In-line milling system

Information

  • Patent Grant
  • 8177788
  • Patent Number
    8,177,788
  • Date Filed
    Wednesday, February 22, 2006
    18 years ago
  • Date Issued
    Tuesday, May 15, 2012
    12 years ago
Abstract
Embodiments of the present invention provide a milling system and method that provides a precise triangular cut in a patient's proximal femur. The system allows the surgeon to mill in a single direction, that is, the drill is in the same or similar longitudinal place as the handle of the milling system, preventing the surgeon from having to enter the patient's leg at two different angles. The present invention also provides a milling system that can be pre-assembled (e.g., on the back table by a nurse while the surgeon is preparing the site), which enables the milling to take place in one step.
Description
FIELD OF THE INVENTION

The present invention relates to devices, systems, and methods for use in milling a femoral canal, and specifically milling the proximal portion of the femur to receive an implant. Embodiments of the present invention provide a precise system and method to prepare a triangular cavity in bone into which a sleeve or body of a hip implant is positioned.


BACKGROUND

Hip replacement implants typically feature a stem with a head that cooperates with an acetabular cup. Hip stems are increasingly being provided in different sizes, lengths, and shapes. Some stems are also being provided with modular sleeves (also referred to as proximal bodies) that enable the stem to effectively “sit” in place with respect to the proximal femur. Sleeves or bodies in different sizes are provided to accommodate different bone structures and quality. The sleeves traditionally have a cone shape with a triangular spout extending from the cone, an example of which is shown by FIG. 7. The spouts approximate a portion of the proximal femur and provide additional support for the stem.


Preparing the proximal femur to receive a sleeve having a spout presents a challenge because bone must be removed in the shape of a triangle to receive the spout. In other words, once the distal femur has been reamed, a generally triangular shaped area needs to be milled out of the proximal reamer to receive the sleeve and spout. The surgeon should remove enough bone to achieve a secure fit, but not so much bone that the spout subsides and fails to support the stem as desired.


One previous preparation method has included aligning a shaft in the femoral canal and angling a cutter with respect to the shaft and moving the entire shaft within the canal to prepare the bone. An example of such a method is shown by FIG. 10 (which is reproduced from U.S. Pat. No. 5,002,578).


Another method has included aligning a shaft having an angled bearing in the femoral canal. A drill is inserted through the bearing at an angle to prepare a triangular cavity. An example of such a method is shown by FIG. 11 (which is reproduced from U.S. Pat. No. 5,540,694).


A variety of problems are encountered when using the methods and instrumentation of these procedures. For example, inserting a shaft into the canal and then separately inserting a drill through a bearing of the shaft causes the surgeon to have to maneuver multiple parts while also having to pay strict attention to the angles involved. One reason this causes a challenge is because the surgeon is holding the shaft at one angle (e.g., in the axis of the femoral canal) and maneuvering the drill at another angle (e.g., at an angle to form a triangular cut with respect to the axis of the canal), all while having to control the depth of the drilling. The surgeon often needs to drill the bone, remove the drill to check depth and shape of the cavity, and then reinsert the drill and continue the preparation. Although surgeons have become quite adept at these procedures, there is still a great deal of guess work involved. If too much bone is removed, the surgeon will often be forced to move to the next largest size of sleeve to accommodate for the excess bone removed.


Accordingly, it is desirable to provide more accurate milling methods that provide a precise cut. It is also desirable to provide a milling system that allows the surgeon to mill in a single direction, without having to enter the patient's leg at two different angles. (This is also beneficial to the patient because it is less invasive and a smaller incision can be used.) It is further desirable to provide a milling system that can be pre-assembled (e.g., on the back table by a nurse while the surgeon is preparing the site), which enables the milling to take place in one step. The systems and methods described herein provide many of these solutions.


SUMMARY

Embodiments of the present invention provide a milling system and method that provides a precise triangular cut in a patient's proximal femur. The system allows the surgeon to mill in a single direction, that is, the drill is in the same or similar longitudinal place as the handle of the milling system, preventing the surgeon from having to enter the patient's leg at two different angles. The present invention also provides a milling system that can be pre-assembled (e.g., on the back table by a nurse while the surgeon is preparing the site), which enables the milling to take place in one step, saving operating room time.





BRIEF DESCRIPTION OF THE DRAWINGS


FIG. 1 shows a top perspective view of components of the milling system before assembly.



FIG. 2 shows the milling handle and milling body in an assembled position and the cutting member prior to its attachment.



FIG. 3 shows a close up view of the assembly of FIG. 2.



FIG. 4 shows a side perspective view of components of the milling system in a partially assembled configuration.



FIG. 5 shows another perspective of the assembly of FIG. 4.



FIG. 6 shows another perspective of the assembly of FIG. 4, showing orientation lines.



FIG. 7 shows various embodiments of proximal bodies (also referred to as sleeves with spouts) that may be used once a cavity has been milled using the systems described herein.



FIG. 8 shows one embodiment of a cross bar and slot connection mechanism between the milling handle and the milling body.



FIG. 9 shows an alternate connection mechanism between the milling handle and the milling body.



FIGS. 10 and 11 show prior art systems that have been used to mill triangular cavities.





DETAILED DESCRIPTION OF THE DRAWINGS

Embodiments of the present invention may be used to mill a triangular cavity in a proximal portion of a femur. Once the surgeon has prepared the distal portion of the femoral canal to receive a stem, he or she needs to prepare the proximal portion of the canal to receive the body of an implant. The triangular cavity to be prepared is shaped and sized to receive a triangular portion of a prosthetic hip implant, as shown in FIG. 7.


In preferred embodiments, unlike previous milling devices, the present invention does not require a component that slides laterally with respect to another component to mill the triangular cavity. Instead, the present invention allows the triangular cavity to be prepared using an in-line milling system that maintains the drill in the same or similar longitudinal plane as the handle of the support assembly. (Although the term “handle” is used throughout the specification and in the claims, it should be understood that an actual grasping portion is not required. The handle may be a rod, a stabilizing portion, or any other member that supports the drill receiving portion and drilling function.) Additionally, the in-line milling device, once assembled, may be inserted into the conically reamed femur cavity as a fixed unit to mill the triangular cavity. The surgeon is not required to insert one part of the assembly, locate the target area, and then insert a drill at an angle into the assembly.


Devices in accordance with embodiments of the present invention feature a milling handle 60, a milling body 40, and at least one cutting member 90. Examples of certain embodiments of these components, disassembled from one another, are shown in FIG. 1, although it is understood that other types of milling handles, milling bodies, and cutting members could also be used.


The milling handle 60 shown in FIG. 1 includes a shaft 70, a drill directing portion 62, and a notched receiver 24. As shown in FIG. 2, the milling handle 60 has a shaft 70 with a longitudinal axis 72. At an upper end of the handle 60 is a handle grip 74. At the lower end is a notched receiver 24. The notched receiver 24 is adapted to provide a stop for the cutting member in use, as will be described more fully below.


Extending from the handle 60 is a drill directing portion 62. The drill directing portion 62 has a drill receiving end 78 and a cutting member receiving end 66. As shown in more detail in FIG. 2, the drill receiving end 78 has a chuck 76 near its distal tip and a shaft. The chuck 76 and shaft are attached to a bearing member 64, which is attached to a drive shaft 32, and in use, the chuck 76 receives a drill that rotates the bearing member 64 and drive shaft 32 to activate the cutting member. In certain embodiments, bearing member 64 is provided with plastic bushings to help rotation.


The cutting member receiving end 66 also has a bearing 28 that allows it to cooperate with the drive shaft 32 of drill receiving end 78 in order to rotate a cutting member. Cutting member receiving end 66 also has a socket 34 that receives a cutting member.


