KR20140138125A - Arthroscopic surgical device - Google Patents

Abstract

The bone tunneling and closure device for arthroscopic surgery of the present invention includes a bone-binding needle and is capable of arthroscopically inserting through the arthroscopic incision into the patient's bone at the first bone position, A bone-engaging needle embossing assembly that is generally capable of being inserted into the bone forward to at least a second bone site along an arcuate tunneling path, and a bone-engaging needle embossing assembly disposed to operably engage the bone-engaging needle embossing assembly, And a bone-engaging pin engaging assembly adapted to be arthroscopically inserted into the patient's bone at a third bone position through a surgical incision.

Description

[0001] ARTHROSCOPIC SURGICAL DEVICE [0002]

Reference to related application

The following US patents, which are incorporated herein by reference and which are believed to be related to the present application and which are the basis of the priority claims of this application under 37 CFR 1.78 (a) (4) and (5) (i) Application:

U.S. Provisional Patent Application No. 61 / 584,267, entitled " Circular Bone Tunneling Device "filed on January 8, 2012;

Entitled " Circular Bone Tunneling Device Employing a Stabilizing Element ", entitled " Circular Bone Tunneling Device Employing a Stabilizing Element, "filed on April 23, 2012, U.S. Provisional Patent Application No. 61 / 636,751; And

U.S. Provisional Patent Application No. 61 / 714,813, filed October 17, 2012, entitled "Arthroscopic Apparatus ";

.

The following PCT patent application which is incorporated herein by reference and which is believed to be related to the present application and which is the basis of the priority claim under 37 CFR 1.78 (a) (1) and (2) (i) :

PCT Patent Application No. PCT / IL2012 / 000318, filed on August 23, 2012, the contents of which are incorporated herein by reference and are entitled "Arthroscopic Apparatus "; And

PCT Patent Application No. PCT / IL2012 / 000319, filed on August 23, 2012, which is incorporated herein by reference and is entitled " Circular Bone Tunneling Device Using a Stabilizing Element ";

.

PCT patent application publication number WO 2012/007941, filed July 11, 2011, the disclosure of which is incorporated herein by reference, and which is entitled " circular bone tunneling device "; And

 U. S. Patent Application No. 61 / 526,717, filed August 24, 2011, entitled " Circular Bone Tunneling Device ", the contents of which are incorporated herein by reference;

See also.

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates generally to arthroscopic devices, and more particularly to an arthroscopic bone tunneling device.

Various types of arthroscopic instruments are known for various applications including orthopedic surgery.

The present invention seeks to provide an improved arthroscopic bone tunneling and sealing apparatus.

Thus, according to a preferred embodiment of the present invention, it is possible to insert arthroscopically into a patient's bone at a first bone location, including a bone-binding needle and through an arthroscopic incision, A bone-engaging needle embossing assembly configured to be inserted into the bone forward at least to a second bone position along a path, and a bone-engaging needle embossing assembly operatively disposed to engage the bone-engaging needle embossing assembly, There is provided a bone tunneling and sealing apparatus for an arthroscopic procedure including a bone-engaging pin engaging assembly configured to engage with a bone of a patient at a third bone position through a portion of the bone-engaging pin engaging assembly.

Advantageously, the bone-engaging pin embedding assembly is configured to mount a suture and configured to position the suture so that the suture can engage the needle at the second bone location. Additionally, the bone-coupled needle embedding assembly is further configured to retract the needle from the second bone location, along with the suture, through the bone along the arcuate tunneling path.

According to a preferred embodiment of the present invention, the bone-engaging pin embedding assembly is configured to move from the third bone location along a generally linear tunneling path to the second bone location where the substantially straight tunneling pathway meets the substantially arcuate tunneling pathway And at least one bone tunneling pin operable to tunnel the bone, thereby positioning the suture so that the suture is engaged with the needle at the second bone location.

Preferably, the bone-engaging pin engaging assembly is separate from the bone-engaging needle engaging assembly and can be selectively engageable with the bone-engaging needle engaging assembly and is operatively connected to the bone-engaging needle engaging assembly Can be separated.

According to a preferred embodiment of the present invention, the bone-engaging pin engaging assembly includes an inner pin and an outer hollow pin in which the inner pin is slidably disposed. In addition, the outer hollow pin is formed in a shape having a pointed end and a through hole.

Preferably, the suture extends between the inner pin and the outer pin, and the suture is annular around the inner pin within the outer pin so that the suture can be engaged with the needle through the through hole. Additionally or alternatively, the bone-engaging pin engaging assembly further includes a base assembly including a forward portion and a back portion, wherein the inner pin is coupled to the rear portion and the outer pin is coupled to the forward portion Lt; / RTI >

According to a preferred embodiment of the present invention, the outer hollow pin is also formed in the form of having a sidewall through slot for receiving a portion of the suture. In addition, the suture is wrapped around the forward end of the inner pin and between the forward end and the pointed end of the inner pin, extending between the inner pin and the outer pin, and both sidewalls of the inner pin Lt; RTI ID = 0.0 > through-slots. ≪ / RTI >

Advantageously, said base assembly is selectably secured to a housing surrounding a portion of said bone-engaging needle embedding assembly. Additionally or alternatively, the front portion and the rear portion of the base assembly may be selectably secured to one another and may slide axially relative to each other, thereby causing the inner pin Thereby providing limited retractability.

According to a preferred embodiment of the present invention, the bone-engaging needle embedding assembly includes a flexible needle driving strip for engaging the bone-engaging needle into the bone along the arcuate tunneling path .

