U.S. patent application number 10/993706 was filed with the patent office on 2006-05-25 for surgical cutting tool.
Invention is credited to Hacene Bouadi.
Application Number | 20060111722 10/993706 |
Document ID | / |
Family ID | 36461884 |
Filed Date | 2006-05-25 |
United States Patent
Application |
20060111722 |
Kind Code |
A1 |
Bouadi; Hacene |
May 25, 2006 |
Surgical cutting tool
Abstract
The present invention pertains generally to a surgical tool for
cutting and shaping bone, cartilage and other anatomical
structures. In particular, described herein are surgical tools
having at least two cutting surfaces.
Inventors: |
Bouadi; Hacene; (Palo Alto,
CA) |
Correspondence
Address: |
CONFOR MIS, INC.
323 VINTAGE PARK DR.,
SUITE C
FOSTER CITY
CA
94404
US
|
Family ID: |
36461884 |
Appl. No.: |
10/993706 |
Filed: |
November 19, 2004 |
Current U.S.
Class: |
606/79 |
Current CPC
Class: |
A61B 17/320016 20130101;
A61B 17/1604 20130101; A61B 2017/320004 20130101; A61B 2017/320008
20130101; A61B 17/1659 20130101; A61B 17/320708 20130101 |
Class at
Publication: |
606/079 |
International
Class: |
A61B 17/16 20060101
A61B017/16 |
Claims
1. A surgical device for cutting and removing target tissue such as
cartilage and bone within a body, said device comprising: a handle;
and a cutting element attached to the handle, the cutting element
comprising at least two cutting surfaces, wherein the cutting
surfaces cut tissue when the device is pushed or pulled along the
target tissue.
2. The device of claim 1, wherein the cutting surfaces are
blades.
3. The device of claim 1, wherein the cutting surfaces are abrasion
surfaces.
4. The device of claim 1, wherein the cutting surfaces are disposed
on opposite sides of the cutting element.
5. The device of claim 1, wherein the cutting surfaces are disposed
on the same side of the cutting surface.
6. The device of claim 1, further comprising a carrier, wherein the
cutting element is disposed within the carrier.
7. The device of claim 1, wherein the cutting element is curved on
at least one of the two cutting surfaces.
8. The device of claim 1, wherein each of the two cutting surfaces
is curved.
9. A surgical device for cutting and removing target tissue such as
cartilage and bone within a body, said device comprising: a handle;
and cutting means attached to the handle, the cutting means
comprising at least two cutting surfaces, wherein the cutting means
cuts tissue when the device is pushed or pulled along the target
tissue.
10. The surgical device of claim 9, wherein the cutting means is
curved on at least one of the two cutting surfaces.
11. The surgical device of claim 9, wherein each of the two cutting
surfaces is curved.
12. A kit comprising one or more surgical devices according to
claim 1 and one or more joint implants.
13. A surgical device for revising a cartilage surface comprising:
a handle; a carrier attached to a proximal end of the hand position
substantially within a plane; and a cutting element disposed within
the carrier such that a blade of the cutting element is at an angle
relative to the plane of the carrier.
14. The surgical device of claim 13, wherein the handle and the
cutting element are formed integrally.
15. The surgical device of claim 13, wherein the cutting element is
removable.
16. The surgical device of claim 13, wherein the cutting element
has a plurality of blades.
17. The surgical device of claim 13, wherein the cutting element
has at least two blades.
18. The surgical device of claim 13, wherein the cutting element
has two cutting surfaces disposed such that the surface oppose each
other.
19. The surgical device of claim 13, wherein the cutting surfaces
are pivotally mounted.
Description
TECHNICAL FIELD
[0001] The present invention pertains generally to medical devices,
particularly surgical tools for cutting and shaping bone, cartilage
and other anatomical structures. In particular, surgical tools
having at least two cutting surfaces are provided.
BACKGROUND
[0002] Generally, joint surgery, such as implantation of
prostheses, includes cutting of bone and cartilage tissue. For
example, total knee replacement (TKR) involves surgical resection
of the entire or the majority of the articular surface of one or
more bones. With these procedures, the marrow space is reamed in
order to fit the stem of the prosthesis. Less invasive joint
arthoplasties, such as those described in U.S. Patent Publication
No. 20030216669 also will generally involve some shaping of the
cartilage and/or bone in the target joint.
