location on the interface between the prosthesis and the bone. The prosthesis is removed using the osteotome. The osteotome is then withdrawn from the slot. The slot may include a curvature to minimize bone loss.

Another implant removal tool is disclosed in U.S. Patent No. 5,627,999 to Massini. Massini discloses a guide means for directing a cutting tool at the interface between the prosthesis and the surrounding bone. The guide means is used to provide a more controlled separation and removal of the prosthesis. The guide can be located on the prosthesis itself or on another component. In the case of a femoral implant, the guide can include a track, channel, or groove oriented along the stem of the implant.

U.S. Patent No. 5,929,999 to Amber discloses a device for removing a prosthesis from bone. The device includes a cutting tool having a cutting tip and an elongated shank designed to allow significant outward bending. A motor is included for providing rotational motion to the cutting tool. A handle is provided that is designed to be held in the hand opposite the cutting tool. The handle includes a bearing carrier with a hole for receiving the shank of the cutting tool. The surgeon manipulates the handle and cutting tool to cut around the prosthesis.

A further example is shown in U.S. Patent No. 5,999,499 to Pendleton. Pendleton discloses a device having at least one blade connected to a handle. The blade is shaped to fit a portion of the implant so that the cutting tip of the blade can be positioned in a desired position relative to the implant and femur. A force is applied to the handle so that the cutting tip of the blade cuts bone growth from the femur into the implant.

U.S. Patent No. 9,867,628 U.S. Patent No. 6,187,012 U.S. Patent No. 5,257,995 U.S. Patent No. 10,751,070

While the background art describes various devices and techniques for removing prostheses, each suffers from significant drawbacks. Specifically, the background art devices rely heavily on the surgeon's technique and do not include tools that properly conform to the shape of the prosthesis being removed, otherwise minimizing bone loss. The implant removal tool of the present disclosure is intended to overcome these and other drawbacks present in the background art.

In accordance with the present disclosure, a tool for removing a femoral implant is provided. The tool includes a proximal end, a proximal connector near the proximal end, a distal end having a leading edge, an arcuate outer wall that allows the distal end to penetrate into the femur substantially adjacent to the outside of the femoral implant, and a side edge extending from the proximal end to the distal end and configured to cut.

The present disclosure also provides a tool for removing a femoral implant. The tool includes a proximal end, a proximal connector near the proximal end, a distal end having a leading edge, and a hook connected to the distal end, all edges of the hook configured for cutting.

Further, in accordance with the present disclosure, a tool set for removing a femoral implant is provided. The tool set includes at least one outer tool, at least one inner tool, and a J-shaped or L-shaped tool. The at least one outer tool includes an outer tool proximal end, an outer tool proximal connector near the outer tool proximal end, an outer tool distal end having an outer tool leading edge, an arcuate outer tool outer wall that allows the outer tool distal end to penetrate into the femur substantially adjacent to the lateral side of the femoral implant, and an outer tool lateral edge extending from the outer tool proximal end to the outer tool distal end and configured to cut. At least one inner tool includes an inner tool proximal end, an inner tool proximal connector near the inner tool proximal end, an inner tool distal end having an inner tool leading edge, an arcuate inner tool outer wall, side edges extending from the proximal end to the distal end configured for cutting, and at least one opening disposed in the inner tool outer wall to allow partial passage of the femoral implant as the inner tool is advanced into the femur. The J-shaped and L-shaped tools each include a side tool proximal end, a side tool proximal connector near the side tool proximal end, a side tool distal end having a side tool leading edge, and a hook connected to the distal end of the side tool, all edges of the hook configured for cutting.

For a more complete understanding of the present disclosure and its advantages, please refer to the following description taken in conjunction with the accompanying drawings.

