METHODS FOR FORMING A TUNNEL IN BONE

An orthopedic tool includes a main body and a reference member. The reference member may be configured to engage an anatomical feature of a patient, such as the patient's bone. The angle of the reference member may be adjusted using a knob.

TECHNICAL FIELD

The present disclosure relates to the field of surgical methods and devices, and more particularly to arthroscopic ligament repair and/or reconstruction surgery.

BACKGROUND

Desired outcomes for arthroscopic ligament reconstruction or repair surgery are generally achieved by establishing the proper shape and placement of torn tissue. While performing such surgery, a surgeon typically makes a small incision in a patient's skin near the surgical site (e.g., a bone joint) to allow a drill assembly to be placed in the bone joint to create tunnels through the patient's bone, through which the surgeon can reconstruct or repair the torn tissue.

For a meniscal root repair, for example, one approach is to create a tunnel through the patient's tibia for the passing of a suture or wire. The suture is passed to the location of repair, and the meniscus is repaired with a button, anchor, or other suitable method of fixation. In some instances, the root repair may involve isolating the root and repositioning the root into a more suitable anatomical position. The current system of meniscus root guide requires pre-operative equipment to be sterilized and processed for the surgical procedure. Often, the MRI is unable to detect the meniscus root tear, leading to challenges with the meniscus root repair.

Accordingly, there is a need for devices and methods to help guide and properly align meniscal root repair procedures. There is a need for disposal guide to allow the meniscus root repair procedure to be perform during any surgical case without prior planning due to the nature of the tears and location of the tears.

SUMMARY

In some examples, a method of forming a tunnel in bone can include: providing an orthopedic tool, wherein the orthopedic tool includes: a main body; a drill guide having a proximal end, a distal end, and a lumen extending from the proximal end to the distal end, the drill guide configured to engage the main body; a reference member having a distal end, the reference member configured to engage the main body, and the reference member including an engagement component on the distal end, the engagement component configured to engage a patient's bone; and a reference member knob configured to engage the main body and the reference member; adjusting, with the reference member knob, an angle of the reference member relative to the drill guide; introducing the reference member to a surgical site such that the reference member engages the patient's bone; introducing the drill guide to a surgical site such that the drill guide engages the patient's bone; and advancing a drill pin through the lumen of the drill guide such that a tunnel is formed in the patient's bone. In some examples, the reference member is moveable with respect to the main body.

In some examples, the method can include positioning a plurality of locking components to engage the drill guide such that the drill guide is locked in place with respect to the main body. In some examples, the method can include advancing a suture through the drill guide and the tunnel. In some examples, the method can include advancing the suture through the engagement component, wherein the engagement component is elliptical. In some examples, the method can include forcing an elliptical drill bit on the distal end of the drill guide into the patient's bone. In some examples, positioning the plurality of locking components such that the drill guide is locked in place with respect to the main body includes rotating the drill guide such that a plurality of grooves of the drill guide engages at least one locking component of the plurality of locking components.

In some examples, an orthopedic tool can include: a main body; a drill guide having a proximal end, a distal end, and a lumen extending from the proximal end to the distal end, the drill guide configured to engage the main body; a reference member having a distal end, the reference member configured to engage the main body, and the reference member including an engagement component on the distal end, the engagement component configured to engage a patient's bone; and a reference member knob configured to engage the main body and the reference member, the reference member knob configured to adjust a position of the reference member relative to the main body.

In some examples, the orthopedic tool can include a plurality of locking components configured to selectively lock the drill guide in place with respect to the main body. In some examples, the plurality of locking components include a plurality of spring-loaded caps configured to engage a threaded portion of the drill guide. In some examples, the plurality of locking components include a ball plunger configured to engage the drill guide. In some examples, the engagement component includes curved components extending laterally from the distal end of the reference member. In some examples, the engagement component includes an elliptical component on the distal end of the reference member. In some examples, the orthopedic tool can include an elliptical drill bit on a distal end of the drill guide. In some examples, the reference member knob is configured to adjust an angle of the reference member relative to the drill guide. In some examples, the reference member includes a first arm configured to engage the main body, a second arm configured to engage the patient's bone, and an angle between the first arm and the second arm. In some examples, the engagement component includes a fork component.

In some examples, disclosed herein is a meniscal root repair guide, comprising one or more of: a drill guide having a proximal end, a distal end, and a channel extending from the proximal end to the distal end; a handle configured to engage the drill guide; a first securement component configured to engage the drill guide and the handle; a reference member configured to engage the handle and a patient's tibia; and a second securement component configured to engage the reference member and the handle.

In examples, the reference member comprises a first arm configured to engage the handle, a second arm configured to engage the patient's tibia, and an angle between the first arm and the second arm.

In examples, the reference member comprises a guide assistance feature at a distal end of the second arm.

