Abstract:
A method for preparing a proximal femoral canal of a patient during total hip replacement surgery uses an instrument having a handle, a shaping member including structure configured to shape bone, wherein the structure configured to shape bone comprises at least two cutting surfaces on opposite sides of the shaping member, and a connecting member connecting the handle and the shaping member, the connecting member having a plurality of transverse cross sections. The connecting member includes a dual offset including a first compound bend between the connecting member and the handle, wherein when following a direction from the connecting member to the handle, the first compound bend includes a bend in a posterior direction and a bend in a lateral direction. The connecting member also includes a second compound bend between the connecting member and the shaping member, the second compound bend in an anterior and a medial direction.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a divisional of U.S. application Ser. No. 13/691,128, filed on Nov. 30, 2012, which is a continuation of U.S. application Ser. No. 13/041,789, now U.S. Pat. No. 8,337,502, filed on Mar. 7, 2011, which is a divisional of U.S. application Ser. No. 11/368,761, now U.S. Pat. No. 7,935,125, filed on Mar. 6, 2006, the disclosures of which are incorporated herein by reference. 
     
    
     BACKGROUND OF THE INVENTION 
       [0002]    A total or partial hip replacement procedure is sometimes necessary to repair diseased or damaged parts of the hip joint, and in particular, the femoral head or the acetabular cup of the hip joint. During replacement of the femoral head, the diseased or damaged head is removed and the remaining portion of the femur is shaped to receive the stem of an implant which extends into the medullary canal of the bone. A prosthetic, spherical or ball-shaped head is attached to the top of the stem and replicates the anatomy of the removed femoral head, fitting into either the remaining acetabular cup or an artificial replacement therefore. 
         [0003]    Shaping of the femoral canal is accomplished using various shaping instruments in the form of femoral rasps or broaches. Generally, such rasps or broaches are designed to match the shape of the stem to be used in the replacement implant so that the femur can be shaped to securely receive the implant. Shaping instruments are inserted into the femoral canal using a handle adapted to affix to the end of the shaping instrument. Many handles have been developed that attach to the proximal portion of shaping instruments for introduction and removal of the shaping instrument from the femur of the patient. However, these handles are designed for use in hip replacement procedures that require either a large incision or a posterior approach in order to gain access to the femur, both of which cause severe trauma to the area surrounding the hip joint increasing the patient&#39;s pain and recovery time, and can result in increased risk to the patient. 
         [0004]    In an effort to provide a safer, less-traumatic surgical procedure for replacement of the femoral head, it has been determined that an anterior approach to the proximal femur causes less trauma to the surrounding tissue. An anterior approach is already necessary to gain access to the acetabulum for replacement thereof; thus, the ability to take an anterior approach to the femur eliminates the need for a second incision, or a single, large incision. Additionally, an anterior approach requires less muscle dissection compared to a posterior approach. Traditional instrument handles, such as straight or single-plane angled handles, are not conducive to use in hip replacement surgery using an anterior approach because this procedure typically does not allow for straight-line access to the femoral canal, especially when using minimally-invasive surgery (MIS) techniques such as decreased incision size. In particular, problems can arise from the use of traditional handles with respect to alignment of the shaping instrument in the femoral canal, which can cause fracture or misalignment of the femoral implant. Furthermore, problems can arise related to tissue damage from extreme pressure that must be applied to the handle while “fighting” against the tissue for alignment of the shaping instrument within the femoral canal. 
         [0005]    Previous attempts at developing an instrument handle for use in minimally invasive surgery have attempted to adapt an instrument handle for use with an incision that does not directly align with the femoral medullary canal. This has resulted in a handle having a “dual offset” design in which the handle incorporates a series of three perpendicular bends to offset the shaping instrument from the proximal section of the handle in both the posterior and lateral directions. This configuration results in a section of the handle that is oriented in the proximal-distal direction, followed by a section that is oriented in the medial-lateral direction, followed next by a section that extends in the anterior-posterior direction, from which the shaping instrument extends in the proximal-distal direction. As used herein when referring to bones or other parts of the body, the term “proximal” means close to the heart and the term “distal” means more distant from the heart. The term “inferior” means toward the feet and the term “superior” means toward the head. The term “anterior” means toward the front part or the face and the term “posterior” means toward the back of the body. The term “medial” means toward the midline of the body and the term “lateral” means away from the midline of the body. 