According to another preferred embodiment of the present invention there is provided a method of tunneling bone during arthroscopic surgery comprising a bone-engaging pin engaging assembly and an arthroscopic incision, And a bone-engaging needle configured to be capable of arthroscopic insertion in conjunction with the bone-engaging needle and configured to be pushed forward into the bone at least to a second bone location generally along an arcuate tunneling pathway. Coupling needle embossing assembly to the bone-engaging needle embossing assembly; engaging the bone-engaging needle embossing assembly with the bone-engaging needle embossing assembly in the first bone position; Wherein the bone-engaging pin engaging assembly is inserted through a cervical incision, and the bone- Tunneling the bone to the bone-engaging pin embossing assembly along a generally linear tunneling path from the third bone site to the second bone site, and inserting the bone into the bone- Engaging the needle into the bone-engaging needle embedding assembly along the generally arcuate tunneling path from the first bone location to at least the second bone location, Tunneling the bone with the bone-binding needle along the tunneling path.

Advantageously, the method of tunneling bone during arthroscopic surgery further comprises the steps of: prior to operatively engaging the bone-engaging pin engaging assembly with the bone-engaging needle engaging assembly, And attaching the suture to the needle at the second bone location after the step of inserting the needle.

According to a preferred embodiment of the present invention, the method of tunneling bone during arthroscopic surgery further comprises the step of, after engaging the suture with the needle, in conjunction with the suture, .

Advantageously, the method of tunneling bone during arthroscopic surgery further comprises retracting said bone-engaging pin engaging assembly from engagement with said bone after said step of retracting said needle.

According to a preferred embodiment of the present invention, the method of tunneling bone during arthroscopic surgery further comprises the steps of retracting the bone-engaging pin embedding assembly, partially re-stretching the needle, And separating the needle from the needle.

Advantageously, the step of operably coupling the bone-engaging pin engaging assembly with the bone-engaging needle engaging assembly further comprises engaging the bone-engaging needle engaging assembly to engage the suture at the second bone location, Aligning the engaging pin engaging assembly with the bone-engaging needle engaging assembly, and then axially and rotationally securing the bone-engaging pin engaging assembly to the bone-engaging needle engaging assembly do.

The invention may be understood and appreciated by the following detailed description, taken in conjunction with the accompanying drawings.

Figures 1a and 1b are schematic views of an arthroscopic surgical apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a first operative position;
Figures 2a and 2b are schematic views of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a second operative position;
Figs. 3a and 3b are schematic views of an arthroscopic surgical apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a third operational deployed state; Fig.
Figures 4a and 4b are schematic diagrams of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a fourth operative deployment state;
Figures 5A and 5B are schematic views of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a fifth operative position;
Figures 6a and 6b are schematic views of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a sixth operative position;
Figures 7a and 7b are schematic views of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a seventh operating position;
Figures 8A and 8B are schematic views of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in an eighth operating position;
Figures 9a and 9b are schematic views of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a ninth operating position;
10A and 10B are schematic views of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention showing both views in a tenth operating position;
11A and 11B are schematic views of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in an eleventh operating deployed state;
12A and 12B are schematic views of an arthroscopic apparatus constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a twelfth operating deployed state;
FIG. 13 is a simplified exploded view of the arthroscopic apparatus of FIGS. 1A-B in a first operative position; FIG.
Figures 14A and 14B are simplified exploded views of a portion of the arthroscopic device of Figures 1A-13 showing both views;
FIG. 14C is a simplified partial assembly view of a portion of the arthroscopic apparatus of FIGS. 14A and 14B; FIG.
Figs. 15A and 15B are schematic views of other parts of the arthroscopic apparatus of Figs. 1A-13 showing both aspects; Fig.
Figures 16A and 16B are simplified exploded views of a portion of the arthroscopic device of Figures 1A-13 showing both views;
FIGS. 17A and 17B are schematic views of a portion of the arthroscopic apparatus of FIGS. 16A and 16B showing both views; FIG.
Figures 18A and 18B are simplified assembly drawings of a portion of the arthroscopic device of Figures 1A-17B showing both aspects;
Figure 19 is a simplified exploded view of a portion of the arthroscopic device of Figures 18a and 18b;
FIGS. 20A, 20B, 20C and 20D are schematic views showing various forms of the upper part of the arthroscopic apparatus shown in FIGS. 18A, 18B and 19;
FIG. 21 is a simplified cross-sectional view along line XXI-XXI of FIG. 18A; FIG.
22 is a simplified cross-sectional view along line XXII-XXII in FIG. 21;
Figures 23A, 23B and 23C are simplified cross-sectional views along line AA, line BB and line CC in Figure 18B;
Figs. 24A and 24B are simplified exploded views of a portion of the arthroscopic apparatus shown in Figs. 18A, 18B and 19 showing both aspects; Fig.
25A and 25B are schematic views of the assembling steps of a part of the arthroscopic apparatus shown in Figs. 18A, 18B and 19;
Figs. 26A and 26B are schematic views of parts constituting a part of the arthroscopic apparatus shown in Figs. 18A, 18B and 19; Fig.
Fig. 27 is a simplified side view shown along the direction indicated by arrow XXVII in Fig. 26A; Fig.
28 is a simplified cross-sectional view along line XXVIII-XXVIII of Fig. 27;
29 is a simplified cross-sectional view along line XXIX-XXIX of FIG. 28;
30A, 30B, 30C, 30D, 30E, 30F, 30G, 30H, 30I, 30J, 30K, 30L, 30M, A schematic view of the details of the operation of the transcranial device; And
Figures 31A, 31B, 31C, 31D, 31E, 31F, 31G, 31H, 31I, 31J, 31K, 311, 31M, 30 < RTI ID = 0.0 > n. ≪ / RTI >

The following is a schematic representation of an arthroscopic device constructed and operative in accordance with a preferred embodiment of the present invention, showing both views in a first operative orientation, and in the following figures in parentheses Reference is made to various additional drawings which are specifically referred to.

