Implant system with sizing templates

• US 20060095049A1
• Filed: 10/28/2005
• Published: 05/04/2006
• Est. Priority Date: 10/29/2004
• Status: Active Grant

• Current Assignee: Depuy Products Incorporated (Johnson & Johnson)
• Original Assignee: Depuy Products Incorporated (Johnson & Johnson)
• Inventors: Schwartz, Herbert E., Jacobs, Andrew M., McAdams, Danny E., Magee, Brian A., Zannis, Anthony D.
• Granted Patent: US 7,857,851 B2
• Time in Patent Office: Days
• US Class Current: 606/102
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/063 for measuring volume
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/4514 Cartilage
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence

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.

Claims

1. A surgical sizing instrument comprising:

a hollow tube having a proximal end and a distal end;

an elongated sizing template extending through the hollow tube, the elongated sizing template including;

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;

wherein the elongated sizing template is reciprocable in the hollow tube between an extended position and a retracted position;

wherein 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; and

wherein 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 being different from the second angular relationship.

2. The surgical sizing instrument of claim 1 wherein the hollow tube has a straight portion and a distal portion, the distal portion defining an obtuse angle with the straight portion.

3. The surgical sizing instrument of claim 1 further comprising a body at the proximal end of the hollow tube, a spur gear mounted to the body and a thumb gear mounted to the body, the spur gear including grooved teeth and the thumb gear including grooved teeth intermeshed with the grooved teeth of the spur gear, the grooves of the intermeshed teeth defining a passageway having a transverse dimension, wherein the intermediate portion of the elongated sizing template extends through the passageway.

4. The surgical sizing instrument of claim 3 wherein the intermediate portion of the elongated sizing template has a transverse dimension greater than the transverse dimension of the passageway.

5. The surgical sizing instrument of claim 1 wherein the elongated sizing template comprises a shape-memory material.

6. The surgical sizing instrument of claim 5 wherein the elongated sizing template comprises nitinol.

7. The surgical sizing instrument of claim 1 wherein the elongated sizing template comprises a super-elastic material.

8. The surgical sizing instrument of claim 7 wherein the super-elastic material comprises nitinol.

9. The surgical sizing instrument of claim 1 wherein the first resilient segment has a straight portion and the second resilient segment has a curved portion.

10. The surgical sizing instrument of claim 1 wherein the elongated sizing template includes a third resilient segment at the distal end adjacent to the second resilient segment.

11. The surgical sizing instrument of claim 1 wherein the intermediate portion of the elongated sizing template has a straight central longitudinal axis and wherein the first resilient segment has a central longitudinal axis defining an obtuse angle with the straight central longitudinal axis of the intermediate portion.

12. The surgical sizing instrument of claim 1 wherein the intermediate portion of the elongated sizing template has a straight central longitudinal axis and wherein the first resilient segment and second resilient segment are not co-linear with the straight central longitudinal axis of the intermediate portion.

13. The surgical sizing instrument of claim 1 wherein the hollow tube has a transverse interior dimension and wherein the length of the first resilient segment is greater than the transverse interior dimension of the hollow tube.

17. The surgical sizing instrument set of claim 12 wherein the elongated sizing template of each surgical sizing instrument comprises a super-elastic material.

18. The surgical sizing instrument of claim 17 wherein the super-elastic material comprises nitinol.

19. The surgical sizing instrument set of claim 12 wherein the hollow tube of the first surgical sizing instrument is straight along its entire length.

20. The surgical sizing instrument set of claim 12 wherein the hollow tube of the second surgical sizing instrument includes a straight portion and a distal portion defining an obtuse angle with the straight portion.

21. The surgical sizing instrument set of claim 12 wherein the first surgical sizing instrument further comprises a body at the proximal end of the hollow tube, a spur gear mounted to the body and a thumb gear mounted to the body, the spur gear including grooved teeth and the thumb gear including grooved teeth intermeshed with the grooved teeth of the spur gear, the grooves of the intermeshed teeth defining a passageway having a transverse dimension, wherein the intermediate portion of the elongated sizing template extends through the passageway.

22. The surgical sizing instrument set of claim 21 wherein the intermediate portion of the elongated sizing template has a transverse dimension greater than the transverse dimension of the passageway.

23. The surgical sizing instrument set of claim 21 wherein the second surgical sizing instrument further comprises a body at the proximal end of the hollow tube, a spur gear mounted to the body and a thumb gear mounted to the body, the spur gear including grooved teeth and the thumb gear including grooved teeth intermeshed with the grooved teeth of the spur gear, the grooves of the intermeshed teeth defining a passageway having a transverse dimension, wherein the intermediate portion of the elongated sizing template extends through the passageway.

24. The surgical sizing instrument set of claim 23 wherein the intermediate portion of the elongated sizing template has a transverse dimension greater than the transverse dimension of the passageway.

14. A surgical sizing instrument set comprising:

a first surgical sizing instrument including;

a hollow tube having a proximal end and a distal end;

an elongated sizing template extending through the hollow tube, the elongated sizing template having;

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;

wherein the elongated sizing template is reciprocable in the hollow tube between an extended position and a retracted position; and

wherein 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 being different from the second angular relationship;

the surgical sizing instrument set further comprising a second surgical sizing instrument including;

a hollow tube having a proximal end and a distal end;

an elongated sizing template extending through the hollow tube, the elongated sizing template having;

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;

wherein the elongated sizing template is reciprocable in the hollow tube between an extended position and a retracted position; and

wherein 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 being different from the second angular relationship;

wherein the length of at least one of resilient segments of the first surgical sizing instrument is greater than the length at least one of the resilient segments of the second surgical sizing instrument.