         [0006]    This type of handle configuration is capable of reaching the femoral medullary canal through an MIS or anterior approach. However, because the handle has two sections that are orthogonal to the direction of movement of the handle, the handle still interferes with the tissue surrounding the femoral medullary canal, resulting in damage thereto. Furthermore, the severity of the bends used in the handle results in a significant loss of linear impaction force from the proximal end of the handle, where the force is applied, to the instrument, where the force acts. This loss in force is due to the tendency of the perpendicular sections to create torque within the handle in both the lateral and anterior directions. While shaping the femoral medullary canal, it is necessary to minimize torque within the shaping handle because such torque is ultimately applied to the bone, which can cause breakage of the bone or misalignment of the implant. At the very least, the loss of the linear force applied to the handle makes it more difficult to shape the medullary canal for acceptance of the implant because the instrument tends to pitch or yaw within the medullary canal. 
         [0007]    Therefore, it is desirous to provide a handle for a shaping instrument that allows for the shaping instrument to be introduced through a small incision, preferably on the anterior side of the patient. The handle should allow for proper alignment of the shaping instrument, and adequate linear force transmission, while minimizing damage to surrounding tissue. 
         [0008]    During hip replacement surgery, it is often necessary to detach the shaping instrument from its handle. This allows a trial ball-shaped head to be attached to the proximal section of the shaping instrument in a well-known manner for trial reduction of the hip joint. Several variations of such locking mechanisms have been previously developed, but these locking mechanisms are only designed to work with straight or single-plane handles. Therefore, it is also desirous to provide a locking mechanism to attach a shaping instrument to a compound offset handle such that the handle can be easily detached and the handle can be removed from the incision. It is also desirous that this locking mechanism be controlled from the proximal portion of the handle which is located outside of the incision. This prevents the operator from having to reach into the wound to release the handle from or to reattach the handle to the shaping instrument. 
         [0009]    Similar advancements are also desired for insertion of the stem portion of an implant into the prepared femoral canal. Preferably, such a device can be used in connection with a minimally invasive or anterior approach to the femoral canal. It is equally important to have accurate control over placement of the implant and adequate force transmission during impaction of the implant as it is with respect to the use of a shaping instrument. 
         [0010]    It is therefore, necessary to provide a handle designed for use with a shaping instrument or a femoral implant that can be used in minimally invasive surgery or in surgeries that use an anterior approach to the femoral canal. It is also important for such a device to allow for accurate placement of the instrument or of the femoral implant and accurate and adequate force transmission from the impaction surface to the instrument or stem. 
       BRIEF SUMMARY OF THE INVENTION 
       [0011]    The present invention relates to a device for use on a patient during surgery. The device includes a distal portion, a transition portion, and a proximal portion. The distal portion is adapted to attach to an implement having a proximal portion, an anterior surface and a posterior surface, each surface being spaced apart from a medial-lateral plane through the implement. The transition portion is angled toward an anterior direction and a medial direction with respect to the implement, the proximal portion of the handle being connected to the transition portion and extending in a proximal direction with a medial-lateral plane therethrough substantially parallel to the medial-lateral plane through the implement. 
         [0012]    The implement used in connection with the device can be a shaping instrument used in preparing a joint for receiving an implant. The shaping instrument can be used in connection with any joint of the human body, particularly the hip, shoulder, knee or wrist. Most preferably, the shaping instrument includes a femoral rasp or broach used in preparing the proximal femur of the hip joint. Further embodiments of the invention contemplate a device to be used with a joint implant of a portion thereof, including a knee, shoulder or wrist implant, but an implant for replacement of the femoral portion of the hip is preferred. 