As shown in FIG. 3, the drill receiving end 78 (which may be a one-piece component, but as discussed above, is preferably a multi-piece component with a chuck, a shaft, a bearing member, and a drive shaft) and the cutting member receiving end 66 are joined, connected, or otherwise associated with one another at an angle α. This angle allows two things to occur: (1) drill receiving end 78 has a longitudinal axis 130 that holds and receives a drill in line with the longitudinal axis 72 of the milling handle 60 and (2) the cutting member receiving end 66 receives a cutting member at an angle that can cut a triangular cavity. Referring back to FIG. 2, with respect the in-line drilling that is facilitated, when the drill is attached to the chuck 76, the drill receiving end 78 is configured so that pressure is applied in the direction of the longitudinal axis 72 of the handle 60 as the cavity is being milled. With respect to the angled cutting member, when the cutting member is attached to the cutting member receiving end 66, it is directed at an angle that allows the cutting member to form a triangular cavity at a very precise position and depth, which will be described in more detail below. One feature of handle 60 that allows the precise depth to be obtained is notched receiver 24, which acts as a stop to allow cutting member to form a precise cavity having the desired depth.


Referring back to the upper part of handle 60, there is also a securing member 80, as partially shown in FIG. 4. The securing member 80 serves to lock the milling body (described below) to the milling handle 60 in the desired position. In one embodiment, the securing member 80 is in the form of an actuator or a plunger that can be engaged with the user's index and middle finger to allow the securing to take place, by for example, a ball and detent mechanism. (The ball portion, which is shown with phantom line 82, of the ball and detent mechanism would be actuated by the plunger 80.)


Although not shown, it is possible to provide more than one ball and detent mechanism, which can help prevent damage to the instrument if the surgeon tries to impact the instrument during placement because it provides more attachment surface area. (It should be noted, however, that it is not desirable or necessary to impact the instrument during placement, but because some previous milling instruments have required impaction, some surgeons automatically use that as part of their milling method. It is thus desirable to provide an attachment mechanism that secures the handle and the milling body together in a secure manner that can withstand being impacted in use.) In another embodiment, the securing member 80 may be in the form of a button 22 on the side of handle (or anywhere on the handle or the handle of grip 74) that can be depressed to secure the components together. Other methods of securing two instruments together may also be used and will be described in more detail below, although non-limiting examples include a Morse taper, a J-lock configuration, a ratchet and receiver mechanism, an actuator, a cross bar and slot mechanism, or any other suitable connection method.


The description will now turn to the milling body 40, shown in FIG. 1. Milling body 40 preferably includes a pilot portion 10, a conical portion 12, and a channeled portion 14. The pilot portion 10 acts to guide the system into place in the femoral canal. In some embodiments, the pilot 10 acts as a stem for the system, stabilizing the system with respect to the already-prepared distal femur. The pilot portion 10 may be removable from milling body 40 (as described in more detail below) or it may be formed as an integral piece.


During preparation of the proximal femur, the surgeon uses a tool that creates a slight ledge on the proximal femur—this is the ledge that the conical portion 12 is adapted to abut. In other words, the conical portion 12 sits in a conically-shaped area prepared in the proximal femur when the system is in use. This prevents the system from being inserted too deeply into the femur and provides the most precise preparation possible. It bears mentioning here that some surgeons may or may not prepare the proximal femur with a ledge and the systems described herein may be used without such a ledge, but it is believed that providing a ledge helps ensure greater accuracy. The distal end 48 of the conical portion 12 preferably defines a ledge 50. The more proximal end 52 of the conical portion 12 has a slight flare, thus forming the conical shape of portion 12. This conical portion 12 is intended to correspond to the cone shaped implant (shown in FIG. 7) for which the cavity is being prepared. The ledge 50 at the distal end 48 is intended to “sit” where the end of the implant would sit, once implanted. In preferred embodiments, the outer profile of the conical portion 12 is sized about ½ mm smaller than the reamer that is used to prepare the proximal femur to allow the milling body 40 to slide in and out of the cavity easily and prevent it from sticking in place.


As shown in FIG. 4, in some embodiments, at the most distal end 48 of the milling body 40 there is provided a connection portion 54. Connection portion 54 is intended to allow the pilot portion 10 to be connected and removed from the milling body 40. In specific embodiments, connection portion 54 may be a protrusion that has screw threads that are received by a corresponding connection portion 56 on pilot 10 that is a threaded cavity. In other embodiments, the cavity and protrusion may be reversed. In further embodiments, the connection mechanism may be a Morse taper or any other mechanism that allows that body 40 and pilot 10 to be detachable. It should also be noted that providing this removability is preferred, but not required. If desired, milling body 40 may be provided as a one-piece component.


Milling body 40 also has a channeled portion 14 that forms the majority of its length. The channeled portion 14 of the milling body 40 is intended to receive the shaft 70 of the milling handle 60 in use. FIGS. 2 and 3 show the handle 60 and milling body 40 assembled together. In one embodiment, the shaft 70 of handle 60 slides into and is received by channeled portion 14. Although this configuration is preferred, it should be noted that handle 60 may have a channeled portion 14 and the milling body 40 may have the shaft 70. Additionally, although the channeled portion 14 is shown as partially open (e.g., not fully enclosed), it may be a hollow channel that is formed within the milling body 40. An alternate embodiment may also be to provide the milling handle and body with solid ends, one of which may have a series of ratchets or slots adapted to receive a cross bar, examples of which are shown in FIGS. 8 and 9, described below. Also, although the milling handle 60 and milling body 40 are described as two separate pieces (which is the preferred embodiment), it is also possible for the handle and body to be a one-piece component or for it to be more than two pieces.


As shown in FIG. 4, the channeled portion includes a corresponding securing member 42 that allows it to be secured to the milling handle 60. In some embodiments, the milling handle 60 securing member 80 is a ball 82 and the milling body 40 securing member is a series of detents 44 or recesses that receive the ball 82. The detents 44 are preferably located along the closed portion 46 of the channeled portion 14. It should be understood, however, that the location of the ball and/or detents may be changed, i.e., the ball could be on the milling body and the detent could be on the handle. In other embodiments, the securing members 80 and 42 are J-locks, where one securing member is a J-shaped channel and another securing member is a tab that is received in the J-shaped channel. A further embodiment that may be used to secure handle 60 to body 40 is a series of Morse tapers of different sizes. One securing member could be a cone shaped receiving member and another could be a tapered portion that engages therewith. In order to provide the desired interchangeability to accommodate the preparation of a cavity that can receive different sizes of sleeves, the taper portion could be removable and different tapers could be provided. The tapers could screw onto the milling body or the handle. Alternatively, the portions could screw to one another without the use of a taper.


An even further embodiment is a ratchet and receiver mechanism or a gate-lock type mechanism. One example of a ratchet and receiver embodiment is shown in FIG. 8. In this embodiment, the handle or the milling body has a ratchet 100 (e.g. a T-shaped lever), and the other has a series of receivers 102. The receivers may have curved edges 104 that secure the ratchet 100 in place and prevent it from sliding out. More than one receiver 102 is preferably provided to allow for adjustability in size. A gate-lock type mechanism (e.g., a sliding member that closes over the ratchet 100 once in place to prevent it from sliding out, similar to the sliding member that closes over a gate to prevent it from being blown open by wind) may also be provided.


A further embodiment is shown in FIG. 9, which details how a cross bar 110 (or ratchet) may be received in indentations 112. Indentations may have curved edges, similar to those shown in FIG. 8, or they may have curved bases 114 only, with their sides and tips 116 extending up in a U-shaped configuration. There are preferably as many cross bars 110 and indentation 112 options as there are sizes to be provided.


Although a few alternate embodiments for securing members have been described, it should be understood that any connection member that allows handle 60 and milling body 40 to be removably attached to one another in different configurations to allow for preparation of a cavity of a different size is considered within the scope of this invention. If body and handle are provided as a single piece, there should be some feature that allows them to expand and retract in size relative to one another to allow for the adjustability options described herein.


For the remainder of this description, the ball and detent securing mechanism will be described as the structure used to secure the handle 60 to the milling body 40. In the preferred embodiment for this configuration, the ball 82 is located on an upper area of the handle 60 and the recess or detent 44 is located on an upper area of the milling body 40. However, these locations may be changed (e.g., to be elsewhere on each component) or the ball 82 may be on the milling body 40 and vice versa. During use, the ball is depressed 82 and allowed to be released within one of the detents 44 to secure the components.