In examples, the guide assistance feature comprises a fork feature.

In examples, the drill guide comprises a screw.

In some examples, the drill guide channel is configured to allow passage of a portion of a drill pin from the drill guide proximal end to the drill guide distal end.

In certain examples, the drill guide channel is configured to allow passage of a portion of a drill pin having an outer diameter of about 2.4 mm.

In some examples, an inner diameter of the drill guide channel is larger than 2.4 mm.

In particular examples, the first securement component comprises a screw.

In some examples, the first securement component comprises a knurled thumbscrew.

In some examples, the first securement component comprises a sliding securement component.

In some examples, the drill guide comprises an engagement feature configured to engage the sliding securement component.

In some examples, the drill guide comprises a plurality of engagement features configured to engage the sliding securement component.

In examples, the second securement component comprises a screw.

In examples, the second securement component comprises a knurled thumbscrew.

In examples, disclosed herein is a meniscal root repair kit, comprising one or more of: a meniscal root repair guide, wherein the meniscal root repair guide comprises: a drill guide having a proximal end, a distal end, and a channel extending from the proximal end to the distal end; a handle configured to engage the drill guide; a first securement component configured to engage the drill guide and the handle; a reference member configured to engage the handle and a patient's tibia; and a second securement component configured to engage the reference member and the handle; a curette configured to remove tissue from a surgical site; a drill pin; a cannulated drill bit; and a delivery device configured to deliver a fixation component to the surgical site.

In some examples, the curette is configured to remove cartilage from the surgical site.

In examples, the drill pin comprises an outer diameter of about 2.4 mm.

In some examples, the drill pin comprises an axial length of about 100-180 mm.

In certain examples, the cannulated drill bit comprises a proximal end, a distal end, and a channel extending from the drill bit proximal end to the drill bit distal end.

In some examples, the channel of the cannulated drill bit is configured to allow passage of a portion of the delivery device through the channel of the cannulated drill bit.

In some examples, the delivery device comprises a suture passer.

In some examples, the delivery device is configured to deliver a suture to the surgical site.

In some examples, the delivery device is configured to deliver a wire to the surgical site.

In some examples, disclosed herein is a method of repairing a meniscal root, comprising one or more of: providing a meniscal root repair guide, wherein the meniscal root repair guide comprises: a drill guide having a proximal end, a distal end, and a channel extending from the proximal end to the distal end; a handle configured to engage the drill guide; a first securement component configured to engage the drill guide and the handle; a reference member configured to engage the handle and a patient's tibia; and a second securement component configured to engage the reference member and the handle; introducing the reference member to a surgical site such that the reference member engages a tibial feature; advancing the drill guide to an extended state, wherein, in the extended state, the drill guide is directed substantially towards the surgical site; positioning the first securement component such that the drill guide and the handle are securely engaged; and advancing a drill pin through the channel of the drill guide such that a tunnel is formed in a tibia.

In some examples, advancing the drill pin through the channel of the drill guide comprises advancing a drill pin having an outer diameter of about 2.4 mm through the channel of the drill guide.

In some examples, the method of repairing a meniscal root comprises advancing a cannulated drill bit over the drill pin, wherein the cannulated drill bit comprises a proximal end, a distal end, and a channel extending therebetween.

In some examples, the method of repairing a meniscal root comprises passing a suture through the channel of the cannulated drill bit.

In some examples, the method of repairing a meniscal root comprises passing a wire through the channel of the cannulated drill bit.

DETAILED DESCRIPTION

Examples disclosed herein relate to devices, systems, and methods of meniscal root repair. Some examples of devices disclosed herein relate to a meniscal root repair guide configured to help align meniscal root repair procedures. Some examples disclosed herein relate to kits for use in meniscal root repair. Some examples disclosed herein relate to methods of guided meniscal root repair.

Meniscal Root Repair Guide

FIG.1illustrates a tibia100, a tibial plateau102, a medial meniscus110, and a lateral meniscus120.FIG.2illustrates a posterior root112of the medial meniscus110separated from the tibial plateau102by a distance illustrated inFIG.2by arrow200, and consequently in need of repair. A plateau line130along an average plane of the tibial plateau102is shown inFIG.1. The plateau line130and the tibial plateau102as used herein will refer to a substantial average plane, or predominant plane, of the superior portion of the tibia100boney surfaces of the tibial plateau102. Because the superior portion of the tibia100boney surfaces are irregular, such a substantial average plane, or predominant plane, is understood by those skilled in the art to serve as an angular reference for a tibia. The illustrated plateau line130is drawn along the tibial plateau102in a substantially anterior-posterior direction at an approximate medial-lateral midline of the tibia100. The devices, systems, and methods herein can be used to drill to the medial meniscus root or the lateral meniscus root. The devices, systems, and methods herein can be used to drill to the anterior and/or posterior root.

