Patent Publication Number: US-2023138945-A1

Title: Engineered sterile cartilage implant plug(s) with sterile, specific instrument kit(s)

Description:
PRIORITY 
     This application is a continuation-in-part of, and claims the benefit of, U.S. patent application, entitled “Engineered Sterile Cartilage Allograft Implant Plug With Sterile, Specific Instrument Kit(s),” filed on Jun. 25, 2020, and having application Ser. No. 16/912,197, which claims the benefit of U.S. patent application Ser. No. 15/795,006 filed on Oct. 26, 2017 and U.S. patent application Ser. No. 15/048,518 filed on Feb. 19, 2016, which claims the benefit of, and priority to, U.S. Provisional Application filed on Feb. 27, 2015 and having application Ser. No. 62/126,053, the entirety of each of said applications being incorporated herein by reference. 
    
    
     FIELD 
     The field of the present disclosure generally relates to surgical implants. More particularly, the field of the invention relates to an apparatus and a method for performing cartilage allograft implant surgeries to repair osteochondral defects. 
     BACKGROUND 
     Articular cartilage is a smooth, white tissue which covers the ends of bones where they come together to form joints in humans and many animals so as to facilitate articulation of the joints and protect and cushion the bones. Cartilage may become damaged, however, due to abrupt trauma or prolonged wear. A number of surgical techniques have been developed to treat damaged cartilage. Restoring articular cartilage is known to relieve pain and facilitate better joint function, as well as potentially delaying or preventing an onset of arthritis. One surgical technique comprises transplantation of a healthy osteochondral allograft so as to replace damaged cartilage and encourage new cartilage growth. 
     During an osteochondral allograft transplantation, an allograft plug, often referred to as an osteochondral plug or core, is harvested from a condyle or rounded joint-forming portion of a donor bone. Typically, the allograft plug comprises a portion of bone with a healthy cartilage on the surface. In some cases, the allograft plug may also include an attached portion of cancellous tissue, which is the porous inner material that is present in many bones. During the transplant procedure, damaged cartilage is removed and a portion of bone is cut away and removed from the joint, thereby forming an osteochondral hole or bore. The allograft plug is then inserted into the osteochondral bore and attached such that the healthy cartilage of the allograft plug aligns with the cartilage on the surface of the bone joint being treated. 
     What is needed, however, is a kit which enables a surgeon to select specifically sized allograft plugs and corresponding surgical implantation tools so as to improve the accuracy and simplicity of osteochondral allograft transplantation surgeries. 
     SUMMARY 
     An apparatus and a method are provided for performing cartilage graft implant surgeries. The apparatus comprises a graft plug kit comprising one or more grafts configured to treat osteochondral defects in various bone joint locations in a patient&#39;s body. Each of the grafts comprises a cartilage layer coupled with a bone portion, and has a diameter and a length suitable for the bone joint location to be treated. In one embodiment, the grafts comprise diameters ranging from substantially 5 millimeters (mm) to substantially 15 mm, and each of the grafts has a length of substantially 12 mm. The cartilage layer comprises a thickness selected to closely match the thickness of existing cartilage at an implant location. The bone portion comprises surface features configured to encourage the patient&#39;s bone tissue to grow into the bone portion, thereby accelerating incorporation of the graft into the patient&#39;s bone. An instrument kit comprises a multiplicity of instruments configured for implantation of the grafts into the patient&#39;s body, including at least a graft inserter, a guidewire, a reamer, and a size gauge. 
     In an exemplary embodiment, an apparatus for performing cartilage graft implant surgeries comprises a sterile graft plug kit comprising one or more grafts configured to treat osteochondral defects in various bone joint locations in a patient&#39;s body, the one or more grafts each comprising a cartilage layer coupled with a bone portion; and at least one sterile instrument kit comprising a multiplicity of instruments including at least a graft inserter, a guidewire, a reamer, and a size gauge, the multiplicity of instruments being configured for implanting the one or more grafts into the patient&#39;s body. 