In a particularly preferred embodiment, there are provided multiple detents 44 that enable ball 82 to be received in multiple configurations. (If another securing mechanism is used, it is preferred that that mechanism also allow various positioning options.) Some embodiments may have three detents 44, as shown in FIG. 4. These detents 44 allow handle 60 to be positioned at three different depths, allowing the triangular cavity to be prepared in three different depths to accommodate one of three differently sized implants or sleeves. Although three sizing options are described and are typically preferred, it is also possible to provide only one option or to provide many more options, depending upon the complication and detail for ease of reference. There may simply be provided 5 or 8 or 10 (or any number) of detents that may receive the ball 82.


The cutting member 90 shown in FIG. 1 includes cutting surface 16, distal pin 18 and shank 20. Cutting member 90 also has a central axis 92 that extends through cutting member 90. Cutting surface 16 may be a blade, a drill bit-type surface, or any other surface used to cut bone. In use the shank 20 is received by the cutting member receiving end 66 of the drill directing portion 62. The distal pin 18 is received by notched receiver 24 of the milling handle 60. This secures the cutting member 90 in place and provides a very accurate cut. One of the benefits of the system described herein is that it prevents the guesswork that is commonly required for preparing a triangular cavity to receive a sleeve with a spout.


Method:


Once the surgeon has reamed the distal femur and prepared the proximal portion of the femur, he or she will need to prepare a triangular cavity to receive the proximal body (also referred to as a sleeve with a spout). It is preferred to use a proximal body that corresponds to the size of the stem diameter. (In other words, if the surgeon is using a 15 mm stem, he or she will want to select a proximal body that cooperates with that stem and has a similar diameter).


The proximal bodies for use with the systems described herein are preferably color coded and provided with a system that makes choosing the proximal body (and thus, the size of the triangular cavity to be prepared) quite effortless. For example, all 15 mm bodies may be colored green and all 13 mm bodies may be yellow. One factor to be considered is the diameter of the body (selected to correspond to the stem), and the other two factors are the extension of the spout and the height/thickness of the body. These other two factors can be simplified by using the preferred proximal body system for use with the milling system of this invention.


As shown in FIG. 7, the bodies are provided in spout sizes 1, 2, and 3 and the size of the bodies are small, medium, and large. These examples are provided only to help the reader visualize the various types of proximal bodies that can be used and they are in no way intended to be limiting. Alternate sizes may be provided in any other appropriate manner, such as using a lettering system (A, B, and C) or a naming system (such as Alpha, Bravo, Charlie), and so forth. FIG. 7 also shows that it is possible to provide standard sized bodies, as well as tall bodies (shown in phantom lines). However, for the ease of this description, the preferred system shown in FIG. 7 will be referred to throughout the remainder of this section.


The surgeon will typically prepare the proximal femur to receive the size of proximal body selected, for example, a small, medium or large. In order to prepare an appropriate triangular cavity, however, the surgeon will need to prepare a triangular cavity that corresponds to either the 1, 2, or 3 position of the spout. That is where the milling system according to certain embodiments of the present invention is particularly useful.


In use, the in-line milling system is completely assembled prior to insertion into the femur cavity. First, the milling handle 60 is assembled to the milling body 40 in one of three different lengths using the securing members 42 and 80. In a preferred embodiment, the members are provided in options of 1, 2, or 3, corresponding to the size of the proximal body to be used. (However, it should again be understood that any number of options may be provided.) In a particularly preferred embodiment, the securing members are a ball 82 on the handle 60 that engages one of the three small detents 44 in the closed portion 46 of the channeled portion 14 of the milling body 40 to lock the milling handle 60 member at the desired length.


The surgeon selects the length of the instrument depending on how large a triangular cavity he or she desires to mill, which depends upon the size of the patient, the size of the femur, and the depth and width of the canal formed within the femur. Increasing the length of the instrument decreases the size of the triangular cavity that will be milled. So, for example, if a “small” body with a “1” spout is to be used, the handle 60 and body 40 will be attached to one another at the “1” configuration.


Once the milling handle 60 is locked into the milling body 40 at the desired length, as shown in FIGS. 2 and 3, the cutting member 90 is secured to the instrument, as shown in FIGS. 4-6. If not already connected, the pilot member 10 should be attached to the connection portion 54 to complete assembly of the instrument, as shown in FIG. 6.


The distal pin 18 on the cutting member 90 fits into a hole in the notched receiver 24, as shown in FIG. 5. The cutting member's shank 20 fits into the socket 34, which cooperates with the drive shaft 32. The cutting member 90 is secured by sliding the locking member 26 slightly distally to fully engage the cutting members' shank in the socket 34. FIGS. 2 and 3 show the locking member 26 in an unlocked orientation and FIGS. 5 and 6 show the locking member 26 in a locked position. Locking member 26 may be adapted to slide up and down the handle, it may be adapted to move and lock independently of the handle, or both. One preferred way that locking member 26 locks is via a bayonet lock, although it should be understood that any locking method may be used. Once the cutting member 90 is secured, rotation of the drive shaft rotates the cutting member. The drive shaft, not the cutting member, is supported by bearing 28.


In use, the surgeon inserts the instrument into the reamed cavity as an electric motor rotates the drive shaft 32 and cutting member 90. The surgeon continues to insert the instrument, milling the triangular cavity in the process, until the conical portion 12 of the milling body 40 contacts the walls of the conically reamed cavity in the femur. At that point, the milling is completed. If the surgeon desires to enlarge the triangular cavity, he or she may shorten the length of the instrument (consequently allowing the cutting member to penetrate deeper into the femur) and re-mill the cavity.


The instruments and methods described above may also be used in connection with computer assisted surgery techniques, devices, and methods. For example, a reference marker, such as a reference fiducial described in co-pending U.S. patent application Ser. No. 10/897,857 filed Jul. 23, 2004 entitled “Surgical Navigation System Component Fault Interfaces and Related Processes” and U.S. patent application Ser. No. 10/689,103 filed on Oct. 20, 2003 (both of which are hereby incorporated by this reference) may be used to identify the location on the patient's hip to be prepared. Specifically, a reference marker or fiducial may be used to identify the greater trochanter, the lesser trochanter, the center of the canal, and/or other portions along the canal to identify where the center of the head should be located. This would allow a computer to create a three-dimensional representation of the surgical site. This can be useful in either (a) assisting the surgeon in choosing the appropriately sized implant to use and/or (b) using a computer to control the milling instruments described to prepare a cavity of the desired depth and size.


Changes and modifications, additions and deletions may be made to the structures and methods recited above and shown in the drawings without departing from the scope or spirit of the invention and the following claims.

