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WO2010046426A1 - Trephine for extracting a bone graft and for placing said graft - Google Patents

Trephine for extracting a bone graft and for placing said graft Download PDF

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Publication number
WO2010046426A1
WO2010046426A1 PCT/EP2009/063864 EP2009063864W WO2010046426A1 WO 2010046426 A1 WO2010046426 A1 WO 2010046426A1 EP 2009063864 W EP2009063864 W EP 2009063864W WO 2010046426 A1 WO2010046426 A1 WO 2010046426A1
Authority
WO
WIPO (PCT)
Prior art keywords
trephine
housing
bone
needle
graft
Prior art date
Application number
PCT/EP2009/063864
Other languages
French (fr)
Inventor
Jordi Asuncion Marquez
Original Assignee
Hospital Clinic I Provincial De Barcelona
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Hospital Clinic I Provincial De Barcelona filed Critical Hospital Clinic I Provincial De Barcelona
Publication of WO2010046426A1 publication Critical patent/WO2010046426A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A61B10/025—Pointed or sharp biopsy instruments for taking bone, bone marrow or cartilage samples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1635—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for grafts, harvesting or transplants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1637—Hollow drills or saws producing a curved cut, e.g. cylindrical

Definitions

  • the present invention relates to the field of bone surgery. More specifically, the invention relates to a trephine capable of operating efficiently with a motor-operated drive, without the drive by said motor involving any reduction in the quality of the bone cylinder obtained, as well as reliably selecting the area from which the bone cylinder is to be extracted.
  • Trephines which allow obtaining a graft or bone cylinder for the purpose of being used in subsequent operations, are applicable in the field of bone surgery.
  • the operation is typically performed such that at an end of the trephine there is arranged a housing with its free end toothed, such than upon turning or rotating on the bone, it is drilled and the bone cylinder is located inside the housing.
  • United States patent US 6,200,319 which describes a trephine operating according to the aforementioned principle, can be mentioned.
  • a trephine operating according to that set forth in the previous paragraph has the following drawbacks. Firstly, when selecting and placing the end of the housing in a position in which the extracted bone cylinder is optimal can be complex given the fact that the trephine itself can hinder the view of the bone. Secondly, in the turning movement of the trephine during the drilling, given the rigidity of the cortical layer of the bone, a shifting of the trephine may occur, with the consequent error and discomfort that this may cause in the patient and the surgeon.
  • the invention in a first aspect, relates to a trephine comprising a distal end in which there is located a housing, with a cylindrical configuration for example, for housing a bone graft, typically a bone cylinder, the longitudinal axis of said housing being an axis of rotation of said housing.
  • said trephine additionally comprises a needle integral therewith located in the axis of rotation of the housing, the needle being configured to have a relative movement with the housing. Said relative movement consists of the capacity of the needle to move in the direction of the axis of rotation, being more or less introduced in the housing.
  • the function of the needle is to act as a guide of the trephine, such that it is possible to easily select the area in which the housing is to be introduced to obtain the bone cylinder.
  • the tip of the needle i.e., its distal end, must simply be aimed towards the area in which the graft is to be obtained.
  • the needle can subsequently be driven into the bone, being fixed in the cortical layer, determining the area in which the extraction will be performed and the orientation which said extraction will have. A relative movement between the trephine and the bone during the first moments of the process for obtaining the graft is thus not possible.
  • the obtained graft will additionally be attached to the needle, given that the latter is located in the axis of rotation of the housing.
  • the needle itself can comprise at least one protrusion, such that said protrusion marks a point after which the needle cannot penetrate further into the bone, i.e., a stop for obtaining the graft.
  • the penetration of the needle in the bone is determined by the defined protrusion, there being able to be different needles for achieving different bone cylinders or grafts with a different length.
  • Said at least one protrusion will be arranged inside the housing.
  • the possible forms of the protrusions can be, for example, outer radii in a variable number, or a disk.
  • the trephine could be driven by a motor.
  • the trephine could be motor- operated without this operation by a motor involving any drawback or loss of quality of the obtained cylinder.
  • the presence of the needle of the trephine of the invention allows the use of a motor given that the possible vibrations that the motor may cause are not detrimental to the insertion of the housing, since the trephine is fixed to the cortical layer of the bone through the needle.
  • Figure 1 shows a general view of the trephine of the invention. - A -
  • Figure 2 shows a detail view of the needle of the trephine of the invention.
  • Figure 3 shows a perspective view of the housing of the trephine of the invention.
  • Figure 4 shows the trephine of the invention, once the graft has been extracted. The graft is confined inside the housing of the trephine.
  • the housing (1 ) shown in the figure has a cylindrical configuration and can be substituted with other possible housings (1 ) with a different configuration, the parameters defining each housing (1 ) being the diameter thereof and its depth. At its distal end the housing (1 ) will have a sharp or toothed edge, such that it possible to drill a bone upon rotating. All these constructive details can be observed in Figure 3.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Hematology (AREA)
  • Immunology (AREA)
  • Rheumatology (AREA)
  • Pathology (AREA)
  • Surgical Instruments (AREA)