         [0013]    A further embodiment of the present invention relates to a device for use on a patient during surgery. The device includes a shaping instrument having a proximal portion, an anterior surface, and a posterior surface, each surface being spaced apart from a medial-lateral plane through the shaping instrument, and a handle having a distal portion, a transition portion, and a proximal portion. The proximal portion of the shaping instrument is affixed to the distal portion of the handle, and the transition portion of the handle is angled toward an anterior direction and a medial direction with respect to the shaping instrument. The proximal portion of the handle is connected to the transition portion and extends in a proximal direction with a medial-lateral plane therethrough substantially parallel to the medial-lateral plane through the shaping instrument. The shaping instrument can be either permanently affixed, or integrally formed, with the handle. Preferably, the shaping instrument is removably attached to the handle. 
         [0014]    A further embodiment of the present invention includes a method for preparing a proximal femoral canal of a patient during hip replacement surgery. In such a method a device according to one embodiment of the present invention is provided. The device is then inserted into the hip joint through a surgical incision and shaping the proximal femur is shaped with the device. The method further includes removing the instrument from the hip joint. 
         [0015]    An alternative embodiment of the present invention includes a method for performing surgery. This method includes providing a device according to a preferred embodiment of the present invention and engaging the distal portion of the device onto a femoral implant. The femoral implant is inserted into the hip joint through a surgical incision and the device is disengaged from the femoral implant. The device is then removed from the surgical incision. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0016]    The present invention will be better understood on reading the following detailed description of nonlimiting embodiments thereof, and on examining the accompanying drawings, in which: 
           [0017]      FIG. 1  is a perspective view of a device according to an embodiment of the present invention; 
           [0018]      FIG. 2  is a top elevation view of a device according to an embodiment of the present invention; 
           [0019]      FIG. 3  is a front view of a device according to an embodiment of the present invention; 
           [0020]      FIG. 4  is a side elevation view of a device according to an embodiment of the present invention; 
           [0021]      FIG. 5  is a perspective view of an example of an attachment mechanism adapted for use in connection with a device according to an embodiment of the present invention; 
           [0022]      FIG. 6  is a cross-section view of an example of an attachment mechanism adapted for use in connection with a device according to an embodiment of the present invention; 
           [0023]      FIG. 7  is a perspective view of an attachment mechanism according to an embodiment of the present invention; 
           [0024]      FIG. 8  is a cross-section view of an attachment mechanism adapted for use with a device according to an embodiment of the present invention; 
           [0025]      FIG. 9  is a cross-section view of an example of an attachment mechanism adapted for use in connection with a device according to an embodiment of the present invention; 
           [0026]      FIG. 10  is an example of a control mechanism adapted for use with a device according to an embodiment of the present invention; 
           [0027]      FIG. 11  is a cross-section view of a control mechanism adapted for use in connection with a device according to an embodiment of the present invention; 
           [0028]      FIG. 12  is a perspective view of a control mechanism adapted for use in connection with a device according to an embodiment of the present invention; 
           [0029]      FIG. 13  is a connection mechanism adapted for use with a device according to an embodiment of the present invention; 
           [0030]      FIG. 14  is a cross-section view of a connection mechanism adapted for use with a device according to an embodiment of the present invention. 
           [0031]      FIG. 15  is a perspective view of a device according to an embodiment of the present invention; and 
           [0032]      FIG. 16  is a cross-section view of an attachment mechanism adapted for use in connection with a device according to an embodiment of the present invention. 
       
    
    
     DETAILED DESCRIPTION 
       [0033]    In describing the preferred embodiments of the subject matter illustrated and to be described with respect to the drawings, specific terminology will be resorted to for the sake of clarity. However, the invention is not intended to be limited to the specific terms so selected, and it is to be understood that each specific term includes all technical equivalents which operate in a similar manner to accomplish a similar purpose. 