Claims
  • 1. An in-line milling system for use with a cutting member, comprising: (a) a milling handle having a longitudinal axis;(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;(c) a securing system configured to lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle; and(d) a drill directing joint associated with the milling handle and comprising a drill receiving portion having an end adapted to receive a drill substantially parallel with the longitudinal axis of the milling handle and a cutting member receiving portion connected at an angle to the drill receiving portion and having an end adapted to receive the cutting member such that the cutting member extends along an axis that is not parallel to the longitudinal axis of the milling handle; wherein the drill receiving portion and the cutting member receiving portion remain connected at the angle to form an angled joint when the cutting member is not secured to the end of the cutting member receiving portion.
  • 2. The in-line milling system of claim 1, wherein the drill receiving portion comprises a rotatable shaft, wherein the cutting member receiving portion comprises a rotatable shaft, and wherein, in use, a drill attached to the end of the drill receiving portion rotates both the rotatable shaft of the drill receiving portion and the rotatable shaft of the cutting member receiving portion in order to rotate the cutting member.
  • 3. The in-line milling system of claim 2, wherein the cutting member receiving portion comprises an axis, wherein the axis of the cutting member receiving portion and the axis of the cutting member substantially align, and wherein the cutting member receiving portion is adapted to apply torque about the axis of the cutting member.
  • 4. The in-line milling system of claim 1, wherein the securing system is configured to lock the milling handle to the milling body in one of multiple pre-determined positions to prevent relative translation between the milling body and the milling handle.
  • 5. The in-line milling system of claim 1, wherein the securing system comprises a ball and detent mechanism.
  • 6. The in-line milling system of claim 1, wherein the securing system comprises a cross bar and indentation mechanism.
  • 7. The in-line milling system of claim 6, wherein the cross bar and indentation mechanism comprises at least one indentation located on one of the milling handle and the milling body and a cross bar associated with the other of the milling handle and the milling body.
  • 8. The in-line milling system of claim 7, wherein the at least one indentation is located on the milling body and wherein the cross bar is associated with the milling handle.
  • 9. The in-line milling system of claim 1, wherein the securing system comprises a bayonet and curved receiver mechanism.
  • 10. The in-line milling system of claim 1, wherein the angle is a fixed angle.
  • 11. The in-line milling system of claim 1, wherein the axis of the cutting member is substantially straight.
  • 12. The in-line milling system of claim 1, wherein each of the drill receiving portion and the cutting member receiving portion comprises a first end and a second end, wherein the first end of the drill receiving portion is adapted to receive the drill and the second end of the cutting member receiving portion is adapted to receive the cutting member and wherein the second end of the drill receiving portion and the first end of the cutting member receiving portion are connected at the angle.
  • 13. An in-line milling system for use with a cutting member having a substantially straight axis, the system comprising: (a) a milling handle having a shaft with a longitudinal axis;(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;(c) a drill directing portion associated with the milling handle, the drill directing portion comprising a drill receiving portion and a cutting member receiving portion having an axis, the drill receiving portion and the cutting member receiving portion connected to one another to form an angled joint such that the drill receiving portion is configured to receive a drill in parallel with the longitudinal axis of the milling handle and the cutting member receiving portion is configured to receive the cutting member such that the axes of the cutting member and the cutting member receiving portion are substantially co-linear and are not parallel to the longitudinal axis of the milling handle; and(d) a securing system configured to lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle.
  • 14. The in-line milling system of claim 13, wherein the drill receiving portion comprises a rotatable shaft, wherein the cutting member receiving portion comprises a rotatable shaft, and wherein, in use, a drill attached to the end of the drill receiving portion rotates both the rotatable shaft of the drill receiving portion and the rotatable shaft of the cutting member receiving portion in order to rotate the cutting member.
  • 15. The in-line milling system of claim 14, wherein the cutting member receiving portion is adapted to apply torque about the axis of the cutting member.
  • 16. The in-line milling system of claim 13, wherein the securing system is configured to lock the milling handle to the milling body in one of multiple pre-determined positions to prevent relative translation between the milling body and the milling handle.
  • 17. The in-line milling system of claim 13, wherein the securing system comprises a cross bar and indentation mechanism.
  • 18. The in-line milling system of claim 17, wherein the cross bar and indentation mechanism comprises at least one indentation located on one of the milling handle and the milling body and a cross bar associated with the other of the milling handle and the milling body.
  • 19. The in-line milling system of claim 18, wherein the at least one indentation is located on the milling body and wherein the cross bar is associated with the milling handle.
  • 20. The in-line milling system of claim 13, wherein the securing system comprises a ball and detent mechanism.
  • 21. The in-line milling system of claim 13, wherein the securing system comprises a bayonet and curved receiver mechanism.
  • 22. The in-line milling system of claim 13, wherein the drill receiving portion and the cutting member receiving portion remain connected at the angled joint when the cutting member is not secured to the cutting member receiving portion.
  • 23. The in-line milling system of claim 13, wherein the angled joint retains the drill receiving portion and the cutting member receiving portion at a fixed angle.
  • 24. A method for preparing a bone for receiving an implant comprising: (a) providing a milling system comprising: (i) a milling handle having a longitudinal axis; (ii) a milling body adapted to be positioned at least partially within the bone and comprising a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body; (iii) a cutting member; and (iv) a drill directing portion associated with the milling handle and comprising a drill receiving portion and a cutting member receiving portion having an axis, the drill receiving portion and the cutting member receiving portion connected to one another to form an angled joint, such that the drill receiving portion is configured to receive a drill substantially parallel with the longitudinal axis of the milling handle and the cutting member receiving portion is configured to receive the cutting member such that the cutting member extends along an axis that is not parallel to the longitudinal axis of the milling handle;(b) assembling the milling system by (i) inserting the milling handle into the channeled portion of the milling body; (ii) locking the milling handle and the milling body together to prevent relative translation between the milling handle and the milling body; and (iii) securing the cutting member to the cutting member receiving portion of the drill directing portion such that the axis of the cutting member and the axis of the cutting member receiving portion are substantially co-linear;(c) inserting the assembled milling system into the bone; and(d) activating the drill to rotate the cutting member to form a triangular-shaped cavity in the bone.
  • 25. The method of claim 24, wherein locking the milling handle and the milling body together to prevent relative translation between the milling handle and the milling body comprises inserting a cross bar associated with one of the milling handle and the milling body into at least one indentation located on the other of the milling handle and the milling body.
  • 26. The method of claim 25, wherein the at least one indentation comprises a plurality of indentations and wherein the method further comprises disengaging the cross bar from the at least one indentation, translating the milling handle and the milling body relative to each other, and inserting the cross bar into another of the indentations.
  • 27. The method of claim 25, wherein the cross bar is associated with the milling handle and wherein the at least one indentation is located on the milling body.
  • 28. A method for preparing a bone for receiving an implant comprising: (a) selecting from a plurality of implants having a triangular-shaped portion an implant having a desired size;(b) providing a milling system comprising: (i) a milling handle having a longitudinal axis; (ii) a milling body adapted to be positioned at least partially within the bone and comprising a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body; (iii) a cutting member; and (iv) a drill directing portion associated with the milling handle and comprising a drill receiving portion and a cutting member receiving portion, wherein the drill receiving portion is configured to receive a drill substantially parallel with the longitudinal axis of the milling handle and the cutting member receiving portion is configured to receive the cutting member such that the cutting member extends along an axis that is not parallel to the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion;(c) assembling the milling system by (i) inserting the milling handle into the channeled portion of the milling body; (ii) selecting from at least two pre-determined relative positions of the milling handle and the milling body the desired relative position of the milling handle and the milling body based at least partially on the desired size of the implant and locking the milling handle and the milling body in the desired pre-determined relative position to prevent relative translation between the milling body and the milling handle; and (iii) securing the cutting member to the cutting member receiving portion such that the cutting member extends along an axis that is not parallel to the longitudinal axis of the milling handle;(d) inserting the assembled milling system into the bone; and(e) activating the drill to rotate the cutting member to form a triangular-shaped cavity in the bone.