Methods and devices described herein are illustrated in association with meniscal root repair; however, the methods and devices described herein may be equally applicable to other repairs. Reattachment or repair may be accomplished, for example and without limitation, on various parts of the medial meniscus110, on various parts of the lateral meniscus120, or any various other soft tissue structures. The soft tissue repaired or reattached may be, for example and without limitation, cartilage, ligaments, tendons, or any combination or part of these soft tissues or others. Bones to which soft tissue may be reattached include, for example and without limitation, a tibia, femur, patella, humerus, radius, or any combination or part of these bones or others. Soft tissue coupled, attached, reattached, repaired, or brought into contact with bone in various examples may consequently be given the opportunity to heal.

FIGS.3A-3Dillustrate various views of an embodiment of a meniscal root repair guide300, also referred to herein as a repair guide300. The repair guide300may include a guide handle310, a drill guide320, and a meniscal guide member330. The meniscal guide member330may also be referred to as a reference member330. The repair guide300may also include securement features340and342, which may also be referred to as a drill guide securement feature340and a reference member securement feature342.

The guide handle310may engage the drill guide320. For example, a through hole in the guide handle310may allow engagement of the guide handle310and the drill guide320. Securement feature340may be used to secure, connect, fasten, or otherwise couple the guide handle310and the drill guide320.

The guide handle310may also engage the reference member330. Securement feature342may be used to secure, connect, fasten, or otherwise couple the guide handle310and the reference member330. In some examples, securement features340and342may be screws. For example, in some examples, securement features340and342may be knurled thumbscrews.

A repair guide300configured of individual, or modular, components may advantageously promote interchangeability, replaceability, and disposability of the components of the repair guide300.

As depicted inFIG.3D, the reference member330may include a first arm332and a second arm334. The first arm332and the second arm334may define an angle336. The angle336can be any desired angle to provide optimal anatomic fixation of the meniscus root.

The first arm332of the reference member330may be configured to engage the handle310. In some examples, as depicted inFIG.3C, the first arm332of the reference member330may engage a slot312of the handle310. A securement feature342may be used to secure, connect, fasten, or otherwise couple the first arm332of the reference member330to the handle310.

The second arm334of the reference member330may be configured to engage a patient's anatomical features. For example, the second arm334may be configured to engage the patient's tibia100. The second arm334may be configured to engage the tibial plateau102of the patient's tibia100. Engagement between the second arm334and the patient's tibia100may advantageously help to align subsequent meniscal root repair procedures, as more fully described below.

In some examples, the second arm334may include a guide assistance feature338at the tip of the second arm334, as depicted inFIG.3A. For example, the guide assistance feature338may include a fork feature, such as a forked tip at the tip of the second arm334. The guide assistance feature338may be configured to engage an anatomical feature of the patient. For example, the guide assistance feature338may be sized and shaped such that it engages a portion of the patient's tibia100. The guide assistance feature338having a forked feature may advantageously give the surgeon improved visual access while placing the meniscal root guide300and performing meniscal root repair procedures. For example, a forked feature at the tip of the second arm334may give the surgeon visual access from an intra articular camera view.

The reference member330may comprise a rigid material. The reference member330may be substantially flat, or thin, which may advantageously reduce the risk of injury or damage to a patient when the reference member330is inserted into the patient.

FIGS.4A-4Cillustrate an embodiment of a drill guide320. In some examples, the drill guide320may comprise a screw. In certain examples, the drill guide320may include external threads. The drill guide320may include a proximal end322, a distal end324, and a length extending from the proximal end322to the distal end324.

The drill guide320may include a channel326. The channel326may extend through the drill guide320. The channel326may extend from the drill guide proximal end322to the drill guide distal end324. The drill guide channel326may be configured to allow passage of a drill pin, which may also be referred to as a guidewire, through the drill guide320. For example, the channel326may be configured to allow passage of a drill pin through the drill guide320, which may allow a surgeon to drill a tunnel into a patient's bone, such as a patient's tibia100. The channel326may be configured to allow passage of a drill pin having an outer diameter of about 0.5 mm to 8 mm, 1 mm to 6 mm, 2 mm to 4 mm, 2 mm to 3 mm or about 2.5 mm such as about 2.4 mm. For example, the channel326may have a diameter that is slightly larger than the drill pin such as about 0.6 mm to 8.1 mm, about 1.1 mm to 6.1 mm, about 2.1 mm to 4.1 mm, about 2.2 mm to 3.1 mm, or about 2.5 mm or about 2.6 mm, or just slightly larger than about 2.4 mm. In certain examples, the channel326may be configured to allow passage of a drill pin having an outer diameter of about 2.4 mm to about 2.9 mm. For example, the channel may be configured to allow passage of a pin having an outer diameter of about 2.6 mm to about 2.7 mm. In such examples, the diameter of the channel326may be larger than the outer diameter of the drill pin.

