Method of using a meniscal vascular punch

• US 6,387,111 B1
• Filed: 12/29/1999
• Issued: 05/14/2002
• Est. Priority Date: 12/31/1998
• Status: Expired due to Fees

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Barber, F. Alan
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US09/473,959
• Time in Patent Office: 867 Days
• Field of Search: 606/1, 606/184, 606/566, 606/567, 128/898
• US Class Current: 606/184
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2090/036 abutting on tissue or skin

Abstract

A method of meniscal repair promotes the healing of avascular meniscal tears undergoing repair. At least one vascular channel is formed from the white zone to the periphery of the meniscus by removing a cylinder of the meniscus. The approximately 1.5-2 mm channel remains open to allow vascularity to the avascular meniscus.

Claims

1. A method of meniscal repair comprising promoting the healing of avascular tissue in a meniscal tear by forming at least one vascular channel from the avascular white zone of the meniscal tissue of the tear toward the periphery of the meniscus to increase clot formation within the tear, the vascular channel being formed by removing a cylinder of the meniscal tissue, the channel remaining open to allow vascularity to the avascular white zone.

2. The method of claim 1, wherein the channel has a diameter of at least about 1.5 mm.

3. The method of claim 1, wherein the channel has a diameter of at least about 2 mm.

4. A method of meniscal repair comprising promoting the healing of avascular tissue in a meniscal tear by forming at least one vascular channel from the avascular white zone of the meniscal tissue of the tear toward the periphery of the meniscus by removing a cylinder of the meniscal tissue using a meniscal punch having a cannulated handle attached to a cannulated cutting tube, the cutting tube having a sharp distal end for trephining a meniscal core, and a depth stop for preventing over-insertion of the punch, the channel remaining open to allow vascularity to the avascular white zone.

5. The method of claim 4, wherein the meniscal punch further comprises formations on the inside of the cutting tube near the distal cutting end for enhancing retention of the core within the punch.

6. The method of claim 4, wherein the meniscal punch further comprises suction tubing attached to the back of the punch for extracting the core by aspiration.

7. A method of meniscal repair comprising the steps of:

introducing a punch through an arthroscopy portal in the knee;

advancing the punch into a meniscal tear toward the meniscus; and

trephining at least one meniscal core to form a vascular channel from the avascular white zone of the meniscal tissue toward the periphery of the meniscus, the channel remaining open to allow vascularity to the avascular white zone of the meniscal tissue, for promoting the healing of the meniscal tear.

8. The method of claim 7, further comprising the step of advancing the punch into the avascular white zone up to a depth established by a depth stop on the punch.

9. The method of claim 7, wherein the punch is fully cannulated, and the method further comprises the step of aspirating the at least one meniscal core using the punch.

10. The method of claim 7, wherein the punch includes an obturator, and the step of introducing the punch into the knee comprises advancing the punch into the meniscal tear toward the medial meniscus with the obturator in place, and removing the obturator prior to trephining the core.

11. The method of claim 7, further comprising forming clots in the tear.