|
View Edit Delete |
VIL-12 |
securing the distal tether end to an articular implant; and |
199 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
securing the proximal tether end within the bone tunnel. |
200 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
22.The method of claim 21, further comprising: |
201 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
reaming the articular implant out of the bone pocket to a size that supports a second articular implant having a greater diameter than the articular implant; |
202 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
restoring the bone tunnel; |
203 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
passing a second tether through the restored bone tunnel; |
204 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
securing a distal tether end of the second tether to the second articular implant; and |
205 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
securing a proximal tether end of the second tether within the restored bone tunnel as at least part of a revision procedure. |
206 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
An improved joint implant apparatus, system, and method. The system includes an implant having a bone-facing articular surface configured to replace at least part of a natural articular surface of a bone adjacent to a joint. The system also includes a transosseous coupler and a bone anchor configured to reside proximate another surface of the bone, separated from the natural articular surface by a bone tunnel. The bone anchor is configured to couple the transosseous coupler to the bone such that the transosseous coupler retains the implant in place on the natural articular surface of the bone. |
207 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
As used herein, “coupling”, “coupling member”, or "coupler" refers to a mechanical device, apparatus, member, component, or structure, that is organized, configured, designed, arranged, or engineered to connect, or facilitate the connection of, the two or more parts, objects, or structures. In certain embodiments, a coupling can connect adjacent parts or objects at their ends. In certain embodiments, a coupling can be used to connect two shafts together at their ends for the purpose of transmitting power. In other embodiments, a coupling can be used to join two pieces of rotating equipment while permitting some degree of misalignment or end movement or both. In certain embodiments, couplings may not allow disconnection of the two parts, such as shafts during operation. (Search "coupling" on Wikipedia.com July 26, 2021. CC-BY-SA 3.0 Modified. Accessed July 27, 2021.) A coupler may be flexible, semiflexible, pliable, elastic, or rigid. A coupler may join two structures either directly by connecting directly to one structure and/or directly to the other or indirectly by connecting indirectly (by way of one or more intermediary structures) to one structure, to the other structure, or to both structures. "Transosseous" refers to a structure, activity, action, or motion that crosses through bone or passes through bone. |
63 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
FIG. 3 illustrates one embodiment in which the bone anchor 330 resides proximate to the another surface (e.g., dorsal surface 210) and is separated from the natural articular surface 260 by the bone tunnel 340. The bone anchor 330 may be of a number of different varieties. In one embodiment, the bone anchor 330 is an interference screw that seats within the proximal end 342. The interference screw may secure a free end of the transosseous coupler 320 to an inside wall of the bone tunnel 340. The bone anchor 330 couples the transosseous coupler 320 to the bone (e.g., first metatarsal 110) such that the transosseous coupler 320 retains the implant 310 in place on the natural articular surface 260. Once deployed the transosseous coupler 320 applies tension on the implant 310. The tension is applied in the direction of the bone anchor 330. The tension holds the joint-facing articular surface 312 in place on the distal end 190 of the bone (e.g., first metatarsal 110). In certain embodiments, the tension provides provisional, adjunctive, or temporary fixation until the bone heals and osseointegrates the implant 310 into the bone. |
73 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
Furthermore, the another surface for the proximal end 342 to exit can vary based on similar factors, including surgeon preference. Having the proximal end 342 exit at, or near the dorsal surface 210 may be advantageous because this location may facilitate access by a surgeon for the procedure. In addition, the bone tunnel 340 may be positioned proximal to or through a physes or epiphyseal plate such that bone growth that closes the bone tunnel 340 after the procedure and during healing may be rapid and complete. In this manner, the system 300 serves as provisional, adjunctive, or temporary fixation until the bone heals and osseointegrates the implant 310 into the bone. |
72 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
In one embodiment, the bone tunnel 340 extends from the natural articular surface 260 of a bone, such as a first metatarsal 110, to another surface of the bone. The another surface can be one of the dorsal surface 210, the plantar surface 220, the medial surface 230, and/or the lateral surface 240 (not shown in FIG. 3). The proximal end 342 may exit at, or near, the another surface. In the illustrated embodiment, the proximal end 342 exits at, or near, the dorsal surface 210. The distal end 344 may exit directly on the natural articular surface 260. In another embodiment, the distal end 344 may exit indirectly onto the natural articular surface 260 by way of another structure, such as a recess or opening, such as a bone pocket (described in more detail below). The length and diameter of the bone tunnel 340 can vary based on a variety of factors including the age, gender, health, size, the joint involved, and/or bone condition of a patient. In one embodiment, the diameter may be between about 1.5 mm and 1.6 mm and the length may be between about 10 mm to about 15 mm. |
