Abstract: An improved metallic bone prosthesis having a porous coating for bone ingrowth or interlocking with bone cement is disclosed. The porous coating comprises two layers of generally ball-shaped metallic particles bonded together at their points of contact, e.g. by sintering, and defining between them a plurality of connected interstitial pores having an average pore size of from about 350 microns to about 500 microns. A high resistance to failure at the coating-substrate and bone-coating (or cement-coating) interfaces is achieved with the use of the improved prosthesis. Also disclosed are a novel method for affixing the porous coating to a metal substrate, and a knee joint prosthesis having bearing portions designed so that the function of said prosthesis closely approximates that of the natural knee.

Abstract: A bone nail for upper arm fractures, including a hollow first shank adapted to be inserted into the proximal end portion of a medullary canal, the first shank having a distal end that has a slotted portion provided with a plurality of slots and an internal thread extending beyond the slotted portion.

Abstract: The guide wire of this invention is especially suited for the percutaneous introduction of a balloon dilatation catheter into a blood vessel. It contains a flexible shaft with a proximal portion and a distal portion. A flexible helical coil assembly surrounds the distal portion of the shaft. The helical coil assembly has a radiographically visible distal helical coil and a proximal radiographically invisible helical coil. The proximal helical coil and the distal helical coil are attached to each other by a connecting helical coil that on one end is screwed into the proximal helical coil and on the other end is screwed into the distal helical coil.

Abstract: A balloon dilatation catheter is disclosed having a multisectioned inner tube having a soft bumper tip, a multisectioned outer tube and a balloon with its distal neck connected to the bumper tip and its proximal neck connected to the outer tube. The various sections of the inner tube and outer tube may be formed from different materials or different grades of the same material. In addition, each section may have different outer diameters. The outer tube is bonded directly to the inner tube at the distal end of the outer tube. Preferably this bond is accomplished by thermal bonding.

Abstract: A catheter device having, in coaxial arrangement, an insertion catheter, a dilation catheter and an occlusion catheter. By means of the occlusion catheter a vessel carrying body fluid is closed off in the direction of flow following a stricture. By means of the dilation catheter, the stricture is treated by dilation. The occlusion catheter positioned beyond the stricture prevents an embolism due to detached particles flowing off. After treatment of the stenosis, vessel fluid together with any detached particles is removed by suction and washed out through the insertion catheter.

Abstract: An electrosurgical control for a trocar has a trocar with a cannula with a stylet coaxially fit therein. The stylet is movable relative to the cannula along a common axis. The trocar is shaped for insertion in a direction generally along the axis through tissue in a puncture procedure with its stylet. A distal end and a proximal end on the elongate cannula so the distal end enters the tissue while the proximal end remains outside. A tip on the stylet end, near the distal end of the cannula, normally extends therebeyond in position to puncture the tissue. The stylet has an energy supply passing from the tip to its opposite end and moves reciprocally relative to the cannula so the tip extends or is fully within the cannula. An electrosurgical generator provides energy to the opposite end of the stylet and an electrosurgically active device is a part of the tip and connects to the energy supply.

Abstract: A monitoring circuit for an electrosurgical generator has active and return output conductors. Voltage, current and the inverse of current picked up inductively are provided to a adder circuits for summing the picked up voltage and current and computing the difference of the picked up voltage and the current. Root mean square to direct current converters signal RMS average values of the sum and difference. A microprocessor squares the values and applies them to a formula wherein the sum signals have subtracted therefrom the difference signals; the results are divided by four to provide the root mean square of the power applied to the load. During desiccation the output is regulated in response to impedance to shut off output. A diagnostic circuit relates impedance load and output response during operation to a look up table or a microprocessor algorithm to calibrate. Feedback modifies the output when the adders determine the power applied to the load in real time.

Abstract: An ultrasonic oscillator drives a tool at a set frequency. An amplitude control runs the oscillator to set the vibration level. A frequency regulator joins the amplitude and the oscillator. A control feedback loop, in the frequency regulator, keeps handpiece linear dynamics. An operational transconductance amplifier, in the oscillator, governs gain of the loop. A circuit connects to the control to retard the rate of current application over time to the amplifier. The circuit has switching to either retard the rate or reset for start up. The amplifier is a current output device with current directly proportional to the bias current and input voltage with bias as gain change for the loop. The circuit limits the bias to the amplifier to modify frequency response and output current. A capacitor delays application of the bias to the amplifier. Replaceable tools of various lengths or shapes positioned along an axis vibrate for surgery at the frequency and a wave length.

Abstract: An acetabular cup for use as a prosthetic implant has an insert with a body including a central bore for receiving a positioning rod therein. A key element is formed on the bore and is adapted to align the positioning rod. The insert has a locating element formed on an outer surface of the body and also includes spring elements extending radially outwardly from the body. The acetabular cup has a generally hemispherical shell member coupled to the outer surface of the insert. The shell has an outer surface for engaging the acetabulum and an inner surface having a circumferential groove for receiving the spring elements. The spring elements may be deflected radially inwardly out of engagement with the groove for releasing the insert from the shell. The spring elements can be deflected by pushing a sleeve down the rod to make contact with and deflect the spring element.

Abstract: A method and apparatus for preparing a planar surface on the distal femur prior to implantation of a femoral knee prosthesis has a femoral plate with an opening therein for exposing both condyles of the femur. A guide with a central aperture is used to align the femoral plate on the distal femur. The guide is releasably secured to the femoral plate and an intramedullary guide rod is placed through the aperture therein and into the intramedullary canal of the femur. After alignment with the intramedullary canal, the femoral plate is pinned to the femur and the rod and guide are removed. A milling guide having two bores, one adjacent each condyle, is then placed on the femoral plate and an end mill is used to mill a planar surface on at least one of the condyles.