1 is a perspective view of an outer implant removal tool according to some embodiments of the present disclosure. FIG. 12A-12C are side views of an outer implant removal tool according to some embodiments of the present disclosure. 1 is a perspective view of an inner implant removal tool according to some embodiments of the present disclosure. FIG. 1 is a side view of an internal implant removal tool according to some embodiments of the present disclosure. FIG. FIG. 10 is a bottom view of a medial implant removal tool according to some embodiments of the present disclosure. FIG. 10 is a perspective view of another embodiment of an internal implant removal tool. FIG. 10 is a side view of another embodiment of an internal implant removal tool. FIG. 10 is a bottom view of another embodiment of an internal implant removal tool. FIG. 10 is a perspective view of another embodiment of an outer implant removal tool. FIG. 10 is a side view of another embodiment of an outer implant removal tool. 11 is a cross-sectional view of an alternative embodiment of the outer implant removal tool taken along line 11-11 of FIG. 10. 11 is another embodiment showing different cross sections of the outer implant removal tool of FIG. 10, each taken along section line 11-11. 11 is another embodiment showing different cross sections of the outer implant removal tool of FIG. 10, each taken along section line 11-11. 11 is another embodiment showing different cross sections of the outer implant removal tool of FIG. 10, each taken along section line 11-11. 11 is another embodiment showing different cross sections of the outer implant removal tool of FIG. 10, each taken along section line 11-11. 11 is another embodiment showing different cross sections of the outer implant removal tool of FIG. 10, each taken along section line 11-11. 1 shows the femoral implant before insertion of the outer or inner tool. 3 illustrates the insertion of the outer implant removal tool of FIGS. 1-2. 3 illustrates the insertion of the outer implant removal tool of FIGS. 1-2. 3 illustrates the insertion of the outer implant removal tool of FIGS. 1-2. 6 illustrates the insertion of the inner implant removal tool of FIGS. 3-5. 6 illustrates the insertion of the inner implant removal tool of FIGS. 3-5. Both outer and inner tools are shown fully inserted. 1 shows the femoral implant after removal of the outer and inner tools. FIG. 6 is a view of an impact hammer fixed to the inner tool of FIGS. 3 to 5; FIG. 3 is a view of an impact hammer used to insert the outer tool of FIGS. 1-2. FIG. 10 is a perspective view of another alternative embodiment of an outer implant removal tool. FIG. 23 is a front view of the outer implant removal tool shown in FIG. 22. FIG. 23 is a rear view of the outer implant removal tool shown in FIG. 22. FIG. 23 is a side view of the outer implant removal tool shown in FIG. 22. 26 is a cross-sectional view of the outer implant removal tool shown in FIG. 22 taken along line 26-26 of FIG. 23. FIG. 10 is a perspective view of yet another embodiment of an outer implant removal tool. FIG. 28 is a front view of the outer implant removal tool shown in FIG. 27. FIG. 28 is a rear view of the outer implant removal tool shown in FIG. 27. FIG. 28 is a side view of the outer implant removal tool shown in FIG. 27. 31 is a cross-sectional view of the outer implant removal tool shown in FIG. 27 taken along line 31-31 of FIG. 28. FIG. 28 is a diagram of the outer implant removal tool shown in FIG. 27 operating in combination with a Gigli wire saw. FIG. 10 is a perspective view of yet another alternative embodiment of an outer implant removal tool. FIG. 34 is an end view of the outer implant removal tool shown in FIG. 33. FIG. 34 is a front view of the outer implant removal tool shown in FIG. 33. FIG. 34 is a rear view of the outer implant removal tool shown in FIG. 33. FIG. 34 is a side view of the outer implant removal tool shown in FIG. 33. FIG. 34 is a view of full insertion of the outer implant removal tool shown in FIG. 33. FIG. 1 is a perspective view of one embodiment of a J-tool. FIG. 40 is an end view of the J-shaped tool shown in FIG. 39. FIG. 40 is a front view of the J-shaped tool shown in FIG. 39. FIG. 40 is a rear view of the J-tool shown in FIG. 39. FIG. 40 is a side view of the J-shaped tool shown in FIG. 39. FIG. 1 is a perspective view of one embodiment of an L-shaped tool. FIG. 45 is an end view of the L-shaped tool shown in FIG. 44. FIG. 45 is a front view of the L-shaped tool shown in FIG. 44. FIG. 45 is a rear view of the L-shaped tool shown in FIG. 44. FIG. 45 is a side view of the L-shaped tool shown in FIG. 44. Diagram of a femoral implant with a flange. FIG. 49 is a view of the J-shaped tool shown in FIG. 39 cutting under the flange of the femoral implant shown in FIG. 49. Like reference numbers refer to like parts throughout the several views of the drawings.

