EP0711535A1
Expired / Lapsed
EP
⏱️ 0.0 years remaining
Bone graft delivery system and method
Assignee: Howmedica Osteonics Corp
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Filing: 1995-11-06
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Granted: —
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Expires: 2015-11-06
Abstract
Abstract A surgical technique for the delivery of bone graft to a medullary canal and implantation of a prosthetic device (35) includes placing bone graft into an elongate hollow tube (10) and arranging a plunger (20) having an elongate rod portion (21) into the hollow tube (10). The hollow tube (10), bone graft and plunger (20) assembly are inserted into the medullary canal which has been prepared for the assembly by reaming the medullary canal with a reamer corresponding in size to the hollow tube (10). The hollow tube (10) is withdrawn from the medullary canal while the plunger (20) is pushed into the canal, resulting in bone graft exiting the hollow tube (10) and being packed by the plunger (20). A trial prosthesis (30) is used to shape the bone graft within the canal for the prosthesis (35). Space for a cement mantle can be left through the use of an appropriately sized trial prosthesis (30).
Inventors
- 👤 Margaret Elizabeth Smith
- 👤 Michael Joseph Cusick
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-27 22:20
CPC Classifications
A; A61; A61F; A61F2/00; A61F2/02; A61F2/30; A61F2/46; A61F2/4601; A61B; A61B17/00; A61B17/56; A61B17/58; A61B17/88; A61B17/8802; A61B17/8805; A61B17/8822; A61F2/30721; A61F2/30723; A61F2/30724; A61F2/32; A61F2/36; A61F2/3662; A61F2/3676; A61F2/4603; A61F2/4607; A61F2/4684; A61F2/28; A61F2002/2835; A61F2002/4631
Claims Analysis
Total Claims: 50
Claim 1
Independent Claim
64 words
A method of preparing bone graft for insertion into a graft receiving area, characterized by the steps of: a. providing a hollow tube (10) having a first end and a second end; and b. placing bone graft into the hollow tube (10), whereby the hollow tube (10) with bone graft therein can be used to deliver the bone graft to a graft receiving area.
Claim 2
Dependent Claim
39 words
The method in Claim 1, further characterized by the step of using a graft retaining structure (22,24) which substantially blocks an end of the hollow tube (10) to facilitate the exit of bone graft from the hollow tube (10).
Claim 3
Dependent Claim
33 words
The method in Claim 2, characterized in that the graft retaining structure (22, 24) is used by maintaining it in one position while moving the tube (10) away from the graft retaining area.
Claim 4
Independent Claim
74 words
A method of preparing bone graft for insertion into a medullary canal of bone, characterized by the steps of: a. providing a hollow tube (10) having a first end and a second end, and being adapted for insertion into a medullary canal; and b. placing bone graft into the hollow tube (10), whereby the hollow tube (10) with the bone graft therein can be used to deliver the bone graft to the medullary canal.
Claim 5
Dependent Claim
82 words
The method in Claim 4, further characterized by the step of arranging a plunger (20) having an elongate rod portion (21) at least partially in the hollow tube (10), whereby the movement of the hollow tube in the direction from the first end to the second end together with the application of pressure to the plunger in the direction from the second end to the first end of the hollow tube facilitates the exit of the bone graft from the hollow tube.
Claim 6
Dependent Claim
80 words
The method in Claim 5, characterized in that the plunger (20) includes a graft retaining portion (22, 24) so that when the plunger (20) is arranged in the hollow tube (10), the graft retaining portion (22, 24) of the plunger (20) will substantially block the second end of the hollow tube (10), thereby facilitating the exit of the bone graft from the first end of the hollow (10) tube into the medullary canal during withdrawal of the hollow tube (10).
Claim 7
Dependent Claim
28 words
The method in Claim 6, characterized in that the graft retaining portion (22, 24) is a flange which is larger in cross-section than the elongate rod portion (21).
