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WO2024049454A1 - Appareil de chirurgie de révision articulaire - Google Patents

Appareil de chirurgie de révision articulaire Download PDF

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Publication number
WO2024049454A1
WO2024049454A1 PCT/US2022/045685 US2022045685W WO2024049454A1 WO 2024049454 A1 WO2024049454 A1 WO 2024049454A1 US 2022045685 W US2022045685 W US 2022045685W WO 2024049454 A1 WO2024049454 A1 WO 2024049454A1
Authority
WO
WIPO (PCT)
Prior art keywords
stem
knife blade
surgical knife
guide plate
guide block
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.)
Ceased
Application number
PCT/US2022/045685
Other languages
English (en)
Inventor
Mark B. WRIGHT
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.)
Map Medical Solutions LLC
Original Assignee
Map Medical Solutions LLC
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
Priority claimed from US17/899,521 external-priority patent/US12502183B2/en
Application filed by Map Medical Solutions LLC filed Critical Map Medical Solutions LLC
Publication of WO2024049454A1 publication Critical patent/WO2024049454A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • A61B17/17—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
    • 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
    • A61B17/1604—Chisels; Rongeurs; Punches; Stamps
    • 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
    • A61B17/1662—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body
    • A61B17/1664—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the hip
    • A61B17/1668—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the upper femur
    • 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
    • A61B17/1735—Guides or aligning means for drills, mills, pins or wires for rasps or chisels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B2050/005—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers with a lid or cover
    • A61B2050/0051—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers with a lid or cover closable by rotation
    • A61B2050/0056—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers with a lid or cover closable by rotation about a lateral axis in the lid plane
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/30—Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments
    • A61B2050/3008—Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments having multiple compartments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2002/4619—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof for extraction

Definitions

  • This application relates to a surgical apparatus used on joint replacement revision surgery in the areas of the hip joint, shoulder joint and knee joint. More particularly, the present application is directed to a Joint Revision Surgery Apparatus includes a surgical knife blade guide block which has a plurality of rearward blade guide slots, a central cavity and a plurality of guide slots having a two-way adjustable L-shaped guide plate.
  • the blade guide block central cavity is positioned over the trunnion end of the existing prosthesis to be removed and secured to the prothesis.
  • Straight, curved and compound curved knife blades are guided by the blade guide slots to cut the pro thesis free.
  • the securing of the guide blade block support apparatus against the femur is accomplished by the means of a T-handle screw or eyebolt threading into one of the threaded orifice in the blade guide block frame.
  • the guide blocks in varying sizes and configurations, straight and curved knifes blades and related accessories may be sold as a complete kit.
  • the Joint Revision Surgery Apparatus facilitates rapid, efficient and complete removal of an existing prosthesis during joint revision surgery.
  • the revision hip implant is comprised of four parts that work together to restore the original function of the ball-and-socket joint, namely. (1 ) A metal hip stem that is inserted into the top of the thighbone; (2) A metal cup which holds the cup liner; (3) A cup liner which holds the femoral head; and (4 ) The femoral head or ball which is attached to the top of the hip stem and is inserted into the cup liner to form the ball-and- socket joint.
  • the hip may become infected after surgery. Although it may be successfully treated with antibiotics, there are severe cases where a follow-up revision surgery may be required.
  • Hip revision operations are performed relatively infrequently. In the United States, there are approximately 18 revision hip replacements performed for every 100 hip replacements. The most common reasons for revision are: (1) Repetitive (recurrent) dislocation of a hip replacement; (2) Mechanical failure (implant wear and tear - loosening or breakage); and (3) Infection.
  • US Patent No. 9,138,242 of Randell J. Lewis describes a femoral hip stem explant system that has an alignment body which is attached to two locations of a femoral bone and has several lockable collet type adjustment features to set the shaft of a reamer or end mill exactly in coincidence with the femoral bone cavity axis.
  • the shaft of the end mill or reamer is supported by a sleeve member, which is inserted into a drill guide central aperture.
  • the drill guide aperture is adjusted first and locked to be in line with the femoral bone cavity.
  • Each of the sleeve members has the same mating outer diameter, which fits into the drill guide central aperture. Accordingly, the sleeve members can be interchanged into the drill guide aperture with shafts of differently sized reamers or end mills.
  • This patent describes a femoral hip stem explant or revision system that has an alignment body which is attached to two locations of a femoral bone and has several lockable collet type adjustment features to set the shaft of a reamer or end mill exactly in coincidence with the femoral bone cavity axis.
  • This patent describes a very invasive surgery to attach at two locations of a femoral bone where the Joint Revision Surgery Apparatus works from the top of the femur only and leaves the most proximal portion in fairly good shape.
  • IM revision tools include reamers with depth markings or stops, an impactor-extractor with a coupling for attaching to tools which are inserted into and removed from the IM canal, a resection guide tower to which a cutting block is attached and which includes a notch which serves as both a witness mark and a holder for a femoral collar, a reversible clean-up cutting block with a quick-connect clamp attachable to the guide tower for resecting the distal femur, a selection of spacer blocks for measuring the space between the femur to determine the size of the components to be installed, a multiple cut cutting guide for preparing the femur, a set of 5 and 10 mm trial wedges, a trial stem valgus adapter, femoral sizing indicators which include indications of anterior/posterior offset, a stabilizer box cutting template which is attachable to the multiple cut cutting guide
  • This patent describes IM revision tools that include reamers with depth markings or stops, an impactor-extractor with a coupling for attaching to tools which are inserted into and removed from the IM canal, a resection guide tower to which a cutting block is attached.
  • This patent describes a number of tools for positioning and alignment where the Joint Revision Surgery Apparatus uses the trunnion and the sides of the existing prostheses and the proximal portion of the femur for support and alignment of the process.
  • IM revision tools include reamers with depth markings or stops, an impactor-extractor with a coupling for attaching to tools which are inserted into and removed from the IM canal, a resection guide tower to which a cutting block is attached and which includes a notch which serves as both a witness mark and a holder for a femoral or tibial collar, a reversible clean-up cutting block with a quick-connect clamp attachable to the guide tower for resecting the distal femur and separate left and right clean-up cutting blocks for resecting the proximal tibia, a selection of spacer blocks for measuring the space between the tibia and femur to determine the size of the components to be installed, a multiple cut cutting guide for preparing the femur, a set of 5 and 10 mm trial wedges, a trial stem valgus adapter, femoral
  • This patent describes an apparatus for removal of a femoral implant that may include a handle portion and a cutting blade opposite the handle portion but does not describe the unique features of the Joint Revision Surgery Apparatus.
  • US Patent No. 9,282,981 of Rebecca L. Chaney describes a number of orthopedic surgical instruments for use in a surgical procedure to prepare a patient's femur to receive an orthopedic prosthesis are disclosed.
  • the tools include guide tools, cutting tools, surgical blocks, and other orthopedic surgical instruments configured to plan and guide the preparation of the patient's femur.
  • This patent describes a number of orthopedic surgical instruments for use in a surgical procedure to prepare a patient's femur to receive an orthopedic prosthesis but does not describe unique features of the Joint Revision Surgery' Apparatus.
  • the principle advantage of the of the Joint Revision Surgery Apparatus is to enable the performance of a significantly quicker, safer and more successfill joint revision surgery procedure.
  • Another advantage of using the Joint Revision Surgery Apparatus is to have significantly less blood loss during the joint revision surgery procedure.
  • Another advantage of using the Joint Revision Surgery Apparatus is to perform joint revision surgery with less instrumentation and tools, for example, cables and long stems during the procedure.
  • Another advantage of using the Joint Revision Surgery Apparatus is to have quicker times to have full weight bearing capability after joint revision surgery.
  • Another advantage of using the Joint Revision Surgery Apparatus is to have fewer complications during and after joint revision surgery.
  • Another advantage of using the Joint Revision Surgery Apparatus is to have less morbidity and mortality following joint revision surgery.
  • Another advantage of using the Joint Revision Surgery Apparatus is that it will accommodate the removal of collared femoral stems which are significantly more difficult to extract than non-collared femoral stems.
  • An advantage of the first alternate embodiment of the Joint Revision Surgery Apparatus is to have the internal elongated cavity allowing the upward movement of the existing prostheses.
  • Another advantage of using the first alternate embodiment of the Joint Revision Surgery Apparatus is by tightening the T handle screw, the existing prostheses can be moved upward.
  • Another advantage of using the first alternate embodiment of the Joint Revision Surgery Apparatus is by tightening the T handle screw to lift upwardly to extract the existing prostheses.
  • An advantage of the second alternate embodiment of the Joint Revision Surgery Apparatus is to have a simpler device to perform the joint revision surgery procedure.
  • the Joint Revision Surgery process entails the positioning of the support apparatus over the trunnion end of the existing prostheses within its internal cavity.
  • the wide knife blades will initially be used to properly align the support apparatus with the side surfaces of the existing prostheses.
  • the securing of the support apparatus down against the femur end is accomplished by the means of the T handle screw threading into the threaded orifice in of the existing prostheses.
  • Wide knife blades or shaped knife blades will be used to loosen both sides of the existing prostheses while narrow blades will be used around the tapered curved apertures and on the ends of the support apparatus.
  • the distal end of one of the curved aperture has an internal curvature to guide the tapered knife blade along the curved front edge of the existing prostheses.
  • the replaceable knives can be used in a pneumatic osteotome or tapped with a surgical hammer.
  • Both the internally curved front edge and back edge of the existing prostheses may be flat or have a curved surface.
  • the blades will be used with the sharp edge section toward the side surfaces of the existing prostheses to keep the knives from digging into or scraping the bone.
  • FIG. 1 depicts a cross section through the preferred embodiment of the support apparatus and tools used in performing the Joint Revision Surgery .
  • FIG. 2 depicts a side view of the hip replacement prostheses.
  • FIG. 3 depicts a narrow blade knife used in the Joint Revision Surgery .
  • FIG. 4 depicts a tapered blade knife used in the Joint Revision Surgery.
  • FIG. 5 depicts a wide blade knife used in the Joint Revision Surgery.
  • FIG. 6 depicts a side view of the T handle screw used in securing and removal of the existing prostheses.
  • FIG. 7 depicts a view of a normal hip illustrating the pelvis, and femur connection.
  • FIG. 8 depicts a view of the femur separated from the pelvis with the existing ball section removed and the plastic cup and metal shell exploded away.
  • the existing hip prosthesis and ball are above the existing cavity.
  • FIG. 9 depicts a perspective view of the femur end with the support apparatus in place.
  • FIG. 10 depicts an end view of the preferred embodiment of the support apparatus.
  • FIG. 11 depicts a side view cross section of the preferred embodiment of the support apparatus.
  • FIG. 12 depicts atop view of the preferred embodiment of the support apparatus.
  • FIG. 13 depicts a side view of the angled blade knife.
  • FIG. 14 depicts a side view of the wide blade knife.
  • FIG. 15 depicts a top view of the first alternate embodiment of the support apparatus.
  • FIG. 16 depicts a cross section through the first alternate embodiment of the support apparatus with the T head screw attached to the existing hip prosthesis.
  • FIG. 17 depicts a cross section through the first alternate embodiment of the support apparatus with angled blade knife or the wide blade knife along the sides of the existing prostheses and curved knives on the ends.
  • FIG. 18 depicts a cross section through the first alternate embodiment of the support apparatus where the T handle screw is tightened to pull the existing hip prosthesis up from the femur.
  • FIG. 19 depicts a perspective view of the second alternate embodiment of the support apparatus with a different configuration.