Abstract: A dilation-drug delivery catheter comprises a dilation portion for dilating a stenosis and a drug delivery portion for delivering antithrombolytic, antiproliferative, or any other type of medication, to the dilation site. The drug delivery portion of the catheter is located within the dilation portion, which can be retracted to reveal the drug delivery portion, after dilation. Occlusion balloons are preferably provided on the drug delivery portion to isolate the dilation site during drug delivery.

Abstract: An apparatus for electrosurgical incision of a stricture within or adjacent to a body lumen, which comprises an electrically conducting, deflectable wire associated with an introducer for introducing the apparatus into the body lumen, wherein a proximal portion of the wire is deflectable outwardly relative to the introducer, and a source of RF electric current connected to the wire whereby RF electric current may be transmitted through the wire when it is in the deflected position.

Abstract: A spacer device for supporting vertebral bodies, comprising a first supporting member to engage a first vertebral body, a second supporting member to engage a second vertebral body and an adjustment means including a sleeve having an internal thread and a pair of bolts each having an outer thread cooperating with said sleeve to adjust the supporting members in a predetermined distance with respect to each other, whereby the adjustment means is provided with clamping faces at either end, which adjustment faces are aligned with the axis of the sleeve and the bolts or alternatively are disposed parallel to said axis, the supporting members are provided with clamping faces extending substantially normally with respect to the supporting faces and a screw connection is provided for each supporting member to press the clamping faces of the adjustment means and the supporting member together in a predetermined position with respect to each other.

Abstract: A prosthetic tibial component has a tibial tray having an underside for engaging a prepared tibial plateau. The tibial component has a stem having a tapered connection at one end. The stem has a non-symmetrically shaped bone engagement element extending therefrom. The tray includes a tapered connection element for mating with the tapered connection element on the stem. The tray includes an alignment element for locating and engaging the bone engagement element on the stem to locate the stem at a predetermined position relative to the tibial plateau.

Abstract: A medical implant made of polymeric material having an increased oxidation resistance is formed by a method including the steps of placing a resin powder in a sealed container. A substantial portion of the oxygen is removed from the sealed container by either a vacuum, an oxygen absorbent or by flushing with inert gas. The container is then repressurized with a gas such as nitrogen, argon, helium or neon so that long term storage may be possible. On use, the resin is transferred to a forming device which both melts and forms the resin in an oxygen reduced atmosphere to produce a polymeric raw material such as a rod or bar stock. The medical implant is then formed from this raw material annealed and sealed in an airtight package in an oxygen reduced atmosphere. The implant is then radiation sterilized and thereafter annealed in the package for a predetermined time and temperature sufficient to form cross-links between any free radicals in neighboring polymeric chains.

Abstract: A catheter with a radially self-expanding cylindrical vascular support made of a permeable mesh of crossed stiff fibers is disclosed. The catheter has a tubular outer catheter shaft and an inner catheter to which the vascular support is fixed. The tubular outer catheter shaft is axially movable with respect to the inner catheter.

Abstract: A storage container for catheters having a separable portion of the front wall detachable from the container to ease removal of the catheter from the container is disclosed. The top portion is preferably separated from the side walls along external score lines at the intersection of the front and side walls. The separable portion of the front wall is preferably hinged on the bottom edge, which is perforated, easing complete separation of the separable portion from the front wall. Internal score lines on the inside surface of the separable portion of the front wall, parallel and proximate the external score lines are preferably provided to form flaps when the top portion of the front wall is detached from the container. The flaps prevent the top of the catheter package from falling out of the container. The separable portion of the front wall enables the catheter to be easily removed from the storage container without it being damaged.

Abstract: A manipulator for reducing a bone fracture has adjustable elements for manipulating external fixation devices which are connected to the bone segments on either side of the fracture. The manipulator includes a circular sector having a first half sector portion and a second half sector portion. The sector portions are coupled for relative sliding movement therebetween for extending and retracting the arc of said circular sector. The manipulator includes a locking element for locking the first and second half sector portion at selected relative positions. Each of said first and second half sector portions has a generally cylindrical recess formed at the outer end thereof.A pair of cylindrical bushings having an outer cylindrical surface with teeth extending parallel to a longitudinal axis of the bushings are provided. One of the cylindrical bushings are rotatably mounted in each of the generally cylindrical recesses in the first and second half sector portions.

Abstract: A bone nail for the medical care of spoke bone (i.e., radius) fractures comprises a hollow shaft (10) curved in a plane, which shaft is to be distally and posteriorly inserted into a spoke bone medullary canal and which includes a proximal end portion which is slotted so as to be able to be spread apart by a spreading body. A straddling member (36) having an outer threaded portion (44) cooperates with an inner threaded portion (18) in the slotted portion (12) of the shaft (10) of the nail so as to radially expand the proximal nail end when the straddling body (36) is rotated. A cross bore (22) at the distal end of the shaft (10) receives a bone screw extending approximately vertical to the plane of the curvature.

Abstract: By virtue of its modular construction, this external fixator makes it possible to position the pins (21 to 25) in the bone fragments (11 to 13) taking account of anatomical criteria. The pins are at least indirectly integral with universal joints (36 to 38) with balls (46 to 48) permitting the orientation of the pins relative to connecting bars 503 and 504. The external fixator additionally comprises connecting pieces for articulation between the connecting bars (501 to 507), such as the articulation (7), the telescopic connecting piece (8) and orientable connecting pieces (97 to 99). After the onset of osseous consolidation, some of the connecting bars and their connecting pieces can be removed, it being possible for the bars (501,502) to be withdrawn from the vices (65, 66).