Methods and apparatus for joint distraction
A method of treating a patient's joint having opposing joint surfaces includes providing an elongate member having a proximal end, a distal end and an expandable member near the distal end. The expandable member is positioned in the joint between the joint surfaces and expanded so as to separate the joint surfaces away from one another into a distracted position. The joint is manipulated while in the distracted position so that the joint is distracted and in flexion. A diagnostic or therapeutic procedure is then performed on the joint while maintaining the joint in the flexed and distracted position.
1. A method for distracting a joint, wherein the joint comprises two articulating bones, wherein one of the articulating bones comprises a convex articulating surface and the other of the articulating bones comprises a concave articulating surface, and wherein the convex articulating surface is received within the concave articulating surface, the method comprising:
providing a balloon catheter comprising:
a shaft having a distal tip, a proximal end and a balloon mounted to the shaft between the distal tip and the proximal end;
wherein the distal tip of the shaft is configured to be releasably coupled to a portion of the shaft proximal to the balloon and distal to the proximal end of the shaft with a flexible pulling element;
wherein the shaft comprises an axial lumen and a side opening extending through the shaft and opening into the axial lumen;
wherein the flexible pulling element is attached to the distal tip of the shaft and extends alongside the balloon, proximally alongside a portion of the shaft, through the side opening in the shaft, into the axial lumen and out of the proximal end of the shaft;
inserting the balloon into a joint space defined between the convex articulating surface and the concave articulating surface while the balloon is in a contracted condition;
pulling the flexible pulling element proximally through the side opening, into the axial lumen and out of the proximal end of the shaft so as to draw the distal tip of the shaft toward the portion of the shaft proximal to the balloon so that the balloon forms a semi-toroidal or toroidal shape in the joint space;
releasably coupling the distal tip of the shaft to the portion of the shaft proximal to the balloon to maintain the semi-toroidal or toroidal shape of the balloon; and
expanding the balloon within the joint space, thereby separating the two articulating bones of the joint away from one another.
2. A method according to claim 1 wherein the balloon comprises a substantially cylindrical shape.
3. A method according to claim 1 wherein the shaft is steerable.
4. A method according to claim 1 wherein the flexible pulling element is one selected from the group consisting of a suture, a cord, a cable and a wire.
5. A method according to claim 1 wherein a distal portion of the shaft is flexible.
6. A method according to claim 1 wherein the portion of the shaft proximal to the balloon is substantially rigid.
7. A method according to claim 1 wherein the shaft is configurable between a linear configuration and a non-linear configuration.
8. A method according to claim 7 wherein the shaft is in the linear configuration when the balloon is inserted into the joint space.
9. A method according to claim 7 wherein drawing the distal tip of the shaft toward a portion of the shaft proximal to the balloon comprises bending the shaft to the non-linear configuration.