JP2019034159A - Retrograde reamer depth tube gage - Google Patents

Abstract

To provide a gage for measuring or determining the thickness of bone remaining while drilling or after having drilled, in a retrograde fashion, a tunnel or bore through bone.SOLUTION: There is provided a thickness gage 400 including a transparent measurement tube 402 configured to receive and be slidingly engaged over a tubular shaft 202 of a retrograde reamer 200. The tubular shaft has linear graduation marks 226 on its surface for indicating linear measures in measuring a thickness of a bridge bone gap. The linear graduation marks are located on the tubular shaft surface such that at least some of the linear graduation marks can be observed through the transparent measurement tube. Each linear graduation mark, when aligned with a proximal end of the measurement tube, indicates a linear measure of the distance between a distal end of the measurement tube and a cutting member 206 of the retrograde reamer positioned such that a central axis of the cutting member is disposed at a non-zero angle relative to a longitudinal axis of the tubular shaft, where the distance corresponds to the thickness of the bridge bone gap.SELECTED DRAWING: Figure 4

Description

  The present application generally measures gauges for use in performing ligament surgery, and more particularly gauges for measuring the depth of tunnels or bores drilled into bone, and bone thickness. For gauges.

  During the performance of a ligament surgical procedure, the surgeon often needs to drill one or more tunnels or bores in the patient's bone. In such ligament surgical procedures, the surgeon typically uses a surgical instrument to pierce the bone and antegradely pierce the tunnel into the bone joint cavity. Typically, the surgeon then deploys at least one cutter or blade of the surgical instrument within the osteoarticular cavity using the same or different surgical instrument and actuates the cutter or blade previously The bone is perforated retrogradely along essentially the same path as the forwardly drilled tunnel. In this way, a receiving socket can be formed in the patient's bone for placement and / or fixation of the tendon graft.

  In order to ensure proper formation of the receiving socket in the patient's bone, it is important for the surgeon to drill a counterbore through the bone to the desired depth. One known technique for measuring or otherwise measuring the depth of tunnels or bores drilled into bone is a retrograde drill with retrograde drill pins, and a drilling depth tube disposed on the retrograde drill pins. With the use of. To achieve drilling a desired depth tunnel or bore in the bone, the surgeon can read the markings on the retrograde drill pin against the patient's skin or bone surface before or during formation of the receiving socket. is there. However, such an approach for measuring or measuring the depth of a tunnel or bore drilled into a bone can be difficult to implement for a surgeon and can often result in measurement results that are less accurate.

  According to the present application, the bone thickness (also referred to herein as a “bridge bone gap”) that remains during or after drilling a tunnel or bore retrogradely into the bone is measured or otherwise A gauge (also referred to herein as a “thickness gauge”) is provided. The disclosed thickness gauge is configured for use with a retrograde drill or reamer (also referred to herein as a “retrograde reamer”), the retrograde drill or reamer comprising a tubular shaft and a distal end of the tubular shaft. A drill bit disposed in the section and at least one cutting member disposed rotatably, slidably or otherwise movable adjacent to the distal end of the tubular shaft. It is possible. The cutting member has a first position whose central axis coincides with the longitudinal axis of the tubular shaft, and a second position whose central axis is disposed at a non-zero angle with respect to the longitudinal axis of the tubular shaft; Can be rotatably disposed adjacent the distal end of the tubular shaft.

  In one aspect, the disclosed thickness gauge is configured to receive a retrograde reamer tubular shaft and is configured to be slidably engaged over the tubular shaft and configured to be a substantially transparent measurement tube. Is provided. In an exemplary embodiment, the retrograde reamer tubular shaft has a plurality of lengths (e.g., 0 mm, 2 mm, 4 mm, 6 mm, 8 mm, ...) for use in measuring the thickness of the bridge bone gap. It has a linear scale mark on its surface. The linear scale marks are located on the surface of the retrograde reamer tubular shaft so that at least some of the linear scale marks can be observed through a substantially transparent measuring tube. Each of the linear tick marks, when aligned with the proximal end of the measurement tube, is connected to the distal end of the measurement tube and to the second position of the cutting member (i.e., the central axis of the tubular shaft with a retrograde reamer). It shows at least an approximate length of the distance between the cutting member of the retrograde reamer at a non-zero angle with respect to the longitudinal axis. Such a distance between the distal end of the measuring tube and the cutting member in the second position corresponds to the thickness of the bridge bone gap.

