US20150250472A1 - Delivery System for Articular Surface Implant - Google Patents

Abstract

A implant delivery system for securing an implant to an anchor. The implant delivery system includes a driver including a shaft, a biasing body having a first end region configured to engage said driver and a second end region configured to engage a portion of an implant, and a suture extending between the anchor and the shaft of the driver. The driver may be rotated to reduce the length of the suture between the driver and the anchor and generate a biasing force urging the implant into engagement with the anchor. The biasing force is substantially not transmitted to the bone.

Description

CROSS REFERENCE TO RELATED APPLICATIONS
• This application claims the benefit of U.S. Provisional Application Ser. No. 61/949,774, filed Mar. 7, 2014; U.S. Provisional Application Ser. No. 61/949,789, filed Mar. 7, 2014; U.S. Provisional Application Ser. No. 61/949,824, filed Mar. 7, 2014; and U.S. Provisional Application Ser. No. 61/950,762, filed Mar. 10, 2014, the entire disclosures of which are fully incorporated herein by reference.
FIELD
• The present disclosure relates to delivery systems for bone implants, and more particularly, to delivery systems for articular surface implants.
BACKGROUND
• Articular cartilage, found at the ends of articulating bone in the body, is typically composed of hyaline cartilage, which has many unique properties that allow it to function effectively as a smooth and lubricious load-bearing surface. When injured, however, hyaline cartilage cells are not typically replaced by new hyaline cartilage cells. Healing is dependent upon the occurrence of bleeding from the underlying bone and formation of scar or reparative cartilage called fibrocartilage. While similar, fibrocartilage does not possess the same unique aspects of native hyaline cartilage and tends to be far less durable.
• In some cases, it may be necessary or desirable to repair the damaged articular cartilage using an implant. One method of installing an implant involves applying a blunt force, e.g., a hammer/mallet or the like, to the implant. Unfortunately, some of the blunt force is transmitted from the implant into the surrounding bone and/or tissue and can cause damage to the bone/tissue. This is particularly problematic in small bones (such as, but not limited to, bones in the hand and/or foot) as well as patients who suffer from reduced bone mass and density that can lead to fracture (such as, but not limited to, osteoporosis or the like).
BRIEF DESCRIPTION OF THE DRAWINGS
• Features and advantages of the claimed subject matter will be apparent from the following detailed description of some example embodiments consistent therewith, which description should be considered with reference to the accompanying drawings, wherein:
• FIG. 1 generally illustrates a cross-sectional view of one embodiment of an implant system consistent with the present disclosure secured within an excision site in a bone;
• FIG. 2 generally illustrates a cross-sectional view of one embodiment of an assembled implant system consistent with the present disclosure;
• FIG. 3 generally illustrates a cross-sectional view of one embodiment of an unassembled implant system consistent with the present disclosure;
• FIG. 4A generally illustrates an exploded, cross-sectional view of one embodiment of an implant delivery system consistent with the present disclosure;
• FIG. 4B generally illustrates a partial view of another embodiment of an implant delivery system consistent with the present disclosure;
• FIG. 5 generally illustrates an assembled, cross-sectional view of one embodiment of an implant delivery system consistent with the present disclosure;
• FIG. 6 generally illustrates an assembled, perspective view of one embodiment of an implant delivery system consistent with the present disclosure;
• FIG. 7 generally illustrates a cross-sectional view of one embodiment of an implant delivery system securing an anchor within an excision site in a bone consistent with the present disclosure;
• FIG. 8 generally illustrates a cross-sectional view of an anchor secured within an excision site in a bone consistent with the present disclosure;
• FIG. 9 generally illustrates a cross-sectional view of an implant delivery system securing an implant to an anchor consistent with the present disclosure;
• FIG. 10 generally illustrates a perspective view of an implant delivery system for securing an implant to an anchor consistent with the present disclosure;
• FIG. 11 generally illustrates another cross-sectional view of an implant delivery system securing an implant to an anchor consistent with the present disclosure; and
• FIG. 12 generally illustrates another perspective view of an implant delivery system for securing an implant to an anchor consistent with the present disclosure.
• Although the following Detailed Description will proceed with reference being made to some illustrative example embodiments, many alternatives, modifications, and variations thereof will be apparent to those skilled in the art.
DETAILED DESCRIPTION
• Generally, the present disclosure may feature systems, devices and/or methods for installing an implant anchor and/or delivering and attaching an implant to the anchor. By way of a general overview, one embodiment of the present disclosure may feature an implant delivery system for use with an implant system having an anchor and an implant (e.g., implant body) configured to be secured thereto. The implant delivery system may be used to facilitate delivering (e.g., securing) the anchor to the bone beneath a patient's articular surface and/or to couple, mount, or otherwise secure the implant body to the anchor. For example, the implant delivery system may be configured to generate sufficient force to allow the implant body to be secured to the anchor without applying any force to the surrounding bone or tissue. More specifically, the implant delivery system may generate and apply a biasing force against the implant and the anchor which urges the implant body into engagement with the anchor, thereby securing the implant body to the anchor without applying any force to the surrounding bone. The biasing force generated by the implant delivery system may therefore be applied only to the implant system, and not the surrounding bone or tissue.
