Methods of repairing a joint using a wedge-shaped implant

• US 9,526,632 B2
• Filed: 08/14/2015
• Issued: 12/27/2016
• Est. Priority Date: 05/26/2011
• Status: Active Grant

• Current Assignee: Cartiva, Inc. (Stryker Corporation)
• Original Assignee: Cartiva, Inc. (Stryker Corporation)
• Inventors: Walsh, Steven P., Tudor, Letitia, Corrao, Ernest N., Berky, Craig B., Bauer, Jonathan P., Hemingway, Jeremy, Axelrod, Michael
• Primary Examiner(s): STEWART, JASON-DENNIS NEILKEN
• Application Number:
  US14/826,918
• Publication Number:
  US 20160038308A1
• Time in Patent Office: 501 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1617 with mobile or detachable parts
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/38 for elbows or knees
• CPC Class Codes: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4618 of cartilage
• CPC Class Codes: A61F 2002/30075 swellable, e.g. when wetted
• CPC Class Codes: A61F 2002/3021 frustoconical
• CPC Class Codes: A61F 2002/30327 differing in diameter
• CPC Class Codes: A61F 2002/30759 Mosaicplasty, i.e. using a plurality of individual cartilage plugs for filling a substantial cartilage defect
• CPC Class Codes: A61F 2002/4627 with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4628 with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping

Abstract

According to some embodiments, a method of treating a joint of a patient comprises creating a recess in a bone located at or near a targeted joint, wherein the recess includes a generally wedge or truncated cone shape. In one embodiment, the recess in a bone comprises a surface opening along an outer surface of the bone and a bottom opening along the distal end of the recess, such that a diameter of the surface opening is generally smaller than a diameter of the bottom opening. The method additionally comprises providing a joint implant having a wedge or truncated cone shape, wherein a diameter of a top end of the joint implant is generally smaller than a diameter of a bottom end of the joint implant, inserting the joint implant within the recess.

Claims

1. A method of treating a targeted joint, comprising:

creating a recess in a bone located at or near the targeted joint, the recess comprising a wedge shape, wherein creating the recess comprises creating a cylindrical opening in the bone and removing additional tissue along the cylindrical opening to create the wedge shape;

wherein the recess in a bone comprises a surface opening along an outer surface of the bone, a bottom opening along the distal end of the recess and side walls generally extending between the surface opening and the bottom opening, wherein a diameter or other cross-sectional dimension of the bottom opening is larger than a diameter or other cross-sectional dimension of the surface opening to provide the wedge shape to the recess;

radially compressing an implant having a wedge shape, the implant comprising a first end and a second end and a body extending between the first end and the second end, the second end being generally opposite of said first end;

wherein when the implant is in a radially uncompressed state, a diameter or other cross-sectional dimension of the first end is smaller than a diameter or other cross-sectional dimension of the second end;

while the implant is in a radially compressed state, inserting the implant within the recess, wherein the second end of the implant is inserted first within the recess;

wherein the second end of the implant is adjacent the bottom opening of the recess, and wherein the first end of the implant is adjacent the surface opening of the recess when the implant is positioned within the recess; and

releasing the implant from a radially compressed state to a less compressed state, when the implant is positioned within the recess;

wherein, when the implant is in a less compressed state, the diameter or other cross-sectional dimension of the second end of the implant is larger than the diameter or other cross-sectional dimension of the surface opening of the recess; and

wherein, when the implant is in a radially uncompressed state, the body of the implant imparts a radial force at least partially along the side walls of the recess, thereby securing the implant within the recess.

2. The method of claim 1,

wherein creating the recess in a bone comprises using a tool comprising a cutter configured to selectively enlarge the recess near the bottom opening along the distal end of the recess;

wherein the tool is cannulated, the tool being configured to be positioned over a guide pin to place a working end of the tool at or near a targeted location of the recess; and

wherein the implant is radially compressed and inserted within the recess using an introducer.

3. The method of claim 1, wherein creating the recess in a bone comprises using a tool comprising a cutter configured to selectively enlarge the recess near the bottom opening along the distal end of the recess.

4. The method of claim 3, wherein the tool is cannulated, the tool being configured to be positioned over a guide pin to place a working end of the tool at or near a targeted location of the recess.