  In one mode of operating the disclosed thickness gauge, the surgeon uses the guide to establish a path for a guide wire that penetrates the patient's bone (e.g., the femur) at the surgical site and establishes the path It is possible to place a guide wire along and then remove the guide. The retrograde reamer's cutting member is in its first position (i.e., where the central axis of the cutting member coincides with the longitudinal axis of the retrograde reamer's tubular shaft) and the retrograde reamer's tubular shaft is placed over the guide wire In a situation, the surgeon may puncture the tunnel antegradely through the patient's femur and into the femoral joint cavity using a drill bit at the distal end of the retrograde reamer's tubular shaft. Is possible. The surgeon then retracts the cutting member from its first position to its second position (i.e., its central axis retrograde) within the femoral joint cavity by at least partially pulling back the guide wire from the tubular shaft of the retrograde reamer. It may be possible to rotate to a position that is arranged at a non-zero angle with respect to the longitudinal axis of the reamer's tubular shaft. Next, the surgeon may advance the tubular shaft of the retrograde reamer through the guide wire to lock the cutting member in its angled second position.

  Prior to drilling a counterbore in the patient's femur, the surgeon positions the thickness gauge measurement tube over the tubular shaft of the retrograde reamer so that the distal end of the measurement tube contacts the surface of the femur Is possible. The surgeon then drills antegradely previously, with the retrograde reamer pivoting independently of the thickness gauge and the distal end of the measurement tube held firmly against the femoral surface. It is possible to retrogradely drill a counterbore in the femur along essentially the same path as the tunnel.

  The surgeon moves the retrograde reamer's tubular shaft proximally relative to the measurement tube by pulling or otherwise moving the retrograde reamer proximally while drilling a counterbore in the patient's femur It is possible to make it. The surgeon determines that the proximal end of the measurement tube is aligned to a linear tick mark (located on the surface of the tubular shaft of the retrograde reamer) indicating the desired thickness of the bridge bone gap. It is possible to continue drilling the counterbore in this manner until the tubular shaft is moved. At this point, the surgeon may place the cutting member in its second position (i.e., by (a) stopping the perforation of the counterbore substantially immediately and (b) pulling the guide wire back from the tubular shaft of the retrograde reamer. Its first axis (i.e. its central axis coincides with the longitudinal axis of the retrograde reamer's tubular shaft) from its central axis at a non-zero angle relative to the longitudinal axis of the retrograde reamer's tubular shaft (C) the distal end of the tubular shaft of the retrograde reamer to the rest of the tunnel previously drilled into the femur Withdrawing, the retrograde reamer can be removed from the surgical site.

  By providing such a thickness gauge configured for use with a retrograde drill or reamer, the bone thickness remaining during or after drilling a tunnel or bore retrogradely through the bone is reduced. It can be determined with high accuracy and ease of use.

  Other features, functions and aspects of the invention will become apparent from the following detailed description.

  The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate one or more embodiments described herein, and together with the detailed description, illustrate these embodiments.

FIG. 3 is a perspective view of an exemplary depth gauge for use in determining the depth of a retrograde bone drilled tunnel or bore according to the present application. FIG. 1b is an exploded view of the depth gauge of FIG. 1a. FIG. 2 shows an exemplary mode of operating the depth gauge of FIGS. 1a and 1b in combination with an exemplary retrograde reamer. FIG. 2 shows an exemplary mode of operating the depth gauge of FIGS. 1a and 1b in combination with an exemplary retrograde reamer. FIG. 2 shows an exemplary mode of operating the depth gauge of FIGS. 1a and 1b in combination with an exemplary retrograde reamer. FIG. 2 shows an exemplary mode of operating the depth gauge of FIGS. 1a and 1b in combination with an exemplary retrograde reamer. FIG. 2 shows an exemplary mode of operating the depth gauge of FIGS. 1a and 1b in combination with an exemplary retrograde reamer. FIG. 2 shows an exemplary mode of operating the depth gauge of FIGS. 1a and 1b in combination with an exemplary retrograde reamer. 2 is a flow diagram illustrating an exemplary method of operating the depth gauge of FIGS. 1a and 1b. Further, a perspective view of an exemplary thickness gauge for use in determining bone thickness remaining during or after drilling a tunnel or bore in a bone retrogradely using an exemplary retrograde reamer in accordance with the present application. It is. FIG. 5 illustrates an exemplary mode of operating the thickness gauge of FIG. 4 in combination with the retrograde reamer of FIG. FIG. 5 illustrates an exemplary mode of operating the thickness gauge of FIG. 4 in combination with the retrograde reamer of FIG. FIG. 5 illustrates an exemplary mode of operating the thickness gauge of FIG. 4 in combination with the retrograde reamer of FIG. FIG. 5 is a flow diagram illustrating an exemplary method of operating the thickness gauge of FIG.