The present disclosure relates to a tool and associated method for removing prosthetic implants. The tool can be used to remove a variety of prosthetic implants, but is particularly suited for removing femoral implants. In one embodiment, both an outer tool and an inner tool are utilized. In some embodiments, at least one outer tool is utilized in conjunction with at least one of one or more inner tools, J-shaped tools, or L-shaped tools. In an exemplary, non-limiting embodiment, the outer tool includes a generally arcuate shape with upstanding sidewalls defining an arcuate interior. Thus, the outer tool is sized to follow the outer contour of the femoral implant. In one embodiment, the inner tool includes opposing sidewalls defining an internal opening. The opening is sized to receive the neck of the femoral implant, thereby allowing the tool to closely conform to the internal bone/implant interface. Details of these tools and how they can be used are described in more detail below.

The disclosed tool is specifically configured to release an implanted prosthesis by closely conforming to the bone/implant interface. This tool can be used to remove a variety of prostheses, such as shoulder and hip implants. However, in the illustrated embodiment, the tool is used to cut around, dislodge, and remove a femoral implant 20, shown in FIG. 12. As shown in FIG. 12, the femoral implant 20 generally includes an outer side 22 and an inner side 24. The implant 20 further includes a stem 26 that is inserted into the upper end of the femur 28. Various coatings and texturing can be used to promote bone ingrowth and implantation of the implant 20 into the femur 28. As shown, the implant 20 includes a textured portion 32 on its upper portion, where bone ingrowth and proper fixation are important. The femoral implant 20 also includes a neck 34 that is angled relative to the body of the implant 20. A head (not shown) is then secured to the end of the neck 34, and the head is ultimately fitted into an acetabular cup (not shown).

Outer Implant Removal Tool. Referring to FIGS. 1-2, the outer tool 36 includes proximal and distal ends (38 and 42), with the distal end 42 forming a leading edge that is inserted into the femur 28. The proximal end 38 includes a threaded opening 44 for connecting the tool to an impact hammer (FIGS. 20-21). The tool 36 can also be coupled to an impact hammer via a quick-release mechanism. Use of an impact hammer is described in more detail below. While femoral implants vary in size and shape, the outer side 22 is often curved to match the contours of the femur 28. As such, the outer tool 36 includes an outer wall 46 having an arcuate extent 48. The outer tool 36 further includes opposing side walls 52. A curved or arcuate inner portion 54 is defined in the area between the opposing side walls 52. The shape and configuration of the tool 36 can be modified to accommodate different types of prostheses.

In one embodiment, each side wall 52 of the outer tool 36 includes a first angled area 56 and a second curved area 58. As shown, the angled area 56 is located near the proximal end 38 of the tool 36, and the curved area 58 is located at the distal end 42 of the tool 36. The curved areas 58 of the tool 36 are preferably angled and sharp. All edges 60 surrounding the inner portion 54 may be sharpened to facilitate insertion of the tool 36. These sharp edges 60 cut bone growth along the bone/implant interface and otherwise enable insertion of the tool 36. A window 62 may be formed in one or both side walls 52 to allow the surgeon to measure how far the tool 36 has been inserted. The distal end 42 of the tool 36 optionally includes a curved, sharp leading edge 64. The sharp leading edge 64 and sharp edges 60 allow the outer tool 36 to be inserted as close as possible along the interface between the femur and the implant. This allows for efficient removal of the femoral implant 20.

