The present invention relates generally to arthroscopic surgical devices and more particularly to arthroscopic bone tunneling devices.
Various types of arthroscopic surgical instruments are known for various applications including orthopedic surgery.
The present invention seeks to provide an improved arthroscopic bone tunneling and suturing device.
There is thus provided in accordance with a preferred embodiment of the present invention an arthroscopic bone tunneling and suturing device including a bone-engaging needle driving assembly including a bone-engaging needle and being adapted for arthroscopic insertion into engagement with a patient's bone at a first bone location through an arthroscopic incision and for driving the needle forwardly along a generally arcuate tunneling path through the bone at least to a second bone location and a bone-engaging pin driving assembly arranged for operative engagement with the bone-engaging needle driving assembly and being adapted for arthroscopic insertion into engagement with a patient's bone at a third bone location through the arthroscopic incision.
Preferably, the bone-engaging pin driving assembly is adapted for mounting a suture thereon and positioning the suture so that it can be engaged by the needle at the second bone location. Additionally, the bone-engaging needle driving assembly is also adapted for retracting the needle, in engagement with the suture, back along the arcuate tunneling path through the bone from the second bone location.
In accordance with a preferred embodiment of the present invention the bone-engaging pin driving assembly includes at least one bone tunneling pin which is operative to tunnel through the bone along a generally linear tunneling path from the third location to the second location at which the generally linear tunneling path intersects the generally arcuate tunneling path, thereby positioning the suture so that it can be engaged by the needle at the second bone location.
Preferably, the bone-engaging pin driving assembly is separate from the bone-engaging needle driving assembly and is selectably engageable therewith and disengageable therefrom.
In accordance with a preferred embodiment of the present invention the bone engaging pin driving assembly includes an inner pin and an outer, hollow pin in which the inner pin is slidably disposed. Additionally, the outer hollow pin is formed with a pointed tip and with a throughgoing aperture.
Preferably, a suture extends between the inner pin and the outer pin, the suture being looped about the inner pin interiorly of the outer pin so as to be engageable by the needle through the throughgoing aperture. Additionally or alternatively, the bone-engaging pin driving assembly also includes a base assembly including a forward portion and a rearward portion, the inner pin being coupled to the rearward portion and the outer pin being coupled to the forward portion.
In accordance with preferred embodiment of the present invention the outer hollow pin is also formed with a throughgoing side wall slot for accommodating part of the suture. Additionally, the suture is wound around a forward end of the inner pin and between the forward end of the inner pin and the pointed tip and extends between the inner pin and the outer pin and partially lies in the throughgoing slot on both sides of the inner pin.
Preferably, the base assembly selectably lockable to a housing which encloses part of the bone-engaging needle driving assembly. Additionally or alternatively, the forward portion and the rearward portion of the base assembly are selectably lockable to each other and axially slidable with respect to each other, thereby to provide limited retractability of the inner pin with respect to the outer pin.
In accordance with a preferred embodiment of the present invention the bone-engaging needle driving assembly includes a flexible needle driving strip which drives the bone engaging needle along the arcuate tunneling path through the bone.
There is also provided in accordance with another preferred embodiment of the present invention a method for tunneling through a bone during arthroscopic surgery, the method including providing a bone-engaging pin driving assembly and a bone-engaging needle driving assembly, the bone-engaging needle driving assembly including a bone-engaging needle adapted for arthroscopic insertion into engagement with a patient's bone at a first bone location through an arthroscopic incision and for being driven forwardly along a generally arcuate tunneling path through the bone at least to a second bone location, operatively engaging the bone-engaging pin driving assembly with the bone-engaging needle driving assembly, inserting the bone-engaging needle driving assembly through the arthroscopic incision into engagement with the bone at the first bone location, inserting the bone-engaging pin driving assembly through the arthroscopic incision into engagement with a patient's bone at a third bone location, tunneling through the bone with the bone-engaging pin driving assembly along a generally linear tunneling path from the third bone location to the second bone location and driving the needle, along the generally arcuate tunneling path from the first bone location at least to the second bone location, with the bone-engaging needle driving assembly, thereby tunneling through the bone with the bone-engaging needle along the generally arcuate tunneling path from the first bone location at least to the second bone location.
