Surgical drill guide device and method

Abstract

A device is provided for positioning and guiding a drill to form a bone passage during surgery. The device may include a handle and a sleeve disposed on the handle. The sleeve may be configured to receive the drill. The device may further include a neck disposed on the handle and a lever disposed on the neck. The neck may be movable in a translational manner relative to the handle. The lever may be movable angularly in a rotational manner relative to the neck. The device may further include a guide arm disposed on the lever and a neck locking mechanism disposed on the handle. The neck locking mechanism may be configured to maintain the neck in place relative to the handle passage and also to release the neck. The device may further include a detent mechanism configured to provide resistance to rotation of the lever.

Description

Technology Field

[0001] [Cross-reference of related applications]

[0002] This application carries a priority claim based on U.S. Provisional Patent Application No. 63 / 626,751, filed on January 30, 2024, with the title of the invention "Device and method for guiding a surgical drill," the entirety of which is incorporated herein by reference.

[0003] [Technology Field]

[0004] The present invention generally relates to arthroscopic surgery. Specifically, the present invention relates to an apparatus and method for a positioning and guiding drill used to form a passage within the bone. Background Technology

[0005] The meniscal root is the anchorage point of the meniscus located on the tibial surface. Treatment of the meniscal root is necessary in various knee-related injuries. For example, a medial meniscal tear typically occurs at or around the meniscal root insertion on the tibial surface. In most meniscal repair procedures, a guide is positioned at the anteromedial (AM) portal, and a camera is positioned at the anterolateral (AL) portal to allow the surgeon to observe the medial root insertion. Subsequently, a passage may be created within the tibia by drilling to allow for the use of sutures or other means configured to fix the meniscus. Observing from the anterolateral insertion while the guide is positioned at the anteromedial portal makes it very difficult to visualize the medial root insertion. Insufficient visibility leads to inaccurate channel formation and subsequent suturing, which can result in difficulty in restoring the biomechanical function of the meniscus and ultimately lead to surgical failure. To compensate for this insufficient visibility, "reverse notchplasty" (e.g., removal of the medial tibial spine) is often required, which introduces additional steps into the surgical process and increases morbidity. Even after performing the additional steps of reverse notchplasty and removal of the tibial spine, visibility of the insertion site may still often remain insufficient to prevent the aforementioned problems. The problem to be solved

[0006] Therefore, it is necessary to improve the device and method for the positioning and guiding drill used to form a passage within the tibia. means of solving the problem

[0007] This entry, [Means for Solving the Problem], is provided to introduce, in a simplified form, the selection of concepts that are explained in more detail in the detailed description below. This entry is not intended to distinguish the core or essential components of the invention described in the claims, nor is it intended to be used to assist in determining the scope of protection of the invention described in the claims.

[0008] According to one embodiment of the present invention, an apparatus for positioning a drill to form a bone passage during surgery is provided. The apparatus may include a handle, a neck portion, a sleeve, a sleeve portion, and a guide arm. The handle may include a first passage formed internally (e.g., a handle passage, a neck passage, etc.) and a second passage formed internally (e.g., a drill passage, a sleeve passage, etc.). The sleeve may be positioned on the handle (e.g., within the second passage) and may be configured to receive a drill. The neck portion may be positioned on the handle (e.g., within the first passage). The neck portion may be movable in a translational manner relative to the handle passage. The sleeve portion may be positioned on the neck portion. The guide arm may be positioned within or on the sleeve portion and may also be movable angularly in a rotational manner relative to the sleeve portion and / or neck portion.

[0009] In some embodiments, the device further comprises a lever. The lever may be positioned on a guide arm. The lever may be configured to rotate so that the guide arm rotates relative to the handle. The lever may be configured to rotate so that the guide arm rotates within the sleeve portion. The handle may be configured to be gripped by the user's hand, and the lever may be configured to be rotated by the user's thumb. In additional embodiments, the lever may be positioned on the neck portion or the sleeve portion.

