Patent ID: 12226267

DEFINITIONS

Various terms are used to refer to particular system components. Different companies may refer to a component by different names—this document does not intend to distinguish between components that differ in name but not function. In the following discussion and in the claims, the terms “including” and “comprising” are used in an open-ended fashion, and thus should be interpreted to mean “including, but not limited to . . . .” Also, the term “couple” or “couples” is intended to mean either an indirect or direct connection. Thus, if a first device couples to a second device, that connection may be through a direct connection or through an indirect connection via other devices and connections.

“Throughbore” shall mean an aperture or passageway through an underlying object. However, the term “throughbore” shall not be read to imply any method of creation. Thus, a throughbore may be created in any suitable way, such as drilling, boring, laser drilling, or casting.

DETAILED DESCRIPTION

The following discussion is directed to various embodiments of the invention. Although one or more of these embodiments may be preferred, the embodiments disclosed should not be interpreted, or otherwise used, as limiting the scope of the disclosure, including the claims. In addition, one skilled in the art will understand that the following description has broad application, and the discussion of any embodiment is meant only to be exemplary of that embodiment, and not intended to intimate that the scope of the disclosure, including the claims, is limited to that embodiment.

Various examples are directed to marker deployment systems and corresponding methods of operation for deploying bone markers used in medical procedures. More particularly, various examples are directed to example marker deployment systems and corresponding methods of operation in which the marker deployment system may be used in a one-handed fashion to improve control and efficiency of the placement of the bone marker by a surgeon. In the example marker deployment systems, a handle extends radially from and longitudinally along a main axis from a proximal handle end to a distal handle end. A driver tube is coupled to and extends from the handle at the distal handle end along the main axis from a proximal tube end to a distal tube end. The driver tube defines a tube bore extending axially therethrough and the distal tube end is configured to support a bone marker. An inner rod of the example marker deployment systems extends axially through the driver tube from a proximal rod end to a distal rod end. The distal rod end includes a plurality of distal rod threads comprising a retention fastener configured to engage and selectively secure the bone marker at the distal tube end. A knob is operably coupled to the inner rod and is rotatable about a knob axis of rotation extending along the main axis. The knob is rotatable in a first direction to secure the bone marker and in a second direction opposite the first direction to release the bone marker. At least a portion of the handle extends axially beyond the knob to define the proximal handle end. The specification first turns to an example surgical system employing the example marker deployment systems to orient the reader.

FIG.1shows a surgical system (not to scale) in accordance with at least some embodiments. In particular, the example surgical system100comprises a tower or device cart102, an example mechanical resection instrument104, an example plasma-based ablation instrument (hereafter just ablation instrument106), and an endoscope in the example form of an arthroscope108and attached camera head110. The device cart102may comprise a camera112(illustratively shown as a stereoscopic camera), a display device114, a resection controller116, and a camera control unit (CCU) together with an endoscopic light source and video controller. In example cases the CCU, endoscopic light source, and video controller not only provide light to the arthroscope108and displays images received from the camera head110, but also implement various additional aspects, such as tracking location of objects within the surgical site. Thus, the CCU, endoscopic light source, and video controller are hereafter referred to as a surgical controller118. In other cases, however, the CCU, endoscopic light source, and video controller may be a separate and distinct systems from the controller that handles aspects of intraoperative tracking, yet the separate devices would nevertheless be operationally coupled.

The example device cart102further includes a pump controller120(e.g., single or dual peristaltic pump). Fluidic connections of the mechanical resection instrument104and ablation instrument106are not shown so as not to unduly complicate the figure. Similarly, fluidic connections between the pump controller120and the patient are not shown so as not to unduly complicate the figure. In the example system, both the mechanical resection instrument104and the ablation instrument106are coupled to the resection controller116being a dual-function controller. In other cases, however, there may be a mechanical resection controller separate and distinct from an ablation controller. The example devices and controllers associated with the device cart102are merely examples, and other examples include vacuum pumps, robotic arms holding various instruments, ultrasonic cutting devices and related controllers, patient-positioning controllers, and robotic surgical systems.