         [0034]    Referring to the drawings, wherein like reference numerals represent like elements, there is shown in  FIG. 1 , in accordance with one embodiment of the present invention, a surgical device designated generally by reference numeral  10 . In describing preferred embodiments of the device of the present invention, reference will be made to the directional nomenclature used in describing the human body. It is noted that this nomenclature is used only for convenience and that it is not intended to be limiting with respect to the scope or structure of the invention. When referring to specific directions, the device is understood to be described only with respect to its orientation and position during an exemplary application to the human body. 
         [0035]    In an embodiment of the present invention, device  10  includes handle  12  and shaping instrument  14 . Shaping instrument  14  is of the type typically used in shaping the proximal portion of a femur during hip replacement surgery. Shaping instrument  14  varies in size in accordance with the amount of material to be removed from the femoral canal in order to insert the desired replacement implant. Often, a series of shaping instruments will be used, each successive shaping instrument increasing in size in order to achieve the appropriate shape for the proximal femur. 
         [0036]    Generally, shaping instrument  14  has a shape that matches that of the femoral implant that is to be inserted into the femoral medullary canal. Generally, shaping instrument  14  has a width such that it defines a medial-lateral plane through the center thereof. Shaping instrument  14  has two outside surfaces  15  that are substantially parallel to and spaced apart from the medial-lateral plane through the center of shaping instrument  14 . These surfaces  15  are formed with a plurality of cutting teeth (not shown) that allow the shaping instrument to remove material from the medullary canal of the proximal femur. Shaping instrument  14  can be in the form of either a femoral rasp or a femoral broach. The design of these devices is generally known in the art. 
         [0037]    Handle  12  is divided into a distal section  16 , a transition section  18 , and a proximal section  20 . Handle  12  is made of a material that is sufficiently rigid so as to withstand the force needed to properly align and impact shaping instrument  14  into the femoral medullary canal through use in multiple surgical procedures. Suitable materials for handle  12  are stainless steal, titanium or other similar materials. For ease of use, proximal section  20  may further include a grip  22  or impaction surface  24 . Grip  22  allows the user of device  10  to easily hold onto handle  12  during use thereof for purposes of alignment or introduction and removal of shaping instrument  12  with respect to the femoral medullary canal. Impaction surface  24  provides an area on the proximal end  20  of device  10  upon which the handle can be struck with a hammer, mallet or other such device in order to force shaping instrument  14  into the femoral medullary canal. To further aid in impaction of shaping instrument  14  into the femoral medullary canal, handle  12  can be adapted to be used with an automatic impaction device, as it is known in the art. 
         [0038]    Handle portion  12  is connected to shaping instrument  14  at distal section  16 . Transition section  18  extends from distal section  16  and links distal section  16  to proximal section  20  such that an appropriate compound offset between proximal section  20  and shaping instrument  14  is achieved. 
         [0039]    In general, transition section  18  extends from distal section  16  to proximal section  20  so that proximal section  20  is substantially parallel to shaping instrument  14 , being offset therefrom in both the anterior and medial directions. Shaping instrument  14  has a longitudinal axis oriented generally in the proximal-distal direction. Similarly, proximal section  20  has a longitudinal axis oriented in the proximal-distal direction, and defines a medial-lateral plane. The distance of the offset in each direction should be such that shaping instrument  14 , can be inserted into the femoral medullary canal using a generally anterior approach, while allowing proximal section  20  of handle  12  to be positioned outside of the wound and while minimizing interference with the soft tissue that surrounds the hip joint of the patient. Preferably, proximal section  20  is offset from shaping instrument  14  in the anterior direction by at least 1 inch, but by no more than 3 inches. Similarly, it is preferred that proximal section is offset from the shaping instrument in the medial direction by at least 2 inches, but by no more than 6 inches. Most preferably proximal section is offset from shaping instrument by about 2 inches in the anterior direction and by about 4 inches in the medial direction. 