[0010] In some embodiments, the device further includes a neck locking mechanism disposed on the handle. The neck locking mechanism may be configured to hold the neck in place relative to the handle and to release the neck. The neck locking mechanism may include a hinge that can move between a first hinge position in which the neck locking mechanism holds the neck in place relative to the handle passage and a second hinge position in which the neck locking mechanism releases the neck. The hinge may be configured to be rotated by a user's index finger.

[0011] In some embodiments, the device further includes a sleeve locking mechanism. The sleeve locking mechanism may include a locking member having a through hole configured to receive a sleeve. The locking member may move between an unlocked position in which the sleeve is movable in an axial translational manner with respect to the through hole, and a locked position in which the sleeve is prevented from moving away from the tip of the guide arm due to the locking member. The locking member may be deflected toward the locked position by a deflection member.

[0012] In some embodiments, the device further includes a detent mechanism disposed in the handle. The detent mechanism may be configured to provide resistance to rotation of the lever. Thus, the detent mechanism may be configured to provide resistance to rotation of the guide arm relative to the sleeve.

[0013] In some embodiments, the guide arm is configured to engage with the tibial plateau of the knee through an anterolateral insertion portion of the knee.

[0014] In some embodiments, the neck and handle passage have a corresponding arch shape.

[0015] According to another embodiment of the present invention, a method for positioning and guiding a drill to form a bone passage during surgery on a knee is provided. The method may include the step of providing the aforementioned handle, neck portion, sleeve, guide arm, and lever. Additionally, the method may include the step of providing the aforementioned sleeve portion and neck portion locking mechanism. As described above, the handle may include a first handle passage formed internally and a second handle passage formed internally. The neck portion may be positioned within the handle passage. The sleeve portion may be positioned within the neck portion. The sleeve may be configured to receive the aforementioned drill. The guide arm may include a tip and may be positioned inside the neck portion (e.g., sleeve portion) or on the neck portion. Additionally, the method may include the step of advancing the guide arm through an anterolateral insertion portion of the knee and positioning the guide arm (e.g., tip of the guide arm) on the tibial plateau of the knee. Additionally, the method may include the step of moving the lever angularly so as to rotate it relative to the neck, thereby causing the guide arm to move angularly in a rotational manner relative to the neck in response to the rotation of the lever. The method may include the step of moving the sleeve so as to be translated relative to the handle so that the sleeve advances toward the knee, and engaging the neck locking mechanism so that the neck is maintained in its proper position relative to the handle. In some embodiments, the method further includes the step of observing at least one image of the tibial plateau via a camera through the anteromedial insertion of the knee. As previously described, the method may further include the step of advancing the sleeve toward the knee through the drill passage.

[0016] In some embodiments, the method further includes the step of providing a lever disposed on a guide arm and rotating the lever to cause the guide arm to move angularly in a rotational manner relative to the sleeve.

[0017] In some embodiments, the method further includes the step of withdrawing the handle away from the guide arm so that the neck portion moves in a translational manner relative to the handle passage.

[0018] In some embodiments, the method further comprises the step of providing a neck locking mechanism disposed on a handle. The neck locking mechanism may include a hinge. The method may further comprise the step of rotating the hinge so that the neck locking mechanism secures the neck in place relative to the handle passage. The handle may be configured to be gripped by a user's hand, the lever may be configured to be rotated by a user's thumb, and the hinge may be configured to be rotated by a user's index finger.

[0019] In some embodiments, the method may further include the step of providing a detent mechanism. The detent mechanism may provide resistance to the guide arm rotating relative to the sleeve.

[0020] In some embodiments, the method further comprises the step of providing a sleeve locking mechanism disposed on a handle. The sleeve locking mechanism may include a locking member having a through hole configured to receive a sleeve. The locking member may be moved from an unlocked position, where a drill is movable in an axial translational manner with respect to the through hole, to a locked position in which the sleeve is prevented from moving away from the tip by the locking member. The locking member may be deflected to the locked position by a deflection member.

