Abstract:
The present invention provides for the harvesting of specific materials in multiple stages of filtration of bone graft materials from a reaming device, specifics of interconnected stages, related filtration materials, and techniques. The harvesting process collects large material in a first stage, and other materials of a limited geometric size in at least a second stage of filtration. Such material captured in the second stage may contain plasma, cellular elements including stem cells as well as growth factors and other particulate matter of a specific geometrically limited size, using various filtration approaches including centrifugation in some embodiments. Further embodiments of the invention provide for an improved tubing interface and management approach to ease use in the operating room. Filtration materials may include biodegradable-material based filters and may allow direct implantation of small scale and larger scale matter in specific portions within the biodegradable-material itself.

Description:
CROSS REFERENCE TO RELATED APPLICATION 
     The present application is a continuation of U.S. patent application Ser. No. 13/091,123 titled Apparatus, System, and Method for Harvesting Improved Bone Graft Material with Reamer-Irrigator-Aspirator (RIA) Device filed on Apr. 21, 2011, which, in turn, claimed priority to U.S. Provisional Patent Application Ser. No. 61/326,234, filed on Apr. 21, 2010, titled Apparatus, System, and Method for Harvesting Improved Bone Graft Material with Reamer-Irrigator-Aspirateor (RIA) Device, the entire contents of each of which are hereby incorporated into this application by reference to provide continuity of disclosure. 
    
    
     FIELD OF THE INVENTION 
     The present invention is in the technical field of medical devices. More particularly, the present invention is in the technical field of harvesting bone graft materials using a reamer device. 
     BACKGROUND OF THE INVENTION 
     Currently, materials in the output stream from a reaming device, such as the Reamer-Irrigator-Aspirator provided by Synthes, are not fully and efficiently collected. While there have been some attempts to collect large scale material, other materials such as plasma, and other cellular elements are not currently collected and are discarded. Further, the approach used even to collect the large scale materials, essentially bone fragments, is not efficient for medical personnel to use in the operating room. 
     SUMMARY OF THE INVENTION 
     It is an object of this invention to provide for an improvement in the collection of bone graft or other materials from the output of a reamer-irrigator-aspirator device. It is a further object of this invention to provide for an improved tubing interface and management approach to ease use in the operating room. It is a further object of this invention to provide for an improved “stage 1” or large scale matter filtering system to retrieve bone fragments and other large scale matter from the output of the RIA device. It is a further object of this invention to provide for a second stage filtration or separation approach to separate the remaining small scale matter, including but not limited to cellular elements, from the irrigation water following the stage 1 filtration system. The current invention operates with a RIA device to provide a filtration approach to retrieve matter which is useful during bone graft harvesting and other procedures. The RIA device reams a bone such as a femur. The RIA device is connected to an improved hosing system where a bi-lumen hose allows for easier management of the hosing in the operating room. One tube of the bi-lumen hosing provides water to the RIA to perform irrigation. The other hose receives the output of the RIA, which consists of water, large scale matter, and small scale matter including cellular elements in some embodiments. The large scale matter has a significant amount of bone fragments. The small scale matter contains a significant amount of plasma, stem cells, marrow material, and further additional elements which may include growth factors, depending on the porosity of the filter mechanism. The tube receiving the waste is connected to the stage 1 filter which filters out the stage 1 material. The filter in this case is a re-usable mesh or porous filter plate. The plate may be removed, and the collected stage 1 material used for bone grafts, or other uses. The output of the stage 1 filter is passed via another tube in one embodiment to a stage 2 filter or separator. Such a separator may be another filtering mechanism, or a centrifuge type device. When a centrifuge is used, a filter is used to remove the stage 2 material. This filter may be made of collagen, such that after collection of the stage 2 materials, the cylindrical collagen filter may be removed from the centrifuge, cut open, and laid flat on a stage 2 material pad. This pad may be combined with the stage 1 material, and used directly in the body for the grafting process, as collagen will dissolve at a later time. The alternative stage 2 filtration approach is to use a filter box, with a collagen filter. In another embodiment, a plurality of filters may be used, each targeted at retaining particulate matter of a desired geometry. In such cases any combination of porosities of each pair of filter stages may be utilized such that a specific range of particulate size is retained in the stage 2 filter or subsequent combination of any two cascaded filters. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1A  is a diagram of the prior art RIA device. 
