This application describes apparatuses, methods, and systems for the positioning of a patient for proper visualization and access of tissues for injection or treatment.
Traditional therapeutic and diagnostic surgical procedures for pathologies located within the body can cause significant trauma to the intervening tissues and potentially the target tissue site. Such procedures often require a long incision, extensive muscle stripping, prolonged retraction of tissues, denervation and devascularization of tissue. Such procedures may require operating room time of several hours followed by several weeks of post-operative recovery time due to the destruction of tissue during the surgical procedure. In some cases, these invasive procedures lead to permanent scarring and pain that can be more severe than the pain leading to the surgical intervention.
The development of percutaneous procedures has yielded a major improvement in reducing recovery time and post-operative pain because minimal dissection of tissue, such as muscle tissue, is required. For example, minimally invasive surgical techniques are desirable for orthopedic applications due to the need for access to locations within the body and the danger of damage to vital intervening tissues. While developments in minimally invasive surgery are steps in the right direction, there remains a need for further development in minimally invasive surgical instruments and methods.
Treatment of internal tissue sites, such as the treatment of an orthopedic joint, often requires proper positioning for visualization of and access to the target internal tissues for imaging and injections. Currently in the field, it is often difficult for a surgeon to access specific areas of the anatomy and thus they often fail to visualize and diagnose completely. However, when a patient is properly positioned, a surgeon or doctor may be able to access specific areas of the anatomy for proper diagnosis. With proper positioning, typically tight or inaccessible tissue sites within the patient can be opened up for visualization and access. Additionally, orthopedic joints must be properly positioned and stabilized for access to the desired internal tissue site, for proper visualization of the desired internal tissue site and to prevent injury to the patient. Consequently, there is need for improved devices and methods for positioning of a patient to open up areas for visualization and access to an internal tissue site.
Examples of the present disclosure relate to joint positioning devices, methods, and systems.
In some examples, a joint positioning device for positioning a joint, includes a patient support having a substantially flat surface. The patient support can be configured to be positioned proximate to a chair. The joint positioning device can further include a shoulder pole mounted to the patient support. The shoulder pole can be oriented substantially perpendicular to the substantially flat surface of the patient support. The joint positioning device can also further include a cylindrical shoulder pad mounted to the shoulder pole. The shoulder pad can be oriented substantially perpendicular to the shoulder pole.
In some examples, the patient support is configured such that the patient may rest on the patient support. The shoulder pad can be configured to be positioned underneath a patient's arm. The shoulder pad can be further configured to brace a patient's shoulder. The shoulder pad can be further configured to position a patient's shoulder to provide access to a glenoid cavity of the shoulder for an endoscopic procedure. In some examples, at least a portion of the patient support is configured to be positioned on a floor beneath the chair. The patient support can include a plurality of holes on a top surface of the patient support, the plurality of holes configured to receive the shoulder pole. The plurality of holes can be positioned along the length of the patient support. The shoulder pole and shoulder pad can be positionable in a hole located at one end of the patient support. The shoulder pole and shoulder pad can be positionable along a side of the chair. The patient support can be sized to counterbalance the weight of the shoulder pole and shoulder pad. The position of the shoulder pole may be adjustable along a length of the patient support. In some examples, a length of the shoulder pole is adjustable based on a height of the patient. The patient support can have a width less than the width of the chair. The shoulder pole can be a metal pole. In some examples, a stabilizer plate can be positioned perpendicular to a longitudinal axis of the patient, the stabilizer plate configured to stabilize the joint positioning device.
In some examples, a method of positioning a shoulder for an endoscopic procedure, can include providing a positioning device comprising a patient support, a shoulder pole, and a shoulder pad; positioning at least a portion of a flat surface of the patient support on a floor beneath a chair; positioning a patient to sit on the chair; adjusting the shoulder pole relative to the height of the patient seated on the chair such that the shoulder pad is positioned within an axilla of the patient; and applying pressure to the shoulder such that an axillary space of the shoulder opens.
The method can further include inserting a needle endoscope into a tissue site and collecting an image. The method can further include inserting a needle endoscope into a tissue site and performing an injection.
Additional examples of joint positioning devices and their methods of use, are described below.
Other features and advantages of the present invention will be apparent from the following detailed description of the invention, taken in conjunction with the accompanying drawings of which:
Examples disclosed in this section or elsewhere in this application relate to devices and methods for positioning joints for minimally invasive tissue visualization and access, including endoscopic procedures.
Before the present invention is described in greater detail, it is to be understood that this invention is not limited to particular examples described, as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular examples only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims.