Claim 8
Dependent Claim
28 words
The method in Claim 6, characterized in that the graft retaining portion (22, 24) is a flange which bears against the interior surface of the hollow tube (10).
Claim 9
Dependent Claim
40 words
The method in Claim 7, characterized in that the flange (22, 24) is so constructed and arranged that the rod portion (21) of the plunger (20) is substantially maintained in a desirable position with respect to the hollow tube (10).
Claim 10
Dependent Claim
48 words
The method in Claim 9, characterized in that the plunger (20) has first and second ends corresponding to the first and second ends of the hollow tube (10), and characterized in that the flange (22, 24) is a cap (22) on the second end of the plunger (20).
Claim 11
Dependent Claim
39 words
The method in Claim 6, characterized in that the graft retaining portion (24) is also a positioning device for maintaining the rod portion (21) of the plunger (20) in a desirable position with respect to the hollow tube (10).
Claim 12
Dependent Claim
61 words
The method in Claim 11, further characterized by a cap (22) on an end of the plunger (20), the cap (122) having an outer surface which bears against the interior surface of the hollow tube (10), the cap (22) together with the positioning device (24) maintains the rod portion (21) in a desirable position with respect to the hollow tube (10).
Claim 13
Dependent Claim
46 words
The method in Claim 12, characterized in that the graft retaining portion (24) includes a collar (24) positioned medially on the plunger (20) above the elongate rod portion (21), the collar having an outer surface which bears against the interior surface of the hollow tube (10).
Claim 14
Dependent Claim
33 words
The method in Claim 13, characterized in that the cap (122) and the collar (124) are removeable from the plunger (20) and are selectable from a plurality of differently sized caps and collars.
Claim 15
Dependent Claim
22 words
The method in Claim 14, further characterized by the step of providing an additional positioning device (52, 54) below the collar (24).
Claim 16
Dependent Claim
33 words
The method in Claim 15, characterized in that the additional positioning device (52, 54) comprises screws (52a, 52b) adapted to be threaded through the hollow tube (10) to engage the rod portion (21).
Claim 17
Dependent Claim
46 words
The method in Claim 15, characterized in that the additional positioning device (52, 54) is a washer (54) disposed around the rod portion (21) by an interference fit and slideable along the rod portion (21) during the insertion of the bone graft into the tube (10).
Claim 18
Dependent Claim
44 words
The method in Claim 5, characterized in that the plunger (20) includes a positioning (24, 52, 54) device associated with the hollow tube (10) for maintaining the rod portion of the plunger (20) in a desirable position with respect to the hollow tube (10).
Claim 19
Dependent Claim
26 words
The method in Claim 5, characterized in that the bone graft is placed into the elongate hollow tube (10) after the plunger (20) is arranged therein.
Claim 20
Dependent Claim
66 words
The method in Claim 19, further characterized by the step of packing bone graft into the hollow tube (10) around the rod portion (21) of the plunger (20) with an at least partially hollow bone graft packer (26) by arranging the bone graft packer (26) around the plunger (20) and inside of the hollow tube (10) and forcing the bone graft into the hollow tube (10).
Claim 21
Dependent Claim
37 words
The method in Claim 5, characterized in that the rod portion (21) of plunger (20) is at least partially tapered from large to small from the second end to the first end of the hollow tube (10).
Claim 22
Dependent Claim
31 words
The method in Claim 5, characterized in that the rod portion (21) of the plunger (20) has a configuration which is similar to at least a portion of the prosthesis configuration.
Claim 23
Dependent Claim
56 words
The method in Claim 5, characterized by the step of selecting an appropriately sized reamer from a set of differently sized reamers, the selected reamer to correspond in size with the hollow tube (10), and further including the step of reaming the medullary canal to prepare the medullary canal for receiving the selected hollow tube (10).
Claim 24
Dependent Claim
50 words
The method in Claim 5, characterized in that the bone graft is disposed in only a portion of the hollow tube (10) such that upon the withdrawal of the hollow tube (10) from the medullary canal, the bone graft can be delivered to a selected area of the medullary canal.
