Apparatus for guiding and positioning an implant

• US 9,463,012 B2
• Filed: 10/05/2005
• Issued: 10/11/2016
• Est. Priority Date: 10/26/2004
• Status: Active Grant

• Current Assignee: P TECH, LLC
• Original Assignee: P TECH, LLC
• Inventors: Bonutti, Peter M., Phillips, Glen A.
• Primary Examiner(s): SEVILLA, CHRISTIAN ANTHONY
• Application Number:
  US11/202,294
• Publication Number:
  US 20070088362A1
• Time in Patent Office: 4,024 Days
• Field of Search: 606/86.R, 606/96, 606/99, 606/104, 606/139, 606/148, 606/147, 606/144, 606/232
• US Class Current: 1/1
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/683 comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
• CPC Class Codes: A61B 17/685 Elements to be fitted on the end of screws or wires, e.g. protective caps
• CPC Class Codes: A61B 17/7053 with parts attached to bones or to each other by flexible wires, straps, sutures or cables
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/7067 Devices bearing against one or more spinous processes and also attached to another part of the spine; Tools therefor
• CPC Class Codes: A61B 17/82 : for bone cerclage apparatus for manipulating wires or straps A61B17/8861; wires, bands or straps other than cerclage A61B17/842
• CPC Class Codes: A61B 17/842 : Flexible wires, bands or straps A61B17/72, A61B17/82, A61B17/86 take precedence
• CPC Class Codes: A61B 17/844 : with expandable anchors or anchors having movable parts
• CPC Class Codes: A61B 17/8861 : Apparatus for manipulating flexible wires or straps devices for inserting Kirschner wires A61B17/1697
• CPC Class Codes: A61B 17/8863 : Apparatus for shaping or cutting osteosynthesis equipment by medical personnel
• CPC Class Codes: A61B 17/8869 : Tensioning devices
• CPC Class Codes: A61B 2017/00004 : (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/00398 : using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00477 : Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00818 : Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00876 : magnetic
• CPC Class Codes: A61B 2017/00893 : pharmaceutically effective
• CPC Class Codes: A61B 2017/00898 : expandable upon contact with fluid
• CPC Class Codes: A61B 2017/00951 : adhesive
• CPC Class Codes: A61B 2017/0404 : Buttons
• CPC Class Codes: A61B 2017/0409 : Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 : having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0417 : T-fasteners
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/2926 : Details of heads or jaws
• CPC Class Codes: A61B 2090/035 : preventing further rotation
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2/0063 : Implantable repair or support meshes, e.g. hernia meshes
• CPC Class Codes: A61F 2/08 : Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0811 : Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2/28 : Bones joints A61F2/30
• CPC Class Codes: A61F 2/30749 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2/4405 : for apophyseal or facet joints, i.e. between adjacent spinous or transverse processes devices implanted between spinous or transverse processes A61B17/7062
• CPC Class Codes: A61F 2/441 : made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• CPC Class Codes: A61F 2/442 : Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2002/2817 : Bone stimulation by chemical reactions or by osteogenic or biological products for enhancing ossification, e.g. by bone morphogenetic or morphogenic proteins [BMP] or by transforming growth factors [TGF]
• CPC Class Codes: A61F 2002/30062 : (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30462 : retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/4435 : Support means or repair of the natural disc wall, i.e. annulus, e.g. using plates, membranes or meshes
• CPC Class Codes: A61F 2002/444 : for replacing the nucleus pulposus
• CPC Class Codes: A61F 2210/0004 : bioabsorbable
• CPC Class Codes: A61F 2310/00293 : containing a phosphorus-containing compound, e.g. apatite
• CPC Class Codes: A61F 2310/00359 : Bone or bony tissue
• CPC Class Codes: A61L 27/58 : Materials at least partially resorbable by the body

Abstract

An implant guidance and positioning device is provided for dynamic and rigid fixation of tissue or an implant. The device includes a handle and an elongated hook connected with the handle, which may have a lumen extending therethrough or may have a socket that can receive fasteners. The device also includes a guide channel or slot disposed in the handle. The longitudinal axis of the guide channel or slot may be generally aligned with or slightly offset from a distal end of the elongated hook or socket.

Claims

1. An apparatus for positioning an implant relative to a fractured and main portion of a bone, the apparatus comprising:

a handle;

a delivery member extending through the handle fixable in a discrete position with respect to the handle, the delivery member having a generally straight proximal portion and a curved member, the curved member including a distal end configured for engaging at least a portion of the fractured portion of the bone;

a guide channel extending through the handle, the guide channel including a longitudinal axis that is configured to substantially align with the distal end of the curved member, wherein the guide channel is configured to move with respect to the handle to position against the main portion of the bone to substantially approximate the fractured portion of the bone to the main portion of the bone, and wherein the guide channel is configured to receive at least a portion of a puncture member configured to move through at least one of the fractured portion and main portion of the bone; and

a locking mechanism coupled to the handle and configured to secure the delivery member with respect to the handle;

wherein the proximal portion of the delivery member and the guide channel are generally parallel, such that the delivery member and the guide channel can be passed through a single portal or incision.

2. The apparatus of claim 1, wherein the guide channel is further configured to receive at least one of a cannula and sleeve of a drill system, the at least one cannula and sleeve operable to link a passage in the bone created by the drill system with the guide channel.

3. The apparatus of claim 1, wherein the delivery member is configured for retaining an implant, wherein the implant is a fastener having a suture attached thereto.

4. The apparatus of claim 3, further including an elongated claw dimensioned for insertion through the guide channel, the elongated claw including a member configured to secure the suture.

5. The apparatus of claim 3, wherein the fastener is fabricated from an ultrasonically-bondable material.

6. The apparatus of claim 1, wherein the device is operable to compress the fractured portion of the bone and the main portion of the bone together, guide an implant through the fractured portion and main portion of the bone, and deliver the implant while retaining the compressed portions of the bone.

7. The apparatus of claim 1, wherein the puncture member is a drill system.

12. The apparatus of claim 1, wherein the guide channel is configured to position against the main portion of the bone to substantially approximate the fractured portion of the bone to the main portion of the bone further comprises the guide channel is configured to position against the main portion of the bone to substantially compress or stabilize the fractured portion of the bone to the main portion of the bone.

8. An apparatus for positioning an implant relative to two portions of body tissue, the apparatus comprising:

a handle;

a delivery member extending through the handle fixable in a discrete position with respect to the handle, the delivery member having a generally straight proximal portion and a curved member, the curved member including a distal end configured for engaging a portion of a first body tissue;

a guide channel extending through the handle, the guide channel including a longitudinal axis that is configured to substantially align with the distal end of the curved member, wherein the guide channel is configured to move with respect to the handle to position against a portion of a second body tissue, wherein the delivery member and the guide channel are configured to compress the first body tissue and the second body tissue; and

a locking mechanism coupled to the handle and configured to secure the delivery member with respect to the handle;

wherein the proximal portion of the delivery member and the guide channel are generally parallel, such that the delivery member and the guide channel can be passed through a single portal or incision.

9. The apparatus of claim 8, wherein the guide channel is configured to receive at least a portion of a puncture member configured to move through the second body tissue to create a passage in the second body tissue.

10. The apparatus of claim 8, wherein the guide channel is configured to receive a fastener that is configured to move through a passage in the second body tissue while the delivery member and the guide channel compress the first body tissue and the second body tissue.

11. The apparatus of claim 8, wherein at least one of the first and second body tissues is hard body tissue.