1A and 1B, an arthroscopic device 100 according to a preferred embodiment of the present invention preferably includes a housing portion formed of a right housing element and a left housing element 102, 104, 1a and 1b include a multiple action driving assembly 106, only a portion of which is shown. The housing portion includes a handle portion formed with a right housing element handle portion and a left housing element handle portion 112, 114, respectively.

The multiple motion pawl assembly 106 preferably includes a bone-engaging pin driving assembly 120 and a bone-engaging needle driving assembly 122 . The bone-engaging pin embedding assembly 120 preferably includes a base assembly 124 that includes a back portion 126 and a forward portion 128. An inner solid pin 130 (see FIG. 21) is fixedly mounted to the rear portion 126 and an outer hollow pin 132 is fixed to the front portion 128 Respectively.

A rearward knurled locking knob 136 is mounted to the rear portion 126 to selectively secure the rear portion 126 to the front portion 128. The front knurl finish fixed knob 138 is mounted to the front portion 128 to selectively secure the front portion 128 to the left housing element handle portion 112.

The outer hollow pin 132 is preferably formed with a pointed end 140 and an aperture 142 through from top to bottom. The suture 144 preferably extends between the inner solid pin 130 (Figure 21) and the outer hollow pin 132 and extends inwardly from the inside of the outer hollow pin 132 so as to be coupled through the hole 142 And is annular around the solid pin 130 (see FIG. 21).

The multiple motion pawl assembly 106 preferably includes a hand-engageable ratchet handle 150 disposed to reciprocate about an axis 152 (see FIG. 13). A directionally selectable ratchet shaft 156 (see FIG. 13) extends through a slot 158 formed in the right housing element handle portion and the left housing element handle portion 112, 114, respectively, Terminates in a knob 160 that controls the direction of movement of the arcuate tunneling needle 162 with the suture engaging groove 164.

A mechanical indicator 170, preferably visible, is disposed on top of each housing portion 102, 104. The indicator 170 preferably provides a visible indication of the extent to which the arcuate tunneling needle 162 has been displaced from the fully retracted position shown in Figures 1A and 1B. The arcuate tunneling needle 162 is adapted to selectively couple the suture 144 in the suture engagement groove 164 through a hole 142 in the outer hollow pin 132.

In the following, reference is made to Figs. 2a and 2b, which are schematic views of the arthroscopic apparatus of Figs. 1A and 1B, showing both views in a second operating deployed state. As described in detail below with respect to FIG. 31B, in the second operative disposition, which is preferably performed after insertion of the forward portion of the bone-engaging needle embedding assembly 122 through the arthroscopic incision, It can be seen that the bone-engaging pin engaging assembly 120 is inserted through the housing such that the pointed end 140 extends to the surface of the bone, as described in detail below with respect to Figures 31A and 31B .

In the following, reference is made to Figs. 3A and 3B, which are schematic views of the arthroscopic apparatus of Figs. 1A and 2B in a third operational deployed state. As described in detail below with respect to FIG. 31C, it can be seen that the bone-engaging pin engaging assembly 120 is fully extended by hitting the rear portion 126 with a hammer.

In the following, reference is made to Figs. 4A and 4B, which are schematic views of the arthroscopic apparatus of Figs. 1A to 3B in a fourth operational deployed state. The rear portion 126 is retracted axially relative to the front portion 128 after the rear portion 126 is disengaged from the front portion 128 by rotating the rear knurl finish fixed knob 136, It can be seen that the inner solid pin 130 (see FIG. 21) is retracted relative to the outer hollow pin 132.

In the following, reference is made to Figs. 5A and 5B which are schematic views of the arthroscopic apparatus of Figs. 1A to 4B in the fifth operating position. It can be seen that the arcuate tunneling needle 162 is partially elongated as indicated by the indicator 170. [ This elongation is accomplished by rotation of the hand-held ratchet handle 150 relative to the axis 152 (see FIG. 13) when the knob 160 is in the upper position in the slot 158.

In the following, reference is made to Figs. 6A and 6B, which are schematic views of the arthroscopic apparatus of Figs. 1A to 5B in the sixth operating position. An arcuate tunneling needle 162 is mounted on the hand held ratchet handle 152 relative to the axis 152 when the knob 160 is in the upper position in the slot 158, It can be seen that it is fully extended through the hole 142 in the outer hollow pin 132, corresponding to the pivotally rotating rotation of the outer hollow pin 132.

In the following, reference is made to Figs. 7A and 7B which are schematic views of the arthroscopic apparatus of Figs. 1A to 6B in the seventh operating position. It can be seen that the suture 144 is manually retracted to engage the arcuate tunneling needle 162 in the suture engaging groove 164 through the hole 142 in the outer hollow pin 132. [ Preferably, prior to retracting the suture 144, the knob 160 is lowered to a lower position in the slot 158.

In the following, reference is made to Figs. 8A and 8B, which are schematic views of the arthroscopic apparatus of Figs. 1A to 7B in the eighth operational deployed state. When the knob 160 is in the lower position in the slot 158 and the suture 144 is engaged with the arcuate tunneling needle 162 in the suture engaging groove 164, 152 corresponding to the pivotally rotating rotation of the hand-held ratchet handle 150. As shown in FIG.

In the following, reference is made to Figs. 9A and 9B which are schematic views of the arthroscopic apparatus of Figs. 1A to 8B in the ninth operating position. The arcuate tunneling needle 162 is further retracted as indicated by the indicator 170 so that the suture thread 144 passes through the hole 142 of the outer hollow pin 132 to the arcuate tunneling needle 162 , So that the arcuate tunneling operation of the arcuate tunneling needle 162 penetrates the bone and pulls the suture 144 backward along with the retraction of the arcuate tunneling needle 162 along the arcuate path previously formed Able to know. The retraction of this arcuate tunneling needle 162 is caused by the additional pivoting rotation of the hand-held ratchet handle 150 relative to the axis 152 when the knob 160 is in the lower position in the slot 158 do.