  Described herein is a depth gauge for use in determining the depth of a tunnel or bore drilled retrogradely into a bone. The disclosed depth gauge is configured for use with a retrograde drill or reamer (also referred to herein as a “retrograde reamer”), the retrograde drill or reamer comprising a tubular shaft and a distal end of the tubular shaft. A drill bit disposed in the shaft, at least one cutting member rotatably disposed adjacent to the distal end of the tubular shaft, slidably or otherwise movable, and the tubular shaft And a bushing located adjacent to the proximal end of the. The cutting member has a first position whose central axis coincides with the longitudinal axis of the tubular shaft, and a second position whose central axis is disposed at a non-zero angle with respect to the longitudinal axis of the tubular shaft; Can be rotatably disposed adjacent the distal end of the tubular shaft.

  FIG. 1a shows an illustrative embodiment of an exemplary depth gauge 100 for use in determining the depth of a counterbore drilled retrogradely into a bone using a retrograde reamer according to the present application. FIG. 1b shows an exploded view of the depth gauge 100 of FIG. 1a. As shown in FIGS.1a and 1b, the depth gauge 100 includes a housing 102, a sliding ruler 104, a sliding reamer docking element 106, and an elongated tip portion 108 attached to the distal end of the housing 102. Is provided. The housing 102 and the sliding ruler 104 are each substantially tubular. The sliding reamer docking element 106 is configured to receive a substantially tubular section 106a (see FIG.1b) at its distal end and a bushing adjacent to the proximal end of the retrograde reamer tubular shaft. And a portion 106b located at the proximal end thereof.

  In the assembled configuration (see FIG. 1 a), the housing 102 receives the tubular section 106 a of the sliding reamer docking element 106 and the sliding ruler 104 is slidably engaged over the housing 102. The housing 102 and the sliding ruler 104 can each be substantially transparent, while the sliding reamer docking element 106 can be substantially opaque. The housing 102, sliding ruler 104, and sliding reamer docking element 106 can each be made from injection molded plastic, surgical plastic, or any other suitable material. For example, the housing 102 can be injection molded over the elongate tip portion 108. Further, the elongated tip portion 108 is substantially rigid and may be made from stainless steel, surgical steel, or any other suitable material.

  As shown in FIG.1a, the sliding ruler 104 has a length (e.g., 0mm, 5mm, ...) for use in measuring the depth of a counterbore drilled into the bone retrogradely using a retrograde reamer. , 35 mm, 40 mm) are provided with a plurality of linear scale marks 104a. The housing 102, the sliding ruler 104, and the tubular section 106a of the sliding reamer docking element 106 each have a slot opening formed therethrough over their respective lengths. As shown in FIG. 1b, the housing 102 has a slot opening 102a, the sliding ruler 104 has a slot opening 104b, and the tubular section 106a of the sliding reamer docking element 106 has a slot opening 106c. When the depth gauge 100 is in the assembled configuration and each slot opening 102a, 104b, 106c is substantially aligned with each other, the depth gauge 100 is connected to each slot opening 102a, 104b, 106c. Can be attached to the tubular shaft of the retrograde reamer by pushing the tubular shaft through and snapping into at least the housing 102 and the tubular section 106a of the sliding reamer docking element 106. The proximal portion 106b of the sliding reamer docking element 106 also has a slot opening 106d formed therethrough through its length. When the retrograde reamer tubular shaft snaps into the housing 102 and the tubular section 106a of the sliding reamer docking element 106, the retrograde reamer bushing pushes through the slot opening 106d in the proximal portion 106b of the sliding reamer docking element 106. Thus, the sliding reamer docking element 106 can be snap-engaged.

  FIGS. 2a-2f illustrate an exemplary mode of operating the depth gauge 100 of FIGS. 1a and 1b in combination with an exemplary retrograde reamer 200 (see, eg, FIG. 2b). As shown in FIG. 2b, the retrograde reamer 200 is rotatable relative to the tubular shaft 202, the drill bit 204 disposed at the distal end of the tubular shaft 202, and the distal end of the tubular shaft 202. It includes at least one cutting member 206 disposed and a bushing 208 located adjacent to the proximal end of the tubular shaft 202.

