CN102781346B - For producing the apparatus of micro-fracture in bone - Google Patents
For producing the apparatus of micro-fracture in bone Download PDFInfo
- Publication number
- CN102781346B CN102781346B CN201080045022.XA CN201080045022A CN102781346B CN 102781346 B CN102781346 B CN 102781346B CN 201080045022 A CN201080045022 A CN 201080045022A CN 102781346 B CN102781346 B CN 102781346B
- Authority
- CN
- China
- Prior art keywords
- micro
- fracture
- tip
- bone
- pierce
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
- 208000013201 Stress fracture Diseases 0.000 title claims abstract description 77
- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 44
- 210000005065 subchondral bone plate Anatomy 0.000 claims abstract description 47
- 238000013519 translation Methods 0.000 claims abstract description 10
- 238000005452 bending Methods 0.000 claims abstract description 8
- 238000004804 winding Methods 0.000 claims abstract description 7
- 239000012530 fluid Substances 0.000 claims description 40
- 238000000034 method Methods 0.000 abstract description 14
- 238000007790 scraping Methods 0.000 abstract description 5
- 210000000845 cartilage Anatomy 0.000 description 10
- 230000014616 translation Effects 0.000 description 6
- 238000005553 drilling Methods 0.000 description 5
- 230000005540 biological transmission Effects 0.000 description 4
- 230000006378 damage Effects 0.000 description 4
- 230000009471 action Effects 0.000 description 3
- 210000001188 articular cartilage Anatomy 0.000 description 3
- 230000007547 defect Effects 0.000 description 3
- 230000002950 deficient Effects 0.000 description 3
- 230000008569 process Effects 0.000 description 3
- 108090000723 Insulin-Like Growth Factor I Proteins 0.000 description 2
- 241000446313 Lamella Species 0.000 description 2
- 102000013275 Somatomedins Human genes 0.000 description 2
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 229940035676 analgesics Drugs 0.000 description 2
- 239000000730 antalgic agent Substances 0.000 description 2
- 230000003115 biocidal effect Effects 0.000 description 2
- 239000012809 cooling fluid Substances 0.000 description 2
- 238000013461 design Methods 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 210000000629 knee joint Anatomy 0.000 description 2
- 230000007246 mechanism Effects 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 230000008439 repair process Effects 0.000 description 2
- 238000007789 sealing Methods 0.000 description 2
- 210000000130 stem cell Anatomy 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 210000003813 thumb Anatomy 0.000 description 2
- SQDAZGGFXASXDW-UHFFFAOYSA-N 5-bromo-2-(trifluoromethoxy)pyridine Chemical compound FC(F)(F)OC1=CC=C(Br)C=N1 SQDAZGGFXASXDW-UHFFFAOYSA-N 0.000 description 1
- 241001061264 Astragalus Species 0.000 description 1
- 229920001287 Chondroitin sulfate Polymers 0.000 description 1
- 102000010834 Extracellular Matrix Proteins Human genes 0.000 description 1
- 108010037362 Extracellular Matrix Proteins Proteins 0.000 description 1
- 102000009123 Fibrin Human genes 0.000 description 1
- 108010073385 Fibrin Proteins 0.000 description 1
- BWGVNKXGVNDBDI-UHFFFAOYSA-N Fibrin monomer Chemical compound CNC(=O)CNC(=O)CN BWGVNKXGVNDBDI-UHFFFAOYSA-N 0.000 description 1
- 229920002683 Glycosaminoglycan Polymers 0.000 description 1
- 241001074085 Scophthalmus aquosus Species 0.000 description 1
- 229910000831 Steel Inorganic materials 0.000 description 1
- 239000012190 activator Substances 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- 229910045601 alloy Inorganic materials 0.000 description 1
- 210000000544 articulatio talocruralis Anatomy 0.000 description 1
- 235000006533 astragalus Nutrition 0.000 description 1
- 230000000975 bioactive effect Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 210000001185 bone marrow Anatomy 0.000 description 1
- 210000001612 chondrocyte Anatomy 0.000 description 1
- 229940059329 chondroitin sulfate Drugs 0.000 description 1
- 230000006866 deterioration Effects 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 229920001971 elastomer Polymers 0.000 description 1
- 239000000806 elastomer Substances 0.000 description 1
- 210000001513 elbow Anatomy 0.000 description 1
- 210000002744 extracellular matrix Anatomy 0.000 description 1
- 229950003499 fibrin Drugs 0.000 description 1
- 210000001624 hip Anatomy 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 239000007788 liquid Substances 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 229910001000 nickel titanium Inorganic materials 0.000 description 1
- 201000008482 osteoarthritis Diseases 0.000 description 1
- 210000004417 patella Anatomy 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 230000001172 regenerating effect Effects 0.000 description 1
- 238000010079 rubber tapping Methods 0.000 description 1
- 210000002832 shoulder Anatomy 0.000 description 1
- 239000002002 slurry Substances 0.000 description 1
- 239000007921 spray Substances 0.000 description 1
- 239000010959 steel Substances 0.000 description 1
- 239000000725 suspension Substances 0.000 description 1
- 210000004233 talus Anatomy 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 238000012546 transfer Methods 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
- A61B17/1644—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans using fluid other than turbine drive fluid
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
- A61B17/1604—Chisels; Rongeurs; Punches; Stamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
- A61B17/1662—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans for particular parts of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
- A61B17/1644—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans using fluid other than turbine drive fluid
- A61B2017/1651—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans using fluid other than turbine drive fluid for cooling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/007—Auxiliary appliance with irrigation system
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Engineering & Computer Science (AREA)
- Dentistry (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
Provide a kind of in subchondral bone, produce micro-fracture when not scraping apparatus and using method thereof.This apparatus comprises the outer sleeve with the shank be connected on hollow pipe, and wherein, the end of pipe is bending, and comprises in order to by the feature of end winding support on subchondral bone.Provide and pierce through element, and it is designed through outer sleeve, and the translation and/or rotate in subchondral bone by outer sleeve when directed.The end of piercing through element has and allows tip to be penetrated into surface in bone, and to provide the micro-fracture by bone, and apparatus without the need to carrying out scraping on subchondral bone.