• Because the biasing force is not transmitted/applied into the surrounding bone or tissue, the implant delivery system may reduce, minimize, and/or eliminate damage to the surrounding bone while securing the implant body to the anchor, thereby allowing the implant delivery system to be used with small bones (such as, but not limited to, phalange bones and/or metatarsal bones in the foot and/or hands) as well with patients who suffer from reduced bone mass and density that can lead to fracture (such as, but not limited to, osteoporosis or the like). Additionally, because the implant delivery system is capable of generating high biasing forces without transmitting/applying the biasing force to the surrounding bone or tissue, the connection between the implant body and the anchor may be stronger and more robust, thereby increasing the life expectancy of the implant system.
• Turning now toFIGS. 1-3, one embodiment of animplant system10 which may be used with an implant delivery system consistent with the present disclosure is generally illustrated. In particular,FIG. 1 generally illustrates theimplant system10 installed in thearticular surface12 of a patient'sbone14,FIG. 2 generally illustrates an assembledimplant system10, andFIG. 3 generally illustrates an exploded, unassembledimplant system10 consistent with the present disclosure. Theimplant system10 may generally include an implant (e.g., implant body)16 configured to be secured to ananchor18. Theanchor18 is configured to be secured to thebone14 within anexcision site20 formed beneath the patient'sarticular surface12 such that aload bearing surface22 of theimplant16 is generally flush with the patient's surroundingarticular surface12 as generally illustrated inFIG. 1. Theexcision site20 may be formed using any method and system known to those skilled in the art, such as, but not limited to, as the systems and methods as described in U.S. Pat. Nos. 6,520,964, 6,610,067, 6,679,917, 7,678,151, 7,896,883, 8,177,841, and 8,388,624, as well as U.S. Publication No. 2010/0368238, all of which are fully incorporated herein by reference. According to one embodiment, theanchor18 may be secured to thebone14, for example, using one or more external threads, ribs, protrusions, bone cement, barbs, grooves or anyother structure21 that enables theanchor18 to be secured to thebone14. The use ofthreads21 as generally illustrated may advantageously allow the height of theimplant12 to be adjusted by rotating theanchor18 within thebone14 such that theimplant16 is flush with the surroundingarticular surface12.
• It should be appreciated that theimplant system10 illustrated is provided for illustrative purposes, and that the implant delivery system may be used with any multi-piece implant having an anchor that is coupled (either directly or indirectly) to an implant/implant body. For example, the implant delivery system may be used with implant systems for replacing any articular surface such as, but not limited to, shoulder joints (e.g., but not limited to, the glenohumeral joint), hip joint (e.g., but not limited to, the acetabulofemoral joint), foot and/or hand joints (e.g., but not limited to, metacarpophalangeal joints, metatarsophalangeal joints, and/or interphalangeal joints), or the like. The implant systems may include total joint implants (wherein all or substantially all of the articular surface of at least one bone is replaced with the artificial surface of the implant) and/or partial implants (wherein substantially only the damaged portion(s) of the articular surface of a bone is replaced with the artificial surface of the implant). The implant delivery system may also be used to secure together a multi-piece pin or rod in a bone to facilitate healing of a fracture or broken bone.
• As discussed above, theimplant16 may be secured to theanchor18 by way of a connection. For example, theimplant16 may include at least onefirst fixation element24 configured to engage with at least onesecond fixation element26 of theanchor18 to secure theimplant16 to theanchor18. According to one embodiment, the first and thesecond fixation elements24,26 may include one or more recesses, groves, slots or the like configured to corresponding to one or more protrusions, ribs, barbs, or the like, for example, in a snap-fit arrangement in which the first and/or second fixation elements resiliently deflect. The first andsecond fixation elements24,26 may be disposed about the entire perimeter/periphery of theimplant16 andanchor18, and/or about one or more regions of the perimeter/periphery. The first andsecond fixation elements24,26 may prevent theimplant16 from becoming free relative to the anchor18 (for example, to prevent axial and/or rotational movement of theimplant16 relative to the anchor18). Optionally, theimplant16 may be at least partially received in animplant cavity28 formed in theanchor18 such that abone facing surface30 of theimplant16 engages against at least a portion of theimplant cavity28, thereby preventing theimplant16 from moving distally when a force is applied to theload bearing surface22.