  In this mode of operating depth gauge 100, the surgeon uses a guide (not shown) to guidewire 210 (see femur 201, see FIG. It is possible to establish a path for (see FIG. 2a), place a guidewire 210 along the established path, and then remove the guide. The cutting member 206 of the retrograde reamer 200 is in a first position (i.e., the center axis 222 (see Fig. 2b) coincides with the longitudinal axis 224 (see Fig.2b) of the tubular shaft 202 of the retrograde reamer 200). With the tubular shaft 202 of the retrograde reamer 200 positioned over the guidewire 210, the surgeon uses the drill bit 204 at the distal end of the tubular shaft 202 to move antegradely (i.e., externally to internally). In addition, the tunnel 212 (see FIG. 2b) can be drilled through the patient's femur 201 and into the femoral joint cavity 214 (see FIG. 2b). The surgeon then moves the cutting member 206 from its first position to its second position (i.e., within the femoral joint cavity 214 by at least partially pulling back the guide wire 210 from the tubular shaft 202 of the retrograde reamer 200. It may be possible to rotate its central axis 222 to a non-zero angle θ relative to the longitudinal axis 224 of the tubular shaft 202 of the retrograde reamer 200 (see, for example, the position disposed at FIG. 2b). The surgeon may then advance the tubular shaft 202 of the retrograde reamer 200 through the guide wire 210 to secure the cutting member 206 in its angled second position.

  With the tubular shaft 202 of the retrograde reamer 200 positioned over the guidewire 210 and cutting member 206 in its second position, the surgeon is essentially identical to the previously perforated tunnel 212. Using the cutting member 206 to puncture along the path, the perforation of the counterbore 216 (see FIG. 2f) in the femur 201 over the guidewire 210 can be initiated retrogradely. When the cutting member 206 begins to pierce the counterbore 216, the surgeon may (a) stop the boring of the counterbore 216 substantially immediately and (b) patient along the tubular shaft 202 of the retrograde reamer 200. Moving the elongated tip portion 108 of the depth gauge 100 to a stable position in contact with the surface of the femur 201 or the epidermis 203 (see FIG. 2c), and (c) the housing 102 and sliding of the depth gauge 100 Snap-engaging the tubular shaft 202 of the retrograde reamer 200 to the tubular section 106a of the reamer docking element 106 (see FIG. 2c in the direction of the directional arrow 205), (d) the sliding reamer docking element of the depth gauge 100 The bushing 208 of the retrograde reamer 200 can be snapped into the proximal portion 106b of 106 (see FIG. 2c in the direction of the directional arrow 207). FIG. 2 d shows the depth gauge 100 snapped to the retrograde reamer 200. As shown in FIG. 2d, the elongate tip portion 108 of the depth gauge 100 is disposed along the tubular shaft 202 of the retrograde reamer 200 to a stable position against the surface of the patient's femur 201.

  With depth gauge 100 snapped to retrograde reamer 200, the surgeon slides sliding ruler 104 over and along housing 102 of depth gauge 100 (housing 102 and sliding ruler). 104 are each substantially transparent), a linear tick mark (see reference) indicating a length of 0 mm at the distal end 106e of the tubular section 106a of the sliding reamer docking element 106 (see FIGS. 1b and 2e) This corresponds to the reference numeral 218 (see FIG. 2e). The distal end 106e of the tubular section 106a of the sliding reamer docking element 106 aligned with a linear tick mark 218 indicating a length of 0 mm indicates that the current depth of the counterbore 216 is approximately 0 mm. Please note the implications. The surgeon then freely pivots the retrograde reamer 200 independent of the depth gauge 100 while pulling the sliding reamer docking element 106 in the proximal direction 209 (see FIG. 2f) with the bushing 208 of the retrograde reamer 200 In the state, it becomes possible to resume drilling the counterbore 216 into the patient's femur 201.

  Such pulling of the sliding reamer docking element 106 in the proximal direction 209 by the bushing 208 of the retrograde reamer 200 causes the distal end 106e of the tubular section 106a of the sliding reamer docking element 106 to be, for example, about 30 mm or any other Until it is aligned with a linear scale mark on the sliding ruler 104 (e.g., linear scale mark 220, see FIG.2f) showing a length corresponding to the desired depth of the spot facing 216, such as the appropriate depth, It is possible to continue. At this point, the surgeon removes the cutting member 206 by (a) stopping the boring of the counterbore 216 substantially immediately and (b) pulling back the guide wire 210 from the tubular shaft 202 of the retrograde reamer 200. From the second position (i.e., the position at which the central axis 222 is disposed at a non-zero angle θ with respect to the longitudinal axis 224 of the tubular shaft 202 of the retrograde reamer 200), the first position (i.e., the central axis 222). Can be rotated back to a position that coincides with the longitudinal axis 224 of the tubular shaft 202 of the retrograde reamer 200, and (c) a tunnel previously drilled in the femur 201 in a forward direction By pulling the distal end of the tubular shaft 202 of the retrograde reamer 200 through the remaining portion of the 212, it is possible to remove the retrograde reamer 200 from the surgical site.