FIG.1further shows additional instruments that may be present during an arthroscopic surgical procedure. In particular,FIG.1shows an example touch probe122, an aimer124, a bone marker126, and a marker deployment system127,727or installation tool for the bone marker126. The touch probe122may be used during the surgical procedure to provide information to the surgical controller118, such as: information to register a three-dimensional bone model to an underlying bone visible in images captured by the arthroscope108and camera head110; and information as to a revised tunnel-entry location and/or a revised tunnel-exit location when the surgeon elects to deviate from the preoperative tunnel plan. The aimer124may be used as a guide for placement and drilling with a drill wire to create an initial or pilot tunnel through the bone. The bone marker126may be rigidly attached to the bone by the marker deployment system127and serve as an anchor location for the surgical controller118to know the orientation of the bone (e.g., after registration of a three-dimensional bone model). Additional tools and instruments will be present, such as the drill wire, various reamers for creating the throughbore and counterbore aspects of a tunnel through the bone, and various tools, such as for suturing and anchoring a graft. These additional tools and instruments are not shown so as not to further complicate the figure.

FIG.2shows a perspective side view of an example bone marker126. In particular, the example bone marker126comprises a polyhedron200, an externally-threaded screw202. The example polyhedron200defines an upper surface or upper face206, and a plurality of outward-facing surfaces, such as outward-facing surface208and outward-facing surface210. In the example ofFIG.2, the polyhedron200is a cube, and thus two additional outward-facing surfaces are present but are not visible in the view ofFIG.2. However, the polyhedron200may take any suitable shape which defines an upper face206, at least three outward-facing surfaces, and a location (e.g., a lower face) from which the externally-threaded screw202protrudes. Each of the outward-facing surfaces, such as outward-facing surfaces208and210visible inFIG.2, have disposed thereon a fiducial pattern, such as fiducial patterns212and214, respectively. Referring to fiducial pattern214as representative, the fiducial pattern214is a machine readable code that uniquely identifies the outward-facing surface210of the polyhedron200. That is, the surgical controller118(FIG.1), receiving images captured by the arthroscope108(FIG.1) and camera head110(FIG.1), may read a value represented by the fiducial pattern214. Moreover, the fiducial pattern214is designed and constructed such that, by analyzing a physical relationships of the three-dimensional features or patterns of the fiducial pattern214(e.g., outside corners, inside corners, relative line widths) within the images of the fiducial pattern214, the surgical controller118may thus determine the physical orientation of the fiducial pattern and thus the bone marker126in the three-dimensional coordinate space in the view of the arthroscope108. It follows that, when the bone marker126is coupled to a bone, the surgical controller118may determine the physical orientation of the attached bone in the three-dimensional coordinate space in the view of the arthroscope108. In example systems, the fiducial pattern on each of the outward-facing surfaces is a unique and distinct pattern.

In the example, the externally-threaded screw202projects from a side of the polyhedron200opposite from the upper face206. In example cases, the polyhedron200and the externally-threaded screw202are a monolithic structure, such as a continuous piece of metallic material (e.g., aluminum). For example, the polyhedron200and the externally-threaded screw202may be simultaneously cast within a mold, or may be milled from single piece of aluminum, stainless steel, or titanium. The example externally-threaded screw202is a self-drilling or self-tapping screw, meaning that the distal end216of the externally-threaded screw202comprises a drilling feature to create the initial aperture into the bone. The externally-threaded screw202further comprises threads218extending from near the distal end216toward the proximal end of the externally-threaded screw202. In some cases the threads218are right-handed threads, meaning the bone marker126is turned clockwise about its longitudinal central axis220, viewed from above the polyhedron200looking along the longitudinal central axis toward the externally-threaded screw, when the bone marker126is being screwed into a bone. The threads218may alternatively be left-handed threads.

The bone marker126is a relatively small object—in one example the outside diameter of the externally-threaded screw202is about 2.5 millimeters (mm)—though larger and smaller sizes are contemplated. In example cases, the polyhedron200may form faces that are about 4 mm in length (measured parallel to the longitudinal central axis220). The overall length of example bone markers may be from 10 mm to 15 mm, inclusive, and in one example 12 mm.

FIG.3shows a perspective view of the example bone marker126. In particular, visible inFIG.3is the polyhedron200and a portion of the externally-threaded screw202. The outward-facing surfaces208and210are also visible, with their respective fiducial patterns (not specifically numbered).