• It should be appreciated that while the first andsecond fixation elements24,26 are generally illustrated as a recess and a protrusion, respectively, theimplant system10 consistent with the present disclosure is not limited to this arrangement unless specifically claimed as such. For example, the first andsecond fixation elements24,26 may include a protrusion and a recess, respectively, as well as other embodiments. Additionally, theanchor18 may optionally include apassageway32, for example, a longitudinal passageway, configured to be advanced over a guide wire (not shown) as generally described in U.S. Pat. Nos. 6,520,964, 6,610,067, 6,679,917, 7,678,151, 7,896,883, 8,177,841, and 8,388,624, as well as U.S. Publication No. 2010/0368238, all of which are fully incorporated herein by reference. For example, theanchor18 may be inserted intobone14 or may be inserted into a shaft drilled in thebone14 to reduce risks or complications arising from the insertion of theanchor18. Without limitation, a pilot hole may be formed in thebone14 for receiving theanchor18 prior to installing theanchor18. A diameter of the pilot hole may be smaller than theanchor18, although example embodiments may vary and are not limited thereto.
• It may be appreciated that the strength or ruggedness of the snap-fit connection between theimplant16 and theanchor18 may depend on the selected materials (e.g., the rigidity) and size/dimensions. In general, more rigid (i.e., less deformable) materials and/or larger sizes/dimensions will result in a stronger, more robust connection between theimplant16 and theanchor18. While a stronger and more robust connection between theimplant16 and theanchor18 is generally desirable, the resulting force necessary to make the snap-fit connection increases.
• Traditionally, the force necessary to secure theimplant16 to theanchor18 has been generated using a blunt force, e.g., a hammer/mallet or the like. More specifically, with theanchor18 secured in thebone14, the surgeon attempts to align theimplant16 relative to theanchor18 and impacts theimplant16 with the hammer/mallet to force theimplant16 into engagement with theanchor18. As may be appreciated, however, a substantial amount of force is also applied to the surroundingbone14, and if the force applied to thebone14 is too great, thebone14 may be damaged. Consequently, the strength of the connection between theimplant16 and theanchor18 may be limited in many applications (e.g., but not limited to, small bones in the hand and foot as well asimplant system10 installed proximate to the perimeter of a bone) by the strength of the surroundingbone14. Additionally, it may be very difficult for the surgeon to properly align theimplant16 with respect to theanchor18.
• As discussed herein, the implant delivery system consistent with one embodiment of the present disclosure solves this problem by generating a biasing force to secure theimplant16 to theanchor18 wherein the biasing force is only applied against theimplant16 and theanchor18. The biasing force generated by the implant delivery system may therefore be applied only to theimplant system10, and not the surrounding bone ortissue14. An implant delivery system consistent with the present disclosure may also be used to facilitate securing theanchor18 into thebone14. Features and aspects of an implant delivery system consistent with the present disclosure will generally be described.
• Turning now toFIGS. 4-12, systems and methods for securing ananchor18 into the bone and securing theimplant16 to theanchor18 using animplant delivery system100 consistent with the present disclosure are generally illustrated. In a first mode (as generally illustrated inFIGS. 4-8), theimplant delivery system100 may be used to secure theanchor18 into an excision site formed in the bone. In a second mode (FIGS. 9-12), thedelivery system100 may be used to secure theimplant16 to theanchor18 to assemble theimplant system10 within the excision site. As may be appreciated, theimplant delivery system100 may be used with anyimplant system10 described herein and is not limited to the illustratedimplant system10 unless specifically claimed as such.
• With reference toFIGS. 4-8, one embodiment of system and method for using theimplant delivery system100 to secure theanchor18 to bone within an excision site is generally illustrated. Theimplant delivery system100 may include adriver110, a biasingbody112, and at least onesuture114. As explained herein, theimplant delivery system100 may be configured to retain theanchor18 into engagement with thedriver110 and to secure theanchor18 tobone14 within an excision site20 (as generally illustrated inFIGS. 7 and 8). For example, thedriver110 may be received through the biasingbody112, and thesuture114 may be disposed around a portion of theanchor18 to provide increased control and/or maintain contact between thedriver110 and theanchor18 while securing theanchor18 into thebone14 within theexcision site20. Theexcision site20 may be formed using any method and system known to those skilled in the art.
• Thedriver110,FIG. 4A, includes a longitudinally disposedshaft116 having anengagement portion118 disposed about adistal end120. Theengagement portion118 is configured to be coupled with acorresponding engagement portion122 of theanchor18 and to transmit torque as generally illustrated inFIGS. 5-7. For example, theengagement portion118 may be a male-shaped coupling unit (such as, but not limited to, a splined or hex-shaped driver) configured to couple with a female-shaped coupling unit122 (such as, but not limited to, a splined or hex-shaped recession formed in the anchor18) in order to rotate or drive theanchor18 into the bone. However, theengagement portions118,122 may vary and are not limited thereto. For example, thedriver110 may be configured to accept interchangeable bits having adifferent engagement portion118 configurations, thereby allowing theengagement portion118 of thedriver110 to be coupled to the engagingportion122 of theanchor18 using several different bits as necessary. Alternatively (or additionally), theengagement portion118 may have a female-shaped coupling unit and theanchor18 may have a male-shaped coupling unit. The shape of the engagingportions118,122 may be other than splined or hexagonal, and those in the art will recognize that one of any number of shapes or configuration for such components may be employed in a device or method consistent with example embodiments. Optionally, theengagement portion118 may be magnetized or otherwise configured to maintain contact or control over theanchor18.