  An exemplary method of operating the depth gauge 100 is described below with reference to FIG. 3 and FIGS. 1a, 1b, and 2a-2f. With the cutting member 206 of the retrograde reamer 200 in its first position (i.e., its central axis 222 coincides with the longitudinal axis 224 of the tubular shaft 202), as shown in block 302 (see FIG. 3). The tunnel 212 is punctured antegradely through the patient's femur 201 and into the femoral joint cavity 214 using a drill bit 204 at the distal end of the tubular shaft 202. In the state where the cutting member 206 is in its second position (i.e., its central axis 222 is located at a non-zero angle θ relative to the longitudinal axis 224 of the tubular shaft 202), as shown in block 304. The counterbore 216 begins drilling retrogradely into the femur 201 using the cutting member 206 to drill along essentially the same path as the previously forwardly drilled tunnel 212.

  When the cutting member 206 begins to pierce the counterbore 216, as shown in block 306, (a) the piercing of the counterbore 216 is stopped and (b) the elongated tip portion 108 of the depth gauge 100 is Moved along the tubular shaft 202 of the retrograde reamer 200 to a stable position against the surface of the femur 201 or the skin 203, (c) the tubular shaft 202 of the retrograde reamer 200 is moved to the housing 102 and the sliding reamer of the depth gauge 100 (D) The bushing 208 of the retrograde reamer 200 is snap-engaged to the proximal portion 106b of the sliding reamer docking element 106 of the depth gauge 100.

  With the depth gauge 100 snapped to the retrograde reamer 200, the sliding ruler 104 is 0 mm in length at the distal end 106e of the tubular section 106a of the sliding reamer docking element 106, as shown in block 308. In order to align the linear scale mark 218, which is shown, is slid along the housing 102 of the depth gauge 100. As shown in block 310, the retrograde reamer 200 has a depth as the perforation of the counterbore 216 into the patient's femur 201 pulls the sliding reamer docking element 106 in the proximal direction 209 by the bushing 208 of the retrograde reamer 200. It is resumed in a freely turning state regardless of the gauge 100.

  As shown in block 312, such pulling of the sliding reamer docking element 106 by the bushing 208 of the retrograde reamer 200 causes the distal end 106e of the tubular section 106a of the sliding reamer docking element 106 to be, for example, about 30 mm or any other This is continued until it is aligned with a linear scale mark 220 that indicates a length corresponding to the desired depth of the spot facing 216, such as the appropriate depth of. As shown in block 314, the cutting member 206 of the retrograde reamer 200 is disposed at its second position (ie, its central axis 222 is at a non-zero angle θ relative to the longitudinal axis 224 of the tubular shaft 202). The distal end of the tubular shaft 202 of the retrograde reamer 200 when rotated back from its first position to its first position (i.e., its central axis coincides with the longitudinal axis 224 of the tubular shaft 202). However, the retrograde reamer 200 is removed from the surgical site by being pulled through the remaining portion of the tunnel 212 previously perforated in the femur 201.

  Although the above exemplary embodiment of the disclosed depth gauge has been described, other alternative embodiments or variations can be made. For example, FIG. 4 further illustrates that, according to the present application, a retrograde reamer (e.g., retrograde reamer 200) is used to retrogradely perforate a bone (e.g., femur 201) against a counterbore (such as a counterbore 216). FIG. 6 illustrates an exemplary embodiment of an exemplary thickness gauge 400 for measuring or otherwise determining bone thickness remaining after a test (also referred to herein as a “bridge bone gap”).

  As shown in FIG. 4, the thickness gauge 400 is configured to receive the tubular shaft 202 of the retrograde reamer 200 and is configured to be slidably engaged with the tubular shaft. The measuring tube 402 is provided. For example, the measurement tube 402 can be made from plastic, surgical plastic, or any other suitable material. The tubular shaft 202 of the retrograde reamer 200 is used to indicate the length (eg, see 4mm, 6mm, 8mm, 10mm, ..., Figure 5c) for use in measuring the thickness of the bridge bone gap. A plurality of linear scale marks (including the exemplary linear scale marks 226, see FIGS. 4 and 5c) are provided on the surface. The linear scale marks 226 are located on the surface of the tubular shaft 202 of the retrograde reamer 200 so that at least some of the linear scale marks 226 can be observed through a substantially transparent measurement tube 402 as shown in FIG. To do. Each of the linear tick marks 226 is aligned with the proximal end 404 (see FIGS. 5b and 5c) of the measurement tube 402 when the distal end 406 (FIGS. 5b and 5c) of the measurement tube 402 is aligned. And the cutting member of the retrograde reamer 200 in its second position (i.e., where the central axis 222 of the cutting member 206 is disposed at a non-zero angle θ relative to the longitudinal axis 224 of the tubular shaft 202). Indicates at least the approximate length of the distance to 206. Such distance between the distal end 406 of the measurement tube 402 and the cutting member 206 in its second position corresponds to the thickness of the bridge bone gap (such as the bridge bone gap 410, see FIG. 5c).