Still referring toFIG.3, the example bone marker126further comprises a retention bore230having an entrance aperture232through the upper face206of the polyhedron200. The retention bore230defines a retention feature234, illustratively shown as threads on an inside surface of the retention bore230. The retention feature234may be used to retain the bone marker126in operational relationship with the marker deployment system127,727(not shown inFIG.3) such that the un-installed bone marker126may be placed through the port through the patient's skin, and then screwed in place into the bone. Once screwed in place, the marker deployment system127,727may release from the retention feature234, enabling the marker deployment system127,727to be withdrawn and leaving the bone marker126in place.

FIG.4Ashows a perspective view of the bone marker126retained on a distal end of an example marker deployment system127. In particular,FIG.4Ashows an example marker deployment system127comprising an elongate shaft or driver tube402defining a distal tube end404and a proximal tube end406. The driver tube402is coupled on the proximal tube end406to a handle408. Though not visible inFIG.4A, the driver tube402and handle408define coaxial throughbores. Also visible inFIG.4Ais the example bone marker126.FIG.4Bshows a magnified view of the distal tube end404comprising the bone marker126. In the example, the bone marker126is retained within the marker deployment system127by the telescoping the polyhedron200into an internal volume at the distal tube end404of the marker deployment system127. As will be shown and discussed in greater detail below, the bone marker126is retained in the telescoped relationship by way of a retention fastener (not visible inFIG.4A or4B) placed in mating relationship with a retention feature234(FIG.2) within the retention bore230(FIG.2). The retention fastener provides an axial force tending to hold the bone marker126in the telescoped relationship. Retaining the bone marker126within the marker deployment system127enables installation of the bone marker126directly, and eliminates the related-art approach of drilling a pilot tunnel with a guide wire and then sliding the bone marker along the guide to direct the bone marker to the correct location on the bone.

During use, the distal tube end404of the marker deployment system127and the retained bone marker126are placed within the surgical site, such as through a port through the patient's skin. The marker deployment system127may then be used to not only place the bone marker126in a suitable location for installation (e.g., in the intercondylar notch for an ACL repair/replacement), but also to provide rotational force to the bone marker126to enable the externally-threaded screw202to enter the bone and affix the bone marker126to the bone. In order to reduce the chances of denting or damaging the fiducial patterns on the outward-facing surfaces of the polyhedron200, in example cases the rotational force applied to the polyhedron200by the marker deployment system127is at a location on each of the outward-facing surfaces that does not touch or overlap the respective fiducial pattern on the outward-facing surfaces. Stated otherwise, the rotational force for installation of the bone marker126is applied on each outward-facing surface at a location outside the boundaries of the respective fiducial pattern.

FIG.5shows an exploded perspective view of the distal end of the marker deployment system127,727and the bone marker126. In particular, the distal tube end404of the driver tube402defines an inside surface designed and constructed to telescope over the polyhedron200of the bone marker126. In the example case of the polyhedron200being a cube, the inside surface of the distal tube end404of the elongate shaft thus defines a square cross-sectional shape. The driver tube402further defines a throughbore or tube bore along the main axis410of the driver tube402. The tube bore intersects the inside surface creating a shoulder region (not specifically shown) that limits axial translation of the polyhedron200into the distal tube end404. Telescoped within the tube bore and along the main axis410is a retention fastener412illustratively shown as an externally threaded portion of an elongate rod or inner rod414. In the example marker deployment system ofFIGS.4A and4B, the inner rod414may extend to and through handle408(FIG.4A) to the distal tube end404. The inner rod414can be attached to and rotated by a knob413at a proximal handle end415of the handle408.

Retaining the bone marker126on the distal tube end404of the marker deployment system127,727may thus comprise telescoping the polyhedron200into the internal volume defined by the inside surface at the distal tube end404of the marker deployment system127,727. The retention fastener412may then be coupled to retention feature234(FIG.2) within the retention bore230(FIG.2) on the upper face of the polyhedron200. In the example shown, the retention fastener412in the form of external threads may threadingly couple to the retention feature234in the form of internal threads within the retention bore230. The inner rod414may thus provide a force tending to hold the bone marker126in mating relationship with the marker deployment system127. In the example, when the bone marker126is retained in mating relationship with the marker deployment system127,727, the longitudinal central axis220of the bone marker126is coaxial with the main axis410of the throughbore of the driver tube402and the inner rod414. In other cases, however, the longitudinal central axis and main axis410need not be coaxial.