         [0040]    Transition section  18  has a longitudinal axis that is angled relative to the longitudinal axis of shaping instrument  14  in both the medial direction and the anterior direction. Similarly, the longitudinal axis of transition portion  18  is angled relative to the longitudinal axis of proximal section  20  in a posterior direction and a lateral direction. This necessitates the incorporation of a series of bends into device  10 . As shown in  FIG. 1 , medial bend  26  is incorporated into shaping instrument  14 . It is also possible to incorporate medial bend  26  in distal section  16  of handle  12 . Medial bend  26  is preferably between 30 and 60 degrees, but is most preferably about 45 degrees. Further locations of medial bend  26  would be apparent to those having reasonable skill in the art having read this disclosure. 
         [0041]    As further shown in  FIG. 1 , anterior bend  28  is incorporated into handle  12  at the point where distal section  16  meets transition section  18 . Anterior bend  28  is preferably between 15 and 45 degrees, but is most preferably about 30 degrees. Posterior bend  30  and lateral bend  32  are generally positioned at or near the point where transition section  18  meets proximal section  20 . Further, posterior bend  30  and lateral bend  32  can be located at approximately the same point in handle  12  forming a compound angle. Preferably, posterior bend  30  is of an angle approximately equal to that of anterior bend  28 , and lateral bend  32  is about equal to the angle of medial bend  26 , such that the longitudinal axes of proximal section  20  and shaping instrument  14  are approximately parallel. 
         [0042]    While shaping instrument  14  and handle  12  can be integrally formed together, it is preferred that shaping instrument  14  is removably attached to handle  12 . This arrangement allows different forms of shaping instrument  14 , including those of different sizes, to be used with a single handle  12 . One form of an attachment mechanism is shown in  FIG. 4 , wherein threaded hole  35  is formed in distal end  16  of handle  14 . A trunion (similar to trunion  46  shown in  FIGS. 5 and 6 ) is attached to proximal end  44  of shaping instrument  14 , so as to fit within hole  36  and has notch  48  formed therein. Threaded hole  35  is formed in distal section  16  such that it can engage a set screw and such that it intersects hole  36 . Set screw is sized and positioned such that it can be turned within threaded hole  35 , advancing the end of set screw through the intersection with hole  36  and into engagement with notch  48 . As such, trunion  46  is secured within bore  36 , thereby affixing shaping instrument  14  to handle  12 . 
         [0043]    An alternative form of attachment mechanism  34  used for fastening shaping instrument  12  to handle  14  is shown in  FIGS. 5 and 6 . This type of mechanism  34  is included in distal section  16  of handle  12 , and includes first bore  36  in distal section  16  of handle  12  extending from attachment surface  37  of handle  12  in a direction orthogonal thereto. Distal section  16  further includes a second bore  38  running from the posterior surface of distal section  16  to the anterior surface thereof in a direction orthogonal thereto. Second bore  38  is positioned within distal section  16  to form an intersection  39  with first bore  36 . Cam  40  is inserted into second bore  38  and has an undercut  42  formed therein. The proximal end of rasp  44  includes a trunion  46  having a notch  48  formed therein. Cam  40  is rotatable within second hole  38  such that it is positionable either in an open position or a closed position. The open position is such that undercut  42  of cam  40  is positioned such that cam  40  does not extend through intersection  39  into first bore  46 . The closed position is such that undercut  42  is turned away from intersection  39 , such that cam  40  extends through the intersection  39  and into first hole  36 . 
         [0044]    When cam  40  is in the open position, trunion  46  may freely pass into and out of first bore  36 . When handle  12  and shaping instrument  14  are assembled together, trunion  46  is inserted into first bore  36  and cam  40  is rotated into the closed position. In the closed position, a portion of cam  40  extends into first bore  36  and engages notch  48  of trunion  46 , such that trunion  46  is secured within second bore  36 . This results in shaping instrument  14  being secured to handle  12 . In order to aid in securing shaping instrument  14  to handle  12 , attachment surface  37  of handle  12  can include a projection  44  that mates with an opening in the proximal end of the shaping instrument  14 . This arrangement prevents rotational movement of shaping instrument  14  with respect to handle  12 . 