FIGS.5A-5Cillustrate another embodiment of a meniscal root repair guide500. The repair guide500may include a guide handle510, a drill guide520, and a meniscal guide member530. The meniscal guide member530may also be referred to as a reference member530. The repair guide500may also include a drill guide securement feature540and a reference member securement feature542.

The drill guide securement feature540may also be referred to as a ratcheting component, a release slide, or a securement slide. When the drill guide securement feature540is in an open, or down, position, the drill guide520may be permitted to move freely or loosely in an axially direction within the guide handle510. For example, when the drill guide securement feature540is in an open position, a surgeon may advance the drill guide520into a patient's tissue, as further discussed below. The drill guide securement feature540may use a spring544to secure the drill guide520.

Positioning the drill guide securement feature540in a closed, or up, position may cause the drill guide520to be axially fixed relative to the guide handle510. When the drill guide securement feature540is in the closed position, the drill guide520may not move axially relative to the guide handle.

In the closed position, the drill guide securement feature540may engage notches, grooves, detents, or other engagement features of the drill guide520in order to secure the drill guide520relative to the guide handle510. In some examples, one side of the drill guide520may comprise notches, grooves, detents, or other engagement features, and the other side of the drill guide520may be substantially smooth. This may advantageously facilitate smooth insertion and removal of the drill guide520while also permitting engagement of the drill guide520with the drill guide securement feature540. In certain examples, the drill guide520may comprise notches, grooves, detents, or other engagement features on all sides of the drill guide520. In some examples, the drill guide520may comprise notches, grooves, detents, or other engagement features along the entire length of the drill guide520. In certain examples, the drill guide520may comprise notches, grooves, detents, or other engagement features along a portion of the drill guide520. A sliding drill guide securement feature542may advantageously allow a surgeon to quickly secure and/or release the drill guide520relative to the guide handle510.

Meniscal Root Repair Kit

FIG.6illustrates a meniscal root repair kit600. The repair kit600may be used to help facilitate a meniscal root repair. The kit600may include a meniscal root repair guide500having a handle510, a drill guide520, a reference member530, and securement features540and542. The kit600may include a righthand reference member530, a lefthand reference member530, or both a righthand and a lefthand reference member530. A lefthand reference member530may be sized and shaped to substantially align with the contour of a left tibial spine. A righthand reference member530may be sized and shaped to substantially align with the contour of a right tibial spine.

The kit600may also include a curette610. The curette610may be configured to remove tissue from the surgical site. For example, the curette610may be configured to remove cartilage from the surgical site. The curette610may be used to remove cartilage from the surgical site in preparation for a meniscal root repair.

The kit600may also include a drill pin620. The drill pin620may be configured to create a tunnel in a patient's bone. For example, the drill pin620may be configured to create a tunnel in a patient's tibia100, which may allow passage of suture, wire, or other method of fixation through the tunnel to the site of repair. The drill pin620may be configured to pass through a channel of the drill guide520. For example, the drill pin620may be sized such that it can pass through the channel of the drill guide520. The drill pin620may have an axial length that is longer than an axial length of the drill guide520. In some examples, the drill pin620may have an axial length of 100 mm, about 100 mm, or greater than 100 mm. In some examples, the drill pin620may have an axial length of about 100 mm to about 180 mm. The drill pin620may have an outer diameter that is smaller than the diameter of the channel of the drill guide520. In some examples, the drill pin620may have an outer diameter of 2.4 mm or about 2.4 mm. In certain examples, the drill pin620may have an outer diameter of about 2.4 mm to about 2.9 mm.

The kit600may also include a cannulated drill bit630. The cannulated drill bit630may include a proximal end, a distal end, and a channel extending from the proximal end to the distal end. The channel of the cannulated drill bit630may be configured to surround the outer diameter of the drill pin620. The channel of the cannulated drill bit630may have a diameter that is slightly larger than the outer diameter of the drill pin620. The channel of the cannulated drill bit630may be configured to allow passage of suture or wire through the channel.

The kit600may also include a delivery device640configured to deliver one or more sutures, wires, or other fixation components to the site of repair. The delivery device640may comprise a suture passer. A surgeon may operate the delivery device640in repairing a meniscus. For example, a surgeon may operate the delivery device640in repairing or reattaching a torn or otherwise damaged meniscal root. The delivery device640may be sized such that the delivery device640can pass through the channel of the cannulated drill bit630. For example, the delivery device640may have an outer diameter that is smaller than the diameter of the channel of the cannulated drill bit630.

The kit600may also include a clamp650configured to hold materials together or back during the medical procedure. The clamp650can be a c-clamp. The clamp650may be configured to hold tissue away from the surgical site. For example, the clamp650may be configured to hold cartilage away from the surgical site. The clamp650may be used to hold cartilage away from the surgical site in preparation for a meniscal root repair.