  • 29. The method of claim 28, wherein locking the milling handle and the milling body in the desired pre-determined relative position to prevent relative translation between the milling body and the milling handle comprises inserting a cross bar associated with one of the milling handle and the milling body into one of at least two indentations located on the other of the milling handle and the milling body, wherein each of the at least two indentations represents one of the at least two pre-determined relative positions.
  • 30. The method of claim 29, wherein the cross bar is associated with the milling handle and wherein the at least two indentations are located on the milling body.
  • 31. The method of claim 29, further comprising disengaging the cross bar from the one of the at least two indentations, translating the milling handle and the milling body relative to each other, and inserting the cross bar into another of the at least two indentations.
  • 32. An in-line milling system for use with a cutting member comprising: (a) a milling handle having a shaft with a longitudinal axis;(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;(c) a drill directing portion associated with the milling handle, the drill directing portion comprising a drill receiving portion having an end and a cutting member receiving portion having an end, wherein the drill receiving portion end is adapted to receive a drill in parallel with the longitudinal axis of the milling handle, and the cutting member receiving portion end is adapted to receive the cutting member such that the cutting member extends along an axis that is not parallel with the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion end; and(d) a securing system adapted to rigidly lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle.
  • 33. An in-line milling system for use with a cutting member comprising: (a) a milling handle having a shaft with a longitudinal axis;(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body; and(c) a drill directing portion associated with the milling handle, the drill directing portion comprising a drill receiving portion and a cutting member receiving portion,
  • 34. A method for preparing a bone for receiving an implant comprising: (a) providing an in-line milling system comprising: (i) a milling handle having a longitudinal axis; (ii) a milling body adapted to be positioned at least partially within the bone and having a length and a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body; (iii) a drill directing portion associated with the milling handle and comprising a drill receiving portion and a cutting member receiving portion adapted to receive a cutting member such that the cutting member is oriented at an angle relative to the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion;(b) inserting the milling handle into the channeled portion of the milling body;(c) selecting from a plurality of pre-determined relative positions of the milling handle and the milling body the desired relative position of the milling handle and the milling body and locking the milling handle and the milling body in the desired pre-determined relative position by inserting a cross bar associated with the milling handle into one of a plurality of indentations located along the length of the milling body;(d) inserting the milling system into the bone; and(e) activating a drill to rotate the cutting member to form a triangular-shaped cavity in the bone.
  • 35. The method of claim 34, further comprising disengaging the cross bar from the one of the plurality of indentations, translating the milling handle and the milling body relative to each other, and inserting the cross bar into another of the plurality of indentations.
  • 36. An in-line milling system for use with a cutting member, comprising: (a) a milling body adapted to be positioned at least partially within a bone and having a channeled portion and a ledge;(b) a milling handle having a longitudinal axis, a shaft, and a notched receiver, wherein the shaft slides into and is received by the channeled portion of the milling body;(c) a drill directing portion extending from the milling handle, wherein the drill directing portion comprises a drill receiving portion having an end and a cutting member receiving portion having an end, wherein the drill receiving portion has an axis parallel to the longitudinal axis of the milling handle, wherein the cutting member is located between the cutting member receiving portion end and the notched receiver, and wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion end; and(d) a securing system configured to lock the milling body to the milling handle in at least one pre-determined position to prevent relative translation between the milling body and the milling handle and to hold the cutting member in a desired position relative to the ledge.
  • 37. The in-line milling system of claim 36, wherein the securing system comprises a cross bar and indentation mechanism.
  • 38. The in-line milling system of claim 37, wherein the cross bar and indentation mechanism comprises at least one indentation located on one of the milling handle and the milling body and a cross bar associated with the other of the milling handle and the milling body.
  • 39. A method for preparing a bone for receiving an implant comprising: (a) inserting a milling handle into a milling body adapted to be positioned at least partially within the bone;(b) locking the milling handle and the milling body together to prevent relative translation between the milling handle and the milling body;(c) securing a cutting member to the milling handle by sliding a locking member distally to fully engage a shank of the cutting member, wherein the milling handle comprises a drill receiving portion and a cutting member receiving portion that remain connected at an angle to form an angled joint when the cutting member is not secured to the milling handle;(d) inserting the assembled milling system into the bone; and(e) activating a drill to rotate the cutting member to form a triangular-shaped cavity in the bone.
  • 40. An in-line milling system for use with a cutting member comprising: (a) a milling handle having a shaft with a longitudinal axis;(b) a milling body adapted to be positioned at least partially within a bone and having a channeled portion and a conical portion, a distal end of the conical portion defining a ledge, the channeled portion and the conical portion adapted to receive the shaft of the milling handle; and(c) a securing system adapted to rigidly lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle, wherein the cutting member is associated with the milling handle and the at least one pre-determined position places the cutting member relative to the ledge and wherein the milling handle comprises a drill receiving portion and a cutting member receiving portion that remain connected at an angle to form an angled joint when the cutting member is not associated with the milling handle.
  • 41. An in-line milling system for use with a cutting member comprising: (a) a milling handle having a shaft with a longitudinal axis;(b) a milling body adapted to be positioned at least partially within a bone, wherein the milling body comprises a channeled portion adapted to receive the milling handle such that the milling handle can translate within the milling body;(c) a drill directing portion connected to the milling handle, the drill directing portion comprising a drill receiving portion and a cutting member receiving portion adapted to receive the cutting member, the drill receiving portion having an axis substantially parallel with the longitudinal axis of the milling handle and the cutting member receiving portion having an axis that is not parallel with the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion, and wherein the cutting member receiving portion is adapted to apply torque about a substantially straight axis shared by both the cutting member receiving portion and the cutting member in use; and(d) a securing system adapted to rigidly lock the milling handle to the milling body in at least one pre-determined position to prevent relative translation between the milling body and the milling handle.
  • 42. A method for preparing a bone for receiving an implant comprising: (a) inserting longitudinally a shaft of a milling handle into a channel portion of a milling body, the milling handle having a longitudinal axis;(b) selecting from a plurality of pre-determined relative positions of the milling handle and the milling body the desired relative position of the milling handle and the milling body;(c) locking the milling handle and the milling body in the desired pre-determined relative position;(d) securing a cutting member to a cutting member receiving portion of the milling handle;(e) connecting a drill to a drill receiving portion of the milling handle, the drill receiving portion having an axis substantially parallel to the longitudinal axis of the milling handle, wherein the drill receiving portion and the cutting member receiving portion remain connected at an angle to form an angled joint when the cutting member is not secured to the cutting member receiving portion;(f) inserting the assembled milling system into the bone; and(g) activating the drill to rotate the cutting member to form a triangular-shaped cavity in the bone.
Parent Case Info