In the following, reference is made to Figs. 10A and 10B which are schematic views of the arthroscopic apparatus of Figs. 1A to 9B in the tenth operating position. The arcuate tunneling needle 162 is fully retracted as indicated by the indicator 170 in engagement with the annular forward end of the suture 144 so that the complete retraction of the arcuate tunneling needle 162 And pulls the suture 144 backward along the arcuate path.

In the following, reference is made to Figs. 11A and 11B, which are schematic views of the arthroscopic apparatus of Figs. 1A to 10B in an eleventh operating deployed state. It can be seen that the bone-engaging pin engaging assembly 120 is retracted after the bone-engaging pin engaging assembly 120 is disengaged from the handle portion 112 by the rotation of the forward knurling fixed knob 138 have.

In the following, reference is made to Figs. 12A and 12B, which are schematic views of the arthroscopic apparatus of Figs. 1A to 11B in a twelfth operating deployed state. It can be seen that the arcuate tunneling needles 162 are partially elongated in order to be able to manually disengage the anterior end of the annular shape of the suture 144 from the suture engaging groove 164 of the arcuate tunneling needle 162. It should be noted that the position in the slot 158 of the knob 160 has already been shifted upwards in order to extend the arcuate tunneling needle 162 in response to ratchet operation. The arrangement of the arcuate tunneling needles 162 is indicated by the indicator 170.

Reference is now made to Figs. 13 to 17B, and in particular to Fig. 13 at first, and a simplified exploded view of a portion of the arthroscopic device of Figs. 1A to 12 showing both views, see Figs. 14A and 14B And see also a simplified partial assembly diagram, Figure 14c. All of the figures show details of the various elements of the multiple motion pawl assembly 106.

It will be appreciated that the ratchet handle 150 is typically formed in a shape having a bottom hole 210 and a slot 212 for receiving the shaft 154. [ The pin 214 is slidably movable within the slot 212 such that the reciprocating arcuate motion of the slot 212 is translated into a reciprocating forward and backward motion on a plane perpendicular to the longitudinal axis 216 of the pin 214. [ have. The first and second reciprocation coupling elements 220 and 222 are secured to the pins 214 in the respective holes 224 and 226 and extend in a reciprocating forward and rearward direction Move with exercise.

The connecting element 222 includes an elongated protrusion 228 which reciprocates in a slot 230 formed in the housing portion 102.

The connecting element 220 includes a side extending shaft 240 that includes a circumferential groove 244 that is mounted to one end of the tension spring 248. The opposite end of the tension spring 248 is mounted in a circumferential groove 250 formed in the shaft 156. The shaft 156 extends through a hole 254 formed in a toggle element 256 and the hole 254 communicates with the hollow shaft portion 258 of the toggle element 256. Shaft 156 extends through slot 158 formed in each housing portion 102, 104.

The dual rack straight toothed element 270 has an upper linear toothed ratchet rack 272 and a lower linear toothed geat rack 274. The pointed edge 275 of the connecting element 220 is selectably engaged with the upper straight tooth rack 272. Preferably a dual rack straight toothed element 270 is formed having a slot 276 which engages with an elongated axial protrusion 277 formed in the housing element 102. An inwardly recessed portion 278, generally adjacent the inner end of the rigid needle embedding strip drive shaft 280, is mounted to a mounting element 282, which is typically bolted to the double rack straight toothed element 270 And is fixedly mounted on the double rack linear toothed element 270. An indicator guide 284 is formed in the mounting element 282 and forms part of the indicator 170.

The second double rack linear toothed element 285 has an upper straight gear tooth rack 286 and a lower straight toothed ratchet rack 287. Preferably a second double rack, linear toothed element 285 is formed having a slot 288 which engages with an elongated axial projection 289 formed in the housing element 102.

The gear 290 with the gear shaft 291 engages the lower straight gear tooth rack 274 of the double rack straight toothed element 270 and at the same time engages the upper straight gear tooth rack 284 of the second double rack straight toothed element 285, (286). Preferably, the gear shaft 291 is mounted at its both ends into the hole 292 of the respective housing element 102, 104.

The pointed edge 293 of the connecting element 220 is selectably engaged with the lower linear toothed ratchet rack 287 of the second dual rack linear toothed element 285.

In the following, reference is made to Figs. 15A to 17B which illustrate a bone-engaging needle embedding assembly 122. The bone-engaging needle-punching assembly 122 includes a linear gear rack element 270 which preferably has an elongated path of travel corresponding to the reciprocating motion of the ratchet handle 150 Therefore, it is driven.

The bone-engaging needle-punching assembly 122 includes a stationary forward portion 300 that includes a mounting base 302 extending forwardly of the front end of the housing, And is attached to an extension shaft 304 that extends axially inward and forward from the mounting base. Preferably, the arcuate needle storage and guiding portion 306 is attached to the extension shaft 304 and extends to the front of the extension shaft.

The mounting base 302 is configured as a generally hollow cylinder for receiving a portion of the extension shaft 304 within the mounting base and is configured to receive the mounting base 302 from the housing portions 102, And a matching side aperture 308 for receiving a mounting pin 310 (see FIG.

 The extension shaft 304 is preferably formed by two side pieces 311 with two identical sides. The two side portions 311 together form two mutually spaced axial mounting bores extending through the two side portions 311, the bore being indicated by reference numeral 312 and reference numeral 314. The bore 312 slidably receives the hollow pin 132 and has a generally circular cross-section.

