SUBCHONDRAL TREATMENT OF BONE DEFECTS WITH BONE-DERIVED IMPLANT
Methods of treating bone defects of the joint, particularly at the subchondral level, such as with bone-derived implants or injectable bone augmentation materials, either in combination or alone, are provided. A system of instruments and tools for delivering the implant and injectable material is also provided. These instruments and tools may be provided with depth control features.
1 . A system for treating a subchondral defect of a bone of a joint, comprising:
a delivery instrument for injecting a bone augmentation material, the instrument comprising a fenestrated delivery device configured to attach to an injection system, the delivery device having a bone cutting edge at its tip to create a bone cavity in the bone, and a protective sleeve configured to receive the fenestrated delivery device;
an injection system containing bone augmentation material; and
an implant comprising bone derived material, the implant being configured to plug the bone cavity.
2 . The system of claim 1 , further comprising a guide wire.
3 . The system of claim 1 , wherein the implant is cannulated.
4 . The system of claim 1 , wherein the delivery device comprises a collar for depth control.
5 . The system of claim 1 , wherein the delivery device comprises visual markers for depth control.
6 . The system of claim 1 , further including an impacter instrument to push the implant through the protective sleeve and into the bone cavity.
7 . The system of claim 1 , wherein the bone augmentation material comprises a bone hardening or bone substitute material.
8 . The system of claim 1 , wherein the implant is an allograft.
9 . The system of claim 1 , further comprising a navigation guide, template guide, or other imaging tool.
10 . A method of treating a subchondral defect of a bone, comprising:
inserting a guide wire into the bone toward the subchondral defect, the guide wire being inserted without violating the articular surface of the bone;
inserting a delivery device over the guide wire and into the bone to create a bone cavity at a subchondral area near the subchondral defect;
injecting a bone augmentation material into the bone cavity; and
inserting an implant into the bone cavity;
wherein the method preserves the articular surface of the bone.
11 . The method of claim 10 , wherein the wire is inserted using a navigation guide, template guide, or other imaging tool.
12 . The method of claim 10 , wherein the injectable material comprises a bone substitute or bone hardening material.
13 . The method of claim 10 , wherein the subchondral defect comprises a bone marrow lesion or bone marrow edema.
14 . The method of claim 10 , further including inserting the delivery device through a protective sleeve and into the bone.
15 . The method of claim 10 , further including pushing the implant through a protective sleeve into the bone cavity using an impacter instrument.
16 . A method of treating a subchondral defect of a bone, comprising:
inserting a delivery device through a protective sleeve and toward the subchondral defect to create a bone cavity at a subchondral area near the subchondral defect, the delivery device being inserted without violating the articular surface of the bone;
injecting a bone augmentation material into the bone cavity; and
inserting an implant into the bone cavity;
wherein the method preserves the articular surface of the bone.
17 . The method of claim 16 , wherein the wire is inserted using a navigation guide, template guide, or other imaging tool.
18 . The method of claim 16 , wherein the injectable material comprises a bone substitute or bone hardening material.
19 . The method of claim 16 , wherein the subchondral defect comprises a bone marrow lesion or bone marrow edema.
20 . The method of claim 16 , wherein the implant is inserted by pushing the implant through the protective sleeve into the bone cavity using an impacter instrument.