[0003] Various tools are currently available for cutting cartilage
and bone. Commercially available osteotomes typically have a single
straight or curved cutting surface. See, e.g., HOKE, HIBBS, and
LAMBOTTE osteomes available from Miltex, Inc. (York, Pa.); tools
available from Biomet, Inc (Warsaw, Ind.); U.S. Pat. No. 4,586,496
to Keller; and U.S. Pat. No. 4,601,290 to Effron et al.
[0004] Surgical tools having a cylindrical cutting surface have
also been described. See, e.g., U.S. Pat. No. 4,203,444 to Bonnell
and U.S. Pat. No. 6,679,917. However, cylindrical configuration of
the rotating cutting edges typically creates a depression with a
curved, concave surface, as opposed to a box-like depression with
more or less flattened sides. As much as the surgeon may attempt to
match the equator of the concavity, removal of additional tissue
always leaves behind a ridge or protrusion on the treated surface.
Such protrusions are particularly disadvantageous in joint surgery
where jagged or protruding surfaces on cartilage or bone can
inhibit free joint movement and lead to pain and inflammation after
surgery.
[0005] Thus, there remains a need for surgical cutting devices that
readily create a cartilage or bone surface that is more or less
normal in topography for the joint or region being treated after
desired tissue is removed, thereby avoiding the production of
ridges, protuberances or odd shaping that may hinder or make joint
movement painful after surgery. There is a further need for a
surgical cutting device that permits more efficient cutting and
sculpting of tissue in order to reduce the duration of surgery.
SUMMARY
[0006] It is a general object of the invention to provide a
surgical cutting device that is capable of creating a substantially
normal surface after tissue removal. More specifically, the
invention provides a versatile and efficient surgical cutting tool
that removes cartilage and/or bone in two directions. Furthermore,
the cutting blades may be curved in either a convex or concave
orientation (relative to the surface to be cut), thereby allowing
the blades to conform to bone and cartilage curvature or create a
desired curvature that better fits an implant.
[0007] In one aspect, the invention includes a surgical device for
cutting and removing target tissue such as cartilage and bone
within a body, the device comprising: a handle; and a cutting
element attached to the handle, the cutting element comprising at
least two cutting surfaces, wherein the cutting surfaces cut tissue
when the device is pushed or pulled along the target tissue. In
certain embodiments, the cutting surfaces are blades, abrasion
surfaces, or combinations thereof. One or more cutting surfaces can
be disposed on opposite sides of the cutting element or,
alternatively, one or more cutting surfaces can be disposed on the
same side of the cutting surface.
[0008] Any of the devices described herein may further comprise a
carrier, wherein the cutting element is disposed within the
carrier.
[0009] In any of the devices described herein, the cutting element
may be curved on one or both of the two cutting surfaces.
[0010] In another aspect, the invention includes a surgical device
for cutting and removing target tissue such as cartilage and bone
within a body, the device comprising: a handle; and cutting means
attached to the handle, the cutting means comprising at least two
cutting surfaces, wherein the cutting means cuts tissue when the
device is pushed or pulled along the target tissue. In certain
embodiments, the cutting means is curved one or both of the two
cutting surfaces.
[0011] In another aspect, the invention includes a kit comprising
one or more surgical devices described herein and one or more joint
implants.
[0012] In yet another aspect, the invention includes a surgical
device for revising a cartilage surface comprising: a handle; a
carrier attached to a proximal end of the hand position
substantially within a plane; and a cutting element disposed within
the carrier such that a blade of the cutting element is at an angle
relative to the plane of the carrier. In certain embodiments, the
handle and the cutting element are formed integrally. In other
embodiments, the cutting element is removable. In any of the
devices described herein, the cutting element may have a plurality
of blades, for example at least two.
[0013] In any of the devices described herein, the cutting element
may comprise two cutting surfaces disposed such that the surfaces
oppose each other. In addition, in any of the devices described
herein, the cutting surfaces may be pivotally mounted.
[0014] These and other objects and advantages of the invention will
become more fully apparent when the following detailed description
of the invention is read in conjunction with the accompanying
drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] FIG. 1 is a perspective view of an exemplary embodiment of
the surgical device of the invention.
[0016] FIG. 2 is a side view of an exemplary embodiment of a
surgical cutting tool as described herein.
[0017] FIG. 3 is detailed side view of an exemplary cutting
element.
[0018] FIG. 4 is a side view of another exemplary device.
[0019] FIG. 5 is a detailed side view of another exemplary cutting
element.