• While the engagingportion122 of theanchor18 is shown located on an inner wall of the narrow portion of theanchor18, example embodiments may vary and are not limited thereto. For example, the engagingportion122 of theanchor18 may be located on an inner wall of the wide portion of theanchor18 and/or on an outer wall of either the narrow portion or the wide portion of theanchor18. Optionally, an intermediate or adapting portion (not shown) may be used to connect thedriver110 to theanchor18.
• Thedriver110 may optionally include ahandle124. Thehandle124 may facilitate grasping of thedriver110 and may be configured to cause a rotational force or a torque on theshaft116, which may ultimately impart a rotational force or torque on theanchor18 to secure theanchor18 into the bone. Thehandle124 may be separate from the shaft116 (either permanently or removably coupled thereto), or may be a unitary, single piece with theshaft116. While thehandle124 is illustrated as having a larger width than theshaft116, example embodiments may vary and are not limited thereto. For example, thehandle124 may include a lever arm or may be configured to couple to a lever arm that is used to create the rotational force or torque.
• Thehandle124 and/or theshaft116 may be cannulated to define alongitudinal passageway126. Thelongitudinal passageway126 may include proximal anddistal openings128a,128bconfigured to be advanced over a guide wire (not shown for clarity), for example, when securing theanchor18 into the bone within the excision site.
• The biasingbody112 defines ashaft passageway132 extending between a first and asecond end region130a,130bhaving a first andsecond opening134a,134b. Theshaft passageway132 is configured to receive at least a portion of theshaft116 of thedriver110, for example, as generally illustrated inFIGS. 5 and 6. Theshaft116 and theshaft passageway132 may be configured such that thedistal end120 of theshaft116 extends beyond thesecond end134bof theshaft passageway132 to allow theengagement portion118 of thedriver110 to engage thecorresponding engagement portion122 of theanchor18, for example, as generally illustrated inFIGS. 5 and 6. Optionally, the biasingbody112 may include adriver cradle121, discussed in greater detail herein, which may be used to secure the implant16 (not shown) with theanchor18.
• Additionally, thesecond end region130bmay include a fixation element25 (FIG. 4B) which substantially corresponds to thefirst fixation element24 of theimplant16. In this manner, thefixation element25 of thesecond end region130bof the biasingbody112 may be coupled to thesecond fixation element26 of theanchor18 to generally secure theanchor18 to the biasingbody112. The connection between the biasingbody112 and theanchor18 may facilitate placement of theanchor18 within the excision site by creating a generally secure connection therebetween. It may be appreciated, however, that the connection between thefixation element25 of thesecond end region130band thesecond fixation element26 of theanchor18 does not need to be as strong as the connection between the first andsecond fixation elements24,26 since it is only generally intended to help advance theanchor18 to and align theanchor18 within the excision site.
• Alternatively (or in addition to), the biasingbody112,FIG. 4A, may be configured to receive asuture114 disposed around (e.g., wrap around) a portion of theanchor18. Tension may be applied to thesuture114 to generally urge theanchor18 into contact with thedriver110 and/or the biasingbody112 to provide more control over and/or maintain contact between thedriver110 and theanchor18. Thesuture114 may be configured to extend through and/or around the biasingbody112 in any manner known to those skilled in the art. For example, thesuture114 may extend through thefirst opening134aof theshaft passageway132 of the biasingbody112, out through one or more suture apertures/openings/passageways136a,136b, through one or more suture alignment guides138a,138band around acontact portion140 of theanchor18. The suture passageways136a,136bmay allow thesuture114 to pass from the exterior of the biasingbody112 to the interior of theshaft passageway132. While thesuture passageways136a,136bare illustrated in the middle of the biasingbody112, example embodiments may vary and are not limited thereto. It should also be appreciated that thesuture114 does not have to pass through theshaft passageway132, and instead the biasingbody112 may include one or more separate passageways (not shown) for thesuture114.
• The suture alignment guides138a,138bare configured to retain thesuture114 about the distal end of the biasingbody112. According to one embodiment, thesuture114 may include a first and asecond portion142a,142b(best seen inFIG. 6) which form a basket, cradle, or frame144 extending about the contact portion of theanchor18. The first andsecond portions142a,142bmay be formed from two or more pieces of suture, or may be formed from a single piece of suture. The suture alignment guides138a,138bmay be configured to prevent the first andsecond portions142a,142bof thecradle144 from slipping off theanchor18 by restricting the separation angle S of the first andsecond portions142a,142bof thecradle144.