Abstract

The present invention relates to a trephine, comprising a distal end in which there is located a housing (1) for housing a bone graft (2), the longitudinal axis of said housing (1) being an axis of rotation. Said trephine additionally comprises a needle (3) integral therewith located in the axis of rotation of the housing (1), the distal end of the needle (3) being configured to project outside the housing (1) and to be inside said housing (1). As a result of this needle (3), the processes for obtaining and placing bone grafts (2) are improved, due to the capacity of the needle (3) to act as a guide, as well as to collaborate in the fixing of the trephine to the bone in the process of penetration of the housing (1) and to facilitate the extraction of the graft (2) from the inside of the trephine.

Description

TREPHINE FOR EXTRACTING A BONE GRAFT AND FOR PLACING SAID GRAFT
Field of the Invention The present invention relates to the field of bone surgery. More specifically, the invention relates to a trephine capable of operating efficiently with a motor-operated drive, without the drive by said motor involving any reduction in the quality of the bone cylinder obtained, as well as reliably selecting the area from which the bone cylinder is to be extracted. Background of the Invention
Trephines, which allow obtaining a graft or bone cylinder for the purpose of being used in subsequent operations, are applicable in the field of bone surgery. The operation is typically performed such that at an end of the trephine there is arranged a housing with its free end toothed, such than upon turning or rotating on the bone, it is drilled and the bone cylinder is located inside the housing. In this sense, United States patent US 6,200,319, which describes a trephine operating according to the aforementioned principle, can be mentioned.
A trephine operating according to that set forth in the previous paragraph has the following drawbacks. Firstly, when selecting and placing the end of the housing in a position in which the extracted bone cylinder is optimal can be complex given the fact that the trephine itself can hinder the view of the bone. Secondly, in the turning movement of the trephine during the drilling, given the rigidity of the cortical layer of the bone, a shifting of the trephine may occur, with the consequent error and discomfort that this may cause in the patient and the surgeon.
Application WO 97/14361 partially solves some of the problems mentioned in the previous paragraph, by means of a cylinder with a tip inside the trephine allowing the trephine to not move upon performing the initial drilling. However, once the first turns of the trephine have been performed, the entire device must be disassembled in order to continue introducing the trephine and obtain the cylinder. The cylinder with a tip of the international application is thus only applicable for the initial centering. After introducing the entire trephine, the entire device must again be disassembled in order to be able to remove the graft from its inside with a plunger. Thus, obtaining the bone cylinder is very laborious given the need to repeatedly disassemble the device, as well as the need to have an additional plunger to release the graft. Likewise, the described trephine does not allow easily placing the bone cylinder in a subsequent operation, it being necessary to have some type of additional surgical apparatus for performing this task. Description of the Invention
In a first aspect, the invention relates to a trephine comprising a distal end in which there is located a housing, with a cylindrical configuration for example, for housing a bone graft, typically a bone cylinder, the longitudinal axis of said housing being an axis of rotation of said housing. According to the invention, said trephine additionally comprises a needle integral therewith located in the axis of rotation of the housing, the needle being configured to have a relative movement with the housing. Said relative movement consists of the capacity of the needle to move in the direction of the axis of rotation, being more or less introduced in the housing. The function of the needle is to act as a guide of the trephine, such that it is possible to easily select the area in which the housing is to be introduced to obtain the bone cylinder. To that end, the tip of the needle, i.e., its distal end, must simply be aimed towards the area in which the graft is to be obtained. The needle can subsequently be driven into the bone, being fixed in the cortical layer, determining the area in which the extraction will be performed and the orientation which said extraction will have. A relative movement between the trephine and the bone during the first moments of the process for obtaining the graft is thus not possible.