     In another exemplary embodiment, the graft inserter comprises an elongate member having a distal graft retainer and a proximal applicator, the distal graft retainer comprising an opening configured to receive and hold the graft, the proximal applicator being in mechanical communication with the distal graft retainer by way of an interior channel of the elongate member whereby the proximal applicator may be used to push the graft out of the distal graft retainer and into an osteochondral bore in the patient&#39;s body. In another exemplary embodiment, the graft inserter comprises a viewport and a graft length indicator, the viewport facilitating direct observation of the graft within the distal graft retainer, the graft length indicator comprising a series of ring lines positioned adjacent to the viewport with a sequentially increasing distance from the distal graft retainer. In another exemplary embodiment, when the graft is fully received into the distal graft retainer, the position of the top of the cartilage layer relative to the graft length indicator provides a visual indication of a total length of the graft. 
     In another exemplary embodiment, the guidewire comprises an elongate shaft having a distal pointed tip and a proximal blunt end, wherein the distal pointed tip is configured to advance through obstructive tissues and structures within bone joints, and wherein the proximal blunt end facilitates manipulation of the guidewire by hand. In another exemplary embodiment, the guidewire is comprised of a surgical stainless steel. 
     In another exemplary embodiment, the reamer comprises a rigid elongate shaft having a distal cutting end and a proximal shank, the distal cutting end comprising a cutting edge suitable for rotatably clearing an osteochondral bore, and the proximal shank being configured to be grasped by a chuck of a surgical drill, or other equivalent rotary tool. In another exemplary embodiment, the distal cutting edge comprises a spiral cutting edge. In another exemplary embodiment, the reamer comprises a central, lengthwise hole whereby the reamer is mountable onto the guidewire so as to direct the distal cutting end to an implant location within the bone joint. 
     In another exemplary embodiment, the size gauge comprises an elongate member having a depth indicator and a proximal handle portion, the depth indicator comprising a series of ring lines positioned on the elongate member with a sequentially increasing distance from a distal end of the size gauge, the ring lines being configured to indicate the depth of an osteochondral bore into which the distal end is inserted. In another exemplary embodiment, the depth indicator correlates with a graft length indicator of the graft inserter so as to enable a surgeon to ensure that the osteochondral bore is drilled to a depth suitable to receive the graft. In another exemplary embodiment, the elongate member comprises a central, lengthwise hole having a diameter suitable to receive the guidewire so as to direct the depth indicator to the osteochondral bore. 
     In another exemplary embodiment, the one or more grafts comprise diameters ranging from substantially 5 millimeters (mm) to substantially 15 mm, and each of the one or more grafts comprises a length of substantially 12 mm. In another exemplary embodiment, the one or more grafts are each harvested as a one-piece component from a bone joint location in a cadaver. In another exemplary embodiment, the cartilage layer comprises a thickness which closely matches a thickness of existing cartilage at an implant location. 
     In another exemplary embodiment, the bone portion comprises a multiplicity of surface features configured to encourage the patient&#39;s bone tissue to grow into the bone portion, thereby accelerating incorporation of the graft into the patient&#39;s bone. In another exemplary embodiment, the surface features comprise holes, dimples, or circumferentially distributed longitudinal grooves. In another exemplary embodiment, the holes comprise diameters depending upon the size of the grafts and the locations within the patient&#39;s body where the grafts are intended to be implanted. In another exemplary embodiment, the longitudinal grooves may be implemented with a variety of widths, lengths, depths and cross-sectional shapes within the bone portion. 
     In an exemplary embodiment, a method for an instrument kit for implanting grafts into bone joints of a patient comprises configuring one or more grafts to treat osteochondral defects in various bone joint locations in the patient&#39;s body, the one or more grafts each comprising a cartilage layer coupled with a bone portion; assembling the one or more grafts into a sterile graft plug kit, the one or more grafts having different diameters that are suitable for the various bone joint locations in the patient&#39;s body; and combining the sterile graft plug kit with a multiplicity of instruments configured for implantation of the one or more grafts into the patient&#39;s body, the multiplicity of instruments including at least a graft inserter, a guidewire, a reamer, and a size gauge. In another exemplary embodiment, configuring comprises forming the one or more grafts such that the diameters of the one or more grafts range from substantially 5 mm to substantially 15 mm. 