  • FIG. 20 depicts a perspective view of the second alternate embodiment of the support apparatus with a different configuration illustrating the tools used in the procedure.
  • FIG. 21 depicts a perspective view of the third alternate embodiment of the blade guide block.
  • FIG. 22 depicts a perspective view of the fourth alternate embodiment of the blade guide block.
  • FIG. 23 depicts a bottom view of the fourth alternate embodiment of the blade guide block.
  • FIG. 24 depicts a side view of the fourth alternate embodiment of the blade guide block.
  • FIG. 25 depicts a top view of the fourth alternate embodiment of the blade guide block.
  • FIG. 26 depicts a perspective view of the fourth alternate embodiment of the blade guide block and the attaching secondary blade guide block.
  • FIG. 27 depicts the bottom view of the secondary blade guide block.
  • FIG. 28 depicts the side view of the secondary blade guide block.
  • FIG. 29 depicts the top view of the secondary blade guide block.
  • FIG. 30 depicts a side view of the fourth alternate embodiment of the blade guide block and the attaching secondary blade guide block connected with a flat blade going through one of the four slots in the end.
  • FIG. 31 depicts a front view of the eye bolt.
  • FIG. 32 depicts a front view of the T handle screw.
  • FIG. 33 depicts a perspective view of the fifth alternate embodiment of the blade guide block with the adjustable insert and the adjusting mechanism raised up.
  • FIG. 34 depicts a perspective view of the fifth alternate embodiment of the blade guide block with the adjustable insert and the adjusting mechanism in position.
  • FIG. 35 depicts a side cut-away view of the fifth alternate embodiment of the blade guide block with the adjustable insert and the adjusting mechanism.
  • FIG. 36 depicts a perspective view of the sixth alternate embodiment of the internal tension spring blade guide ball using an internal spring tensioner.
  • FIG. 37 depicts a side view of the sixth alternate embodiment of the external spring blade guide ball using an internal spring tensioner.
  • FIG. 38 depicts a perspective view of the sixth alternate embodiment of the blade guide ball using an external spring tensioner.
  • FIG. 39 depicts a side view of the seventh alternate embodiment of the blade guide ball using an external spring tensioner.
  • FIG. 40 depicts a perspective view of a two part eighth alternate embodiment of the blade guide ball with internal spring tensioners exposed.
  • FIG. 41 depicts perspective view of a two part eighth alternate embodiment of the blade guide ball with internal spring tensioners.
  • FIG. 42 depicts a side view of a prostheses attached to a cut-away third alternate embodiment of the blade guide block illustrating a thin curved blade with handle in position with the eye bolt secured against the prostheses trunnion.
  • FIG. 43 depicts a side view of a large prosthesis.
  • FIG. 44 depicts a side view of a small prostheses with a trunnion adapter extended away from it.
  • FIG. 45 depicts a top view of the small prostheses illustrating the semi-hexagonal shape.
  • FIG. 46 depicts a top view of a heavy curved blade a curved sharp end and a metal end cap.
  • FIG. 47 depicts a side view of a heavy curved blade a curved sharp end and a metal end cap.
  • FIG. 48 depicts a top view of a thin curved blade a curved sharp end and a metal end cap.
  • FIG. 49 depicts a side view of a thin curved blade a curved sharp pointed end and a metal end cap.
  • FIG. 50 depicts a top view of a straight narrow flat blade with a chisel shaped sharp end and a metal end cap.
  • FIG. 51 depicts a top view of a straight wide flat blade with a triangular shaped sharp end and a metal end cap.
  • FIG. 52 depicts a side view of a thin curved blade a sharp pointed end, a straight handle and a metal end cap.
  • FIG. 53 depicts side view of a thin curved blade a sharp pointed end, a two part handle with the metal end cap enclosed.
  • FIG. 54 depicts a perspective view of a typical prosthesis with a two part blade guide ball and a two part handle.
  • FIG. 55 depicts side view of a typical prosthesis with a two part blade guide ball and a two part handle with the metal end cap enclosed.
  • FIG. 56 depicts a perspective view of the insert section of the two part blade guide ball.
  • FIG. 57 depicts a perspective view of the base section of the two part blade guide ball.
  • FIG. 58 depicts a perspective view of the two part blade guide ball.
  • FIG. 59 depicts a perspective view of a box style of container illustrating a typical assortment of the prosthesis replacement equipment assembled in a surgeon's hospital kit for prosthesis extraction according to the present invention.
  • FIG. 60 depicts an exploded top and side perspective view of a surgical knife blade guide block illustrating the two-piece construction, surgical knife blade slots and the locking rings w ithin a locking ring cavity capable of accepting a prothesis stem trunnion and securing it for an extraction operation.
  • FIG. 61 depicts an alternate embodiment of the locking rings capable of accepting a prothesis stem trunnion and securing it for an extraction operation.
  • FIG. 62 depicts a cross-sectional view of the surgical knife blade guide block having a single channel front slot and multiple rear slots, illustrating the position of the surgical knife blade slots and the locking ring cavity accepting a prothesis stem trunnion of a stem cemented in place within a patient’s femur.
  • FIG. 63 depicts a front and top partial perspective view of the surgical knife blade block shown in FIG. 62 illustrating the shape of the single channel front surgical knife blade slot therein.
  • FIG. 64 depicts femoral stem extraction Step 1 wherein a cross sectional view of a stem within a femur wherein a Lambotte osteotome is beginning to remove a small triangle of bone therein.
  • FIG. 65A depicts femoral stem extraction Step 2 showing a cross-sectional view of the surgical knife blade guide block having a single channel front slot, illustrating the position of a rigid surgical knife blade and a flexible surgical knife blade within the single slot and passing the collar to enter the removed bone triangle within a patient’s femur.
  • FIG. 65B depicts a partial magnification of FIG. 65A femoral stem extraction Step 2 showing greater detail of the movement and position of the surgical knife blades.
  • FIG. 65C depicts a cross-sectional view of FIG. 65A showing the curved rigid surgical knife blade below and guiding the flexible surgical knife blade above.
  • FIG. 66A depicts femoral stem extraction Step 3 showing a cross-sectional view of the surgical knife blade guide block having a single channel front slot, illustrating the position of a rigid surgical knife blade and a flexible surgical knife blade within the single slot and passing the collar to enter the removed bone triangle within a patient’s femur, wherein the rigid surgical knife blade is extended downward reaching the stem, then backing off about 3 - 4 millimeters and the flexible surgical knife blade is guided to the stem by the rigid surgical knife blade and is extended downward cutting the cement material holding the stem in place within the femur.
  • FIG. 66B depicts a partial magnified view of FIG. 66A showing greater detail and illustrating the positions of the lower surgical rigid knife blade which guides the flexible surgical knife blade and the upper flexible surgical knife blade which cuts through the cement on the surface of the stem.
  • FIG. 67 depicts a cross-sectional view of the surgical knife blade guide block having a single channel front slot and multiple channel rear slots, illustrating the position of a rigid surgical knife blade and a flexible surgical knife blade extending downward within the single slot, and a surgical knife blade extending downward on the opposite side of the stem to be removed.
  • FIG. 68 depicts a front and top partial perspective view of the surgical knife blade block shown in FIG. 67 illustrating the shape of the single channel front surgical knife blade slot therein.
  • FIG. 69 depicts a top and side perspective view of a specialized surgical knife blade guide tool which when placed within the surgical knife blade slot is used to act as a rigid guide for the flexible surgical knife blade which may be extended in one of two surgical knife blade slots above or below' the lower portion of the guide tool.
  • FIG. 70 depicts a cross-sectional view' of the surgical knife blade guide block having a multiple channel front slot and multiple channel rear slots, illustrating the position of a rigid surgical knife blade and a flexible surgical knife blade extending downward within the multiple slots, and a surgical knife blade extending downward on the opposite side of the stem to be removed.
  • FIG. 71 depicts a front and top partial perspective view of the surgical knife blade block shown in FIG. 70 illustrating the shape of the multiple channel front surgical knife blade slots therein.
  • FIG. 72 depicts a cross-sectional view' of the surgical knife blade guide block having a multiple channel front slot and multiple channel rear slots, illustrating the surgeon’s hand grasping the surgical knife blade guide block to initiate removal of the stem after all stem cement cutting operations have been completed.
  • FIG. 73 depicts a cross-sectional view' of the surgical knife blade guide block having a multiple channel front slot and multiple channel rear slots, illustrating the surgeon’s hand grasping the surgical knife blade guide block to complete removal of the stem after all stem cement cutting operations have been completed.
  • FIG. 74 depicts a rigid surgical knife blade for attachment to an osteotome to act to guide a flexible cutting blade.
  • FIG. 75 depicts another rigid surgical knife blade for attachment to an osteotome to act to guide a flexible cutting blade.
  • FIG. 76 depicts a flexible surgical knife blade for attachment to an osteotome used to cut through cement on the stem after being guided by the rigid guide surgical knife blade.
  • FIG. 77 depicts another flexible surgical knife blade for attachment to an osteotome used to cut through cement on the stem after being guided by the rigid guide surgical knife blade.
  • FIG. 78A depicts another flexible surgical knife blade for attachment to an osteotome having a plurality of protrusions on the cutting edge, used to cut through cement on the stem after being guided by the rigid guide surgical knife blade.
  • FIG. 78B depicts an enlarged partial side view of the flexible surgical knife blade shown in FIG. 78A, illustrating the plurality of protrusions on the cutting edge, used to cut thr ough cement on the stem after being guided by the rigid guide surgical knife blade.
  • FIG. 79 depicts a side cutting blade for extending down the sides of a stem to be removed.
  • FIG. 80 depicts another side cutting blade for extending down the sides of a stem to be removed.
  • FIG. 81 depicts another flexible knife blade for attachment to an osteotome used to cut through cement on the stem after being guided by the rigid guide knife blade.
  • FIG. 82 depicts a top and side perspective view of an assembled surgical knife blade guide block illustrating the two-piece construction and the relative position of the surgical knife blade slots therein.
  • FIG. 83 depicts a boxed surgeon’s hospital kit having all of the tools required for prosthesis extraction according to the present invention.
  • FIG. 84 depicts a top and side perspective view of an assembled surgical knife blade guide block illustrating the two-piece construction and the relative position of the surgical knife blade large forward slot with adjustable guide plate and the rearward multiple surgical knife blade slots therein.
  • FIG. 85 depicts a right side view of an assembled surgical knife blade guide block illustrating the position of a knurled knob threaded plate adjustment screw and the adjustment plate mounting screws.
  • FIG. 86 depicts a left side view of an assembled surgical knife blade guide block illustrating the position of a knurled knob thr eaded plate adjustment screw and the adjustment plate mounting screws.
  • FIG. 87 depicts a top view of an assembled surgical knife blade guide block illustrating the position of a knurled knob threaded plate adjustment screw and the adjustment plate mounting screws.
  • FIG. 88 depicts a bottom view of an assembled surgical knife blade guide block illustrating the position of a knurled knob threaded plate adjustment screw and the adjustment plate mounting screws.
  • FIG. 89 depicts a rear perspective view of an assembled surgical knife blade guide block illustrating the position of a knurled knob threaded plate adjustment screw and the adjustment plate mounting screws.
  • FIG. 90 depicts a front perspective view of an assembled surgical knife blade guide block illustrating the position of a knurled knob threaded plate adjustment screw and the adjustment plate mounting screws.
  • FIG. 91 depicts a cross-sectional view of the surgical knife blade guide block illustrating the position of the knurled knob threaded plate adjustment screw, adjustment plate, and a stem trunnion securing piece within a central cavity, shown in FIG. 90.