The bore 314 slidably receives a portion of the flexible arcuate needle punching assembly and the flexible arcuate needle punching assembly includes a flexible needle embedding strip 318 preferably formed of spring steel and Includes a generally rigid flexible needle embedding strip drive shaft 280 mounted to the rear of the flexible needle embedding strip 318, as shown in enlarged view A and enlarged view B in FIG. 15A have. This mounting preferably includes a protrusion 319 formed adjacent the front end of the rigid flexible needle embedding strip drive shaft 280 and a corresponding hole (not shown) formed adjacent the rear end of the flexible needle embedding strip 318 320).

15A, the bore 314 has a central portion 322 having a generally circular cross-sectional shape to receive the shaft 280, and the side edges of the flexible needle embedding strip 318 A pair of symmetrical side cutouts 324 extends from the center portion for receiving.

15A, an arcuate needle storage and guiding portion 350 is preferably formed in front of the elongate shaft 304, and the arcuate needle storage and guiding portion 350, Shaped bore 352 that includes a portion 354 having a generally rectangular cross-section that slidably receives the arcuate tunneling needles 162. The arcuate bore 352 includes a portion 354 having a generally rectangular cross-section. A pair of symmetrical side cutouts 356 extend outwardly from the generally rectangular section 354 and receive the side edges of the flexible needle embedding strip 318.

16A, the suture engaging groove 164 of the arcuate tunneling needle 162 is partially formed by the partially overlying portion 357 of the arcuate tunneling needle 162, . 16A, it can be seen that the front end of the flexible needle embedding strip 318 is attached to the arcuate tunneling needle 162. This attachment is preferably achieved by a combination of a projection 366 formed adjacent the rear end of the arcuate tunneling needle 162 and a corresponding hole 367 formed adjacent the front end of the flexible needle embedding strip 318 .

Reference is now made to Figs. 18A, 18B and 19 which show the bone-engaging pin engaging assembly 120. Fig. As described above, the bone-engaging pin engaging assembly 120 preferably includes a base assembly 124 that includes a back portion 126 and a forward portion 128. The inner solid pin 130 is fixedly mounted to the rear portion 126 and the outer hollow pin 132 is fixedly mounted to the front portion 128.

The rear knurl finish fixed knob 136 is mounted to the rear portion 126 to selectively secure the rear portion 126 to the front portion 128. [ The front knurl finish fixed knob 138 is mounted to the front portion 128 to selectively secure the front portion 128 to the left housing element handle portion 112.

 The outer hollow pin 132 is preferably formed in a shape having a pointed end 140 and a hole 142 penetrating from the top to the bottom. The suture 144 preferably extends between the inner solid pin 130 and the outer hollow pin 132 and defines an inner solid pin 130 within the outer hollow pin 132 to be coupled therethrough. ) In the form of an annulus.

In particular, as shown in Figs. 18A, 18B and 19, a throughgoing side wall slot 400 is formed perpendicularly to the hole 142 passing from top to bottom, The slot 400 receives the suture 144, as described below. 18A, 18B, and 19 also illustrate a through shaft 401 extending through a corresponding side-to-side bore formed in the rear portion 126. 24A and 24B show various elements to be assembled as shown in Figs. 18A, 18B and 19, but for the sake of clarity, they are shown without the suture 144. Fig.

 20A, 20B, 20C, and 20D illustrate various alternative configurations of the pointed end 140. As shown in FIG. 20A shows a generally conical end portion 402 having a suture receiving slot 404. 20B shows a generally tapered threaded end portion 406 having a suture receiving slot 408 therein. FIG. 20C shows a generally conical drill end 410 having a suture receiving slot 412. FIG. 20D shows a generally diamond cut end 414 having a suture receiving slot 416. FIG.

Reference is now made to Figs. 21-23C which illustrate the initial positioning of the suture 144 in the bone-engaging pin embedding assembly 120. Fig.

FIG. 21 is a simplified cross-sectional view along line XXI-XXI in FIG. 18A, and FIG. 22 is a simplified cross-sectional view along line XXII-XXII in FIG. Figs. 23A to 23C are cross-sectional views along the line shown in Fig. 18B. These figures clearly show the arrangement of the sutures 144 with respect to the pins 130 and 132 and the holes 142 and the slots 400 so that the suture 144 is positioned in the inner solid pin 130 And is wrapped between the end portions of the inner solid pin 130 and the end portion 140 and partially on both sides of the slot 400.

 25A and 25B show the assembling process of the bone-coupling pin insertion assembly 120. FIG. 25A, once the suture 144 is wound around the inner solid pin 130, the inner solid pin 130 is inserted into the outer hollow pin 132 through the bore 480 (see FIG. 26A) The rear portion 126 including the inner solid pin 130 on which the suture 144 is wrapped is connected to the front portion 128 by inserting the suture thread. And then the rear portion 126 is fixed to the front portion 128 by the operation of the rear knurl finish fixing knob 136. [ The axial separation of the front portion 128 and the rear portion 126 is limited by inserting the retaining pin 420 into the rear portion 126 so that the inner solid pin Thereby restricting the axial retraction of the shaft 130. An additional retaining pin 424 may be provided to securely retain the rear knurl finish fixed knob 136 away from the rear portion 126.

26A and 26B, which are schematic views of a portion of the arthroscopic apparatus shown in Figs. 18A, 18B and 19; Figure 27, which is a simplified side view shown along the direction indicated by arrow XXVII in Figure 26A; Figure 28, which is a simplified cross-sectional view along line XXVIII-XXVIII in Figure 27; Reference is now made to Fig. 29, which is a simplified cross-sectional view along line XXIX-XXIX of Fig.