This application claims the benefit of U.S. Provisional Application Ser. No. 60/655,171, filed Feb. 22, 2005 titled “In-Line Milling System” and U.S. Provisional Application Ser. No. 60/730,184 filed Oct. 25, 2005 titled “In-Line Milling System,” the entire contents of each of which are hereby incorporated by reference.

US Referenced Citations (441)
Number Name Date Kind
100602 Coes Mar 1870 A
1076971 Geiger Oct 1913 A
1201467 Hoglund Oct 1916 A
2092869 Baum Sep 1937 A
3412733 Ross Nov 1968 A
3457922 Ray Jul 1969 A
3702611 Fishbein Nov 1972 A
4305394 Bertuch, Jr. Dec 1981 A
4323080 Melhart Apr 1982 A
4393729 Wilson Jul 1983 A
4421112 Mains et al. Dec 1983 A
4456010 Reimels et al. Jun 1984 A
4457307 Stillwell Jul 1984 A
4483554 Ernst Nov 1984 A
4524766 Petersen Jun 1985 A
4534364 Lamoreux Aug 1985 A
4565192 Shapiro Jan 1986 A
4566448 Rohr, Jr. Jan 1986 A
4567885 Androphy Feb 1986 A
4567886 Petersen Feb 1986 A
4574794 Cooke et al. Mar 1986 A
4583554 Mittelman et al. Apr 1986 A
4671275 Deyerle Jun 1987 A
4703751 Pohl Nov 1987 A
4712951 Brown Dec 1987 A
4718413 Johnson Jan 1988 A
4722056 Roberts et al. Jan 1988 A
4738256 Freeman et al. Apr 1988 A
4759350 Dunn et al. Jul 1988 A
4768504 Ender Sep 1988 A
4777942 Frey et al. Oct 1988 A
4802468 Powlan Feb 1989 A
4803976 Frigg et al. Feb 1989 A
4809689 Anapliotis Mar 1989 A
4815899 Regan Mar 1989 A
4875475 Comte et al. Oct 1989 A
4892093 Zarnowski et al. Jan 1990 A
4913163 Roger et al. Apr 1990 A
4938762 Wehrli Jul 1990 A
4952213 Bowman et al. Aug 1990 A
4964862 Arms Oct 1990 A
4991579 Allen Feb 1991 A
5002545 Whiteside et al. Mar 1991 A
5002578 Luman Mar 1991 A
5016639 Allen May 1991 A
5037423 Kenna Aug 1991 A
5037426 Goble et al. Aug 1991 A
5049149 Schmidt Sep 1991 A
5053039 Hofmann et al. Oct 1991 A
5078719 Schreiber Jan 1992 A
5092869 Waldron Mar 1992 A
5094241 Allen Mar 1992 A
5097839 Allen Mar 1992 A
5098426 Sklar et al. Mar 1992 A
5116338 Poggie et al. May 1992 A
5119817 Allen Jun 1992 A
5122144 Bert et al. Jun 1992 A
5129909 Sutherland Jul 1992 A
5147408 Noble Sep 1992 A
5190547 Barber, Jr. et al. Mar 1993 A
5211164 Allen May 1993 A
5213312 MacDonald May 1993 A
5217499 Shelley Jun 1993 A
5230338 Allen et al. Jul 1993 A
5246444 Schreiber Sep 1993 A
5254119 Schreiber Oct 1993 A
5263972 Evans et al. Nov 1993 A
5289826 Kovacevic Mar 1994 A
5305203 Raab Apr 1994 A
5342363 Richelsoph Aug 1994 A
5342366 Whiteside et al. Aug 1994 A
5342969 Ford et al. Aug 1994 A
5360016 Kovacevic Nov 1994 A
5364401 Ferrante et al. Nov 1994 A
5364402 Mumme et al. Nov 1994 A
5365996 Crook Nov 1994 A
5375588 Yoon Dec 1994 A
5379133 Kirk Jan 1995 A
5383454 Bucholz Jan 1995 A
5387218 Meswania Feb 1995 A
5389101 Heilbrun et al. Feb 1995 A
5395376 Caspari et al. Mar 1995 A
5397329 Allen Mar 1995 A
5403320 Luman Apr 1995 A
5423828 Benson Jun 1995 A
5425355 Kulick Jun 1995 A
5445166 Taylor Aug 1995 A
5445642 McNulty et al. Aug 1995 A
5449360 Schreiber Sep 1995 A
5452407 Crook Sep 1995 A
5462548 Pappas et al. Oct 1995 A
5462549 Glock Oct 1995 A
5468244 Attfield et al. Nov 1995 A
5470354 Hershberger et al. Nov 1995 A
5474559 Bertin et al. Dec 1995 A
5484437 Michelson Jan 1996 A
5486178 Hodge Jan 1996 A
5490854 Fisher et al. Feb 1996 A
5491510 Gove Feb 1996 A
5507824 Lennox Apr 1996 A
5514139 Goldstein et al. May 1996 A
5517990 Kalfas et al. May 1996 A
5527316 Williamson Jun 1996 A
5540691 Elmstrom et al. Jul 1996 A
5540694 DeCarlo, Jr. Jul 1996 A
5540695 Levy Jul 1996 A
5540696 Booth, Jr. et al. Jul 1996 A
5569260 Petersen Oct 1996 A
5597379 Haines et al. Jan 1997 A
5598269 Kitaevich et al. Jan 1997 A
5603318 Heilbrun et al. Feb 1997 A
5613969 Jenkins, Jr. Mar 1997 A
5643268 Vilsmeier et al. Jul 1997 A
5643272 Haines et al. Jul 1997 A
5658290 Lechot Aug 1997 A
5669914 Eckhoff Sep 1997 A
5676668 McCue et al. Oct 1997 A
5681316 DeOrio et al. Oct 1997 A
5682886 Delp et al. Nov 1997 A
5683397 Vendrely et al. Nov 1997 A
5688279 McNulty et al. Nov 1997 A
5693056 Carls et al. Dec 1997 A
5695501 Carol et al. Dec 1997 A
5702406 Vilsmeier et al. Dec 1997 A
5704941 Jacober et al. Jan 1998 A
5707370 Berki et al. Jan 1998 A
5709689 Ferrante et al. Jan 1998 A
5715836 Kliegis et al. Feb 1998 A
5716361 Masini Feb 1998 A
5720752 Elliott et al. Feb 1998 A
5722978 Jenkins, Jr. Mar 1998 A
5733292 Gustilo et al. Mar 1998 A
5735904 Pappas Apr 1998 A
5743915 Bertin et al. Apr 1998 A
5748767 Raab May 1998 A
5755725 Druais May 1998 A
5755803 Haines et al. May 1998 A
5769861 Vilsmeier Jun 1998 A
5772593 Hakamata Jun 1998 A
5772594 Barrick Jun 1998 A
5776064 Kalfas et al. Jul 1998 A
5782842 Kloess et al. Jul 1998 A
5792147 Evans et al. Aug 1998 A
5797924 Schulte et al. Aug 1998 A
5799055 Peshkin et al. Aug 1998 A
5800352 Ferre et al. Sep 1998 A
5800438 Tuke et al. Sep 1998 A
5807252 Hassfeld et al. Sep 1998 A
5810827 Haines et al. Sep 1998 A
5810841 McNeirney et al. Sep 1998 A
5817097 Howard et al. Oct 1998 A
5830214 Flom et al. Nov 1998 A
5836954 Heilbrun et al. Nov 1998 A
5848967 Cosman Dec 1998 A
5850836 Steiger et al. Dec 1998 A
5860981 Bertin et al. Jan 1999 A
5865809 Moenning et al. Feb 1999 A
5871018 Delp et al. Feb 1999 A
5871445 Bucholz Feb 1999 A
5879352 Filoso et al. Mar 1999 A
5879354 Haines et al. Mar 1999 A
5880976 DiGioia, III et al. Mar 1999 A
5885296 Masini Mar 1999 A
5885297 Matsen, III Mar 1999 A
5897559 Masini Apr 1999 A
5916221 Hodorek et al. Jun 1999 A
5920395 Schulz Jul 1999 A
5921992 Costales et al. Jul 1999 A
5925049 Gustilo et al. Jul 1999 A
5935128 Carter et al. Aug 1999 A
5938665 Martin Aug 1999 A
5944722 Masini Aug 1999 A
5947971 Kuslich et al. Sep 1999 A
5947973 Masini Sep 1999 A
5951561 Pepper et al. Sep 1999 A
5957926 Masini Sep 1999 A
5961523 Masini Oct 1999 A
5971989 Masini Oct 1999 A
5980526 Johnson et al. Nov 1999 A
5980535 Barnett et al. Nov 1999 A
5999837 Messner et al. Dec 1999 A
6001106 Ryan et al. Dec 1999 A
6002859 DiGioia, III et al. Dec 1999 A
6006126 Cosman Dec 1999 A