FIG.7Aillustrates the ratchet mechanism engaged. The spring544allows the drill guide securement feature540to secure the drill guide520. The ratchet mechanism is engaged when the notches, grooves, detents, or other engagement features of the drill guide520contact the notches, grooves, detents, or other engagement features of the drill guide securement feature540.

FIG.7Billustrates the ratchet mechanism disengaged. The spring544allows the drill guide securement feature540to secure the drill guide520. The ratchet mechanism is disengaged when the notches, grooves, detents, or other engagement features of the drill guide520do not contact the notches, grooves, detents, or other engagement features of the drill guide securement feature540.

FIG.8Aillustrates a perspective view of an embodiment of a meniscal root repair guide on a patient's bone. The drill guide520and guide assistance feature538are engaged with the patient's anatomical feature. In this embodiment, the patient's anatomical feature is a bone.

FIG.8Billustrates a perspective view of an embodiment of a meniscal root repair guide on a patient's bone. The drill guide520and guide assistance feature538are engaged with the patient's anatomical feature. In this embodiment, the patient's anatomical feature is a bone.

Method of Repairing a Meniscal Root

The above-described features of the meniscal root repair guide300,500,900can help guide and properly align meniscal root repair procedures. An example method of repairing a meniscal root is described with further reference toFIGS.1-6.

A surgeon may make a small incision in the patient's skin near the surgical site. The site of the meniscus tear may then be visually evaluated using a probe or rasp. Cartilage may then be removed from the location of repair. After the site of the meniscus tear has been evaluated and prepared for repair, a meniscus root repair guide300may be used to help facilitate the meniscal root repair. In certain examples, the meniscal root repair guide500can be placed at the anatomic footprint of the root. The meniscal root repair guide500can be used to ensure the drill guide520will exit at the footprint of the meniscus root anatomy. In some examples, the drill guide500is the 2.4 mm drill guide or any other suitable drill guide such as those disclosed herein.

A meniscal repair guide500may be provided. The repair guide500may be in a first configuration, which may also be referred to as a retracted configuration. In the first configuration, the guide handle510may engage the reference member530. A reference member securement feature542may provide for secure engagement of the handle510and the reference member530. For example, reference member securement feature542may comprise a thumbscrew which may be operated to apply a compressive force to the reference member530and guide handle510.

In the first configuration, a drill guide520may be in a retracted state. In its retracted state, the distal end524of the drill guide520may be positioned within the guide handle510. In certain examples, in its retracted stated, the distal end524of the drill guide520may protrude just slightly from the guide handle510. Alternatively, in the first configuration, the drill guide320may not yet engage the guide handle510.

With the repair guide500in its first configuration, the reference member530may be inserted into the patient. For example, the second arm534of the reference member530may be inserted into the patient through an incision in the patient's skin. The reference member530may be positioned such that it engages an anatomical feature of the patient. For example, the reference member530may be positioned such that it engages the patient's tibia100, or the tibial plateau102of the patient's tibia100. The reference member530may be positioned such that the guide assistance feature538engages an anatomical feature of the patient, such as the patient's tibia.

With the reference member530positioned such that it engages an anatomical feature of the patient, the drill guide520may then be advanced distally to an extended state. In advancing the drill guide520to its extended state, the drill guide520may be inserted into the patient. For example, the drill guide520may be inserted into the patient through an incision in the patient's skin. In certain examples, the drill guide320may be advanced using a pushing motion, a screwing motion, or a combination of pushing and screwing motions.

With the drill guide520advanced to its extended state, a drill guide securement feature540may provide for secure engagement of the handle510and the drill guide520. For example, drill guide securement feature540may comprise a ratcheting component, which may also be referred to as a release slide or a securement slide, configured to engage drill guide520. Alternatively, as previously discussed, drill guide securement feature540may comprise a thumbscrew which may be operated to apply a compressive force to the drill guide520and handle510.

With the drill guide520in its extended, or deployed, configuration, a drill pin620may then be advanced through the channel of the drill guide520. In some examples, a drill pin620having an outer diameter of 2.4 mm or about 2.4 mm (such as described herein) may be advanced through the channel of the drill guide520. In certain examples, the drill pin620may have an outer diameter of about 2.4 mm to about 2.9 mm (such as described herein). In some examples, the drill pin620may be operated to form a tunnel in the patient's tibia. Such a tunnel in the patient's tibia may allow for passage of suture, wire, or other method of fixation.

With the drill pin620inserted into the patient's tibia, the surgeon may remove the drill guide520and the reference member530from the patient. A cannulated drill bit630may then be advanced over the drill pin620. With the cannulated drill bit630advanced to the site of repair, the drill pin620may then be removed from the patient.