The rear portion 126 is preferably a generally cylindrical element 428 extending along the cylindrical axis 430 and is formed in the form of various bores and slots as described below. A side slot 432 extends axially forward from the rear surface 434 of the cylindrical element 428 about one-third of the axial length of the cylindrical element 428, And terminates in a narrow axial bore 436 that extends all the way to the front surface 438. A transverse bore 439 is in communication with the axial bore 436 and a rear nulling fixed knob 136 (see Figure 19) is inserted into the axial bore 436 and the side slot 432 The retaining pin 424 (see FIG.

The transverse bore 440 extends perpendicularly to the cylindrical axis 430 and receives the through shaft 401 (see FIGS. 18A, 18B and 19).

The side slots 442 extend axially rearward from the front surface 438 of the cylindrical element 428 over approximately two-thirds of the axial length of the cylindrical element 428. The side slot 442 receives the forward knurled-working fixed knob 138.

A bore 450 having a generally rectangular cross-section is formed in the front surface 438. A transverse bore 452 is in communication with the bore 450 and receives the retaining pin 420 (see FIG. 19) which limits axial displacement with respect to the rear portion 126 of the front portion 128.

The front portion 128 is preferably a generally disk-shaped cylindrical element 468 extending along the cylindrical axis 430 and is shaped in the form of various bores, slots and protrusions as described below. A side slot 472 extends axially forward from the rear surface 474 of the cylindrical element 468 to the front surface 478 of the cylindrical element 468.

The central bore 480 extends from the front surface 478 of the cylindrical element 468 to the rear surface 474 of the cylindrical element 468 and beyond the rear surface to form a generally rectangular And extends through an axial protrusion 482 having a cross section. A transverse retaining slot 486 extending perpendicularly to the cylindrical axis 430 is formed in the upper surface of the axial protrusion 482 and extends in the axial direction The axial displacement of the protrusion 482 is limited to limit the relative displacement of the front portion 128 and the rear portion 126 respectively so that the retraction of the inner solid pin 130 within the outer hollow pin 132 And is coupled to the retaining pin (420) which limits the opening.

The stepped, partially threaded bore 490 is formed such that the threaded portion 492 extends forwardly from the rear surface 474 and the unscrewed bore portion 496 continues from the shoulder 494 And extends to the front surface 478.

A suture access slot 498 is in communication with the central bore 480 and enables suture 144 to be threaded.

30A, 30B, 30C, 30D, 30E, 30F, 30G, 30H, 30I, 30J, 30D, 30D, FIGS. 31A, 31B, 31C, 31D, 31E, 31F, 31C, 31D and 31D are schematic views of the operation of the arthroscopic apparatus of FIGS. 30K, 30L, 30M and 30N, 31g, 31h, 31i, 31j, 31k, 311, 31m and 31n.

Prior to inserting the arthroscopic device 100 through the patient's arthroscopic incision, as can be seen generally in Figs. 30A and 31A corresponding to Figs. 1A-2B, A bone-engaging pin engaging assembly 120, such as that described above, is mounted to the arthroscopic surgical apparatus 100.

 31A shows an initial, axially forward positioning of the bone-engaging pin engaging assembly 120 in the arthroscopic device 100, as indicated by arrow 500. As shown in FIG. At this stage, the end portion 140 of the bone-engaging pin embedding assembly 120 is not protruding from the bore 312.

 Figure 31B shows that the arcuate needle storage and guiding portion 306 is in contact with the incision 501 so that the foremost end 502 of the arcuate needle storage and guiding portion 306 abuts the bone as shown in this figure in humerus, As shown in FIG.

In Figures 30A, 31A and 31B, the inner solid pin 130 and the outer hollow pin 132 are shown in their respective fully retracted positions.

Figures 30b and 31c, generally corresponding to Figures 2a and 2b, show the continuous straight forward displacement of the bone-engaging pin engaging assembly 120 in the arthroscopic device 100, as indicated by arrow 504 . This displacement is preferably accomplished by an operator placing the bone-engaging pin engaging assembly 120 in the rest of the arthroscopic device 100, as indicated by arrow 504, until the end portion 140 abuts the bone. As shown in FIG.

Figures 30c and 31d, generally corresponding to Figures 3a and 3b, show the continuous maximum straight forward displacement of the bone-engaging pin engaging assembly 120 in the arthroscopic device 100, as indicated by arrow 506 have. This displacement is such that the tip 140 of the bone-engaging pin engaging assembly 120 reaches its forefront position within the bone such that the hole 142 meets the arcuate trajectory of the needle 162 within the bone Until the operator finishes hitching the end portion 140 and the fins 130 and 132 axially into the bone by hamming the rear portion 126 as shown in the figure. This foremost position is defined by the front surface 478 of the front portion 128 abutting against the rear surface of the housing.

As an alternative form, hammering may be accomplished by, for example, using an alternatively shaped end portion 406 or end portion 410 (see Figures 20b and 20c) that can be driven by hand, Can be replaced by a rotational displacement.

It should also be noted that the desired rotational positioning of the outer hollow pin 132 is achieved by aligning the indicia 508 on the front portion 128 with the corresponding indicia 510 adjacent the rear surface of the housing. This rotational positioning is necessary to ensure that the holes 142 are aligned vertically in Figures 3a, 3b and 30c. In this position, the bone-engaging pin engaging assembly 120 is moved axially and rotationally by arithmetic operation of the forward knurled-working fixed knob 138, as described above with respect to Figures 18A-20 And is fixed to the apparatus 100.

Reference is now made to Figs. 30D and 31E, which correspond to Figs. 4A and 4B, illustrating retraction of the inner solid pin 130 relative to the outer hollow pin 132. Fig. This retraction releases the rear portion 126 and the front portion 128 from each other by suitable rotation of the rear knurled and fixed knob 136 and causes the rear portion 126 to be moved forwardly In the axial direction.