  During use, the measurement tube 402 disposed over the tubular shaft 202 of the retrograde reamer 200 has its second position (i.e., the central axis 222 of the cutting member 206 is zero with respect to the longitudinal axis 224 of the tubular shaft 202). When facing the cutting member 206 at a position that is not at an angle, preferably a linear tick mark indicating a length of 0 mm is aligned with the proximal end 404 of the measuring tube 402. Note that this indicates that the resulting thickness of the bridge bone gap is about 0 mm.

  FIGS. 5 a-5 c show an exemplary mode of operating the thickness gauge 400 of FIG. 4 in combination with the retrograde reamer 200. In this mode of operating the thickness gauge 400, the surgeon uses a guide (not shown) for a guidewire 210 (see FIG.5a) that penetrates the patient's bone (e.g., femur 201) at the surgical site. Can be established, the guidewire 210 can be placed along the established path, and then the guide can be removed. The cutting member 206 of the retrograde reamer 200 is in its first position (i.e., its central axis 222 coincides with the longitudinal axis 224 of the tubular shaft 202), and the tubular shaft 202 of the retrograde reamer 200 covers the guide wire 210. In the deployed state, the surgeon tunnels through the patient's femur 201 and into the femoral joint cavity 214 using a drill bit 204 at the distal end of the tubular shaft 202. (Such as tunnel 212, see FIG. 5b) can be drilled. The surgeon then moves the cutting member 206 from its first position to its second position (i.e., within the femoral joint cavity 214 by at least partially pulling back the guide wire 210 from the tubular shaft 202 of the retrograde reamer 200. It may be possible to rotate the central axis 222 to a position that is disposed at a non-zero angle with respect to the longitudinal axis 224 of the tubular shaft 202. The surgeon may then advance the tubular shaft 202 of the retrograde reamer 200 through the guide wire 210 to secure the cutting member 206 in its angled second position.

  Prior to drilling a counterbore (such as the counterbore 216) in the femur 201, the surgeon will install a retrograde reamer so that the distal end 406 of the measurement tube 402 contacts the surface of the femur 201 as shown in FIG. The measuring tube 402 of the thickness gauge 400 is positioned over the 200 tubular shafts 202. The surgeon then moves forward, with the retrograde reamer 200 pivoting independently of the thickness gauge 400 and the distal end 406 of the measurement tube 402 held firmly against the femoral surface. A counterbore 216 (see FIG. 5c) is drilled retrogradely into the femur 201 along essentially the same path as the manually drilled tunnel 212.

  The surgeon pulls or otherwise moves the retrograde reamer 200 in the proximal direction 211 while drilling the counterbore 216 in the patient's femur 201 (see FIG. It is possible to move 202 in the proximal direction 211 relative to the measurement tube 402. The surgeon may have a linear tick mark (e.g., a linear tick mark 228) where the measurement tube 402 proximal end 404 indicates the desired thickness length of the bridge bone gap 410, e.g., about 4 mm or any other suitable thickness. It is possible to continue drilling the counterbore 216 in such a manner until the tubular shaft 202 of the retrograde reamer 200 moves to the extent that it is aligned with (see FIG. 5c). At this point, the surgeon removes the cutting member 206 by (a) stopping the boring of the counterbore 216 substantially immediately and (b) pulling back the guide wire 210 from the tubular shaft 202 of the retrograde reamer 200. From the second position (i.e., where its central axis 222 is disposed at a non-zero angle relative to the longitudinal axis 224 of the tubular shaft 202) from its first position (i.e., whose central axis is the longitudinal axis of the tubular shaft 202). And (c) the retrograde reamer 200 to the rest of the tunnel 212 previously perforated in the femur 201. The retrograde reamer 200 can be removed from the surgical site by pulling through the distal end of the tubular shaft 202.