In certain examples, the drill pin620and the cannulated drill bit630may be advanced simultaneously into the patient. The drill pin620may be positioned within the channel of the cannulated drill bit630, such that the drill pin620and the cannulated drill bit630are concentric with each other when inserted into the patient. The drill pin620and the cannulated drill bit630may be advanced through the channel of the drill guide520.

A surgeon may then pass suture, wire, or another method of fixation through the channel of the cannulated drill bit630and to repair the meniscus tear. A surgeon may pass the suture, wire, or other method of fixation via a delivery device640. The meniscus may be repaired with a button, anchor, or other method of fixation.

FIG.9Ais a perspective view of another example of a meniscus repair guide900.FIG.9Bis a side view of the example of the meniscus repair guide900ofFIG.9A.FIG.9Cis an exploded view of the example of the meniscus repair guide900ofFIG.9A.FIG.9Dis a zoomed in view of an engaged ratcheting mechanism of the example of the meniscus repair guide900ofFIG.9A.FIG.9Eis a zoomed in view of a disengaged ratcheting mechanism of the example of the meniscus repair guide900ofFIG.9A.FIG.9Fis a perspective view of the example of the meniscus repair guide900ofFIG.9Aengaging a bone.FIG.9Gis a side view of the example of the meniscus repair guide900ofFIG.9Aengaging a bone.

The meniscus guide900can be similar to the meniscus guides300,500described herein. The meniscus guide900can include a knob942that allows the reference member930, or guide member, to be adjusted along the handle910. The reference member930can be moveable with respect to the handle910. A dial, switch, or other component may be used to move the reference member930.

The knob942can be rotated to adjust the position of the reference member930along the handle910. The reference member930can include two arms forming an angle. The reference member930can include a first arm935that can fit within a cavity915of the handle910. The reference member930can include a second arm931with an engagement component938at the distal end.

The knob942can include a shaft that extends through the central aperture936of the securement portion of the reference member930. The shaft of the knob942can also extend through an aperture911in the handle910. Rotating the knob942can adjust the first arm935up and down in the cavity915. A user can adjust the reference member930using the knob942while the reference member930is positioned on a bone. This can adjust the angle of the drill guide920on the bone due to the change in position of the handle910relative to the reference member930.

In some examples, the first arm935of the meniscus guide900can be visible while the user is adjusting the angle of the reference member930. In some examples, the first arm935of the reference member930can be marked with degrees. This marking can indicate the angle between the reference member930and the drill guide920when the knob942is aligned with the marking. Advantageously, this can indicate to a user the angle at which they can drill into the anatomical feature.

The engagement component938can be used to contact an anatomical feature, for example a bone. Tools, for example sutures, that extend through the bone can be routed through the engagement component938. The engagement component938of the reference member930can include two curved portions that extend laterally from the distal end of the guide member. The engagement component938can be wider than the rest of the reference member930. The engagement component938can be U-shaped.

The meniscus repair guide900can include a drill bit960on the distal end of the drill guide920. The drill bit960can be an elliptical drill bit. For example, the drill bit960can be circular or ovoid. The drill bit960can be malleted into the anatomical feature. Advantageously, the drill bit960can be sized and shaped to secure to the anatomical feature easily. For example, the circular drill bit960can be malleted into a tibial bone.

The drill guide920can include a drill guide knob922on the proximal end. The drill guide knob922can be rotated to extend and retract the drill guide920. The drill guide knob922can be shaped for efficient and easy rotation by a user. The drill guide knob922can be cylindrical with an inwardly depressed mid-section. The diameter of the drill guide knob922can be smaller near the center along the longitudinal axis. A user can enact force on the drill guide knob922to mallet the drill bit960into the anatomical feature. Tools can be passed through the channel of the drill guide920. For example, a suture can be passed through the drill guide920and extend into a cavity in the anatomical feature. The tools can be passed through a proximal end of the drill guide knob922. The tools can pass through the center of the drill bit960along the longitudinal axis. Tools can extend through an aperture on the distal end of the drill bit960. Once the drill guide920is in position, a pin, reamer, or drill bit may be used to form a tunnel in the anatomical feature, for example a patient's bone.

The meniscal repair guide900can include one or more sets of spring-loaded features for engaging the ratchet of the drill guide920. The securement components can selectively lock the drill guide920in place relative to the handle910. For example, the meniscal repair guide900can include two sets of spring-loaded features for engaging the ratchet of the drill guide920. In some examples, the meniscal repair guide900can include between 3 and 10 sets of spring-loaded features for engaging the ratchet of the drill guide920. The spring-loaded features944can include a ratchet, a spring, a cap, and/or a spring cup. The spring-loaded features944can engage grooves924of the drill guide920to secure the drill guide920in place. The grooves924of the drill guide920can extend longitudinally along the drill guide920. The grooves924can be cut orthogonal to the centerline axis of the drill guide920.