• While the suture alignment guides138a,138bare shown at the distal end of the biasingbody112 nearest theanchor18, example embodiments may vary and are not limited thereto. For example, the suture alignment guides138a,138bmay be located anywhere along the biasingbody112 provided the suture alignment guides138a,138bmay prevent thesuture114 from slipping off theanchor18. Additionally, while the suture alignment guides138a,138bare shown as an exterior protrusion of the biasingbody112 with holes to allow thesuture114 to pass through, example embodiments may vary and are not limited thereto. For example, the suture alignment guides138a,138bmay be flush with the biasingbody112 or may protrude in an arc shape, with a gap between one edge of the suture alignment guides138a,138band the biasingbody112 to allow thesuture114 to enter. It may also be appreciated that the length of the suture alignment guides138a,138bmay vary and the suture alignment guides138a,138bmay be integrated into thesuture passageways136a,136b.
• While thecontact portion140 of theanchor18 is shown on the bottom edge of theanchor18, example embodiments may vary and thecontact portion140 may be situated anywhere along theanchor18. For example, thecontact portion140 may also be disposed about the top portion ofanchor18. Thecontact portion140 of theanchor18 may include a flat edge or may include guides, grooves, slots, or channels configured to receive thesuture114. For example, thesuture114 may extend through a passageway formed in theanchor18 such that a portion of theanchor18 generally surrounds thesuture114, and thecradle144 may be eliminated.
• To secure theanchor18 to thebone14 within theexcision site20, thesuture114 may be received through the biasing body112 (e.g., through thefirst opening134aof theshaft passageway132, out through thesuture passageways136a,136b, and through the suture alignment guides138a,138b) such that thecradle144 is disposed about thecontact portion140 of theanchor18 as generally illustrated inFIG. 4A. Thedriver110 may be advanced throughshaft passageway132 until theengagement portion118 contacts thecorresponding engagement portion122 of theanchor18. Thesuture114 may then be tensioned to retain the engagement between thedriver110 and theanchor18, for example, by applying a force against thesuture114 in a direction generally away from theanchor18 as generally illustrated inFIGS. 5 and 6. Alternatively (or in addition), the fixation element25 (FIG. 4B) of the biasingbody112 may be secured to thefixation element26 of theanchor18, and thedriver110 may engage theanchor18 as described herein.
• With theanchor18 securely engaged with thedriver110, theanchor18 may be advanced to and aligned with the excision site20 (as generally illustrated inFIG. 7) formed in the patient'sarticular surface12 andbone14. Optionally, theanchor18 may be aligned with theexcision site20 using aguide wire146 extending outwardly from thebone14 within theexcision site20. Because theanchor18 is retained against thedriver110, it is easier for the surgeon to align theanchor18 relative to theexcision site20. As discussed herein, theanchor18 may optionally include a cannulated passageway32 (best seen inFIG. 4A) that is generally aligned with (e.g., generally co-axial) thelongitudinal passageway126 of the driver110 (as best illustrated inFIG. 7) such that theanchor18 and the driver110 (and optionally the biasing device112) may be advanced over theguide wire146. The optionally use of the cannulatedpassageway32 and theguide wire146 may further aid in aligning theanchor18 at the desired angle with respect to theexcision site20 and the surroundingarticular surface12.
• Once theanchor18 is aligned with respect to theexcision site20, thedriver110 may then be used to secure theanchor18 into thebone14, for example, by rotating thedriver110, thereby causing theanchor18 to rotate. The height of theanchor18 may be verified using a trial gauge (not shown) which may be easily inserted/placed into theanchor18 to ensure that the implant16 (e.g.,FIG. 1) is substantially flush with the surroundingarticular surface21. Once the height of theanchor18 is verified, the driver110 (and optionally thebiasing device112 and/or the guide wire146) may be removed, leaving the anchor18 (and optionally the suture114) remaining in thebone14, as generally illustrated inFIG. 8. While theanchor18 is illustrated havingthreads21, it may be appreciated that theanchor18 may be secured to thebone14 using any device(s) known to those skill in the art including, but not limited to, ribs, barbs, bone cement, porous structures, and the like.
• It should also be appreciated that thebiasing device112 does not have to be used when advancing and/or aligning theanchor18 with respect theexcision site20. For example, thebiasing device112 may be eliminated and tension may be applied to thesuture114 to keep theanchor18 engaged with thedriver110. Alternatively, theanchor18 may be advanced to and aligned with theexcision site20 without using thedriver110. For example, thesuture114 may be secured about a portion of theanchor18, and once theanchor18 is aligned within theexcision site20, thedriver110 may engage theanchor18 and used to secure theanchor18 within theexcision site20 in thebone14.
• Turning now toFIGS. 9-12, systems and methods for securing animplant16 to theanchor18 using animplant delivery system100 consistent with the present disclosure are generally illustrated. As discussed herein, theimplant delivery system100 may be configured to generate a biasing force to secure theimplant16 to theanchor18 wherein the biasing force is only applied against theimplant16 and theanchor18, and not the surrounding bone ortissue14.