     In an exemplary embodiment, a sterile graft plug kit for treating osteochondral defects in bone joint locations in a patient&#39;s body comprises one or more grafts configured to treat the osteochondral defects, the one or more grafts each comprising a cartilage layer coupled with a bone portion that are comprised of materials suitable for implantation in the joint locations; and a sterile instrument kit comprising a multiplicity of instruments configured for implanting the one or more grafts into the patient&#39;s body. 
     In another exemplary embodiment, the multiplicity of instruments is comprised of at least a graft inserter, a guidewire, a reamer, and a size gauge. In another exemplary embodiment, the graft inserter comprises an elongate member having a distal graft retainer and a proximal applicator, the distal graft retainer being configured to receive and hold a graft, the proximal applicator being configured to enable pushing the graft out of the distal graft retainer and into an osteochondral bore in the patient&#39;s body. In another exemplary embodiment, the guidewire is comprised of a surgical stainless-steel shaft having a distal pointed tip and a proximal blunt end, the distal pointed tip being configured to advance through obstructive tissues and structures within bone joints, and the proximal blunt end being configured to facilitate manipulation of the guidewire by hand. In another exemplary embodiment, the reamer is comprised of a rigid elongate shaft having a distal cutting end and a proximal shank, the distal cutting end being configured for rotatably clearing an osteochondral bore, the proximal shank being configured to be grasped by a chuck of a rotary tool, and a central, lengthwise hole being disposed in the reamer and configured for mounting the reamer onto the guidewire so as to direct the distal cutting end to an implant location. In another exemplary embodiment, the size gauge is comprised of an elongate member having a depth indicator and a proximal handle portion, the depth indicator being configured to indicate the depth of an osteochondral bore into which the distal end is inserted, the proximal handle portion being configured to facilitate manipulation of the size gauge by hand, and a central, lengthwise hole being configured to receive the guidewire so as to direct the depth indicator to the osteochondral bore. 
     In another exemplary embodiment, the cartilage layer is comprised of a material that closely matches existing cartilage at an implant location. In another exemplary embodiment, the cartilage layer is comprised of a synthetic implantable material. In another exemplary embodiment, the cartilage layer is comprised of polyvinyl alcohol (PVA) and configured for use as artificial cartilage. In another exemplary embodiment, the cartilage layer is comprised of a biostable polyurethane that is suitable for long-term implantation in the patient&#39;s body. In another exemplary embodiment, the biostable polyurethane is comprised of polycarbonate-urethane (PCU) or silicone-polycarbonate-urethane (TSPCU). 
     In another exemplary embodiment, any one of the one or more grafts is of a xenograft variety that is harvested from a donor species and then grafted into the patient&#39;s joint. In another exemplary embodiment, the any one of the one or more grafts is comprised of one or more of collagen, bone, and cartilage that is bovine or porcine in origin. In another exemplary embodiment, the any one of the one or more grafts are harvested as one-piece components from a suitable cartilage/bone joint location in a donor animal, such that the cartilage layer is affixed to the bone portion and is suitable for implantation in the joint to be treated. 
     In another exemplary embodiment, any one of the one or more grafts is of a graft variety that is harvested from a bone joint location in a cadaver, such that the cartilage layer comprises a thickness that substantially matches the thickness of existing cartilage at an implant location. In another exemplary embodiment, the one or more grafts comprise diameters and lengths that depend upon the particular bone joints into which the one or more grafts are to be implanted, the diameters and lengths being configured to correlate with one another and ranging from relatively small to relatively large. In another exemplary embodiment, the one or more grafts are configured to be specifically sized grafts whereby a surgeon may select any one or more of the one or more grafts based on the particular bone joint to be treated. 