Description
background of invention
correlation technique
The damage of articular cartilage and defect are frequent, and can cause serious stress and strain to joint.Typically, articular cartilage cannot oneself repair or recovery from illness, and if do not obtain medical treatment, articular cartilage can develop into osteoarthritis.Micro-fracture is the process being usually used for treating Articulatory Defect and damage.Micro-fracture comprises and penetrates subchondral bone, to cause the formation of fibrin grumeleuse, and causes primordial stem cell to move to defective cartilage site from bone marrow.As United States Patent (USP) 6,960, described in 214, the base portion in defective region is scraped or is wiped, and to cause bleeding, then uses micro-fracture apparatus in subcartilaginous osseous lamella, produce aperture or micro-fracture.In some operations, impact the end of apparatus in a manual fashion with hammer or other this apparatus.Apparatus penetrates vascular territory, thus generation diameter is the hole of 2-3mm, and hole is penetrated into the degree of depth of 3-4mm in subcartilaginous osseous lamella in articular bone surface.Then this will form grumeleuse on ready bone bed, and grumeleuse will regenerate, to form cartilage.
Angle residing when shortcoming about known micro-fracture apparatus is apparatus process subchondral bone.Specifically, if micro-fracture apparatus is not orthogonal to bone surface and directed, when with hammer or pneumatic tool impact, apparatus can scraping or beat on bone surface.This can lead to complications to micro-fracture operation, and cause bad grumeleuse to be formed and regenerating bone or cartilage long.Checked by hip arthroscopy, this vertical orientation realizing current apparatus and bone surface is very difficult, this is because the degree of depth in joint, the confined space between femoral head and acetabular bone, and the reason of the orientation of entrance and bone surface.Even if current apparatus can be bending at its tip place, but do not apply necessary power perpendicular to bone surface.In addition, most of full thickness cartilage infringement comprises the superolateral surface of acetabular bone.Be difficult to make this region produce micro-fracture with apparatus available at present, because in fact subchondral bone cannot be generally perpendicular to existing micro-fracture pick apply power.Micro-fracture for the other parts of Patella, astragalus, coronoid process and knee joint and shoulder is also like this.
The power of impact apparatus makes apparatus tendency of scraping on bone surface more complicated.Other problem about the apparatus of prior art is, they carry out work often through drilling, and this action is easy to cause tissue deterioration; In addition, use these apparatuses to produce heat, and therefore also usually hot injury can occur.Therefore, having such apparatus will be desirable: it contributes to being generally perpendicular to bone surface and orientation to carry out micro-Fracture Technique during the arthroscopy in hip and other joint, and make the power piercing through element to be generally perpendicular to bone surface, and be generally perpendicular to bone surface and guide this power.Also by desirable: apparatus to be rotated by bone drill or screw tip with lower friction and drilling in subchondral bone, thus promotion has lower velocity variations along the direction of force of piercing.This design will reduce the scraping power seen when traditional micro-fracture pick.
Invention field
The present invention relates to the apparatus for repairing cartilage defects, and more specifically, relate to for performing micro-fracture to repair the apparatus of cartilage on subchondral bone.
summary of the invention
According to one embodiment of present invention, provide a kind of micro-fracture apparatus, what it comprised the guide member that can comprise outer sleeve and extended through this outer sleeve pierces through element.Outer sleeve comprises the shank be connected on hollow pipe, and wherein, the end of pipe is bending, and comprises in order to by the feature of end winding support on subchondral bone.Pierce through element design to become to be contained in outer sleeve, and the translation and/or rotate in subchondral bone by outer sleeve.Pierce through element and have flexible end portion part, flexible end portion part has tip, flexible end portion part allows tip to be penetrated in bone, to provide the micro-fracture by bone.Piercing through element can for good and all be connected on sleeve.Piercing through element can integrally or partly be attached on sleeve removedly.The flexible end portion part thereon with tip can be interchangeable, or tip can be separately interchangeable.In one embodiment, the tip of flexible end portion part had before operating means, to allow tip to be fixed to sawtooth on bone.