Once the bone marker126is placed in the bone, the retention fastener412may be detached from the retention bore230(FIG.2). In particular, in the example case of the retention fastener412being external threads, the marker deployment system127,727may be used to hold the bone marker126in a constant rotational orientation while the external threads of the retention fastener412are unscrewed from mating relationship. In some cases, the threads of the example retention fastener412are right-handed threads, but the given that the bone marker126may be held in place with the marker deployment system127,727, unscrewing the threads of the example retention fastener412does not unscrew the bone marker126from the bone. In other cases, however, the threads of the example retention fastener412may be left-handed threads and the threads of the externally-threaded screw202may be right-handed threads (or vice versa), such that the act of unscrewing the threads of the example retention fastener412will tend to further tighten the connection of the bone marker126to the underlying bone.

FIG.6shows placement of the bone marker126in a bone by a surgeon (inset) using the marker deployment system127ofFIGS.4A and4B. While the example marker deployment system127shown inFIGS.4A and4Bis well suited to placing the bone marker126, use of the marker deployment system127to screw or unscrew the threads of the example retention fastener412typically requires that two hands are used (one to hold the handle408and another to turn knob413). Such two handed operation is a result of the knob413being located at the proximal handle end415of the handle408. Accordingly, the surgeon must use both hands to use the marker deployment system127, while an assistant operates the endoscope (e.g., arthroscope108), for example. Two handed operation can slow down the speed and efficiency of the overall surgical procedure.

Consequently, referring now toFIGS.7-12, example marker deployment systems727that may be operated in a one-handed fashion are shown. The example marker deployment systems727include a handle408extending radially from and longitudinally along a main axis410from a proximal handle end (not shown) to a distal handle end700. As in the above example marker deployment system127, the marker deployment system727ofFIGS.7-12also includes a driver tube402coupled to and extending from the handle408at the distal handle end700along the main axis410from a proximal tube end406to a distal tube end404and defining a tube bore702extending axially therethrough. The distal tube end404is configured to support the bone marker126. In addition, the marker deployment system727includes an inner rod414extending axially through the driver tube402from a proximal rod end704to a distal rod end706(FIG.5) including a plurality of distal rod threads comprising a retention fastener412configured to engage and selectively secure the bone marker126at the distal tube end404. So, for the example marker deployment systems727ofFIGS.7-12, the distal tube end404and inner rod414extending axially through the driver tube402to the distal rod end706and operation of the retention fastener412are the same as for the example marker deployment system127shown inFIG.5. Similar to the example marker deployment system127ofFIGS.4A and4B, the marker deployment systems727also includes a knob713operably coupled to the inner rod414and rotatable about a knob axis of rotation708extending along the main axis410in a first direction to secure the bone marker126and in a second direction opposite the first direction to release the bone marker126. However, in contrast to the example marker deployment system127ofFIGS.4A and4B, at least a portion of the handle408extends axially beyond the knob713to define the proximal handle end415.

Referring specifically to the example marker deployment system727ofFIGS.7-8, the knob axis of rotation708is offset and parallel to the main axis410. The inner rod414includes a plurality of rod teeth712extending radially outwardly therefrom and adjacent the proximal rod end704. The knob713is annularly shaped to define a knob opening714. The knob713includes a plurality of knob teeth716extending radially inwardly into the knob opening714. The plurality of knob teeth716are configured to meshingly engage one or more of the plurality of rod teeth712to rotate the inner rod414about the main axis410as the knob713is rotated about the knob axis of rotation708.