71 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
The bone tunnel 340 may be one type of opening. As used herein, an “opening” refers to a gap, a hole, an aperture, a port, a portal, a space or recess in a structure, a void in a structure, or the like. In certain embodiments, an opening can refer to a structure configured specifically for receiving something and/or for allowing access. In certain embodiments, an opening can pass through a structure. In other embodiments, an opening can exist within a structure but not pass through the structure. An opening can be two-dimensional or three-dimensional and can have a variety of geometric shapes and/or cross-sectional shapes, including, but not limited to a rectangle, a square, or other polygon, as well as a circle, an ellipse, an ovoid, or other circular or semi-circular shape. As used herein, the term “opening” can include one or more modifiers that define specific types of “openings” based on the purpose, function, operation, position, or location of the “opening.” As one example, a “fastener opening” refers to an “opening” adapted, configured, designed, or engineered to accept or accommodate a “fastener.” |
70 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
FIG. 3 is a perspective side view of the system of FIG. 2 deployed on a foot joint according to one embodiment. FIG. 3 illustrates an MTP joint 250 between a first proximal phalanx 130 and a first metatarsal 110. In one embodiment, the first metatarsal 110 may include a bone tunnel 340. The bone tunnel 340 may include a proximal end 342 and a distal end 344. |
69 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
In the illustrated embodiment, the bone anchor 330 is a cylindrical screw fastener configured to engage with walls of a bone tunnel and secure the transosseous coupler 320 to a wall of the bone tunnel. In one example embodiment, the bone anchor 330 may include external threads 332 configured to engage with walls of a bone tunnel. In one embodiment, the bone anchor 330 may engage an end of the transosseous coupler 320 and press the end against a wall of the bone tunnel. In this manner, the bone anchor 330 may secure the end of the transosseous coupler 320 to bone such that the transosseous coupler 320 retains the implant 310 in place on the natural articular surface (i.e., natural articular surface 260) of the bone. The bone anchor 330 and transosseous coupler 320 may be coupled to each other using an interference fit between the bone anchor 330 and the bone. The transosseous coupler 320 may couple the implant 310 to the bone anchor 330. |
68 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
The bone anchor 330 serves to couple the transosseous coupler 320 to bone. As used herein, an “anchor" refers to an apparatus, instrument, structure, member, part, device, component, system, or assembly structured, organized, configured, designed, arranged, or engineered to secure, retain, stop, and/or hold, an object to or at a fixed point, position, or location. Often, an anchor is coupled and/or connected to a flexible member such as a tether, chain, rope, wire, thread, suture, suture tape, or other like object. Alternatively, or in addition, an anchor may also be coupled, connected, and/or joined to a rigid object or structure. In certain embodiments, an anchor can be a fixation device. Said another way, a fixation device can function as an anchor. A bone anchor is an anchor, a type of fixation device, that can engage bone and can couple or connect another structure to bone. In certain embodiments, the bone anchor is a corkscrew anchor. |
67 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
In certain embodiments, the transosseous coupler 320 is a flexible member such as a suture, knotless suture, suture ball, suture connected to a suture ball, or the like. In such an embodiment, the flexible transosseous coupler 320 may be coupled to, couplable to, or otherwise joined to one, or the other, or both of the implant 310 and the bone anchor 330 or a bone fixation point. |
66 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
FIG. 2 illustrates an embodiment in which the transosseous coupler 320 is part of the implant 310. The transosseous coupler 320 may be made of the same material or different material from the implant 310. In the illustrated embodiment, the transosseous coupler 320 is flexible and is an elongated structure. The transosseous coupler 320 is long enough to couple the implant 310 to a bone fixation point and/or to a bone anchor 330. The transosseous coupler 320 is configured and designed to apply a tension force between the implant 310 and a bone fixation point and/or to a bone anchor 330. As used herein, a "tension" refers to a force that is applied to both ends of a structure. The structure may have a variety of shapes including fat, thin, wide, elongated, or the like. In one example, a ligament such as a lateral collateral ligament may experience tension due to how the ligament is attached to a femur bone and tibia bone and stretched during flexing of the knee joint. In another example, a tether, suture, or other structure may experience and/or transfer tension as the structure is connected between an implant and an anchor, such as a bone anchor. |
65 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |
|
View Edit Delete |
VIL-12 |
In certain embodiments, the transosseous coupler 320 is part of, or formed together with, the implant 310 such that the transosseous coupler 320 and implant 310 are a single unitary component. In other embodiments, the transosseous coupler 320 is part of, or formed together with, a bone anchor 330 such that the transosseous coupler 320 and bone anchor 330 are a single unitary component. In still other embodiments, the transosseous coupler 320 may be a separate and distinct structure that may be coupled to either or both of an implant 310 and/or a bone anchor 330. |
64 |
Added by DJM 2 2022 |
2/5/22, 12:00 AM |