         FIG. 1B  is a diagram of the prior art RIA device tubing interface. 
         FIG. 2  shows the bi-lumen tube conned to a tube port in a RIA or other device. 
         FIG. 3  shows the improved stage 1 filter with the water irrigation hose bypassing the filter (not integrated). 
         FIG. 4  shows the Stage 1 filter with an integrated pass through irrigation source hose for use with the bi-lumen tubing. 
         FIG. 5  shows the stage 1 filter with the lid open, and stage 1 material inside. 
         FIG. 6  shows the removed filter plate from the stage 1 filter with the stage 1 material being collected from the filter plate into a canister for later use. 
         FIG. 7  shows the stage 1 filter connected to a stage 2 collector centrifuge, with a collagen sponge or filter cylinder inside in one embodiment of the invention. 
         FIG. 8  shows the collagen filter removed from the centrifuge after collection, then cut into a flat “pad” of stage 2 material on the collagen filter or sponge in one embodiment. 
         FIG. 9  shows the collagen or other filter material removed from the centrifuge, cut and laid flat as a stage 2 pad. 
         FIG. 10  shows an alternative stage 2 collector using a filtration system, containing a collagen or other materials filter plate or sponge. 
         FIG. 11  shows the collagen filter being removed from the stage 2 filter, for use of the retained stage 2 materials. 
         FIG. 12  shows stage 1 material in one embodiment being added to the stage 2 materials on a collagen filter, pad, or sponge and use as part of a bone graft in a patient. In this case the collagen filter, or sponge would be placed inside the patient along with the stage 1 and stage 2 materials, which may be modified in proportions. The filter, in one embodiment, would dissolve at a later time. 
         FIG. 13  shows an alternative embodiment of stage 1 materials being added to the stage 2 materials on a collagen filter, pad, or sponge and use as part of a bone graft in a patient. 
     
    
    
     Note that the specific examples provided are not intended to be limiting but are specific embodiments of the invention. Various alternative materials and processes may be used as known in the art. 
     DETAILED DESCRIPTION OF THE INVENTION 
     Referring to  FIG. 1A , the depiction of the RIA which stands for Reamer Irrigator Aspirator. Depicted is a power source  101 , a drill of any variety used within the operating room. The RIA device  102  which is designed as a medullary bone graft harvesting device. The bone graft material would be harvested from the medullary canal of a native human femur  103  using the RIA device  102 . A guide wire  104  is inserted into the medullary canal providing a guide for the RIA device  102  to remain within the medullary canal. The reamer head  105  is designed to cut the bone that is currently being harvested by the device. Through Port  106 , the entry portal, saline is pumped into the device exiting out of Port  107 . Suction is applied to the device through Port  109 , providing an avenue for fluid as well as bone graft material to exit the medullary canal via Port  108 . It is then tunneled through Port  109  to a collection device or to the waste suction canister within the operating room.  FIG. 1B  is a depiction of the current device in larger scale at the region where the suction as well as irrigation ports meet with the RIA device  102 . The RIA device with Port  106 , labeled  102 , is the port allowing for saline to float within the device and Port  109  being the port providing suction and an avenue for the evacuation of material from the medullary canal. 
       FIG. 2  is a depiction of the improved tubing system in one embodiment of this current invention. Depicted is the RIA device  102  with modified coupling Zones  201  as well as  202 .  201  would be the coupling point for saline inflow into the RIA device  102 ; whereas, Port  202  would provide for efflux and evacuation of fluid as well as bone graft material that is applied via suction. The suction source would be obtained through a source available within the operating room. The tubing is coupled  203  to provide for less entanglement and more streamlined use within the operating room. These tubes would branch allowing for filtration/separation canisters, to be described later. Tube  204  would provide an inflow source for saline whereas Tube  205  would provide suction as well as an egress pathway for bone graft as well as saline or other fluids. 