Inner Implant Removal Tool Referring to FIGS. 3-5, the inner tool 66 includes proximal and distal ends (68 and 72) and opposing sidewalls 74. The sidewalls 74 are defined by inner and outer edges (76 and 78), and in a preferred embodiment, the outer edges 78 of the walls 74 are sharpened. However, unlike the outer tool 36, the inner tool 66 is not closed. Rather, the inner tool 66 includes a generally central opening 82. The purpose of the opening 82 will be described below. The inner and outer edges 80 surrounding the central opening 82 are preferably all sharpened. A U-shaped trough 84 having a sharpened leading edge 86 is formed in the distal end 72 of the inner tool 66. The inner tool 66 is adapted to be inserted between the femur 28 and the inner side 24 of the femoral implant 20. All of the sharpened edges 80, including the outer edge 78, inner edge 76, and leading edge 86, aid in insertion. Additionally, the neck 34 of the femoral implant 20 can extend through an opening 82 in the inner tool 66. In this regard, the opening 82 is specially sized to accommodate the neck 34 and the end of the implant 20. Sharp edges surrounding the opening 82 enable the tool 66 to cut along the anterior and posterior sides and the inner surface of the implant 20.

In another exemplary embodiment, as shown in Figures 3-4, the side walls 74 can have different lengths, allowing the overall length of the inner tool 66 to accommodate different implants.

Methods of Using the Outer and Inner Tools The methods of using the outer tool 36 and inner tool 66 will now be described with reference to FIGS. 13-19. Both the outer tool 36 and inner tool 66 can be used in conjunction with one another to remove the femoral implant 20. However, the present disclosure is not limited to the use of both tools (36 and 66), and the advantages disclosed herein can be achieved using either tool 36 or 66 individually. Each tool is inserted into bone via an associated impact tool (88 and 96) (FIGS. 20-21). More specifically, a first impact tool 88 (FIG. 21) includes a threaded area 92 secured to the threaded hole 44 of the outer tool 36. A nut 120 can be secured immediately above the threaded area 92 to prevent unintentional rotation of the impact tool 88 relative to the outer tool 36. The impact tool 88 includes a textured area 94 that allows the surgeon to manipulate the outer tool 36 during insertion. The surgeon uses the first impact tool 88 to guide the leading edge 64 and curved area 58 of the outer tool 36 into the femur 28. The weighted slide 90 is used as a hammer to apply force to the top of the outer tool 36. During insertion of the outer tool 36, the bone growth between the femoral implant 20 and the femur 28 is cut.

The second impact tool 96 (FIG. 20) is substantially similar to the first impact tool 88 and is similarly used to position and insert the inner tool 66. That is, the second impact tool 96 enables the leading edge 86, outer edge 78, inner edge 76 (and all edges 80 surrounding the opening 82) of the inner tool 66 to cut bone growth between the femoral implant 20 and the femur 28 during the insertion process. Similarly, the second impact tool 96 includes a threaded area 98, a sliding weight 100, and a guide 102. Each impact tool (88, 96) can be inserted manually or, optionally, via a pneumatic hammer or other impact tool.

As discussed, the outer and inner implant removal tools (36 and 66) can be used in conjunction with one another. It is preferable to insert and remove the outer tool 36 before inserting and removing the inner tool 66. Figure 18 shows that in a preferred embodiment, the outer and inner tools (36 and 66) are inserted into the femur 28 so that the curved area 58 of the outer tool 36 overlaps the outer edge 78 of the inner tool 66.

The overlapping edges (58 and 78) ensure that all bone growth immediately surrounding the implant 20 is removed. This ensures efficient removal of the implant 20 with minimal bone loss.

Alternative Inner Tool Embodiment Another embodiment of an inner tool 112 is shown in FIGS. 6-8. The tool 112 is generally the same as the inner tool 66 (FIGS. 3-4), but includes a side cutout 114 that provides a narrower distal size compared to the opening 118. The inner tool 112 also includes the opening 118 to accommodate different neck shapes and has a lower rounded sharp edge 116. The inner tool 112 also includes opposing side walls 124 with inner sharp edges 122. The side walls 124 can have different lengths to make the overall length of the inner tool 66 accommodate different implants.