In more detail, the handle408defines a handle throughbore or handle cavity718extending along the main axis410and the driver tube402extends axially into the handle cavity718. The driver tube402includes a top tube portion720and a bottom tube portion722and defines a gear window724extending through the driver tube402into the tube bore702. The gear window724is disposed on the top tube portion720and is configured to enable the plurality of knob teeth716to meshingly engage the one or more of the plurality of rod teeth712. The handle408extends radially outwardly to a peripheral surface726configured to be held in one hand of a user. The handle408includes a knob support wall728extending radially outwardly from the handle cavity718to the peripheral surface726proximate the distal handle end700of the handle408. The handle408also includes a tube support portion730extending axially away from the knob support wall728and along the bottom tube portion722of the driver tube402. The tube support portion730also extends axially through the knob opening714to define the distal handle end700of the handle408. The tube support portion730is configured to abut at least some of the plurality of knob teeth716. At least one of the knob713and the handle408are configured to retain the knob713axially and enable the user to turn the knob713. According to an aspect, the handle408additionally includes a knob retaining ring732annularly extending about and engaging the driver tube402and the tube support portion730of the handle408. The knob retaining ring732is configured to retain the knob713axially in sliding abutment with the knob support wall728and enable the user to turn the knob713with the one hand and enable rotation of the knob713about the knob axis of rotation708. While the knob retaining ring732is shown, it should be appreciated that other structures or arrangements may be employed instead to prevent the knob713from translating distally. For example, the knob713may be a split knob configured to be retained on the handle408.

So, the example marker deployment system727shown inFIGS.7-8employs the inner rod414, which is configured as a pinion gear (i.e., the plurality of rod teeth712) and mated to the knob713with a mating internal gear (i.e., the plurality of knob teeth716). In addition, the knob713is eccentric relative to the main axis410. This arrangement includes a window or the gear window724in the driver tube402which enables the knob713to be located at the most distal end (i.e., distal handle end700of the handle408), under the user's thumb/forefinger. Once the fiducial or bone marker126is placed in the bone (e.g., condylar bone), the user can rotate the knob713without repositioning their hand on the handle408and without assistance. The rotation of the knob713is transferred to the distal rod end706of the inner rod414, releasing, or capturing the bone marker126from the driver tube402.

Now referring specifically toFIGS.9-10, another example marker deployment system727is shown. The marker deployment system727includes the handle408extending radially from and longitudinally along the main axis410from the proximal handle end415to the distal handle end700to define a proximal half900of the handle408adjacent the proximal handle end415and a distal half902of the handle408adjacent the distal handle end700. As in the example marker deployment system727ofFIGS.7-9, the driver tube402is coupled to and extends from the handle408at the distal handle end700along the main axis410from the proximal tube end406to a distal tube end (FIG.5). The driver tube402defines the tube bore702extending axially therethrough. The distal tube end404is configured to support the bone marker126. Again, the inner rod414extends axially through the driver tube402from the proximal rod end704to the distal rod end706(FIG.5) that includes a plurality of distal rod threads comprising the retention fastener412configured to engage and selectively secure the bone marker126at the distal tube end404. The knob713is operably coupled to the inner rod414and rotatable about the knob axis of rotation708extending along the main axis410. The inner rod414is rotatable in a first direction to secure the bone marker126and in a second direction opposite the first direction to release the bone marker126. As shown, the knob713is disposed in the distal half902of the handle408.

Still referring toFIGS.9-10, the knob axis of rotation708is coaxial with the main axis410. The knob713rotates with the inner rod414and is movable axially along the handle408. The handle408defines handle cavity718extending axially through the distal handle end700to a linear translation portion904including a plurality of handle threads906defined therein. The proximal rod end704extends past the proximal tube end406of the driver tube402and at least partially into the linear translation portion904of the handle cavity718. The proximal rod end704includes a plurality of proximal rod threads908configured to threadingly engage one or more of the plurality of handle threads906and cause simultaneous rotation about and axial translation of the inner rod414along the main axis410as the knob713is rotated about the knob axis of rotation708.