[0021] Many other objects, advantages, and features of the present invention will be clearly understood by a person skilled in the art by referring to the following drawings and description of preferred embodiments. Brief explanation of the drawing

[0022] FIG. 1 shows a perspective view of a portion of a knee including a meniscal root tissue injury in some embodiment of the present invention. FIG. 2a shows a side view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, in which the guide arm of the device is shown in the first guide arm position. FIG. 2b shows a side view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, in which the guide arm of the device is shown in the position of a second guide arm. FIG. 2c shows a perspective view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, wherein the guide arm of the device is shown in the first guide arm position. FIG. 2d shows a side view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, in which the guide arm of the device is shown in the third guide arm position. FIG. 2e shows a side view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the guide arm of the device is shown in the first guide arm position. FIG. 2f shows a side view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the guide arm of the device is shown in the position of a second guide arm. FIG. 2g shows a perspective view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the guide arm of the device is shown in the first guide arm position. FIG. 2h shows a side view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the guide arm of the device is shown in the position of a third guide arm. FIG. 3a shows a side view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the guide arm of the device is shown extended toward a second guide arm position. FIG. 3b shows a perspective view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, wherein the guide arm of the device is shown extended toward a second guide arm position. FIG. 3c shows a side view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the guide arm of the device is shown extended toward a second guide arm position. FIG. 3d shows a perspective view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the guide arm of the device is shown extended toward a second guide arm position. FIG. 4a shows a side view of a guide arm assembly of a device for positioning a drill to form a bone passage during surgery, according to some embodiment of the present invention. FIG. 4b shows a side view of a guide arm of a device for positioning a drill to form a bone passage during surgery, according to some embodiment of the present invention. FIG. 4c shows a side view of a guide arm assembly of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 4d shows a side view of a guide arm of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 4e shows an exploded view of a guide arm assembly of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 5a shows a side view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, in which a guide arm is shown rotating relative to the sleeve of the device. FIG. 5b shows a side view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, in which a guide arm is shown rotating relative to the sleeve of the device. FIG. 6a shows a side perspective view of a lever for rotating a guide arm of a device for positioning a drill to form a bone passage during surgery, according to some embodiment of the present invention. FIG. 6b shows a detailed front perspective view of a lever for rotating a guide arm of a device for positioning a drill to form a bone passage during surgery, according to some embodiment of the present invention. FIG. 6c shows a detailed side view of a lever for rotating a guide arm of a device for positioning a drill to form a bone passage during surgery, according to some embodiment of the present invention. FIG. 6d shows a detailed front perspective view of a lever for rotating a guide arm of a device for positioning a drill to form a bone passage during surgery, according to some embodiment of the present invention, wherein the lever is shown in a first angled position. FIG. 6e shows a detailed perspective view of a lever for rotating a guide arm of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention, wherein the lever is shown in a second angle position. FIG. 6f shows a detailed upper perspective view of a lever for rotating a guide arm of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 6g shows a detailed plan view of a sleeve portion having ribs for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 6h shows an upper perspective view of a lever for rotating a guide arm of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 6i shows a lower perspective view of a lever for rotating a guide arm of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 7a shows a side view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, in which the hinge of the locking mechanism of the device is rotated to allow relative movement of the guide arm with respect to the handle of the device. FIG. 7b shows a side perspective view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, in which the hinge of the locking mechanism of the device is rotated to allow relative movement of the guide arm with respect to the handle of the device. FIG. 7c shows a side view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the hinge of the locking mechanism of the device is rotated to allow relative movement of the guide arm with respect to the handle of the device. FIG. 7d shows a detailed side view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the hinge of the locking mechanism of the device is rotated to allow relative movement of the guide arm with respect to the handle of the device. FIG. 7e shows an upper perspective view of a cam of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 7f shows a side perspective view of a cam of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 7g shows a side view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, in which a screw lock of the device’s locking mechanism is rotated to allow relative movement of the guide arm with respect to the handle of the device. FIG. 8a shows a detailed side cross-sectional view of a device for positioning a drill to form a bone passage during surgery, according to some embodiment of the present invention. FIG. 8b shows a side cross-sectional view of a device for positioning a drill to form a bone passage during surgery, according to some embodiment of the present invention. FIG. 8c shows a detailed side cross-sectional view of a device for positioning a drill to form a bone passage during surgery, according to an additional embodiment of the present invention. FIG. 9a shows a detailed side cross-sectional view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, wherein the drill advancement mechanism of the device is shown in a first position. FIG. 9b shows a perspective view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, wherein the drill advancement mechanism of the device is shown in a first position. FIG. 9c shows a detailed side cross-sectional view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, wherein the drill advancement mechanism of the device is shown in a second position. FIG. 9d shows a detailed side cross-sectional view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the drill advancement mechanism of the device is shown. FIG. 9e shows an upper perspective view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the drill advancement mechanism of the device is shown. FIG. 9f shows a detailed upper perspective view of a device for positioning a drill to form a bone passage during surgery according to an additional embodiment of the present invention, wherein the drill advancement mechanism of the device is shown. FIG. 10 shows a perspective view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, wherein the drill is shown being held in the user's hand. FIG. 11a shows a perspective view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, wherein the guide arm of the device is shown passing through an anterolateral insertion part of the knee and engaging with the tibial plateau of the knee. FIG. 11b shows a perspective view of a device for positioning a drill to form a bone passage during surgery according to some embodiment of the present invention, wherein the guide arm of the device is shown passing through an anteromedial insertion part of the knee and engaging with the tibial plateau of the knee. Figure 12 illustrates a camera view of the tibial plateau according to a conventional method, in which the camera captures the guide arm through the anterolateral insertion when the guide arm is introduced into the tibial plateau through the anteromedial insertion. FIG. 13 illustrates a camera view according to some embodiment of the present invention, wherein the camera has an improved view compared to the case of FIG. 18, based on the view of the tibial plateau seen through the anteromedial insertion when the guide arm is introduced into the tibial plateau through the anterolateral insertion. FIG. 14 illustrates a camera view according to some embodiment of the present invention, wherein the camera has an improved view compared to the case of FIG. 18, based on the view of the tibial plateau seen through the anteromedial insertion when the guide arm is introduced into the tibial plateau through the anterolateral insertion. Specific details for implementing the invention

