IP Library › Granted Patent US 10,172,627
Granted Patent B2
US 10,172,627 · App. 14/753,418 · Granted Jan 8, 2019

Graft placement system and method

Inventors: Daniel Haberman (Boston, MA); Stephen A. Santangelo (Sturbridge, MA); Nikhil N. Verma (Chicago, IL)
Assignee: Smith & Nephew, Inc.
A61B17/1635A61B17/17A61B17/1739A61B17/1778A61B17/8866A61B2017/2808A61B2090/061A61F2002/285A61F2002/2835
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Quick Facts
Patent No.
US 10,172,627
App. No.
14/753,418
Filed
Jun 29, 2015
Granted
Jan 8, 2019
Kind
B2
Art Unit
3774
USPC
606/80
Abstract

Embodiments of the invention include a system and method for coupling a graft to a bone. A graft preparation tool may be used to place one or more holes in a graft and an offset measurement tool may be used to determine the distance of the one or more holes from an edge of the graft to be aligned with a portion of the bone. One or more complementary holes may then be created in the bone and fasteners applied through the holes to couple the graft to the bone.

Claims (84)

1. A method of performing a Latarjet protocol procedure comprising:

severing at least a portion of a coracoid process from a patient;

drilling one or more holes in the severed coracoid process;

providing an offset measurement tool comprising:

a body,

a pin with a cross-sectional center axis, the pin coupled to the body, wherein the pin is sized to fit within at least one of the one or more holes in the severed coracoid process, and

two or more legs coupled to the body and extending to two or more different distances from the cross-sectional center axis of the pin;

measuring an offset distance from a first one of the holes in the severed coracoid process to an edge of the severed coracoid process that is to be aligned with a face of a glenoid of the patient by inserting the pin of the offset measurement tool into the first one of the holes in the severed coracoid process and observing which extent of one of the two or more legs most nearly aligns with the edge of the severed coracoid process that is to be aligned with a face of a glenoid, the observation occurring when the offset measurement tool is rotated about the axis of the first one of the holes in the severed coracoid process;

selecting an offset drill guide that correlates with the offset distance measured from the first one of the holes in the severed coracoid process to an edge of the severed coracoid process with the offset measurement tool;

aligning a portion of the offset drill guide with the face of the glenoid;

drilling a first hole in the glenoid through the offset drill guide;

aligning the first one of the holes in the severed coracoid process with the first hole in the glenoid; and

inserting a first screw through the first one of the holes in the severed coracoid process and through the first hole in the glenoid to couple the severed coracoid process to the glenoid.

2. The method of claim 1 wherein the act of severing a least a portion of a coracoid process does not include removing a conjoined tendon near a distal end of the severed coracoid process from the severed coracoid process.

3. The method of claim 1 wherein the act of drilling one or more holes in the severed coracoid process includes holding the severed coracoid process in a graft preparation tool that includes a holder and a drilling alignment mechanism that is coupled to the holder, wherein the drilling alignment mechanism is adjustably coupled to the holder and includes drilling guides to direct drilling of holes through the severed coracoid process.

4. The method of claim 1 wherein the act of measuring an offset distance includes observing which extent of one of the legs coupled to the body most nearly aligns with the edge of the severed coracoid process that is to be aligned with the face of the glenoid.

5. The method of claim 1 wherein the act of measuring an offset distance includes observing a number written on the leg that includes an extent that most nearly aligns with the edge of the severed coracoid process that is to be aligned with the face of the glenoid.

6. The method of claim 5 wherein the act of observing a number written on the leg that includes an extent that most nearly aligns with the edge of the severed coracoid process that is to be aligned with the face of the glenoid includes viewing the number from beyond a proximal end of the offset measurement tool.

7. The method of claim 1 wherein the act of aligning the first one of the holes in the severed coracoid process with the first hole in the glenoid includes placing a guide wire through the first one of the holes in the severed coracoid process and the first hole in the glenoid.

8. The method of claim 1 , further comprising removing a portion of soft tissue from the severed coracoid process where the severed coracoid process will contact the glenoid to be coupled with the glenoid.

9. The method of claim 1 , further comprising:

aligning the edge of the severed coracoid process with the face of the glenoid;

drilling a second hole in the glenoid through a second one of the holes in the severed coracoid process; and

inserting a second screw through the second one of the holes in the severed coracoid process and through the second hole in the glenoid to couple the severed coracoid process to the glenoid.