Where a range of values is provided, it is understood that each intervening value between the upper and lower limit of that range and any other stated or intervening value in that stated range, is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included in the smaller ranges and are also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the invention.
Certain ranges are presented herein with numerical values being preceded by the terms “about,” “around,” and “approximately.” These terms are used herein to provide literal support for the exact number that it precedes, as well as a number that is near to or approximately the number that the term precedes. In determining whether a number is near to or approximately a specifically recited number, the near or approximating unrecited number may be a number which, in the context in which it is presented, provides the substantial equivalent of the specifically recited number.
It is noted that, as used herein and in the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise. It is further noted that the claims may be drafted to exclude any optional element. As such, this statement is intended to serve as antecedent basis for use of such exclusive terminology as “solely,” “only” and the like in connection with the recitation of claim elements, or use of a “negative” limitation.
As will be apparent to those of skill in the art upon reading this disclosure, each of the individual examples described and illustrated herein has discrete components and features which may be readily separated from or combined with the features of any of the other several examples without departing from the scope or spirit of the present invention. Any recited method can be carried out in the order of events recited or in any other order which is logically possible.
In some examples, the joint positioning device 5 may include a patient support 100, a vertical pillar 200, a shoulder pole 500, and a shoulder pad 300. The patient support 100 of the joint positioning device 5 may be positioned beneath the chair 10, as shown in
In some examples, the patient support 100 may be positioned anywhere beneath or alongside the chair 10. The patient support 100 may be positioned to lay flat on the surface or floor beneath the chair 10, as shown in
The patient support 100 may have a longitudinal axis and lateral axis, where the longitudinal axis and lateral axis are substantially perpendicular from each other. The longitudinal axis may be substantially parallel to the length of the patient support 100. The lateral axis may be substantially parallel to the width of the patient support 100.
The length of the patient support 100 may be substantially aligned with the width of the chair 10. The longitudinal axis of the patient support 100 may be aligned with the lateral axis or width of the chair 10. The patient support 100 may have a length longer than the width of the chair 10, such that one or more ends of the patient support 100 may extend beyond the width of the chair 10. The patient support 100 may be positioned along either side of the chair 10, such that the length of the patient support is aligned with the longitudinal axis or length of the chair 10.
In some examples, the joint positioning device 5 may be positioned on a standard medical examination table (not shown). The joint positioning device 5 may be positioned on other various types and sizes of medical examination tables, such as surgical or operating tables, bariatric tables, pediatric exam tables, or treatment tables.
The patient support 100 may be a substantially flat board or platform. The patient support 100 may be substantially rigid. The patient support 100 may be flexible. The patient support 100 may be made of plastic, metal, foam, for example closed-cell foams, or other suitable material. The metal may be stainless steel, chrome, or any suitable metal that is corrosion-resistant and readily cleanable.
The patient support 100 may be substantially rectangular, as shown in
While the dimensions of the patient support 100 may vary, the length of the patient support 100 ranges from about 10 inches to about 100 inches, such as about 59.5 inches to about 75.5 inches, including about 20 inches to about 60 inches. For example, 26 inches or 33 inches. While the dimensions of the patient support 100 may vary, the width of the patient support 100 ranges from 1 inch to 30 inches, including 2 inches to 20 inches, and including 3 inches to 5 inches. While the dimensions of the patient support 100 may vary, the thickness or height of the patient support 100 ranges from 0.1 inches to 5 inches, such as 0.3 inches to 3 inches, including 0.5 inches to 1.5 inches. The dimensions of the chair may vary depending on the size of the patient.
The shoulder pole 500 can be telescoping such the height of the shoulder pole 500 can be raised or lowered. The length or height of the shoulder pole 500 can be adjusted depending on the patient's size or orientation. The shoulder pole 500 may have an adjustable height that can be adjusted by loosening a collar, extending the pole and then tightening the collar, to optimize the position of the shoulder pad 300 and the patient's shoulder for access and visualization for an endoscopic procedure.
While the dimensions of the shoulder pole 500 may vary, the length or height of the shoulder pole 500 ranges from 20 inches to 80 inches, such as 25 inches to 70 inches, including 30 inches to 60 inches. While the dimensions of the shoulder pole 500 may vary, the diameter of the shoulder pole 500 ranges from 0.2 inches to 5 inches, such as 0.3 inches to 3 inches, including 0.5 inch to 1.5 inches.