Therefore, with the inclusion of the needle, two of the problems existing in the state of the art are solved, which are the need to have a means allowing the effective selection of the area of the bone in which the extraction is to be performed and the fixing or limitation of the movement of the trephine in the initial moments of the extraction of the graft.
The obtained graft will additionally be attached to the needle, given that the latter is located in the axis of rotation of the housing. For the purpose of being able to have the bone cylinder, defining its length and facilitating its removal from the housing and from the needle, the needle itself can comprise at least one protrusion, such that said protrusion marks a point after which the needle cannot penetrate further into the bone, i.e., a stop for obtaining the graft. Thus, in the aforementioned moment in which the needle is driven into the bone, the penetration of the needle in the bone is determined by the defined protrusion, there being able to be different needles for achieving different bone cylinders or grafts with a different length. Said at least one protrusion will be arranged inside the housing. The possible forms of the protrusions can be, for example, outer radii in a variable number, or a disk.
The trephine could be driven by a motor. The trephine could be motor- operated without this operation by a motor involving any drawback or loss of quality of the obtained cylinder. Compared to other trephines of the state of the art in which the operation by a motor is not viable given the nil fixing of the trephine to the bone, since the point of insertion of the trephine can be modified due to the rotational speed of the motor, the presence of the needle of the trephine of the invention allows the use of a motor given that the possible vibrations that the motor may cause are not detrimental to the insertion of the housing, since the trephine is fixed to the cortical layer of the bone through the needle.
Description of the Drawings
To complement the description which is being made and for the purpose of aiding to better understand the features of the invention, a set of drawings is attached as an integral part of said description, in which the following has been depicted with an illustrative and non-limiting character:
Figure 1 shows a general view of the trephine of the invention. - A -
Figure 2 shows a detail view of the needle of the trephine of the invention.
Figure 3 shows a perspective view of the housing of the trephine of the invention. Figure 4 shows the trephine of the invention, once the graft has been extracted. The graft is confined inside the housing of the trephine.
Figure 5 shows the trephine of Figure 4, in which the graft has been extracted from the housing, pushing the needle towards the outside of the housing. Preferred Embodiment of the Invention
A preferred embodiment of the trephine object of this invention is described below with reference to the figures. The terms bone cylinder or cylinder and graft (2) will be used without distinction throughout the invention.
Figure 1 shows a general view of the trephine of the invention, in which the drive motor of the trephine, the housing (1 ) and the needle (3) can be observed.
The housing (1 ) shown in the figure has a cylindrical configuration and can be substituted with other possible housings (1 ) with a different configuration, the parameters defining each housing (1 ) being the diameter thereof and its depth. At its distal end the housing (1 ) will have a sharp or toothed edge, such that it possible to drill a bone upon rotating. All these constructive details can be observed in Figure 3.
Figure 2 shows a possible embodiment of the needle (3) of the trephine of the invention. As in the case of the housings (1 ), there can be different configurations of needles (3), the parameter of each of the possible configurations being the distance at which the stop or protrusion (4) is located. In this case the protrusion (4) will have the form of a disk perpendicular to the longitudinal axis of the needle (3). The stop (4) will be located inside the housing (1 ), typically and during the extraction process at the bottom of said housing (1 ). Thus, when the extraction is performed, the stop (4) does not substantially modify the parameters of the housing (1 ). Likewise, the graft (2) can be extracted by simply pushing the needle (3) until removing the graft (2) from the housing (1 ).
