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EP-4734858-A1 - SURGICAL DEVICE FOR ABRASIVELY MACHINING A NATURAL HIP JOINT

EP4734858A1EP 4734858 A1EP4734858 A1EP 4734858A1EP-4734858-A1

Abstract

The invention relates to a surgical device (1) for abrasively machining a hip joint (2) comprising a first bone (2a) and a second bone (2b). The device (1) comprises a sleeve (3), a stop element (4), a machining means (5), and a guide (6) which can be connected to the machining means (5) in order to guide the machining means (5). The invention additionally relates to a surgical treatment system and to a method for abrasively machining a hip joint (2) of a patient.

Inventors

  • WEBER, CHRISTOPH
  • BECK, MARTIN

Assignees

  • Beck, Martin

Dates

Publication Date
20260506
Application Date
20240626

Claims (20)

  1. 1. Surgical device (1) for the abrasive treatment of a hip joint (2) comprising a first bone (2a) and a second bone (2b), the device (1) comprising: a. a sleeve (3) extending along an axial direction (A), b. a stop element (4) for positioning the device (1) on the first bone (2a); c. a processing means (5) which is designed for the abrasive treatment of the second bone (2b); and d. a guide (6) connectable to the processing means (5) for Guiding the processing means (5), wherein the guide (6) is in operative connection with the stop element (4).
  2. 2. Surgical device (1) according to claim 1, wherein the device (1) is designed such that the processing means (5) is movable relative to the stop element (4) in a transverse direction, preferably within a transverse range of motion of 1 mm to 40 mm, preferably from 1 mm to 20 mm.
  3. 3. Surgical device (1 ) according to claim 1 or 2, wherein the device (1 ) is designed such that the processing means (5) is movable relative to the Stop element (4) is movable in the axial direction (A), preferably within an axial movement range of 1 mm to 70 mm, in particular from 5 mm to 40 mm.
  4. 4. Surgical device (1) according to one of claims 1-3, wherein the device (1) is designed such that the processing means (5) is movable relative to the sleeve (3) in the axial direction (A), preferably only in the axial direction (A).
  5. 5. Surgical device (1) according to one of the preceding claims, wherein the processing means (5) comprises a milling cutter with a milling head.
  6. 6. Surgical device (1) according to claim 5, wherein the milling head has a diameter of 3 mm to 10 mm, preferably 5 mm to 7 mm, in particular 6 mm.
  7. 7. Surgical device (1) according to one of the preceding claims, wherein the stop element (4) is pivotable relative to the sleeve (3).
  8. 8. Surgical device (1) according to claim 7, wherein the stop element (4) is adapted to be transferred by pivoting from an insertion position into a pivoted-out position.
  9. 9. Surgical device (1) according to claim 8, wherein the stop element (4) extends in the insertion position substantially along the axial direction (A).
  10. 10. Surgical device (1) according to one of claims 8 or 9, wherein the stop element (4) extends radially away from the sleeve (3) in the pivoted-out position.
  11. 11. Surgical device (1) according to one of the preceding claims, wherein the stop element (4) comprises a fixing element for fixing the device (1) to the first bone (2a).
  12. 12. Surgical device (1) according to claim 11, wherein the fixing element comprises a claw structure.
  13. 13. Surgical device (1) according to one of the preceding claims, wherein the stop element (4) is movable relative to the sleeve (3) in a transverse direction.
  14. 14. Surgical device (1) according to one of the preceding claims, wherein the processing means (5), optionally together with the sleeve (3), is pivotable relative to the stop element (4).
  15. 15. Surgical device (1) according to one of the preceding claims, wherein at least one invasive working portion of the surgical device (1) has an elongated shape in the insertion position of the surgical device (1), so that the invasive working portion of the surgical device can be inserted into the body along its length through a tissue protection tube (T).
  16. 16. Surgical treatment system comprising a surgical device (1) according to one of the preceding claims and a patient positioning unit for positioning a patient, wherein the surgical device (1) and the positioning unit are operatively connected to one another.
  17. 17. Surgical treatment system according to claim 16, wherein the positioning unit comprises a first holding unit for holding a first body part of the patient and a second holding unit for holding a second body part of the patient, wherein the first holding unit and the second holding unit are movable relative to each other.
  18. 18. Method for abrasive machining of a hip joint (2) of a patient, comprising: a. providing a surgical device (1) according to one of claims 1-15 or a surgical treatment system according to one of claims 16-17; b. introducing the surgical device (1) into the body of the patient so that the stop element (4) is positioned on a first bone (2a) of the hip joint (2); c. machining a second bone (2b) of the hip joint (2) by means of the machining means (5); and d. removing the device (1) from the body of the patient.
  19. 19. The method according to claim 18, wherein the processing means (5) comprises a milling cutter with a milling head and the processing comprises milling the second bone (2b).
  20. 20. Method according to one of claims 18 or 19, wherein the first bone (2a) comprises the acetabulum and the second bone (2b) comprises the femur, particularly the hip bone and the femoral neck of the femur.