[0023] Although the fabrication and use of various embodiments of the present invention are described in detail below, it should be understood that the present invention provides many applicable inventive concepts that are embodied in a wide variety of specific contexts. The specific embodiments described herein are merely illustrative of specific ways of fabricating and using the present invention and do not limit the scope of protection of the present invention. A person skilled in the art will recognize numerous equivalents to the specific apparatus and method described herein. Such equivalents are included within the scope of protection of the present invention and are encompassed by the claims.

[0024] For clarity, not all reference numerals are included in each drawing. Additionally, positional terms such as "upper," "lower," "side," "top," and "bottom" are intended to describe the device in the orientations depicted in the drawings unless otherwise noted. A person skilled in the art will recognize that the device may be positioned in various orientations during use.

[0025] The present invention provides a drill guide device ("device") (10) for use in a surgical procedure for a site including but not limited to the knee. For example, the device (10) may be used to position and guide a drill for forming a bone passage in a surgical procedure such as knee surgery. FIG. 1 illustrates an example of a knee (110) in which the upper end of the tibia (112) is shown, including the medial meniscus (116) and the lateral meniscus (118). The medial meniscus (116) includes a posterior root (128) and an anterior root (130). The lateral meniscus (118) includes a posterior root (124) and an anterior root (126). Each root is attached to the tibia (112) at a local tissue attachment site along the tibial plateau (114). Various types of injury may result in at least one root tear or injury in the medial meniscus or lateral meniscus. An example of a root tear (132) of the lateral posterior root (124) is illustrated in FIG. 1.