The extraction will be performed with the aid of the needle (3), which will act as a guide, aiming at the area from which the bone cylinder (2) is to be obtained with such needle. By driving the needle (3) into the cortical layer of the bone until the stop (4), the trephine will be fixed to the bone, such that the motor can start driving the trephine, making the housing (1 ) turn, which housing, as a result of its sharp edges will penetrate the bone, a graft (2) according to the parameters established by the housing (1 ) being obtained. As has already been mentioned, the cylinder (2) will be obtained by pushing the needle (3) until the graft (2) is located outside the housing (1 ).
Figure 4 shows the trephine once the extraction has ended, in which the graft (2) is located inside the housing (1 ) of the trephine. Figure 5 shows the graft (2) outside the housing (1 ). The graft (2) has been extracted out of the housing by simply moving the needle (3) out of the housing (1 ), pulling the graft due to the effect of the stop (4) of the needle (3).
The placement of the bone cylinder (2) in the bone or joint will be performed in a manner similar to the extraction thereof. As in the previous case, the placement area can be easily selected by aiming with the needle (3). Likewise, the orientation in which the bone cylinder (2) must be placed can be established by considering the orientation of the needle (3). Once these parameters are established, a cavity will be made with a diameter equal to or slightly less than the diameter of the bone cylinder (2) to be placed, typically one millimeter less. The bone cylinder (2) can be placed in the cavity made, using to that end the needle (3) with the defined stops (4). The bone cylinder (2) will be placed in the needle (3), inserting the needle (3) in the cavity according to the defined orientation. Given the size of the cavity, the bone cylinder (2) will fit tightly, therefore when the needle (3) is removed, the bone cylinder (2) will remain in the cavity, thus achieving placing the bone.
The trephine of the invention is also applicable for the fusion of a joint, this intervention being applicable in those cases of arthrosis, for example, in which the movement of the joint causes great pain, it being worthwhile to fuse the joint for the purpose of preventing the pain caused by its movement. The conventional solution for this operation consists of using concave- convex burs, such that a concave bur would act at the terminal end of one of the bones of the joint and the convex bur would act at the terminal end of the second bone. Two complementary ends are thus obtained which, with the aid of screws or clamps for fixing both ends, can calcify and fuse the joint.
The process proposed in the present invention is based on creating a male end and a female end in the two bones of the joint. The male end is configured by inserting the housing (1 ) of a trephine in the terminal end of one of the bones and eliminating, by means of a bur, for example, the bone portion which is not protected or covered by the housing (1 ). Since the housing (1 ) has a substantially cylindrical configuration, a boss is thus created at the terminal end of the first bone.
The female end, or cavity, is created by using a trephine such as the one described in the present invention. To that end, the cavity is made at the terminal end of the second bone, using a housing (1 ) identical to the one used to create the male end. The orientation of the trephine and the place in which the cavity is made can be defined without margin for error as a result of the guide needle (3).
The length of the boss and the cavity must be similar, in order for the attachment to be correctly performed, the depth of the cavity having to be in any case greater than or equal to the length of the boss. As a guideline value, a length of about 3-5 millimeters is proposed.
As has been explained, the joint will be fused by inserting the boss in the cavity. The joint is thus fused such that the end result can be the expected one, given that there is no possibility of the attachment being calcified in a manner different to the established one. This is not so with the known art. The attachment of concave-convex bone terminal ends does not allow fixing the final configuration of the attachment, due to that fact that during the calcification process there may be relative movements between the two bones of the joint.
In view of this description and set of drawings, the person skilled in the art will understand that the invention has been described according to a preferred embodiment thereof, but that multiple variations can be introduced in said preferred embodiment without departing from the object of the invention as it has been claimed.