10. The method of claim 1 , further comprising:

measuring an offset distance from a second one of the holes in the severed coracoid process to an edge of the severed coracoid process that is to be aligned with a face of a glenoid of the patient by inserting the pin of the offset measurement tool into the second one of the holes in the severed coracoid process and observing which extent of one of the two or more legs most nearly aligns with the edge of the severed coracoid process that is to be aligned with the face of the glenoid when the offset measurement tool is rotated about the axis of the second one of the holes in the severed coracoid process;

selecting an offset drill guide that correlates with the offset distance measured from the second one of the holes in the severed coracoid process to an edge of the severed coracoid process with the offset measurement tool;

aligning a portion of the offset drill guide with the face of the glenoid;

drilling a second hole in the glenoid through the offset drill guide;

aligning the second one of the holes in the severed coracoid process with the second hole in the glenoid; and

inserting a second screw through the second one of the holes in the severed coracoid process and through the second hole in the glenoid to couple the severed coracoid process to the glenoid.

11. A method of performing a Latarjet protocol procedure comprising:

severing at least a portion of a coracoid process from a patient, wherein the severed portion of a coracoid process includes a back surface with an edge to be aligned with a face of a glenoid to accomplish the Latarjet protocol procedure;

drilling one or more holes in the severed coracoid process;

measuring an offset distance along the back surface from a first one of the holes in the severed coracoid process to the edge of the severed coracoid process to be aligned with the face of the glenoid with an offset measurement tool comprising: a body, a pin with a cross-sectional center axis, the pin coupled to the body, wherein the pin is sized to fit within at least one of the one or more holes in the severed coracoid process, and two or more legs coupled to the body and extending to two or more different distance from the cross-sectional center of the pin, wherein the measuring act includes inserting the pin of the offset measurement tool into the first one of the holes in the severed coracoid process and observing which extent of one of the two or more legs most nearly aligns with the edge of the severed coracoid process that is to be aligned with a face of a glenoid, the observation occurring when the offset measurement tool is rotated about the axis of the first one of the holes in the severed coracoid process;

selecting an offset drill guide that correlates with the offset distance along the back surface from a first one of the holes in the severed coracoid process to the edge of the severed coracoid process to be aligned with the face of the glenoid;

aligning a portion of the offset drill guide with the face of the glenoid;

drilling a first hole in the glenoid through the offset drill guide;

aligning the first one of the holes in the severed coracoid process with the first hole in the glenoid; and

inserting a first screw through the first one of the holes in the severed coracoid process and through the first hole in the glenoid to couple the severed coracoid process to the glenoid.

12. The method of claim 11 wherein the act of severing a least a portion of a coracoid process does not include removing a conjoined tendon near a distal end of the severed coracoid process from the severed coracoid process.

13. The method of claim 11 wherein the act of drilling one or more holes in the severed coracoid process includes holding the severed coracoid process in a graft preparation tool that includes a holder and a drilling alignment mechanism that is coupled to the holder, wherein the drilling alignment mechanism is adjustably coupled to the holder and includes drilling guides to direct drilling of holes through the severed coracoid process.

14. The method of claim 11 wherein the act of measuring an offset distance includes observing a number written on the offset measurement tool that includes an extent that most nearly aligns with the edge of the severed coracoid process that is to be aligned with the face of the glenoid.

15. The method of claim 14 wherein the act of observing a number written on the offset measurement tool includes viewing the number from beyond a proximal end of the offset measurement tool.

16. The method of claim 11 wherein the act of aligning the first one of the holes in the severed coracoid process with the first hole in the glenoid includes placing a guide wire through the first one of the holes in the severed coracoid process and the first hole in the glenoid.

17. The method of claim 11 , further comprising removing a portion of soft tissue from the back surface of the severed coracoid process where the severed coracoid process will contact the glenoid to be coupled with the glenoid.

18. The method of claim 11 , further comprising:

aligning the edge of the severed coracoid process with the face of the glenoid;

drilling a second hole in the glenoid through a second one of the holes in the severed coracoid process; and

inserting a second screw through the second one of the holes in the severed coracoid process and through the second hole in the glenoid to couple the severed coracoid process to the glenoid.

19. The method of claim 11 , further comprising:

measuring an offset distance along the back surface from a second one of the holes in the severed coracoid process to the edge of the severed coracoid process to be aligned with the face of the glenoid;

selecting an offset drill guide that correlates with the offset distance along the back surface from a second one of the holes in the severed coracoid process to the edge of the severed coracoid process to be aligned with the face of the glenoid;

aligning a portion of the offset drill guide with the face of the glenoid;

drilling a second hole in the glenoid through the offset drill guide;

aligning the second one of the holes in the severed coracoid process with the second hole in the glenoid; and

inserting a second screw through the second one of the holes in the severed coracoid process and through the second hole in the glenoid to couple the severed coracoid process to the glenoid.

