Patent Application
20110238070
The present disclosure is directed to tools/instruments for use in orthopedic applications and to systems/methods for forming openings and/or cavities in anatomical structures, e.g., bone and cartilage structures. The present disclosure further relates to advantageous applications of the disclosed tools/instruments, systems and methods in clinical (e.g., orthopedic) applications.
Articular cartilage is a complex structure that, once damaged, has little capacity for permanent repair. One technique that has received attention for addressing cartilage-related issues involves repair with living hyaline cartilage through osteochondral autograft transplant (OAT). This procedure is sometimes referred to as mosaicplasty and generally involves removing injured tissue from a damaged area. One or more cylindrical sockets are drilled into the underlying bone and one or more cylindrical plug grafts—consisting of healthy cartilage from the knee—are implanted in each socket. The foregoing procedures and related technology are described in greater detail in a PCT application filed on behalf of John S. Reach, Jr., entitled “Systems, Devices and Methods for Cartilage and Bone Grafting,” in the U.S. Receiving Office under Certificate of Express Mailing dated May 29, 2009. The foregoing PCT application is incorporated herein in its entirety.
Commercially available instruments for use in OAT procedures include Acufex instruments available from Smith & Nephew, Inc. (Andover, Mass.), the COR System available from Innovasive Technologies (Marlborough, Mass.), and the Arthrex Osteochondral Autograft Transfer System available from Arthrex (Naples, Fla.).
Despite efforts to date, a need remains for instruments, systems and methods for efficient, effective and reliable creation of openings and/or cavities in anatomical structures, e.g., bone and cartilage structures. In addition, a need remains for instruments/systems/methods that facilitate deposit of materials that promote healing in such openings and/or cavities. These and other needs are met by the instruments, systems and associated methods disclosed herein.
The present disclosure provides advantageous apparatus, systems and methods for creating openings and/or cavities in anatomical structures, e.g., bone and cartilage structures. The disclosed apparatus deliver a clean and crisp cut to anatomical structures, thereby facilitating interaction with subsequently delivered plugs and/or implants. For example, cartilage implant material may be introduced to openings/cavities formed in a cartilage substrate. In like measure, bone implant material may be introduced to openings/cavities formed in a bone substrate. Thus, the present disclosure is further directed to advantageous clinical (e.g., orthopedic) applications of the disclosed apparatus and systems.
Of note, the disclosed apparatus, systems and methods are effective in depositing materials that promote healing, e.g., bone chips, blood and/or pulp, in such openings and/or cavities during the process of forming such openings/cavities. The deposited materials may be left in place (in whole or in part) to promote healing, e.g., when an implant is positioned in the opening/cavity, or the deposited materials may be harvested (in whole or in part) for use elsewhere in the body. Thus, the design and operation of the disclosed apparatus is generally effective in retaining and/or collecting anatomical materials having potential utility in clinical settings, e.g., without a need for the user to engage in distinct retention and/or collection steps/actions.
Additional features, functions and benefits of the disclosed apparatus, systems and methods will be apparent from the detailed description which follows, particularly when read in conjunction with the accompanying figures.
For a more complete understanding of the present invention, reference is made to the following detailed description of exemplary embodiment(s) considered in conjunction with the accompanying drawings, in which:
The disclosed tools/instruments, systems and methods are adapted to create openings and/or cavities in anatomical structures, e.g., bone and cartilage structures. The openings/cavities created by the disclosed tools/instruments, systems and methods are generally characterized by clean and crisp edges/walls, thereby facilitating interaction with subsequently delivered plugs and/or implants. The disclosed tools/instruments, systems and methods also generally operate to automatically deposit materials generated during the cutting operation in the opening/cavity created thereby. The deposited materials typically include materials that promote healing, e.g., bone chips, blood and/or pulp, and may be left in place (in whole or in part) and/or harvested (in whole or in part) for use elsewhere in the body.
