Patent Publication Number: US-2021186529-A1

Title: Ndicating position and length of a bone tunnel and implementations thereof

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     The present application is a divisional of U.S. patent application Ser. No. 15/075,731 filed on Mar. 21, 2016 (U.S. Pat. No. 10,939,926), which claims priority to and the benefit of U.S. provisional patent application No. 62/136,560, filed on Mar. 22, 2015, the entire contents of which are hereby incorporated by reference. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present disclosure is directed generally to surgical devices and surgical procedures for drilling into a bone, and more particularly, to a surgical device for indicating the position and length of a bone tunnel prior to penetrating the bone. 
     2. Description of the Related Art 
     Many surgical procedures to repair torn or damaged tissue require the surgeon to form a tunnel in a bone or boney member. The tunnel serves as a site to anchor repair tissue or sutures. For reconstructive repair of the knee, for example, tunnels penetrate through both the tibia and femur to allow graft tissue to extend all the way through these bones. The graft tissue operates to join the bones together to restore normal functions of the joint. The positioning of the bone tunnel is considered to be one of the most important factors determining the success of a knee reconstruction. It is important, therefore, that the tunnels are in the proper position and of sufficient length to ensure the most secure attachment of the repair tissue. This ability to precisely identify the location and trajectory of the potential bone tunnel is made more difficult when using a guide with a bent or curved tip. 
     As the positioning of the bone tunnel is directly influenced by the surgeon, it is critical that a device used by the surgeon to execute the bone tunnel be precise and easy to use intraoperatively. Drill guides are known in the art for facilitating the formation of a bone tunnel; however, these guides lack a feature for providing measurements of the bone tunnel length. The ability to measure the length of a potential bone tunnel could provide the surgeon with more information to determine where to place the bone tunnel. 
     Accordingly, there is a need in the art for a surgical tool to facilitate the drilling of a bone tunnel with a feature for providing measurements of the bone tunnel length. 
     Description of the Related Art Section Disclaimer: To the extent that specific patents/publications/products are discussed above in this Description of the Related Art Section or elsewhere in this application, these discussions should not be taken as an admission that the discussed patents/publications/products are prior art for patent law purposes. For example, some or all of the discussed patents/publications/products may not be sufficiently early in time, may not reflect subject matter developed early enough in time and/or may not be sufficiently enabling so as to amount to prior art for patent law purposes. To the extent that specific patents/publications/products are discussed above in this Description of the Related Art Section and/or throughout the application, the descriptions/disclosures of which are all hereby incorporated by reference into this document in their respective entirety(ies). 
     SUMMARY OF THE INVENTION 
     Embodiments of the present invention recognize that there are potential problems and/or disadvantages with the conventional devices for determining the position of a bone tunnel as described above. Therefore, a need exists for a simple to use device which engages opposing sides of a boney member to indicate location of potential bone tunnel apertures and measure the length of a potential bone tunnel. Various embodiments of the present invention may be advantageous in that they may solve or reduce one or more of the potential problems and/or disadvantages discussed herein. 
     The present disclosure is directed to an inventive configuration, structure, and resulting function of an apparatus for providing an indication of position and length of a bone tunnel prior to penetrating the bone. Various embodiments herein are directed to an apparatus for indicating the position and length of a bone tunnel, including, but not limited to: a first member configured to couple with a drill guide; and a second member in spaced relation to the first member, the second member comprising an indicator configured to provide an indication of thickness of a boney member with the first member disposed on a first side of the boney member and the second member disposed on a second side of the boney member. 
     According to an alternative embodiment, the apparatus for indicating the position and length of a bone tunnel, includes, but is not limited to a shaft having a bent portion; a first member coupled with the shaft, the first member comprising a body with a first axis and configured to couple with a drill guide; and a second member coupled with the shaft, the second member having a second axis, wherein the shaft is configured to locate the second member in spaced relation to the first member so that the second axis aligns with a drill axis at an end of the drill guide. 
     According to an another aspect, a system for use with a drill guide to measure a length of a tunnel in a bone includes, but is not limited to, a support structure with a first axis and a second axis intersecting at a drill angle; and a transitory member configured to move relative to the support structure, the bone, the transitory member comprising a gauge marker, wherein, with the support structure in position on the drill guide, the drill angle is configured to align the second axis with a drill axis at a curved end of the drill guide, and wherein the gauge marker has a first position and a second position relative to the support structure, at least one of which corresponds with a value for the length for the tunnel that is zero. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present invention will be more fully understood and appreciated by reading the following Detailed Description in conjunction with the accompanying drawings. The accompanying drawings illustrate only typical embodiments of the disclosed subject matter and are therefore not to be considered limiting of its scope, for the disclosed subject matter may admit to other equally effective embodiments. 