Alternative Embodiments of the Outer Tool FIGS. 9 and 10 show another embodiment of the outer tool as outer tool 104. Outer tool 104 is similar to outer tool 36 in most respects. Outer tool 104 includes a generally straight posterior wall 106 and a leading edge 108 that is more curved than leading edges 60 and 64 of outer tool 36. This shape may be preferred for the outer tool depending on the shape and size of the implant being removed. FIGS. 11 and 11A-11E show a U-shaped cross section that makes up the body of outer tool 104. However, any of a variety of cross-sectional shapes can be used. FIGS. 11 and 11A-11E show several possible cross-sectional shapes for the outer tool.

Figures 22-26 illustrate an alternative embodiment of the outer tool as outer tool 200. The outer tool 200 includes a proximal end 202 and a distal end 204, with the distal end 204 forming a leading edge 206 for insertion into the femur. The proximal end 202 includes a proximal connector 208 and may include indicia 210. Two opposing side walls 212 extending from the proximal end 202 to the distal end 204 and an outer wall 214 extending from the proximal end 202 to the distal end 204 provide the outer tool 200 with a generally U-shaped or C-shaped cross-section at most locations perpendicular to the longitudinal direction. The two opposing side walls 212 may be substantially parallel to one another. The inner surfaces of the opposing side walls 212 and the outer wall 214 define a generally arcuate interior region 216. In some embodiments, the outer wall 214 may have an opening 218. The openings 218 may be located completely in the outer wall 214, or may be located partially in the outer wall 214 and partially in the side wall 212. At some locations along its length, the openings 218 effectively remove the outer wall 214, leaving only the side wall 212 or portions of the side wall 212.

As shown in Figures 22-25, the leading edge 206 can have a curved portion and two pointed ends 220. The leading edge 206 can be sharp, rounded, or blunt.

To allow the outer tool 200 to be connected to an impact hammer, as shown in FIGS. 20 and 21 , the proximal connector 208 may include a threaded opening, a friction fit connection, a twist lock, or other connector that allows for releasable connection to the impact hammer. In other aspects, the proximal connector 208 may allow for releasable connection to other instruments, such as a handle or vibration generator. The proximal connector 208 may also include a quick release mechanism or a more permanent locking mechanism.

Indicia 210 can be used for identification purposes. As shown in Figures 22 and 24, in a non-limiting example, indicia "14" is used to indicate that the opening along the arcuate blade is 14 mm wide. Other sizes are possible, as are indicia that identify the tool by other criteria.

While femoral implant shapes vary, the inner surface of the outer wall 214 often has a curved area to match the outer contour of the femoral implant. In some embodiments, the side edge 222 is sharp or configured for cutting and is curved or arcuate. The side edge 222 should be understood as the edge of the side of the outer tool 200 and may be the edge of the side wall 212 or the outer wall 214. In some embodiments, the outer tool 200 may have a side wall 212 that tapers in height from the proximal end 202 to the distal end 204.

Furthermore, with reference to the outer tool 200 in FIGS. 22-26, all edges surrounding the interior region 216 are sharp or configured for cutting to facilitate insertion of the outer tool 200 into the femur. These edges cut along the bone-to-implant interface and otherwise enable insertion of the outer tool 200 into the femur. In some aspects, these edges may be configured with teeth or scalloped edges to aid in cutting the bone.

As described above, the leading edge 206 may be curved between the two pointed ends 220; however, the leading edge 206 may alternatively include one or more straight edges between the pointed ends 220. To facilitate insertion into the femur, the leading edge 206 may include one or more teeth or scalloped edges. The leading edge 206, the lateral edges 222, and the interior extent of the outer wall 214 allow the outer tool 200 to be inserted as close as possible to the interface between the femur and the implant. This advantageously allows for efficient removal of the implant.

