System and method of treatment of bone lesions
The present disclosure describes a method and device for treatment of bone lesions. The device may include a combination of a drill device, a drill guide, a guide wire, and a syringe. The drill device includes a cannula through which a substance may be injected, an attachment head, and a drill bit. The attachment head may include a fitting for a powered or manual drill and a luer fitting for attaching a syringe or other device. The drill guide includes a cannula with an inner diameter sized to accommodate the cannula of the drill device. The method may include: placing a drill guide near a bone-lesion site, inserting a guide wire through the drill guide, inserting a drill device into the drill guide, removing the guide wire, drilling the bone, and injecting a cellular component and a retention medium into the bone near the lesion site.
1. A method of treating a bone marrow lesion, the method comprising:
drilling, using a drilling system, a subchondral channel into a bone, the drilling system comprising:
a drill guide having a first cannula with a proximal end and a distal end;
a wire guide having a second cannula with an outer diameter adapted to fit within the first cannula of the drill guide and further configured with a length that extends from an area proximate to an injury site to beyond the proximal end of the drill guide;
a guide wire with diameter configured to fit within the second cannula and to extend from the injury site beyond a proximal end of the wire guide;
a drill device having an outer diameter configured to fit within the first cannula and comprising:
a third cannula extending through the drill device;
a head portion at a proximal end of the drill device, the head portion comprising a Jacobs-Chuck and luer fitting; and
a bit at a distal end of the drill device and comprising a hollow configured to allow the guide wire to pass therethrough;
providing a cellular component to the injury site by injecting the cellular component through the third cannula of the drill device, the cellular component comprising autologous adipose tissue that has been filtered, enzymatically digested, and or concentrated to isolate progenitor cells at a concentration greater than 1.1× than natural adipose fluid and to remove adipocytes and connective tissue; and
injecting a retention medium into the injury site via a syringe connected to the luer fitting to promote retention of the cellular component at the injury site.
2. The method of claim 1 , further comprising, prior to the drilling, setting the guide wire into the bone with a distal end of the guide wire positioned close to the injury site and a proximal end of the guide wire positioned outside of the bone.
3. The method of claim 2 , further comprising:
subsequent to setting the guide wire, positioning the drill guide around the guide wire; and
prior to drilling with the drill device, inserting the drill device into the drill guide.
4. The method of claim 3 , wherein drilling into the bone further comprises placing the bit proximate to the distal end of the guide wire.
5. The method of claim 1 , further comprising, prior to providing the cellular component, confirming placement of the bit proximate to the injury site via an imaging process.
6. The method of claim 1 , wherein the retention medium further comprises an allogenic fibrin glue.
7. The method of claim 1 , wherein the retention medium creates a chemical bond among cells of the injury site of the bone.
8. The method of claim 1 , wherein the cellular component and the retention medium are injected to the injury site together.
9. The method of claim 1 , wherein the retention medium comprises at least one of an integrin and a cellular adhesion molecule.
10. The method of claim 1 , wherein the retention medium and the cellular component are mechanically coupled to an environment near the injury site.
11. The method of claim 1 , wherein the third cannula of the drill device is made of a shape memory plastic.
12. The method of claim 1 , wherein the third cannula of the drill device is made of nitinol.