ELECTROSURGICAL SYSTEM AND METHOD FOR TREATING HARD BODY TISSUE

• US 20120197344A1
• Filed: 02/02/2011
• Published: 08/02/2012
• Est. Priority Date: 02/02/2011
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Taft, Richard J., Seybold, Danielle
• Granted Patent: US 9,131,597 B2
• Time in Patent Office: Days
• US Class Current: 607/51
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 2018/00565 Bone
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00583 Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/144 Wire
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/44 Applying ionised fluids ion generators H01J37/00
• CPC Class Codes: H05H 1/46 using applied electromagnetic fields, e.g. high frequency or microwave energy H05H1/26 takes precedence
• CPC Class Codes: H05H 1/466 using capacitive coupling means, e.g. electrodes
• CPC Class Codes: H05H 2245/34 Skin treatments, e.g. disinfection or wound treatment

Abstract

A method of preparing a target hard body tissue, such as osseous or dental tissue, to receive an implant component including; positioning an active electrode in proximity to a target tissue and proximate an electrically conductive fluid, followed by applying a high frequency voltage between the active electrode and a return electrode, the high frequency voltage sufficient to form a plasma. This plasma modifies at least a portion of the target tissue. An implant component may then be placed adjacent at least a portion of the modified target tissue.

Claims

1. A method of preparing a target tissue, including bone tissue and any surrounding wound tissue, to receive an implant component comprising:

positioning an active electrode in proximity to the target tissue and proximate an electrically conductive fluid;

applying a high frequency voltage between the active electrode and a return electrode, the high frequency voltage sufficient to form a plasma, wherein the plasma modifies at least a portion of the target tissue; and

disposing an implant component adjacent at least a portion of the modified target tissue.

2. The method of claim 1, wherein the target tissue comprises an area of bone tissue exposed following a resection of a portion of a bone body.

3. The method of claim 2, in which the bone body comprises at least one of the group consisting of:

a femur, a tibia, an acetabulum, a humerus, a scapula, a spine, a jaw bone, an area proximate a bone graft site, a bone graft and an area proximate a bone harvest site.

4. The method of claim 1, wherein the target tissue comprises an area proximate a bone fracture site.

5. The method of claim 1, wherein the target tissue comprises an area proximate a bone being prepared to receive a bone plate system.

6. The method of claim 2, wherein the resection portion creates a bone tunnel operable to receive a ligament anchor.

7. The method of claim 1 further comprising treating at least a portion of the target tissue with an osteoinductive compound.

8. The method of claim 1, wherein the target tissue is selected from the group consisting of cortical bone, cancellous bone and bi-cortical bone.

9. The method of claim 1, wherein applying the high frequency voltage modifies at least a portion of the target tissue according to at least one of the group consisting of:

inducing blood flow to the tissue, debriding the tissue, creating a tissue surface geometry for enhanced implant bonding, sterilizing the tissue, invoking a gene expression in the target tissue, eliciting a change in the metabolic response of the tissue, eliciting a biochemical response in the tissue, and eliciting a physiological response in the tissue.

10. The method of claim 1 further comprising applying the high frequency voltage for a period sufficient to promote ingrowth of the target bone tissue into at least a portion of the implant component.

11. The method of claim 1, whereby positioning the active electrode comprises translating the active electrode axially and radially over tissue in the proximity of the target tissue.

12. The method of claim 1, wherein the plasma is generated within the electrically conductive fluid.

13. The method of claim 1, wherein the electrically conductive fluid comprises a conductive bridge disposed between the active and return electrodes.

14. The method of claim 1, wherein the electrically conductive fluid comprises a least one selected from the group consisting of:

a body fluid, a conductive gel, isotonic saline and Ringer'"'"'s lactate solution.

15. The method of claim 1, wherein the active electrode is selected from the group consisting of an electrode having a pointed tip, a wire electrode, a screen electrode, a loop electrode, and a suction electrode.

16. The method of claim 1, further comprising at least partially contacting the target tissue with the active electrode.

17. The method of claim 1, further comprising wetting the target tissue with the conductive fluid.

18. The method of claim 1, further comprising limiting the period of the application of high frequency voltage between the active electrode and the return electrode for about 0.05 seconds to 3 seconds on each instance.

19. The method of claim 1, further comprising limiting the period of the application of high frequency voltage between the active electrode and the return electrode for about 0.5 seconds on each instance.

20. The method of claim 1, wherein the plasma applies an electrical field to at least a portion of the target tissue to stimulate bone repair and growth.

21. The method of claim 1, wherein modifying the tissue comprises coagulating at least a portion of the target tissue.

22. The method of claim 1 wherein modifying the target tissue comprises inducing at least a portion of target bone tissue to molecularly dissociate.

23. The method of claim 22, wherein inducing the target tissue to molecularly disassociate further comprises ablating target tissue to a controlled depth to form a modified tissue surface having a substantially non-necrotic surface.

24. The method of claim 1 wherein the step of positioning the active electrode is performed using a robot.

25. The method of claim 1 wherein the surrounding tissue comprises a hematoma.

26. An electrosurgical method of treating bone tissue and any proximate tissue comprising:

positioning an active electrode in proximity to a target bone tissue and an electrically conductive fluid; and

applying a high frequency voltage between the active electrode and a return electrode, the high frequency voltage sufficient to form a plasma, wherein the plasma modifies the bone tissue and proximate tissues to stimulate bone repair and growth.