[0026] Although various drawings illustrate an exemplary posterior lateral meniscus tear injury and the use of a device (10) for treating such injury, the device of the present invention and the method including said device (10) are applicable to many different types of injuries, including but not limited to tears and injuries of the anterior lateral meniscus and posterior lateral meniscus, as well as the anterior medial meniscus, posterior medial meniscus, anterior cruciate ligament, and posterior cruciate ligament. Examples illustrating application to a posterior lateral meniscus tear are provided merely as non-limiting examples.

[0027] Now, referring to FIGS. 2a through 2h, a front view of a device (10) according to various embodiments of the present invention is shown. As described in more detail below, the device (10) may include a handle (14), a neck (24) (see FIGS. 2b, 2c, and 2f in particular), a sleeve (20), a cuff (16), and a guide arm (12) (e.g., a surgical locator probe). Referring further to FIG. 4e, the neck (24) may include a first end (24a) and a second end (24b). In some embodiments, the neck (24) includes a cuff (16) formed at the first end (24a) of the neck (24). In other embodiments, the cuff (16) is disposed on the neck (24).

[0028] In some embodiments, the handle (14) includes a second handle passage (18) formed therein. The second handle passage (18) may define a first longitudinal axis (52), and the guide arm (12) may define a second longitudinal axis (54). Referring further to FIG. 6g, a sleeve passage (23) passing through the sleeve (16) may be formed. In a further embodiment, the second longitudinal axis (54) is defined by the sleeve passage (23). Referring further to FIG. 8a through 8c, the handle (14) may further include a first handle passage (15) formed therein.

[0029] As described above, and particularly as illustrated in FIGS. 2b through 2d and FIGS. 2f through 2h, the device (10) may further include a sleeve (20) (e.g., a drill sleeve) disposed on a handle (14). In particular, the sleeve (20) may be disposed in a second handle passage (18). Particularly referring to FIGS. 2b and 2d, the sleeve (20) may be configured to receive a drill (29). Thus, the device (10) may further include a drill (29).

[0030] In some embodiments, the neck portion (24) is positioned on the handle (14) and is movable in a translational manner relative to the handle (14). In particular, the neck portion (24) may be positioned in the first handle passage (15) and is movable in a translational manner relative to the first handle passage (15). For example, particularly referring to FIG. 2c, the handle (14) may include a handle opening (13) formed at the end of the first handle passage (15), and the neck portion (24) may advance or retract through this handle opening (13). Further referring to FIG. 4e, the neck portion (24) may include a first end portion (24a) and a second end portion (24b). Thus, the first end portion (24a) may be free from the handle passage (15), and the second end portion (24b) may be positioned in the handle passage (15). The sleeve portion (16) may be formed on the neck portion (24) (e.g., the first end portion (24a)). The guide arm (12) may be positioned on the sleeve portion (16) and may be movable in a rotational manner relative to the sleeve portion (16).

[0031] As described above, the neck portion (24) may be disposed inside or on the first handle passage (15), and the sleeve (20) may be disposed inside or on the second handle passage (18). Accordingly, depending on the embodiment, the first handle passage (15) may be considered as a "handle passage" or a "neck passage," and the second handle passage (18) may be considered as a "drill passage" or a "sleeve passage."

[0032] As previously proposed, in some embodiments, the device (10) is a device for positioning a sleeve (20) to form a bone passage during surgery. The sleeve (20) may be configured to receive and guide a drill (29) within it. The device (10) may be used to treat a meniscal muscle tear of the knee, such as the muscle tear (132) of the knee (110) shown in FIG. 1, for example. Accordingly, the device (10) may be configured to position and guide a drill (29) through the sleeve (20) to form a bone passage through a bone, such as the tibia (112) shown in FIG. 1, during the surgical procedure. In this sense, the device (10) may be configured to provide structures and / or supports necessary to implement sutures or other suitable structures for knee treatment.