  An exemplary method of operating the thickness gauge 400 is described below with reference to FIG. 6 and FIGS. 4 and 5a-5c. As shown in block 602 (see FIG. 6), the cutting member 206 of the retrograde reamer 200 is in its first position (i.e., its central axis 222 coincides with the longitudinal axis 224 of the tubular shaft 202). A tunnel 212 is punctured through the femur 201 into the femoral joint cavity 214 antegradely at the surgical site. As shown in block 604, the cutting member 206 of the retrograde reamer 200 is in its second position (i.e., its central axis 222 is disposed at a non-zero angle with respect to the longitudinal axis 224 of the tubular shaft 202). In some situations, the counterbore 216 begins to be drilled retrogradely into the femur 201. When the cutting member 206 begins to drill the counterbore 216, as shown in block 606, (a) the drilling of the counterbore 216 is stopped, and (b) the measurement tube 402 is moved to the distal end of the measurement tube 402. Positioned over the tubular shaft 202 of the retrograde reamer 200 so that 406 contacts the surface of the femur 201. Alternatively, the measurement tube 402 is the tubular shaft of the retrograde reamer 200 (so that the distal end 406 of the measurement tube 402 abuts the surface of the femur 201) before the counterbore 216 is drilled. It can be positioned over 202.

  As shown in block 608, the retrograde counterbore 216 perforation in the femur 201 is the desired thickness of the bridge bone gap, such as the proximal end 404 of the measurement tube 402 being 4 mm or any other suitable thickness. The retrograde reamer 200 is resumed in a freely swiveling state regardless of the measurement tube 402 until it is aligned with a linear scale mark indicating a length corresponding to the length. As shown in block 610, the cutting member 206 has its first position from its second position (i.e., its central axis 222 is disposed at a non-zero angle with respect to the longitudinal axis 224 of the tubular shaft 202). The distal end of the tubular shaft 202 of the retrograde reamer 200 has previously been rotated in a state where it has been rotated back to its position (i.e. its central axis 222 coincides with the longitudinal axis 224 of the tubular shaft 202). The retrograde reamer 200 is removed from the surgical site by being pulled through the remaining portion of the tunnel 212 that is punctured through the femur 201 in a row.

  Those skilled in the art will appreciate that further modifications and variations of the depth and thickness gauges described above may be made without departing from the inventive concepts disclosed herein. Accordingly, the invention should not be viewed as limited except as by the scope and spirit of the appended claims.

100 depth gauge
102 housing
102a Slot opening
104 Sliding ruler
104a Linear scale mark
104b Slot opening
106 Sliding reamer docking element
106a substantially tubular section
106b part
106c slot opening
106d slot opening
106e distal end
108 Slender tip
200 Retrograde reamer
201 femur
202 Tubular shaft
203 hull
204 Drill bit
205 directional arrows
206 Cutting material
207 direction arrow
208 Bush
210 Guide wire
212 Tunnel
214 Femoral joint cavity
216 counterbore
218 Linear scale mark
220 Linear scale mark
222 Center axis
224 Longitudinal axis

Claims (15)