  • FIG. 92 depicts a right side view of an assembled surgical knife blade guide block illustrating the position of a forward inserted flexible cutting blade, adapter and handle and a rearward inserted rigid cutting blade.
  • FIG. 93 depicts a front view of an assembled surgical knife blade guide block illustrating the position of a rearward inserted rigid cutting blade.
  • FIG. 94 depicts a rear view of an assembled surgical knife blade guide block illustrating the position of a rearward inserted rigid cutting blade.
  • FIG. 95 depicts a cross-sectional view of the surgical knife blade guide block illustrating the position of the knurled knob threaded plate adjustment screw, adjustment plate, a forward inserted flexible cutting blade, adapter and handle, a rearward inserted rigid cutting blade and a stem trunnion securing piece within a central cavity, shown in FIG. 94.
  • FIG. 96 depicts another cross-sectional view' of the surgical knife blade guide block illustrating the position of the knurled knob threaded plate adjustment screw', adjustment plate, a forward inserted flexible cutting blade, adapter and handle, a rearward inserted rigid cutting blade and a stem trunnion securing piece w'ithin a central cavity, showm in FIG. 94.
  • FIG. 97 depicts another cross-sectional view of the surgical knife blade guide block illustrating the position of the knurled knob threaded plate adjustment screw', adjustment plate, a forward inserted flexible cutting blade, adapter and handle, a rearward inserted rigid cutting blade and a stem trunnion securing piece within a central cavity, shown in FIG. 94.
  • FIG. 98 depicts an exploded perspective view' of an assembled surgical knife blade guide block illustrating the position of the knurled knob threaded plate adjustment screw, adjustment plate, a forward inserted flexible cutting blade, adapter and handle, a rearward inserted rigid cutting blade and a stem trunnion securing piece within a central cavity.
  • FIG. 99 depicts a side view of a stem trunnion securing piece.
  • FIG. 100 depicts a cross-sectional view of the stem trunnion securing piece, as shown in FIG. 99.
  • FIG. 101 depicts a bottom view of a stem trunnion securing piece.
  • FIG. 102 depicts a side perspective view of a stem trunnion securing piece.
  • FIG. 103 depicts a top plan view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate.
  • FIG. 104 depicts a side elevational view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate.
  • FIG. 105 depicts a bottom view of an alternate embodiment of the joint revision surgery ⁇ apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate.
  • FIG. 106 depicts a top, side elevational and perspective view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate.
  • FIG. 107 depicts a bottom rear view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate.
  • FIG. 108 depicts a top, side elevational and perspective view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate fully extended downwardly.
  • FIG. 109A depicts a side elevational view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate fully extended downwardly.
  • FIG. 109B depicts an enlarged side elevational view of the upper section guide plate and guide plate adjustment screw having an integral retaining washer welded to the underside of the upper section guide plate.
  • FIG. 110 depicts a front view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate fully extended downwardly.
  • FIG. Ill depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate fully extended downwardly of FIG. 110.
  • FIG. 112 depicts a top, side elevational and perspective view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate fully retracted upwardly.
  • FIG. 113 depicts a side elevational view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate frilly retracted upwardly.
  • FIG. 114 depicts a front view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate fully retracted upwardly.
  • FIG. 115 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate fully retracted upwardly of FIG. 114.
  • FIG. 116 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate folly extended downwardly and positioned in the middle knife blade guide slot within the guide block.
  • FIG. 117 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate folly retracted upwardly and positioned in the middle knife blade guide slot within the guide block.
  • FIG. 118 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate folly extended downwardly and positioned in the upper most knife blade guide slot within the guide block.
  • FIG. 119 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate folly retracted upwardly and positioned in the upper most knife blade guide slot within the guide block.
  • FIG. 120 depicts an exploded view of the alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate, illustrating the position of the knife blades before insertion into the forward and rearward knife blade guide slots within the guide block.
  • FIG. 121 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate, showing the surgical knife blades inserted into the forward and rearward knife blade guide slots within the guide block, for removal of a non-collared implanted femoral stem.
  • FIG. 122 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate, showing the surgical knife blades inserted into the forward and rearward knife blade guide slots within the guide block, for removal of a non-collared implanted femoral stem.
  • FIG. 123 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate, showing the surgical knife blades inserted into the forward and rearward knife blade guide slots within the guide block, for removal of a non-collared implanted femoral stem.
  • FIG. 124 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate, showing the surgical knife blades inserted into the forward and rearward knife blade guide slots within the guide block, for removal of a non-collared implanted femoral stem.
  • FIG. 125 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate, showing the surgical knife blades inserted into the forward and rearward knife blade guide slots within the guide block, for removal of a non-collared implanted femoral stem.
  • FIG. 126 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate, showing the surgical knife blades inserted into the forward and rearward knife blade guide slots within the guide block, for removal of a collared implanted femoral stem.
  • FIG. 127 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus illustrating an assembled knife blade guide block having an adjustable L- shaped knife blade guide plate, showing the surgical knife blades inserted into the forward and rearward knife blade guide slots within the guide block, for removal of a collared implanted femoral stem.
  • FIG. 1 depicts a cross section through the preferred embodiment of the support apparatus 10A and tools used in performing the Joint Revision Surgery.
  • the process entails the positioning of the support apparatus 12A over the trunnion end 14 of the existing prostheses 16 within its internal cavity 17.
  • the wide knife blades 24 will initially be used to properly align the support apparatus 12A with the side surfaces 42 of the existing prostheses 16. Then, securing the support apparatus 12A down against the femur end 18 by the means of the T handle screw 20 that threads into the threaded orifice 22 in of the existing prostheses 16.
  • FIG. 2 depicts a side view of the hip replacement prostheses 40 with the trunnion end 14 and the lower stem portion 44. A threaded existing orifice 46 is located on the exposed shoulder 48.
  • FIG. 3 depicts a narrow blade knife 28 used in the Joint Revision Surgery.
  • the blades will be used with the sharp edge 76 section away from the side surfaces 78 of the existing prostheses 16 to keep the knives from digging into or scraping the metal.
  • FIG. 4 depicts a shaped blade knife 26 used in the Joint Revision Surgery.
  • FIG. 5 depicts a wide blade knife 24 used in the Joint Revision Surgery.
  • FIG. 6 depicts a side view of the T handle screw 20 used in securing and removal of the existing prostheses 16.
  • FIG. 7 depicts a view of a normal hip illustrating the pelvis 52, and femur- end 18 connection to the pelvis 52.
  • FIG. 8 depicts a view of the femur end 18 separated from the pelvis 52 with the existing ball section 54 removed and the plastic cup 56 and metal shell 58 exploded away.
  • the hip replacement prosthesis 40 and replacement ball 60 are above the existing cavity 62 in the femur end 18.
  • FIG. 9 depicts a perspective view of the femur end 18 with the support apparatus 12A in place.
  • One of the wide knife blades 24 is positioned above one of the two tapered guide slots 68 that extend to the side surfaces 42 of the existing prostheses 16.
  • the T handle screw 20 is shown above the orifice 70 in the support apparatus 12A that extends to the existing threaded orifice 46 in the existing prostheses 16.
  • Two optional curved knives 72 are illustrated above the tapered curved slots 74 in the support apparatus 12A.
  • FIG. 10 depicts an end view of the preferred embodiment of the support apparatus 12A illustrating the angles 80 of the tapered slots 68.
  • FIG. 11 depicts a side view cross section of the preferred embodiment of the support apparatus 12A illustrating the internal cavity 17 the tapered curved aperture 30 and the tapered curved aperture 31 with the internal curvature 32 at the distal end.
  • the bottom surface 82 of the support apparatus 12A will have an internally beveled edge 84 on its perimeter.
  • FIG. 12 depicts atop view of the preferred embodiment of the support apparatus 12A illustrating the tapered curved aperture 30 and the tapered curved aperture 31 with the internal curvature 32 at the distal end, the two tapered guide slots 68 and the orifice for the “T’ handle screw 20.
  • FIG. 13 depicts a side view of the angled blade flat knife 86 to be used on the first alternate embodiment of the support apparatus 12B.
  • FIG. 14 depicts a side view of the wide blade knife 88 to be used on the first alternate embodiment of the support apparatus 12B.
  • FIG. 15 depicts a top view of the first alternate embodiment of the support apparatus 10B with support apparatus 12B having an elongated orifice 90 at the top of the enlarged internal elongated cavity 92.
  • the cavity has been elongated to the back side to allow the existing prostheses 16 to only move back and up when the T head screw 20 is tightened to extract the device.
  • FIG. 16 depicts a cross section through the first alternate embodiment of the of the support apparatus 10B with the T head screw 20 attached to the existing prosthesis 16 and the wide blade knife 88 is inserted in one of the tapered guide slots 68 to align the support apparatus 12B in position on the existing prosthesis 16.
  • FIG. 17 depicts a cross section through the first alternate embodiment of the support apparatus 10B with angled blade knife 86 or the wide blade knife 88 inserted along the sides of the existing prostheses 16 and curved knives 72 on the ends.
  • FIG. 18 depicts a cross section through the first alternate embodiment of the support apparatus 10B where the T handle screw 20 is tightened to pull the existing prosthesis 16 up from the femur end 18. If necessary, the T handle screw 20 can be partially backed out of the existing prosthesis 16 and can be moved up and down to further release the adhesive bond on the device.
  • FIG. 19 depicts a perspective view of the second alternate embodiment of the support apparatus 10C with a different simpler configuration of the support apparatus 12C with two tapered guide slots 68, the tapered curved aperture 30 and tapered aperture 31 with the internal curvature 32 in the distal end.
  • a conventional style of screw 94 will be used to secure the support apparatus 10C in place over the femur end 18.
  • FIG. 20 depicts a perspective view of the second alternate embodiment of the support apparatus 10C with the different simpler configuration of the support apparatus 12C illustrating the tools used in the procedure.
  • a wide blade knife 98 with a depth restricting section 100 can be used with the pneumatic osteotome 36 or tapped with a surgical hammer.
  • Two optional curved blades 72 may be used in the tapered curved aperture 30 and tapered aperture 31 with the internal curvature 32.
  • Two small blade adapters 102 and one large blade adapter 104 will fit over the top of the blades when they are used by hand pressure or tapped with a surgical hammer.
  • FIG. 21 depicts a perspective view of the third alternate embodiment of the one- piece blade guide block 10D illustrating the locations of the angular blade slots 200, the smooth alignment orifice 202, the threaded angled eye bolt orifice 204 and the threaded securing orifice 206 along with the curved blade cavity 208.
  • This one-piece guide blade block 10D could be constructed of stainless steel, composite materials or hard plastic.
  • FIG. 22 depicts a perspective view of the fourth alternate embodiment of the two- piece blade guide block 10E illustrating the locations of the angular blade slots 200, the smooth alignment orifice 202, the threaded angled eye bolt orifice 204 and the threaded securing orifice 206 and the insert cavity 212 with the insert 214 moved away, along with the curved blade cavity 208 with the eye bolt 210 raised above and the insert cavity 212.
  • This two-piece guide blade block 10E could be constructed of stainless steel, composite materials or hard plastic.
  • FIG. 23 depicts a bottom view of the fourth alternate embodiment of the blade guide block 10E detailing the bottom view with angular blade slots 200, the smooth alignment orifice 202, the threaded angled eye bolt orifice 204 and the threaded securing orifice 206 along with the curved blade cavity 208 with the insert cavity 212 and the flat front blade guide surface 216.
  • the prosthesis trunnion cavity 218 does not fully penetrate completely through the device.