[0033] As described above, the device (10) may include a handle (14), a neck portion (24), a sleeve portion (16), and a guide arm (12). As described in detail below with reference to FIG. 11a, the guide arm (12) (particularly, the tip (26)) may be configured to engage with the tibial plateau (114) of the knee (110) via the anterolateral insertion portion (138) of the knee (110) (see FIG. 11a). Accordingly, the guide arm (12) can advance to the anterolateral insertion portion (138), thereby enabling a separate camera (50) to capture or observe at least one image of the tibial plateau (114) through the anteromedial insertion portion (136) of the knee (110) (see FIG. 11a). In this sense, by configuring the guide arm (12) to advance toward the anterolateral insertion part (138), the camera (50) can secure a clear path for observing the meniscus (e.g., the posterior root (124) and / or anterior root (126) shown in FIG. 1) during the surgical procedure. As illustrated in more detail in FIG. 4a to 4d, the guide arm (12) and the neck (24) can be considered as components of the guide arm assembly (22).

[0034] As described above, the device (10) may include a handle (14) that may include a first handle passage (15) and a second handle passage (18), each formed inside. As illustrated in FIGS. 8a through 8c, the second handle passage (18) may be configured to accommodate a sleeve (20). Referring to FIG. 10, the handle (14) may be grasped by the hand (99) of a user (e.g., practitioner, doctor, surgeon, etc.) to perform the method described herein. For example, the handle (14) may have a series of grooves that are fitted to facilitate the user's grasping of the handle (14).

[0035] Referring to FIGS. 3a through 3d, an extended state of the device (10) according to various embodiments of the present invention is illustrated. For example, the guide arm assembly (22) is translationally movable relative to the handle (14). As described in detail below with reference to FIGS. 4a through 4d, the guide arm assembly (22) may include a neck portion (24), the neck portion (24) may be disposed within the first handle passage (15) and may also be movable in an arc in a translational manner relative to the first handle passage (15). For example, the neck portion (24) may be inserted into a handle opening (13) formed at the first end of the handle (14). Thus, the neck portion (24) may be a telescoping neck. Since the handle (14) and the first handle passage (15) can be provided in an arc-shaped configuration and the neck portion (24) can be provided in a corresponding arc-shaped configuration, the neck portion (24) can be considered to be movable in an axial translational manner relative to the first handle passage (15). Accordingly, the guide arm assembly (22) can be translated relative to the handle (14) along the path (19).

[0036] Now, referring to FIGS. 4a through 4e, a guide arm assembly (22) according to various embodiments of the present invention is illustrated herein. As previously described, the guide arm assembly (22) may include a guide arm (12) and a neck portion (24). In particular, in some embodiments as illustrated in FIGS. 4a and 4c, the guide arm assembly (22) further includes a sleeve portion (16) of the neck portion (24). The sleeve portion (16) may be formed on the neck portion (24) and configured to mechanically secure the guide arm (12) to the neck portion (24). In particular, as illustrated in FIGS. 4b and 4d, the guide arm (12) may be provided to have any configuration (e.g., length, curvature, etc.) suitable for exploring the anterior-lateral insertion portion (138).

[0037] As described above, the sleeve portion (16) and the neck portion (24) may be formed as a single part. For example, the sleeve portion (16) may be integrally formed on the first end of the neck portion (24) on the opposite side of the second end of the neck portion (24) that is inserted into the handle opening (13). In this sense, the sleeve portion (16) may be formed and fixed to the neck portion (24) permanently (e.g., so that the sleeve portion (16) cannot slide or move relative to the neck portion (24). In another embodiment, the sleeve portion (16) may be fixed to the neck portion (24) by an adhesive or any other suitable mechanical fastening means. As described above, the sleeve portion (16) may include a sleeve portion passage (23). The sleeve portion passage (23) may be a longitudinal channel extending through the sleeve portion (16), which may be configured to accommodate a portion of the guide arm (12). Accordingly, the guide arm (12) can be positioned on the sleeve (16) and can be rotated angularly with respect to the sleeve (16) (and, accordingly, the handle (14)).