Preferably, the method for tunneling through a bone during arthroscopic surgery also includes mounting a suture on the bone-engaging pin driving assembly prior to the operatively engaging the bone-engaging pin driving assembly with the bone-engaging needle driving assembly and subsequent to the driving, engaging the suture with the needle at the second bone location.
In accordance with a preferred embodiment of the present invention the method for tunneling through a bone during arthroscopic surgery also includes subsequent to the engaging, retracting the needle, in engagement with the suture, along the generally arcuate tunneling path.
Preferably, the method for tunneling through a bone during arthroscopic surgery further includes, subsequent to the retracting the needle, retracting the bone-engaging pin driving assembly from engagement with the bone.
In accordance with a preferred embodiment of the present invention the method for tunneling through a bone during arthroscopic surgery also includes, subsequent to the retracting the bone-engaging pin driving assembly, partially re-extending the needle and disengaging the suture from the needle.
Preferably, the operatively engaging also includes aligning the bone-engaging pin driving assembly with the bone-engaging needle driving assembly so that the needle can engage the suture at the second bone location and subsequently axially and rotationally locking the bone-engaging pin driving assembly to the bone-engaging needle driving assembly.
The present invention will be understood and appreciated from the following detailed description, taken in conjunction with the drawings in which:
Reference is now made to
As seen in
The multiple action driving assembly 106 preferably includes a bone-engaging pin driving assembly 120 and a bone-engaging needle driving assembly 122. Bone-engaging pin driving assembly 120 preferably includes a base assembly 124 including a rearward portion 126 and a forward portion 128. An inner, solid pin 130 (
A rearward knurled locking knob 136 is mounted onto rearward portion 126 and selectably locks rearward portion 126 to forward portion 128. A forward knurled locking knob 138 is mounted onto forward portion 128 and selectably locks forward portion 128 to the left housing element handle portion 112.
Outer hollow pin 132 is preferably formed with a pointed tip 140 and with a throughgoing top to bottom aperture 142. A suture 144 preferably extends between the inner pin 130 (
The multiple action driving assembly 106 preferably includes a hand-engageable ratchet handle 150 which is arranged for reciprocal motion about an axis 152 (
A visible mechanical indicator 170 is preferably arranged on the top of respective housing portions 102 and 104. Indicator 170 preferably provides a visible indication of the extent that arcuate tunneling needle 162 is displaced from its fully retracted position shown in
Reference is now made to
Reference is now made to
Reference is now made to
Reference is now made to
Reference is now made to
Reference is now made to
Reference is now made to
Reference is now made to
Reference is now made to
Reference is now made to
Reference is now made to
Reference is now made to
It is seen that ratchet handle 150 is typically formed with a lower aperture 210, which accommodates a shaft 154, and a slot 212. A pin 214 is slidably movable in slot 212, such that reciprocal arcuate motion of slot 212 is translated into reciprocal planar forward and rearward motion perpendicular to a longitudinal axis 216 of pin 214. First and second reciprocal motion connection elements 220 and 222 are fixed to pin 214 at respective apertures 224 and 226 and move together therewith in reciprocal forward and rearward linear motion in response to rotational motion of ratchet handle 150.
Connection element 222 includes an elongate protrusion 228, which moves reciprocally in a slot 230 formed in housing portion 102.
Connection element 220 includes a side extending shaft 240 which includes a circumferential groove 244 onto which is mounted one end of a tension spring 248. An opposite end of tension spring 248 is mounted in a circumferential groove 250 formed in shaft 156. Shaft 156 extends through an aperture 254 formed in a toggle element 256, which communicates with a hollow shaft portion 258 of toggle element 256. Shaft 156 extends through slots 158 formed on respective housing portions 102 and 104.
A double rack linear toothed element 270 is provided with an upper linear toothed ratchet rack 272 and a lower linear toothed gear rack 274. A pointed corner 275 of connection element 220 selectably engages upper linear toothed rack 272. Double rack linear toothed element 270 is preferably formed with a slot 276 which engages an elongate axial protrusion 277 formed in housing element 102.