       Reference is now made briefly to the accompanying drawings, in which: 
         FIG. 1  is a perspective view schematic representation of an exemplary embodiment of an apparatus to provide an indication of a length of a potential tunnel in a bone in accordance with an embodiment; 
         FIG. 2  is a perspective view schematic representation of an exemplary embodiment of an apparatus to provide an indication of a length of potential tunnel in a bone in accordance with an embodiment; 
         FIG. 3  is a perspective view schematic representation of the apparatus of  FIG. 2  with parts positioned to provide an indication of a first length in accordance with an embodiment; 
         FIG. 4  is a perspective view schematic representation of the apparatus of  FIG. 2  with parts positioned to provide an indication of a second length in accordance with an embodiment; 
         FIG. 5  is a perspective view schematic representation of an exemplary embodiment of an apparatus to provide an indication of a length of a potential tunnel in a bone in accordance with an embodiment; 
         FIG. 6  is an elevation view of the apparatus of  FIG. 5  in accordance with an embodiment; 
         FIG. 7  is a detail view of the apparatus of  FIG. 5  in accordance with an embodiment; 
         FIG. 8  is a detail view of the apparatus of  FIG. 5  in accordance with an embodiment; 
         FIG. 9  is a perspective view of the apparatus of  FIGS. 5, 6, 7, and 8  disposed on an example of a drill guide in accordance with an embodiment; 
         FIG. 10  is an elevation view of the cross-section of the apparatus of  FIG. 9  in accordance with an embodiment; and 
         FIG. 11  depicts a detail of the apparatus of  FIG. 10  in accordance with an embodiment. 
     
    
    
     Where applicable, like reference characters designate identical or corresponding components and units throughout the several views, which are not to scale unless otherwise indicated. Moreover, the embodiments disclosed herein may include elements that appear in one or more of the several views or in combinations of the several views. 
     DETAILED DESCRIPTION 
     Referring now to the drawings, wherein like reference numerals refer to like parts throughout, there is seen in  FIG. 1  a perspective view schematic representation of an exemplary embodiment of an apparatus  100  to locate a tunnel prior to drilling. The apparatus  100  is part of a system  10  that can include a drill guide  12  and drill (not shown). The system  10  is shown proximate a boney member  14 . In use, the system  10  can locate a potential tunnel  16  of length L in a boney member  14 . The tunnel  16  can have an entrance  18  and an exit  20  wherein the entrance  18  is disposed on a first side  22  of the boney member  14  and the exit  20  is disposed on an opposing second side  24  of the boney member  14 . 
     As also shown in  FIG. 1 , the drill guide  12  has an elongated structure  26  terminating at bent or curved end  28  with a tip  30  designed to direct a flexible guide pin at an angled trajectory to create a longer bone tunnel. The elongated structure  26  is cannulated, forming a bore  32  with a drill axis  34 . During a surgical procedure and prior to drilling, the surgeon can position the tip  30  in a location on the first side  22  against the boney member  14 . The tip  30  engages the boney member  14  to maintain the position of the system  10 . Specifically, the tip  30  operates as a fulcrum wherein the surgeon can move the system  10  in position relative to the boney member  14 . 
     The apparatus is configured as an aid to locate the potential tunnel  16  prior to any breach of the boney member  14 . This aid provides an indication of the thickness of the boney member  14  at the exit  20  measured between the sides  22 ,  24 . The thickness corresponds with length L of the potential tunnel  16  in many surgical procedures in which the potential tunnel  16  penetrates through the boney member  14  (as shown in  FIG. 1 ). In response to movement of the system  10  by the surgeon, the indication on the apparatus  100  changes to reflect the thickness at various points along the surface of the second side  24  of the boney member  14 . Thus, the surgeon is provided with an easily visible and immediate indication that the thickness of the boney member  14  has changed. This feature avoids unnecessary trauma to the boney member  14 . For example, the surgeon can use the apparatus  100  to select the position for the potential tunnel  16  that is best situated to receive and secure tissue (or other material) in the boney member  14  prior to drilling. Then, with the drill guide  12  in the appropriate position, the surgeon can proceed to form the potential tunnel  16 , typically by first inserting the flexible guide pin (not shown) through the bore  32  of the drill guide  12  to puncture the boney member  14 . The surgeon can then locate a separate, flexible guide pin on the second side  24  of the boney member  14 . The flexible guide pin can be used with the drill and a drill bit (not shown) that inserts over the flexible guide pin and is sized to create the potential tunnel  16  with an appropriate diameter, as desired. 
