Device for in situ milling of joint surfaces
A device for in situ milling of joint surfaces, including a milling device and a joint clamping device. The joint clamp device is designed to be inserted between two joint components forming a joint, particularly bones, and for pushing the joint components apart with a predetermined or adjustable tension, wherein the joint clamping device includes a recess in which the milling device can be inserted, wherein the milling device includes a face milling cutter.
1. A device for in situ milling of joint surfaces, comprising:
a milling device; and
a joint-tensioning device,
wherein the joint-tensioning device is inserted between two joint components, the two joint components being bones, that form a joint, and press the joint components apart with a predetermined or adjustable tension,
wherein the joint-tensioning device has a recess into which the milling device can be inserted,
wherein the milling device has a face milling cutter,
wherein the joint-tensioning device includes claws which, in a state when inserted into the joint, bear on joint parts, and
wherein the joint-tensioning device is a one-piece or multi-piece elastomer body or comprises one or more elastomer bodies.
2. The device as claimed in claim 1 , wherein the face milling cutter has milling surfaces both on its face and also on its periphery or has a curved milling profile.
3. The device as claimed in claim 1 , wherein the milling device has a chassis for the face milling cutter, wherein the chassis can be inserted into the recess of the joint-tensioning device and/or can be fixed in the recess of the joint-tensioning device.
4. The device as claimed in claim 1 , wherein the milling device can be driven by a gearwheel drive with toothed wheels, wherein one toothed wheel is connected to the face milling cutter or is formed in one piece with the face milling cutter, and another toothed wheel, which meshes in the toothed wheel connected to the face milling cutter or formed in one piece with the face milling cutter, is connected to a spindle.
5. The device as claimed in claim 4 , wherein the spindle is connected to a drive device.
6. The device as claimed in claim 1 , wherein the joint-tensioning device has a bearing surface for a resection surface of the bone.
7. The device as claimed in claim 1 , wherein the recess of the joint-tensioning device has a shaft shape.
8. The device as claimed in claim 7 , wherein the recess has means for mounting, guiding and/or fixing a milling device.
9. The device as claimed in claim 7 , wherein to sides of the recess, the joint-tensioning device has support surfaces for supporting on the bone that is to be resected.
10. The device as claimed in claim 9 , wherein the support surfaces have concave curvatures for receiving curved parts of the bone.
11. The device as claimed in claim 1 , further comprising a base unit, which can be fixed on the bone and which has means for mounting the joint-tensioning device.
12. The device as claimed in claim 11 , wherein the joint-tensioning device has openings or means for mounting on the base unit and/or for engagement with holding means of the base unit.
13. The use of the device as claimed in claim 1 for in situ milling of joint surfaces.
14. A method for in situ milling of joint surfaces with the device of claim 1 , comprising the following method steps:
pushing the joint-tensioning device in between the joint components, adjacent to the joint, of which one joint component is already resected, wherein the joint is subjected to a predetermined or adjustable tension,
inserting the milling device with the face milling cutter into the recess of the joint-tensioning device, wherein the face milling cutter is driven during the insertion to form a resection surface on a hitherto non-resected joint component, and
producing a curved resection surface on the hitherto non-resected joint component by swinging the joint through once.
15. The method as claimed in claim 14 , wherein a resection surface is produced beforehand on bone, by placing a base unit on the bone adjacent to the joint and mounting a saw jig onto the base unit.
16. The method as claimed in claim 15 , wherein the saw jig is removed from the base unit after the resection surface has been produced on the bone.
17. The method as claimed in claim 14 , wherein after the curved resection surface has been produced, the milling device and the joint-tensioning device are removed from the joint, and the joint components, on which the joint-tensioning device had previously rested, are removed.
18. The method as claimed in claim 17 , wherein a final curved resection surface is obtained and/or a remaining joint component is completely covered with a prosthesis.