The shoulder pad 300 may mount to the shoulder pole 500. The shoulder pad 300 may be oriented such that the length of the shoulder pad 300 may be substantially perpendicular to the length of the shoulder pole 500. The length of the shoulder pad 300 may be aligned with the width of the patient support 100. The shoulder pad 300 may be oriented such that the length of the shoulder pad 300 may be substantially parallel to the length of the patient support 100. The shoulder pad 300 may adjustable to turn or rotate to adjust the orientation of the shoulder pad 300. The shoulder pad 300 may be adjustable similar to the height of the shoulder pole and may be adjustable using the same collar or a separate collar. The shoulder pad 300 can be adjusted by loosening the collar, rotating or spinning the shoulder pad 300 and then tightening the collar to lock the shoulder pad 300 in the desired position, such as aligned with the patient's arm pit.
In some examples, the shoulder pad 300 may be rotated relative to the shoulder pole 500 and/or the patient support 100. The shoulder pad 300 may be rotated such that the longitudinal axis or length of the shoulder pad 300 may be aligned along different axes, for example, aligned with the length of the seat of the chair 10 or with the sagittal axis of the patient's torso when seated on the chair 10. The shoulder pad 300 may be positioned or rotated to correctly position the patient's arm and shoulder.
While the dimensions of the shoulder pad 300 may vary, the length the shoulder pad 300 ranges from 4 inches to 12 inches, such as 5 inches to 10 inches, including 6 inches to 8 inches. While the dimensions of the shoulder pad 300 may vary, the diameter of the should pad 300 ranges from 0.5 inches to 5 inches, such as 1.0 inches to 3 inches, including 1.0 inch to 1.5 inches. In examples, the shoulder pad 300 may be generally cylindrical with end portions having a diameter that is greater than a center portion of the shoulder pad 300, such that the shoulder pad is ergonomically favorable for a patient to rest an arm over the should pad while seated in the chair 10. The shoulder pad may have an internal hole, extending along a longitudinal axis along the entire length of the shoulder pad or part of the entire length of the shoulder pad.
Turning to
The patient support 100 may have a series of holes 114, as shown in
Although the series of holes 114 shown in
As shown in
The patient support 100 may have a substantial height or thickness counterbalance the weight of the shoulder pole 500 and shoulder pad 300 as well as any pressure applied by a patient or doctor. The patient support 100 may have a height or thickness that is optimized to stabilize the joint positioning device 5, even when pressure or weight is applied to the joint positioning device 5.
Also shown in
The vertical pillar 200 may be positioned at the end of the patient support 100, as shown in
As shown in
While the dimensions of the pole 204 may vary, the height of the pole 204 ranges from 4 inches to 30 inches, such as 5 inches to 15 inches, including 6 inches to 10 inches. While the dimensions of the pole 204 may vary, the diameter of the pole 204 ranges from 0.3 inches to 6 inches, such as 0.5 inches to 3 inches, including 0.7 inch to 1.5 inches.
The joint positioning device 5 may include a base 210. The base 210 may include a central hole or aperture 306 to receive the pole 204. While the dimensions of the base 210 may vary, the diameter of the base 210 ranges from 1 inches to 15 inches, such as 2 inches to 10 inches, including 3 inches to 5 inches.
The pole 204 may include a central hole or aperture 202. The ends 206 of the pole 204 may be threaded or otherwise structured to engage and secure the pole 204 to the base 210. The ends 206 of the pole 204 may be threaded or otherwise structured to engage center hole or aperture 306 of the base 210. The center hole or aperture 306 of the base 210 may have corresponding threading or structure to engage with the threads of the ends 206 of the pole 204. One of skill in the art will understand that the pole 204 may be secured into base 210 via any suitable means disclosed herein this section or elsewhere in the specification. For example, the pole 204 may be secured via press-fit and/or via bayonet attachment.
As described above, the patient support 100 may include a series of holes 114 may be threaded or otherwise structured to engage with and secure the pole 204 to the patient support 100. The screws 312 may be inserted through the base 210 and into the patient support 100. The base 210 may include a series of holes or apertures 212 configured to receive screws 312. The screws 312 may be used to secure the base 210 to the patient support 100. The central hole 306 of the base 210 may receive the pole 204.
The pole 204 may be attached or secured to the patient support 100 in a number of ways. The pole 204 may be integral with the patient support 100. The pole 204 may attach directly to the patient support 100 without the base 210. For example, the patient support 100 may have a series of holes 114 dimensioned to receive the pole 204. The pole 204 may have threads or be structured to engage with holes 114 of the patient support 100.
While the dimensions of the vertical pillar 200 may vary, the height of the vertical pillar 200 ranges from 4 inches to 30 inches, such as 5 inches to 15 inches, including 6 inches to 10 inches. While the dimensions of the vertical pillar 200 may vary, the diameter of the vertical pillar 200 ranges from 2 inches to 12 inches, such as 4 inches to 10 inches, including 5 inches to 6 inches.