       FIG. 3  depicts an embodiment of a modified Stage 1 filter for the collection of materials from the harvesting site. Saline and bone graft material would flow into the device via Tube  205 . The device container,  301 , would contain a hinged lid  302 . Within the container  301 , would be a Removable Porous Filter Device,  303 , that is porous in nature to capture large bone graft material but provide for the flow through of saline, blood products, plasma, cells, and growth factors, and other particulate matter of a specific geometrically limited size. The material would be drawn through the filter via suction applied through Port  304 . Also depicted in  FIG. 3  would be Tubing  204  that would allow for saline to flow to the RIA device  102  and provide irrigation to facilitate the evacuation of bone graft material. 
       FIG. 4  is an alternative embodiment of the Stage 1 filter. Tube  401  would be contained within the Filter Device container,  301 , once again avoiding significant entanglement and providing for more efficient use within the operating room. The remaining portion of the device would function very similar as the device in  FIG. 3 . A hinged lid,  302 , providing access to Porous Filter  303 , would catch material entering via Port  205  once again allowing for saline, blood products, plasma, cells, growth factors and other particulate matter of a specific geometrically limited size to pass through and be drawn out via Port  304 . 
       FIG. 5  shows one depiction of the initial stage filter with additional details noted. Through Tube  205  saline as well as graft material evacuated from the medullary canal would enter Stage 1 container  301 . The lid now hinged open, depicted at  302 , allows for access to Removal Filter  303  containing Bone Graft Material  501 . The remaining portion of the fluid, containing blood products, plasma, cells, growth factors and other particulate matter of a specific geometrically limited size would be evacuated via suction, through Tube  304 . 
       FIG. 6  depicts the removal of the material off of Porous Filter  303 . Bone Graft Material  501  would then be removed via Spatula Device  601  into Container  602 . These Devices,  601  as well as  602 , would be sterile and used within the operative field. The Collection Container  602  provides for a sterile container to contain the Bone Graft Material  501  for later re-implantation at the desired clinical site. 
       FIG. 7  represents one embodiment of the second stage filtration system which would be designed to remove excess water yet retain additional graft material including but not limited to blood products, plasma, cellular bone marrow/stem cell elements, as well as growth factors and other particulate matter of a specific geometrically limited size. Depicted in  FIG. 7  is the initial Stage Filter  303  contained within the Filtration container  301  covered by Lid  302 . Initial material harvested from the RIA device  102  would enter the container via Tube  205 . Large bone graft material would be trapped by Filter  303  allowing for the pass through/flow through of the remaining material through Tube  304 . This material once again would represent blood products, plasma, and cellular elements including stem cells as well as growth factors and other particulate matter of a specific geometrically limited size. This material would then enter Centrifugal Filtration Device  701 . This device would contain a porous filtration capturing membrane  801 . It will be covered and contained within the centrifugal filtration device via Lid  703 . The porous filtration capturing membrane  801  would be porous in its design to allow for capturing of blood products, plasma, cellular elements/stem cells, as well as growth factors and other particulate matter of a specific geometrically limited size, yet provide for the separation of fluid. This separation would then allow for a concentration of the graft elements and further to extract fluid from the system via centrifugation. The fluid may exit via Tubing  702  connected to an evacuation port in the various embodiments of the second stage filter as illustrated, for example, in  FIG. 7 . 
       FIG. 8  is a detailed depiction of the porous filtration capturing membrane within the Filtration Device  701 . The cylindrical porous filtration capturing membrane  801  would be removed from Centrifugal Filtration Device  701  and cut to provide for a rectangular surface  802  and function as a graft impregnated membrane for re-implantation within the patient. 