  • FIG. 24 depicts a side view of the fourth alternate embodiment of the blade guide block 10E illustrating the flat front blade guide surface 216.
  • FIG. 25 depicts a top view of the fourth alternate embodiment of the blade guide block 10E detailing the top view with angular blade slots 200, the smooth alignment orifice 202, the threaded angled eye bolt orifice 204 and the threaded securing orifice 206 along with the curved blade cavity 208 with the insert cavity 212 and the flat front blade guide surface 216.
  • FIG. 26 depicts a perspective view of the fourth alternate embodiment of the two- piece blade guide block 10E with a secondary handle-shaped guide block 10F, illustrating the top view with angular blade slots 200, the smooth alignment orifice 202, the threaded angled eye bolt orifice 204 and the threaded securing orifice 206 along with the curved blade cavity 208 with the insert 212 cavity and the flat front blade guide surface 216.
  • the attaching secondary blade guide block 10F is shown raised up illustrating the location of the locating dow'el 222 that mates with the smooth alignment orifice 202 and the threaded T-screw 224 goes through the orifice 226 in the secondary blade guide block 10F and into the threaded securing orifice 206.
  • the distal end 228 of the secondary blade guide block 10F is shown with four slots 230 that will align with the flat front blade guide surface 216 of the blade guide block 10E for different styles of prosthesis.
  • the dowel 232 when inserted allows the insert 214 to move slightly keeping it from binding with the different knife blades.
  • FIG. 27 depicts the bottom view of the secondary blade guide block 10F showing the four slots 230 the end of the locating dowel 222 and the orifice 226.
  • FIG. 28 depicts the side view of the secondary blade guide block 10F showing the four slots 230 the end of the locating dowel 222.
  • FIG. 29 depicts the top view of the secondary blade guide block 10F showing the four slots 230 and the orifice 226.
  • FIG. 30 depicts a side view of the fourth alternate embodiment of the blade guide block 10E with the attached secondary blade guide block 10F with the T handle screw 20 and a flat knife blade 232 with the upper metal cap end 234 extending through one of the slots 230 located in the secondary blade guide block 10F.
  • FIG. 31 depicts a front view of the eye bolt 210.
  • FIG. 32 depicts a front view of the T handle screw 20.
  • FIG. 33 depicts a perspective view of the fifth alternate embodiment of the blade guide block 10G with angular blade slots 200, the smooth alignment orifice 202, the threaded angled eye bolt orifice 204, the threaded securing orifice 206 and the curved blade cavity 208.
  • the insert 212 cavity with the adjustable insert 240 and the adjusting mechanism 242 has a pressure adjustment knob 244 shown raised up.
  • the adjusting mechanism 242 can be slid down through grooves 246 on either side of the insert cavity 212 in the blade guide block 10G to be able to move the adjustable insert 240 forward and backward.
  • FIG. 34 depicts a perspective view of the fifth alternate embodiment of the blade guide block 10G with the adjustable insert 240 in the insert cavity 212 and the adjusting mechanism 242 in position.
  • FIG. 35 depicts a side cut-away view of the fifth alternate embodiment of the blade guide block 10G with the adjustable insert 240 and the adjusting mechanism 242.
  • the pressure adjustment knob 244 is secured in place in the adjusting mechanism 242 by the means of a snap ring 248 so that when the pressure adjustment knob 244 is rotated the adjustable insert 240 can move forward and backward to be able to put a light pressure on a blade within the curved blade cavity 208.
  • FIG. 36 depicts a perspective view of the sixth alternate embodiment of the internal tension spring blade guide ball 10H using an internal spring tensioner 254 to restrain the female guide ball section 256 to the male guide ball section 260 that has the prosthesis trunnion orifice 262 at the bottom.
  • FIG. 37 depicts a side view of the sixth alternate embodiment of the external spring blade guide ball 10H using an internal spring tensioner 254 to restrain the female guide ball section 256 to the male guide ball section 260 that has the prosthesis trunnion orifice 262 at the bottom.
  • FIG. 38 depicts a perspective view of the sixth alternate embodiment of the blade guide ball 10J using an external spring tensioner 264 to restrain the female guide ball section 256 to the male guide ball section 260 to restrain the female guide ball section 256 to the male guide ball section 260 that has the prosthesis trunnion orifice 262 at the bottom.
  • FIG. 39 depicts a side view of the seventh alternate embodiment of the blade guide ball 10J using an external spring tensioner 264 to restrain the female guide ball section 256 to the male guide ball section 260.
  • FIG. 40 depicts a perspective view of a two part eighth alternate embodiment of the blade guide ball 10K with an external elastic tensioner 266 to restrain the female guide ball section 256 to the male guide ball section 260 that has the prosthesis trunnion orifice 262 at the bottom.
  • FIG. 41 depicts a side view of a two part eighth alternate embodiment of the blade guide ball 10K with an external elastic tensioner 266 to restrain the female guide ball section 256 to the male guide ball section 260.
  • FIG. 42 depicts a side view of a large prostheses 270 attached to a cut-away third alternate embodiment of the basic blade guide block 10D illustrating a thin curved blade with straight handle 274 in the compound curved prosthesis blade 288 and a curved handle 274 cavity 208 with the eye bolt 210 secured tightly against the prostheses trunnion 272 to aide in the extraction of the prosthesis.
  • FIG. 42 depicts a side view of a large prostheses 270 attached to a cut-away third alternate embodiment of the basic blade guide block 10D illustrating a thin curved blade with straight handle 274 in the compound curved prosthesis blade 288 and a curved handle 274 cavity 208 with the eye bolt 210 secured tightly against the prostheses trunnion 272 to aide in the extraction of the prosthesis.
  • FIG 43 depicts a side view of a small prosthesis 276 having the trunnion 272 and the trunnion size adaptor 278 which fits over the prostheses trunnion 272 to add thickness to the prostheses trunnion 272 for a better fit with the blade guide block used in the revision surgery procedure.
  • FIG. 44 depicts a top view of the small prostheses 276 illustrating the semi- hexagonal shape 280 of the upper section of the small prostheses 276 that conforms to the angular slots 200 in the blade guide blocks 10D, 10E and 10G.
  • Different sizes are anticipated to accommodate differing sizes of implanted stems undergoing revision surgery.
  • FIG. 45 depicts a cross section through a compound curved prosthesis blade 288 where the inner surface 290 conforms to the shape of the typical prosthesis radius and the length of the typical blade has a sweeping curve to it.
  • FIG. 46 depicts a top view of a heavy compound curved prosthesis blade 288 with a curved sharp end 218 and a metal end cap 234.
  • FIG. 47 depicts a side view of a heavy compound curved prosthesis blade 288 a curved sharp end 218 and a metal end cap 234.
  • FIG. 48 depicts a top view of a thin compound curved prosthesis blade 288 with a curved sharp pointed end 292 and a metal end cap 234.
  • FIG. 49 depicts a side view of a thin compound curved prosthesis blade 288 with a curved sharp pointed end 292 and a metal end cap 234.
  • FIG. 50 depicts a top view' of a straight narrow flat blade 294 with a chisel shaped sharp end 296 and a metal end cap 234.
  • FIG. 51 depicts a top view of a straight wide flat blade 298 with a triangular shaped sharp end 300 and a metal end cap 234.
  • FIG. 52 depicts a side view of a thin compound curved prosthesis blade 288 with a straight handle 274 and a metal end cap 234.
  • FIG. 53 depicts side view of a thin compound curved prosthesis blade 288 with a two part handle 302 and the metal end cap 234 enclosed.
  • FIG. 54 depicts a perspective view of a large prosthesis 270, the compound curved prosthesis blade 288 with a two part blade guide ball 304 and a two part handle 302.
  • FIG. 55 depicts side view of a large prosthesis 270 the compound curved prosthesis blade 288 with a two part blade guide ball 304 and a two part handle 302with the metal end cap 234 enclosed.
  • FIG. 56 depicts a perspective view of the female guide ball section 256 of the two part blade guide ball 304 where the female guide ball section 256 includes two wings on both sides of the female guide ball section 256.
  • FIG. 57 depicts a perspective view of the male guide ball section 260 of the two part blade guide ball 304 where the male guide ball section 260 includes two slots for accepting the wings located on both sides of the female guide ball section 256 (see FIG. 56).
  • FIG. 58 depicts a perspective view of the two part blade guide ball 304 assembled together, where the female guide ball section 256 two wings located on both sides of the female guide ball section 256 have mated with the two slots located on the male guide ball section 260 for accepting the wings located on both sides of the female guide ball section 256.
  • FIG. 59 depicts a perspective view of a box style of container 306 illustrating a typical assortment of prosthesis removal devices. It is anticipated that these assembled kits for performing joint revision surgery will contain any number, style and varying sizes of blade guide blocks, blade guide balls, curved knife blades, straight knife blades, narrow' knife blades, wide knife blades, knife blades with attached knife blade handles, one-piece removable replacement knife blade handles, two-piece removeable replacement knife blade handles, eyebolts, T handle screws, T screws and possibly even a pneumatic osteotome. [0232] FIG.
  • FIG. 60 depicts an exploded top and side perspective view of a Joint Revision Surgery Apparatus 10K surgical knife blade guide block 400 illustrating the two-piece construction, the location of the multiple surgical knife blade slots 406, 408 and 410 and the position of the locking rings 418 within a locking ring cavity 416 capable of accepting a prothesis stem trunnion and securing it for an extraction operation.
  • the surgical knife blade guide block 400 is constructed of two half sections 402 and 404 and when assembled these two half sections 402 and 404 are held together by three Allen screws 420 and stabilized by two stabilization pins 422. When assembled, the two half sections 402 and 404 form a centrally located retaining ring cavity 416 which contains a plurality of slots for accepting retaining rings 418.
  • Multiple surgical knife blade slots 406, 408 and 410 are visible from the top surfaces 412 and 414 of the surgical knife blade guide block 400 and lead to channels extending through the surgical knife blade guide block 400 for the purpose of guiding surgical knife blades inserted into each slot.
  • FIG. 61 depicts an alternate embodiment of the retaining rings 424 capable of accepting a prothesis stem trunnion and securing it for an extraction operation.
  • These retaining rings 424 differ from the retaining rings 418 seen in FIG. 60 above in that they are capable of securing stem trunnions smaller in diameter. It is anticipated that retaining rings for this purpose will be sized in various diameters to accommodate all sizes of femoral stems to be extracted using the Joint Revision Surgery Apparatus according to the present invention. All of the varying sizes will be capable of being inserted and secured by the retaining ring cavity formed when the surgical knife blade guide block 400 is assembled.
  • FIG. 62 depicts a cross-sectional view of the Joint Revision Surgery Apparatus 10K surgical knife blade guide block half section 404 having a single channel 436 front slot and multiple rear slots 410, illustrating the position of the surgical knife blade slots 436 and 410 and the retaining ring cavity 416 accepting a prothesis stem trunnion 426 having a trunnion end portion 428 of a femoral stem 430 cemented in place within a patient’s femur 432.
  • a rigid surgical knife blade 434 and a flexible surgical knife blade 438 extending down through the slot and through the channel 436 to reach the femur 432 and the stem 430 cemented into the femur 432 to be extracted in the joint revision surgery operation.
  • the lower blade is the rigid guide blade 434 and guides the path of the upper blade which is the flexible cutting blade 438.
  • Flexible cutting blade 438 is capable of cutting through the cement (represented here by a heavy black line around the stem 430) and releasing the stem 430 from the patient’s femur 432 during the joint revision surgery operation.