[0020] FIG. 6 is a side view of another exemplary device.
[0021] FIG. 7 is a detailed side view of another exemplary cutting
element.
DETAILED DESCRIPTION OF THE INVENTION
[0022] The present disclosure relates to surgical devices capable
of cutting and removing body tissue such as cartilage and bone from
a joint region or similarly restricted interior space within the
body. The surgical instrument includes a cutting element
(optionally housed within a carrier) sized for insertion into a
joint or similar restricted interior space within the body and
having a first and second end. At least two cutting surfaces
protrude from the cutting element. The operator shaves the selected
tissue by moving the cutting elements against the tissue via
movement of a handle attached to the cutting element. The movement
of the device by the operator shaves and/or abrades away tissue
depending on the direction of movement and the configuration of the
cutting surfaces.
[0023] Turning now to FIG. 1, the surgical device of the invention
will now be described. For the purposes of the following
disclosure, the end of the device that is closest to or in contact
with the patient is designated the distal end. The end closest to
the surgeon is designated the proximal end.
[0024] The surgical device (10) includes a handle (20), an optional
carrier for the cutter (30) and a cutting element 40. During
cutting, the operator (surgeon) actuates the device by gripping
handle (20) and contacting cutting element (40) with the surface to
be shaved. Handle (20) may be straight (FIGS. 4 and 6) or include
one or more angled or curved portions (FIGS. 1 and 2). Handle (20)
may be made of a wide variety of materials, including but not
limited to, metals, polymers, alloys and combinations thereof so
long as the material is not harmful to the patient (e.g., toxic,
etc.).
[0025] Cutting element (40) is attached to the distal end of the
handle (20) directly or may be placed in a carrier (30) that is
attached to the distal end of the handle (20). In certain
embodiments, cutting element (40) is disposed with in a carrier
(30) such that the cutting element (40) can be readily replaced. In
certain embodiments, cutting element (40) (or carrier (30)
containing the cutting element (40)) is fixedly attached to handle
(20) and does not move in relation to the handle. Alternatively,
cutting element (40) may be moveable in relation to the handle (20)
for example by using springs, hinges or other moveable attachment
mechanisms.
[0026] Cutting element comprises two or more cutting surfaces (41,
42) that contact the surface (cartilage or bone) to be shaved.
Cutting surfaces (41, 42) typically blade-like structures that
extend outward from cutting element (40). Cutting surfaces (41, 42)
may be variously configured to achieve different cutting styles and
surface sculpturing. FIG. 3 shows cutting element (40) in which
cutting surfaces (41, 42) are disposed on either end of the cutting
element (40) and in which cutting surfaces (41, 42) are on opposite
sides of cutting element (40). FIG. 5 shows a variation in which
cutting surfaces (41, 42) are disposed on either end of the cutting
element (40) and in which cutting surfaces (41, 42) are on the same
side of the cutting element (40) and are angled toward each other.
FIG. 7 shows cutting element (40) having cutting surfaces (41, 42)
disposed at the distal end of cutting element (40). It will be
appreciated any combination of angled, opposed, facing and other
configurations of two or more cutting surfaces may be used in a
single device.
[0027] In addition to blade cutting surfaces (41, 42), cutting
element may also includes one or more surfaces (43) that can be
used to achieve different abrasive effects. For example, serrated
surfaces, ridges, teeth-like surfaces or any other projections may
be included, all as shown in FIG. 7. Blade-like cutting surfaces
(41, 42) and abrasive cutting surfaces (43) can be used in
combination together during the cutting procedure much like a
carpenter's plane, removing pieces of tissue and then smoothing
over the surface to achieve a substantially planar surface after
treatment.
[0028] Other configurations, such as those with concave and convex
surfaces, can also be provided for situations in which the surgeon
wishes to leave behind a curved surface after tissue removal is
completed.
[0029] In variations in which the cutting surfaces (41, 42) are
angled (e.g., with respect to the cutting element a whole), it will
be apparent that the angles can vary greatly, for example between
about 10.degree. and about 120.degree. (or any value therebetween),
more preferably between about 20.degree. and about 90.degree. (or
any value therebetween), and even more preferably, between about
20.degree. and about 40.degree. (or any value therebetween). For
example, as depicted in FIG. 2, the angle of cutting surface (41)
in relation to cutting element (40) is approximately 35.degree..
FIG. 5 depicts a variation in which the angles of the cutting
surfaces (41, 42) are 26.degree. and 25.degree., respectively. FIG.