     In an exemplary embodiment, a method for a sterile graft plug kit for treating osteochondral defects in bone joint locations in a patient&#39;s body comprises configuring one or more grafts to treat the osteochondral defects, each of the one or more grafts being comprised of a cartilage layer coupled with a bone portion; assembling the one or more grafts into the sterile graft plug kit, the one or more grafts having different diameters that are suitable for the bone joint locations in the patient&#39;s body; and combining the sterile graft plug kit with a multiplicity of instruments configured for implantation of the one or more grafts into the patient&#39;s body, the multiplicity of instruments including at least a graft inserter, a guidewire, a reamer, and a size gauge. 
     In another exemplary embodiment, configuring comprises harvesting any one or more of the one or more grafts from a donor species. In another exemplary embodiment, configuring comprises harvesting any one or more of the one or more grafts from a human cadaver. In another exemplary embodiment, configuring comprises harvesting any one or more of the one or more grafts from a bovine or porcine donor animal. In another exemplary embodiment, configuring comprises forming the cartilage layer of a synthetic implantable material that substantially matches existing cartilage at bone joint location to be treated. 
     In an exemplary embodiment, an apparatus for treating osteochondral defects comprises: one or more grafts comprising a cartilage layer and a bone portion for implantation in joint locations; and a sterile instrument kit comprising instruments configured for implanting the one or more grafts in the joint locations. 
     In another exemplary embodiment, the sterile instrument kit comprises at least a graft inserter, a guidewire, a reamer, and a size gauge. In another exemplary embodiment, the graft inserter comprises an elongate member having a distal graft retainer for holding a graft and a proximal applicator for pushing the graft from the distal graft retainer into an osteochondral bore. In another exemplary embodiment, the graft inserter includes a graft length indicator and a viewport enabling direct observation of the graft within the distal graft retainer. In another exemplary embodiment, the graft length indicator comprises a series of ring lines positioned adjacent to the viewport with a sequentially increasing distance from the distal graft retainer. 
     In another exemplary embodiment, the one or more grafts are configured to be specifically sized grafts to enable a surgeon to select any one or more of the one or more grafts based on the joint location to be treated. In another exemplary embodiment, the one or more grafts have a length of substantially 12 mm and diameters ranging between about 5 mm and about 15 mm. 
     In another exemplary embodiment, the cartilage layer includes a central portion that is disposed slightly above the surrounding cartilage. In another exemplary embodiment, the central portion includes a shape configured to approximate an osteochondral surface to be replaced. In another exemplary embodiment, the shape of the central portion includes either a convex curvature or a concave curvature configured to approximate the curvature of the osteochondral surface to be replaced. 
     In another exemplary embodiment, the cartilage layer comprises a material configured to closely match existing cartilage at an implant location. In another exemplary embodiment, the cartilage layer comprises a thickness configured to closely match the thickness of existing cartilage at an implant location. In another exemplary embodiment, the cartilage layer comprises a synthetic implantable material. In another exemplary embodiment, the cartilage layer comprises polyvinyl alcohol or a biostable polyurethane. In another exemplary embodiment, the biostable polyurethane comprises polycarbonate-urethane or thermoplastic silicone-polycarbonate-urethane. 
     In another exemplary embodiment, the bone portion includes surface features configured to encourage bone tissue growth into the bone portion. In another exemplary embodiment, the surface features comprise dimples and/or circumferentially distributed longitudinal grooves having a hemispherical or rectangular cross-sectional shape. In another exemplary embodiment, the bone portion comprising any one or more of the one or more grafts comprises a monophasic material. In another exemplary embodiment, any one or more of the one or more grafts is of a xenograft variety that is harvested from a donor species. In another exemplary embodiment, any one or more of the one or more grafts is of an allograft variety that is harvested from a cadaver. 
     These and other features of the concepts provided herein may be better understood with reference to the drawings, description, and appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The drawings refer to embodiments of the present disclosure in which: 
         FIG.  1    illustrates a lower perspective view of an exemplary embodiment of a graft plug kit, according to the present disclosure; 
         FIG.  2    illustrates an upper perspective view of an exemplary embodiment of a graft plug kit in accordance with the present disclosure; and 
         FIG.  3    illustrates a perspective view of an exemplary embodiment of a sterile instrument kit for implanting graft plugs into bone joints of a patient in accordance with the present disclosure. 
