Precision Hip Replacement Method

Abstract

A method for accurately positioning the acetabular cup in a minimally invasive total hip arthroplasty (THA), comprising the steps of (a) placing the cup in roughly the correct position in the acetabulum using a acetabular component placement tool, (b) taking a first abduction reading and a first anteversion reading using a gyroscopic positioning unit aligned with the acetabular component placement tool, (c) taking an image of at least a portion of the cup using a radiography unit, (d) using the image to determine the actual orientation of the cup and required position of the cup to properly orient the acetabular component, (e) incrementally altering the position of the cup by using a striking tool, (f) taking new abduction and anteversion readings using the gyroscopic unit to determine the relative movement of the cup caused by the tapping, and (g) repeating any of the steps as necessary.

1 . A method for performing a conventional or minimally invasive, tendon sparing total hip arthroplasty, comprising:
 a. identifying a proper positioning of a portal incision from inside a patient with a tubular body;   b. aligning an acetabular component relative to an acetabulum using a first gyroscope; and   c. preparing a femur with a femoral broach by aiming a laser pointer down the back or front of a thigh of a patient to confirm a proper alignment of the femoral broach, the laser pointer being aligned to a broach handle connected to the femoral broach.   
     
     
         2 . The method of  claim 1 , further comprising the steps of:
 a. making a main incision to access the acetabulum of a patient;   b. determining a trajectory generally perpendicular to a plane defined by a face or opening of the acetabulum;   c. using a cutting member to cut a safe path from the inside out through the patient's tissue along the trajectory perpendicular to the plane defined by the face of the acetabulum as to a point on the patient's skin thereby allowing a surgeon to avoid numerous blood vessels, muscles, tendons, and nerves in the process; and   d. making the portal incision at or near the point.   
     
     
         3 . The method of  claim 2 , further comprising the step of:
 a. passing a guide wire through the safe path created by the cutting member; and   b. inserting a cannula, trough, or spatula into the safe path around the guide wire.   
     
     
         4 . The method of  claim 1 , further comprising the step of:
 a. preparing the acetabulum to receive an acetabular component using either a single incision, or a single incision and portal incision;   b. attaching the acetabular component to an acetabular component placement tool;   c. using the acetabular component placement tool to place the acetabular component in a best guess position with respect to the acetabulum of the patient; and   d. taking a first abduction and a first anteversion reading using the first gyroscope aligned with the acetabular component placement tool.   
     
     
         5 . The method of  claim 4 , further comprising:
 a. taking an image of at least a portion of the acetabular component using a radiography unit prior to the first abduction and first anteversion reading;   b. using the image to determine a current position of the acetabular component and a correct position of the acetabular component;   c. determining a correction required to position the acetabular component in the correct position;   d. incrementally altering the current position of the acetabular component by tapping a contact surface at one or more striking ports, wherein the contact surface is in mechanical communication with the acetabular component;   e. taking new abduction and anteversion readings to determine a relative movement of the acetabular component caused by the tapping; and   f. repeating steps c and d until the correction has been made.   
     
     
         6 . The method of  claim 5 , wherein the incrementally altering the current position step is performed by tapping a strike plate mated with the acetabular component. 
     
     
         7 . The method of  claim 4 , further comprising taking one or more reference angular readings from a second gyroscope aligned with a point on the patient's pelvis. 
     
     
         8 . The method of  claim 7 , further comprising monitoring the reference angular readings from the second gyroscope and adjusting the readings of the first gyroscope accordingly to compensate for any adjustment of the acetabular component being caused by movement of the patient's pelvis. 
     
     
         9 . The method of  claim 1 , further comprising taking one or more reference angular readings from the first gyroscope to monitor any movement of the patient's pelvis. 
     
     
         10 . The method of  claim 1  w herein the first gyroscope is configured to transmit the readings aurally, so that the surgeon does not have to look at the readings on a screen during the operation. 
     
     
         11 . The method of  claim 1  w herein the anteversion reading is taken from a compass aligned with the acetabular component placement tool. 
     
     
         12 . The method of  claim 1  further comprising rotating a mounting arm for the laser pointer so that the laser pointer is offset from a central axis of the broach handle in an angle that is different than an anteversion angle of the femoral broach itself. 
     
     
         13 . A method of properly positioning an acetabular component in a conventional or minimally invasive total hip arthroplasty procedure, comprising the steps of:
 a. attaching the acetabular component to an end of an acetabular component placement tool,   b. using the acetabular component placement tool to place the acetabular component in a best guess position with respect to an acetabulum of a patient,   c. taking a first abduction and a first anteversion reading using a first gyroscopic positioning unit aligned with the acetabular component placement tool,   d. taking an image of the pelvis containing the acetabular component using a radiography unit,   e. using the image to determine a current position and a correct position of the acetabular component relative to the acetabulum and pelvis,   f. incrementally altering the position of the acetabular component by tapping a contact surface at one or more striking ports, wherein the contact surface is in mechanical communication with the acetabular component,   g. taking new abduction and anteversion readings using the first gyroscopic unit to determine the relative movement of the acetabular component caused by the tapping, and   h. repeating steps f and g until the acetabular component has reached the correct position, thereby properly positioning the acetabular component without having to place any positioning pins in or on the patient and thereby avoiding pain, risk of infection, and risk of pin movement that accompanies positioning or transmitting pin methods.   
     
     
         14 . The method of  claim 13  wherein the first gyroscopic unit is removably attached to the acetabular component placement tool. 
     
     
         15 . The method of  claim 13  wherein the first gyroscopic unit is integral to the handle of the acetabular component placement tool. 
     
     
         16 . The method of  claim 13  wherein the first gyroscopic unit is provided by a smartphone or other electronic device configured with a gyroscopic application. 
     
     
         17 . The method of  claim 13  wherein the first gyroscopic unit is enclosed in a bag that is at least partially transparent in one location and is sterilized sufficiently for use in surgery. 
     
     
         18 . The method of  claim 13  wherein the anteversion reading is taken from a compass aligned with the acetabular component placement tool. 
     
     
         19 . The method of  claim 13  wherein the first gyroscopic unit is configured to transmit the readings to a local computer or local computer network. 
     
     
         20 . The method of  claim 13  wherein the first gyroscopic unit is configured to transmit the readings aurally, so that a surgeon does not have to look at the readings on a screen during the operation. 
     
     
         21 . The method of  claim 13  further comprising aligning a second gyroscopic unit with a pelvis of the patient to provide readings indicative of any movement of the pelvis during the procedure. 
     
     
         22 . The method of  claim 21  further comprising modifying the abduction and anteversion readings of the first gyroscopic unit to compensate for any changes in the readings from the second gyroscopic unit. 
     
     
         23 . The method of  claim 22 , further comprising displaying an image reflecting the orientation of the acetabular component relative to the acetabulum based on the combined readings from the first and second gyroscopic units. 
     
     
         24 - 27 . (canceled)