Claim 25
Dependent Claim
97 words
Surgical instruments characterized by a hollow tube (10) having a first end and a second end, and being constructed so that it can receive bone graft to be delivered to a graft receiving area of a body, so that said first end can be arranged at least adjacent to the graft receiving area, and so that the bone graft can be delivered from said first end of said hollow tube (10) to the graft receiving area of a body upon movement of said hollow tube (10) in a direction from said first end to said second end.
Claim 26
Dependent Claim
55 words
The instruments in Claim 25, further characterized by a graft retaining structure (24, 52, 54) which substantially blocks an end of the hollow tube (10) to facilitate the exit of bone graft from the hollow tube (10) during movement of the hollow tube (10) in a direction from the first end to the second end.
Claim 27
Dependent Claim
120 words
The instruments in Claim 25, characterized in that said hollow tube (10) is adapted to be inserted into a medullary canal, and further including a plunger (20) having an elongate rod portion (21) adapted to be removably inserted into to said hollow tube (10), at least a portion of said elongate rod portion (21) being spaced from said hollow tube (10) to create a space for bone graft, said hollow tube (10) and plunger (20) being so constructed and arranged as to facilitate the withdrawal of said hollow tube (10) from a medullary canal while leaving in the medullary canal the plunger (20) and bone graft, said plunger (20) being constructed to pack the bone graft within the medullary canal.
Claim 28
Dependent Claim
52 words
The instruments in Claim 27, characterized in that said plunger (20) includes a graft retaining portion (24, 52, 54) which substantially blocks an end of the hollow tube (10) to facilitate the exit of bone graft from the hollow tube (10) into the medullary canal during withdrawal of the hollow tube (10).
Claim 29
Dependent Claim
39 words
The instruments in Claim 28, characterized in that the graft retaining portion (24) is also a positioning device for maintaining the rod portion (21) of the plunger (20) in a desirable position with respect to the hollow tube (10).
Claim 30
Dependent Claim
62 words
The instruments in Claim 29, further characterized by a cap (22) on an end of the plunger (20), the cap (22) having an outer surface which bears against the interior surface of the hollow tube (10), the cap (22) together with the graft retaining portion (24) substantially maintain the rod portion in a desirable position with respect to the hollow tube (10).
Claim 31
Dependent Claim
47 words
The instruments in Claim 29, characterized in that the graft retaining portion (24) includes a collar (24) positioned medially on the plunger (20) above the elongate rod portion (21), the collar (24) having an outer surface which bears against the interior surface of the hollow tube (10).
Claim 32
Dependent Claim
33 words
The instruments in Claim 31, characterized in that the cap (22) and the collar (24) are removeable from the plunger (20) and are selectable from a plurality of differently sized caps and collars.
Claim 33
Dependent Claim
44 words
The instruments in Claim 27, characterized in that said plunger (20) includes a positioning device (22, 24, 52, 54) associated with said hollow tube (10) for maintaining the rod portion of the plunger in a desirable position with respect to the hollow tube (10).
Claim 34
Dependent Claim
18 words
The instruments in Claim 33, further characterized by an additional positioning device (52, 54) below the collar (24).
Claim 35
Dependent Claim
33 words
The instruments in Claim 34, characterized in that the additional positioning device (52, 54) comprises screws (52a, 52b) adapted to be threaded through the hollow tube (10) to engage the rod portion (21).
Claim 36
Dependent Claim
46 words
The instruments in Claim 34, characterized in that the additional positioning device (52, 54) is a washer (54) disposed around the rod portion (21) by an interference fit and slideable along the rod portion (21) during the insertion of the bone graft into the tube (10).
Claim 37
Dependent Claim
31 words
The instruments in Claim 33, characterized in that said positioning device (22, 24) is a cap (22) on an end of said plunger and a collar located medially on said plunger.