  • FIG. 63 depicts a front and top enlarged partial perspective view of the surgical knife blade block assembled half sections 402 and 404 shown in FIG. 62 illustrating the shape of the single channel front surgical knife blade slot 406 therein.
  • This single channel front surgical knife blade slot 406 has an expanded top section 408 to accommodate the flexible cutting surgical knife blade 438 (see FIG. 62) after the rigid surgical knife guide blade 438 has been inserted into the curved lower section of the slot 406.
  • FIG. 64 depicts femoral stem extraction Step 1 wherein a cross sectional view of a collared stem 440 within a patient’s femur 442, wherein a Lambotte osteotome 444 is beginning to remove a small triangle of bone below the collar portion 443 of the collared stem 440.
  • Removal of collared stems presents a unique problem to a surgeon performing joint revision surgery. Collared stems are significantly more difficult to remove as the collar hinders extraction blades from reaching the stem cement for cutting the stem free of the patient’s femur.
  • Step 1 of this process for removing collared stems is using a Lambotte osteotome 444 to remove a small triangle of bone below the collar portion 443 of the collared stem 440.
  • FIG. 65A depicts femoral stem extraction Step 2 showing a cross-sectional view of a Joint Revision Surgery Apparatus 10L surgical knife blade guide block 450 having a single straight channel front slot 452, illustrating the position of a rigid surgical knife blade 454 and a flexible surgical knife blade 456 within the single slot channel 452 and passing the collar portion 443 of the collared stem 440 to enter the Step 1 removed bone triangle 445 within a patient’s femur 442.
  • Step 2 requires that the surgeon insert a rigid guide surgical knife blade 454 first and extend it downward passing through the removed triangle of bone 445 until it makes contact with the stem wall, then flex downward until it passes the collar portion 443, then back off the rigid guide blade 2 - 4 millimeters to create a passageway for the flexible cutting blade 456 to pass by the collared portion 443.
  • surgical knife blade 460 is inserted into knife blade slot 458 and extended down along the stem 440.
  • FIG. 65B depicts a partial magnification of FIG.
  • 65A femoral stem extraction Step 2 showing greater detail of the movement (see movement arrows) around the collared stem 440 and position of the surgical knife blades with respect to the removed triangle of bone 445, including the rigid lower guide blade 454 and the flexible upper cutting blade 456.
  • FIG. 65C depicts a cross-sectional view of FIG. 65A showing the curved rigid surgical knife blade 454 below and in a position for guiding the flexible surgical knife blade 456 above it. After the curved rigid surgical knife blade 454 is inserted and extended to the stem surface, then pushed slightly downward and backed off about 2 - 4 millimeters, it is in position to guide the flexible surgical knife blade 456 which is inserted above it and passes through to the stem for the stem cement cutting operation.
  • FIG. 66A depicts femoral stem extraction Step 3 showing a cross-sectional view of a Joint Revision Surgery Apparatus 10L surgical knife blade guide block 450 having a single straight channel front slot 452, illustrating the position of a rigid surgical knife blade 454 and a flexible surgical knife blade 456.
  • Step 3 involves the actual cutting of the cement on the interface between the collared stem and the patient’s femur (represented by a heavy black line). This is accomplished by extending the flexible surgical knife blade 456 down the medial calcar of the collared stem 440 and cutting it away from the femur 442. The flexible surgical knife blade 456 is guided past the collar portion of the collared stem using the positioning of the rigid guide surgical knife blade 454.
  • Step 1 cuts a triangle of femur bone below the collar
  • Step 2 sets the position of the guide blade
  • Step 3 is the actual cutting of the medial calcar for removal of the collared stem.
  • FIG. 66B depicts a partial magnification of FIG. 66A femoral stem extraction Step 3 showing greater detail of the movement (see movement arrows) around the collared stem 440 and position of the surgical knife blades with respect to the removed triangle of bone 445, including the rigid lower guide blade 454 and the flexible upper cutting blade 456, and illustrating the positions of the lower surgical rigid knife blade 454 which guides the flexible surgical knife blade 456 and the upper flexible surgical knife blade extending past the collar portion 443 of the stem, downward along the stem 440 which cuts through the cement (heavy black line) on the surface of the stem 440 and between the interface of the stem 440 and the patient’s femur 442 (see FIG. 66A). Therefore, Step 3 is the actual cutting stem enabling the removal of the collared stem.
  • FIG. 67 depicts a cross-sectional view of a Joint Revision Surgery Apparatus 10M and the surgical knife blade guide block 470 constructed of two half sections, with half section 472 seen here, having a single curved channel front slot 488 and multiple channel rear slots 484, illustrating the position of a rigid surgical knife blade 490 and a flexible surgical knife blade 492 extending downward within the single slot channel 488, and a surgical knife blade 486 extending downward through slot 484 on the opposite side of the stem 480 to be removed from the patient’s femur 482.
  • This a Joint Revision Surgery Apparatus 10M has a slot channel 488 specifically shaped to be capable of accommodating a specialized tool for guiding the surgical knife blades down to the stem to be removed (see FIG. 68 and 69). Additionally, this surgical knife blade guide block 470 having a single curved channel front slot 488 forms a retaining ring cavity 474 which enables retaining rings within the cavity 464 to secure the trunnion end 476 of the stem trunnion 478.
  • FIG. 68 depicts a front and top partial perspective view of the surgical knife blade block, including half sections 471 and 472, as seen in FIG. 67 illustrating the shape of the single curved channel front surgical knife blade slot 488 therein.
  • the single curved channel front surgical knife blade slot 488 is specifically altered in shape 489, specifically extended to be larger on top and bottom of the curved slot 488, to accommodate a specialized surgical knife blade guide tool (see FIG. 69).
  • FIG. 69 depicts a top and side perspective view of a specialized surgical knife blade guide tool 494 which when its lower section 495 placed within the surgical knife blade slot 488 (see FIG. 67 and 68) is used to act as a rigid guide for the flexible surgical knife blade which may be extended in one of two surgical knife blade slots 496 and 498 above or below the lower portion of the guide tool.
  • the specialized surgical knife blade guide tool 494 is inserted into slot channel 488 and accommodates flexible knife blades in slot extension 489 when they are passed through slots 496 and 498 in the specialized surgical knife blade guide tool 494.
  • FIG. 70 depicts a cross-sectional view of the Joint Revision Surgery Apparatus ION surgical knife blade guide block 500 constructed of two half sections 502 (and 501 not shown) having multiple channel front slots having a curved lower channel 504 and a straight upper channel 506 as well as multiple channel rear slots 512.
  • FIG. 70 further illustrates the position of a curved rigid surgical knife blade 508 within lower curved channel 504 and a flexible surgical knife blade 510 extending downward within the straight upper channel 506 slot, and a surgical knife blade 514 extending downward on the opposite side of the stem 518 within the patient’s femur to be removed.
  • flexible surgical knife blade 510 is extending down along the medial calcar to cut through the cement between the interface of the femur bone and the stem 518.
  • the trunnion end 516 of the stem 518 is secured by retaining rings within the retaining ring cavity 520 formed when surgical knife blade guide block 500 is assembled from two half sections with on half section represented here by half section 502.
  • FIG. 71 depicts a front and top partial perspective view of the surgical knife blade block 500 shown in FIG. 70 constructed of two half sections, namely, half section 501 and half section 502, illustrating the shape of the multiple channels 504 and 506 front surgical knife blade slots therein.
  • Front lower surgical knife blade channel 504 is curved in shape to accommodate curved surgical knife blades, such as surgical knife blade 508 (see FIG. 70), whereas front upper surgical knife blade channel 506 is straight in shape to accommodate straight surgical knife blades such as surgical knife blade 510 (see FIG. 70).
  • FIG. 72 depicts a cross-sectional view of the Joint Revision Surgery Apparatus 10N surgical knife blade guide block 500 having a multiple channel front slot 504 and 506 and multiple channel rear slots 512, illustrating the surgeon’s hand grasping the surgical knife blade guide block 500 to initiate removal of the femoral stem 522 from the patient’s femur bone 526 after all stem cement cutting operations have been completed by the rigid guide surgical knife blades and the flexible cutting surgical knife blades (not shown).
  • FIG. 73 depicts a cross-sectional view of the Joint Revision Surgery Apparatus ION surgical knife blade guide block 500 having a multiple channel front slots 504 and 506 and multiple channel rear slots 512, illustrating the surgeon’s hand 530 grasping the surgical knife blade guide block 500 to complete removal of the femoral stem 522 lower section 523 from the patient’s femur bone 526 after all stem cement cutting operations have been completed and the stem has been cut free of the femur. It is possible to pull out the collared stem because the upper trunnion section 520 is retained securely by the plurality of retaining rings within retaining ring cavity 520 (see FIG. 60 for the position of the retaining rings within the retaining ring cavity). If it is not possible to remove the stem by hand at this point, then a surgical hammer may be employed to tap upwardly on the surgical knife blade guide block 500.
  • FIG. 74 depicts a curved rigid surgical knife blade 540 with a shaft 542 and a mounting section 544 for attachment to an osteotome to act to guide a flexible cutting blade.
  • This rigid surgical knife blade 540 is flexible in the lateral directions (see movement arrows).
  • FIG. 75 depicts a curved flexible cutting surgical knife blade 546 with a shaft 552 and a mounting section 554 for attachment to an osteotome to act to guide a flexible cutting surgical knife blade.
  • the top portion 548 of this surgic al knife blade 546 includes a plurality of protrusions 550 capable of cutting through tough cement found at the interface between the stem and the femur bone, which is typically used to originally affix the stem to the femur.
  • FIG. 76 depicts a longer length straight flexible cutting surgical knife blade 556 with a shaft 558 and a mounting section 560 for attachment to an osteotome, this knife blade 556 is used to cut through cement on the stem after being guided by any one of the disclosed rigid guide surgical knife blade.
  • FIG. 77 depicts another long flexible cutting surgical knife blade 562 with no shaft (all blade) and a mounting portion 564 for attachment to an osteotome used to cut through cement on longer implanted stems after being guided by the rigid guide surgical knife blade.
  • FIG. 78A depicts another long flexible surgical spoon shaped knife blade 566 with no shaft (all blade here) and a mounting section 572 for attachment to an osteotome, having a spoon shaped blade end 568 including a plurality of protrusions 570 on the cutting edge.
  • This blade with protrusions is used to cut through tough cement on the interface of the stem and femur bone, after being guided by the rigid guide surgical knife blade.
  • FIG. 78B depicts an enlarged partial side view of the flexible surgical knife blade 566 shown in FIG. 78A, illustrating the blade end 568 having a plurality of protrusions 570 on the cutting edge, used to cut through tough cement on the interface of the stem and the femur bone after being guided by the rigid guide surgical knife blade.
  • FIG. 79 depicts a lateral side cutting blade 572 for extending down the lateral sides of a stem to be removed.
  • This blade includes a shaft 574 and an osteotome mounting section 576. It is possible to use this blade mounted in an adjustable H-block guide block system configuration similar to that for a Prothesis Extraction Apparatus as disclosed in US patent application serial number 17/198,396, which US utility patent application, namely, US patent application serial number 17/198,396 is incorporated in its entirely by reference herein.
  • FIG. 80 depicts another lateral side cutting blade 578 for extending dowm the lateral sides of a stem to be removed.
  • This blade includes a shaft 580 and an osteotome mounting section 582. It is possible to use this blade 578, in conjunction with the blade shown in FIG. 79 above 572, mounted in an adjustable H-block guide block configuration similar to that for a Prothesis Extraction Apparatus as disclosed in US application serial number 17/198,396, which US utility patent application, namely, US patent application serial number 17/198,396 is incorporated in its entirely by reference herein.
