Imaging method, device and system

• US 20070129630A1
• Filed: 12/07/2005
• Published: 06/07/2007
• Est. Priority Date: 12/07/2005
• Status: Abandoned Application

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Shimko, Daniel
• Application Number:
  US11/295,639
• Publication Number:
  US 20070129630A1
• Time in Patent Office: Days
• US Class Current: 600/431
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/32037 for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3933 Liquid markers
• CPC Class Codes: A61B 50/30 Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 6/481 involving the use of contrast agents
• CPC Class Codes: A61B 6/487 involving fluoroscopy
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61F 2/0095 Packages or dispensers for prostheses or other implants for intraocular lenses A61F2/1691; for dental surgery A61C19/02
• CPC Class Codes: A61F 2/30756 Cartilage endoprostheses A61F2/3603 takes precedence
• CPC Class Codes: A61F 2/34 Acetabular cups
• CPC Class Codes: A61F 2/3859 Femoral components
• CPC Class Codes: A61F 2/389 Tibial components A61F2/3868 takes precedence
• CPC Class Codes: A61F 2/488 Means for detecting or monitoring wear
• CPC Class Codes: A61F 2002/2839 Bone plugs or bone graft dowels
• CPC Class Codes: A61F 2002/30158 trapezoidal
• CPC Class Codes: A61F 2002/30673 Lubricating means, e.g. synovial pocket
• 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 2002/30785 parallel
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30878 : with non-sharp protrusions, for instance contacting the bone for anchoring, e.g. keels, pegs, pins, posts, shanks, stems, struts
• CPC Class Codes: A61F 2002/3401 : with radial apertures, e.g. radial bores for receiving fixation screws
• CPC Class Codes: A61M 5/007 : for contrast media

Abstract

A method, device and system or kit treat a lesion by injecting a contrast agent into a body area to distinguish an osteolytic lesion for imaging; and delivering an effective amount of a debridement fluid to debride the distinguished lesion.

Claims

1. A method for treatment of a lesion, comprising:

injecting a contrast agent into a body area; and

allowing the contrast agent to migrate to an osteolytic lesion area to distinguish the osteolytic lesion for imaging.

2. The method of claim 1, further comprising delivering an effective amount of a debridement fluid to debride the distinguished lesion.

3. The method of claim 1, comprising injecting the contrast agent into synovial fluid in the body area that is in fluid communication with the osteolytic lesion, wherein the contrast agent migrates to the lesion by flow or diffusion.

4. The method of claim 1, comprising injecting the contrast agent into synovial fluid in the body area that is in fluid communication with the osteolytic lesion, wherein the contrast agent migrates to the lesion by flow or diffusion;

and imaging a location or extent of a lesion in the area that has been distinguished by the contrast agent.

5. The method of claim 1, comprising injecting the contrast agent into synovial fluid in the body area that is in fluid communication with the osteolytic lesion, wherein the contrast agent migrates to the lesion by flow or diffusion;

imaging a location or extent of a lesion in the area that has been distinguished by the contrast agent; and

controlling debridement of the osteolytic lesion according to the imaging.

6. The method of claim 1, comprising injecting the contrast agent into synovial fluid in the body area that is in fluid communication with the osteolytic lesion, wherein the contrast agent migrates to the lesion by flow or diffusion;

imaging a location or extent of a lesion in the area that has been distinguished by the contrast agent; and

controlling debridement of the osteolytic lesion according to the imaging;

wherein the debridement comprises delivering a debridement fluid and intermittently aspirating the fluid by pulse lavage.

7. The method of claim 1, comprising injecting the contrast agent into synovial fluid in the body area that is in fluid communication with the osteolytic lesion, wherein the contrast agent migrates to the lesion by flow or diffusion;

imaging a location or extent of a lesion in the area that has been distinguished by the contrast agent; and

controlling debridement of the osteolytic lesion according to the imaging;

wherein the debridement comprises delivering of a fluid with suspended particulate abrasive and the delivering is adjusted according to the imaging to direct the fluid with suspended particulate to the lesion area.

8. The method of claim 1, further comprising:

emitting x-rays toward the lesion area, detecting x-rays that have traversed the lesion area, constructing a real-time fluoroscopic image of delivering fluid and the lesion area from signals that are responsive to the detected x-rays;

adjusting the delivering of the debridement fluid according to the fluoroscopic image to debride the lesion.

9. The method of claim 1, wherein the contrast agent comprises a biosorbable material that is capable of being detected or monitored by fluoroscopy, x-ray photography, CAT scan or ultrasound.

10. The method of claim 1, wherein the contrast agent comprises a biosorbable material that is capable of being detected or monitored by fluoroscopy, x-ray photography, CAT scan or ultrasound suspended or dissolved in a carrying fluid.