In another embodiment of the present invention, a kind of method making subchondral bone produce micro-fracture comprises the following steps: provide micro-fracture apparatus, and micro-fracture apparatus comprises: the outer sleeve with shank; Be connected to the pipe extended vertically on shank and from shank, the end of pipe is bending, and comprise for by the end winding support of pipe to the device on subchondral bone; Tip near the crooked end of pipe; And to be contained in outer sleeve and extend through outer sleeve pierce through element.In the method, surgeon, close to subchondral bone, removes any unnecessary cartilage from subchondral bone.Once produce clean position or field of operation, place micro-fracture apparatus, make the tip of micro-fracture apparatus on subchondral bone; Element will be pierced through through micro-fracture apparatus, and abut against subchondral bone and engage and pierce through element, to make bone produce micro-fracture.To understand, revise the method by such mode: the device assembled in advance is placed to and abut against bone, and that is have the apparatus piercing through element to be placed to abut against bone by pre-assembled.
In an alternative embodiment, provide a kind of micro-fracture apparatus, it comprises the outer sleeve with shank and is connected to the pipe extended vertically on shank and from shank.The end of the pipe of embodiment is bending, and comprise for by the end winding support of pipe to the device on subchondral bone.This device comprise further be contained in outer sleeve and extend through outer sleeve pierce through element, pierce through element and comprise for the tip to bone carrying capacity.But this embodiment also comprises fluid port and in order to fluid is transported to device near the end of piercing through element tip from fluid port.In use, piercing through element can translation and rotation in exterior tube, and with by providing power to make subchondral bone produce micro-fracture to subchondral bone, and fluid can be transported to the site of bone as required.During the operation of type involved in the present invention, such as anesthetis, antibiotic, flush fluid, cooling fluid, somatomedin, analgesics in fluid form can be used or produce or improve the fluid of micro-fracture even under stress or be found to have the fluid of recovery or the comfortable any fluid helping patient.In one embodiment, pierce through element and comprise and being connected on fluid port and the intubate manifested near tip, fluid is transported through wherein.In another embodiment, pierce through element and comprise the trough of belt outward flange be connected on fluid port, fluid is traversed near tip from port at outer sleeve and piercing through between element.The tip of this embodiment will comprise applicable edge, make fluid can proceed to field of operation along the edge of tip.
In any embodiment of the invention, micro-fracture apparatus can comprise such as the flip-flop element in pistol, and flip-flop element alternatively furthers tip, and abuts against bone and discharge tip, to cause micro-fracture.The control provided for user in this device applies power with the accuracy improved to bone by allowing.
In using method of the present invention, once get out field of operation, just can the tip of deployment instrument, make to pierce through element and be generally perpendicular to the surface of bone and impact bone.In another embodiment, the method can comprise the following steps: be attached to by surgical drill and pierce through on element, and starts brill, to make bone produce micro-fracture, or manual activator mechanism is attached to and pierces through on element, and repeatedly engage trigger, produce micro-fracture to make bone.When use there is the device of fluid delivery device time, the method can comprise the following steps: be designed to assist cartilage-derived growth or to protect from infection or the comfortable fluid that contributes to patient comes constantly, repeatedly or occasionally cleans field of operation or its specific region.
According to the detailed description hereinafter provided, other application of the present invention will become apparent.Should be appreciated that when providing embodiments of the invention, detailed description and instantiation are only intended for illustrative object, and are not intended to limit the scope of the invention.
accompanying drawing is sketched
According to the detailed description and the accompanying drawings, the present invention will more fully be understood, wherein:
Fig. 1 is the perspective view according to micro-fracture apparatus of the present invention.
Fig. 2 be show in Fig. 1 and the perspective view piercing through element removed in the outer sleeve shown from Fig. 1.
Fig. 3 is the perspective view of the tip of the micro-fracture apparatus shown in Fig. 1.
Fig. 3 A is the perspective view of an alternative of the tip of the micro-fracture apparatus shown in Fig. 1.
Fig. 4 A is the perspective cutaway view of the micro-fracture apparatus shown in Fig. 1, which show take out in Fig. 2 show pierce through element time handle.
Fig. 4 B be the end sections of the micro-fracture apparatus shown in Fig. 1 take out in Fig. 2 show pierce through element time perspective view.
Fig. 4 C is the perspective view of the end sections of the micro-fracture apparatus shown in Fig. 1, which show the handle pierced through when element stretches out shown in fig. 2.
Fig. 4 D is the perspective view pierced through when element stretches out shown in fig. 2 of the handle of the micro-fracture apparatus shown in Fig. 1.
Fig. 5 A and 5B is the cross sectional elevation of an alternative of the device made according to instruction of the present invention.
Fig. 6 is the sectional view of another alternative of the device made according to instruction of the present invention.
Fig. 7 is the sectional view of another alternative of the device made according to instruction of the present invention.
Fig. 8 is the sectional view of another alternative of the device made according to instruction of the present invention
Fig. 9 is the partial section of piercing through element of one embodiment of the present of invention.
Figure 10 is the front view piercing through the front portion of the tip of element of the embodiment of Fig. 9.
Figure 11 is the partial section of piercing through element of one embodiment of the present of invention.
Figure 12 is the front view piercing through the front portion of the tip of element of the embodiment of Figure 11.
detailed description of preferred embodiment
Although the present invention admits of various forms of embodiment, show the many presently preferred embodiments discussed in more detail below in the drawings.Should be appreciated that and will think that the disclosure is illustration of the present invention, and the disclosure is not intended to the specific embodiment that limit the invention to illustrate.Should understand further, the title of this part (" detailed description of exemplary embodiment ") of the application is relevant with the requirement of USPO, and should not think to limit theme disclosed herein.
Fig. 1 shows during the arthrocsopic surgery of hip and other joint and bone for the micro-fracture apparatus 10 in micro-Fracture Technique.Micro-fracture apparatus 10 comprises outer sleeve 12 and pierces through element 14 with the inner flexible extending through outer sleeve 12.
The rigid hollow pipe 20 that outer sleeve 12 has shank 16 and extends vertically from shank 16, wherein, pipe 20 can fixedly or removedly be attached on shank 16.See Fig. 4 A, limit passage 22 by shank 16 and pipe 20, and passage 22 is configured to reception pierces through element 14.In one embodiment (substantially see Fig. 4), outer sleeve 12 has the profile from shank 16 to hollow pipe 20 convergent.Alternatively, outer sleeve 12 can be formed with one or more transition parts of the small diameter near the end sections 24 from the larger diameter near shank 16 to pipe 20, optimizes its hardness with (except other reason) in the length of outer sleeve 12.
Outer sleeve 12 can be constructed thereon according to by the requirement of the micro-fracture used on the joint of apparatus 10.Thus, depend on the desired use of outer sleeve and bone or the joint of outer sleeve, outer sleeve will be used thereon can be built into all size, shape, camber and the angle with the specific joint being configured for such as (but not limited to) hip, shoulder, knee joint, elbow and ankle.In addition, in a preferred embodiment, the profile of end sections 24 is farthest reduced, to improve joint proximity and location.
The end sections 24 of pipe 20 also bends with the optimized angle between about thirty degrees to approximately ninety degrees relative to pipe 20, with the shaving power reducing to apply on subchondral bone during producing micro-fracture.Although it will be appreciated by the skilled addressee that, as preferred embodiment to provide the scope of angle, the angle from zero degree to 180 degree is feasible, and does not depart from novel scope of the present invention.Specifically, the angle of end sections 24 allows end sections 24 to be positioned to preferred substantially vertical with subchondral bone structure.In a preferred embodiment of the invention, general shank is used to allow the pipe 20 of any angle to exchange with the pipe (see Fig. 3 A) of the end sections with another angle as required for concrete operation application.In a preferred embodiment, end sections 24 also can comprise jagged edge or end wall 26, to assist the end sections 24 of apparatus 10 to be fixed on subchondral bone during micro-Fracture.It will be appreciated by the skilled addressee that other device and/or the tube end feature of such as single or multiple anchor point or pin etc. can assist end sections 24 to be fixed on bone, and do not depart from novel scope of the present invention.
In an alternative of device of the present invention, as shown in Figure 5, in order to adapt to specific joint or bone further, by using the wire rod and/or cable 240 that are arranged in the wall of pipe 220, outer sleeve 212 curves joint from straight position and bends to bending position.The angle of end sections 224 is adjustable in the scope of about 0 degree to 180 degree.Shank 216 comprises thumb wheel 260, to allow the angle of user adjustment end part 224.Certainly, as one of ordinary skill will appreciate, button or slide block can be used to replace thumb wheel, and do not depart from novel scope of the present invention.And, as one of ordinary skill will appreciate, the different actuating assembly of such as (but not limited to) electronics, hydraulic pressure or manual actuation part can be used to bend to make end sections 224.
Outer sleeve 12 and 212 comprises the passage 22 or 222 limited by outer sleeve 12 and 212.Pierce through element 14 translation and/or be rotated through passage 222 and 22.Allow to pierce through the angle of element 14 through the end sections 224 and 24 of pipe 20 and 220 at the flexible portion 30 of the end of piercing through element 14.Make, and such as spring and other form can be formed as one in the group that flexible portion 30 can be made up of elastomer, plastics, rustless steel, NiTi alloy or their combination, as below by illustrating further.In another embodiment, flexible portion 30 is configured to axial load and spin load to be transferred to subchondral bone.Therefore, flexible portion 30 can be made up of flexible transfer pipeline, the wire rod (such as velometer cable) that such as stacked interlaced helical is wound around.
In the operation of device of the present invention, the tip 27 of piercing through element 14 is configured to be penetrated in subchondral bone.Tip 27 can be selected from comprise micro-fracture tip, trough of belt apex point portion, chit drill and/or " K wire rod " type tip group in any one, and do not depart from novel scope of the present invention.In addition, various shape can be taked in tip 27, such as: taper shape, tubulose and zigzag.In addition, tip 27 can comprise the cutting edge of one or more sharpening, or can have the trocar tip with one or more plane.In another embodiment, tip 27 is level and smooth, does not have cutting edge, or has coarse sandpaper-like surface.To understand, more slowly drilling so that the self-tapping screw reducing friction is preferred, can thus reduce the probability of division and hot injury.
Pierce through element 14 and comprise the handle 28 being positioned at the end relative with tip 27 further.Pin 32 extends from handle 28, and is configured to allow to pierce through on cylinder bur or other rotary apparatus that element 14 is connected to standard, makes to pierce through element 14 rotatable, to get in subchondral bone, to cause micro-fracture while the shaving power producing minimum.Alternatively, available hammer or similar operating theater instruments clash into handle 28, extend to subchondral bone from outer sleeve 12 to make piercing through element 14.The end advance making to pierce through element 14 and/or other device rotated can be comprised at shank 16, or at these devices of applications, such as, by use pneumatic equipment, electronic equipment, hydraulic test, spring action, other people's force mechanisms or these any combination causing necessity and enough translations and/or rotation.In the type of available device, screw type can be used to construct and to make to pierce through element 14 translation simultaneously and rotation.In drilling and/or during clashing into, the angle of end sections 24 and 224 makes to pierce through element 14 can make subchondral bone produce micro-fracture, prevents shaving power from making apparatus 10 shaving on subchondral bone simultaneously.
It will be understood by those skilled in the art that before the surgery, prepared the site of micro-fracture by the cartilage flap that removes the surrounding in defective region and the calcified cartilage layer of top that removes subchondral bone.Then the outer sleeve 16 of device is inserted in joint or adjacent bone, end sections 224 and 24 to be positioned in expect in the region of micro-fracture less perpendicular on subchondral bone.
In the exemplary embodiment, the jagged edge 26 and 226 of end sections 24 and 224 is fixed on subchondral bone, moves during micro-Fracture to prevent apparatus 10 due to shaving power.Then promote to pierce through element 14 by outer sleeve 12, until tip 27 contacts subchondral bone.When tip 27 is positioned against subchondral bone, pierces through element 14 and clashed into and/or rotate and in subchondral bone, produce micro-fracture.In one embodiment, bore to advance by the standard clinical be connected on the pin 32 of handle 28 and pierce through element 14, thus in subchondral bone, get out micro-fracture.Alternatively, clash into handle 28 by hammer or similar operating theater instruments, extend, to clash into subchondral bone from outer sleeve end sections 24 and 224 to make piercing through element tip 27.In yet another embodiment, use and pierce through element 14 and clash into and drilling subchondral bone simultaneously.During micro-fracture operation, end sections 24 and 224 can reduce the shaving power on apparatus 10 relative to the angle of pipe 20 and 220, thus prevents apparatus 10 shaving or slip on subchondral bone.
Then can from field of operation apparatus for removing, with close to the micro-fracture in subchondral bone.If necessary, repeat micro-Fracture, to produce micro-fracture hole of right quantity, to cover the subchondral bone surface region exposed.
Referring now to Fig. 6, show an alternative embodiment of the invention.To see in figure 6, the driving force that can control with the body action of user or motive power combine any device of use embodiment above.In figure 6, the housing 16 of Fig. 1 is replaced by sealing cover 300, and as illustrated, sealing cover 300 holds the transmission nut 302 be communicated with to cooperatively with driving screw 304.Transmission nut 302 is attached on flip-flop element 306, thus gives the motive power that transmission nut makes driving screw 304 advance.Driving screw 304 is communicated with micro-fracture tip 308 to cooperatively, and make when device is placed in its work structuring (as described in detail above), tip 308 is driven in bone by the startup of flip-flop element 306.As one of ordinary skill will appreciate, draw trigger 306 by user and start tip 308, driving screw 304 and transmission nut 302, the present embodiment uses element to provide ability power being passed to bone for user.The element of such as trigger reset spring 310 and translation back-moving spring and trigger pivotal point 314 will be necessary, and can variously and/or use various device element to manufacture, as one of ordinary skill will appreciate.Although show the mechanical means triggering repeatability impact, but will understand, multiple device can be suitable for the impact providing identical type, such as, can utilize electronic equipment, servo motor, hydraulic unit driver and other use, and not depart from the novel scope of the present embodiment.
Referring now to Fig. 7 and 8, show the extra element of any embodiment that can be suitable for showing or any micro-fracture device for this object herein.Knownly usually fluid is incorporated into field of operation and carrys out assisting operation and/or make patient have comfortable and kilter.At the intra-operative of type involved in the present invention, such as anesthetis, the antibiotic in fluid form, flush fluid, cooling fluid, somatomedin, analgesics, suspension stem cell, chondrocyte, other bioactive substance (such as extracellular matrix can be used, comprise Dan Baiduotang proteoglycan PG, mucopolysaccharide (GAG), chondroitin sulfate and/or under stress to produce or to improve the fluid of micro-fracture), and/or find that there is and help patient and recover or the fluid of comfortable any fluid (comprising gel).Thus, show in figures 7 and 8 in order to introduce such fluid means and method by the necessary mode of assisting operation.Those skilled in the art will appreciate that, term " fluid " uses in the meaning that it is the most wide in range, be suspended in any liquid in fluid or gel or gelatinous mass or many kinds of substance (comprise listed above in those whole) to comprise, and find the slurry that can advance in the device made according to the present invention and equivalents thereof.
Fig. 8 is the illustration of device of the present invention, and this device has fluid loading structure along the main shaft of device.In this device, show fluid carrying elements 320 (such as (but being not limited to) syringe) and there is the delivery port 322 coaxial with the main shaft M of device.In this device 318 (in this example, only unrestricted for illustration purposes, device 318 is configured to the device being similar to Fig. 6), pierce through element 324 and limit fluid and can flow through intubate 326 wherein.As shown in Fig. 9 and 10, substantially medially cross pierce through element time, intubate 326 can manifest on the face 308f of tip 308, and the effect of tip 308 can not be weakened owing to introducing opening, and be still directed to by fluid needs place simultaneously.In the figure 7, show similar structure, just introduce fluid (in any mode known in the art, comprise the mechanical connection of display and/or spray in order to the syringe based on pin) by sidewall 322.In the embodiment of Fig. 7, fluid is by the length at the inwall of sheath 368 and the groove pierced through between element 324 or passage through sheath 368.As shown in Figure 11 and 12, end mill(ing) cutter 330 can be produced, make to transmit fluid towards tip 308 around it, and fluid be left by the end of passage 330c.To understand, this embodiment is shown as illustrative, and does not mean that as restrictive, it will be appreciated by the skilled addressee that combination or displacement are feasible, and does not depart from novel scope of the present invention.
Because various amendment can be made to exemplary embodiment, described by the illustration above with reference to correspondence, and do not depart from scope of the present invention, and so it is intended that comprise all the elements shown in the foregoing written description and in the accompanying drawings and all should be interpreted as illustrative, and unrestriced.Thus, width of the present invention and scope should not limited by any above-described exemplary embodiment, but should only limit according to claims and equivalents thereof.
Claims (12)
1. a micro-fracture apparatus, comprising:
There is the outer sleeve of shank;
Be connected to the pipe extended vertically on described shank and from described shank, the end of described pipe is bending, and comprise for by the end winding support of described pipe to the device on subchondral bone;
To be contained in described outer sleeve and extend through described outer sleeve pierce through element; And
Wherein, described in pierce through element can translation and rotation in described outer sleeve, produce micro-fracture to make described subchondral bone.
2. micro-fracture apparatus according to claim 1, is characterized in that, described in pierce through element there is flexible end portion part, described flexible end portion part has tip, and described flexible end portion part allows described tip to be penetrated in described bone, to provide micro-fracture.
3. micro-fracture apparatus according to claim 1, is characterized in that, described in pierce through element and can for good and all be connected on described sleeve.
4. micro-fracture apparatus according to claim 1, is characterized in that, described in pierce through element and can integrally or partly be attached on described sleeve removedly.
5. micro-fracture apparatus according to claim 2, is characterized in that, the described flexible end portion part thereon with described tip can be exchanged with other end sections.
6. micro-fracture apparatus according to claim 5, is characterized in that, the described tip of described flexible end portion part can exchange with other tip.
7. micro-fracture apparatus according to claim 5, is characterized in that, the described tip of described flexible end portion part has sawtooth.
8. micro-fracture apparatus according to claim 1, is characterized in that, for by the end winding support of described pipe to the described device on subchondral bone being the zigzag tip of the end of described pipe.
9. a micro-fracture apparatus, comprising:
There is the outer sleeve of shank;
Be connected to described shank and the pipe extended vertically from described shank, the end of described pipe is bending, and comprise for by the end winding support of described pipe to the device on subchondral bone;
To be contained in described outer sleeve and extend through described outer sleeve pierce through element, described in pierce through element and comprise for the tip to bone carrying capacity;
Fluid port and in order to pierce through element tip described in being transported to from described fluid port by fluid end near device, and
Wherein, described in pierce through element can translation and rotation in described outer sleeve, with by providing power to make described subchondral bone produce micro-fracture to described subchondral bone, and fluid can be transported to the site of described bone as required.
10. micro-fracture apparatus according to claim 9, is characterized in that, described in pierce through element and comprise and being connected on described fluid port and the intubate manifested near described tip.
11. micro-fracture apparatuses according to claim 9, it is characterized in that, the described element that pierces through comprises the trough of belt outward flange be connected on described fluid port, and fluid is traversed near described tip from described port at described outer sleeve and described piercing through between element.
12. micro-fracture apparatuses according to claim 9, it is characterized in that, described micro-fracture apparatus comprises trigger element, and described trigger element alternatively furthers described tip, and abuts against bone and discharge described tip, rotate or translation or their any combination.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US23003909P | 2009-07-30 | 2009-07-30 | |
| US61/230039 | 2009-07-30 | ||
| PCT/US2010/043746 WO2011014677A1 (en) | 2009-07-30 | 2010-07-29 | Instrument for creating microfractures in a bone |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN102781346A CN102781346A (en) | 2012-11-14 |
| CN102781346B true CN102781346B (en) | 2015-11-25 |
Family
ID=43529701
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201080045022.XA Expired - Fee Related CN102781346B (en) | 2009-07-30 | 2010-07-29 | For producing the apparatus of micro-fracture in bone |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP2459082A4 (en) |
| JP (1) | JP5815522B2 (en) |
| CN (1) | CN102781346B (en) |
| AU (1) | AU2010278867B2 (en) |
| WO (1) | WO2011014677A1 (en) |
Families Citing this family (18)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2009129272A2 (en) | 2008-04-15 | 2009-10-22 | Lonnie Paulos | Tissue microfracture apparatus and methods of use |
| AT510503B1 (en) * | 2010-10-01 | 2013-06-15 | Gebhart Christoph G | DEVICE WITH FIXING DEVICE |
| DE102011013888A1 (en) * | 2011-03-07 | 2012-09-13 | Karl Storz Gmbh & Co. Kg | Medical plunge tool |
| DE102011100695B4 (en) * | 2011-05-06 | 2013-10-31 | Richard Wolf Gmbh | Mikrofraktor |
| PL2822483T3 (en) | 2012-03-09 | 2016-05-31 | George J Sikora | Microfracture apparatuses |
| BR112015022177A2 (en) * | 2013-03-14 | 2017-07-18 | Smith & Nephew Inc | microfracture punch |
| KR101429395B1 (en) * | 2013-03-22 | 2014-08-13 | 가톨릭대학교 산학협력단 | Joint parts for drilling equipment |
| WO2015041888A1 (en) | 2013-09-23 | 2015-03-26 | Sikora George J | Microfracture apparatuses |
| US10076385B2 (en) | 2013-12-08 | 2018-09-18 | Mazor Robotics Ltd. | Method and apparatus for alerting a user to sensed lateral forces upon a guide-sleeve in a robot surgical system |
| US9808264B2 (en) | 2014-05-21 | 2017-11-07 | The Uab Research Foundation | Hinged microfracture awls |
| US10702395B2 (en) | 2014-10-01 | 2020-07-07 | Arthrosurface, Inc. | Microfracture apparatuses and methods |
| WO2016057576A1 (en) * | 2014-10-06 | 2016-04-14 | Smith & Nephew, Inc. | Microfracturing instrument |
| KR101825270B1 (en) * | 2015-10-26 | 2018-02-02 | 아주대학교산학협력단 | Boring device for minute fracture surgery |
| WO2017126089A1 (en) * | 2016-01-21 | 2017-07-27 | 公益財団法人高輝度光科学研究センター | Retarding potential type energy analyzer |
| IT201600132039A1 (en) * | 2016-12-29 | 2018-06-29 | Medacta Int Sa | GUIDE FOR FLEXIBLE BONE CUTTER AND BONE RESECTION TOOL |
| US10874406B2 (en) | 2017-02-28 | 2020-12-29 | MFr Technologies, Inc. | Handheld surgical instrument |
