Hip joint instrument and method

1. A surgical instrument for operating hip joint osteoarthritis in a human patient, a hip joint comprising an acetabulum, the acetabulum being a part of a pelvic bone, and a caput femur, the caput femur being a proximal part of a femoral bone, wherein said surgical instrument is adapted to assist in the operating of the hip joint osteoarthritis from an abdominal side of the pelvic bone of said human patient, said surgical instrument comprising an abdominal portion insertable through an incision in skin in an abdominal region and adapted to be placed between the incision in the abdominal region and the pelvic bone when the instrument is in use, and a pelvic portion connected to the abdominal portion, being partially insertable through a hole in the pelvic bone from the abdominal side of the pelvic bone, when the instrument is in use, wherein a portion of the pelvic portion is adapted to operate at least partially in a surgically created hole in the pelvic bone.

2. The surgical instrument according to claim 1 , wherein said surgical instrument comprises a bend between said abdominal portion and said pelvic portion, wherein said bend comprises at least one of; a bend with a fixed angle, a bend with an adjustable angle, at least one gear wheel, and at least one universal joint.

3. The surgical instrument according to claim 1 , wherein said surgical instrument comprises a parallel displacing part or section placed between the abdominal portion and the pelvic portion so that the abdominal portion and the pelvic portion are axially displaced.

4. The surgical instrument according to claim 1 , wherein the abdominal portion is more than 100 mm such that the abdominal portion can reach from the incision in the abdominal region to an area of the hip joint opposite the acetabulum.

5. The surgical instrument according to claim 2 , further comprising a gripping end for handling of the instrument, wherein said gripping end is connected to the abdominal portion and adapted to remain outside the skin of the patient when the instrument is in use, wherein a portion between the gripping end and the bend is at least one of; at least 100 mm such that the bend can be placed at the pelvic bone on an opposite side from acetabulum, and more than 200 mm such that the instrument can operate inside of the hip joint from the abdominal side of the pelvic bone.

6. The surgical instrument according to claim 1 , wherein the surgical instrument is a laparoscopic instrument adapted to be inserted through the skin of the abdominal region through a laparoscopic port.

7. The surgical instrument according to claim 1 , wherein said instrument is at least one of:

a special laparoscopic instrument introduced into an abdomen and further down to the pelvic bone on an opposite side of the acetabulum and introduced into the hip joint, further comprising a gripping end, placed outside an abdominal wall when in use, and a hip joint end adapted to be placed in an area of the hip joint, wherein a length of said instrument is adapted to reach from a gripping end and into the hip joint via a surgically created hole in the pelvic bone and wherein a longitudinal extension of said instrument comprises at least one bend, for the instrument to reach, when used as a special laparoscopic instrument to operate the hip joint, from the gripping end into the abdomen and further down to the pelvic bone on the opposite side of the acetabulum and be introduced into the hip joint through the surgically created hole in the pelvic bone,

a special pelvic instrument introduced into a pelvic region and further to the pelvic bone on the opposite side of the acetabulum, and introduced into the hip joint via a surgically created hole in the pelvic bone, further comprising a gripping end, placed outside the skin above the pelvic region when in use, and a hip joint end adapted to be placed in an area of the hip joint, wherein the length of said instrument is adapted to reach from the gripping end and into the hip joint, and wherein the longitudinal extension of said instrument comprises at least one bend, for the instrument to reach, when used as special pelvic instrument to operate the hip joint, from the gripping end into the pelvic region and further down to the pelvic bone on the opposite side of the acetabulum, and introduced into the hip joint through the surgically created hole in the pelvic bone, and

a special retroperitoneal instrument introduced into the body just above a inguinal region following the pelvic bone down to the opposite side of the acetabulum and thereafter introduced into the hip joint via a surgically created hole in the pelvic bone, further comprising a gripping end, placed outside the skin above the pelvic region when in use, and a hip joint end adapted to be placed in an area of the hip joint, wherein the length of said instrument is adapted to reach from the gripping end and into the hip joint and wherein the longitudinal extension of said instrument comprises at least one bend, for the instrument to reach, when used as special retroperitoneal instrument to operate the hip joint, from the gripping end following the pelvic bone and further down to the pelvic bone on the opposite side of the acetabulum and introduced into the hip joint through the surgically created hole in the pelvic bone.

8. The surgical instrument according to claim 1 , wherein said instrument further comprises at least one holding portion connected to the pelvic portion, and at least one mechanical element adapted to be fitted to said at least one holding part of said instrument, wherein said mechanical element is adapted to perform a function during an operation of the hip joint, wherein said mechanical element is adapted to be part of an instrument adapted to be used for at least one of the following functions; drilling, reaming, cooling, heating, flushing, introducing a fluid, sucking, inserting at least one part, connecting at least one part, fixating at least one part, inserting a mould, filling a mould, injecting, lubricating, viewing, optically displaying, placing screws, placing adhesive, placing bone cement.

9. The surgical instrument according to claim 5 , wherein a distance between the gripping end and the bend is at least one of; at least 150 mm, at least 200 mm, at least 300 mm, at least 400 mm, and at least 500 mm.

10. The surgical instrument according to claim 2 , wherein said bend is bent with an angle of at least one of; at least 10 degrees, at least 20 degrees, at least 30 degrees, at least 40 degrees, at least 50 degrees, and at least 60 degrees.

11. The surgical instrument according to claim 2 , wherein the distance between said bend and the pelvic portion of the instrument is at least one of; at least 20 mm, at least 40 mm, at least 60 mm, at least 80 mm, at least 100 mm, at least 120 mm, and at least 140 mm.

12. The surgical instrument according to any one of claim 1 , wherein said surgical instrument is adapted to at least one of; ream the acetabulum of said human patient, ream the caput femur of said human patient, and ream both the acetabulum and the caput femur of said human patient, wherein said surgical instrument is expandable, thus allowing said surgical instrument to be inserted through a hole in the pelvic bone smaller than an area possible to ream using said surgical instrument.

13. The surgical instrument according to any one of claim 1 , wherein said surgical instrument further comprises at least one camera or at least one light source.

14. The surgical instrument according to any one of claim 1 , wherein said surgical instrument is adapted to cool an area of the hip joint or an area of the pelvic bone.

15. The surgical instrument according to any one of claim 1 , wherein said surgical instrument is adapted to provide a fluid to an area of the pelvic bone or the hip joint.

16. The surgical instrument according to any one of claim 1 , wherein said surgical instrument is adapted to provide suction to an area of the pelvic bone or an area of the hip joint.

17. The surgical instrument according to claim 1 , wherein said surgical instrument is adapted to at least one of:

introduce a prosthesis through the hole in the pelvic bone and into the hip joint,

connect at least two prosthetic parts to each other after insertion into the hip joint,

fixate an artificial hip joint surface, or a part of an artificial hip joint surface, to the pelvic bone or the femoral bone, and

place or fixate fixating elements to the pelvic bone or a prosthetic part in the hip region or the pelvic bone region.

18. The surgical instrument according to claim 1 , wherein said surgical instrument is adapted to introduce a mould into the hip joint or inject a fluid into a mould placed in the hip joint.

19. The surgical instrument according to claim 1 , wherein said surgical instrument is adapted to introduce adhesive into the hip joint.

20. The surgical instrument according to claim 1 , wherein said surgical instrument is adapted to inject a lubricating fluid into the hip joint, and wherein said surgical instrument comprising:

at least one container,

a fluid injecting member, and

a fluid driving member in fluid connection with said fluid injecting member and said at least one container.