More specifically, the driver tube402partially extends axially into the handle cavity718. The handle408extends radially outwardly a first diameter910to the peripheral surface726that is configured to be held in one hand of a user. The handle408includes a knob sliding portion912having a second diameter914less than the first diameter910to define a distal knob shoulder916between the peripheral surface726and the knob sliding portion912and a proximal knob shoulder918between the peripheral surface726and the knob sliding portion912, the distal knob shoulder916configured to abut the knob713in a marker locked position of the knob713(i.e., as far axially as the knob713can move toward the distal handle end700) and the proximal knob shoulder918configured to abut the knob713in a marker unlocked position of the knob713(i.e., as far axially as the knob713can move toward the proximal handle end415). The knob713extends radially outwardly a third diameter920greater than the first diameter910. The knob713is annularly shaped to define a knob opening714configured to surround and slidingly abut the knob sliding portion912and includes at least one knob pin (not shown) extending radially inwardly. The knob sliding portion912defines at least one rod engagement slot922and the at least one knob pin extends through the at least one rod engagement slot922and attaches the knob713to the inner rod414to fix the inner rod414for rotation with the knob713. The at least one rod engagement slot922and knob sliding portion912are configured to enable the user to turn the knob713with the one hand and provide limited axial movement of the knob713as the knob713is simultaneously rotated about the knob axis of rotation708and axially translated along the main axis410. According to an aspect, the plurality of proximal rod threads908may be different than the plurality of handle threads906of the linear translation portion904of the handle cavity718. So, the threads on each end of the inner rod414may be different to alter the number of turns for the proximal and distal ends. Specifically, threads of different pitches may separate the number of turns of the knob713from the number of engaging turns of the retention fastener412.

Thus, in the example marker deployment system727ofFIGS.9-10, once the fiducial or bone marker126is placed in the bone, the user can rotate the knob713using their thumb/forefinger. The rotation of the knob713is transferred to both the proximal and distal ends of the inner rod414. On the proximal rod end, the inner rod414is engaged with threads in the handle408(i.e., the plurality of handle threads906in the linear translation portion904), creating linear translation. The rotation on the distal rod end706of the inner rod414releases or captures the bone marker126from the driver tube402.

Now referring specifically toFIG.11, yet another example marker deployment system727is shown. Similar to the example shown inFIGS.9-10, the driver tube402partially extends axially into the handle cavity718. Again, the handle408extends radially outwardly a first diameter910to a peripheral surface726configured to be held in one hand of a user. However, the handle408includes a distal knob barrier1100within the handle cavity718and extending radially inwardly from the peripheral surface726. Similarly, the handle408includes a proximal knob barrier1102within the handle cavity718and extending radially inwardly from the peripheral surface726. The distal knob barrier1100is configured to abut the knob713in a marker locked position of the knob713(i.e., as far axially as the knob713can move toward the distal handle end700) and the proximal knob barrier1102is configured to abut the knob713in a marker unlocked position of the knob713(i.e., as far axially as the knob713can move toward the proximal handle end415). And in contrast to the example shown inFIGS.9-10, the knob713extends radially outwardly from the inner rod414a third diameter1104less than the first diameter910and is configured to rotate in the handle cavity718. The handle408defines at least one knob access window1106extending radially inwardly from the peripheral surface726into the handle cavity718. The at least one knob access window1106is configured to enable the user to turn the knob713with the one hand and provide limited axial movement of the knob713as the knob713is simultaneously rotated about the knob axis of rotation708and axially translated along the main axis410.

The one handed operation of the marker deployment system727described herein enables the surgeon to hold the endoscope (e.g., arthroscope108) in one hand and the marker deployment system727in the other, providing more overall control and efficiency in the placement of the bone marker126.

Now referring specifically toFIG.12, a further example marker deployment system727is shown. The knob axis of rotation708is coaxial with the main axis410and the knob713rotates with the inner rod414. The handle408includes a free swivel1200coupled to the handle408. The free swivel1200extends axially beyond the knob713to define the proximal handle end415. The free swivel1200is rotatable about the main axis410completely independently from rotation of the knob713and the handle408. Rotation of the knob713causes rotation of the inner rod414about the main axis410as the knob713is rotated about the knob axis of rotation708.

FIG.13shows a method of operating the marker deployment system727in accordance with at least some embodiments. In particular, the method starts (block1300) and comprises: telescoping a bone marker126into an internal volume at a distal end of an marker deployment system727, the bone marker126comprising a polyhedron200and an externally-threaded screw202extending distally from the polyhedron200and a retention bore230having an entrance aperture through an upper face of the polyhedron200(block1302); turning a knob713in a first direction about a knob axis of rotation708, the knob713operably coupled to an inner rod414extending along a main axis410of the marker deployment system727from a proximal rod end704through a distal handle end700of a handle408and a driver tube402of the marker deployment system727to a distal rod end706defining a retention fastener412and at least a portion of the handle408extends axially beyond the knob713to define a proximal handle end415(block1304); placing the retention fastener412within the retention bore230of the bone marker126in response to turning the knob713in the first direction, the retention fastener412retains the bone marker126in a mating relationship with the marker deployment system727(block1306); positioning a distal end of the externally-threaded screw202against a bone at a marker location (block1308); and screwing the externally-threaded screw202into the bone by way of the marker deployment system727(block1310). Thereafter, the example methods ends (block1312). According to an aspect, the placing the retention fastener412within the retention bore230of the bone marker126in response to turning the knob713in the first direction can further comprise threading distal rod threads of the retention fastener412into mating relationship with internal threads of the retention bore230.

