Anterior hip replacement retractor assembly

A retractor assembly has a first clamp adapted to be mounted to a table, a first vertically oriented post supported by the clamp, a first main arm mounted for at least one of angular and lateral movement relative to the first post, and lockable in a selected position, and a tree assembly configured at one end of the second post. The tree assembly has at least two accessory arms, with each accessory arm having a first ball joint on a first end, and a pivot lock knob at an immediate portion, and each accessory arm having a second end configured to accept the mounting of a retractor to the accessory arm. The retractor assembly may also include a J-shaped hook mounted to a ratcheting linearly movable distractor assembly and trochanteric retractors mounted to the accessory arms for femoral elevation and exposure.

FIELD OF THE INVENTION

Some embodiments of the invention relate to the field of orthopedic surgery. Further, some embodiments of the invention relate to retractor assemblies that are used during surgery such as, for example, hip replacement surgery.

BACKGROUND OF THE INVENTION

Many types of surgery are performed on the human body, including hip replacement surgery. During such procedures, it is known to use the retractor assemblies in order to hold soft tissue in a position that permits the position to access the surgical area. In one common practice, a single retractor, or a number of retractors, will each be manually supported by an assistant. In these systems, the assistant will hold the retractor in position, and may apply a force against the soft tissue at the same time. In the case of relatively complex procedures such as hip replacement surgery, it may be necessary to use two or even a larger number of separate retractors, which may necessitate two or more assistants to manually operate the retractors. This may at some times be somewhat cumbersome.

SUMMARY OF THE INVENTION

In various embodiments, a retractor assembly comprises: a first clamp adapted to be mounted to a table; a first vertically oriented post supported by the clamp; a first main arm mounted for at least one of angular and lateral movement relative to the first post, and lockable in a selected position; and a tree assembly configured at one end of the second post, the tree assembly comprising at least two accessory arms, with each accessory arm having a first ball joint on a first end thereof, and a pivot lock knob at an immediate portion thereof, and each accessory arm having a second end configured to accept the mounting of a respective retractor to the accessory arm.

In other various embodiments, a retractor assembly comprises: a first main post; a first main arm mounted to the first main post; a fitting disposed at one end of the first main arm; a first accessory arm operatively supported by the fitting and adopted to operatively support a first retractor; a second main arm mounted to the second main post; a second accessory arm operatively supported by the fitting and adopted to operatively support a second retractor; a third main arm mounted to the third main post; and a third accessory arm operatively supported by the fitting and adopted to operatively support a third retractor.

In alternative various embodiments, a retractor assembly comprises: a first main post a first main arm mounted to the first main post; a fitting disposed at one end of the first main arm; a first accessory arm operatively supported by the fitting and adopted to operatively support a first retractor; a second main arm mounted to the second main post; a second accessory arm operatively supported by the fitting and adopted to operatively support a second retractor; a third main arm mounted to the third main post; a third accessory arm operatively supported by the fitting and adopted to operatively support a third retractor; a second main arm mounted to the first main post; and a fourth accessory arm operatively mounted to the second main arm and adapted for supporting a retractor.

In still other alternative embodiments, a retractor assembly comprises: a second clamp adapted to be mounted to the table; a second vertically oriented post supported by the clamp; a third main arm mounted for at least one of angular and lateral movement relative to the second post, and lockable in a selected position; a J-shaped hook; and a distractor assembly movable linearly with respect to the third main arm, wherein the distractor is adapted to support the J-shaped hook.

The foregoing objects and advantages of the invention are illustrative of those that can be achieved by the various exemplary embodiments and are not intended to be exhaustive or limiting of the possible advantages which can be realized. Thus, these and other objects and advantages of the various exemplary embodiments will be apparent from the description herein or can be learned from practicing the various exemplary embodiments, both as embodied herein or as modified in view of any variation that may be apparent to those skilled in the art. Accordingly, the present invention resides in the novel methods, arrangements, combinations, and improvements herein shown and described in various exemplary embodiments.

Some embodiments of the invention will now be described with reference to the drawing figures, in which like reference numbers refer to like parts thereof. The following description refers toFIGS. 1 through 3taken together, except that in some instances specific reference will be made toFIG. 4AthroughFIG. 6B.

A retractor assembly10is shown for use with an operating table12. The operating table12is the only suitable table such as, for example, an orthopedic table which has a hinged portion to help position the patient. The patient is not illustrated, but can recline on the orthopedic table during surgery. The table12has longitudinal rails14and16as shown. These rails14and16provide a support for the retractor assembly.

A table clamp20is slidably mounted along the rail14. The table clamp20supports a vertical side post22. A T-post24is mounted to the post22on a clamp block30.

FIGS. 4A and 4Cshow additional details of the post22and the clamp block30. The clamp block30includes a first clamp32which can pivot around the post22, slide longitudinal along the post22, and also be fixed on the post22. The clamp block30also has a second clamp34which can rotate around the axis B. A lever36is part of the second clamp34, so that movement of the lever can compress the clamp block30, thereby tightening it. The second clamp34holds a T-post24as will be described below.

Returning toFIGS. 1 through 3, a T-post24is supported by the clamp block30and can be moved longitudinally within the clamp block30. The T-post24terminates in four quick connect ends40,42and44respectively.

