Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
1999-06-17
2001-03-13
Buiz, Michael (Department: 3731)
Surgery
Instruments
Orthopedic instrumentation
C606S075000, C606S077000, C411S005000
Reexamination Certificate
active
06200323
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to devices and methods for resectioning a bone, and, more particularly, to devices and associated methods for gauging resection depth.
2. Description of Related Art
In arthroscopic surgical procedures for alleviating joint damage, it is typical to remove a portion of a bone. An exemplary procedure is that undertaken to correct impingement syndrome in the shoulder, when the subacromial space in the rotator cuff is tight, or if a spur or downward curvature is present in the acromion. Bone may also be thinned preparatory to attaching a soft tissue graft, such as in anterior cruciate ligament replacement surgery, wherein 5-7 mm of the lateral femoral condyle may be removed to avoid impingement on the ligament graft.
At present there is no known method of determining precisely how much bone should be removed, nor of gauging how much bone has been removed during the procedure. As these procedures are performed through the limited perspective available from arthroscopy, further limited by its monocular nature, depth perception is compromised. Consequently, a surgeon may remove an insufficient amount of bone, possibly mis-sizing, resulting in an impingement problem, or may oversize, creating an inadequate fit, potentially leaving the patient with too little bone mass and with a susceptibility to subsequent fracture.
Other situations also require a knowledge of bone thickness: for gauging bone removal in an osteomyelitis procedure, during reaming of long bones having intramedullary fractures, and for cortex thinning prior to insertion of stemmed arthroplasty components. There is currently no device or method for measuring bone thickness for any of these applications.
SUMMARY OF THE INVENTION
It is therefore an object of the present invention to provide a device for gauging bone thickness during a surgical procedure.
It is an additional object to provide such a device for use in arthroscopic procedures.
It is a further object to provide such a device that is biocompatible.
It is another object to provide such a device that is bioresorbable.
It is yet an additional object to provide such a device that provides a continuous indication of bone thickness.
It is yet a further object to provide a system for measuring a bone shape.
It is yet another object to provide a system for contouring a bone to a desired shape.
An additional object is to provide a method of gauging bone thickness during a surgical procedure.
A further object is to provide a method of deploying a bone thickness gauge during a surgical procedure.
Another object is to provide a method for contouring a bone to a predetermined shape.
Yet an additional object is to provide a method of defining an anatomical boundary for an arthroscopic procedure.
These objects and others are attained by the present invention, a bone depth gauge and methods of using. The gauge, which is for measuring bone thickness, includes an elongated pin for insertion into a bore through a bone section slated for resection. The pin has a length sufficient to span the entire bone section with a distal tip protruding therefrom. Additionally, the pin comprises a material that is excisable along with the bone material
The pin further has a length measurement indicator disposed along at least a portion of an outer surface, such as, but not limited to, a series of colored bands or indicia, the visualization of which communicates bone thickness.
The gauge also has a head affixed at a proximal end of the pin, and preferably coformed therewith, which is dimensioned to prevent its movement into the bone section's bore. In a particular embodiment a protrusion, such as a barb or screw thread, extends from the pin's outer surface to assist in retaining the pin within the bore.
In another embodiment the gauge comprises a headless pin that is insertable through a cannula placed at the bone surface adjacent a predrilled hole. In other respects the pin is substantially identical.
Methods utilizing gauges as described above are valuable in arthroscopic procedures, for example, in resectioning an anterior corner of an acromion to relieve effects of tight tolerances in the rotator cuff area of the shoulder. Another exemplary use is in notchplasty, such as in the removal of bone material from the medial wall of the lateral femoral condyle preparatory to anterior cruciate ligament replacement in the knee. Yet another exemplary use is in reaming a bone canal to remove bone and/or cement material.
A further method includes utilizing a plurality of at least one of the types of above-described gauges disposed about a section of bone to permit the contouring of the bone to a predetermined shape, with each gauge being visualized to ascertain a bone thickness at a plurality of points about the bone section.
The features that characterize the invention, both as to organization and method of operation, together with further objects and advantages thereof, will be better understood from the following description used in conjunction with the accompanying drawing. It is to be expressly understood that the drawing is for the purpose of illustration and description and is not intended as a definition of the limits of the invention. These and other objects attained, and advantages offered, by the present invention will become more fully apparent as the description that now follows is read in conjunction with the accompanying drawing.
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Allen Dyer Doppelt Milbrath & Gilchrist, P.A.
Buiz Michael
Woo Julian W.
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