  • FIG. 81 depicts another long flexible knife blade 584 having an elongated flexible blade section 586 in place of a shaft, and a mounting section 588 for attachment to an osteotome used to cut through cement on longer length stems after being guided by the rigid guide knife blade.
  • FIG. 82 depicts a top and side perspective view of the Joint Revision Surgery Apparatus 10K illustrating an assembled surgical knife blade guide block 400 illustrating the two-piece construction of half sections 412 and 414 having been affixed together using Allen screws 420, as well as the relative position of the surgical knife blade slots 406 and 410 therein which extend through the assembled body of the surgical knife blade guide block 400.
  • FIG. 83 depicts a boxed surgeon’s hospital kit 590 having all of the tools required for prosthesis extraction assembled in one boxed kit, according to the present invention.
  • a surgical knife blade guide block 400 Within the kit is a surgical knife blade guide block 400, a plurality of rigid guide blades and flexible cutting blades 592, and elongated cutting blade 584, lateral cutting blades 572 and 578 and a container 594 with spare parts and associated tools.
  • the spare parts include a disassembly tool Allen wrench 596 and a plurality of extra retaining rings 418 of differing sizes, which when secured to stem trunnions, are not removable following extraction.
  • FIG. 84 depicts a top and side perspective view of an assembled surgical knife blade guide block 10P illustrating the two-piece construction of the assembled surgical knife blade guide block 600 and the two pieces 602 and 604 which are secured together using Allen screws 606, 608 and 610.
  • the relative position of the surgical knife blade large forward slot 616 with an adjustable guide pressure plate 618 is located in the forward section of the surgical knife blade guide block 600.
  • the adjustable guide pressure plate 618 is secured using two Allen screws 620 and 622.
  • the threaded upper portion of a stem trunnion securing member 624 is visible, and is adjustably attached to the assembled surgical knife blade guide block 600 by a securing nut 626.
  • a knurled knob 630 is threaded through the assembled surgical knife blade guide block 600. and is used to adjust the adjustable guide pressure plate having upper portion 618 and lower portion 628 (not shown in FIG. 84).
  • the surgical knife blade guide block of the present invention could be manufactured and formed in one piece by being molded or computer numerical control (CNC) formed from a piece of material, including but not limited to metal, plastic, wood, ceramic and composite.
  • CNC computer numerical control
  • FIG. 85 depicts a right side view of an assembled surgical knife blade guide block 10P illustrating an assembled surgical knife blade guide block 600 and the position of a knurled knob threaded plate adjustment screw 630 and the adjustment plate mounting Allen screw's 620 (not shown) and 622.
  • the lowrnr portion of the adjustable guide pressure plate 628 is visible on the bottom of the assembled surgical knife blade guide block 600.
  • FIG. 86 depicts a left side view of an assembled surgical knife blade guide block 10P, the opposite view of FIG. 85, illustrating an assembled surgical knife blade guide block 600 and the position of a knurled knob threaded plate adjustment screw' 630 and the adjustment plate mounting Allen screw's 620 and 622 (not showm).
  • the lower portion of the adjustable guide pressure plate 628 is visible on the bottom of the assembled surgical knife blade guide block 600. Also showm is the stem trunnion securing member 624 and the stem trunnion securing member 624 securing nut 626.
  • FIG. 87 depicts a top view' of an assembled surgical knife blade guide block 10P illustrating an assembled surgical knife blade guide block 600 and the position of the rearward knife blade slots 612 and a female threaded orifice 614, the adjustment plate mounting screw's 620 and 622, and adjustable guide pressure plate 618 is secured using two Allen screw's 620 and 622. Also showm is the stem trunnion securing member 624 and the stem trunnion securing member 624 securing nut 626.
  • FIG. 88 depicts a bottom view of an assembled surgical knife blade guide block 10P illustrating an assembled surgical knife blade guide block 600 and the position of the rearw'ard knife blade slots 612 and a central cavity 632 to accommodate the stem trunnion securing member 624 (not showm, see FIG. 91 below), the adjustment plate mounting screws 620 and 622. the knurled knob 630, the lower portion of the adjustable guide pressure plate 628 located within the surgical knife blade large forward slot 616.
  • FIG. 89 depicts a rear perspective view of an assembled surgical knife blade guide block 10P illustrating an assembled surgical knife blade guide block 600 and the position of the surgical knife blade large forward slot 616 with the lower portion of the adjustable guide pressure plate 628 visible. Also shown is the stem trunnion securing member 624 located within central cavity 632, and secured to the assembled surgical knife blade guide block 600 by nut 626 (not shown, see FIG. 91 below). The upper portion adjustable guide pressure plate 618 is secured using two Allen screws 620 and 622. Knurled knob 630 is located in the lower front portion of the assembled surgical knife blade guide block 600.
  • FIG. 90 depicts a front perspective view of an assembled surgical knife blade guide block 10P illustrating an assembled surgical knife blade guide block 600 and the position of the surgical knife blade large forward slot 616. Also shown is the surgical knife blade large forward slot 616 with the location of the lower portion of the adjustable guide pressure plate 618 visible.
  • the adjustable guide pressure plate 618 is secured using two Allen screws 620 and 622.
  • the threaded upper portion of a stem trunnion securing member 624 is visible, and is adjustably attached to the assembled surgical knife blade guide block 600 by a securing nut 626.
  • a knurled knob 630 is threaded through the assembled surgical knife blade guide block 600.
  • FIG. 91 depicts a cross-sectional view of the surgical knife blade guide block 10P illustrating the assembled surgical knife blade guide block 600 shown in FIG. 90.
  • FIG. 91 there is shown the position of the upper portion of the adjustable guide pressure plate 618 and the lower portion of the adjustable guide pressure plate 628 within the surgical knife blade large forward slot 616.
  • Allen screws 620 and 622 (not shown ) secure the upper portion of the adjustable guide pressure plate 618 and the lower portion of the adjustable guide pressure plate 628 is actuated inwardly and outwardly by turning the threaded knurled knob 630.
  • the two Allen screws 620 and 622 could also be used to adjust the position of the adjustable guide pressure plate 616 and 628 in the upwardly (superior) and downwardly (inferior) directions, thereby making superior and inferior adjustments of the guide pressure plate possible.
  • the stem trunnion securing member 624 is secured to the assembled surgical knife blade guide block 600 within the large central cavity 632 by nut 626, and when the nut 626 is tightened, this tightens the stem trunnion securing member 624 onto the stem trunnion to be removed (not shown, see FIG. 95 below). Also shown here in FIG. 91 is the rearward knife blade slots 612 and a female threaded orifice 614.
  • the female threaded orifice 614 is used to secure an eyebolt or hook to facilitate removal of a stem from a femur during joint revision surgery. It is anticipated that this female threaded orifice 614 could also receive a surgical slap hammer directly threaded into the surgical knife blade guide block without the use of an attached eyebolt or hook.
  • FIG. 92 depicts a right side elevational view of an assembled surgical knife blade guide block 10P illustrating the assembled surgical knife blade guide block 600 in position for use in joint revision surgery.
  • the stem trunnion securing member 624 is secured to the assembled surgical knife blade guide block 600 within the large central cavity 632 by nut 626, and when the nut 626 is tightened, this tightens the stem trunnion securing member 624 onto the stem.
  • a cutting blade handle 650 is attached to a blade/handle adapter 652 which allows for the connecting of various forward flexible cutting blades 660 as required.
  • the flexible lower portion 662 of flexible cutting blade 660 extends through the assembled surgical knife blade guide block 600 and rests on the stem 640 to be removed during joint revision surgery .
  • Rigid cutting blade 680 extends down through blade slots 612 to allow the rigid lower portion 682 of rigid cutting blade 680 to cut the stem 640 away from the bone (not shown).
  • Eye bolt 634 has been threaded into threaded orifice 614 to facilitate the removal of the stem 640.
  • the next step involves rotating the knurled knob 630 to actuate the lower portion of the adjustable guide pressure plate 628 is actuated inwardly. This operation will align the flexible lower portion 662 of flexible cutting blade 660 to properly slide downwardly along the medial surface of the stem 640.
  • This FIG. 92 represents Step 1 of the stem removal process: securing the stem trunnion to the stem trunnion securing member 624 to the assembled surgical knife blade guide block 600, and inserting the rearward and forward cutting blades into rearward blade slots 612 and the surgical knife blade large forward slot 616, respectively.
  • FIG. 93 depicts a front view of an assembled surgical knife blade guide block 10P illustrating an assembled surgical knife blade guide block 600 and the position of the forward inserted flexible cutting blade 660 extended down into the surgical knife blade large forward slot 616.
  • the flexible cutting blade 660 is attached to a blade/handle adapter 652 which is connected to a handle 650.
  • the lower portion 662 of the flexible cutting blade 660 is in contact with the medial surface of stem 640.
  • Allen screws 620 and 622 secure the upper portion of the adjustable guide pressure plate 618.
  • Knurled knob 630 is used to actuate the pressure plate inwardly or outwardly when rotated clockwise or counterclockwise. When rotated clockwise, the knurled knob 630 moves the lower portion of the adjustable guide pressure plate 628 inward to put pressure on the inserted lower portion of the flexible cutting blade 662.
  • FIG. 94 depicts a rear -view of an assembled surgical knife blade guide block 10P illustrating an assembled surgical knife blade guide block 600 and the position of a rearward inserted rigid cutting blade 680 extending through blade slots 612.
  • the lower portion 682 of rigid cutting blade 680 extends through blade slots 612 to make contact with the surface of the stem 640 to be removed in joint revision surgery.
  • the lower portion 682 of rigid cutting blade 680 is extended through blade slots 612 at a distance needed to cut the surface of the stem and thereby extract the stem from the bone. This distance will vary' depending on the overall length of the stem to be extracted.
  • FIG. 95 depicts a cross-sectional view of the surgical knife blade guide block 10P illustrating the position of the assembled surgical knife blade guide block 600, shown in FIG. 94.
  • FIG. 96 depicts another cross-sectional view of the surgical knife blade guide block 10P illustrating the position of the assembled surgical knife blade guide block 600, shown in FIG. 94. This represents Step 2 in 'which the knurled knob 630 is rotated (see direction arrow's) to actuate the lower portion of the adjustable guide pressure plate 628 inward to put pressure on the inserted lower portion of the flexible cutting blade 662.
  • the flexible cutting blade 660 is then extended downward (see direction arrows) to begin cutting the stem 640 away from the bone.
  • the knurled knob 630 is rotated clockwise to actuate the adjustable guide pressure plate 628 inwardly to put pressure on the inserted lower portion of the flexible cutting blade 662.
  • the flexible cutting blade cuts closely along the medial surface of the stem to be removed, in between the stem and the bone right at the stem/bone interface. This allows for a very fast and efficient extraction of the stem with significantly less blood loss by the patient.
  • FIG. 97 depicts another cross-sectional view of the surgical knife blade guide block 10P illustrating the position of the assembled surgical knife blade guide block 600, shown in FIG. 95.
  • Step 3 in which the knurled knob 630 is rotated to actuate the lower portion of the adjustable guide pressure plate 628 further inward to put the maximum desired pressure on the inserted lower portion of the flexible cutting blade 662.
  • the blade is effectively guided down the medial surface of the stem 640 to be removed.
  • the length and flexibility of the flexible cutting blade 660 allows the medial surface of the stem 640 to be fully detached from the bone, facilitating fast and efficient removal of the stem 640. Because the operation is quick, there is significantly less blood loss by the patient.