6006127 Van Der Brug et al. Dec 1999 A
6007537 Burkinshaw et al. Dec 1999 A
6010506 Gosney et al. Jan 2000 A
6011987 Barnett Jan 2000 A
6016606 Oliver et al. Jan 2000 A
6021342 Brabrand Feb 2000 A
6021343 Foley et al. Feb 2000 A
6022377 Nuelle et al. Feb 2000 A
6026315 Lenz et al. Feb 2000 A
6030391 Brainard et al. Feb 2000 A
6033410 McLean et al. Mar 2000 A
6041249 Regn Mar 2000 A
6044291 Rockseisen Mar 2000 A
6045556 Cohen Apr 2000 A
6050724 Schmitz et al. Apr 2000 A
6053922 Krause et al. Apr 2000 A
6056756 Eng et al. May 2000 A
6068633 Masini May 2000 A
6069932 Peshkin et al. May 2000 A
6073044 Fitzpatrick et al. Jun 2000 A
6077269 Masini Jun 2000 A
6081336 Messner et al. Jun 2000 A
6083163 Wegner et al. Jul 2000 A
6096048 Howard et al. Aug 2000 A
6102916 Masini Aug 2000 A
6132433 Whelan Oct 2000 A
6143390 Takamiya et al. Nov 2000 A
6144875 Schweikard et al. Nov 2000 A
6146390 Heilbrun et al. Nov 2000 A
6148280 Kramer Nov 2000 A
6161033 Kuhn Dec 2000 A
6162190 Kramer Dec 2000 A
6165181 Heilbrun et al. Dec 2000 A
6167145 Foley et al. Dec 2000 A
6167292 Badano et al. Dec 2000 A
6167295 Cosman Dec 2000 A
6167296 Shahidi Dec 2000 A
6168627 Huebner Jan 2001 B1
6174335 Varieur Jan 2001 B1
6185315 Schmucker et al. Feb 2001 B1
6187010 Masini Feb 2001 B1
6190320 Lelong Feb 2001 B1
6190395 Williams Feb 2001 B1
6195168 De Lega et al. Feb 2001 B1
6197064 Haines et al. Mar 2001 B1
6198794 Peshkin et al. Mar 2001 B1
6200316 Zwirkoski et al. Mar 2001 B1
6205411 DiGioia, III et al. Mar 2001 B1
6211976 Popovich et al. Apr 2001 B1
6214011 Masini Apr 2001 B1
6216029 Paltieli Apr 2001 B1
6223067 Vilsmeier et al. Apr 2001 B1
6226548 Foley et al. May 2001 B1
6228090 Waddell May 2001 B1
6228092 Mikhail May 2001 B1
6235038 Hunter et al. May 2001 B1
6236875 Bucholz et al. May 2001 B1
6241735 Marmulla Jun 2001 B1
6249581 Kok Jun 2001 B1
6258095 Lombardo et al. Jul 2001 B1
6258096 Seki Jul 2001 B1
6264647 Lechot Jul 2001 B1
6283971 Temeles Sep 2001 B1
6285902 Kienzle, III et al. Sep 2001 B1
6295513 Thackston Sep 2001 B1
6317616 Glossop Nov 2001 B1
6319256 Spotorno Nov 2001 B1
6332891 Himes Dec 2001 B1
6333971 McCrory et al. Dec 2001 B2
6344853 Knight Feb 2002 B1
6347240 Foley et al. Feb 2002 B1
6351659 Vilsmeier Feb 2002 B1
6351661 Cosman Feb 2002 B1
6377839 Kalfas et al. Apr 2002 B1
6383188 Kuslich et al. May 2002 B2
6385475 Cinquin et al. May 2002 B1
6405072 Cosman Jun 2002 B1
6413261 Grundei Jul 2002 B1
6434507 Clayton et al. Aug 2002 B1
6440140 Bullivant et al. Aug 2002 B2
6443956 Ray Sep 2002 B1
6451059 Janas et al. Sep 2002 B1
6458135 Harwin et al. Oct 2002 B1
6463351 Clynch Oct 2002 B1
6468202 Irion et al. Oct 2002 B1
6477400 Barrick Nov 2002 B1
6478799 Williamson Nov 2002 B1
6484049 Seeley et al. Nov 2002 B1
6490467 Bucholz et al. Dec 2002 B1
6491429 Suhm Dec 2002 B1
6491702 Heilbrun et al. Dec 2002 B2
6494913 Huebner Dec 2002 B1
6503249 Krause Jan 2003 B1
6503254 Masini Jan 2003 B2
6527443 Vilsmeier et al. Mar 2003 B1
6540739 Lechot Apr 2003 B2
6546279 Bova et al. Apr 2003 B1
6551319 Lieberman Apr 2003 B2
6551324 Muller Apr 2003 B2
6551325 Neubauer et al. Apr 2003 B2
6554837 Hauri et al. Apr 2003 B1
6558391 Axelson, Jr. et al. May 2003 B2
6558421 Fell et al. May 2003 B1
6567687 Front et al. May 2003 B2
6574493 Rasche et al. Jun 2003 B2
6595997 Axelson, Jr. et al. Jul 2003 B2
6602259 Masini Aug 2003 B1
6620168 Lombardo et al. Sep 2003 B1
6620268 Cho et al. Sep 2003 B2
6640127 Kosaka et al. Oct 2003 B1
6652142 Launay et al. Nov 2003 B2
6662036 Cosman Dec 2003 B2
6673077 Katz Jan 2004 B1
6675040 Cosman Jan 2004 B1
6685711 Axelson, Jr. et al. Feb 2004 B2
6690964 Bieger et al. Feb 2004 B2
6692447 Picard Feb 2004 B1
6695848 Haines Feb 2004 B2
6702821 Bonutti Mar 2004 B2
6711431 Sarin et al. Mar 2004 B2
6712823 Grusin et al. Mar 2004 B2
6712824 Millard et al. Mar 2004 B2
6716249 Hyde Apr 2004 B2
6718194 Kienzle Apr 2004 B2
6725080 Melkent et al. Apr 2004 B2
6725082 Sati et al. Apr 2004 B2
6728599 Wang Apr 2004 B2
6729211 Snow May 2004 B1
6772026 Bradbury et al. Aug 2004 B2
6780190 Maroney Aug 2004 B2
6785593 Wang Aug 2004 B2
6799088 Wang Sep 2004 B2
6814490 Suhm et al. Nov 2004 B1
6827723 Carson Dec 2004 B2
6836703 Wang Dec 2004 B2
6871117 Wang Mar 2005 B2
6882982 McMenimem Apr 2005 B2
6892112 Wang et al. May 2005 B2
6905514 Carignan et al. Jun 2005 B2
6923817 Carson Aug 2005 B2
6947786 Simon et al. Sep 2005 B2
6993374 Sasso Jan 2006 B2
7001346 White Feb 2006 B2
7035702 Jelonek et al. Apr 2006 B2
7237556 Smothers Jul 2007 B2
7241298 Nemec et al. Jul 2007 B2
20010001120 Masini May 2001 A1
20010014772 Lampotang et al. Aug 2001 A1
20010016745 Bullivant et al. Aug 2001 A1
20010034530 Malackowski et al. Oct 2001 A1
20010036245 Kienzle, III et al. Nov 2001 A1
20010039421 Heilbrun et al. Nov 2001 A1
20020002330 Vilsmeier Jan 2002 A1
20020002365 Lechot Jan 2002 A1
20020007294 Bradbury et al. Jan 2002 A1
20020011594 DeSouza Jan 2002 A1
20020016540 Mikus et al. Feb 2002 A1
20020018981 Andersson et al. Feb 2002 A1
20020029041 Hover et al. Mar 2002 A1
20020032451 Tierney et al. Mar 2002 A1
20020038085 Immerz Mar 2002 A1
20020052606 Bonutti May 2002 A1
20020065461 Cosman May 2002 A1
20020068942 Neubauer et al. Jun 2002 A1
20020072748 Robioneck Jun 2002 A1
20020072821 Baker Jun 2002 A1
20020077533 Bieger et al. Jun 2002 A1
20020077540 Kienzle, III Jun 2002 A1
20020085681 Jensen Jul 2002 A1
20020087101 Barrick et al. Jul 2002 A1
20020095081 Vilsmeier Jul 2002 A1
20020102214 Briley-Saebo et al. Aug 2002 A1
20020107518 Neubauer et al. Aug 2002 A1
20020115934 Tuke Aug 2002 A1
20020133161 Axelson, Jr. et al. Sep 2002 A1
20020133175 Carson Sep 2002 A1
20020147455 Carson Oct 2002 A1
20020151894 Melkent et al. Oct 2002 A1
20020151898 Sohngen et al. Oct 2002 A1
20020156371 Hedlund et al. Oct 2002 A1
20020156479 Schulzki et al. Oct 2002 A1
20020188194 Cosman Dec 2002 A1
20020193800 Kienzle, III et al. Dec 2002 A1
20020198448 Zuk et al. Dec 2002 A1