23-24, the opening 218 is shown as a rectangular shape with its length along the longitudinal axis of the outer tool 200 greater than its width. The corners of the opening 218 may include chamfers, as shown, or may be rounded. The proximal opening edge 228, the distal opening edge 230, or the side opening edge 232 may include sharp, rounded, or blunt edges. The opening 218 is shaped to allow certain features of the implant to pass through as the outer tool 200 advances into the femur. More specifically, the opening 218 allows the side edges 222 to cut closely along the implant/bone interface because the shape of the interior region 216 of the outer tool 200 does not perfectly match the exterior shape of the implant. Thus, the shape of the opening 218 can be customized for the implant to be removed. For example, while the opening 218 is shown as a rectangle, it may have another shape, such as an oval or egg shape. The outer tool 200 may also include two or more openings. The opening 218 may be located over a smaller portion of the outer tool 200.

As described with reference to the previous embodiment, a window (not shown) or other measurement feature can be formed in one or both side walls 212 or in outer wall 214 to allow the surgeon to measure how far the outer tool has been inserted.

In some exemplary embodiments, as shown in FIGS. 27-31, the outer tool 300 is similar to the outer tool 200, except that: the outer tool 300 has a sidewall 312 that has a height that rapidly tapers so that the side edge 322 becomes the edge of the outer wall 314; the interior region 316 becomes the region defined by the inner surface of the arcuate outer wall 314; a chamfer 324 may be formed on the sidewall 312 or the outer wall 314 and angled relative to the point 320. In some embodiments, the chamfer 324 is sharp or configured for cutting.

In one embodiment, as shown in FIG. 32, the distal end 304 of the outer tool 300 can be configured to accommodate a wire saw 334 or other instrument, such that once the outer tool 300 is inserted along the implant 336, the surgeon can use the wire saw to cut along the implant 336 to facilitate removal of the implant. Advantageously, the saw wire 338 can be traversed around the implant prior to introduction, thereby assisting the wire saw 334 in releasing the lateral, medial, anterior, and posterior aspects of the implant 336 from the bone 340. While the wire saw 334 is only shown in FIG. 32, it can also be used with other examples of the present disclosure.

Figures 33-37 show yet another alternative embodiment of the outer tool as outer tool 400. The outer tool 400 has a proximal end 402 and a distal end 404. As shown in the front view of the outer tool 400 in Figure 34, the outer tool 400 has two parallel side walls 406 and an outer wall 408 having a curved cross-section, defining an interior region 410. The leading edge 412 and the side edges 414 around the interior region 410 are sharp or configured for cutting on the lateral, anterior, and posterior sides of the implant as the outer tool 400 is advanced into the femur.

The outer wall 408 of the outer tool 400 is substantially straight in the longitudinal direction and has a longitudinal axis that is angled relative to the side edge 414. The opening 416 can be located in a significant portion of the outer wall 408 and in an adjacent section of the side wall 406, leaving the outer wall 408 present only near the distal end 404 of the outer tool 400. The cross-sectional shape of the outer wall 408 can be customized to match the outer shape of the implant to be removed. Advantageously, a shorter outer wall 408 can allow the outer tool 400 to fit implants with a greater variety of outer curvatures. The side edge 414 can be sharpened or configured for cutting along the anterior and posterior sides of the implant. In this exemplary embodiment, the side edge 414 is straight. However, the side edge 414 may be curved or arcuate, or have segments at different angles to facilitate cutting on the anterior and posterior sides of the implant.

The opening 416 can have sharpened or cutting edges, as shown in FIG. 38, and is large enough to allow a feature of the implant to pass through as the outer tool 400 advances into the femur. In this exemplary embodiment, a portion of the implant does not conform to the shape of the interior region 410 of the outer tool 400 and extends outward through the opening 416. The opening 416 can be shorter than the lateral edge 414. The proximal edge 418 of the opening 416 is distal to the proximal end 420 of the lateral edge 414. However, the proximal edge 418 of the opening 416 can be proximal to the proximal end of the lateral edge 414.