     
    
    
     While the present disclosure is subject to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. The invention should be understood to not be limited to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the present disclosure. 
     DETAILED DESCRIPTION 
     In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present disclosure. It will be apparent, however, to one of ordinary skill in the art that the invention disclosed herein may be practiced without these specific details. In other instances, specific numeric references such as “first graft,” may be made. However, the specific numeric reference should not be interpreted as a literal sequential order but rather interpreted that the “first graft” is different than a “second graft.” Thus, the specific details set forth are merely exemplary. The specific details may be varied from and still be contemplated to be within the spirit and scope of the present disclosure. The term “coupled” is defined as meaning connected either directly to the component or indirectly to the component through another component. Further, as used herein, the terms “about,” “approximately,” or “substantially” for any numerical values or ranges indicate a suitable dimensional tolerance that allows the part or collection of components to function for its intended purpose as described herein. 
     In general, the present disclosure describes an apparatus and a method for performing cartilage graft implant surgeries. The apparatus comprises a graft plug kit comprising one or more grafts configured to treat osteochondral defects in various bone joint locations in a patient&#39;s body. The grafts each comprise a cartilage layer coupled with a bone portion. The cartilage layer comprises a thickness which closely matches the thickness of existing cartilage at an implant location. The bone portion comprises surface features configured to encourage the patient&#39;s bone tissue to grow into the bone portion, thereby accelerating incorporation of the graft into the patient&#39;s bone. In some embodiments, the grafts comprise diameters ranging from substantially 5 millimeters (mm) to substantially 15 mm, and each of the grafts comprises a length of substantially 12 mm. An instrument kit comprises a multiplicity of instruments including at least a graft inserter, a guidewire, a reamer, and a size gauge. The instruments are configured for implantation of the grafts into the patient&#39;s body. In some embodiments, the graft inserter comprises an elongate member having a distal graft retainer and a proximal applicator. The distal graft retainer includes an opening configured to receive and hold the graft. The proximal applicator facilitates pushing the graft out of the distal graft retainer and into an osteochondral bore formed in a bone joint of the patient. 
       FIGS.  1  and  2    illustrate respective lower and upper perspective views of exemplary embodiments of a graft plug kit  100  advantageously configured for repairing a wide range of osteochondral defects, according to the present disclosure. The graft plug kit  100  generally comprises a multiplicity of grafts  104  ranging from a relatively small diameter to a relatively large diameter. It will be appreciated that the range in diameters facilitates using the graft plug kit  100  to treat osteochondral defects in various bone joint locations in the human body, such as by way of non-limiting example, a femoral condyle (most common), a humeral head, a talus, a capitellum of the elbow, and the like. 
     In the exemplary embodiments illustrated in  FIGS.  1  and  2   , the graft plug kit  100  comprises four grafts  104  ranging in size from substantially 5 millimeters (mm) in diameter to substantially 15 mm in diameter. In some embodiments, the graft plug kit  100  may comprise a number of grafts greater than four, and thus grafts having diameters smaller than 5 mm and/or greater than 15 mm may be included in the graft plug kit  100 . Moreover, the grafts  104  in the embodiments illustrated in  FIGS.  1  and  2    each comprises a length of substantially 12 mm. In some embodiments, however, the grafts  104  may comprise different lengths, depending upon the particular bone joints for which the grafts  104  are intended. In some embodiments, the lengths of the grafts  104  may range from a relatively small value to a relatively large value. In some embodiments, the length of each graft  104  may be configured to correlate with the diameter of the graft. It will be appreciated that the graft plug kit  100  advantageously provides specifically sized grafts  104  whereby a surgeon may select the grafts based on a particular bone joint to be treated. Further, it should be understood that a wide variety of dimensions and sizes of the grafts  104  may be incorporated into the graft plug kit  100  without deviating from the spirit and scope of the present disclosure. 