At this stage, the indicator 170 represents the full retraction of the flexible needle embedding strip drive shaft 280 and the arcuate tunneling needle 162.

In the following, it will be seen that the arcuate tunneling needle 162 partially extends into the bone, as represented generally by Figures 5A and 5B, and as indicated by indicator indicator 284 of indicator 170. Figures 30E and 31F . The partial extension of the arcuate tunneling needle 162 into the bone in this manner causes the knob 160 to move upwardly as indicated by the hand 1 and then to move the handle 150, Lt; / RTI >

Figs. 30E, 30F, 30G, 30H, 30G, 30G and 30H corresponding to Figs. 6A and 6B are enlarged views B and 31G, The ratchet handle 150 is rotated relative to the axis of rotation defined by the shaft 154 as indicated by arrow 518 and the first reciprocating coupling element 220 is rotated through the pin 214 As indicated by the arrow 520 and moves forward linearly so that the sharp edges 275 of the first reciprocating coupling element 220 and the upper linear sawtooth rack 272 of the double rack linear toothed element 270 Pushes the double rack straight toothed element 270 and the needle embedding strip drive shaft 280 forward and thereby causes the arcuate tunneling needle 162 to move in the direction of the arcuate bore 352 Through a portion 354 having a rectangular cross section, Into a type moving along the path and through the bone denotes to be combined with the bone stretched out to the edge.

 Figure 30h shows that the double rack straight toothed element 270 can be moved forward and backward by gripping the handle 150 one or more times to thereby achieve an arcuate extension of the continuous arcuate tunneling needles 162, The handle 150 is subjected to the force of a spring 248 which causes the pointed edge 275 to be operatively disengaged from the upper linear sawtooth rack 272 of the dual rack straight toothed element 270, Backward.

By the simultaneous engagement of the gear 290 with the upper linear gear rack 286 of the lower linear gear rack 274 of the double rack linear toothed element 270 and the second double rack linear toothed element 285, It can be seen that the rearward movement of the second double rack linear toothed element 285 is performed corresponding to the forward rectilinear movement of the linear toothed element 270.

Figures 30i and 31h, which generally correspond to Figures 7a-8b, move knob 160 downward, as indicated by arrow 532 and hand 1, as shown by arrow 535 and hand 2, By retracting the handle 150, it is shown that the arcuate tunneling needles 162 embedded in the bones are retracted in an arcuate fashion, as indicated by arrow 534. Prior to this retraction, the operator pulls back the suture 144, as indicated by arrow 536, to pull the suture along the arcuate path of travel of the arcuate tunneling needle 162 by retraction of the arcuate tunneling needle 162 To engage with the suture engaging groove 164 of the arcuate tunneling needle 162 and to be retained in the suture engaging groove 164 by the partially overlying portion 357 of the arcuate tunneling needle 162.

30J and 31I corresponding generally to FIGS. 9A and 9B illustrate that by partially retracting the arcuate tunneling needle 162 in engagement with the suture 144, the suture 144 ) To be traversed through the arcuate passage. This partial retraction is accomplished by continuously grasping the handle 150, as indicated by arrow 535. [ During this retraction, the operator may notice that the operator continues to pull the suture 144 backward as indicated by arrow 536.

Figs. 30K and 31J, which generally correspond to Figs. 10A and 10B, show the complete retraction of the arcuate tunneling needles 162. Fig. The full retraction of the arcuate tunneling needle 162 is indicated by the indicator 284 of the indicator 170. In this step, the suture 144 extends completely through the bone along the arcuate path opened by the arcuate tunneling needle 162, as described above, in a folded, overlapping fashion. This retraction is accomplished by grasping the handle 150, as indicated by arrow 535. During this retraction, the operator may notice that the operator continues to pull the suture 144 backward, as indicated by arrow 536.

Figs. 30L and 31K show that the front portion 128 is unlocked from the housing by operation of the forward knurled working fixing knob 138 as described above.

30M and 31L, which generally correspond to FIGS. 11A and 11B, show that the bone-engaging pin engaging assembly 120, with the suture 144 extending into the bone and still attached to the arcuate tunneling needle 162, Is withdrawn from the state of engagement with the bone.

 31M shows removal of the arthroscopic apparatus 100 from the patient through the incision 501. Fig.

Figures 30n and 31n, generally corresponding to Figures 12a and 12b, show that the arcuate tunneling needles 162 partially re-extend so that the suture 144 can be separated from the arcuate tunneling needles 162 by hand. . This partial re-stretch is accomplished by moving the knob 160 upwardly, as indicated by the hand 1, and then actuating the handle 150, as indicated by the hand 2. After this partial re-stretch, the suture 144 is manually removed, as indicated by the hand 3

By gripping the handle 150, as indicated by arrow 540, the double rack straight serration element 270 is moved forward, thereby pushing the needle embedding strip drive shaft 280 forward, Moving coupling element 220 by moving knob 160 upward, as indicated by arrow 538, to partially re-extend arcuate tunneling needle 162, as indicated by arrow 542, This causes the sharp edges 275 of the coupling element 220 to engage the upper straight ratchet rack 272 of the double rack linear toothed element 270, as can be seen in FIG.

Those skilled in the art will recognize that the invention is not limited by what has been particularly shown and described hereinabove. Rather, the scope of the invention encompasses the various features described above, as well as combinations and subordinate combinations of modifications thereof, which are not in the prior art, but which can be read by those skilled in the art and be described in the head.