       FIG. 9 , once again, provides for a drawing of this process starting with the Centrifugal Filtration Device  701  that is sealed via Lid  703 . Material filtered through the first stage filtration system enters via Tube  304 . After a centrifugal filtration process takes place, within  701 , the material is trapped within the porous filtration capturing membrane  801  which is porous in nature to provide for the capture of blood products, plasma, cellular elements including stem cells, as well as growth factors and other particulate matter of a specific geometrically limited size, but allow for the pass through of fluid that would exit via Tubing  702  connected to an evacuation port in the various embodiments of the second stage filter as illustrated, for example, in  FIG. 9 . The porous filtration capturing membrane  801  could then be cut to size and later implanted within the patient. 
       FIG. 10  represents an alternative embodiment of the second stage filter. This filter would be designed for a more passive filtration process facilitated by vacuum negative pressure. Filtration Canister  1002  would contain a Hinged Lid  1003 . Material exiting the first stage filter would enter the device via Tube  304 . The undulating surface depicted as  1005  would be a filtration surface undulated for increasing surface area. It would reside on top of a porous yet Hydrophilic Membrane  1004  that would facilitate the extraction of fluid. The retention of blood products, plasma, cellular elements including stem cells, growth factors and other particulate matter of a specific geometrically limited size, would take place on the second stage (or any subsequent stage) filtration surface  1005 . Excess fluid would then be evacuated via Tube  1001  connected to an evacuation port in the various embodiments of the second stage filter as illustrated, for example, in  FIG. 10 . 
     In  FIG. 11  a more detailed depiction of the second stage filter and hydrophilic membrane is depicted. The undulating Second Stage Filter  1005  would initially lie on top of porous Hydrophilic Membrane  1004 . The Filtration Surface  1005  would then be peeled away from hydrophilic/porous Surface  1004  after it has been exposed to the second stage graft/fluid material. This surface would then be available for implantation within the desired clinical setting. 
       FIG. 12  represents the final combination of material from the first as well as second stage of filtration, or any combination of a plurality of filtration stages. Material from the first stage of filtration, depicted as  501 , and being contained within Sterile Container  602 , would then be placed on top of Undulating Porous Sponge  1005 . This would become a combination graft of large fragments of bone graft material from stage 1 combined with desired blood products, plasma, cellular elements/stem cells, growth factors and other particulate matter of a specific geometrically limited size. This combined graft can then be used in the desired clinical location. The location being depicted in  FIG. 12  as  1201 , a tibial bone graft site, although other site may be desired. 
     An alternative embodiment of the combined graft would be depicted in  FIG. 13  that would provide for a combination of material from the first stage filtration as well as material captured via centrifugal filtration device and contained within the porous filtration capturing membrane  801 . Material from the first stage of Filtration  501  would be removed from Container  602 . It would then be placed on the cut porous filtration capturing membrane  801 , which would contain blood products, plasma, cellular elements including stem cells as well as growth factors and other particulate matter of a specific geometrically limited size. This would then be made available for implantation within a desired clinical bone graft site depicted as a tibial site  1301  in  FIG. 13 , although other site may be desired. 
     It is therefore submitted that the instant invention has been shown and described in what is considered to be the most practical and preferred embodiments. It is recognized, however, that departures may be made within the scope of the invention and that obvious modifications will occur to a person skilled in the art. With respect to the above description then, it is to be realized that the optimum dimensional relationships for the parts of the invention, to include variations in size, materials, shape, form, function and manner of operation, assembly and use, are deemed readily apparent and obvious to one skilled in the art, and all equivalent relationships to those illustrated in the drawings and described in the specification are intended to be encompassed by the present invention. 
     Therefore, the foregoing is considered as illustrative only of the principles of the invention. Further, since numerous modifications and changes will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and operation shown and described, and accordingly, all suitable modifications and equivalents may be resorted to, falling within the scope of the invention.