The shoulder pad 300 may be substantially cylindrical. The shoulder pad 300 may be contoured round pincushion (vertical lines go toward center) as shown in
The shoulder pole 500 may be secured to the patient support 100 in several ways. The shoulder pole 500 may be integral with the patient support 100. As shown in
As described herein, the shoulder pole 500 can be telescoping such the height of the shoulder pole 500 can be raised or lowered. The length or height of the shoulder pole 500 can be adjusted depending on the patient's size or orientation. The shoulder pole 500 may have an adjustable height that can be adjusted to optimize the position of the shoulder pad 300 and the patient's shoulder for access and visualization for an endoscopic procedure. As described herein, the shoulder pad 300 may be rotated to different orientations, depending on the position of the patient and/or the patient support 100.
The patient's arm may be positioned over the shoulder pad 300 such that the shoulder pad 300 is positioned underneath the patient's arm, in the patient's armpit or axillary. The patient's shoulder of interest may be braced against the shoulder pad 300. Once the patient's shoulder is braced against the shoulder pad 300, a physician may press, push, or apply pressure to the patient's shoulder or arm to position the patient. The patient may hold a weight in their hand to further provide traction and pressure to open the shoulder joint and provide access to the glenoid cavity.
The physician may appropriately adjust the patient, shoulder pad 300, and shoulder pole 500, and/or the patient support 100 such that the patient's shoulder is braced in the correct position. The physician may position or place the patient's shoulder in an outward position to open up the glenoid cavity of the patient's shoulder. The physician may apply pressure to the shoulder such that the glenoid cavity of the shoulder becomes open. Once the patient is in the correct position, the glenoid cavity of the shoulder of interest is accessible. While the patient's shoulder and arm is being rotated or extended outward, the patient's upper body remains stabilized to put a slight torque or force on the patient's shoulder.
The patient may be positioned on either side of the shoulder pad 300 and shoulder pole 500 to allow for access of either shoulder or arm of the patient.
Once the glenoid cavity of the patient's shoulder is in an open position, the physician may then have the necessary access and visualization of the glenoid cavity of the patient's shoulder to examine the internal tissue of the shoulder, such as via a needle endoscope. The physician may insert a needle endoscope into a tissue site and collect an image. Additionally, once the glenoid cavity of the patient's shoulder is accessible, the physician may and perform any necessary procedures or treatments such as an injection. The physician may then inject the patient's joint, such as via a needle endoscope, with access to the glenoid cavity of the shoulder.
Features, materials, characteristics, or groups described in conjunction with a particular aspect, embodiment, or example are to be understood to be applicable to any other aspect, embodiment or example described in this section or elsewhere in this specification unless incompatible therewith. All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), and/or all of the steps of any method or process so disclosed, may be combined in any combination, except combinations where at least some of such features and/or steps are mutually exclusive. The protection is not restricted to the details of any foregoing examples. The protection extends to any novel one, or any novel combination, of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or to any novel one, or any novel combination, of the steps of any method or process so disclosed.
While certain examples have been described, these examples have been presented by way of example only, and are not intended to limit the scope of protection. Indeed, the novel methods and systems described in this section or elsewhere in this specification may be embodied in a variety of other forms. Furthermore, various omissions, substitutions and changes in the form of the methods and systems described in this section or elsewhere in this specification may be made. Those skilled in the art will appreciate that in some examples, the actual steps taken in the processes illustrated and/or disclosed may differ from those shown in the figures. Depending on the example, certain of the steps described above may be removed, others may be added. Furthermore, the features and attributes of the specific examples disclosed above may be combined in different ways to form additional examples, all of which fall within the scope of the present disclosure.
Although the present disclosure includes certain examples and applications, it will be understood by those skilled in the art that the present disclosure extends beyond the specifically disclosed examples to other alternative examples and/or uses and obvious modifications and equivalents thereof, including examples which do not provide all of the features and advantages set forth in this section or elsewhere in this specification. Accordingly, the scope of the present disclosure is not intended to be limited by the specific disclosures of preferred examples in this section or elsewhere in this specification, and may be defined by claims as presented in this section or elsewhere in this specification or as presented in the future.
This application claims priority under 35 USC 119(e) to U.S. Provisional Application No. 62/923,169, entitled DEVICE AND METHOD FOR POSITIONING A JOINT, filed Oct. 18, 2019; the disclosure of which is hereby incorporated by reference in its entirety.
Number | Date | Country | |
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62923169 | Oct 2019 | US |