15. The surgical sizing instrument set of claim 14 wherein the elongated sizing template of each surgical sizing instrument comprises a shape-memory material.

16. The surgical sizing instrument of claim 15 wherein the elongated sizing template of each surgical sizing instrument comprises nitinol.

25. A surgical instrument having a proximal end and a distal end, the instrument comprising:

a handle at the proximal end;

a tube extending distally from the handle, the tube defining a channel;

a first gear rotatably mounted to the handle, the first gear having a plurality of grooved teeth;

a second gear rotatably mounted to the handle, the second gear having 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 defining a passageway aligned with the channel of the tube

an elongated member extending through the passageway and into the channel of the tube, the elongated member being movable in a proximal direction by rotating the first gear in one direction and being movable in the distal direction by rotating the first gear in the opposite direction.

26. The surgical instrument of claim 25 wherein the elongated member comprises a shape-memory material.

27. The surgical instrument of claim 26 wherein the elongated member comprises nitinol.

28. The surgical instrument of claim 25 wherein the elongated member comprises a super-elastic material.

29. The surgical instrument of claim 28 wherein the super-elastic material comprises nitinol.

30. The surgical instrument of claim 25 wherein the elongated member comprises a sizing template.

31. The surgical instrument of claim 25 wherein the elongated member has an outer diameter and the passageway has a transverse dimension less than the outer diameter of the elongated member.

32. The surgical instrument of claim 25 further comprising a thumb wheel rotatably mounted to the handle and operable to drive the first gear.

33. A surgical implant system comprising:

a first implant having a width and a length;

a second implant having a width and a length, wherein at least one of the width and length of the second implant being larger than the corresponding dimension of the first implant;

a first surgical sizing instrument including;

a hollow tube having a proximal end and a distal end;

an elongated sizing template extending through the hollow tube, the elongated sizing template having;

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;

wherein the elongated sizing template is reciprocable in the hollow tube between an extended position and a retracted position;

wherein 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;

wherein 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 being different from the second angular relationship;

the surgical sizing instrument set further comprising a second surgical sizing instrument including;

a hollow tube having a proximal end and a distal end;

an elongated sizing template extending through the hollow tube, the elongated sizing template having;

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;

wherein the elongated sizing template is reciprocable in the hollow tube between an extended position and a retracted position;

wherein the first resilient segment 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; and

wherein 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 being different from the second angular relationship.

34. The implant system of claim 33 wherein the first implant and second implant are sized and shaped to replace a portion of a meniscus.

35. The implant system of claim 33 wherein:

the first implant has an edge along its width and an edge along its length;

the second implant has an edge along its with and an edge along its length;

the shape of the first resilient segment of the first surgical sizing instrument corresponds with the shape of the edge along the width of the first implant;

the shape of the second resilient segment of the first surgical sizing instrument corresponds with the shape of the edge along the length of the first implant;

the shape of the first resilient segment of the second surgical sizing instrument corresponds with the shape of the edge along the width of the second implant; and

the shape of the second resilient segment of the second surgical sizing instrument corresponds with the shape of the edge along the length of the second implant.

36. The implant system of claim 33 wherein the elongated sizing template of each surgical sizing instrument comprises a shape-memory material.

37. The implant system of claim 36 wherein the elongated sizing template of each surgical sizing instrument comprises nitinol.

38. The implant system of claim 33 wherein the elongated sizing template of each surgical sizing instrument comprises a super-elastic material.

39. The implant system of claim 38 wherein the super-elastic material comprises nitinol.

40. The implant system of claim 33 wherein the hollow tube of the first surgical sizing instrument is straight along its entire length.

41. The implant system of claim 40 wherein the hollow tube of the second surgical sizing instrument includes a straight portion and a distal portion defining an obtuse angle with the straight portion.

42. The implant system of claim 33 wherein the first surgical sizing instrument further comprises a body at the proximal end of the hollow tube, a spur gear mounted to the body and a thumb gear mounted to the body, the spur gear including grooved teeth and the thumb gear including grooved teeth intermeshed with the grooved teeth of the spur gear, the grooves of the intermeshed teeth defining a passageway having a transverse dimension, wherein the intermediate portion of the elongated sizing template extends through the passageway.

43. The implant system of claim 42 wherein the intermediate portion of the elongated sizing template has a transverse dimension greater than the transverse dimension of the passageway.

44. The implant system of claim 42 wherein the second surgical sizing instrument further comprises a body at the proximal end of the hollow tube, a spur gear mounted to the body and a thumb gear mounted to the body, the spur gear including grooved teeth and the thumb gear including grooved teeth intermeshed with the grooved teeth of the spur gear, the grooves of the intermeshed teeth defining a passageway having a transverse dimension, wherein the intermediate portion of the elongated sizing template extends through the passageway.

45. The implant system of claim 33 wherein the intermediate portion of the elongated sizing template has a transverse dimension greater than the transverse dimension of the passageway.

46. The implant system of claim 33 wherein the distal end of the hollow tube of each instrument has a maximum cross-sectional outer dimension of 12 mm.