Methods and systems for hip replacement

Abstract

Methods and apparatus of the present invention provide for orthopaedic replacement of the hip while substantially preserving muscles and soft tissues around the hip joint resulting in reduced healing time and decreased risk of dislocation following the procedure. In an exemplary embodiment, an intramedullary rod 1502 is inserted longitudinally into the femur. A prosthetic femoral neck 3102 is then inserted from a point along the side of the patient's body and into the side of the femur and through a pre-existing lateral bore in the intramedullary rod 1502 and through the remainder of the femur to join the prosthetic femoral head 1102 . The methods and apparatus include structures and techniques for fixing the prosthetic femoral neck 3102 in relation to the intramedullary rod 1502.

1 - 17 . (canceled) 
     
     
         18 . A method of performing a total hip arthroplasty, comprising:
 seating a prosthetic acetabular cup in an acetabulum;   fitting a prosthetic femoral head within the prosthetic acetabular cup, the prosthetic femoral head rotatable with respect to the prosthetic acetabular cup;   inserting into the femur at least a portion of an intramedullary rod having a neck bore;   inserting a head-engaging end of a prosthetic femoral neck into (i) a femoral bore defining a passage through the femur from a side of the femur opposite the acetabulum and (ii) the neck bore in the inserted intramedullary rod; and   joining the head-engaging end of the prosthetic femoral neck to the prosthetic femoral head.   
     
     
         19 . The method of  claim 18 , further comprising:
 prior to seating the prosthetic acetabular cup, surgically accessing the acetabulum; and   preparing the acetabulum to receive the prosthetic acetabular cup.   
     
     
         20 . The method of  claim 18 , further comprising:
 prior to inserting into the femur at least the portion of the intramedullary rod, surgically accessing the femur; and   preparing the femur to receive the intramedullary rod.   
     
     
         21 . The method of  claim 18 , further comprising:
 fixing the prosthetic femoral neck with respect to the inserted intramedullary rod.   
     
     
         22 . The method of  claim 18 , wherein the femoral bore is created before a natural femoral head is removed. 
     
     
         23 . The method of  claim 18 , wherein at least one anterior incision provides surgical access to the acetabulum and to the femur, and wherein a posterior incision provides surgical access to the femur. 
     
     
         24 . The method of  claim 18 , wherein the femoral bore is created by:
 removably fixing an alignment tool to the intramedullary rod, the alignment tool having a guide bore which, when the alignment tool is removably fixed to the intramedullary rod, is in alignment with the neck bore of the intramedullary rod; and   advancing a drilling bit through the guide bore, through the side of the femur opposite the acetabulum, through the neck bore in the intramedullary rod in a direction toward the acetabulum.   
     
     
         25 . The method of  claim 24 , wherein the alignment tool further comprises a first fixation keyway and the intramedullary rod further comprises a second fixation keyway which removably interlocks with the first fixation keyway to facilitate removable fixation of the alignment tool to the intramedullary rod. 
     
     
         26 . The method of  claim 18 , wherein the insertion of at least the portion of the intramedullary rod comprises inserting a guide wire into an intramedullary canal of the femur. 
     
     
         27 . A system for hip arthroplasty, comprising:
 a prosthetic femoral head;   an intramedullary rod positionable in a femur of a patient; and   a prosthetic femoral neck extendible through a bore in a femur, from a side of the femur opposite the acetabulum, and in a direction toward the patient's acetabulum, the prosthetic femoral neck configured to be joined to the intramedullary rod and having an end configured to be joined to the prosthetic femoral head;   wherein the intramedullary rod comprises a threaded neck fixation bore extending within, and along a long axis of, the intramedullary rod;   wherein the intramedullary rod further comprises a tapered neck fixation bore extending from a proximal side of the intramedullary rod to a distal side of the intramedullary rod;   wherein the intramedullary rod is rotationally engageable to the prosthetic femoral neck;   wherein the threaded bore and the tapered bore cooperate to fix the prosthetic femoral neck relative to the intramedullary rod.   
     
     
         28 . The system of  claim 27 , further comprising a support sleeve adapted to be seated in a trochanteric region of the femur, the support sleeve including a rod bore and a neck passage, the rod bore configured to hold a portion of a proximal end of the intramedullary rod while a distal end of the intramedullary rod is positioned in the femur. 
     
     
         29 . The system of  claim 28 , wherein fixation ridges formed on a surface defining, at least in part, the neck passage engage the prosthetic femoral neck to resist movement of the prosthetic femoral neck within the neck passage. 
     
     
         30 . The system of  claim 27 , wherein a threaded fixation screw removably tightened into the neck fixation bore fixes the prosthetic femoral neck relative to the intramedullary rod in a position in which a head engagement end of the prosthetic femoral neck fixedly joins a neck engagement portion of the prosthetic femoral head. 
     
     
         31 . The system of  claim 27 , wherein at least a shaft portion of the prosthetic femoral neck has a non-circular cross-section. 
     
     
         32 . The system of  claim 27 , wherein a shaft portion of the prosthetic femoral neck is curved. 
     
     
         33 . The system of  claim 27 , wherein the tapered bore comprises a Morse taper. 
     
     
         34 . The system of  claim 27 , wherein the distal end of the intramedullary rod comprises at least two prongs. 
     
     
         35 . The system of  claim 27 , wherein an outer bone-engaging surface of the distal end of the intramedullary rod includes at least one flute. 
     
     
         36 . The system of  claim 35 , wherein a shaft portion of the prosthetic femoral neck is curved and wherein at least one fixation groove is formed in both top and bottom sides of the prosthetic femoral neck. 
     
     
         37 . The system of  claim 27 , wherein respective surfaces of the tapered neck fixation bore and the prosthetic femoral neck are configured to resist movement of the prosthetic femoral neck within the lateral bore.