11. A system for treatment of a lesion, comprising:

a delivery device for injecting a contrast agent into a body area to distinguish an osteolytic lesion for imaging;

a fluid reservoir;

a debridement fluid contained within the fluid reservoir;

a tubular conduit having a pickup end and delivery/aspirator end and first and second cannulas extending with one another longitudinally as part of the tubular conduit;

the first cannula having at least one orifice at the delivery/aspirator end of the tubular conduit to deliver or aspirate debridement fluid to or from the distinguished lesion; and

the second cannula substantially open at the delivery/aspirator end of the tubular conduit to deliver or aspirate fluid to or from the distinguished lesion; and

an imaging device to monitor delivery of the debridement fluid to the distinguished lesion.

12. The system of claim 11, wherein the imaging device comprises a fluoroscopy imaging device that includes an x-ray source oriented to emit x-rays toward the lesion area;

a radiation detector that detects x-rays from the source that have traversed the lesion area;

an image display to generate a real-time fluoroscopic image showing the relationship of the delivery/aspirator end of the tubular conduit to the area on a display monitor from signals that are responsive to the detected x-rays.

13. The system of claim 11, wherein the contrast agent comprises a biosorbable material that is capable of being detected or monitored by fluoroscopy, x-ray photography, CAT scan or ultrasound.

14. The system of claim 11, wherein the contrast agent comprises a biosorbable material that is capable of being detected or monitored by fluoroscopy, x-ray photography, CAT scan or ultrasound suspended or dissolved in a carrying fluid.

15. The system of claim 11, wherein the contrast agent is water soluble and comprises metrizamide, iopamidol, iothalamate sodium, iodomide sodium or meglumine.

16. The system of claim 11, wherein the contrast agent is water insoluble and comprises tantalum, tantalum oxide, barium sulfate, gold powder, tungsten powder or platinum powders.

17. The system of claim 11, wherein the contrast agent is a liquid.

18. The system of claim 11, wherein the contrast agent is suspended or dissolved in an aqueous carrying fluid.

19. The system of claim 11, wherein the contrast agent is suspended or dissolved in a clear biosorbable fluid.

20. The system of claim 11, wherein the contrast agent is suspended or dissolved in warm isotonic saline or normal saline.

21. The system of claim 11, wherein the contrast agent is suspended or dissolved in a carrying fluid that includes an antibiotic, a buffer, a bicarbonate, citric acid or tanic acid.

22. The system of claim 11, wherein the contrast agent is suspended or dissolved in an aqueous carrying fluid comprising a mixture of inorganic salts and minerals, compounded to mimic an electrolyte concentration and a body fluid mixture in an isotonic state.

23. The system of claim 11, wherein the contrast agent is suspended or dissolved in an aqueous carrying fluid comprising a halide salt of lithium, sodium, potassium or calcium.

24. The system of claim 11, wherein the contrast agent is suspended or dissolved in an aqueous carrying fluid comprising an electrolyzed solution having a pH within 2 to about 5, an oxidation reduction potential within +600 mV to +1200 mV and an hypohalous acid concentration within 10 ppm to about 200 ppm.

25. The system of claim 11, wherein the contrast agent is suspended or dissolved in an aqueous carrying fluid that has bactericidal, fungicidal or sporicidal properties.

26. The system of claim 11, wherein the contrast agent is suspended or dissolved in the carrying fluid in a weight percent from 0.001 mg/ml to 1000 mg/ml.

27. The system of claim 11, wherein the contrast agent is suspended or dissolved in the carrying fluid in a weight percent from 0.01 mg/ml to 800 mg/ml.

28. The system of claim 11, wherein the contrast agent is suspended or dissolved in the carrying fluid in a weight percent from 0.1 mg/ml to 600.

29. A diagnostic procedure, comprising:

injecting a contrast agent into synovial fluid in a body area in need of treatment; and

imaging a location or extent of a lesion in the area that has been distinguished by the contrast agent.

30. The diagnostic procedure of claim 29, further comprising determining a treatment for the lesion according to the imaged location or extent.

31. A method of imaging an osteolytic lesion, comprising:

injecting a contrast agent into synovial fluid in a vicinity of the osteolytic lesion;

permitting contrast agent injected synovial fluid to circulate to the lesion;

positioning an imaging device responsive to the contrast agent adjacent the vicinity of the osteolytic lesion; and

imaging the osteolytic lesion distinguished by the contrast agent from adjacent tissue.

32. The method of claim 31, wherein the osteolytic lesion is fluoroscopically imaged and a location and orientation of a debridement delivery device is adjusted according to location or extent of the fluoroscopically image.

33. The method of claim 31, wherein the vicinity is a knee or hip joint space.

34. The method of claim 31, wherein injecting the contrast agent comprises:

positioning an injection catheter into the vicinity of the osteolytic lesion; and

injecting the contrast agent into synovial fluid in the vicinity through the injection catheter.

35. The method of claim 31, further comprising debrideing the distinguished lesion by a pulse lavage process.

36. The method of claim 31, further comprising:

emitting x-rays from the imaging device toward the distinguished lesion, detecting x-rays that have traversed the lesion, constructing a tomographic image from signals that are responsive to the detected x-rays to generate a real-time fluoroscopic image on a display monitor depicting the distinguished lesion and the relationship of a delivery/aspirator end of a debridement device to the area; and

adjusting the location and orientation of the delivery/aspirator end of the debridement device according to the display monitor image to debride the lesion.