     Referring again to  FIG. 1 , the apparatus  100  can have a support structure with a first member  102  (as “fastening member  102 ”) and a second member  104  (also, “gauge member  104 ”). The members  102 ,  104  are disposed on opposite sides  22 ,  24  of the boney member  14 . These positions are useful to present the indication (at the gauge member  104 ) in a manner that is visible to the surgeon and surgical staff during the procedure. In one example, the fastening member  102  is configured to couple with the drill guide  12 . Upon fastening, the gauge member  104  is maintained coplanar with the bore  32  of the drill guide  12 . The gauge member  104  can be configured with an indicator  106  to provide the indication of material thickness and, in turn, the length L of the potential tunnel  16 . In one embodiment, the support structure can also include a coupling member, generally indicated by the dashed line enumerated as  108 . The coupling member  108  can provide structure (e.g., frame members) to couple the members  102 ,  104  together in a spaced relationship. In the system  10 , this spaced relationship locates the fastening member  102  and the gauge member  104  on the first side  22  and the second side  24  of the boney member  14  (as shown in  FIG. 1 ), respectively. 
     Referring now to  FIG. 2 , there is shown a perspective view schematic representation of an apparatus  200  in partially exploded form. The fastening member  202  defines a first axis  210 . The gauge member  204  includes a guide member  212  and a transitory member  214 , preferably an elongated body  216  with a pair of ends (e.g., a distal end  218  and a proximal end  220 ). The elongated body  216  can also include a gauge maker  222  spaced longitudinally apart from the ends  218 ,  220 . As also shown in  FIG. 2 , the guide member  212  has a bore  224  with a pair of open ends (e.g., a first end  226  and a second end  228 ) and a second axis  230  extending therebetween. The bore  224  is oriented so that the second axis  230  intersects the first axis  210  at a guide angle α. Values for the guide angle α are nominally in a range of from approximately 90 degrees to approximately 180 degrees and, in one example, the guide angle α is approximately 140 degrees. In one implementation, the value for the guide angle α aligns the second axis  230  with the drill axis  34  ( FIG. 1 ) at the curved end  28  of the drill guide  12  ( FIG. 1 ). This alignment is useful to position the elongated body  216  along the travel of the guide wire and drill bit into the boney member  14 . In this way, the apparatus  200  can provide the surgeon with a visual approximation for the exit  20  ( FIG. 1 ) of the potential tunnel  16  ( FIG. 1 ) from the boney member  14  ( FIG. 1 ). 
     The bore  224  is configured to receive the distal end  218  of the elongated body  216 . This configuration aligns the elongated body  216  with the second axis  230 . In use, the elongated body  216  can move relative to the guide member  212  along the second axis  230 , as indicated by the arrow enumerated  232 . Movement  232  changes the position of the gauge marker  222  from a first position to a second position. To facilitate the movement  232 , the apparatus  200  may utilize a loose slip fit between the dimensions of the interior surface of the bore  224  and the dimensions of the outer surface of the elongated body  216 . In some embodiments, it may be preferred to use a slight interference fit to retain the elongated body  216  in position relative to the guide member  212  until acted on, e.g., by the surgeon during the surgical procedure. 
     Referring again to  FIG. 2 , the indicator  206  is configured to provide a visual representation of the indication of material thickness (and length L of the potential tunnel  16  of  FIG. 1 ). The indicator  206  can include an aperture  234  and a gauge  236 . The aperture  234  penetrates the guide member  212 . This feature may embody an elongated slot to expose a portion of the bore  224 ; however, this disclosure does contemplate that other geometry, e.g., one or more annular and/or circular openings, might also provide geometry that is suitable for use in the embodiment. 
     The gauge  236  has one or more markings (e.g., a first marking  238 , a second marking  240 , and a third marking  242 ) that reside proximate the aperture  234 . The markings  238 ,  240 ,  242  relate to a reference point, shown generally as point  244 . The reference point  244  is useful to solidify a position of the gauge  236  on the guide member  212  and on the apparatus  200 , generally. This position ensures the location of the gauge marker  222  relative to the markings  238 ,  240 ,  242 , and reflects the material thickness of the boney member  14  ( FIG. 1 ). In one example, the location of the reference point  244  is defined by one or more coordinates (e.g., a first or radial coordinate  246 ). The radial coordinate  246  measures a distance between the reference point  244  and the first axis  210 . As discussed more below, this distance accommodates for the offset between the first axis  210  and the tip  30  ( FIG. 1 ) of the drill guide  12  ( FIG. 1 ). 