In more detail, the step of turning a knob713in a first direction about a knob axis of rotation708extending along a main axis410of the marker deployment system727can further be defined as grasping a peripheral surface726of a handle408of the marker deployment system727with one hand of a user and turning the knob713in the first direction about the knob axis of rotation708extending along the main axis410of the marker deployment system727using the one hand of the user.

The method can also include further include, after screwing the externally-threaded screw202into the bone, turning the knob713in a second direction about the knob axis of rotation708opposite the first direction. Next, removing the retention fastener412from within the retention bore230in response to turning the knob713in the second direction. Specifically, the step of turning the knob713in a second direction about the knob axis of rotation708opposite the first direction can further be defined as grasping a peripheral surface726of a handle408of the marker deployment system727with one hand of a user and turning the knob713in the second direction about the knob axis of rotation708opposite the first direction using the one hand of the user.

After the bone marker126has been screwed into the bone at the marker location by way of the marker deployment system727(block1310), the steps shown in blocks1302-1306can be repeated to capture and retrieve the bone marker126. Specifically, once the bone marker126is in the internal volume at the distal end of the marker deployment system727and the retention fastener412is in the retention bore230(block1306), the user can unscrew the externally-threaded screw202from the bone by rotating the handle408about the main axis410in an opposite direction than used for screwing the externally-threaded screw202into the bone (e.g., in the step shown in block1310). With the bone marker126retained in the marker deployment system727, the bone marker126can then be removed from the surgical site.

As discussed above with reference toFIGS.7-8, the knob axis of rotation708is offset and parallel to the main axis410. The inner rod414includes a plurality of rod teeth712extending radially outwardly therefrom adjacent the proximal rod end704. The knob713is annularly shaped to define a knob opening714and includes a plurality of knob teeth716extending radially inwardly into the knob opening714. The knob teeth716are configured to meshingly engage one or more of the plurality of rod teeth712. Thus, the method can further include the step of rotating the inner rod414about the main axis410in response to the knob713being rotated about the knob axis of rotation708.

As discussed above with reference toFIGS.9-11, the knob axis of rotation708is coaxial with the main axis410. The knob713rotates with the inner rod414and is movable axially along the handle408. The handle408defines handle cavity718extending axially through the distal handle end700to a linear translation portion904including a plurality of handle threads906defined therein. The proximal rod end704of the inner rod414extends past a proximal tube end406of the driver tube402and at least partially into the linear translation portion904of the handle cavity718and includes a plurality of proximal rod threads908. The plurality of proximal rod threads908are configured to threadingly engage one or more of the plurality of handle threads906. So, the method can further include the step of simultaneous rotating about and axial translating of the inner rod414along the main axis410in response to the knob713being rotated about the knob axis of rotation708. According to an aspect, the proximal rod threads908are different than the plurality of handle threads906of the linear translation portion904of the handle cavity718.

As discussed above with reference toFIG.12, the knob axis of rotation708is coaxial with the main axis410, the knob713rotates with the inner rod414. The handle408includes a free swivel1200coupled to the handle408and extending axially beyond the knob713to define the proximal handle end415. Therefore, the method can further include the step of rotating the free swivel1200about the main axis410completely independently from rotation of the knob713and the handle408. The method can also include the step of rotating the inner rod414about the main axis410in response to the knob713being rotated about the knob axis of rotation708.

The above discussion is meant to be illustrative of the principles and various embodiments of the present invention. Numerous variations and modifications will become apparent to those skilled in the art once the above disclosure is fully appreciated. It is intended that the following claims be interpreted to embrace such variations and modifications.