20020198451 Carson Dec 2002 A1
20020198531 Millard et al. Dec 2002 A1
20030006107 Thompson Jan 2003 A1
20030018338 Axelson, Jr. et al. Jan 2003 A1
20030045883 Chow et al. Mar 2003 A1
20030050643 Taft Mar 2003 A1
20030069591 Carson Apr 2003 A1
20030073901 Simon et al. Apr 2003 A1
20030153829 Sarin et al. Aug 2003 A1
20030153859 Hinshon Aug 2003 A1
20030153978 Whiteside Aug 2003 A1
20030164172 Chumas et al. Sep 2003 A1
20030181918 Smothers et al. Sep 2003 A1
20030187351 Franck et al. Oct 2003 A1
20030187452 Smith et al. Oct 2003 A1
20030192557 Krag et al. Oct 2003 A1
20030225329 Rossner et al. Dec 2003 A1
20040019382 Amirouche et al. Jan 2004 A1
20040030237 Lee et al. Feb 2004 A1
20040030245 Noble et al. Feb 2004 A1
20040054489 Moctezuma De La Barrera Mar 2004 A1
20040073279 Malackowski et al. Apr 2004 A1
20040087852 Chen et al. May 2004 A1
20040097952 Sarin et al. May 2004 A1
20040152970 Hunter et al. Aug 2004 A1
20040153081 Tulkis Aug 2004 A1
20040153083 Nemec et al. Aug 2004 A1
20040167391 Solar et al. Aug 2004 A1
20040171924 Mire et al. Sep 2004 A1
20040243481 Bradbury et al. Dec 2004 A1
20040254586 Sarin Dec 2004 A1
20040260290 Zander et al. Dec 2004 A1
20050021037 McCombs et al. Jan 2005 A1
20050021043 Jansen Jan 2005 A1
20050075632 Russell et al. Apr 2005 A1
20050085715 Dukesherer et al. Apr 2005 A1
20050085822 Thornberry et al. Apr 2005 A1
20050101966 Lavallee May 2005 A1
20050109855 McCombs May 2005 A1
20050113658 Jacobson et al. May 2005 A1
20050113659 Pothier May 2005 A1
20050113846 Carson May 2005 A1
20050119639 McCombs Jun 2005 A1
20050119777 Arbogast et al. Jun 2005 A1
20050124988 Terrill-Grisoni et al. Jun 2005 A1
20050148843 Roose Jul 2005 A1
20050149003 Tierney et al. Jul 2005 A1
20050149041 McGinley Jul 2005 A1
20050154331 Christie et al. Jul 2005 A1
20050159759 Harbaugh et al. Jul 2005 A1
20050177172 Acker Aug 2005 A1
20050197569 McCombs Sep 2005 A1
20050197814 Aram et al. Sep 2005 A1
20050203384 Sati et al. Sep 2005 A1
20050209726 Voit et al. Sep 2005 A1
20050216305 Funderud Sep 2005 A1
20050228266 McCombs Oct 2005 A1
20050228404 Vandevelde Oct 2005 A1
20050234332 Murphy Oct 2005 A1
20050234465 McCombs et al. Oct 2005 A1
20050234466 Stallings Oct 2005 A1
20050234468 Carson Oct 2005 A1
20050245808 Carson Nov 2005 A1
20050279368 McCombs Dec 2005 A1
20050288676 Schnieders Dec 2005 A1
20060015120 Richard et al. Jan 2006 A1
20060149285 Burgi et al. Jul 2006 A1
20060161051 Terrill-Grisoni et al. Jul 2006 A1
20060190011 Ries Aug 2006 A1
20060200025 Elliott Sep 2006 A1
20070118055 McCombs May 2007 A1
20070123912 Carson May 2007 A1
20070169782 Castleman Jul 2007 A1
Foreign Referenced Citations (130)
Number Date Country
042 25 112 Dec 1993 DE
296 00 990 Apr 1996 DE
196 29 011 Jan 1998 DE
197 09 960 Sep 1998 DE
299 06 438 Sep 1999 DE
296 23 941 Nov 2000 DE
200 21 494 Mar 2001 DE
201 03 416 Jul 2001 DE
100 12 042 Aug 2001 DE
100 31 887 Jan 2002 DE
102 07 035 Feb 2002 DE
100 45 381 Apr 2002 DE
202 13 243 Oct 2002 DE
203 09 399 Aug 2003 DE
0 337 901 Oct 1989 EP
0 340 176 Nov 1989 EP
0 216 794 Dec 1989 EP
0 366 488 May 1990 EP
0 376 657 Jul 1990 EP
0 380 451 Aug 1990 EP
0 415 837 Mar 1991 EP
0 466 659 Jan 1992 EP
0 359 097 Aug 1992 EP
0 538 152 Apr 1993 EP
0 538 153 Apr 1993 EP
0 555 003 Aug 1993 EP
0 428 303 Jul 1995 EP
0 676 178 Oct 1995 EP
0 720 834 Jul 1996 EP
0 619 097 Jun 1999 EP
0 1 149 562 Oct 2001 EP
1 033 108 Feb 2002 EP
1 190 676 Mar 2002 EP
1 226 788 Jul 2002 EP
0 782 842 Sep 2002 EP
1 236 450 Sep 2002 EP
1 249 207 Oct 2002 EP
1 348 384 Oct 2003 EP
1 384 456 Jan 2004 EP
0 406 203 Apr 2004 EP
0 406 203 Apr 2004 EP
1 405 603 Apr 2004 EP
1 435 223 Jul 2004 EP
0 327 509 Aug 2004 EP
0 327 509 Aug 2004 EP
1 442 715 Aug 2004 EP
1 459 686 Sep 2004 EP
1 532 946 May 2005 EP
1 563 795 Aug 2005 EP
2 828 397 Feb 2003 FR
2 224 937 May 1990 GB
2 397 769 Aug 2004 GB
2002-304439 Oct 2002 JP
WO 8605384 Sep 1986 WO
WO 8909570 Oct 1989 WO
WO 9417733 Aug 1994 WO
WO 9515714 Jun 1995 WO
WO 9635387 Nov 1996 WO
WO 9716129 May 1997 WO
WO 9723172 Jul 1997 WO
WO 9729683 Aug 1997 WO
WO 9829032 Jul 1998 WO
WO 9846169 Oct 1998 WO
WO 9915097 Apr 1999 WO
WO 9927860 Jun 1999 WO
WO 9960939 Dec 1999 WO
WO 9965380 Dec 1999 WO
WO 0000093 Jan 2000 WO
WO 0021442 Apr 2000 WO
WO 0047103 Aug 2000 WO
WO 0064367 Nov 2000 WO
WO 0101845 Jan 2001 WO
WO 0119271 Mar 2001 WO
WO 0134050 May 2001 WO
WO 0164124 Sep 2001 WO
WO 0167979 Sep 2001 WO
WO 0191647 Dec 2001 WO
WO 0193770 Dec 2001 WO
WO 0224096 Mar 2002 WO
WO 0241794 May 2002 WO
WO 02063236 Aug 2002 WO
WO 02063236 Aug 2002 WO
WO 02064042 Aug 2002 WO
WO 02067783 Sep 2002 WO
WO 02067784 Sep 2002 WO
WO 02067800 Sep 2002 WO
WO 02080824 Oct 2002 WO
WO 03006107 Jan 2003 WO
WO 03015642 Feb 2003 WO
WO 03030787 Apr 2003 WO
WO 03030787 Apr 2003 WO
WO 03034213 Apr 2003 WO
WO 03034933 May 2003 WO
WO 03037192 May 2003 WO
WO 03039377 May 2003 WO
WO 03041566 May 2003 WO
WO 03065931 Aug 2003 WO
WO 03065949 Aug 2003 WO
WO 03068090 Aug 2003 WO
WO 03071969 Sep 2003 WO
WO 03075740 Sep 2003 WO
WO 03079940 Oct 2003 WO
WO 03096870 Nov 2003 WO
WO 2004001569 Dec 2003 WO
WO 2004017842 Mar 2004 WO
WO 2004019792 Mar 2004 WO
WO 2004029908 Apr 2004 WO
WO 2004030556 Apr 2004 WO
WO 2004030559 Apr 2004 WO
WO 2004046754 Jun 2004 WO
WO 2004069036 Aug 2004 WO
WO 2004070580 Aug 2004 WO
WO 2004084740 Oct 2004 WO
WO 2005009303 Feb 2005 WO
WO 2005039430 May 2005 WO
WO 2005041802 May 2005 WO
WO 2005044126 May 2005 WO
WO 2005048851 Jun 2005 WO
WO 2005053559 Jun 2005 WO
WO 2005057439 Jun 2005 WO
WO 2005070312 Aug 2005 WO
WO 2005070319 Aug 2005 WO
WO 2005072629 Aug 2005 WO
WO 2005096982 Oct 2005 WO
WO 2005104977 Nov 2005 WO
WO 2005104978 Nov 2005 WO
WO 2006044367 Apr 2006 WO
WO 2006060631 Jun 2006 WO
WO 2006078236 Jul 2006 WO
WO 2008021494 Feb 2008 WO
Related Publications (1)
Number Date Country
20060229626 A1 Oct 2006 US
Provisional Applications (2)
Number Date Country
60655171 Feb 2005 US
60730184 Oct 2005 US