The proximal end 402 of the outer tool 400 can have a proximal connector 422. In some embodiments, the proximal connector 422 can include threaded holes, a friction fit connection, a twist lock, or other connectors that allow for releasable connection to an impact hammer. In other aspects, the proximal connector 422 can allow for releasable connection to other instruments, such as a handle or vibration generator. The proximal connector 422 can also include a quick release mechanism or a more permanent fixation mechanism. As shown in FIGS. 33-37 , the proximal connector 422 can be aligned or offset parallel to the axis of the straight outer wall 408. Advantageously, the surgeon or operator of the outer tool 400 can apply force via an attachment to the proximal connector 422 in an optimal orientation to facilitate advancement of the leading edge 412 into the femur. However, the proximal connector 422 can be customized to be angled relative to the axis of the straight outer wall 408 to optimize it for the particular type of implant being removed.

Undercut Tools In some embodiments, when an implant has a flange near the stem, a J-shaped tool 500, shown in FIGS. 39-43, or an L-shaped tool, shown in FIGS. 44-48, is used. The J-shaped tool 500 and the L-shaped tool 600 are each formed from a portion of a generally cylindrical shell. The J-shaped tool 500 has a straight blade 502 having a proximal end 504 and a distal end 506, and a hook 508 connected to the distal end 506 of the straight blade 502. The proximal end 504 is connected to a cylindrical tool base 510. The hook 508 includes a proximal end 512 that is sharp or configured for cutting. The L-shaped tool 600 has a straight blade 602 having a proximal end 604 and a distal end 606 of the straight blade 602. The proximal end 604 is connected to the cylindrical tool base 610. The tool base 510 or 610 may be any other shape and may include features to facilitate handling. The hook 608 includes a proximal end 512 that is sharp or configured for cutting. The hook 508 or 608 extends circumferentially from the distal end 506 or 606, respectively, and follows the same cylindrical curvature. All edges of the straight blade 502 or 602 and the hook 508 or 608 are sharp or configured for cutting.

FIG. 49 illustrates a femoral implant 700. In some embodiments shown in FIG. 49, the implant 700 may include a flange 710 near its stem 720, leaving an undercut medial side 730. The implant 700 is advanced into the femur with a J-shaped tool 500 or L-shaped tool 600, either before or after using other lateral and/or medial tools, rotated to place the hook 508 or 608 under the flange 710, and then pulled along the medial side 730 while using the proximal end 512 or 612 of the hook 508 or 608 to cut along the implant/bone interface below the flange 710 of the implant 700. This allows the J-shaped tool 500 or L-shaped tool 600 to cut around the undercut in the implant.

Figure 50 shows a J-shaped tool 500 cutting along the inside 730 of an implant 700. Those skilled in the art will understand how to perform a similar task using an L-shaped tool 600. Those skilled in the art will also understand how the J-shaped tool 500 and L-shaped tool 600 can cut around flanges at different locations on the implant.

The disclosed tools and tool sets offer several advantages. For example, the tools of the tool set are shaped to fit the interface between the bone and a prosthesis, such as a femoral implant. The tools can also include openings that correspond to the neck or other features of the prosthesis that will be passed through, so the shape of the interior region of the tool does not need to perfectly match the shape of the implant to enable cutting along the implant/bone interface. The edges on both sides and around the opening can be sharp or configured for cutting, allowing the tool to cut along the anterior and posterior sides of the implant while simultaneously cutting along the lateral or medial aspects. All of this allows the tool to be inserted along the edge of the prosthesis directly adjacent to the stem or other feature of the prosthesis, thereby efficiently removing the prosthesis.

An advantage of the disclosed tool is that it allows for efficient removal of the prosthesis in minimal time.

An additional benefit of this tool is that it allows the prosthesis to be removed while minimizing the loss of existing bone.

An added benefit of this tool is that it allows for efficient removal of the prosthesis, significantly reducing recovery time.

Another advantage is that efficient prosthesis removal reduces the need for anesthesia and overall operating room costs.

In one embodiment, the tool provides grooves or recesses to accommodate additional cutting elements, such as a wire saw, that further facilitate implant removal, thereby allowing for efficient removal of the prosthesis.