27. The method of claim 26, wherein the bone tissue comprises an area of bone tissue exposed following a resection of a portion of a bone body, so as to receive an implant component.

28. The method of claim 27, in which the bone body comprises at least one of the group consisting of:

a femur, a tibia, an acetabulum, a humerus, a scapula, a spine, a jaw bone, an area proximate a bone graft site, a bone graft and an area proximate a bone harvest site.

29. The method of claim 26, wherein the tissue comprises an area proximate a bone fracture site.

30. The method of claim 27, wherein the resected target bone tissue creates a bone tunnel operable to receive an implant.

31. The method of claim 27 further comprising treating at least a portion of the bone tissue with an osteoinductive compound.

32. The method of claim 26, wherein the bone tissue is selected from the group consisting of cortical bone, cancellous bone and bi-cortical bone.

33. The method of claim 27 further comprising applying the high frequency voltage for a period sufficient to promote osseointegration between the bone tissue and at least a portion of the implant component.

34. The method of claim 26, wherein applying the high frequency voltage modifies at least a portion of the tissue according to at least one of the group consisting of:

inducing blood flow to the tissue, sterilizing the tissue, debriding the tissue, creating a tissue surface geometry for enhanced implant bonding, invoking a gene expression in the tissue, eliciting a change in the metabolic response of the tissue, eliciting a biochemical response in the tissue, and eliciting a physiological response in the tissue.

35. The method of claim 26, whereby positioning the active electrode comprises translating the active electrode axially and radially over tissue in the proximity of the tissue.

36. The method of claim 26, wherein the plasma is generated within the electrically conductive fluid.

37. The method of claim 26, wherein the electrically conductive fluid comprises a conductive bridge disposed between the active and return electrodes.

38. The method of claim 26, wherein the electrically conductive fluid comprises a least one selected from the group consisting of:

a body fluid, a conductive gel, isotonic saline and Ringer'"'"'s lactate solution.

39. The method of claim 26, wherein the active electrode is selected from the group consisting of an electrode having a pointed tip, a wire electrode, a screen electrode, a loop electrode, and a suction electrode.

40. The method of claim 26, further comprising at least partially contacting the tissue with the active electrode.

41. The method of claim 26, further comprising wetting the tissue with the conductive fluid.

42. The method of claim 26, further comprising limiting the period of the application of high frequency voltage between the active electrode and the return electrode for about 0.05 seconds to 3 seconds on each instance.

43. The method of claim 26, further comprising limiting the period of the application of high frequency voltage between the active electrode and the return electrode for about 0.5 seconds on each instance.

44. The method of claim 26, wherein modifying the tissue comprises coagulating at least a portion of the tissue.

45. The method of claim 26, wherein modifying the tissue further comprises inducing at least a portion of tissue to molecularly dissociate.

46. The method of claim 45, wherein inducing the tissue to molecularly disassociate further comprises ablating bone tissue to a controlled depth to form a modified tissue surface having a substantially non-necrotic surface.

47. The method of claim 26 wherein the step of positioning the active electrode is performed using a robot.

48. A method of treating bone tissue and some proximate tissue comprising:

positioning an active electrode in proximity to a target bone tissue; and

applying a high frequency voltage between the active electrode and a return electrode, the high frequency voltage sufficient to develop a high electric field intensity associated with a vapor layer proximate the active electrode, wherein the electric field intensity stimulates the secretion of at least one growth mediator associated with bone repair.

49. The method of claim 48, wherein the target bone tissue comprises an area of bone tissue being resected so as to receive an implant.

50. The method of claim 49, in which the target bone tissue comprises at least one of the group consisting of:

a femur, a tibia, an acetabulum, a humerus, a scapula, a spine, a jaw bone, an area proximate a bone graft site, a bone graft and an area proximate a bone harvest site.

51. The method of claim 48, wherein the target bone tissue comprises an area proximate a bone fracture site.

52. The method of claim 49, wherein the target bone tissue comprises an area proximate a bone being prepared to receive a bone plate.

53. The method of claim 49, wherein the resection portion creates a bone tunnel operable to receive an anchor.

54. The method of claim 48, further comprising treating at least a portion of the target bone tissue with an osteoinductive compound.

55. The method of claim 48, wherein a plasma is generated within the electrically conductive fluid.

56. The method of claim 48, wherein the electrically conductive fluid comprises a least one selected from the group consisting of:

a body fluid, a conductive gel, isotonic saline and Ringer'"'"'s lactate solution.

57. The method of claim 48, wherein the high frequency voltage induces the target bone tissue to molecularly disassociate and ablates the bone tissue to a controlled depth to form a modified tissue surface having a substantially non-necrotic surface.

58. The method of claim 48, wherein the step of positioning the active electrode is performed using a robot.

59. A method of preparing a target bone tissue comprising:

positioning an active electrode in proximity to a target bone tissue and proximate an electrically conductive fluid, wherein the target tissue is being prepared to receive an implant component; and

applying a high frequency voltage between the active electrode and a return electrode, the high frequency voltage sufficient to form a plasma, wherein the plasma applies an electrical field to at least a portion of the target bone tissue and some proximate tissues to stimulate bone repair and growth.