A tubular shaft; a drill bit disposed at a distal end of the tubular shaft; and at least one cutting member movably disposed adjacent to the distal end of the tubular shaft. A device for measuring the thickness of a target material configured for use in combination with a retrograde drill comprising:
A substantially transparent measuring tube having a proximal end and a distal end, configured to receive the tubular shaft of the retrograde drill and slidably engaged with the tubular shaft. Comprising a measuring tube configured to
The cutting member of the retrograde drill has a first position where a central axis of the cutting member coincides with a longitudinal axis of the tubular shaft of the retrograde drill, and the central axis of the cutting member is the tubular of the retrograde drill. Operate to move between a second position disposed at a non-zero angle with respect to the longitudinal axis of the shaft;
The tubular shaft of the retrograde drill has a plurality of linear scale marks on the surface for indicating a plurality of lengths, respectively, and at least some of the plurality of linear scale marks are the substantially transparent measurement. Can be observed through the tube,
Each of the plurality of linear scale marks aligned with the proximal end portion of the measurement tube has the distal end portion of the measurement tube and the retrograde drill of the retrograde drill disposed at the second position. Indicates the length of each of the distances to the cutting member, each length remaining during or after drilling a tunnel or bore in the target material using the retrograde drill Device corresponding to the thickness of the target material.   The device of claim 1, wherein the measurement tube is substantially rigid.   The device according to claim 1 or 2, wherein the measuring tube is made from a material selected from the group consisting of plastic and surgical plastic.   The target material is bone, and the measuring tube remains in or after drilling the tunnel or the bore in the bone using the retrograde drill in a ligament surgical procedure. 3. A device according to claim 1 or 2 operative to measure the thickness of the device. A system for measuring the thickness of a target material,
A retrograde drill comprising a tubular shaft having a surface, a distal end, and a longitudinal axis, a drill bit disposed at the distal end of the tubular shaft, and at least one cutting member having a central axis. The cutting member is movably disposed adjacent to the distal end of the tubular shaft;
A substantially transparent measuring tube having a proximal end and a distal end, configured to receive the tubular shaft of the retrograde drill and slidably engaged with the tubular shaft. A substantially transparent measuring tube configured to be
The cutting member has a first position where a central axis of the cutting member coincides with the longitudinal axis of the tubular shaft, and the central axis of the cutting member is zero with respect to the longitudinal axis of the tubular shaft. The retrograde drill is operable to move between a second position disposed at an angle and the target in the state in which the cutting member of the retrograde drill is disposed at the second position. Operates to retrogradely drill at least one tunnel or bore into the material;
The tubular shaft of the retrograde drill has a plurality of linear scale marks on the surface for indicating a plurality of lengths, respectively, and at least some of the plurality of linear scale marks are the substantially transparent measurement. Can be observed through the tube,
Each of the plurality of linear scale marks aligned with the proximal end portion of the measurement tube has the distal end portion of the measurement tube and the retrograde drill of the retrograde drill disposed at the second position. Indicates the length of each of the distances between the cutting members, each length remaining during or after drilling the at least one tunnel or bore in the target material retrogradely A system corresponding to the thickness of the target material.   6. The system of claim 5, wherein the measurement tube is substantially rigid.   The system according to claim 5 or 6, wherein the measuring tube is made from a material selected from the group consisting of plastic and surgical plastic.   The retrograde drill punctures at least another tunnel or bore in the target material in a forward direction using the drill bit in a state where the cutting member of the retrograde drill is disposed at the first position. 7. A system according to claim 5 or 6 further operative to:   The retrograde drill is configured to retrogradely drill the at least one tunnel or bore in the target material along substantially the same path through the target material, and to the target material. 9. The system of claim 8, further operative to puncture a tunnel or bore antegradely.   6. The system of claim 5, wherein the retrograde drill is further operative to freely pivot independently of the measurement tube while drilling the at least one tunnel or bore.   The target material is bone and the measurement tube remains during or after drilling the at least one tunnel or bore in the bone using the retrograde drill in a ligament surgical procedure 11. A system according to claim 5 or 10 operative to measure the bone thickness. A method for measuring the thickness of a target material, comprising:
A retrograde drill is provided that includes a tubular shaft having a surface, a distal end, and a longitudinal axis, a drill bit disposed at the distal end of the tubular shaft, and at least one cutting member having a central axis. A step wherein the cutting member is movably disposed adjacent to the distal end of the tubular shaft;
Providing a substantially transparent measuring tube having a proximal end and a distal end, wherein the measuring tube is configured to receive the tubular shaft of the retrograde drill and slidably covers the tubular shaft; Providing a substantially transparent measuring tube configured to be engaged with the cutting member from a first position where a central axis of the cutting member coincides with the longitudinal axis of the tubular shaft; Moving the cutting member of the retrograde drill to a second position where a central axis is disposed at a non-zero angle with respect to the longitudinal axis of the tubular shaft;
Drilling at least one tunnel or bore in the target material retrogradely with the retrograde drill in a state where the cutting member of the retrograde drill is disposed in the second position, The tubular shaft has a plurality of linear scale marks on the surface for indicating a plurality of lengths, and at least some of the plurality of linear scale marks can be observed through the substantially transparent measurement tube. Is a step,
The proximal end of the measurement tube to indicate the length of each distance between the distal end of the measurement tube and the cutting member of the retrograde drill disposed at the second position Aligning each one of the plurality of linear tick marks with a portion, each length of which is during the retroperforating the at least one tunnel or bore in the target material Or a step corresponding to the thickness of the target material remaining after drilling. With the cutting member of the retrograde drill disposed in the first position, at least another tunnel or bore in the target material is drilled forward with the retrograde drill using the drill bit. The method of claim 12 further comprising a step. Position the measurement tube such that the distal end of the measurement tube contacts the surface of the target material while the measurement tube is slidably engaged over the tubular shaft of the retrograde drill. 14. The method according to claim 12 or 13, further comprising the step of: The target material is bone;
In the ligament surgical procedure with the measuring tube, measuring the thickness of the bone remaining during or after drilling the at least one tunnel or bore in the bone using the retrograde drill 14. The method according to claim 12 or 13, further comprising.