• With theanchor18 secured to thebone14 and thesuture114 disposed about thecontact portion140 of theanchor18 as described herein, theimplant16 may be arranged (i.e., placed) between theanchor18 and thesecond end region130bof thebiasing device112 as generally illustrated inFIGS. 9 and 10. Thesuture114 may extend around thecontact portion140 of theanchor18, through suture alignment guides138a,138bandsuture passageways136a,136b, and exit through thefirst opening134aof theshaft passageway132 of the biasingbody112. Thesuture114 may also be generally coupled or secured to a portion of thedriver110, for example, a portion of theshaft116. For example, thedriver110 may include asuture engagement148 configured to allow thesuture114 to be generally fixed or retained by thedriver110.
• According to one embodiment, thesuture engagement148 may include a hole or aperture through theshaft116. At least a portion of thesuture114 may pass through thehole148, and thesuture114 may be secured within thesuture engagement148 as thedriver110 is rotated to reduce the length L of thesuture114 between thedriver110 and theanchor18 as explained herein. It should be appreciated that thesuture engagement148 may include any device for generally securing thesuture114 to thedriver110. For example, thesuture engagement148 may include an external protrusion, a groove, non-cylindrical region, and/or a slot configured to secure thesuture114. Alternatively, thesuture114 may be wrapped around theshaft116, and the tension generated by the rotation of thedriver110 may secure thesuture114 thereto. The length of the biasingbody112 may be selected to allow the surgeon sufficient room to rotate thedriver110, and therefore may depend on the intended application.
• With thesuture114 generally secured to thedriver110, thedriver110 may be rotated about its longitudinal axis A as it is received within thedriver cradle121. Thedriver cradle121 may be configured to receive the driver110 (e.g., the shaft116) and generally retain theshaft116 as theshaft116 is rotated relative to the biasingbody112. For example, thedriver cradle121 may include one or ore recesses, grooves, or lips formed in thefirst end region134aof the biasingbody112. Thedriver cradle121 may also include one or more holes or passageways formed through the biasingbody112 configured to receive and generally retain theshaft116.
• Optionally, thedriver cradle121 may include an enlarged opening150 (best seen inFIG. 9). As thedriver110 is rotated, thesuture114 begins to wrap around theshaft116, thereby increasing the diameter of theshaft116. Theenlarged opening150 provides a void space that thesuture114 can pass through as thedriver110 is rotated and thesuture114 builds up around theshaft116. As a result, thesuture114 may generally avoid contact with thedriver cradle121, and the torque necessary to rotate thedriver110 may be reduced.
• Turning now toFIGS. 11 and 12, with theimplant16 disposed between theanchor18 and the second end region132bof the biasingbody112, and the driver110 (along with thesuture114 generally secured thereto) disposed within thedriver cradle121, the surgeon may rotate thedriver110 about longitudinal axis A to reduce the length L of thesuture114 extending between thedriver110 and thecontact portion120 of theanchor118. The reduction in the length L of thesuture114 generates a biasing force which urges theimplant16 into engagement with theanchor18. As may be appreciated, theimplant delivery system100 generates a biasing force which is applied against theimplant16 andanchor18 through thesuture114 only (i.e., substantially no force is applied to the surroundingbone14 or tissue).
• More specifically, because thesuture114 supports theanchor18, rotation of thedriver110 about longitudinal axis A increases the tension on the suture114 (and therefore the biasing force between theimplant16 and the anchor18) in an opposite direction of the downward force being placed upon theimplant16 by the biasingbody112. Continued rotation of thedriver110 increases the biasing force between theimplant16 and theanchor18 and, once the biasing force exceeds the required threshold to install theimplant16, theimplant16 may be successfully installed (e.g., secured) in theanchor18. Thus, as a result of thesuture114 applying a relatively equal and opposite force to theanchor18 and the biasing device110 (and therefore the implant16), the underlyingbone14 and other structures are not affected, preventing or reducing potential injury from securing theimplant16 into theanchor18. Theimplant delivery system100 therefore avoids and/or reduces any impact to the bone14 (e.g., eliminates blunt force due to a hammer/mallet or the like), and therefore avoids and/or reduces damage to thebone16.
• Because the biasing force is not transmitted/applied into the surroundingbone14 or tissue, theimplant delivery system100 may be used with small bones (such as, but not limited to, phalange bones and/or metatarsal bones in the foot and/or hands. Additionally, because theimplant delivery system100 is capable of generating high biasing forces without transmitting/applying the biasing force to the surroundingbone14 or tissue, the connection between theimplant body16 and the anchor18 (e.g., first andsecond fixation elements24,26 as discussed herein) may be stronger and more robust, thereby increasing the life expectancy of theimplant system10. Moreover, theimplant delivery system100 may deliver the biasing force uniformly to theimplant16 and be self-leveling or self-aligning, thereby reducing and/or eliminating the difficulties associated with aligning theimplant16 with respect to theanchor18.