Mounted to the quick connect40is a small fixed angle arm46, which may be a non-straight extension arm. The small fixed angle arm46terminates on its own quick connect48. Attached to the quick connect48is an accessory arm50.FIGS. 5A through 5Cshow further details of an accessory arm50. This illustration also corresponds to the components of the other accessory arms60and80. Returning toFIGS. 1-3, the accessory arm50includes a connector52, which connects to the quick connect48, and which also has a ball and socket joint permitting a range of two-dimensional pivotal motion around the ball. The connector52may also include a ball and socket connection. Each ball and socket connection includes a tightening lockdown feature to fix it at a desired angle. The accessory arm50also has a pivot54which can be locked in position by a handle56. The accessory arm50terminates in a connector58which also has a ball turn fitting. This connector58is adapted to receive a retractor, such as the illustrated straight hohmann retractor1000.

Returning to the T-post24, an accessory arm60is connected to the quick connect42. This accessory arm60includes components62,64,66and68which correspond to items52,54,56and58described above. The accessory arm64thus supports a retractor2000, such as the illustrated femur retractor2000.

Returning to the T-post24, connected to the quick connect44is a large fixed accessory arm70, which may be a non-straight extension arm, that has at one end in its own quick connect72, to which is connected another accessory arm80. This accessory arm60includes components62,64,66and68which correspond to items52,54,56and58described above. The accessory arm64thus supports a retractor2000, such as the illustrated femur retractor2000.

Also supported on the post22by a clamp block100is an arm102. The clamp block100is substantially similar in configuration to the clamp block30. The arm102terminates at the ball joint104that supports an arm106. A quick connect108leads to an accessory arm110. The accessory arm110includes components112,114,116and118which correspond to components52,54,56and58as described above.

From the above, it will be appreciated that the above-described componentry provides for convenient positioning and locking of up to four retractors,1000,2000,3000and4000. The wide range of degrees of freedom of are presented so that the retractors can be provisioned with a wide range of locations on the table at varying heights, and at varying spatial angles. Also the arm102may be attached to post222instead of post22.

Retractor1000may be a straight hohmann retractor. Retractor1000may be used to retract soft tissue or bones. During various stages of an operation, retractor1000and/or similar retractors may be mounted to one or more accessory arms to provide constant exposure of the surgical site.

Retractor2000may be a two pronged stout trochanteric retractor. Retractor2000may be placed around the lesser trochanter of the femur. Retractor2000may be used to retract the proximal femur medially. Retractor2000may be secured to post22via accessory arm60and T-post24such that retractor2000comes from a direct medial location.

Retractor3000may be a smooth stout trochanteric retractor. Retractor3000may be placed around the greater trochanter of the femur. In various alternative embodiments, retractor3000may be a two pronged stout trochanteric retractor similar to retractor2000. Retractor3000may be used to assist in femoral elevation. Retractor3000may be mounted to post22via accessory arm80and T-post24such that retractor3000comes from a posterior proximal location. In various alternative embodiments, retractor3000may be mounted to post222via an arm102and accessory arm110. This alternative embodiment may allow retractor3000to be used from a lateral, posterior, proximal location.

Retractor4000may be an angled hohmann retractor. Retractor4000may be used to retract soft tissue or bones. During various stages of an operation, retractor4000and/or similar retractors may be mounted to one or more accessory arms to provide constant exposure of the surgical site.

Mounted to the rail16is a table clamp220which supports a vertical side post222. A clamp block230, similar to the clamp block30, supports an arm240. The arm240supports a ratcheting or rack and pinion femur distractor assembly250, which is illustrated in more detail inFIGS. 6A and 6B. As shown inFIGS. 6A and 6B, the femur distractor250includes a rack252which can be laterally driven by a knob254having gear teeth, relative to a slider256which is mounted to a clamp258which grips the arm240. A lever260compresses the clamp258to lock the distractor250onto the arm240. Thus, the hook connection end262of the distractor250can be moved relative to the arm240. Since the distractor250is arranged in the vertical configuration projecting down from the arm240, it will be appreciated that rotation of the knob254can raise or lower the hook connection262. The hook connection262is adapted to support in a swinging fashion a J-hook5000. The J-hook5000is adapted to support the weight of a femur.

From the above it will be appreciated that the assembly provides a convenient method for positioning a femur J-hook and for mechanically raising and lowering the J-hook by turning a knob. A ratchet feature may also be incorporated along with or instead of the rack and pinion drive system.

J-hook5000may be adapted to be inserted around the proximal femur at a point just distal to the lesser trochanter. As described above, retractors2000and3000may be used to retract tissue and provide exposure and space for insertion of J-hook5000. In various exemplary embodiments, J-hook5000may include a pointed tip that allows J-hook5000to pierce through the gluteus maximus tendon. J-hook5000includes a handle that may be used for holding the J-hook during insertion. The handle may also be used to pull the J-hook5000upwards toward distractor250, where the J-hook5000may be attached at hook connection262.

FIG. 1also depicts a wrench99which is a movable tool that can be used to secure or release the quick connects. The accessory arm110supports an angled hohmann and retractor4000as shown.