     As further illustrated in  FIGS.  1  and  2   , each of the grafts  104  comprises a bone portion  108  and a cartilage layer  112 . In some embodiments, the grafts  104  may be allografts that are harvested as one-piece components from a cartilage/bone joint location in a cadaver, and thus the cartilage layer  112  is advantageously affixed to the bone portion  108 . It will be recognized by those skilled in the art that during implantation of the graft  104  into a recipient patient, damaged cartilage and underlying bone is removed from a joint to be treated, thereby forming an osteochondral bore having a diameter advantageously sized to receive the graft  104 . The graft  104  is then inserted into the bore such that the surface of the cartilage layer  112  is aligned with the surrounding cartilage, thus encouraging healing and incorporation of the graft  104  into the patient&#39;s joint. As such, the cartilage layer  112  preferably comprises a thickness which closely matches the thickness of the existing cartilage in the patient&#39;s joint. In some embodiments, the cartilage layer  112  comprises a thickness which depends upon the location in the cadaver from where the graft  104  is harvested. In some embodiments, the cartilage layer  112  is roughly 2 mm in thickness. 
     In some embodiments, the cartilage layer  112  includes a central portion  114  that is configured to be disposed slightly above the surrounding cartilage. As such, the central portion  114  can include a shape configured to approximate the osteochondral surface to be replaced. In some embodiments, such as the illustrated embodiment of  FIG.  2   , the shape of the central portion  114  includes a convex curvature that approximates the curvature of the osteochondral surface to be replaced. In embodiments of the central portion  114  including a convex curvature, the graft  104  includes a positive curvature height. In some embodiments, however, the central portion  114  can include a concave curvature that corresponds to a negative curvature height of the graft  104 . It is contemplated that an embodiment of the graft  104  including a negative curvature height is advantageously configured for treating cartilage defects in the 1 st  proximal phalangeal bone. 
     It is contemplated that the grafts  104  may be comprised of any of various synthetic implantable materials, without limitation. For example, either or both of the bone portion  108  and the cartilage layer  112  may be comprised of any of various biostable polyurethanes, such as polycarbonate-urethane (PCU) or thermoplastic silicone-polycarbonate-urethane (TSPCU). As will be appreciated, PCU materials generally possess durability, elasticity, fatigue and wear resistance, as well as compliance and tolerance in the body during healing, and thus are suitable for long-term implantation. The modulus of elasticity of implantable polyurethanes is known to be similar to that of articular cartilage, and thus it is contemplated that PCU materials may be suitable for use as the cartilage layer  112 . Further, in some embodiments, the cartilage layer  112  may be comprised of polyvinyl alcohol (PVA), a synthetic polymer derived from polyvinyl acetate through partial or full hydroxylation. It is contemplated that PVA is suitable for use as artificial cartilage and meniscus due to the low protein adsorption characteristics, biocompatibility, high water solubility, and chemical resistance of PVA. It is further contemplated that, in some embodiments, the bone portion  108  of the grafts  104  may be comprised of any of various monophasic materials, such as, by way of non-limiting example, any of various biostable polyurethanes, polyvinyl alcohol (PVA), bioglass, collagen, silicone, and the like. 
     Moreover, in some embodiments, the grafts  104  may be of a xenograft variety, wherein either or both of the bone portion  108  and the cartilage layer  112  may be harvested from a donor species and then grafted into the patient&#39;s joint, as described herein. For example, in some embodiments, the grafts  104  may be comprised of collagen, bone, and/or cartilage that is bovine or porcine in origin. The grafts  104  may be harvested as one-piece components from suitable cartilage/bone joint locations in a donor animal, such that the cartilage layer  112  is affixed to the bone portion  108  and is suitable for implantation in the joint to be treated. 
     It is envisioned that the grafts  104  are not to be limited to xenografts or allografts, nor limited to the above-mentioned synthetic materials. Rather, it is contemplated that either or both of the bone portion  108  and the cartilage layer  112  may be comprised of any material(s) that may be found to be suitable for implantation in the joint to be treated, without limitation. 