  • FIG. 98 depicts an exploded perspective view of 10P a disassembled surgical knife blade guide block 600 illustrating the position of the knurled knob threaded plate adjustment screw 630, the surgical knife blade large forward slot 616, adjustable guide pressure plate 618 is secured using two Allen screws 620 and 622, a forward flexible cutting blade 660, blade adapter 652 and handle 650, a rearward rigid cutting blade 680 w ith lower portion 682, and a stem trunnion securing member 624 within a central cavity 632. Also shown is the two-piece construction of the assembled surgical knife blade guide block 600 and the two pieces 602 and 604 w hich are secured together using Allen screw's 606, 608 and 610.
  • rearward knife blade slots 612 and a female threaded orifice 614 for accommodating a hook or eyebolt 634.
  • the relative position of the surgical knife blade large forward slot 616 with an adjustable guide pressure plate 618 is located in the forward section of the surgical knife blade guide block 600.
  • An eye bolt 634 is shown above the threaded orifice 614 used for securing the eye bolt 634 to the assembled surgical knife blade guide block 600.
  • FIG. 99 depicts a side elevational view of a stem trunnion securing piece 624 having a threaded portion 682 and a groove 684 running the length of the threaded portion 682.
  • the stem trunnion securing piece 624 is conical in shape and tapers from a large diameter to a small diameter towards the threaded portion 682.
  • the groove 684 is used to orient mounting the stem trunnion securing piece 624 within the central cavity 634 and when mounted, to keep the stem trunnion securing piece 624 from rotating during operation.
  • FIG. 100 depicts a cross-sectional view of the stem trunnion securing piece 624, as shown in FIG. 99.
  • the stem trunnion securing piece 624 has a partially hollow body 688, having a ribbed inner portion 686 running roughly half way from the large diameter to the small diameter proximal to the threaded portion 682.
  • a ribbed inner portion 686 Within the outer body 688 of the stem trunnion securing piece 624 is a ribbed inner portion 686 having a plurality of circular ribs 690 thereon.
  • the ribbed inner portion 686 is slidably affixed to the outer body.
  • the ribbed inner portion 690 within the hollow section 686 also has exterior slots (not shown, see FIG.
  • FIG. 101 depicts a bottom view of a stem trunnion securing piece 624 illustrating the outer body 688 and the inner ribbed portion 690 within the hollow section 686.
  • Four slots 692, 694, 696 and 698 are located at 90 degrees from each other around the ribbed inner portion 686.
  • the stem trunnion securing piece 624 is placed on the stem trunnion 642 and the plurality of circular ribs 690 make contact with the stem trunnion 642 upper section.
  • the stem trunnion 642 cannot be released from the stem trunnion securing piece 624 until the nut 626 is loosened and the diameter of the ribbed inner portion 686 is increased to its original size.
  • the nut 626 may be tightened and loosened using a standard wench, such as a 10 mm box wrench.
  • FIG. 102 depicts a side perspective view of a stem trunnion securing piece 624 illustrating the threaded portion 682 having a slot 684 therein, and the inner ribbed portion 686 having four slots therein, here with one slot 694 shown labeled by a reference character. It is anticipated that varying sizes of the stem trunnion securing piece 624 will be made available to accommodate the varying sizes of the stem trunnions to be extracted. Different sizes of the stem trunnion securing piece 624 will be readily mounted by placing the stem trunnion securing piece 624 into the central cavity then securing it in place using the nut 626. In this way, the stem trunnion securing piece 624 will also be replaceable and reusable as when the nut 626 is loosened the stem trunnion 642 is released after extraction of the stem.
  • FIG. 103 depicts a top plan view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L- shaped knife blade guide plate.
  • the guide block is made from two half sections 702 and 704 held together using Allen screws and alignment pins (see FIG. 120 below).
  • the L-shaped knife blade guide plate has an upper portion 706 and a lower portion 718.
  • the guide plate upper portion includes an adjustable guide plate retaining screw slot 708 in which the adjustable guide plate retaining screw 710 is threaded into an threaded orifice (not shown here) with in the guide block assembly 700.
  • Integral to the guide block assembly 700 is a plurality of forward blade guide slots 716 for accepting the adjustable guide plate 718 and the knife blades (not shown, see below), and a central cavity 720.
  • the central cavity 720 is configured to accept a trunnion securing member 724 (best seen in FIG. Ill), and the trunnion securing member is secured using securing nut 726.
  • the assembled guide block 700 defines a plurality of rearward blade guide slots. In this way, the guide block can be adjusted for any size femoral stem implant encountered for removal during revision surgery. The various adjustments are described in greater detail below.
  • FIG. 104 depicts a side elevational view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate upper section 706 and lower section 718, which drawing figure includes the same parts. This view better shows the lower guide plate 718 extending downward below the guide block assembly 700.
  • FIG. 105 depicts a bottom view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate upper section 706 and lower section 718, which drawing figure includes the same parts. This view better shows the upper guide plate retaining screw slot 708 as well as the rearward blade guide slots 712 integral to the guide block assembly 700.
  • FIG. 106 depicts a top, side elevational and perspective view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate upper section 706 and lower section 718, which drawing figure includes the same parts. This view better shows the lower guide plate 718 extending downward below the guide block assembly 700 as well as the trunnion securing member 724 retaining nut 726.
  • FIG. 107 depicts a bottom rear view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate upper section 706 and lower section 718, which drawing figure includes the same parts. This view better shows the lower guide plate 718 extending downward below the guide block assembly 700, as well as the central cavity 720 and the plurality of guide blade slots 716.
  • FIG. 108 depicts a top, side elevational and perspective view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 718 fully extended downwardly and positioned in the frontmost blade guide slot within the plurality of blade guide slots 716.
  • This view clearly illustrates the position of the guide plate adjustment screw 710 and the adjustment screw slot 708 within the upper section of the L-shaped guide plate 706.
  • the adjustment screw 710 can be adjusted upwardly and downwardly by threading in or out of the assembled guide block 700, and it can be placed in any of the plurality of blade guide slots 716 within the guide block 700.
  • FIG. 109 A depicts a side elevational view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 718 fully extended downwardly. This view better shows the lower guide plate 718 extending downward below the guide block assembly 700.
  • FIG. 109B depicts an enlarged side elevational view of the upper section guide plate 706 and guide plate adjustment screw 710 having an integral retaining washer 709 welded to the underside of the upper section guide plate 706.
  • the guide plate retaining screw 710 here is partially threaded out exposing the threaded section 722. This retaining washer makes it possible for the guide plate upper section 706 to rise and be secured in an upward position when the adjustment plate retaining screw 710 is threaded upwardly or to be lowered when the retaining screw 710 is threaded in downwardly.
  • FIG. 110 depicts a front view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 718 fully extended downwardly. This view better shows the lower guide plate 718 extending downward into the plurality of forward blade guide slots 716 within the guide block assembly 700.
  • FIG. Ill depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L- shaped knife blade guide plate upper section 706 and lower section 718 fully extended downwardly of FIG. 110.
  • Uris view illustrates the position of the central cavity 720 and the trunnion securing member 724 within the central cavity 720 secured by the securing nut 726. It also clearly shows the plurality of blade guide slots 716 and the lower guide plate 718 extending down into the foremost of the plurality of guide slots 716.
  • the lower guide plate 718 can be adjusted by being positioned in any one of the plurality of guide slots 716 by removing the retaining screw 710 and shifting the lower guide plate 718 to a different slot within the plurality of guide slots 716.
  • FIG. 112 depicts a top, side elevational and perspective view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate upper section 706 and lower section 718 fully retracted upwardly. This view better shows the adjustment slot 708 in the guide plate upper section 706 which allows for the repositioning of the guide plate lower section 718 into differing slots within the plurality of guide slots 716.
  • the lower guide plate 718 can be positioned in any one of the slots making up the plurality of guide slots 716 and thus, is adjustable forward (toward the femoral stem implant) and backward (away from the femoral stem implant) to accommodate differing sizes of femoral stem implants to be removed during revision surgery.
  • FIG. 113 depicts a side elevational view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate upper section 706 and lower section 718 having the lower section guide plate 718 fully retracted upwardly.
  • the retaining screw 710 has been rotated to extend outwardly along screw threads 722.
  • Retaining washer 711 keeps the upper section guide plate 706 from falling back down toward the guide block assembly 700.
  • the lower guide plate 718 is adjustable upwardly away from the femoral stem implant and downwardly toward the femoral stem implant to accommodate differing sizes of femoral stem implants to be removed during revision surgery.
  • FIG. 114 depicts a front view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 706 and 718 partially retracted upwardly. This front view better shows the threaded portion 722 of retaining screw 710.
  • FIG. 115 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade lower guide plate 718 and upper guide plate section 706 fully retracted upwardly as seen in FIG. 114.
  • the guide plate retaining screw 710 is threaded 722 all the way out and the upper section guide plate 706 is being held up by retaining washer 711.
  • the lower section guide plate 718 is in the foremost guide slot position within the plurality of guide slots 716.
  • This cross-sectional view also clearly shows the central cavity 720, the trunnion securing member 724 and securing nut 726, along with the rearward blade guide slots 712 and the threaded orifice 714 for accepting an eyebolt (not shown see FIG.’s 120 - 127).
  • This position farthest from the medial calcar, would accommodate a larger or collared femoral stem implant.
  • FIG. 116 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate upper section 706 and lower section 718 fully extended downwardly and positioned in the middle knife blade guide slot within the guide block.
  • This view clearly shows that the lower section guide plate 718 has been moved and repositioned in one of the middle guide slots within the plurality of guide slots 716. This position, a medium distance to the medial calcar, would accommodate a medium sized femoral stem implant.
  • FIG. 117 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate lower section 718 fully retracted upwardly and positioned in the middle knife blade guide slot within the plurality of guide slots 716 integral to the guide block assembly 700. It also shows the retaining washer 711 which holds the upper section guide plate 706 in the upward position.
  • FIG. 118 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate upper section 706 and lower section 718 fully extended downwardly and positioned in the knife blade guide slot closest to the central cavity 720 within the guide block.
  • FIG. 119 depicts a cross-sectional view of an alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate lower section 718 fully retracted upwardly and positioned in the middle knife blade guide slot within the plurality of guide slots 716 integral to the guide block assembly 700. It also shows the retaining washer 711 which holds the upper section guide plate 706 in the upward position. This position, closest to the medial calcar but frilly retracted upwardly, would accommodate a smaller to medium sized femoral stem implant.
  • FIG. 120 depicts an exploded view of the alternate embodiment of the joint revision surgery apparatus 10Q illustrating a disassembled knife blade guide block assembly 700 having an adjustable L-shaped knife blade guide plate 706 and 718, and showing its use during revision surgery 800 with respect to the relative positions of the medial calcar knife blade 816 and posterior knife blade 822 before insertion into the forward knife blade guide slots 716 and rearward knife blade guide slots 712 within the guide block assembly 700, as its relative position to the femoral stem implant 830 and femoral stem implant trunnion portion 832.
  • Assembly of the two half sections 702 and 704 is accomplished using Allen screws 732, 734, 736 and 738 along with alignment pins 740 and 742.
  • FIG. 121 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate, in use during revision surgery 800 showing the surgical knife blades 816 and 822 inserted into the forward 716 and rearward 712 knife blade guide slots within the assembled guide block 700, for removal of a non - collared implanted femoral stem 830.
  • the guide plate lower section 718 has been inserted into the farthest most (away from the femoral stem implant) guide slot within the plurality of guide slots 716.