As shown with respect toFIGS.9D and9E, the drill guide920can be rotated to engage or disengage the grooves924. The drill guide knob922can be used to rotate the drill guide920. In some examples, the drill guide920can include a divot opposite the grooves924to receive part of a ball plunger946.

In some examples, the meniscal repair guide900can include a ball plunger946for engaging the drill guide920. The ball plunger946can engage the drill guide920when the ratchet mechanism is engaged. Advantageously, engaging the drill guide920with both the spring loaded features944and the ball plunger946can increase the stability of the drill guide920.

FIG.10shows another example of a kit1000for meniscal repair.

The kit1000can include a meniscus repair guide900. The kit can include a cutteage950. The kit1000can include a pin952. In some examples, the pin952can be a 2.4 mm pin. In some examples, the pin952can be between 2 mm and 3 mm. In some examples, the pin952can be between 1 mm and 5 mm. In some examples, the kit1000can include a suture retriever. In some examples, the meniscus repair guide900can be assembled in the kit1000. In some examples, the meniscus repair guide900can be disassembled in the kit1000.

The cutteage950can be a curette to remove tissue by scraping and/or scooping. The pin952can be used in the drill guide of the meniscus repair guide900. The meniscus repair guide900can have a lefthand reference member and/or a righthand reference member. In some examples, the kit100may include a suture button. In some examples, the kit100may include a clamp.

FIG.11Ais a perspective view of an example of an anterior cruciate ligament (ACL) repair guide1100.FIG.11Bis a side view of the example of the ACL repair guide1100ofFIG.11A.FIG.11Cis an exploded view of the example of the ACL repair guide1100ofFIG.11A.FIG.11Dis a zoomed in view of an engaged ratcheting mechanism of the example of the ACL repair guide1100ofFIG.11A.FIG.11Eis a zoomed in view of a disengaged ratcheting mechanism of the example of the ACL repair guide1100ofFIG.11A.

The ACL repair guide1100can be similar to the meniscus repair guide900as described with respect toFIGS.9A-9E.

The ACL guide1100can be similar to the ACL guides300,500described herein. The ACL guide1100can include a knob1142that allows the reference member1130, or guide member, to be adjusted along the handle1110.

The knob1142can be rotated to adjust the position of the reference member1130along the handle1110. The reference member1130can include two arms forming an angle. The reference member1130can include a first arm1135that can fit within a cavity1115of the handle1110. The reference member1130can include a second arm1131with an engagement component1138at the distal end.

The knob1142can include a shaft that extends through the central aperture1136of the securement portion of the reference member1130. The shaft of the knob1142can also extend through an aperture1111in the handle1110. Rotating the knob1142can adjust the first arm1135up and down in the cavity1115. A user can adjust the reference member1130using the knob1142while the reference member1130is positioned on a bone. This can adjust the angle of the drill guide1120on the bone due to the change in position of the handle1110relative to the reference member1130.

In some examples, the first arm1135of the ACL guide1100can be visible while the user is adjusting the angle of the reference member1130. In some examples, the first arm1135of the reference member1130can be marked with degrees. This marking can indicate the angle between the reference member1130and the drill guide1120when the knob1142is aligned with the marking. Advantageously, this can indicate to a user the angle at which they can drill into the anatomical feature.

The engagement component1138can be used to contact an anatomical feature, for example a bone. Tools, for example sutures, that extend through the bone can be routed through the engagement component1138. The guide member1130can include an engagement feature1138at the distal end. The engagement feature1138can be elliptical. For example, the engagement feature1138can be circular or ovoid. The circular engagement feature1138can surround sutures routed from the distal end of the tunnel formed in a patient's bone. In some examples, the engagement feature1138can be another closed shape, for example a square, a rectangle, a hexagon, an octagon, or a triangle.

The ACL repair guide1100can include a drill bit1160on the distal end of the drill guide1120. The drill bit1160can be an elliptical drill bit. For example, the drill bit1160can be circular or ovoid. The drill bit1160can be malleted into the anatomical feature. Advantageously, the drill bit1160can be sized and shaped to secure to the anatomical feature easily. For example, the circular drill bit1160can be malleted into a tibial bone.

The drill guide1120can include a drill guide knob1122on the proximal end. The drill guide knob1122can be rotated to extend and retract the drill guide1120. The drill guide knob1122can be shaped for efficient and easy rotation by a user. The drill guide knob1122can be cylindrical with an inwardly depressed mid-section. The diameter of the drill guide knob1122can be smaller near the center along the longitudinal axis. A user can enact force on the drill guide knob1122to mallet the drill bit1160into the anatomical feature. Tools can be passed through the channel of the drill guide1120. For example, a suture can be passed through the drill guide1120and extend into a cavity in the anatomical feature. The tools can be passed through a proximal end of the drill guide knob1122. The tools can pass through the center of the drill bit1160along the longitudinal axis. Tools can extend through an aperture on the distal end of the drill bit1160. Once the drill guide1120is in position, a pin, reamer, or drill bit may be used to form a tunnel in the anatomical feature, for example a patient's bone.