     Referring now to  FIGS. 3 and 4 , there are shown perspective view schematic representations of the apparatus of  FIG. 2  with parts positioned to provide an indication of a first length and a second length, respectively.  FIG. 3  illustrates an example of the apparatus  200  in assembled form with the gauge marker  222  in the first or zero position, and  FIG. 4  illustrates an example of the apparatus  200  in assembled form with the gauge marker  222  in the second or measured position. In  FIG. 3 , the apparatus  200  is configured with the distal end  218  of the elongated body  216  disposed proximate the tip  30  of the drill guide  12 . The gauge marker  222  is located on the elongated body  216  so that the zero position corresponds with a length L 1  that is approximately zero (or null). In one implementation, the apparatus  200  may be configured for the gauge marker  222  to reside outside of the guide member  212  in the zero position as shown in  FIG. 3 . This zero position is useful for the surgeon or surgical staff to calibrate the apparatus  200  (e.g., to ensure that the elongated body  216  is properly selected with respect to the drill guide  12  prior to use during the surgical procedure).  FIG. 4  shows the apparatus  200  with the distal end  218  of the elongated body  216  in contact with the second side  24  of the boney member  14 . The gauge marker  222  is found within the aperture  234  and proximate the gauge  236 . The gauge  236  is configured to approximate the length L 2  so that, in use, the surgeon can estimate the length L 2  in accordance with the relationship between the gauge marker  222  and the gauge markings  238 ,  242 ,  244 . 
     Referring now to  FIG. 5 , there is shown a perspective view schematic representation of an exemplary embodiment of an apparatus  300  in assembled form. Moving from right to left in the diagram, the elongated body  316  embodies a pin  348  of generally cylindrical cross-section. The guide member  312  can embody a tube  350  or like thin-walled cylinder that is configured to receive the pin  348 . The tube  350  may lend itself to constructions of sheet metal that is bent or formed around the second axis  330 , although the part may be machined from a block or billet of material. 
     The pin  348  may be constructed of metal (e.g., stainless steel) or other suitable surgical material, typically as turned and/or extruded shaft. At the distal end  318 , the shaft can terminate at a sharp point, or tapered end, that is configured to pierce skin and/or bone, as necessary. The gauge marker  322  can be formed on the metal shaft using etching and related techniques (e.g., paint, dye, plating, etc.). In on example, the pin  348  can include an identifier  352  to allow the surgeon or surgical staff to visually identify the pin  348 . The identifier  352  may indicate the type and/or style of the pin  348 , and/or may show that the pin  348  is useful for and/or corresponds with a particular surgical procedure or application. 
     The coupling member  308  can include a shaft  354 . The shaft  354  can be solid or hollow, in whole or in part. Selected construction may depend at least in part on weight and cost considerations for the apparatus  300 . The construction will preferably use surgical grade metals and like material of sufficient strength, rigidity, and durability. It is important, for example, that the construction can maintain the spaced relationship between the fastening member  302  and the tube  350  after repeated usage as necessary within the disclosed subject matter contemplated herein. 
     The shaft  354  can have one or more generally straight portions (e.g., a first portion  356  and a second portion  358 ) and a bent portion  360  disposed therebetween. On one end of the shaft  354 , the first portion  356  couples with the tube  350 , preferably using a weld and/or similar fastening technique, although these components may be configured for fasteners (e.g., screws). In one example, the apparatus  300  may include one or more intermediary pieces (e.g., a clamp and/or a bracket) to secure the first portion  356  and the tube  350  together. At the other end of the shaft  354 , the second portion  358  couples with the fastening member  302 . The second portion  358  may penetrate into the fastening member  302  (as shown in  FIGS. 10 and 11  below). 
     The fastening member  302  has a body  362  with a first end  364  and a second end  366 . The features of the body  362  may lend to machining, casting, or molding of suitable materials (e.g., metals, plastics, composites, etc.). In one implementation, the body  362  is configured into at least a pair of sections (e.g., a first section  364  and a second section  366 ). In the first section  364 , the body  362  has an outer surface  372  that tapers inwardly towards the first axis  310  from the first end  364  towards the second end  366 . The taper forms the body  362  with a generally frusto-conical shape. The outer surface  372  also can have one or more depressions (e.g., a first depression  374 ). These depressions can populate the body  362  to facilitate implementation of fastening member  302  on the drill guide  12  ( FIGS. 1, 3, and 4 ). For example, the depressions can be configured to receive or more fingers (e.g., thumb and forefinger) of the surgeon, thus improving tactile feel and increasing leverage for the surgeon to engage the fastening member  302  onto the drill guide ( FIGS. 1, 3, and 4 ). 