  • the guide plate adjustment screw 710 is threaded all the way into the block such that the guide plate lower section 718 is farthest from the femoral stem implant to be removed.
  • Trunnion securing member 724 is securely fastened to the trunnion portion 832 of the stem 830.
  • Posterior blade shaft 820 and cutting blade 822 extend down through rearward guides slots 712 and cut the posterior portion of the stem 830.
  • Medial calcar blade 816 runs down through the plurality of guide slots 716 and is guided by the position of the guide plate lower section 718.
  • FIG. 121 represents Steps 1 - 4 of the procedure for revision surgery to remove a femoral stem implant, namely. Step 1: adjust the guide plate height and slot position for the type and size of the femoral stem implant to be removed; Step 2: secure the trunnion portion 832 to the trunnion securing member 724; Step 3 : insert the posterior cutting blade through the rearward blade guide slots 712; Step 4: after all adjustments have been made to the guide plate, and the rearward or posterior cutting blade 822 has been inserted, then the medial calcar blade 816 insertion is initiated. In this way, the correct and appropriate adjustments have been made to accommodate the size and shape of the femoral stem implant 830 to be removed during the subsequent steps of the revision surgery procedure using the joint revision surgery apparatus 10Q guide block assembly 700.
  • FIG. 122 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 706 and 718, in use during revision surgery 800 showing the surgical knife blades 816 and 822 inserted into the forward 716 and rearward 712 knife blade guide slots within the assembled guide block 700, for removal of a non-collared implanted femoral stem.
  • This FIG. 122 represents Step 5 of the procedure for revision surgery to remove a femoral stem implant, namely, Step 5: insert medial calcar cutting blade 816 until it makes contact with the femoral stem implant 830 to be removed.
  • FIG. 123 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 706 and 718, in use during revision surgery 800 showing the surgical knife blades 816 and 822 inserted into the forward 716 and rearward 712 knife blade guide slots within the assembled guide block 700, for removal of a non-collared implanted femoral stem.
  • Step 6 represents Step 6 of the procedure for revision surgery to remove a femoral stem implant 830, namely, Step 6: continue downward pressure and motion of the medial calcar cutting blade 816 until it advances past the point of initial contact with the femoral stem implant 830 to be removed, and begins cutting the femoral stem implant away from the femur bone.
  • the L-shaped guide plate 706 and 718 are positioned within the guide slot farthest away from the femoral stem implant 830.
  • the guide plate lower section 718 is secured at its lowest point possible, closest to the femoral stem implant 830 to be removed during revision surgery.
  • FIG. 124 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 706 and 718, in use during revision surgery 800 showing the surgical knife blades 816 and 822 inserted into the forward 716 and rearward 712 knife blade guide slots within the assembled guide block 700, for removal of a non-collared implanted femoral stem.
  • Step 6 again represents Step 6 of the procedure for revision surgery to remove a femoral stem implant 830, namely, Step 6: continue downward pressure and motion of the medial calcar cutting blade 816 until it advances past the point of initial contact with the femoral stem implant 830 to be removed, and begins cutting the femoral stem implant away from the femur bone.
  • the L-shaped guide plate 706 and 718 are positioned within the guide slot closest to the femoral stem implant 830.
  • the guide plate lower section 718 is secured at a slightly raised position relative to its lowest point possible, a bit farther away from the femoral stem implant 830 to be removed during revision surgery.
  • FIG. 125 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 706 and 718, in use during revision surgery 800 showing the surgical knife blades 816 and 822 inserted into the forward 716 and rearward 712 knife blade guide slots within the assembled guide block 700, for removal of a non-collared implanted femoral stem.
  • Step 6 again represents Step 6 of the procedure for revision surgery to remove a femoral stem implant 830, namely, Step 6: continue downward pressure and motion of the medial calcar cutting blade 816 until it advances past the point of initial contact with the femoral stem implant 830 to be removed, and begins cutting the femoral stem implant away from the femur bone.
  • the L-shaped guide plate 706 and 718 are positioned within the guide slot closest to the femoral stem implant 830. This view better shows the retaining washer 711 used to keep the guide plate upper section 706 up when the adjustment plate retaining screw 710 is raised.
  • the guide plate lower section 718 is secured at a more raised position relative to its lowest point possible, a bit farther away from the femoral stem implant 830 to be removed during revision surgery .
  • FIG. 126 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 706 and 718, in use during revision surgery 800 showing the surgical knife blades 816 and 822 inserted into the forward 716 and rearward 712 knife blade guide slots within the assembled guide block 700, for removal of a collared implanted femoral stem 840 including a collar 850.
  • the femoral stem trunnion section 842 has been secured to the trunnion securing member 724.
  • Step 5 represents Step 5 of the procedure for revision surgery to remove a collared femoral stem implant, namely, Step 5: inserting the medial calcar cutting blade 816 until it makes initial contact with the femoral stem implant 840 to be removed, here bypassing the collar 850 on the collared stem 840.
  • the L-shaped guide plate 706 and 718 are positioned within the guide slot in the middle section of the plurality of guide slots 716 a medium distance from the femoral stem implant 840.
  • the adjustment plate retaining screw 710 is slightly raised allowing the guide plate lower section 718 to guide a cutting blade 816 beneath the collar 850 on the collared stem 840.
  • This view better shows the retaining washer 711 used to keep the guide plate upper section 706 up when the adjustment plate retaining screw 710 is raised. Also note that the guide plate lower section 718 is secured at a more raised position relative to its lowest point possible, a bit farther away from the collared femoral stem implant 840 to be removed during revision surgery.
  • FIG. 127 depicts a cross-sectional view of the alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 706 and 718, in use during revision surgery 800 showing the surgical knife blades 816 and 822 inserted into the forward 716 and rearward 712 knife blade guide slots within the assembled guide block 700, for removal of a non-collared implanted femoral stem.
  • the femoral stem trunnion section 842 has been secured to the trunnion securing member 724.
  • This FIG. 127 again represents Step 6 of the procedure for revision surgery to remove a collared femoral stem implant 840, namely.
  • Step 6 continue downward pressure and motion of the medial calcar cutting blade 816 until it advances past the point of initial contact with the collared femoral stem implant 840 to be removed, and begins cutting the collared femoral stem implant 840 away from the femur bone.
  • the L-shaped guide plate 706 and 718 are positioned within the guide slot closest to the femoral stem implant 840.
  • the guide plate lower section 718 is secured at a more raised position relative to its lowest point possible, a bit farther away from the femoral stem implant 840 to be removed during revision surgery. This allows the guide plate 718 to guide the cutting blade 816 down passed the collar 850 on the collared stem 840.
  • the alternate embodiment of the joint revision surgery apparatus 10Q illustrating an assembled knife blade guide block 700 having an adjustable L-shaped knife blade guide plate 706 and 718 can be adjusted in two separate ways.
  • the adjustment plate retaining screw 710 can be threaded outwardly (lifted) or threaded inwardly (lowered) to retract or extend the lower adjustment plate 718 towards or away from the stem.
  • the adjustment plate retaining screw 710 can be removed altogether and the guide plate lower section 718 shifted to a different guide slot within the plurality of guide slots 716, with that guide slot being closer or farther away from the stem to be extracted.
  • One or both of the aforementioned guide plate adjustments can be made to successfully guide a cutting blade down to a stem of varying size, and in this way the guide block assembly 700 can accommodate varying sized stems to be removed during revision surgery. Moreover, both a collared and non-collared stem can be extracted by making the appropriate adjustments to the length and distance of the adjustable guide plate.
  • the surgical knife blade guide block 600 and 700 of the present invention could be manufactured and formed in one piece by being molded or computer numerical control (CNC) formed from a piece of material, including but not limited to metal, plastic, wood, ceramic and composite.
  • CNC computer numerical control
  • the stem trunnion securing member of the present invention could be manufactured and formed in one or two pieces by being molded or computer numerical control (CNC) formed from one or two pieces of material, including but not limited to metal, plastic, wood, ceramic and composite.
  • the Joint Revision Surgery Apparatus 10A, 10B, 10C, 10D, 10E, 10F, 10G, 10H, 10J, 10K, 10L, 10M, 10N, 10P and 10Q shown in the drawings and described in detail herein disclose arrangements of elements of particular construction and configuration for illustrating preferred embodiments of structure and method of operation of the present design.
  • the terms “generally parallel” and “substantially parallel” refer to a value, amount, or characteristic that departs from exactly parallel by less than or equal to 15 degrees, 10 degrees, 5 degrees, 3 degrees, 1 degree, or 0.1 degree.

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

Abstract

La présente invention concerne un appareil de chirurgie de révision articulaire qui comprend un bloc de guidage de lame de couteau chirurgical qui a une pluralité de fentes de guidage de lame arrière, une cavité centrale et une pluralité de fentes de guidage ayant une plaque de guidage en forme de L réglable à deux voies. La cavité centrale de bloc de guidage de lame de couteau chirurgical loge un élément de fixation de tourillon de tige et est positionnée sur le tourillon de la prothèse existante devant être retirée et fixée à la prothèse. Le bloc de lame de guidage est fixé au tourillon de la prothèse à extraire à l'aide d'un élément de fixation de tourillon de tige logé à l'intérieur du bloc de guidage. Des lames de couteau rigides et flexibles incurvées, droites, incurvées et composées sont guidées par les fentes de guidage de lame après réglage de la plaque de guidage en forme de L réglable à deux voies pour couper la prothèse libre. L'appareil de chirurgie de révision articulaire facilite le retrait rapide, efficace et complet d'une prothèse sans collerette ou d'une prothèse à collerette pendant une chirurgie de révision articulaire, et augmente significativement les résultats médicaux positifs pour des procédures de révision articulaire.
PCT/US2022/045685 2022-08-30 2022-10-04 Appareil de chirurgie de révision articulaire Ceased WO2024049454A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US17/899,521 US12502183B2 (en) 2022-08-30 Joint revision surgery apparatus
US17/899,521 2022-08-30

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WO2024049454A1 true WO2024049454A1 (fr) 2024-03-07

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4686971A (en) * 1984-11-19 1987-08-18 Harris William H Method and apparatus for extraction of prostheses
US5674225A (en) * 1994-04-25 1997-10-07 Protek Ag Extraction tool for a shaft of a hip joint prosthesis or of a corresponding rasp
US20100010493A1 (en) * 2006-04-05 2010-01-14 Depuy International Limited Orthopaedic cutting guide instrument
US20150057666A1 (en) * 2013-08-26 2015-02-26 Scott Kelley Osteotome Guide Configured to Attach to an Implanted Femoral Component
US20210212838A1 (en) * 2019-04-30 2021-07-15 MAP Medical Solutions, LLC Joint revision surgery apparatus
US20220313282A1 (en) * 2021-03-30 2022-10-06 MAP Medical Solutions, LLC Joint revision surgery apparatus

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4686971A (en) * 1984-11-19 1987-08-18 Harris William H Method and apparatus for extraction of prostheses
US5674225A (en) * 1994-04-25 1997-10-07 Protek Ag Extraction tool for a shaft of a hip joint prosthesis or of a corresponding rasp
US20100010493A1 (en) * 2006-04-05 2010-01-14 Depuy International Limited Orthopaedic cutting guide instrument
US20150057666A1 (en) * 2013-08-26 2015-02-26 Scott Kelley Osteotome Guide Configured to Attach to an Implanted Femoral Component
US20210212838A1 (en) * 2019-04-30 2021-07-15 MAP Medical Solutions, LLC Joint revision surgery apparatus
US20220313282A1 (en) * 2021-03-30 2022-10-06 MAP Medical Solutions, LLC Joint revision surgery apparatus

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