5. The method of claim 1, wherein the implant is radially compressed and inserted within the recess using an introducer.

6. The method of claim 5, wherein the implant is moved through an interior of the introducer using a plunger or other pusher member.

7. The method of claim 5, wherein the implant is moved through an interior of the introducer using a mechanically-assisted device.

8. The method of claim 7, wherein the mechanically-assisted device comprises a handle and a clamp coupled to the handle, wherein moving the clamp relative to the handle urges a plunger within an introducer to radially compress the implant and insert the implant within the recess.

9. The method of claim 1, wherein the implant comprises a hydrogel.

10. The method of claim 1, wherein a ratio of the diameter or other cross-sectional dimension of the second end of the implant to the diameter or other cross-sectional dimension of the first end of the implant is approximately between 1.05 and 1.3.

11. The method of claim 1, wherein the diameter or other cross-sectional dimension of the second end of the implant is approximately 5% to 25% larger than the diameter or other cross-sectional dimension of the implant.

12. The method of claim 1, wherein the recess is located within or near at least one of a toe, finger, ankle, knee, shoulder, hip or other joint.

13. A method of treating a targeted joint, comprising:

creating a recess in a bone located at or near the targeted joint, the recess comprising a wedge shape with a bottom opening having a larger diameter or other cross-sectional dimension than a surface opening, wherein creating the recess comprises creating a cylindrical opening in the bone and removing additional tissue along the cylindrical opening to create the wedge shape;

at least partially radially compressing an implant having wedge shape, wherein when the implant is in a radially uncompressed state, a diameter or other cross-sectional dimension of a first end of the implant is smaller than a diameter or other cross-sectional dimension of a second end of the implant;

while the implant is at least partially radially compressed, inserting the implant within the recess, wherein the second end of the implant is inserted first within the recess; and

allowing the implant to be released from a radially compressed state to a less compressed state when the implant is positioned within the recess;

wherein, when the implant is in a less compressed state, the diameter or other cross-sectional dimension of the second end of the implant is larger than the diameter or other cross-sectional dimension of the surface opening of the recess; and

wherein, when the implant is in a radially uncompressed state, the body of the implant imparts a radial force against walls of the recess, thereby helping to secure the implant within the recess.

14. The method of claim 13,

wherein the implant is at least radially compressed and inserted within the recess using an introducer;

wherein creating the recess in a bone comprises using a tool with a cutter; and

wherein the tool is configured to be positioned over a guide pin to place a working end of the tool at or near a targeted location of the recess.

15. The method of claim 14, wherein the tool is cannulated, the tool being configured to be positioned over a guide pin to place a working end of the tool at or near a targeted location of the recess.

16. The method of claim 13, wherein creating the recess in a bone comprises using a tool with a cutter.

17. The method of claim 13, wherein the implant is at least partially radially compressed and inserted within the recess using an introducer.

18. A method of treating a targeted joint, comprising:

creating an opening in a bone located at or near the targeted joint, the opening comprising a wedge shape with a bottom area having a larger diameter or other cross-sectional dimension than a surface area;

wherein creating the opening comprises creating a cylindrical opening in the bone and removing additional tissue along the cylindrical opening to create the wedge shape;

at least partially radially compressing an implant having wedge shape, wherein when the implant is in a radially uncompressed state, a diameter or other cross-sectional dimension of a first end of the implant is smaller than a diameter or other cross-sectional dimension of a second end of the implant;

while the implant is at least partially radially compressed, inserting the implant within the opening; and

allowing the implant to be released from a radially compressed state to a less compressed state when the implant is positioned within the opening.

19. The method of claim 18,

wherein the implant is at least partially radially compressed and inserted within the opening using an introducer;

wherein creating the opening in a bone comprises using a tool with a cutter; and

wherein the tool is configured to be positioned over a guide pin to place a working end of the tool at or near a targeted location of the opening.

20. The method of claim 18, wherein the implant is at least partially radially compressed and inserted within the opening using an introducer.

21. The method of claim 18, wherein, when the implant is in a radially uncompressed state, the body of the implant imparts a radial force against walls of the opening, thereby helping to secure the implant within the opening.

22. The method of claim 18, wherein creating a wedge shape opening comprises using a single device or using at least two devices.