An inward recessed portion 278 adjacent an inner end of a generally rigid flexible needle driving strip driving shaft 280 is fixedly mounted onto double rack linear toothed element 270 by means of a mounting element 282 which is typically bolted onto element 270. An indicator finger 284 is formed on mounting element 282 and forms part of indicator 170.
A second double rack linear toothed element 285 is provided with an upper linear toothed gear rack 286 and a lower linear toothed ratchet rack 287. Double rack linear toothed element 285 is preferably formed with a slot 288 which engages an elongate axial protrusion 289 formed in housing element 102.
A gear 290, having a gear shaft 291, engages lower linear toothed gear rack 274 of element 270 and also simultaneously engages upper linear toothed gear rack 286 of element 285. Gear shaft 291 preferably is mounted at its opposite ends in apertures 292 in respective housing elements 102 and 104.
A pointed corner 293 of connection element 220 selectably engages lower linear toothed ratchet rack 287 of element 285.
Reference is now made specifically to
Bone-engaging needle driving assembly 122 includes a static forward portion 300, including a mounting base 302, which extends forwardly of a forward end of the housing, which is fixed to an extension shaft 304 extending axially inwardly thereof and forwardly therefrom. Fixed to extension shaft 304 and extending forwardly thereof, there is preferably formed an arcuate needle storage and guiding portion 306.
Mounting base 302 is generally configured as a hollow cylinder to accommodate part of extension shaft 304 therewithin and is formed with matching side apertures 308 which accommodate mounting pins 310 (
Extension shaft 304 is preferably formed of two identical side by side pieces 311. Side pieces 311 together define two mutually spaced axial mounting bores extending therethrough, which bores are designated by reference numerals 312 and 314. Bore 312 slidably accommodates hollow pin 132 and has a generally round cross-section.
Bore 314 slidably accommodates parts of a flexible arcuate needle driving assembly, which preferably includes a flexible needle driving strip 318, preferably formed of spring steel, and generally rigid flexible needle driving strip driving shaft 280, which is mounted at the rear of flexible needle driving strip 318, preferably as shown in enlargements A & B in
As seen in enlargement A of
As seen particularly in enlargement D of
As seen particularly in
Reference is now made to
A rearward knurled locking knob 136 is mounted onto rearward portion 126 and selectably locks rearward portion 126 to forward portion 128. A forward knurled locking knob 138 is mounted onto forward portion 128 and selectably locks forward portion 128 to the left housing element handle portion 112.
Outer hollow pin 132 is preferably formed with a pointed tip 140 and with a throughgoing top to bottom aperture 142. A suture 144 preferably extends between the inner pin 130 and the outer pin 132, being looped about the inner pin 130 interiorly of the outer pin 132 so as to be engageable through aperture 142.
As seen particularly in
Reference is now made to
Reference is now made to
Rearward portion 126 is preferably a generally cylindrical element 428 extending along a cylindrical axis 430 and is formed with various bores and slots as described hereinbelow. A side slot 432 extends axially forwardly from a rear surface 434 of element 428 along approximately one third of the axial length of element 428 and terminates in a narrowed axial bore 436 which extends all of the way to a forward surface 438 of element 428. A transverse bore 439 communicates with bore 436 and accommodates pin 424 (
A transverse bore 440 extends perpendicularly to axis 430 and accommodates shaft 401 (
A side slot 442 extends axially rearwardly from forward surface 438 of element 428 along approximately two thirds of the axial length of element 428. Side slot 442 accommodates knob 138.
A bore 450, having a generally rectangular cross section, is formed on forward surface 438. A transverse bore 452 communicates with bore 450 and accommodates pin 420 (
Forward portion 128 is preferably a generally disk-like cylindrical element 468 extending along cylindrical axis 430 and is formed with various bores, slots and protrusions as described hereinbelow. A side slot 472 extends axially forwardly from a rear surface 474 of element 468 through to a forward surface 478 of element 468.