     As shown in  FIGS.  1  and  2   , the bone portion  108  comprises a multiplicity of surface features configured to promote growth of the recipient patient&#39;s bone tissue into the bone portion  108 , thereby accelerating incorporation of the graft  104  into the patient&#39;s bone. In the embodiments illustrated in  FIGS.  1  and  2   , the surface features comprise holes  116  and longitudinal grooves  120 . In some embodiments, the holes  116  may be relatively shallow so as to form dimples on the sides of the bone portion  108 . In some embodiments, the holes  116  may be relatively deep, or extend all the way across the diameter of the bone portion  108 . Further, various diameter sizes of the holes  116  may be implemented depending upon the size of the grafts  104  and the locations within the patient&#39;s body for which the grafts  104  are intended to be implanted. 
     Similarly, the longitudinal grooves  120  may be implemented with a variety of widths, lengths, and depths within the bone portion  108 . Further, any number of the longitudinal grooves  120  may be formed into the bone portion  108  and distributed around the circumference of the graft  104 . As will be appreciated, the specific number and dimensions of the longitudinal grooves  120  may be implemented based on the sizes of the grafts  104  and the locations within the patient&#39;s body where the grafts  104  are to be implanted. For example, the number of longitudinal grooves  120  may range between 2 grooves and 12 grooves, without limitation. In some embodiments, the number of longitudinal grooves  120  ranges between 4 grooves and 8 grooves. Further, the longitudinal grooves  120  may be implemented with a wide variety of cross-sectional shapes and sizes. In some embodiments, the longitudinal grooves  120  comprise a hemispherical cross-sectional shape. In some embodiments, the longitudinal grooves  120  comprise a rectangular cross-sectional shape. In some embodiments, the longitudinal grooves  120  comprise a triangular, or wedge, cross-sectional shape. 
     Moreover, the longitudinal grooves  120  incorporated into an individual graft  104  are not limited to possessing the same cross-sectional shape, but rather various cross-sectional shapes may be applied to the longitudinal grooves  120  formed on each individual graft  104 . It should be understood, therefore, that individual grafts  104  need not be limited to one type of surface feature, but rather different types of surface features may be mixed and incorporated into each of the grafts  104 . Further, surface features other than holes and longitudinal grooves, as may become apparent to those skilled in the art, can be incorporated into the grafts  104  without going beyond the scope of the present disclosure. 
       FIG.  3    illustrates a perspective view of an exemplary embodiment of an instrument kit  140  configured for implanting the grafts  104  into bone joints of a patient, as described herein. In the embodiment illustrated in  FIG.  3   , the instrument kit  140  comprises a graft inserter  144 , a guidewire  148 , a reamer  152 , and a size gauge  156 . In some embodiments, the instrument kit  140  may further comprise a tamp (not shown). As will be appreciated, the instrument kit  100  comprises instruments necessary to perform cartilage graft implant surgeries. The sizes of the instruments comprising the kit  140  will depend upon the size of the particular graft  104  to be implanted into the patient. It is envisioned, therefore, that a surgeon may select one or more of the grafts  104  and a correspondingly sized embodiment of the instrument kit  140  based on the location and size of the bone joint to be treated. 
     Referring still to  FIG.  3   , the graft inserter  144  comprises a generally elongate member  160  having a distal graft retainer  164  and a proximal applicator  168 . The proximal applicator  168  is in mechanical communication with the distal graft retainer  164  by way of an interior channel of the elongate member  160 . The distal graft retainer  164  comprises an opening configured to receive and advantageously hold the graft  104  while the graft inserter  144  is used to direct the graft  104  to an implant location within the patient. As will be appreciated, the implant location generally is a surgically performed osteochondral bore formed to remove damaged articular cartilage and a portion of the underlying bone tissue so as to accommodate implantation of the graft  104 . As such, the osteochondral bore has a diameter and a depth suitable to receive the graft  104 , such that the cartilage layer  112  aligns with surrounding healthy cartilage in the bone joint. Once the graft  104  is suitably positioned at the implant location, the proximal applicator  168  may be used to push the graft  104  out of the distal graft retainer  164  and into the osteochondral bore. 