Description

Surgical device for abrasive treatment of a natural hip joint TECHNICAL FIELD The present invention relates to a surgical device for abrasive treatment of a hip joint, a surgical treatment system and a method for treating a hip joint of a patient. STATE OF THE ART Various surgical devices for abrasive processing of a hip joint are known from the state of the art. For example, milling machines are known that can be introduced into the body in a minimally invasive manner and used for milling the hip joint. The previously known surgical devices are typically guided freely by the surgeon, if necessary with the support of simultaneous imaging or computer-assisted navigation. Previously known surgical devices are used, for example, to treat femoro-acetabular impingements (FAI). Femoro-acetabular impingement describes a pathological conflict between the femoral neck and the acetabular edge of the natural hip joint, which leads to premature wear (arthrosis) of the hip joint. In the final stage, the implantation of a total hip prosthesis may be necessary. In the case of so-called cam shaft or 'cam' impingement, the transition from the femoral head to the femoral neck is not harmoniously tapered, but there is a protrusion or hump that so-called cam shaft or cam deformity. The deformity can have different dimensions and be several millimeters high. When the hip moves, especially when it bends and rotates internally, this protrusion is rotated into the hip socket and against the labrum, leading to large pressure and shear forces that damage the labrum and the articular cartilage of the hip socket until cartilage defects are eventually present (Fig. 1 a and 1 b). The final stage of the wear process leads to the development of hip arthrosis, which ultimately has to be treated with the implantation of an artificial hip joint (total hip prosthesis). One of the first treatments for FAI involved open removal of the cam deformity through surgery in which the hip was dislocated (surgical hip dislocation) and the roundness of the femoral head was restored with a chisel. Later, arthroscopic techniques were developed in which a burr was inserted and the cam deformity was removed with the aid of imaging techniques. The image from a camera was transmitted to a screen to assist the procedure, allowing the surgeon to determine the location and depth of correction. The previously known therapies and the previously known surgical devices for treating hip joints are associated with numerous problems. For example, when using the known surgical devices, it is necessary to gradually remove the excess bone. This takes time and may require additional surgical interventions. Furthermore, the precision of the surgical procedure when using known surgical devices. In particular, it is difficult to achieve a desired target contour by milling with high precision. For example, it is difficult to mill a perfect hemisphere using previously known surgical devices. Another problem is that the stability of the hip joint may be impaired after the procedure has been performed. Furthermore, the previously known devices and methods require changing the surgical instruments between the portals in order to reach all parts of the joint to be treated. Furthermore, the previously known surgical devices require great surgical skill in order to achieve a successful treatment. For example, many of the previously known devices require the simultaneous movement, operation or control of various elements of the surgical device. Furthermore, in many previously known surgical devices it is necessary to control the milling cutter located inside the body arthroscopically from outside the body with great care and precision, typically in all three spatial directions. This means that there is a risk of incorrect control. Furthermore, there is a risk of over- or under-correction of the hip joint when using the previously known surgical devices. Both overcorrection, where too much bone is removed, and undercorrection, where the deformity is not completely removed, can lead to a poor clinical outcome with persistent pain. Possible further consequences are instability of the hip. Over- or undercorrection can still require revision surgery. SUMMARY OF THE INVENTION A general object of the invention is to improve the state of the art with regard to surgical devices for the abrasive processing of a hip joint and with regard to methods for processing a patient's hip joint. In advantageous embodiments, the disadvantages of the state of the art are completely or partially overcome. In an advantageous embodiment, the present disclosure relates to a surgical device for milling a hip joint, in particular a natural hip joint, and to a method for milling a hip joint, in particular a natural hip joint. In an advantageous embodiment, the present disclosure relates to a surgical device for milling a femoral neck and to a method for milling a femoral neck. In a first aspect, the present disc