The meniscal repair guide1100can include one or more sets of spring-loaded features for engaging the ratchet of the drill guide1120. The securement components can selectively lock the drill guide1120in place relative to the handle1110. For example, the meniscal repair guide1100can include two sets of spring-loaded features for engaging the ratchet of the drill guide1120. In some examples, the meniscal repair guide1100can include between 3 and 10 sets of spring-loaded features for engaging the ratchet of the drill guide1120. The spring-loaded features1144can include a ratchet, a spring, a cap, and/or a spring cup. The spring-loaded features1144can engage grooves1124of the drill guide1120to secure the drill guide1120in place. The grooves1124of the drill guide1120can extend longitudinally along the drill guide1120. The grooves1124can be cut orthogonal to the centerline axis of the drill guide1120.

As shown with respect toFIGS.11D and11E, the drill guide1120can be rotated to engage or disengage the grooves1124. The drill guide knob1122can be used to rotate the drill guide1120. In some examples, the drill guide1120can include a divot opposite the grooves1124to receive part of a ball plunger1146.

In some examples, the meniscal repair guide1100can include a ball plunger1146for engaging the drill guide1120. The ball plunger1146can engage the drill guide1120when the ratchet mechanism is engaged. Advantageously, engaging the drill guide1120with both the spring loaded features1144and the ball plunger1146can increase the stability of the drill guide1120.

FIG.12shows an example of a kit1200for ACL repair.

The kit1200can include an ACL repair guide1100. The kit1200can include a pin1152. In some examples, the pin1152can be a 2.4 mm pin. In some examples, the pin1152can be between 2 mm and 3 mm. In some examples, the pin1152can be between 1 mm and 5 mm. The kit1200can include a reamer1154. In some examples, the reamer1154can be a low profile reamer. In some examples, the reamer1154can be 10 mm. In some examples, the reamer1154can be between 5 mm and 15 mm. In some examples, the reamer1154can be between 1 mm and 25 mm. In some examples, the ACL repair guide1100can be assembled in the kit1200. In some examples, the ACL repair guide1100can be disassembled in the kit1200.

ACL repair guide1100can have a lefthand reference member and/or a righthand reference member. In some examples, the kit1200can include a hook guide. In some examples, the kit1200can include a sterile pouch for containing one or more of the contents of the kit1200. In some examples, the kit1200can include a sterile tray. In some examples, the kit1200can include a screwdriver.

Other Variations

While certain examples have been described, these examples have been presented by way of example only, and are not intended to limit the scope of protection. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms. Furthermore, various omissions, substitutions and changes in the form of the methods and systems described herein may be made. Those skilled in the art will appreciate that in some examples, the actual steps taken in the processes illustrated and/or disclosed may differ from those shown in the figures. Depending on the embodiment, certain of the steps described above may be removed, others may be added. For example, the actual steps and/or order of steps taken in the disclosed processes may differ from those shown in the figure. Depending on the embodiment, certain of the steps described above may be removed, others may be added.

Unless otherwise explicitly stated, articles such as “a” or “an” should generally be interpreted to include one or more described items. Accordingly, phrases such as “a device configured to” are intended to include one or more recited devices. Such one or more recited devices can also be collectively configured to carry out the stated recitations.

It should be noted that the terms “couple,” “coupling,” “coupled” or other variations of the word couple as used herein may indicate either an indirect connection or a direct connection. For example, if a first component is “coupled” to a second component, the first component may be either indirectly connected to the second component or directly connected to the second component. As used herein, the term “plurality” denotes two or more. For example, a plurality of components indicates two or more components.

Although the present disclosure includes certain examples, examples and applications, it will be understood by those skilled in the art that the present disclosure extends beyond the specifically disclosed examples to other alternative examples and/or uses and obvious modifications and equivalents thereof, including examples which do not provide all of the features and advantages set forth herein. Accordingly, the scope of the present disclosure is not intended to be limited by the specific disclosures of preferred examples herein, and may be defined by claims as presented herein or as presented in the future.

Headings are included herein for reference and to aid in locating various sections. These headings are not intended to limit the scope of the concepts described with respect thereto. Such concepts may have applicability throughout the entire specification.

The previous description of the disclosed implementations is provided to enable any person skilled in the art to make or use the present invention. Various modifications to these implementations will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other implementations without departing from the spirit or scope of the invention. Thus, the present invention is not intended to be limited to the implementations shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.