Various embodiments of the present disclosure may possess none, some, or all of these advantages. Other technical advantages of the present disclosure will be readily apparent to those skilled in the art.

While this disclosure has been described with respect to specific embodiments and generally associated methods, modifications and permutations of these embodiments and methods will be apparent to those skilled in the art. Accordingly, the above description of exemplary embodiments does not define or limit the disclosure. Other modifications, substitutions, and alterations are possible without departing from the spirit and scope of the disclosure.

20 femoral implant 22 lateral 24 medial 26 stem 28 femur 34 neck 36, 104, 200, 300, 400 outer tool 38 proximal end 42 distal end 44 threaded opening 46 lateral wall 48 arcuate area 52 side wall 54 medial portion 56 first angled area 58 second curved area 60 edge 62 window 64 distal edge 66, 112 inner tool 68 proximal end 72 distal end 74 side wall 76 inner edge 78 outer edge 80 edge 82 central opening 84 U-shaped trough 86 distal edge 88, 96 impact tool 500 J-shaped tool 600 L-shaped tool 504, 604 proximal end 506, 606 Distal end 502, 602 Straight blade 508, 608 Hook 510, 610 Cylindrical tool base

Claims (18)

1. A tool for removing a femoral implant, comprising:
a proximal end;
a proximal connector near the proximal end;
a distal end having a leading edge;
an arcuate outer wall that allows the distal end to penetrate the femur approximately closely along the outside of the femoral implant;
a side edge extending from the proximal end to the distal end and configured for cutting;
and at least one opening disposed in said outer wall through which a feature of the implant to be removed can pass . The tool of claim 1, wherein the side edges are curved. The tool of claim 1 , wherein the outer wall has only one opening. The tool of claim 3 , wherein the opening is rectangular and has a length along a longitudinal axis of the tool, the length of the opening being greater than the width of the opening. The tool of claim 3 , wherein the proximal edge of the opening is distal to the proximal end of the side edge. The tool of claim 1 , wherein the at least one opening has a sharp edge. The tool of claim 1, wherein the leading edge is sharp. The tool of claim 1, wherein the leading edge has two pointed ends and a chamfer proximal to the pointed ends, the chamfer being sharp. The tool of claim 8 , wherein the leading edge between the two pointed ends is curved. The tool of claim 8 , wherein the leading edge between the two pointed ends is straight. The tool of claim 1, wherein the proximal connector is configured to couple to a handle parallel to the cutting surface of the leading edge. The tool of claim 1, wherein the outer wall has an internal surface shape that matches the external shape of the outer side of the femoral implant. The tool of claim 1, wherein the outer wall is straight in the longitudinal direction. The tool of claim 1, wherein the tool has one or more recesses that accommodate additional cutting elements to further facilitate implant removal. The tool of claim 1, wherein the side edges taper in height from the proximal end to the distal end of the tool. The tool of claim 1, wherein at least one indicator is formed between the two side edges to allow measurement of how far the tool has been inserted into the femur. The tool of claim 16 , wherein the indicia is a window. 1. A tool kit for removing a femoral implant, comprising:
At least one tool according to claim 1 penetrated along the outside of the femoral implant ;
at least one of at least one medial tool, a J-shaped tool, or an L-shaped tool inserted along the medial side of the femoral implant ;
Equipped with
The at least one inner tool comprises :
an inner tool proximal end;
an inner tool proximal connector near the inner tool proximal end;
an inner tool distal end having an inner tool leading edge;
an arcuate inner tool outer wall;
a side edge extending from the proximal end to the distal end and configured for cutting;
at least one opening disposed in the inner tool outer wall through which a femoral implant can partially pass as the inner tool is advanced toward the femur;
Equipped with
The J-shaped tool and the L-shaped tool each have:
a side tool proximal end;
a side tool proximal connector near the side tool proximal end;
a side tool distal end having a side tool leading edge;
a hook connected to the side tool distal end, all edges of the hook configured for cutting;
A toolkit comprising: