US20060095048A1 - Method of repairing soft tissue using sizing templates - Google Patents
Method of repairing soft tissue using sizing templates Download PDFInfo
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- US20060095048A1 US20060095048A1 US11/261,041 US26104105A US2006095048A1 US 20060095048 A1 US20060095048 A1 US 20060095048A1 US 26104105 A US26104105 A US 26104105A US 2006095048 A1 US2006095048 A1 US 2006095048A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/107—Measuring physical dimensions, e.g. size of the entire body or parts thereof
- A61B5/1076—Measuring physical dimensions, e.g. size of the entire body or parts thereof for measuring dimensions inside body cavities, e.g. using catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/063—Measuring instruments not otherwise provided for for measuring volume
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
- A61B5/4514—Cartilage
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/45—For evaluating or diagnosing the musculoskeletal system or teeth
- A61B5/4528—Joints
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Abstract
Surgical instruments for use in sizing tissue defects and selecting an appropriate implant for the defect include sizing templates. The sizing templates are sized and shaped to correspond to the size and shape of the implants. The sizing templates may be retractable into a tube for use in arthroscopic surgery. The retractable sizing templates are resilient to allow them to be retracted into a small diameter tube, and to expand on release from the tube to the desired size and shape. The method of using the instrument set is also described.
Description
- This application claims the benefit of U.S. Provisional Application No. 60/623,366 filed on Oct. 29, 2004, by Anthony D. Zannis, Danny E. McAdams, Brian A. Magee, Herbert E. Schwartz and Andrew M. Jacobs entitled “Implant System and Method with Sizing Templates,” which is incorporated by reference herein in its entirety.
- The present invention relates to implants and surgical instruments and more particularly to surgical instrument sets that can be used to intraoperatively select the most appropriate implant for repair of a tissue defect.
- Various types of MIS are being performed by surgeons, including laparascopy, endoscopy and arthroscopy surgery. In arthroscopy, small incisions are made at the affected joint to form portals for the insertion of instruments, including a small lens and lighting system (an arthroscope). The arthroscope is connected to a viewing device, such as a television camera to allow the surgeon to see the interior of the joint. Other instruments are inserted through other portals to perform a variety of tasks. For example, the surgical instrument may include an implement for manipulating native tissue (for example, tissue grasping, tissue cutting, bone abrading), or an implement for introducing and implanting a therapeutic device.
- Typical surgical instruments used in arthroscopic procedures include rongeurs, such as the Kerrison rongeur, punch forceps, basket forceps, suction punches and cup curet, for example. Examples of arthroscopic instruments are described and illustrated in O'Connor's Textbook of Arthroscopic Surgery, 2nd ed., 1992,
Chapter 19. - In many surgical settings, it is often necessary for the surgeon to make measurements between two points. Due to the confined spaces of arthroscopic surgery, measuring such distances is often quite difficult, particularly when the measurement needed is larger than the size of the incision or transverse to the direction of the incision. Arthroscopic knee surgery provides many such situations. For example, it may be helpful if a surgeon could measure the size of a defect in the meniscus of a knee, to aid in choosing the appropriate method to repair the defect.
- An arthroscopic measuring device is disclosed in U.S. Pat. No. 6,427,351B1, which is incorporated by reference herein in its entirety. The device disclosed in that patent provides a handle and an extension. The extension has a distal tip for intraoperative insertion into the body through an incision. Two wires extend from a block in the handle through passageways in two separate tubes that comprise the extension. The block is connected to an actuator element. The actuator elements disclosed can be moved back and forth in a direction parallel to the longitudinal axis of the handle to move the wires out of an into the tubes. At their distal ends, the tubes diverge at a fixed angle so that the distance between the ends of the wires increases as the wires are pushed further outward and decreases as the wires are pulled back into the handle. Calibrations on the handle correspond with the distance between the ends of the wires so that the surgeon can determine one or more of the dimensions of a defect in the bone or cartilage.
- Although the arthroscopic measuring device disclosed in U.S. Pat. No. 6,427,351B1 provides a useful surgical tool, operation of the actuating mechanism disclosed can be difficult for the surgeon, particularly due to friction as the wires are pushed through the divergent tube endings. In addition, use of that device may require that the surgeon use both hands to hold the handle and move the actuating mechanism. Finally, use of that device may not allow for repeatable measurements of the tissue and changes in the tissue over time.
- Determining the size and location of a defect at a tissue site, such as the meniscus of the knee joint, can be useful in several arthroscopic procedures. Common surgical procedures for treating meniscal damage include tear repairs and menisectomies. A tear repair is most commonly performed when the tear is a clean longitudinal vertical lesion in the vascular red zone of the meniscus. The basic strategy is to stabilize the tear by limiting or eliminating radial separation of the faces of the tear when the meniscus is load bearing. Many devices and surgical procedures exist for repairing meniscal tears by approximating the faces of the meniscus at the tear. Examples of such devices and procedures are disclosed in the following U.S. Pat. Nos.: 6,319,271; 6,306,159; 6,306,156; 6,293,961; 6,156,044; 6,152,935; 6,056,778; 5,993,475; 5,980,524; 5,702,462; 5,569,252; 5,374,268; 5,320,633; and 4,873,976.
- Menisectomies involve the surgical removal of part of the meniscus. Such procedures have generally been performed in cases of radial tears, horizontal tears, vertical longitudinal tears outside the vascular zone, complex tears, or defibrillation. Although menisectomies provide immediate relief to the patient, in the long term the absence of part of the meniscus can cause cartilage wear on the condylar surface, eventually leading to arthritic conditions in the joint.
- A variety of orthopaedic implants are available for treating damaged soft tissue. Orthopaedic implants for treatment of damaged menisci are disclosed in the following U.S. Pat. Nos. 6,042,610; 5,735,903; 5,681,353; 5,306,311; 5,108,438; 5,007,934; and 4,880,429.
- The sizes and shapes of meniscal defects, including the gaps left following menisectomies, can vary from patient to patient. Typically, orthopaedic implants for treating such defects would be provided in a variety of sizes. To select the appropriate implant for a patient, the surgeon would typically use an arthroscopic probe to approximate the size of the defect. However, due to a large margin of error in such approximations, it is desirable to provide surgeons with a more accurate way to select the most appropriate implant for a particular defect.
- The present invention provides an instrument set and a surgical technique for sizing a tissue defect so that the most appropriate size of implant is selected for the defect.
- In one aspect, the present invention provides a surgical sizing instrument comprising a hollow tube and elongated sizing template. The hollow tube has a proximal end and a distal end. The elongated sizing template extends through the hollow tube, and includes proximal end, a distal end, an intermediate portion between the proximal end and distal end, a first resilient segment adjacent to the intermediate portion, and a second resilient segment adjacent to the first resilient segment and positioned between the first resilient segment and the distal end of the elongated sizing template. The elongated sizing template is reciprocable in the hollow tube between an extended position and a retracted position. The first resilient segment and second resilient segment are received within the hollow tube when the elongated sizing template is in the retracted position and exposed outside of the hollow tube when the elongate sizing template is in the extended position. The first resilient segment and second resilient segment have a first relative orientation when the elongated sizing template is in the extended position and a second relative orientation when the elongated sizing template is in the retracted position. The first relative orientation being different from the second relative orientation.
- In another aspect, the present invention provides a surgical sizing instrument set comprising first and second surgical sizing instruments. Both surgical sizing instruments include a hollow tube and an elongated sizing template. The hollow tubes have a proximal end and a distal end. Each of the elongated sizing templates extends through one hollow tube Each elongate sizing template has a proximal end, a distal end, an intermediate portion between the proximal end and distal end, a first resilient segment adjacent to the intermediate portion, and a second resilient segment adjacent to the first resilient segment and positioned between the first resilient segment and the distal end of the elongated sizing template. The elongated sizing templates are reciprocable in the hollow tubes between extended positions and retracted positions. In each instrument, the first resilient segment and second resilient segment have a first angular relationship when the elongated sizing template is in the extended position and a second angular relationship when the elongated sizing template is in the retracted position. In each, the first angular relationship is different from the second angular relationship.
- In another aspect, the present invention provides a surgical instrument having a proximal end and a distal end. The instrument comprises a handle at the proximal end and a tube extending distally from the handle. The tube defines a channel. The instrument also comprises a first gear, a second gear and an elongated member. The first gear is rotatably mounted to the handle, and has a plurality of grooved teeth. The second gear is rotatably mounted to the handle, and has a plurality of grooved teeth intermeshed with the grooved teeth of the first gear. The grooves of the intermeshed teeth of the first gear and second gear define a passageway aligned with the channel of the tube. The elongated member extends through the passageway and into the channel of the tube. The elongated member is movable in a proximal direction by rotating the first gear in one direction and movable in the distal direction by rotating the first gear in the opposite direction.
- In another aspect, the present invention provides a surgical implant system. The system comprises first and second implants and first and second sizing instruments. The first implant has a width and a length and the second implant has a width and a length. At least one of the width and length of the second implant is larger than the corresponding dimension of the first implant. The first surgical sizing instrument includes a hollow tube and an elongated sizing template. The hollow tube has a proximal end and a distal end. The elongated sizing template extends through the hollow tube, and has a proximal end, a distal end, an intermediate portion between the proximal end and distal end, a first resilient segment adjacent to the intermediate portion, a second resilient segment adjacent to the first resilient segment and positioned between the first resilient segment and the distal end of the elongated sizing template. The elongated sizing template is reciprocable in the hollow tube between an extended position and a retracted position. The first resilient segment has a length corresponding with the width of the first implant and the second resilient segment has a length corresponding with the length of the first implant. The first resilient segment and second resilient segment have a first angular relationship when the elongated sizing template is in the extended position and a second angular relationship when the elongated sizing template is in the retracted position. The first angular relationship is different from the second angular relationship. The second surgical sizing instrument includes a hollow tube and an elongated sizing template. The hollow tube has a proximal end and a distal end. The an elongated sizing template extends through the hollow tube and has a proximal end, a distal end, an intermediate portion between the proximal end and distal end, a first resilient segment adjacent to the intermediate portion, a second resilient segment adjacent to the first resilient segment and positioned between the first resilient segment and the distal end of the elongated sizing template. The elongated sizing template of the second sizing instrument is reciprocable in the hollow tube between an extended position and a retracted position. The first resilient segment of the elongated sizing template of the second sizing instrument has a length corresponding with the width of the second implant and the second resilient segment has a length corresponding with the length of the second implant. The first resilient segment and second resilient segment of the second sizing instrument have a first angular relationship when the elongated sizing template is in the extended position and a second angular relationship when the elongated sizing template is in the retracted position, the first angular relationship being different from the second angular relationship.
- In another aspect, the present invention provides a method of repairing soft tissue. Soft tissue is removed to create a defect having a first side having a length and orientation and a second non-parallel side having a length and orientation. First and second implants are provided. The first implant includes a first side having a length and orientation and a second non-parallel side having a length and orientation. The second implant also has a first side having a length and orientation and a second non-parallel side having a length and orientation. First and second sizing templates are provided. The first sizing template includes a first side having a length and orientation corresponding to the length and orientation of the first side of the first implant and a second side having a length and orientation corresponding to the length and orientation of the second side of the first implant. The second sizing template includes a first side having a length and orientation corresponding to the length and orientation of the first side of the second implant and a second side having a length and orientation corresponding to the length and orientation of the second side of the second implant. One of the sizing templates is introduced to the area of the defect and positioned with its first side at the first side of the defect and with its second side at the second side of the defect. The surgeon can then determine whether the introduced sizing template fits the defect. The sizing template is removed and one of the implants is introduced to the area of the defect and positioned in the defect.
- Additional features of the present invention will become apparent to those skilled in the art upon consideration of the following detailed description of preferred embodiments exemplifying the best mode of carrying out the invention as presently perceived.
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FIG. 1 is a top plan view of a set of surgical instruments with sizing templates in an extended position; -
FIG. 2 is a top plan view of the surgical instruments ofFIG. 1 with sizing templates in a retracted position; -
FIG. 3 is a bottom plan view of the tube and shoulder assembly of some of the instruments ofFIGS. 1-2 ; -
FIG. 4 is a side elevation of the tube and shoulder assembly ofFIG. 3 ; -
FIG. 5 is a cross-section of the tube and shoulder assembly ofFIGS. 3-4 , taken along line 5-5 ofFIG. 4 ; -
FIG. 6 is a bottom plan view of the tube and shoulder assembly of other instruments in the set ofFIGS. 1-2 ; -
FIG. 7 is a side elevation of the tube and shoulder assembly ofFIG. 6 ; -
FIG. 8 is a cross-section of the tube and shoulder assembly ofFIGS. 6-7 , taken along line 8-8 ofFIG. 7 ; -
FIG. 9 is an enlarged top plan view of the distal end portion of the large sizing template of the instrument set ofFIGS. 1-2 ; -
FIG. 10 is an enlarged top plan view of a large size meniscal implant that may be included as part of the system of the present invention; -
FIG. 11 is an enlarged top plan view of the distal end portion of the medium sizing template of the instrument set ofFIGS. 1-2 ; -
FIG. 12 is an enlarged top plan view of a medium size meniscal implant that may be included as part of the system of the present invention; -
FIG. 13 is an enlarged top plan view of the distal end portion of the small sizing template of the instrument set ofFIGS. 1-2 ; -
FIG. 14 is an enlarged top plan view of a small size meniscal implant that may be included as part of the system of the present invention; -
FIG. 15 is an end view of one of the meniscal implants ofFIGS. 10, 12 and 14; -
FIG. 16 is a plan view of the small sizing template of the instrument set ofFIGS. 1-2 ; -
FIG. 17 is a plan view of the medium sizing template of the instrument set ofFIGS. 1-2 ; -
FIG. 18 is a plan view of the large sizing template of the instrument set ofFIGS. 1-2 ; -
FIG. 19 is a cross-section of the distal end of the straight tube of one of the instruments ofFIGS. 1-2 , shown with the large sizing template in a retracted position; -
FIG. 20 is a cross-section of the distal end of the straight tube of another of the instruments ofFIGS. 1-2 , shown with the medium sizing template in a retracted position; -
FIG. 21 is a cross-section of the distal end of the straight tube of another of the instruments ofFIGS. 1-2 , shown with the small sizing template in a retracted position; -
FIG. 22 is a cross-section of the distal end of the angled tube of one of the another of the instruments, shown with the large sizing template in a retracted position; -
FIG. 23 is a cross-section of the distal end of the angled tube of one of the another of the instruments, shown with the medium sizing template in a retracted position; -
FIG. 24 a cross-section of the distal end of the angled tube of one of the another of the instruments, shown with the small sizing template in a retracted position; -
FIG. 25 is a longitudinal cross-section of the handle assembly of one of the instruments ofFIGS. 1-2 , taken along line 25-25 ofFIG. 2 ; -
FIG. 26 is a transverse cross-section of the handle assembly of one of the instruments ofFIGS. 1-2 , taken along line 26-26 ofFIG. 2 ; -
FIG. 27 is an enlarged view of a portion ofFIG. 26 , showing a sizing template in a passageway defined by grooves in the intermeshing teeth of two gears; -
FIG. 28 is a diagrammatic perspective view of a meniscus, illustrating use of one of the instruments of the present invention to size a defect in the meniscus; -
FIG. 29 is a perspective view of an alternative embodiment of an instrument useful in sizing a defect; and -
FIG. 30 is a perspective view of another alternative embodiment of an instrument useful in sizing a defect. - Surgical instruments embodying the principles of the present invention are illustrated in the accompanying drawings.
FIG. 1 illustrates a surgical instrument set 10 comprising a plurality ofindividual instruments - As shown in
FIG. 1 , each of the illustratedinstruments set 10 has aproximal end - It should be understood that the illustrated instrument set is designed for use in sizing meniscal implants; variations may be made in the illustrated instrument set for application to use at other tissue sites in the patient's body.
- As shown in
FIG. 1 , eachillustrated instrument set 10 includes an elongatedhollow tube elongated sizing template tube distal end FIGS. 5 and 8 ). Each sizingtemplate proximal end intermediate portion distal end FIG. 1 , each illustrated instrument includes ahandle assembly hollow tubes - The illustrated instrument set 10 includes instruments with three different styles of elongate tubes. Three of the illustrated
instruments tubes instruments tubes instruments tube -
FIGS. 3-8 illustrate two of thehollow tubes FIGS. 1-2 . For simplicity, only these illustratedtubes hollow tubes - As shown in
FIGS. 5 and 8 , thehollow tubes longitudinal channels channels proximal end distal end tubes tubes shoulder components FIGS. 5 and 8 , theshoulder components distal channel proximal channel channels - The
hollow tubes hollow tube 14A is 4.25 inches long, has an outer diameter of 0.148 inches and an inner diameter of 0.118 inches. In the curvedhollow tube 14D, the curved distal portion defines a 45° angle with the straight portion of the tube; the proximal straight portion has a length of about 3.525 inches and the tube has an overall length of 4.160 inches. Theshoulders shoulders tubes FIGS. 3-8 . The proximal portions of theshoulder components dimples handle assembly - The sizing
templates tubes shoulder components handle assemblies FIG. 1 , theinstruments set 10 are illustrated with the sizingtemplates tubes FIG. 1 is shown inFIG. 2 with the sizingtemplates distal end templates templates - In the illustrated instrument set 10, three different sizes of sizing templates are provided for each tube style. Generally, at least one instrument is included in the kit to correspond with each size of implant in the system. For example, if the implant system includes three sizes of meniscal implants, small, medium and large, the instrument set would include at least three sizing templates, small, medium and large.
- Three sizes of meniscal implants are illustrated in
FIGS. 10, 12 and 14.FIG. 10 illustrates a largesize meniscal implant 50 andFIG. 9 illustrates an example of thedistal end sizing template sized implant 50.FIG. 12 illustrates a mediumsize meniscal implant 52 andFIG. 11 illustrates an example of thedistal end sizing template medium size implant 52.FIG. 14 illustrates a smallsize meniscal implant 53 andFIG. 13 illustrates an example of thedistal end 21C. 21F of asizing template small size implant 53. All threeimplants large implant 50 is illustrated inFIG. 15 , showing the wedge-shape of the implant. - Each of the three illustrated
meniscal implants cover 55 and awedge 57. As illustrated, the top portion of thecover 55 extends over and beyond the sides or edges of thewedge 55 to providefixation areas fixation areas implant wedge 55 generally fills the gap in the native meniscal tissue left after a partial meniscetomy. It is anticipated that surgeons will trim thefixation areas cover 55 may comprise a laminate of sheets of tissue repair material, and thewedge 57 may also comprise tissue repair material, as disclosed in U.S. patent application Ser. No. 10/747,349, entitled “Implantable Tissue Repair Device and Method,” filed on Dec. 29, 2003 by Malaviya et al., which is incorporated by reference herein in its entirety. The therapeutic implant, method of making the implant, and method of repairing cartilage using the implant may include the teachings of the following U.S. patent applications, the complete disclosures of which are incorporated by reference herein: Ser. No. 10/172,347 entitled “Hybrid Biologic-Synthetic Bioabsorbable Scaffolds” (U.S. Patent Publication No. 20030023316A1); Ser. No. 10/195,334 entitled “Cartilage Repair and Regeneration Scaffolds and Method” (U.S. Patent Publication No. 20030033021A1); Ser. No. 10/195,341 entitled “Hybrid Biologic/Synthetic Porous Extracellular Matrix Scaffolds” (U.S. Patent Publication No. 20030021827A1); Ser. No. 10/195,344 entitled “Unitary Surgical Device and Method” (U.S. Patent Publication No. 20030078617A1); Ser. No. 10/195,354 entitled “Porous Extracellular Matrix Scaffold and Method” (U.S. Patent Publication No. 20030044444A1); Ser. No. 10/195,606 entitled “Cartilage Repair and Regeneration Device and Method” (U.S. Patent Publication No. 20030033022A1); Ser. No. 10/195,633 entitled “Porous Delivery Scaffold and Method” (U.S. Patent Publication No. 2003-0049299A1; Attorney Docket No. 265280-71207, DEP-762); Ser. No. 10/195,719 entitled “Devices from Naturally Occurring Biologically Derived Materials” (U.S. Patent Publication No. 20030032961A1); and Ser. No. 10/195,794 entitled “Meniscus Regeneration Device and Method” (U.S. Patent Publication No. 20030036797A1; Attorney Docket No. 265280-71141, DEP-745). It should be understood that the particular implants, features of the implants, methods of making the implants and methods of repairing cartilage are provided as examples only; the present invention is not limited to the illustrated implants or to meniscal implants or to any particular method of making or using implants unless expressly called for in the claims. - As shown in
FIGS. 10, 12 and 14-15, each of the illustratedimplants cover 55, an overall width W1, W2, W5 between the front and back edges of thecover 55, and a maximum thickness T1 between the top and bottom surfaces of thecover 55. Thewedge portion 57 of eachimplant wedge 57, a width W3, W4, W6 between the front and back edges of thewedge 57, and a maximum thickness T2 between the top and bottom surfaces of thewedge 57. In the illustrated embodiments: L1 is about 1.30 inches; L2 is about 1.11 inches; L5 is about 0.91 inches; L3 is about 0.98 inches; L4 is about 0.79 inches; L6 is about 0.59 inches; W1 is about 0.87 inches; W2 is about 0.87 inches; W5 is about 0.87 inches; W3, W4, W6 are about 0.47 inches; T1 is about 0.31 inches; and T2 is about 0.22 inches. It should be understood that these dimensions are provided as examples only; the present invention is not limited to any particular dimension unless expressly called for in the claims. - As shown in
FIGS. 9-11 , the sizingtemplates segments intermediate portions segments segments segments segment segment segment - Although each of the illustrated
sizing templates 16A-16F has three sides orsegments 54A-54F, 56A-56F and 58A-58F, it should be understood that fewer or additional segments in different shapes could be used. The invention is not limited to any particular number or shape of the distal end of the sizing template unless expressly called for in the claims. - In addition, in the instrument set 10 of
FIGS. 1 and 2 , the three sides orsegments 54A-54F, 56A-56F, 58A-58F are all resilient. However, as described below with respect toFIGS. 29 and 30 , the sides or segments comprising the template need not be resilient, and the present invention is not limited to resilient templates unless expressly called for in the claims. - As illustrated in
FIGS. 9, 11 and 13, theintermediate portion template longitudinal axis first segment longitudinal axis longitudinal axis intermediate portion template second segment third segment first segment sizing templates distal segments 54A-54F, 56A-56F, 58A-58F define an overall U-shape in plan view, although the invention is not limited to such a shape unless expressly called for in the claims. - Each of the illustrated
large sizing templates first segment third segment first segment third segment medium sizing templates first segments third segment first segment third segment small sizing templates first segment third segment first segment third segment - In each of the illustrated embodiments, the three
segments 54A-54F, 56A-56F, 58A-58F of each sizingtemplate 16A-16F are co-planar with the respectiveintermediate portion 20A-20F. However, it should be understood that the segments could be angled to lie in a separate plane. In addition, the one or more of the segments could lie in a plane separate from that of the other segments. - Thus, for the
large sizing template wedge 57 of thelarge size implant 50 and the distance D2 corresponds with the width W3 of thewedge 57 of thelarge size implant 50. For themedium sizing template wedge 57 of themedium size implant 52 and the distance D4 corresponds with the width W4 of thewedge 57 of themedium size implant 52. For thesmall sizing template wedge 57 of thesmall size implant 53 and the distance D6 corresponds with the width W6 of thewedge 57 of thesmall size implant 53. It should be understood that these correspondences in dimensions between the wedges of the implants and the sizing templates are provided as examples only; the sizing templates could instead be set to correspond for example with the outer dimensions of thecovers 55 of the implants, or with some other feature of the implant as well. Accordingly, the present invention should not be limited to any particular correspondence of template size and implant size unless expressly set forth in the claims. - For each of the illustrated sizing templates, all three
segments 54A-54F, 56A-56F, and 58A-58F are exposed outside of the distal ends 18A-18F of therespective tubes 14A-14F when the sizingtemplate 16A-16F is in the extended position. All threesegments 54A-54F, 56A-56F and 58A-58F are held within thechannels 30A-30F of therespective tubes 14A-14F when the sizingtemplate 16A-16F is in the retracted position. -
FIG. 19 illustrates thelarge sizing template 16A in the retracted position within thestraight tube 14A;FIG. 20 illustrates themedium sizing template 16B in the retracted position within thestraight tube 14B; andFIG. 21 illustrates thesmall sizing template 16C in the retracted position within thestraight tube 14C.FIG. 22 illustrates thelarge sizing template 16D in the retracted position within theangled tube 14D;FIG. 23 illustrates themedium sizing template 16E in the retracted position within theangled tube 14E; andFIG. 24 illustrates thesmall sizing template 16F in the retracted position within theangled tube 14F. - To allow the
sizing templates FIGS. 9, 11 , 13 and 16-18), have sufficient rigidity to retain its pre-determined shape when extended over a distance such as 10-50 mm, that can deform to fit within the shape of thechannel 30A-30F of thetube 14A-14F when retracted, and that will regain its pre-determined shape when extended beyond the channel. Finally, the material should be one that is suitable for surgical use. An example of a suitable material is nitinol (nickel-titanium alloy). It is anticipated that other alloys and other materials such as polymers and composites will also be usable as a shape memory material for the rulers. Accordingly, the present invention should not be limited to any particular material unless expressly called for in the claims. - To ease movement of the sizing
templates handle assembly 26A-26F of the illustrated instrument set 10 utilizes a gear mechanism that the surgeon can manipulate with the thumb or finger of the same hand that is used to grasp thehandle assembly 26A-26F. Thehandle assembly 26A-26F in each of the illustrated instruments is the same. - A representative handle assembly is shown in longitudinal cross-section in
FIG. 25 and in transverse cross-section inFIG. 26 . InFIGS. 25 and 26 and in the following description of the handle assemblies, reference numbers are used without letter designations to indicate that the illustration and description applies to thehandle assemblies illustrated instruments - As shown in
FIG. 25 , thehandle assembly 26 includes abase 64, ahandle post 66, twoscrews thumb gear assembly 72, aspur gear 74 and twoball plungers 76. Thebase 64 has a distallongitudinal channel 78 and two transverse bores in communication with the distal longitudinal channel. The distallongitudinal channel 78 receives theshoulder 34 of the tube assembly, and the twoball plungers 76 are inserted into the bores to engage the dimples 40 in theshoulder 34 to thereby mount the tube assembly to thehandle assembly 26. The distallongitudinal channel 78 communicates with a longitudinaldistal bore 80, which communicates with a centralopen area 82, which communicates with a longitudinal female threadedopening 84. The female threaded opening 84 receives a distal male threadedportion 86 of thepost 66. Thepost 66 includes alongitudinal channel 88 that communicates with the centralopen area 82 and extends to or near theproximal end 90 of thepost 66. The distallongitudinal channel 78 and longitudinal distal bore 80 of thebase 64 andlongitudinal channel 88 of thepost 66 are co-axial with thechannel 30 of thetube 14. The sizingtemplate 16 extends through thetube 14, through thedistal channel 36 of theshoulder 34, through the reduced diameter proximal channel 38 of theshoulder 34, through the longitudinal distal bore 80 of thebase 64, through the centralopen area 82 of the base and through thelongitudinal channel 88 of thepost 66. In the centralopen area 82 of thebase 64, the sizingtemplate 16 passes between thethumb gear assembly 72 and thespur gear 74. - As shown in
FIGS. 25 and 26 , thethumb gear assembly 72 is mounted to thebase 64 by thescrew 68 and thespur gear 74 is mounted to thebase 64 by thescrew 70. Thethumb gear assembly 72 is freely rotatable on the smooth shaft of thescrew 68 and thespur gear 74 is freely rotatable on the smooth shaft of thescrew 70. - The
thumb screw assembly 72 comprises athumb wheel 90 and athumb gear 92 mounted coaxially on thescrew 68. The outer surface of thethumb wheel 90 has a plurality ofaxial splines 94 so that the surgeon can easily rotate thewheel 90 with a thumb or finger. Thethumb wheel 90 receives a reduced diameter portion of thethumb gear 92 so that thethumb wheel 90 andthumb gear 92 rotate together. - The
thumb gear 92 has a plurality ofgrooved teeth 94 that intermesh with thegrooved teeth 96 of thespur gear 74. As shown inFIG. 26 , the intermeshing groovedteeth 94 of thethumb gear 92 andgrooved teeth 96 of thespur gear 74 define apassageway 98 that is co-axially aligned with the distallongitudinal channel 78 and longitudinal distal bore 80 of thebase 64 andlongitudinal channel 88 of thepost 66. The intermediate portion 20 of the sizingtemplate 16 extends between thethumb gear 92 and thespur gear 74, passing through thepassageway 98 defined by thegrooved teeth thumb gear teeth 94 meets and engages the distal surface of one of thespur gear teeth 96, at least one of the transverse dimensions of thepassageway 98 is slightly less than the outer diameter of the intermediate portion 20 of the sizingtemplate 16 so that themating teeth template 16. Thus, the sizingtemplate 16 can be reciprocated in the proximal-distal direction by rotating thethumb wheel 90, and the surgeon can extend and retract the sizingtemplate 16 with the same hand used to grasp thehandle post 66. - All of the components of the
handle assembly 26 can be made of standard materials for surgical instruments. For example, thebase 64 and post 66 can be made of acetyl co-polymer, and thegears thumb wheel 90, screws 68, 70 andball plungers 76 can be made of stainless steel. It should be understood that all of these materials are identified as examples only; the present invention is not limited to any particular material unless expressly called for in the claims. - Use of the illustrated instrument set 10 is described below and illustrated in
FIG. 28 in treating adefect 100 in themeniscus 102. In the illustrations, thetissue defect 100 comprises a gap in the posterior portion of themedial horn 104 of themeniscus 102 created by a partial menisectomy. Although not described in detail below, it should be understood that the technique described below may also be used in treating tissue defects in other areas of themedial horn 104 of the meniscus as well as in thelateral horn 106 of the meniscus. It should also be understood that the technique described below may also be applied in treating defects at other tissue sites in a patient's body. InFIG. 28 , a portion of the anterior cruciate ligament is shown at 108 and a portion of the posterior cruciate ligament is shown at 110. - The surgeon can perform standard arthroscopic procedures to create portals to gain access to the
medial horn 104 of the meniscus. Standard cannulae can be inserted through the portals, and a standard arthroscope (not shown) can be used for visualization of the tissue site. An appropriate sizing instrument, for example the medium instrument with a 45° offset is selected. It should be understood that the selection of the shape of the sizing instrument will depend on the defect site, surgical approach and surgeon preference. The 45° offset instrument is discussed below as an example only. - In the case illustrated in
FIG. 28 , because of the defect site and surgical approach, the 45° offset sizing instrument has been flipped 1800 from the position illustrated inFIG. 1 so that the bottom side of the instrument is facing up and so that thedistal end 18E of thetube 14E is angled to the left. The surgeon selects the size of the sizing instrument based upon an initial approximation of the size of implant to be used to repair the defect. - The surgeon may then retract the three
segments channel 30 of the tube so that the sizingtemplate 16E is in the retracted position shown in FIGS. 2 and 23. Thetube 14E may then be inserted through one of the cannulae and guided to themedial meniscus 104. - When the
distal end 18E of thetube 14E is in position at themedial meniscus 104, the surgeon may extend the sizing template by turning thethumb wheel 90 with a finger on the same hand that is used to hold thepost 66 of the instrument. When the sizingtemplate 16E has been fully extended to the positions shown inFIGS. 1 and 11 , the surgeon can then move thesizing template 16E until the shapedsegments tissue defect 100. As illustrated inFIG. 28 , thedefect 100 is visible (either be means of the arthroscope or by eye if the instruments are used in open surgery) even with the shaped end of the sizingtemplate 16E in place over or within the defect. If the surgeon is satisfied that an implant corresponding with the size of the template will be appropriate for the defect, the surgeon can then turn thethumb wheel 90 to retract thesizing template 16E and remove theinstrument 12E. An implant may then be delivered and fixed implant in place. If the surgeon is not satisfied that the implant corresponding with that sizing template is appropriate, the surgeon can retract the sizing template, remove theinstrument 12E and then follow the same procedure with thelarger sizing instrument 12D orsmaller sizing instrument 12F until satisfied that the most appropriate size of implant will be used. - Using the instrument set 10 with retractable and extendable sizing templates, the surgeon can use templates having shapes and sizes that would not normally fit through an arthroscopic cannula, and that could be damaged or become misshapen if introduced without a cannula.
- To deliver the implant arthroscopically, devices may be used like those disclosed in the following U.S. patent applications, which are incorporated by reference herein in their entireties: U.S. patent application Ser. No. 10/610,287 entitled “Slide and Kit for Delivering Implants” (filed Jun. 30, 2003) and U.S. Provisional Patent Application Ser. No. 60/483,804 entitled “Instrument for Delivery of Implant” (filed Jun. 30, 2003). However, the present invention is not limited to any particular implant, surgical technique or surgical instrument unless expressly set forth in the claims.
- Although the technique of the present invention has been described above with respect to an arthroscopic procedure, it should be understood that the instruments and technique of the present invention can also be used with more invasive surgical procedures, such as a mini-arthrotomy or an open surgical procedure.
- While the illustrated instrument set 10 all utilize
retractable sizing templates 16, it should be understood that some of the advantages of the present invention can also be obtained through use of instruments having a non-retractable sizing template. Examples of such instruments are illustrated inFIGS. 29-30 . While the instruments ofFIGS. 29-30 may not be as easily introduced to the defect site, they do offer advantages. Theinstrument 110 ofFIG. 29 allows the surgeon to view the relationship between the size of the defect and the size of thetemplate 112 without the template covering the defect, and both theinstruments FIGS. 29 and 30 offer the opportunity to determine the appropriate size of implant that best suits the size of the defect. Thetemplate portion FIGS. 29-30 can be made or stainless steel, a polymer or a composite, and can be designed to be reusable or disposable after each use, while the handle could also be designed to be reusable or disposable. Thetemplate portions FIGS. 29-30 havesides FIGS. 29 and 30 would include several instruments with different sizes of distal ends, and would include instruments corresponding with the different sizes of implants available. - It should be appreciated that some of the features of the retractable instrument set 10 can also be applied to other types of surgical instruments. For example, a thumb gear assembly and spur gear on an instrument handle to extend and retract another component of the instrument can be applied to other surgical instruments, particularly those in which the component to be extended and retracted comprises a shape-memory material such as nitinol. One example of such a possible use of the intermeshing gears is in the United States Provisional Patent Application filed concurrently herewith by Anthony D. Zannis, Jack Farr, M.D., Randall L. Holcomb, M.D., Herbert E. Schwartz, Prasanna Malaviya, Keith M. McGrath, Danny E. McAdams and Andrew M. Jacobs and entitled “Coordinate Instrument Set”, the complete disclosure of which is incorporated by reference herein.
- While only specific embodiments of the invention have been described and shown, it is apparent that various alternatives and modifications can be made thereto. Those skilled in the art will also recognize that certain additions can be made to the illustrative embodiments. It is, therefore, the intention in the appended claims to cover all such alternatives, modifications and additions as may fall within the true scope of the invention.
Claims (9)
1. A method of repairing soft tissue comprising:
removing soft tissue to create a defect having a first side having a length and orientation and a second non-parallel side having a length and orientation;
providing a first implant including a first side having a length and orientation and a second non-parallel side having a length and orientation;
providing a second implant including a first side having a length and orientation and a second non-parallel side having a length and orientation;
providing a first sizing template including a first side having a length and orientation corresponding to the length and orientation of the first side of the first implant and a second side having a length and orientation corresponding to the length and orientation of the second side of the first implant;
providing a second sizing template including a first side having a length and orientation corresponding to the length and orientation of the first side of the second implant and a second side having a length and orientation corresponding to the length and orientation of the second side of the second implant;
introducing one of the sizing templates to the area of the defect and positioning the sizing template with its first side at the first side of the defect and with its second side at the second side of the defect;
determining whether the introduced sizing template fits the defect;
removing the sizing template;
introducing one of the implants to the area of the defect and positioning the implant in the defect.
2. The method of claim 1 wherein the soft tissue comprises the meniscus.
3. The method of claim 1 wherein at least the majority of the defect is visible with the sizing template in position at the defect.
4. The method of claim 1 wherein the step of introducing the sizing template to the area of the defect and the step of introducing one of the implants to the area of the defect are done arthroscopically.
5. The method of claim 1 wherein the sizing template is introduced through a cannula.
6. The method of claim 1 wherein the step of removing tissue comprises performing a partial meniscectomy.
7. The method of claim 1 wherein the second side of the first sizing template and second side of the second sizing template are curved.
8. The method of claim 1 wherein:
the first sizing template includes a third side connected to the second side, and the second side is connected to the first side;
the second sizing template includes a third side connected to the second side, and the second side is connected to the first side.
9. The method of claim 8 wherein the first side, second side and third side of the first sizing template comprise segments of a wire and the first side, second side and third side of the second sizing template comprise segments of a wire.
Priority Applications (1)
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US11/261,041 US20060095048A1 (en) | 2004-10-29 | 2005-10-28 | Method of repairing soft tissue using sizing templates |
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Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20040267277A1 (en) * | 2003-06-30 | 2004-12-30 | Zannis Anthony D. | Implant delivery instrument |
US20060095049A1 (en) * | 2004-10-29 | 2006-05-04 | Zannis Anthony D | Implant system with sizing templates |
US20060095053A1 (en) * | 2004-10-29 | 2006-05-04 | Zannis Anthony D | Method of delivering therapeutic implant |
Families Citing this family (39)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8551100B2 (en) | 2003-01-15 | 2013-10-08 | Biomet Manufacturing, Llc | Instrumentation for knee resection |
US7887542B2 (en) | 2003-01-15 | 2011-02-15 | Biomet Manufacturing Corp. | Method and apparatus for less invasive knee resection |
US7837690B2 (en) | 2003-01-15 | 2010-11-23 | Biomet Manufacturing Corp. | Method and apparatus for less invasive knee resection |
US7789885B2 (en) | 2003-01-15 | 2010-09-07 | Biomet Manufacturing Corp. | Instrumentation for knee resection |
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US7695479B1 (en) * | 2005-04-12 | 2010-04-13 | Biomet Manufacturing Corp. | Femoral sizer |
US20060235418A1 (en) * | 2005-04-13 | 2006-10-19 | Sdgi Holdings, Inc. | Method and device for preparing a surface for receiving an implant |
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US20150335438A1 (en) | 2006-02-27 | 2015-11-26 | Biomet Manufacturing, Llc. | Patient-specific augments |
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US7780672B2 (en) | 2006-02-27 | 2010-08-24 | Biomet Manufacturing Corp. | Femoral adjustment device and associated method |
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US9795399B2 (en) | 2006-06-09 | 2017-10-24 | Biomet Manufacturing, Llc | Patient-specific knee alignment guide and associated method |
US8265949B2 (en) | 2007-09-27 | 2012-09-11 | Depuy Products, Inc. | Customized patient surgical plan |
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US8357111B2 (en) | 2007-09-30 | 2013-01-22 | Depuy Products, Inc. | Method and system for designing patient-specific orthopaedic surgical instruments |
JP2010035853A (en) * | 2008-08-06 | 2010-02-18 | Fujifilm Corp | Successive clipping device |
FR2940759B1 (en) * | 2009-01-08 | 2011-10-07 | Memometal Technologies | INTRA MEDULLAIRE ANCHORING ROD FOR ORTHOPEDIC IMPLANT HEAD |
FR2940760B1 (en) | 2009-01-08 | 2010-12-31 | Memometal Technologies | ORTHOPEDIC IMPLANT FOR DIGITAL ARTHROPLASTY |
US8535330B2 (en) * | 2009-07-02 | 2013-09-17 | Arthrex, Inc. | Arthroscopic tibial sizer |
US9968376B2 (en) | 2010-11-29 | 2018-05-15 | Biomet Manufacturing, Llc | Patient-specific orthopedic instruments |
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US8584853B2 (en) | 2012-02-16 | 2013-11-19 | Biomedical Enterprises, Inc. | Method and apparatus for an orthopedic fixation system |
US9241729B2 (en) | 2012-12-14 | 2016-01-26 | DePuy Synthes Products, Inc. | Device to aid in the deployment of a shape memory instrument |
USD780312S1 (en) | 2014-12-31 | 2017-02-28 | Biomedical Enterprises, Inc. | Orthopedic implant sizing device |
US10390959B2 (en) | 2015-11-24 | 2019-08-27 | Agada Medical Ltd. | Intervertebral disc replacement |
US11298931B2 (en) | 2015-11-24 | 2022-04-12 | Agada Medical Ltd. | Intervertebral disc replacement |
US20180085104A1 (en) * | 2016-09-27 | 2018-03-29 | Arthrex, Inc. | Arthroscopic retracting probe |
US10722310B2 (en) | 2017-03-13 | 2020-07-28 | Zimmer Biomet CMF and Thoracic, LLC | Virtual surgery planning system and method |
US11051829B2 (en) | 2018-06-26 | 2021-07-06 | DePuy Synthes Products, Inc. | Customized patient-specific orthopaedic surgical instrument |
Citations (25)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4873976A (en) * | 1984-02-28 | 1989-10-17 | Schreiber Saul N | Surgical fasteners and method |
US4880429A (en) * | 1987-07-20 | 1989-11-14 | Stone Kevin R | Prosthetic meniscus |
US5007934A (en) * | 1987-07-20 | 1991-04-16 | Regen Corporation | Prosthetic meniscus |
US5108438A (en) * | 1989-03-02 | 1992-04-28 | Regen Corporation | Prosthetic intervertebral disc |
US5242448A (en) * | 1991-08-01 | 1993-09-07 | Pettine Kenneth A | Bone probe |
US5306311A (en) * | 1987-07-20 | 1994-04-26 | Regen Corporation | Prosthetic articular cartilage |
US5374268A (en) * | 1991-05-13 | 1994-12-20 | United States Surgical Corporation | Device and method for repairing torn tissue |
US5569252A (en) * | 1994-09-27 | 1996-10-29 | Justin; Daniel F. | Device for repairing a meniscal tear in a knee and method |
US5702462A (en) * | 1996-01-24 | 1997-12-30 | Oberlander; Michael | Method of meniscal repair |
US5980524A (en) * | 1997-06-02 | 1999-11-09 | Innovasive Devices, Inc. | Device for repairing a meniscal tear in a knee and method |
US6019739A (en) * | 1998-06-18 | 2000-02-01 | Baxter International Inc. | Minimally invasive valve annulus sizer |
US6042610A (en) * | 1987-07-20 | 2000-03-28 | Regen Biologics, Inc. | Meniscal augmentation device |
US6056778A (en) * | 1997-10-29 | 2000-05-02 | Arthrex, Inc. | Meniscal repair device |
US6156044A (en) * | 1996-12-11 | 2000-12-05 | Ethicon, Inc. | Meniscal repair device |
US6173563B1 (en) * | 1998-07-13 | 2001-01-16 | General Electric Company | Modified bottoming cycle for cooling inlet air to a gas turbine combined cycle plant |
US6293961B2 (en) * | 1998-12-30 | 2001-09-25 | Ethicon, Inc. | Suture locking device |
US6306156B1 (en) * | 1997-11-20 | 2001-10-23 | Ron Clark | Meniscus repair anchor system |
US6306159B1 (en) * | 1998-12-23 | 2001-10-23 | Depuy Orthopaedics, Inc. | Meniscal repair device |
US6427351B1 (en) * | 1998-12-28 | 2002-08-06 | Depuy Orthopaedics, Inc. | Arthroscopic measuring device |
US20030074075A1 (en) * | 2001-08-27 | 2003-04-17 | Thomas James C. | Expandable implant for partial disc replacement and reinforcement of a disc partially removed in a discectomy and for reduction and maintenance of alignment of cancellous bone fractures and methods and apparatuses for same |
US20040073110A1 (en) * | 2002-10-14 | 2004-04-15 | Stewart Mark T. | Transseptal access tissue thickness sensing dilator devices and methods for fabricating and using same |
US20050203541A1 (en) * | 2004-03-03 | 2005-09-15 | Zimmer Technology, Inc. | Tibial sizer |
US20060089621A1 (en) * | 2004-03-18 | 2006-04-27 | Mike Fard | Bone mill and template |
US20060111726A1 (en) * | 2002-07-11 | 2006-05-25 | Advanced Bio Surfaces, Inc. | Method and kit for interpositional arthroplasty |
US7160333B2 (en) * | 2000-08-04 | 2007-01-09 | Depuy Orthopaedics, Inc. | Reinforced small intestinal submucosa |
Family Cites Families (29)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5346498A (en) | 1991-11-06 | 1994-09-13 | Imagyn Medical, Inc. | Controller for manipulation of instruments within a catheter |
US5320633A (en) | 1992-12-10 | 1994-06-14 | William C. Allen | Method and system for repairing a tear in the meniscus |
US5993475A (en) | 1998-04-22 | 1999-11-30 | Bristol-Myers Squibb Co. | Tissue repair device |
US6652534B2 (en) * | 1998-10-20 | 2003-11-25 | St. Francis Medical Technologies, Inc. | Apparatus and method for determining implant size |
JP4365475B2 (en) * | 1999-04-20 | 2009-11-18 | オリンパス株式会社 | Endoscopy instrument |
US6821276B2 (en) * | 1999-08-18 | 2004-11-23 | Intrinsic Therapeutics, Inc. | Intervertebral diagnostic and manipulation device |
US8366787B2 (en) | 2000-08-04 | 2013-02-05 | Depuy Products, Inc. | Hybrid biologic-synthetic bioabsorbable scaffolds |
WO2003007839A2 (en) | 2001-07-16 | 2003-01-30 | Depuy Products, Inc. | Devices form naturally occurring biologically derived |
US7819918B2 (en) | 2001-07-16 | 2010-10-26 | Depuy Products, Inc. | Implantable tissue repair device |
WO2003007784A2 (en) | 2001-07-16 | 2003-01-30 | Depuy Products, Inc. | Meniscus regeneration device and method |
US7201917B2 (en) | 2001-07-16 | 2007-04-10 | Depuy Products, Inc. | Porous delivery scaffold and method |
US7163563B2 (en) | 2001-07-16 | 2007-01-16 | Depuy Products, Inc. | Unitary surgical device and method |
US7361195B2 (en) | 2001-07-16 | 2008-04-22 | Depuy Products, Inc. | Cartilage repair apparatus and method |
JP4197157B2 (en) | 2001-07-16 | 2008-12-17 | デピュイ・プロダクツ・インコーポレイテッド | Cartilage repair and reproduction apparatus and method |
US8025896B2 (en) | 2001-07-16 | 2011-09-27 | Depuy Products, Inc. | Porous extracellular matrix scaffold and method |
WO2003007790A2 (en) | 2001-07-16 | 2003-01-30 | Depuy Products, Inc. | Hybrid biologic/synthetic porous extracellular matrix scaffolds |
US20040166169A1 (en) | 2002-07-15 | 2004-08-26 | Prasanna Malaviya | Porous extracellular matrix scaffold and method |
US6994730B2 (en) * | 2003-01-31 | 2006-02-07 | Howmedica Osteonics Corp. | Meniscal and tibial implants |
US7559941B2 (en) | 2003-06-30 | 2009-07-14 | Depuy Products, Inc. | Instrument for delivery of implant |
US7563266B2 (en) | 2003-06-30 | 2009-07-21 | Depuy Products, Inc. | Slide and kit for delivering implants |
US7819880B2 (en) | 2003-06-30 | 2010-10-26 | Depuy Products, Inc. | Implant delivery instrument |
US7473259B2 (en) | 2003-06-30 | 2009-01-06 | Depuy Products, Inc. | Implant stabilizing instrument, kit and method |
US7326236B2 (en) * | 2003-12-23 | 2008-02-05 | Xtent, Inc. | Devices and methods for controlling and indicating the length of an interventional element |
US20050249772A1 (en) | 2004-05-04 | 2005-11-10 | Prasanna Malaviya | Hybrid biologic-synthetic bioabsorbable scaffolds |
US7569233B2 (en) | 2004-05-04 | 2009-08-04 | Depuy Products, Inc. | Hybrid biologic-synthetic bioabsorbable scaffolds |
WO2006050087A2 (en) | 2004-10-29 | 2006-05-11 | Depuy Products, Inc. | Coordinate instrument set |
AU2005227409B2 (en) | 2004-10-29 | 2012-01-19 | Depuy Products, Inc. | Implant system with sizing templates |
EP1652484B1 (en) | 2004-10-29 | 2007-08-01 | DePuy Products, Inc. | Instruments and kit for suture management |
US20080065120A1 (en) | 2005-10-31 | 2008-03-13 | Zannis Anthony D | Surgical instrument, kit and method for creating mattress-type stitches |
-
2005
- 2005-10-28 AU AU2005227409A patent/AU2005227409B2/en not_active Ceased
- 2005-10-28 US US11/261,041 patent/US20060095048A1/en not_active Abandoned
- 2005-10-28 EP EP05256710A patent/EP1652473A1/en not_active Withdrawn
- 2005-10-28 US US11/261,204 patent/US7857851B2/en active Active
Patent Citations (25)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4873976A (en) * | 1984-02-28 | 1989-10-17 | Schreiber Saul N | Surgical fasteners and method |
US4880429A (en) * | 1987-07-20 | 1989-11-14 | Stone Kevin R | Prosthetic meniscus |
US5007934A (en) * | 1987-07-20 | 1991-04-16 | Regen Corporation | Prosthetic meniscus |
US5306311A (en) * | 1987-07-20 | 1994-04-26 | Regen Corporation | Prosthetic articular cartilage |
US6042610A (en) * | 1987-07-20 | 2000-03-28 | Regen Biologics, Inc. | Meniscal augmentation device |
US5108438A (en) * | 1989-03-02 | 1992-04-28 | Regen Corporation | Prosthetic intervertebral disc |
US5374268A (en) * | 1991-05-13 | 1994-12-20 | United States Surgical Corporation | Device and method for repairing torn tissue |
US5242448A (en) * | 1991-08-01 | 1993-09-07 | Pettine Kenneth A | Bone probe |
US5569252A (en) * | 1994-09-27 | 1996-10-29 | Justin; Daniel F. | Device for repairing a meniscal tear in a knee and method |
US5702462A (en) * | 1996-01-24 | 1997-12-30 | Oberlander; Michael | Method of meniscal repair |
US6156044A (en) * | 1996-12-11 | 2000-12-05 | Ethicon, Inc. | Meniscal repair device |
US5980524A (en) * | 1997-06-02 | 1999-11-09 | Innovasive Devices, Inc. | Device for repairing a meniscal tear in a knee and method |
US6056778A (en) * | 1997-10-29 | 2000-05-02 | Arthrex, Inc. | Meniscal repair device |
US6306156B1 (en) * | 1997-11-20 | 2001-10-23 | Ron Clark | Meniscus repair anchor system |
US6019739A (en) * | 1998-06-18 | 2000-02-01 | Baxter International Inc. | Minimally invasive valve annulus sizer |
US6173563B1 (en) * | 1998-07-13 | 2001-01-16 | General Electric Company | Modified bottoming cycle for cooling inlet air to a gas turbine combined cycle plant |
US6306159B1 (en) * | 1998-12-23 | 2001-10-23 | Depuy Orthopaedics, Inc. | Meniscal repair device |
US6427351B1 (en) * | 1998-12-28 | 2002-08-06 | Depuy Orthopaedics, Inc. | Arthroscopic measuring device |
US6293961B2 (en) * | 1998-12-30 | 2001-09-25 | Ethicon, Inc. | Suture locking device |
US7160333B2 (en) * | 2000-08-04 | 2007-01-09 | Depuy Orthopaedics, Inc. | Reinforced small intestinal submucosa |
US20030074075A1 (en) * | 2001-08-27 | 2003-04-17 | Thomas James C. | Expandable implant for partial disc replacement and reinforcement of a disc partially removed in a discectomy and for reduction and maintenance of alignment of cancellous bone fractures and methods and apparatuses for same |
US20060111726A1 (en) * | 2002-07-11 | 2006-05-25 | Advanced Bio Surfaces, Inc. | Method and kit for interpositional arthroplasty |
US20040073110A1 (en) * | 2002-10-14 | 2004-04-15 | Stewart Mark T. | Transseptal access tissue thickness sensing dilator devices and methods for fabricating and using same |
US20050203541A1 (en) * | 2004-03-03 | 2005-09-15 | Zimmer Technology, Inc. | Tibial sizer |
US20060089621A1 (en) * | 2004-03-18 | 2006-04-27 | Mike Fard | Bone mill and template |
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US8574238B2 (en) | 2004-10-29 | 2013-11-05 | Depuy Mitek, Llc | Instruments, kit and method for suture management |
Also Published As
Publication number | Publication date |
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US20060095049A1 (en) | 2006-05-04 |
US7857851B2 (en) | 2010-12-28 |
EP1652473A1 (en) | 2006-05-03 |
AU2005227409B2 (en) | 2012-01-19 |
AU2005227409A1 (en) | 2006-05-18 |
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