7 depicts a variation in which cutting surface (42) is angled at
approximately 30.degree., relative to the linear cutting element
(40).
[0030] Cutting element (40) and, hence, cutting surfaces (41, 42)
can be made out of any suitable material that is both strong and
resistant to shocks and stresses encountered in surgery. Further,
the composition of the material should not contain biotoxic
elements or compounds. In this regard, the chrome content of the
composition is preferably less than about 10%. Preferably, the
composition must also have a Knoop hardness of 466 or greater in
order to ensure continued cutting efficiency. A number of
compositions meet or exceed these specifications including ceramics
such as Alumina, Zirconia, MgO partially stabilized TTZ, and
tempered titanium. Injection molded materials may be also be
employed.
[0031] The overall dimensions of the device will vary depending on
the application and target surface. For example, a device to be
used in a typically knee arthroplasty will range in length (distal
to proximal ends) from approximately 100 mm to 200 mm (and any
value therebetween) and more preferably between about 120 mm and
170 mm (or any value therebetween). Similarly, the cutting element
in a device used in knee surgery is generally between about 10 mm
and 20 mm (or any value therebetween) in length and between about 2
and 20 mm wide (or any value therebetween). It will be apparent
that the devices as a whole or elements thereof can be made larger
or smaller for other indications. For example, the handle
dimensions may remain fairly constant in order for the operator to
maintain a grip, while the carrier and/or cutting elements are
dimensioned so as to be maneuvered within the space to be operated
on.
[0032] The tools described herein are used in conjunction with
conventional surgical techniques, including arthroscopic and
laproscopic procedures. Specifically, the instrument may be
inserted into the selected joint through an incision, or can be
applied directly to the treatment site if the treatment site is
already exposed. As pressure is applied by the surgeon to the
cutting element (via the handle), cartilage and/or bone is abraded
away.
[0033] As noted above, the devices described herein include cutting
surfaces that are capable of cutting tissue when the device is both
pushed and pulled along a target surface. As depicted in FIG. 3 for
example, cutting surface (41) will shave target tissue on one side
of the cutting element (40) when the device is moved in the
direction of the solid arrow and cut tissue on the other side of
the cutting element (40) when cutting surface (42) is moved by the
operator in the direction of the dashed arrow. FIG. 5 shows another
variation in which tissue on the same side cutting element (40) is
cut when the device is moved in either direction. In particular,
when the device is moved in the direction of the solid arrow,
cutting element (41) shaves the target tissue. When the device is
moved in the direction of the dashed arrow, cutting element (42)
shaves the target tissue. Thus, in either axial direction, the
cutting and/or shaping of the target tissue (e.g., cartilage and/or
bone) is achieved.
[0034] It will be appreciated that the operation of the cutting
device of the present invention differs considerably from that of
currently available devices. Because the devices described herein
cut when moved in both lateral directions (pushed and pulled), a
surgeon can much more easily remove target. In addition, unlike
rotating abrading devices, such as burs, which are suited to more
planar surfaces and tend to jump or skip over curved surfaces
without satisfactory cutting, the configuration of the cutter
element and cutting surfaces can be satisfactorily applied to areas
of the joint with strong curvature.
[0035] The operation of the invention also permits versatility in
surface sculpturing. Unlike conventional devices that may leave
behind sharp ridges and valleys, the devices described herein can
be used to shape surfaces more precisely, whether they be flat or
curved. This sculpturing capacity is particularly important in the
field of joint repair and reconstruction where the finished joint
surface is critical to operation and well being of the repaired
joint. Irregular surfaces frequently left behind by conventional
devices often result in inflammation, pain, loss of mobility and
recurrence of pathology that the operation was originally intended
to cure.
[0036] The ability of the devices described herein to efficiently
cut and shape surfaces such as bone and cartilage with greater
precision is particularly useful in the context of minimally
invasive joint reconstructions, for example as disclosed in U.S.
Patent Publication No. 20030216669. Thus, in certain aspects, the
invention includes a kit comprising one or more of the tools
described herein in combination with one or more implants. The kits
can include other materials, for example, instructions, reagents,
containers and/or imaging aids.
[0037] Modifications of the procedure and devices described above,
and the methods of using them in keeping with this invention will
be apparent to those having skill in this mechanical and surgical
art. These variations are intended to be within the scope of the
claims that follow.
* * * * *