• Once theimplant16 is secured to theanchor18, thesuture114 may be removed from theimplant system10. For example, one or more portions of thesuture114 may be cut and the resulting pieces may be removed (e.g., pulled out) from theexcision site20. Alternatively, a first end of thesuture114 may be released and thesuture114 may be pulled through the biasingbody120 by a second end of thesuture114, resulting in the first end traveling through the shaft passageway132c, through one of thesuture passageways136a,136b, out one of the alignment guides138a,138b, around theanchor18 and through the second of the alignment guides138a,138bandsuture passageways136a,136b, and theshaft passageway132. However, example embodiments may vary and are not limited thereto.
• If thesuture114 is cut prior to removal, example embodiments may vary and may include thesuture114 having various shapes or loops. For example, thesuture114 may form a basket or loop to wrap around theanchor18. This shape may help support theanchor18 and may increase control over theanchor18 prior to thesuture114 being wrapped around thedriver110. In this configuration, the loop may extend so that the loop can be severed after installation of theimplant system10.
• According to one aspect, the present disclosure may feature a delivery system for securing an implant with an anchor. The delivery system may include a driver including a shaft and a biasing body. The driver may be configured to wind a portion of a suture, wherein the suture is configured to extend around a contact portion of the anchor disposed within a bone. The biasing body may have a first end region and a second end region. The first end region may include a driver cradle configured to generally retain a portion of the shaft as the driver is rotated relative to the biasing body. The second end region may be configured to engage a portion of the implant. Rotation of the driver applies a biasing force against the implant and the anchor to secure the implant with the anchor, wherein the biasing force is substantially not transmitted to the bone.
• According to another aspect, the present disclosure may feature a system comprising an implant system, at least one suture, and an implant delivery system. The implant system includes an anchor configured to be secured in bone beneath a patient's articular surface, and an implant configured to be secured to the anchor. The implant is configured to replace a portion of the patient's articular surface. The suture has a first portion configured to be disposed about a portion of the anchor. The implant delivery system includes a driver including a shaft, and a biasing body having a first end region configured to engage the driver and a second end region configured to engage a portion of an implant. The driver is configured to wind a second portion of the suture while engaged against the first end region to reduce a length of the suture between the driver and the anchor and generate a biasing force urging the implant into engagement with the anchor, wherein the biasing force is substantially not transmitted to the bone.
• According to yet another aspect, the present disclosure may feature a method of installing an articular surface implant in an excision site formed in a patient's bone. The method includes securing an anchor in the patient's bone within the excision site, and applying a biasing force against an implant to urge the implant into engagement with the anchor, wherein the biasing force is substantially not transmitted to the bone.
• According to a further aspect, the present disclosure may feature an implant system. The implant system may include an implant body and an anchor. The implant body may include a load bearing surface having a contour substantially corresponding to a removed portion of a patient's articular surface, a bone facing surface, and a first fixation element. The anchor may be configured to be secured in bone beneath the removed portion of the patient's articular surface, and may include a second fixation element. The first and the second fixation element may be are configured to form a snap-fit connection therebetween.
• The terms and expressions which have been employed herein are used as terms of description and not of limitation, and there is no intention, in the use of such terms and expressions, of excluding any equivalents of the features shown and described (or portions thereof), and it is recognized that various modifications are possible within the scope of the claims. Accordingly, the claims are intended to cover all such equivalents. Various features, aspects, and embodiments have been described herein. The features, aspects, and embodiments are susceptible to combination with one another as well as to variation and modification, as will be understood by those having skill in the art. The present disclosure should, therefore, be considered to encompass such combinations, variations, and modifications.
• All definitions, as defined and used herein, should be understood to control over dictionary definitions, definitions in documents incorporated by reference, and/or ordinary meanings of the defined terms.
• The indefinite articles “a” and “an,” as used herein in the specification and in the claims, unless clearly indicated to the contrary, should be understood to mean “at least one.”
• The phrase “and/or,” as used herein in the specification and in the claims, should be understood to mean “either or both” of the elements so conjoined, i.e., elements that are conjunctively present in some cases and disjunctively present in other cases. Other elements may optionally be present other than the elements specifically identified by the “and/or” clause, whether related or unrelated to those elements specifically identified, unless clearly indicated to the contrary.
• All references, patents and patent applications and publications that are cited or referred to in this application are incorporated in their entirety herein by reference.