With reference to
With particular reference to shank 106 of instrument component 100, it is noted with reference to
As shown in
In exemplary implementations of the present invention, an instrument component 100 may be mounted with respect to a drive mechanism. To the extent the instrument component 100 includes a “stop” structure and to the extent the stop structure is repositionable, e.g., stop 104, the stop may be positioned at a desired cutting depth. The distal end of the shank 106 of the instrument component 100 is positioned adjacent the anatomical structure-of-interest and the drive mechanism is actuated to cause rotational motion of the shank 106. Control of the cutting rpm may be provided, as is known in the art.
Importantly, the cutting edge 107 of instrument component 100 is rotated such that the cutting edge 107 contacts the structure-of-interest along its tapered surface, thereby forming a clean/crisp cut and feeding the cut materials into the fluted region 109 which substantially deposits such materials in the cavity/opening being formed through the noted cutting action. Thus, with reference to
Through such structural/geometric configuration and rotational motion, the disclosed tools/instruments, systems and methods are effective in generating clean/crisp cutting edges to the structures-of-interest (e.g., bone and cartilage) and further effective in depositing materials generated by such cutting action in the cavity/opening being formed. Of note, by depositing such materials in the cavity/opening—rather than conveying such materials proximally along the instrument shaft—the potential for chipping and other abrasive effects that can translate into surface irregularities are generally avoided. Specifically, as the instrument component 100 rotates about a longitudinal axis in the direction of arrow “A”, the cutting edge cuts downward relative to the surface being penetrated. Due to the fibrous nature of cartilage, “up-cutting,” i.e. standard cutting, will leave an undesirable edge that is not clean or crisp.
In exemplary clinical applications of the disclosed tools/instruments, the shaft portion 102 is mounted relative to a drive mechanism so as to supply a source of rotational motion thereto. The drive mechanism is associated with a power source, as is well known in the art. The shank 106 of the tool/instrument is then positioned adjacent a desired anatomical location. In exemplary clinical uses, an incision and/or dissection is required to gain access to the desired anatomical location. Alternatively, the disclosed tools/instruments may be used in a minimally invasive manner, e.g., through a cannula, arthroscope or other access device.
Once the shank 106 of the disclosed tool/instrument is brought adjacent to the desired anatomical structure, e.g., bone or cartilage, the drive mechanism is actuated so as to deliver rotational force to the shank 106. As noted above, the direction of rotation is determined by the geometric arrangement of the shank 106 but, in the case of the exemplary embodiment depicted in
The advantageous cutting features of the disclosed tool/instrument are effective to create openings and/or cavities in the targeted anatomical structures, e.g., bone and cartilage structures. The openings/cavities are generally characterized by clean and crisp edges/walls, thereby facilitating interaction with subsequently delivered plugs and/or implants. In addition, the cutting action of the disclosed tools/instruments automatically deposit materials generated during the cutting operation in the opening/cavity created thereby. The deposited materials typically include materials that promote healing, e.g., bone chips, blood and/or pulp, and may be left in place (in whole or in part) and/or harvested (in whole or in part) for use elsewhere in the body.
The buffer 120 may be compressible and generally functions to provide a cushion upon full insertion of the shank 106 into an anatomical structure during clinical use of the disclosed apparatus/systems. Specifically, the stop 104 can be positioned to a desired cutting depth and the buffer 120 positioned so that the planar surface 105 of the stop 104 does not forcefully engage the anatomical structure, but rather the buffer 120 engages the anatomical structure and provides a cushioned stop. Even further, the buffer 120 may function as a stop whereby a user can set the buffer 120 to a desired cutting depth and then choose to provide a deeper cut when at the set depth by compressing the buffer 120.
Although the tools/instruments, systems and methods of the present disclosure have been described with reference to exemplary embodiments, the present disclosure is not limited by or to such exemplary embodiments. Rather, the tools/instruments, systems and methods of the present disclosure are susceptible to many variations, modifications and/or implementations without departing from the spirit or scope of the present disclosure.
The present application claims the benefit of a co-pending provisional patent application entitled “Orthopedic Downcutting Instrument and Associated Systems and Methods”, which was filed on Mar. 1, 2010, and assigned Ser. No. 61/309,057. The entire contents of the foregoing provisional patent application are incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 61309057 | Mar 2010 | US |