20. A method of performing a Latarjet protocol procedure comprising:

preparing a glenoid surface of a patient to receive a graft by removing tissue from the glenoid, wherein the glenoid surface shares an edge along a face of the glenoid;

severing at least a portion of a coracoid process from a patient, wherein the severed portion of a coracoid process includes a back surface with an edge to be aligned with the edge of the prepared glenoid surface shared with the face of the glenoid to accomplish the Latarjet protocol procedure;

drilling one or more holes in the severed coracoid process;

measuring an offset distance along the back surface from a first one of the holes in the severed coracoid process to the edge of the severed coracoid process to be aligned with the edge of the prepared glenoid surface shared with the face of the glenoid with an offset measurement tool comprising: a body, a pin with a cross-sectional center axis, the pin coupled to the body, wherein the pin is sized to fit within at least one of the one or more holes in the severed coracoid process, and two or more legs coupled to the body and extending to two or more different distance from the cross-sectional center of the pin, wherein the measuring act includes inserting the pin of the offset measurement tool into the first one of the holes in the severed coracoid process and observing which extent of one of the two or more legs most nearly aligns with the edge of the severed coracoid process that is to be aligned with a face of a glenoid, the observation occurring when the offset measurement tool is rotated about the axis of the first one of the holes in the severed coracoid process;

selecting an offset drill guide that correlates with the offset distance along the back surface from a first one of the holes in the severed coracoid process to the edge of the severed coracoid process to be aligned with the edge of the prepared glenoid surface shared with the face of the glenoid;

aligning a portion of the offset drill guide with the edge of the prepared glenoid surface shared with the face of the glenoid;

drilling a first hole in the glenoid through the offset drill guide;

aligning the first one of the holes in the severed coracoid process with the first hole in the glenoid; and

inserting a first screw through the first one of the holes in the severed coracoid process and through the first hole in the glenoid to couple the severed coracoid process to the glenoid.

21. The method of claim 20 wherein the act of severing a least a portion of a coracoid process does not include removing a conjoined tendon near a distal end of the severed coracoid process from the severed coracoid process.

22. The method of claim 20 wherein the act of drilling one or more holes in the severed coracoid process includes holding the severed coracoid process in a graft preparation tool that includes a holder and a drilling alignment mechanism that is coupled to the holder, wherein the drilling alignment mechanism is adjustably coupled to the holder and includes drilling guides to direct drilling of holes through the severed coracoid process.

23. The method of claim 20 wherein the act of measuring an offset distance includes observing a number written on the offset measurement tool that includes an extent that most nearly aligns with the edge of the severed coracoid process that is to be aligned with the edge of the prepared glenoid surface shared with the face of the glenoid.

24. The method of claim 23 wherein the act of observing a number written on the offset measurement tool includes viewing the number from beyond a proximal end of the offset measurement tool.

25. The method of claim 20 wherein the act of aligning the first one of the holes in the severed coracoid process with the first hole in the glenoid includes placing a guide wire through the first one of the holes in the severed coracoid process and the first hole in the glenoid.

26. The method of claim 20 , further comprising removing a portion of soft tissue from the back surface of the severed coracoid process where the severed coracoid process will contact the glenoid to be coupled with the glenoid.

27. The method of claim 20 , further comprising:

aligning the edge of the severed coracoid process with the edge of the prepared glenoid surface shared with the face of the glenoid;

drilling a second hole in the glenoid through a second one of the holes in the severed coracoid process; and

inserting a second screw through the second one of the holes in the severed coracoid process and through the second hole in the glenoid to couple the severed coracoid process to the glenoid.

28. The method of claim 20 , further comprising:

measuring an offset distance along the back surface from a second one of the holes in the severed coracoid process to the edge of the severed coracoid process to be aligned with the edge of the prepared glenoid surface shared with the face of the glenoid;

selecting an offset drill guide that correlates with the offset distance along the back surface from a second one of the holes in the severed coracoid process to the edge of the severed coracoid process to be aligned with the edge of the prepared glenoid surface shared with the face of the glenoid;

aligning a portion of the offset drill guide with the edge of the prepared glenoid surface shared with the face of the glenoid;

drilling a second hole in the glenoid through the offset drill guide;

aligning the second one of the holes in the severed coracoid process with the second hole in the glenoid; and

inserting a second screw through the second one of the holes in the severed coracoid process and through the second hole in the glenoid to couple the severed coracoid process to the glenoid.

Assignments (1)
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Nov 19, 2015
From: HABERMAN, DANIEL; SANTANGELO, STEPHEN A.; VERMA, NIKHIL N.
To: SMITH & NEPHEW, INC.
Reel/Frame 037090/0815 →
Continuity (1)
Related Publication 20160374694A1 · Dec 29, 2016
Cited By (2)
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