Claims (20)

An arthroscopic bone tunneling and sealing device,
A bone-joint needle, and can be arthroscopically inserted through the arthroscopic incision to engage the patient's bone at the first bone site, and the needle is inserted into the bone at least along the arcuate tunneling path, A bone-engaging needle forging assembly configured to be able to be inserted into a 2-bone position; And
A bone-engaging pin engaging assembly configured to be operably engaged with the bone-engaging needle engaging assembly and configured to be arthroscopically inserted into the patient's bone at a third bone position through the arthroscopically- ;
And a bone tunneling and sealing device for arthroscopic bone tunneling. 2. The method of claim 1, wherein the bone-engaging pin embedding assembly is configured to mount a suture and configured to position the suture so that the suture can engage the needle at the second bone location Bone tunneling and closure devices for arthroscopic surgery. 3. The method of claim 2, wherein the bone-engaging needle-punching assembly is further configured to retract the needle from the second bone position, along with the suture, through the bone along the arcuate tunneling path And the bone tunneling and sealing apparatus for arthroscopic surgery. 4. The method of claim 2 or 3, wherein the bone-engaging pin engaging assembly is configured to guide the bone-engaging pin from the third bone location along a generally straight tunneling path to the second bone location where the generally straight tunneling path meets the substantially arcuate tunneling path. Wherein at least one bone tunneling pin is operative to tunnel the bone until the suture thread is in contact with the needle at the second bone location, thereby positioning the suture thread Bone tunneling and suturing devices. 5. The bone-engaging pin engaging assembly of claim 1, wherein the bone-engaging pin engaging assembly is separate from the bone-engaging needle engaging assembly and can be selectively engageable with the bone-engaging needle engaging assembly. And wherein said bone tunneling and sealing device is removable from said bone-coupled needle forging assembly. 2. The bone tunneling and sealing apparatus of claim 1, wherein the bone-engaging pin engaging assembly includes an inner pin and an outer hollow pin slidably disposed on the inner pin. [7] The apparatus of claim 6, wherein the outer hollow pin has a pointed end and a through hole. 8. The needle assembly of claim 7, wherein the suture extends between the inner pin and the outer pin, and the suture is annularly formed around the inner pin within the outer pin so as to engage the needle through the through hole And the bone tunneling and suturing device for arthroscopic surgery. 8. The bone-engaging pin engaging assembly of claim 7, wherein the bone-engaging pin engaging assembly further comprises a base assembly including a front portion and a rear portion, the inner pin is coupled to the rear portion, And the bone tunneling and suturing device for arthroscopic surgery. 10. The apparatus of claim 8 or 9, wherein the outer hollow pin is also formed with a sidewall penetrating slot for receiving a portion of the suture. 11. The suture of claim 10, wherein the suture is wrapped around a forward end of the inner pin and between the forward end and the pointed end of the inner pin and extends between the inner pin and the outer pin, Wherein the bone tunneling and suturing device is partially located in the through slot on both sides. 12. Arthroscopic bone tunneling device according to any one of claims 9 to 11, characterized in that the base assembly is selectably fastenable to a housing surrounding a part of the bone- And a sealing device. 13. A device as claimed in any one of claims 9 to 12, wherein the front portion and the rear portion of the base assembly are selectably mutually fixed and axially slidable with respect to each other, Wherein said inner pin provides a limited retraction of said inner pin relative to said bone. 14. The bone-engaging needle assembly according to any one of claims 1 to 13, wherein the bone-engaging needle embedding assembly comprises a flexible needle embedding strip for engaging the bone-engaging needle along the arcuate tunneling path into the bone And the bone tunneling and suturing device for arthroscopic surgery. A method of tunneling bone during arthroscopic surgery,
A bone-engaging pin embedding assembly and an arthroscopic incision can be arthroscopically inserted to engage the patient's bone at the first bone site and can be arthroscopically inserted into the bone along at least the second bone site along the arcuate tunneling path. Providing a bone-engaging needle embedding assembly including a bone-engaging needle configured to be pushed forward;
Operatively engaging the bone-engaging pin engaging assembly with the bone-engaging needle engaging assembly;
Inserting the bone-engaging needle forging assembly through the arthroscopic incision in association with the bone at the first bone location;
Inserting the bone-bonding pin insertion assembly through the arthroscopic incision in combination with the patient's bone at a third bone location;
Tunneling the bone with the bone-engaging pin engaging assembly along a generally linear tunneling path from the third bone position to the second bone position; And
Engaging the needle with the bone-engaging needle embossing assembly along the generally arcuate tunneling path from the first bone location to at least the second bone location;
And tunneling the bone with the bone-joining needle along the generally arcuate tunneling path from the first bone location to at least the second bone location. 16. The method of claim 15,
Attaching the suture to the bone-engaging pin engaging assembly prior to operatively engaging the bone-engaging pin engaging assembly with the bone-engaging needle engaging assembly; And
Engaging the needle with the suture at the second bone location, following the step of inserting the needle;
≪ / RTI > The method of claim 1, further comprising the step of: braiding the bone during arthroscopic surgery. 18. The method of claim 16, further comprising retracting the needle along the generally arcuate tunneling pathway in engagement with the suture, subsequent to engaging the suture with the needle. How to tunnel your bones. 18. The method of claim 17, further comprising retracting the bone-engaging pin engaging assembly from a state of engagement with the bone, following the step of retracting the needle. Way. 19. The method of claim 18, wherein after the step of retracting the bone-
Partially re-extending the needle; And
Separating the suture from the needle;
≪ / RTI > The method of claim 1, further comprising the step of: braiding the bone during arthroscopic surgery. 20. The method according to any one of claims 16 to 19,
Coupling the bone-engaging pin engaging assembly to the bone-engaging needle engaging assembly,
Aligning the bone-engaging pin engaging assembly with the bone-engaging needle engaging assembly such that the needle can engage the suture at the second bone location; And
Subsequently pinning the bone-engaging pin engaging assembly axially and rotationally to the bone-engaging needle engaging assembly;
≪ / RTI > The method of claim 1, further comprising the step of: braiding the bone during arthroscopic surgery.

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