| CN108685603B (en) * | 2018-08-08 | 2024-04-26 | 北京大学第三医院 | Talus drilling instrument |
| CN119791913A (en) * | 2025-03-17 | 2025-04-11 | 苏州星悦智慧医疗科技有限公司 | Myeloid stimulator cone system |
Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5921987A (en) * | 1996-09-13 | 1999-07-13 | Depuy Orthopaedic Technology, Inc. | Articular cartilage transplant instrument set |
| CN2340380Y (en) * | 1998-10-19 | 1999-09-29 | 阚士峰 | Medical canula style needle for trephination |
Family Cites Families (12)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH0529696Y2 (en) * | 1988-11-28 | 1993-07-29 | ||
| RU2169532C2 (en) * | 1995-10-30 | 2001-06-27 | Биомедикал Энтерпрайзис, Инк. | System and method for picking of materials |
| US6558386B1 (en) * | 2000-02-16 | 2003-05-06 | Trans1 Inc. | Axial spinal implant and method and apparatus for implanting an axial spinal implant within the vertebrae of the spine |
| US6440141B1 (en) * | 2000-07-24 | 2002-08-27 | Oratec Interventions, Inc. | Method and apparatus for treating osteochondral pathologies |
| US20040147932A1 (en) * | 2002-10-15 | 2004-07-29 | Brian Burkinshaw | Device for performing automated microfracture |
| US7901408B2 (en) * | 2002-12-03 | 2011-03-08 | Arthrosurface, Inc. | System and method for retrograde procedure |
| SE0302983D0 (en) * | 2003-11-11 | 2003-11-11 | Bone Support Ab | Apparatus for providing spongy bone with bone replacement and / or bone strengthening material and associated method |
| AU2005277078A1 (en) * | 2004-08-20 | 2006-03-02 | Arthrosurface, Inc. | System and method for retrograde procedure |
| US20060229624A1 (en) * | 2005-03-31 | 2006-10-12 | Zimmer Technology, Inc. | Orthopaedic cutting instrument and method |
| US8251998B2 (en) * | 2006-08-16 | 2012-08-28 | Biomet Sports Medicine, Llc | Chondral defect repair |
| US20080045964A1 (en) * | 2006-08-16 | 2008-02-21 | Allan Mishra | Device for cartilage repair |
| US20100191195A1 (en) * | 2006-10-08 | 2010-07-29 | Ira Kirschenbaum | Cannulated apparatus and method relating to microfracture and revascularization methodologies |
-
2010
- 2010-07-29 CN CN201080045022.XA patent/CN102781346B/en not_active Expired - Fee Related
- 2010-07-29 AU AU2010278867A patent/AU2010278867B2/en not_active Ceased
- 2010-07-29 WO PCT/US2010/043746 patent/WO2011014677A1/en active Application Filing
- 2010-07-29 EP EP10805058.4A patent/EP2459082A4/en not_active Withdrawn
- 2010-07-29 JP JP2012523047A patent/JP5815522B2/en not_active Expired - Fee Related
Patent Citations (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5921987A (en) * | 1996-09-13 | 1999-07-13 | Depuy Orthopaedic Technology, Inc. | Articular cartilage transplant instrument set |
| CN2340380Y (en) * | 1998-10-19 | 1999-09-29 | 阚士峰 | Medical canula style needle for trephination |
Also Published As
| Publication number | Publication date |
|---|---|
| AU2010278867A1 (en) | 2012-02-16 |
| AU2010278867B2 (en) | 2015-10-01 |
| EP2459082A1 (en) | 2012-06-06 |
| JP5815522B2 (en) | 2015-11-17 |
| WO2011014677A1 (en) | 2011-02-03 |
| EP2459082A4 (en) | 2015-07-08 |
| JP2013500786A (en) | 2013-01-10 |
| CN102781346A (en) | 2012-11-14 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN102781346B (en) | For producing the apparatus of micro-fracture in bone | |
| JP5883786B2 (en) | Surgical instrument for cutting a cavity in an intramedullary canal | |
| US8663230B2 (en) | Retrograde delivery of resurfacing devices | |
| US8012157B2 (en) | Internal bone fixation sizing device and methods | |
| US8388621B2 (en) | Retrodrill system | |
| US10092303B2 (en) | System for use in tissue repair | |
| CN104837427B (en) | Tubulose hammer drill accessory | |
| JP5154537B2 (en) | Micro fracture pick | |
| US20120245586A1 (en) | Bone Drill | |
| CN101677823A (en) | Tissue cavitation device and method | |
| JP2009500145A (en) | Culet system | |
| CN101720207A (en) | Devices, systems, and methods for delivering curable material into bone | |
| JP2019063582A (en) | Microfracture pick | |
| JP2010063876A (en) | Remote-controlled actuator | |
| CN101272741A (en) | curette system | |
| CN210228339U (en) | Percutaneous spinal endoscope controller | |
| US20210219964A1 (en) | Powered bone-graft harvester | |
| JP2003529437A (en) | Device for acting on human and / or animal tissue | |
| CN207520177U (en) | Pulp cavity middle-device |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20151125 Termination date: 20180729 |
|
| CF01 | Termination of patent right due to non-payment of annual fee |