Claims (31)

What is claimed is:

1. A delivery system for securing an implant with an anchor, the delivery system comprising:

a driver including a shaft, said driver configured to wind a portion of a suture, said suture configured to extend around a contact portion of said anchor disposed within a bone; and

a biasing body having a first end region including a driver cradle configured to generally retain a portion of said shaft as said driver is rotated relative to said biasing body, and a second end region configured to engage a portion of said implant;

wherein rotation of said driver applies a biasing force against said implant and said anchor to secure said implant with said anchor, and wherein said biasing force is substantially not transmitted to said bone.

2. The delivery system ofclaim 1, further comprising said suture, wherein said suture includes a first region configured to be generally secured to said shaft and a second region configured to be disposed about said contact portion of said anchor.

3. The delivery system ofclaim 2, wherein said second region of said suture includes a first and a second portion defining a cradle configured to engage said contact portion of said anchor.

4. The delivery system ofclaim 3, wherein said biasing body is configured to maintain a separation angle of said first and second portions of said cradle.

5. The delivery system ofclaim 1, wherein said driver cradle includes an enlarged opening configured to allow said suture to wind about said shaft as said shaft is rotated.

6. A system comprising:

an implant system including:

an anchor configured to be secured in bone beneath a patient's articular surface; and

an implant configured to be secured to said anchor, said implant replacing a portion of said patient's articular surface;

at least one suture having a first portion configured to be disposed about a portion of said anchor; and

an implant delivery system comprising:

a driver including a shaft; and

a biasing body having a first end region configured to engage said driver and a second end region configured to engage a portion of an implant;

wherein said driver is configured to wind a second portion of said suture while engaged against said first end region to reduce a length of said suture between said driver and said anchor and generate a biasing force urging said implant into engagement with said anchor, and wherein said biasing force is substantially not transmitted to said bone.

7. The system ofclaim 6, wherein said first end region includes a driver cradle configured to generally retain a portion of said shaft as said driver is rotated relative to said biasing body.

8. The system ofclaim 6, wherein the suture includes a cradle configured to engage a contact portion of said anchor.

9. The system ofclaim 8, wherein said biasing body is configured to maintain a separation angle of said cradle.

10. The system ofclaim 9, wherein the biasing body includes at least one suture alignment guide configured to guide maintain said separation angle of said cradle.

11. The system ofclaim 6, wherein the driver and said anchor include engagement portions configured to transmit torque.

12. The system ofclaim 6, wherein the biasing body is self-aligning with respect to said implant as said biasing force is applied.

13. A method of installing an articular surface implant in an excision site formed in a patient's bone, said method comprising:

securing an anchor in said patient's bone within said excision site; and

applying a biasing force against an implant to urge said implant into engagement with said anchor, wherein said biasing force is substantially not transmitted to said bone.

14. The method ofclaim 13, wherein the applying said biasing force comprises:

applying a downward force on the implant assembly and an upward force on the fixation element.

15. The method ofclaim 14, wherein a suture is coupled around a portion of said anchor and a portion of a driver, and wherein said biasing force is transmitted by through suture.

16. The method ofclaim 15, wherein the applying a biasing force comprises:

rotating the driver to increase a tension of the suture between the driver and the anchor.

17. The method ofclaim 16, further comprising a biasing body disposed between said drive and said implant.

18. The method ofclaim 17, wherein the suture includes a cradle configured to engage a contact portion of said anchor, and wherein said biasing body is configured to guide maintain a separation angle of said cradle.

19. The method ofclaim 18, wherein a first end region of the biasing body includes a driver cradle configured to generally retain a portion of a shaft of said driver as said driver is rotated relative to said biasing body.

20. The method ofclaim 13, wherein a suture is coupled around a portion of said anchor and a portion of a driver, and wherein applying said biasing force includes reducing a length of said suture between said driver and said anchor.

21. An implant system comprising:

an implant body comprising:

a load bearing surface having a contour substantially corresponding to a removed portion of a patient's articular surface;

a bone facing surface; and

a first fixation element; and

an anchor configured to be secured in bone beneath said removed portion of said patient's articular surface, said anchor comprising a second fixation element;

wherein said first and said second fixation element are configured to form a snap-fit connection therebetween.

22. The implant system ofclaim 21, wherein said anchor defines an implant cavity configured to receive at least a portion of said bone facing surface of said implant.

23. The implant system ofclaim 22, wherein at least a portion of a periphery of said cavity includes said second fixation element and wherein at least a portion of said bone facing surface includes said first fixation element.

24. The implant system ofclaim 23, wherein said second fixation element extends along the entire periphery of said cavity.

25. The implant system ofclaim 23, wherein said first fixation element extends along a periphery of said implant body.

26. The implant system ofclaim 21, wherein said first and said second fixation elements are configured to prevent rotation of said implant body relative to said anchor.

27. The implant system ofclaim 21, wherein first and said second fixation elements are selected from a protrusion and a groove.

28. The implant system ofclaim 21, wherein at least a portion of said anchor includes a threaded region configured to secure said anchor to said bone.

29. The implant system ofclaim 21, wherein at least a portion of said anchor includes at least one external protrusion configured to secure said anchor to said bone.

30. The implant system ofclaim 21, wherein at least a portion of said anchor includes at least one external groove configured to secure said anchor to said bone.

31. The implant system ofclaim 21, wherein anchor includes a longitudinal passageway.

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