     A viewport  172  facilitates directly observing the position of the graft  104  within the distal graft retainer  164 . Further, the viewport  172  facilitates observing the length of the graft by way of a graft length indicator  176 . The graft length indicator  176  comprises a series of ring lines positioned adjacent to the viewport  172  with a sequentially increasing distance from the distal graft retainer  164 . As will be appreciated, when the graft  104  is fully received into the distal graft retainer  164 , the position of the top of the cartilage layer  112  relative to the graft length indicator  176  provides a visual indication of the total length of the graft  104 . Thus, the viewport  172  and the graft length indicator  176  advantageously enables the surgeon to verify that a correctly sized graft  104  has been selected for surgery. 
     As illustrated in  FIG.  3   , the guidewire  148  comprises an elongate shaft  180  having a distal pointed tip  184  and a proximal blunt end  188 . The guidewire  148  is configured to be inserted into confined spaces within bone joints and serves to direct a subsequent insertion of the reamer  152  and the size gauge  156  to the implant location within the bone joint. In some embodiments, the guidewire  148  is comprised of a surgical stainless steel, such as austenitic 316 stainless steel, martensitic 440 stainless steel, martensitic 420 stainless steel, and the like. It will be appreciated that the distal pointed tip  184  facilitates advancing the guidewire  148  through obstructive tissues and structures, and the proximal blunt end  188  facilitates manipulating the guidewire  148  by hand, or by way of an appropriate tool. 
     The reamer  152  comprises a rigid elongate shaft  192  having a distal cutting end  196  and a proximal shank  200 . The distal cutting end  196  comprises a cutting edge suitable for rotatably clearing an osteochondral bore, thereby removing damaged articular cartilage and an underlying bone portion from the bone joint being treated. In some embodiments, the distal cutting end  196  comprises a spiral cutting edge, although other suitable cutting-edge configurations will be apparent. The proximal shank  200  is configured to be grasped by a chuck of a surgical drill, or other equivalent rotary tool. Further, in some embodiments the reamer  152  may comprise a central, lengthwise hole whereby the reamer may be mounted onto the guidewire  148  so as to direct the distal cutting end  196  to the implant location within the bone joint. 
     With continuing reference to  FIG.  3   , the size gauge  156  comprises a generally elongate member  204  having a depth indicator  208  and a proximal handle portion  212 . The size gauge  156  further comprises a central, lengthwise hole  216  having a diameter suitable to receive the guidewire  148 . The central hole  216  facilitates mounting the size gauge onto the guidewire  148  so as to direct the depth indicator  208  to the osteochondral bore formed within the bone joint. The depth indicator  208  comprises a series of ring lines positioned on the elongate member with a sequentially increasing distance from a distal end of the size gauge  156 . As will be appreciated, upon inserting the depth indicator  208  fully into the osteochondral bore, the ring lines provide the surgeon with a direct observation of the depth of the bore. It should be understood that the depth indicator  208  generally correlates with the graft length indicator  176  of the graft inserter  144  so as to ensure that the osteochondral bore is drilled to a depth suitable to accommodate the graft  104 , such that the cartilage layer  112  aligns with the surrounding cartilage within the bone joint. 
     It is envisioned that the instrument kit  140  is to be suitably sterilized for surgeries and packaged into sterilized containers. In some embodiments, the size gauge  156  is packaged in a first sterile container, while the graft inserter  144 , the guidewire  148 , and the reamer  152  are packaged in a second sterile container, and the graft  104  is packaged in a third sterile container. The first, second, and third sterile containers are then bundled together into a single, exterior container, thereby forming a convenient surgery-specific cartilage graft package. It is envisioned that other packaging techniques will be apparent to those skilled in the art without deviating from the spirit and scope of the present disclosure. 
     While the invention has been described in terms of particular variations and illustrative figures, those of ordinary skill in the art will recognize that the invention is not limited to the variations or figures described. In addition, where methods and steps described above indicate certain events occurring in certain order, those of ordinary skill in the art will recognize that the ordering of certain steps may be modified and that such modifications are in accordance with the variations of the invention. Additionally, certain of the steps may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above. To the extent there are variations of the invention, which are within the spirit of the disclosure or equivalent to the inventions found in the claims, it is the intent that this patent will cover those variations as well. Therefore, the present disclosure is to be understood as not limited by the specific embodiments described herein, but only by scope of the appended claims.