         [0045]    Referring now to  FIGS. 7-9 , an alternative variation of attachment mechanism  134  is shown. Attachment mechanism  134  includes slot  136  formed in distal section  16  of handle  12  that mates with trunion  46  formed on the proximal portion  44  of shaping instrument  14 . Distal portion  16  of handle  12  further includes a bore  138  formed between and orthogonal to the anterior and posterior surfaces of distal section  16 . Second bore  138  is positioned such that it intersects the medial side of slot  136 . Cam  140 , having undercut  142 , is positioned in bore  138  such that it is rotatable between an open position and a closed position. In the open position, undercut  42  of cam  40  is oriented such that cam  40  does not extend through the intersection of bore  138  and slot  136 . The closed position is such that the undercut is turned away from the intersection, and the body of cam  140  extends through the intersection and into a portion of slot  136 . Third bore  150  is formed parallel to bore  138  such that it forms an intersection with the lateral end of slot  136 . Third bore  150  has a fixed post  152  secured therein that extends into a portion of slot  136 . When cam  140  is in the open position, trunion  146  allows cam  140  to freely pass in and out of slot  136 . To allow trunion  146  to be freely moveable in and out of slot  136  when cam is in the open position, slot  136  should have a length sufficient to allow trunion to clear post  152 . When cam  140  is rotated into the closed position, cam  140  pushes trunion  146  toward the medial end of slot  136  such that notch  148  formed in trunion  146  mates with post  152 , thereby securing trunion  146  within slot  136 , and thus, securing shaping instrument  14  to distal section  16 . 
         [0046]    In order for the user of device  10  to detach and reattach shaping instrument  14  from handle  12  without the need to physically reach into the incision in the patient through which device  10  is inserted, a control means is provided in conjunction with handle  12 . An example of such control means is shown in  FIGS. 10 and 11 . Handle  12  has a generally hollow structure defining cavity  153  therein. Within cavity  153  there is included slide member  155  that is slideable in the proximal-distal direction. Plate  154  is affixed to the outside surface of the handle  12  on the lateral section thereof in order to secure slide member  155  within cavity  153 . The proximal end of spring  156  is attached to the proximal end of handle  12 , and the distal end of spring  156  is attached to slide member  155  such that it urges slide member  155  toward the proximal end  24  of handle  12 . The distal end of slide member  155  includes a fork  158 , which is attached using pin  60  to slot  62  formed in lever  64  that is attached to cam  40  extending from bore  38  to the outside of distal section  16 . In this mechanism, when slide member  155  is in its natural position, toward the proximal end of handle  12 , cam  40  is forced into the closed position. When the user of the device  10  slides slide member  155  toward the distal end of handle  12  using trigger  151 , pin  60  secured within fork  158  pushes forward on lever  64  causing cam  40  to rotate into its open position. 
         [0047]    Due to positioning of the elements of connection mechanism within distal section  16  of handle  12 , it may be necessary to provide a slide member  155  that urges cam  40  into the open position by sliding in the proximal direction. If this is necessary, spring  156  will be such that it urges slide member  155  in the distal direction. 
         [0048]    An alternative control mechanism is shown in  FIG. 12 , in which cam  40  is affixed to an elongated lever  66  that extends along transition portion  18  of handle  12  generally in the proximal direction. To selectively control the rotation of cam as between the open and closed positions the user rotates lever  66  in the appropriate direction. 
         [0049]    In  FIGS. 13 and 14  there is shown an alternative attachment mechanism  234  for removably affixing shaping instrument  14  to handle  12 . This attachment mechanism  234  includes a slot  236  formed in distal section  16  of handle  12  that is oriented orthogonally with respect to the attachment surface  37  of handle  12 . Slot  236  is adapted to engage trunion  246  which is affixed to proximal section  44  of rasp  14 . Distal section  16  of handle  12  includes bore  250  that has a fixed post  252  secured therein that is adapted to engage notch  248  formed in trunion  246 . Cavity  270  is formed in transition section  18  and distal section  16  of handle  12  and two corresponding sets of slots  274  are formed through the outside wall of transition section  18  to provide access to cavity  270 . 