       FIG. 6  depicts an elevation view of the apparatus  300 . The structure of the apparatus  300  has a profile that is useful to locate the reference point  344  and, thus, coordinate dimensions for the gauge marker  222  ( FIGS. 2, 3, and 4 ), the gauge  236  ( FIGS. 2, 3, and 4 ), and the gauge markings  238 ,  240 ,  242  ( FIGS. 2, 3, and 4 ) as contemplated herein. The profile includes the first axis  310  and the second axis  330 . The profile also includes a third axis  376  and a fourth axis  378 , one each formed by the first portion  356  and the second portion  358  of the shaft  354 , respectively. As shown in  FIG. 6 , in the profile, the third axis  376  intersects with the second axis  330  at an angle α 1  and with the fourth axis  378  at α 2 . Proximate the fastening member  302 , the fourth axis  378  intersects the first axis  310  at an angle α 3 . In one implementation, the profile for the structure of the apparatus  300  is configured in accordance with Equations (1), (2), (3), and (4) below: 
       C 1 =C 3 ,  Equation (1)
 
       C 2 =C 4 ,  Equation (2)
 
       α=α 2 ,  Equation (3)
 
       α 1 =α 3 ,  Equation (4)
 
     wherein C 1  measures the length between the first axis  310  and the third axis  376  (along the second axis  330 ), C 2  measures the length between the second axis  330  and the fourth axis  378  (along the third axis  376 ), C 3  measures the length between the first axis  310  and the third axis  376  (along the fourth axis  378 ), and C 4  measures the length between the second axis  330  and the fourth axis  378  (along the first axis  310 ). 
     Referring now to  FIG. 7 , there is shown a detail view of the apparatus in  FIG. 5 . The body  362  has a planar surface  380  arranged perpendicular to the first axis  310 . The planar surface  380  can serve as a reference, separating the sections  368 ,  370 . In the second section  370 , the body  362  has a reduced diameter (as compared to the diameter of the body  362  in the first section) with an elongated protrusion  382  that extends along the first axis  310  and away from the planar surface  380 . The elongated protrusion  382  supports a hasp element  384 . Configurations of the hasp element  384  can embody a hook, clip, or like fastener. In use, this fastener is configured to releasably engage the body  362  with the drill guide  12  ( FIG. 1 ) as noted herein. 
     Referring now to  FIG. 8 , there is shown an elevation view of the back of the apparatus  300  of  FIG. 7 . The body  362  includes a slotted bore  386  with an open bottom portion  388  and annular top portion  390 . The slotted bore  386  penetrates through the body  362  along the first axis  310 . The annular top portion  390  circumscribes the first axis  310 . In one implementation, the diameter of the annular top portion  390  and width of the open bottom portion  377  are configured to receive the elongated structure  26  ( FIG. 1 ) of the drill guide  12  ( FIG. 1 ) therein. This configuration allows the surgeon to rest the body  362  on the elongated structure  26  ( FIG. 1 ) and insert the body  362  into a portion of the drill guide  12  ( FIG. 1 ). The hasp element  388  will retain the body  362  in the inserted position. 
     Referring now to  FIGS. 9-11 , there are shown various views of the apparatus  300  in position on an exemplary drill guide  12 .  FIG. 9  is a perspective view of the apparatus  300 . The drill guide  12  includes a handle  36  that secures to a drill shaft  38 . The handle  36  incorporates an actuatable member  40 , shown here in position of the handle  36  for the surgeon to actuate with the thumb.  FIG. 10  is an elevation view of the cross-section of the apparatus of  FIG. 9  taken at line  10 - 10 . This view shows an example of the integrations of the second portion  358  of the shaft  354  with the body  362  in the first section  368 . In one implementation, the body  362  may include a bore (or detent) to receive the second portion  358  under a press and/or interference fit; however, in other configurations, the second portion  358  may secure to the body  362  using appropriately configured welds, fasteners, and like techniques.  FIG. 11  is a detail view of the cross-section of  FIG. 10 . The actuatable member  40  can include a recess  42 . Geometry for the recess  42  is compatible with the geometry of the hasp element  388 . In use, the surgeon can actuate the actuatable member  40 , which moves the recess  42  to secure and release the hasp element  388  on the body. 
     While embodiments of the present invention has been particularly shown and described with reference to certain exemplary embodiments, it will be understood by one skilled in the art that various changes in detail may be effected therein without departing from the spirit and scope of the invention as defined by claims that can be supported by the written description and drawings. Further, where exemplary embodiments are described with reference to a certain number of elements it will be understood that the exemplary embodiments can be practiced utilizing either less than or more than the certain number of elements.