Abstract: Configurations are described for conducting minimally invasive medical diagnoses and interventions utilizing elongate instruments and assemblies comprising one or more imaging devices, and one or more remote retraction and distraction devices. Retraction and distraction devices, such as balloons, mechanical retraction members, and/or trocar screw geometries may be utilized to access, investigate, and intervene at the joint capsule, or inside of the joint capsule. Imaging devices, such as optical image capture devices, ultrasound transducers, and optical coherence tomography fibers, may be utilized to assist with navigation of the pertinent tools during diagnostic and interventional steps.

Abstract: Configurations are described for conducting minimally invasive medical diagnoses and interventions utilizing elongate instruments and assemblies comprising one or more imaging devices, and one or more remote retraction and distraction devices. Retraction and distraction devices, such as balloons, mechanical retraction members, and/or trocar screw geometries may be utilized to access, investigate, and intervene at the joint capsule, or inside of the joint capsule. Imaging devices, such as optical image capture devices, ultrasound transducers, and optical coherence tomography fibers, may be utilized to assist with navigation of the pertinent tools during diagnostic and interventional steps.

Abstract: Configurations are described for conducting minimally invasive medical diagnoses and interventions utilizing elongate instruments and assemblies comprising one or more imaging devices, and one or more remote retraction and distraction devices. Retraction and distraction devices, such as balloons, mechanical retraction members, and/or trocar screw geometries may be utilized to access, investigate, and intervene at the joint capsule, or inside of the joint capsule. Imaging devices, such as optical image capture devices, ultrasound transducers, and optical coherence tomography fibers, may be utilized to assist with navigation of the pertinent tools during diagnostic and interventional steps.

Abstract: Ultrasonic vibrations are employed for forming a cavity into which a prosthesis is implanted. This technique includes vibrating the prosthesis itself as it is inserted to enlarge the cavity and assure a tight fit.

Abstract: Disclosed is a method and apparatus for removing a polymethylmethacrylate or other cement plug from the medullary canal during hip-revision surgery. In accordance with the method, a portion of the PMMA plug is softened and a plug removal tool is advanced through the softened portion to become imbedded in the plug. The plug is permitted to harden around the tool, and the tool is withdrawn thereby pulling the plug with it. Softening may be accomplished by conducting ultrasonic energy through the removal tool tip, or by other means. Hardening is accomplished by removing the heat source and permitting passive cooling of the material, or by accelerating cooling of the material through the use of a heat sink or a circulating media such as a compressed gas. Also disclosed is a self-cooling tool tip.

Abstract: Disclosed are improved methods and apparatus for implantation and extraction of osteal prostheses. Ultrasonic energy coupling adapters are disclosed for propagating ultrasonic energy along an incidence axis which deviates from a longitudinal axis of the prosthesis within a predetermined angular range. Methods of implantation and extraction of osteal prostheses are also disclosed, in which ultrasonic energy is propagated along an axis which extends at an angle with respect to a longitudinal axis of the prosthesis.

Abstract: Disclosed is a mechanical junction for facilitating the rapid attachment and removal of ultrasonic surgical components for the transfer of ultrasonic energy across the junction from an ultrasonic transducer to an ultrasonically activated tool bit. The junction achieves a high, evenly distributed compressive force to optimize propagation of the ultrasonic energy from the transducer to a tool bit, while maintaining a relatively small outside diameter of the ultrasonic tool.

Abstract: A steerable surgical device including an inner tubular member and an outer tubular member surrounding the inner tubular member. A distal end of the inner tubular member and/or the outer tubular member is prebent in a curved configuration. A distal end of the device can be oriented in a desired direction by rotating the inner and outer tubular members with respect to each other. A tool such as an arthroscopic grasper can be mounted on a distal end of the inner and/or outer tubular members and the tool can be oriented in any desired direction simply by rotating one of the tubular members with respect to the other tubular member.

Abstract: Disclosed is a mechanical junction for facilitating the rapid attachment and removal of ultrasonic surgical components for the transfer of ultrasonic energy across the junction from an ultrasonic transducer to an ultrasonically activated tool bit. The junction achieves a high, evenly distributed compressive force to optimize propagation of the ultrasonic energy from the transducer to a tool bit, while maintaining a relatively small outside diameter of the ultrasonic tool. Also disclosed are a plurality of ultrasonic energy activated tool tips for introducing and removing an orthopedic prosthesis.

Abstract: Apparatus particularly suited for implantation and/or extraction of osteal prostheses, comprising an ultrasonic power generator, regulator means for regulating the ultrasonic power generator in accordance with a predetermined algorithm, at least one transducer connected to the output line for converting said electrical energy to a linear mechanical motion, an acoustic transformer for increasing or decreasing peak-to-peak motion of the transducer and means for connecting the acoustic transformer to a surgical tool or a prosthetic device. The system suitably comprises a pair of transducers, one operating at each of 20 KHz and 40 KHz frequencies. Novel adapters for the four major types of osteal prosthesis are also provided.

Abstract: Apparatus particularly suited for implantation and/or extraction of osteal prostheses, comprising an ultrasonic power generator, regulator means for regulating the ultrasonic power generator in accordance with a predetermined algorithm, at least one transducer connected to the output line for converting said electrical energy to a linear mechanical motion, an acoustic transformer for increasing or decreasing peak-to-peak motion of the transducer and means for connecting the acoustic transformer to a surgical tool or a prosthetic device. The system suitably comprises a pair of transducers, one operating at each of 20 KHz and 40 KHz frequencies. Novel adapters for the four major types of osteal prosthesis are also provided.

Abstract: A hip joint prosthesis or the like may be removed from the bone for a revision by applying ultrasonic vibration sufficient to disrupt connection of the prosthesis with the bone. This is particularly desirable for disrupting cancellous bone at the interface adjacent to the porous surface of a prosthesis designed for ingrowth of cancellous bone. Preferably the ultrasonic vibrations are applied to the prosthesis with sufficient energy for disrupting cancellous bone at the porous surface interface or softening a cement employed for securing the prosthesis to the bone. An ultrasonically vibrated osteotome may be inserted along the porous surface of a prosthesis for disrupting cancellous bone adjacent to the interface. Preferably the ultrasonic transducer is coupled to the prosthesis by a self-holding taper on the prosthesis and a complementary tapered socket connected to an ultrasonic transducer. Ultrasonic vibrations may also be employed for forming a cavity into which a prosthesis is implanted.