Claims

1.- Trephine comprising a distal end in which there is located a housing (1 ) for housing a bone graft (2), the longitudinal axis of said housing (1 ) being an axis of rotation, characterized in that it additionally comprises a needle (3) integral with the trephine located in the axis of rotation of the housing (1 ), the needle (3) being configured to have a relative movement with the housing (1 ) in the direction of the axis of rotation.
2.- Trephine according to claim 1 , characterized in that the needle
(3) comprises at least one protrusion (4), said at least one protrusion (4) being located in the housing (1 ).
3.- Trephine according to claim 2, characterized in that the at least one protrusion (4) is a disk perpendicular to the axis of rotation.
4.- Trephine according to any of claims 1 -3, characterized in that it comprises a motor configured to drive the trephine.
5.- Trephine according to any of claims 1 -4, characterized in that the housing (1 ) has a cylindrical configuration.
PCT/EP2009/063864 2008-10-22 2009-10-22 Trephine for extracting a bone graft and for placing said graft WO2010046426A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ES200802989A ES2337436B1 (en) 2008-10-22 2008-10-22 TREFINA FOR THE EXTRACTION OF A BEAR GRAFT AND FOR THE PLACEMENT OF THE INJERTO.
ESP200802989 2008-10-22

Publications (1)

Publication Number Publication Date
WO2010046426A1 true WO2010046426A1 (en) 2010-04-29

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2009/063864 WO2010046426A1 (en) 2008-10-22 2009-10-22 Trephine for extracting a bone graft and for placing said graft

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ES (1) ES2337436B1 (en)
WO (1) WO2010046426A1 (en)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8920423B2 (en) 2011-01-21 2014-12-30 Benjamino Kah Hung LEE Bone harvesting device
US9925068B2 (en) 2014-05-30 2018-03-27 Treace Medical Concepts, Inc. Bone harvester and bone marrow removal system and method
CN110179521A (en) * 2019-06-25 2019-08-30 杨军 Combined bone taking device

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5632747A (en) * 1995-03-15 1997-05-27 Osteotech, Inc. Bone dowel cutter
FR2749154A1 (en) * 1996-05-30 1997-12-05 Jbs Sa Surgical trepanning implement
EP1488747A2 (en) * 1998-04-09 2004-12-22 SDGI Holdings, Inc. Method and instrumentation for vertebral interbody fusion
FR2902309A1 (en) * 2006-06-14 2007-12-21 Jean Claude Yeung Harvested bone releasing device for e.g. bone surgery, has inner element with upper rod sliding in inner central bore of mandrel, stabilizing zone for avoiding element to be detached from interior of trepan, and lower guide rod

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4696308A (en) * 1986-04-09 1987-09-29 The Cleveland Clinic Foundation Core sampling apparatus
GB0223582D0 (en) * 2002-10-11 2002-11-20 Depuy Int Ltd A reamer assembly
FR2902310B1 (en) * 2006-06-14 2014-07-18 Ynnovations Yeung System TREPAN FOR THE REMOVAL OF A BONE CARROT, PROVIDED WITH A GUIDING DEVICE WITHIN THE BONE, REMOVING THE CARROT OUT OF THE TREPAN, AND IRRIGATION DURING BONE SAMPLING.

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5632747A (en) * 1995-03-15 1997-05-27 Osteotech, Inc. Bone dowel cutter
FR2749154A1 (en) * 1996-05-30 1997-12-05 Jbs Sa Surgical trepanning implement
EP1488747A2 (en) * 1998-04-09 2004-12-22 SDGI Holdings, Inc. Method and instrumentation for vertebral interbody fusion
FR2902309A1 (en) * 2006-06-14 2007-12-21 Jean Claude Yeung Harvested bone releasing device for e.g. bone surgery, has inner element with upper rod sliding in inner central bore of mandrel, stabilizing zone for avoiding element to be detached from interior of trepan, and lower guide rod

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8920423B2 (en) 2011-01-21 2014-12-30 Benjamino Kah Hung LEE Bone harvesting device
US9925068B2 (en) 2014-05-30 2018-03-27 Treace Medical Concepts, Inc. Bone harvester and bone marrow removal system and method
US11020244B2 (en) 2014-05-30 2021-06-01 Treace Medical Concepts, Inc. Bone harvester and bone marrow removal system and method
CN110179521A (en) * 2019-06-25 2019-08-30 杨军 Combined bone taking device
CN110179521B (en) * 2019-06-25 2024-01-23 杨军 Combined bone taking device

Also Published As

Publication number Publication date
ES2337436A1 (en) 2010-04-23
ES2337436B1 (en) 2011-03-11

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