A central bore 480 extends axially rearwardly from forward surface 478 of element 468 to rear surface 474 of element 468 and therebeyond through an axial protrusion 482, having a generally rectangular cross section, as a side opened slot 484. A transverse retaining slot 486, extending perpendicularly to axis 430 is provided on a top surface of protrusion 482 and is engaged by pin 420 for limiting axial displacement of protrusion 482 within bore 450, thus limiting relative displacement of the forward and rearward portions 128 and 126 respectively and thus limiting retraction of pin 130 within pin 132.
A stepped, partially threaded bore 490 extends forwardly from rear surface 474 as a threaded portion 492 and continues at a shoulder 494 as a non-threaded bore portion 496 to forward surface 478.
A suture access slot 498 communicates with central bore 480 and allows threading of suture 144 therethrough.
Reference is now made to
As seen in
It is seen in
Alternatively, hammering may be replaced by rotational displacement, such as by using alternative tips 406 or 410 (
It is also noted that the desired rotational positioning of hollow pin 132 is achieved by lining up a marking 508 on the forward portion 128 with a corresponding marking 510 adjacent the rear surface of the housing. This rotational positioning is required to ensure that aperture 142 is aligned vertically in the sense of
Reference is now made to
It is noted that at this stage indicator 170 shows full retraction of flexible needle driving strip driving shaft 280 and of arcuate tunneling needle 162.
Reference is now made to
It is appreciated that simultaneous engagement of gear 290 with lower linear toothed gear rack 274 of element 270 and upper linear toothed gear rack 286 of element 285 produces rearward linear motion of element 285 corresponding to forward linear motion of element 270.
Upward repositioning of knobs 160, as indicated by an arrow 538, causes repositioning of connection element 220, causing pointed corner 275 of connection element 220 to engage upper linear toothed ratchet rack 272 of element 270, as seen in
It will be appreciated by persons skilled in the art that the present invention is not limited by what has been particularly shown and described hereinabove. Rather the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove as well as modifications thereof which would occur to persons skilled in the art upon reading the foregoing description and which are not in the prior art.
Number | Date | Country | Kind |
---|---|---|---|
PCT/IL2012/000318 | Aug 2012 | WO | international |
PCT/IL2012/000319 | Aug 2012 | WO | international |
Reference is made to the following U.S. Provisional patent applications which are believed to be related to the present application, the contents of which are hereby incorporated by reference herein and priority of which is hereby claimed under 37 CFR 1.78(a)(4) and (5)(i): U.S. Provisional Patent Application Ser. No. 61/584,267, entitled “Circular Bone Tunneling Device” and filed Jan. 8, 2012; U.S. Provisional Patent Application Ser. No. 61/636,751, entitled “Circular Bone Tunneling Device Employing a Stabilizing Element” and filed Apr. 23, 2012; and U.S. Provisional Patent Application Ser. No. 61/714,813, entitled “Arthroscopic Surgical Device” and filed Oct. 17, 2012. Reference is also made to the following PCT Patent Applications which are believed to be related to the present application, the contents of which are hereby incorporated by reference herein and priority of which is hereby claimed under 37 CFR 1.78(a)(1) and (2)(i): PCT Patent Application No. PCT/IL2012/000318, entitled “Arthroscopic Surgical Device” and filed Aug. 23, 2012, the contents of which are hereby incorporated by reference herein; and PCT Patent Application No. PCT/IL2012/000319, entitled “Circular Bone Tunneling Device Employing a Stabilizing Element” and filed Aug. 23, 2012, the contents of which are hereby incorporated by reference herein. Reference is also made to: Published PCT Patent Application No. WO 2012/007941, entitled “Circular Bone Tunneling Device” and filed Jul. 11, 2011, the contents of which are hereby incorporated by reference herein; and U.S. Provisional Patent Application Ser. No. 61/526,717, entitled “Circular Bone Tunneling Device” and filed Aug. 24, 2011, the contents of which are hereby incorporated by reference herein.
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Number | Date | Country | |
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Number | Date | Country | |
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61584267 | Jan 2012 | US | |
61636751 | Apr 2012 | US | |
61714813 | Oct 2012 | US |