Claim 38
Dependent Claim
24 words
The instruments in Claim 33, characterized in that at least a portion of said elongate rod portion (21) of said plunger (20) is tapered.
Claim 39
Dependent Claim
24 words
The instruments in Claim 27, characterized in that at least a portion of said elongate rod portion (21) of said plunger (20) is tapered.
Claim 40
Dependent Claim
33 words
The instruments in Claim 39, characterized in that said tapered portion of said elongate rod portion (21) matches at least a portion of a prosthetic device to be implanted in the medullary canal.
Claim 41
Dependent Claim
43 words
The instruments in Claim 27, characterized in that at least a portion of said elongate rod portion (21) of said plunger (20) is of a shape which is similar to the shape of a prosthetic device to be implanted in the medullary canal.
Claim 42
Dependent Claim
49 words
The instruments in Claim 25, further characterized by a bone graft packer (26), at least a portion of said bone graft packer (26) being hollow, said bone graft packer (26) being sized to fit telescopically within said hollow tube (10) to pack bone graft into the hollow tube (10).
Claim 43
Dependent Claim
66 words
The instruments in Claim 27, further characterized by a bone graft packer (26), at least a portion of said bone graft packer (26) being hollow, said bone graft packer (26) being sized to fit telescopically within said hollow tube (10) about said plunger (10) to pack bone graft into the hollow tube (10) prior to the insertion of the hollow tube/plunger assembly into a medullary canal.
Claim 44
Dependent Claim
34 words
The instruments in Claim 43, further characterized by an extraction cap (12) attached to an end of said hollow tube (10) to facilitate the withdrawal of the hollow tube (10) from the medullary canal.
Claim 45
Dependent Claim
126 words
The instruments in Claim 44, further characterized by an extractor (36) to facilitate the withdrawal of the hollow tube (10) from a medullary canal, said extractor (36) including a housing, means (38) for connecting said housing to said extraction cap (12), a rod (39) moveable within said housing for applying pressure to said plunger (20) upon actuation of the extractor (36), and actuating means for applying pressure to said plunger (20), said extractor (36) being constructed and arranged so that upon the actuation of said extractor (36), said rod (39) applies pressure against said plunger (20), and said housing, together with said extraction cap (12) and hollow tube (10), move away from said plunger (20) to thereby withdraw the hollow tube (10) from the medullary canal.
Claim 46
Dependent Claim
29 words
The instruments in Claim 25, characterized in that the hollow tube (10) is made of a disposable material, such that it can be disposed of after a single use.
Claim 47
Dependent Claim
39 words
The instruments in Claim 25, further characterized by bone graft (50) within the hollow tube (10), the hollow tube (10) and bone graft (50) being capable of being stored for a period of time for use in a surgery.
Claim 48
Dependent Claim
29 words
The instruments in Claim 46, characterized in that the hollow tube (10) is made of a disposable material, such that it can be disposed of after a single use.
Claim 49
Dependent Claim
185 words
Surgical instruments characterized by an extractor (36) to facilitate the controlled movement of a tube (10) which surrounds a rod (20) in an arranged position, while leaving the rod (20) substantially in the arranged position, said extractor (36) including a housing, a connector (38) for connecting the housing to the tube (10), a stem (39) movable within said housing for applying pressure to a rod (20) in its arranged position upon actuation of the extractor (36), and actuating means for applying pressure to such a rod (20), said stem (39) having a rod-engaging portion (39a) sized to engage a rod (20) in a tube (10) and to permit the tube (10) to be withdrawn from around the rod (20) so that the tube (10) is disposed around the stem (39), said extractor (36) being constructed and arranged so that upon actuation of said extractor (36), said stem (39) applies pressure against the rod (20), and said housing, together with a connected tube (10), move the tube (10) away from the arranged position and the rod (20), thereby leaving the rod (20) in the arranged position.
Claim 50
Dependent Claim
17 words
The instruments in Claim 49, characterized in that said extractor (36) is a modified cement injector gun.
References Cited (Backward Citations)
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