         [0050]    Slots  274  are preferably generally oriented at approximately a forty-five degree angle with respect to the longitudinal axis of transition portion  18 . This results in slots  274  being oriented approximately in the anterior-posterior direction. Slots  274  and are adapted to engage pins  276 , which are affixed to arm  272  disposed in cavity  270 , such that pins  276  lie on an anterior-posterior plane. Pins  276  are affixed to and provide support for arm  272  which has hook section  280  formed thereon. Hook section  280  is slideably engaged with wedge  278  which is slideably mounted in cavity  270  such that it can be slid into and out from the intersection formed between cavity  270  and the proximal end of slot  236 . In operation, trunion  246  is inserted into slot  236  at the end nearest wedge  278  such that proximal end  44  of rasp  14  contacts attachment surface  37  of handle  12 . Pins  276  are then slid in the posterior direction, forcing arm  272  to move within cavity in the same direction such that it exerts a force on wedge  278 . The slideable engagement between wedge and hook section  280  of arm  272  allows wedge  278  to move within cavity  270  toward distal end of handle, thereby pushing trunion  246  toward and into engagement with post  252  such that trunion  246  is secured within slot  236 . Attachment mechanism  234  is secured in the closed position by the friction generated between all of the moving parts of this arrangement, in particular between pins  276  and slots  274  and between hook section  280  and wedge  278 . 
         [0051]    Referring now to  FIGS. 15-16 , an alternative embodiment of device  310  is shown in which device  310  is adapted to attach to joint implant  314 . Although joint implant  314  is shown as a femoral hip stem implant, it is not limited as such. Device  10  of the present invention could be used in connection with similar procedures conducted on any joint of the body that can be replaced, including the shoulder, knee or wrist. Implant  314  shown is of the type generally used in hip replacement surgery and includes a stem section  315  and a post section  317  that is adapted to engage a ball portion (not shown) of the artificial joint typical of such an arrangement. 
         [0052]    Implant  314  has a threaded hole  380  formed therein that is adapted to mate with a rotating threaded post  382  that is affixed to distal section  316  of handle  312 . Distal section  316  has further affixed thereon a support  384  that is adapted to engage post  317  affixed to the proximal end of implant  314 . In operation, threaded hole  380  is aligned with post  382  and then post  382  is turned to engage the threads between hole  380  and post  382  which draws implant  314  into contact with distal portion  316  of handle  312 . Support  384  is used to restrict the rotational movement of implant  314  with respect to the handle  312  and to help maintain an appropriate position for implant  314  with respect to handle  312 . 
         [0053]    Preferably, the rotational movement of post  382  is controlled by knob  386  which extends from transition section  318  of handle  312 . Knob  386  is attached to rod  388  which extends through transition section  318  toward distal section  316 . Rod  388  is attached to post  382  using universal joint  390 . Universal joint  390  transfers rotational motion about a longitudinal axis of rod  388  into rotational motion about a longitudinal axis of post  382  where the longitudinal axes of the respective elements are oblique relative to each other. The use of such a universal joint  390  is known in the art. 
         [0054]    A device according to this particular embodiment of the present invention is used by selecting an appropriate femoral implant  314  and attaching that femoral implant  314  to handle  310 . Then handle  312  is used to insert femoral implant  314  through an incision created during surgery and into the proximal end of the femur having been appropriately prepared to receive implant  314 . Implant  314  is then aligned using handle  312  which can be aided by including a radio frequency identification (RFID) device (not shown) either in distal section  316  the handle or in implant  314 . The use of RFID devices in alignment of implants and shaping instruments is known in the art. Once proper alignment is achieved, knob  386  is rotated so as to detach implant  314  from handle  312 . Implant  314  is then checked for proper reduction. If necessary, handle  312  is reattached to implant  314  which can be repositioned using handle  312 . Once proper reduction is achieved, handle  312  is removed from the incision and the surgery is completed. 
         [0055]    Although the invention herein has been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present invention as defined by the appended claims.