[0038] In particular, in some embodiments illustrated in FIG. 4b, 4d, and 4e, the guide arm (12) includes a tip (26) at the distal end of the guide arm (12), a key (27) at the proximal end of the guide arm (12) on the opposite side of the tip (26), and also includes a guide arm curvature (28) extending between the tip (26) and the key (27). As illustrated in FIG. 11a, when the guide arm (12) advances through the anterolateral insertion (138) of the knee (110), the tip (26) can engage with the tibial plateau (114) of the knee (110). In order to allow the guide arm to advance through the anterolateral insertion (138) of the knee (110), the guide arm curve (28) may have a “biphasic” curvature, thereby allowing the guide arm (12) to enter the anterolateral insertion (138) and form a contour along the tibial spine (on the tibial plateau) so that the tip (26) can be positioned to contact the meniscal insertion (e.g., the posterior root (124) and / or anterior root (126) shown in FIG. 1). Thus, the tip (26) can grasp the tibial plateau (114) when the device (10) is operated as described herein to position the sleeve (20) (by the drill (29)) to form a bone passage in the knee (110) during surgery.

[0039] In particular, in some embodiments illustrated in FIG. 4c and 4e, the neck portion (24) is provided with an indicia (51). For example, the indicia (51) may be a numerical engraving. The indicia (51) may provide a visual indication of the angular translation of the guide arm (12) and the sleeve (20).

[0040] As described in detail below, the device (10) may further include a lever (30). In some embodiments, the lever (30) is positioned on the neck portion (24). In other embodiments, the lever (30) is positioned on the guide arm (12). In other words, the guide arm (12) may be positioned on the lever (30).

[0041] In some embodiments, the lever (30) is angularly movable with respect to the handle (14). For example, the lever (30) may be configured to rotate so that the guide arm (12) rotates within the sleeve (16). In this sense, the guide arm assembly (22) may further include the lever (30).

[0042] In particular, in some embodiments illustrated in FIG. 4e, the guide arm assembly (22) may be assembled through mechanical fixation between the lever (30) and the guide arm (12). For example, the guide arm assembly (22) may further include a fastener (37) (e.g., a screw). Additionally, referring to FIG. 6g, the key (27) of the guide arm (12) may be provided with a thread (29) corresponding to the fastener (37).

[0043] Referring further to FIG. 6g, the sleeve passage (23) can be formed to pass through the sleeve (16). The key (27) can be advanced into the sleeve passage (23) (and accordingly into the sleeve (16)), and the fastener (37) can be inserted into the sleeve passage (23) via the lever (30), and accordingly the fastener (37) can be guided through the thread (29) on the key (27). Thus, the key (27) of the guide arm (12) and the fastener (37) can be engaged within the sleeve passage (23) of the sleeve (16). Consequently, the sleeve (16) and the corresponding neck (24) can be "interposed" between the fastener (37) and the guide arm (12).

[0044] As described below, the guide arm (12) is angularly movable with respect to the sleeve portion (16) while fixed at an angle with respect to the lever (30), so that the lever (30) can be used to rotate the guide arm (12) with respect to the sleeve portion (16) (and accordingly the neck portion (24)). In other words, the guide arm (12) can be configured to move angularly in a rotational manner with respect to the sleeve portion (16) according to the rotation of the lever (30).

[0045] Now, referring to FIGS. 5a and 5b, a device (10) according to some embodiment of the present invention is shown having a guide arm (12) rotated angularly relative to a sleeve portion (16). A lever (30) may be rotatably configured so that the guide arm (12) rotates within the sleeve portion passage (23) of the sleeve portion (16) (e.g., around a second longitudinal axis (54) of the guide arm (12). Additionally, referring to the example shown in FIG. 6i, the lever (30) may include a round insert (39) that can be advanced into the sleeve portion passage (23) of the sleeve portion (16) (see FIG. 6g). Subsequently, referring further to FIG. 6i, the round insert (39) may include a recess (41) fitted with a key. The key (27) of the guide arm (12) can be configured to advance into the lumbar portion (41) in which the key of the lever (30) is mounted, so that the angular movement of the lever (30) is transmitted to the angular movement of the guide arm (12). Accordingly, in some embodiments, the sleeve portion (16) can be configured to allow the guide arm (12) to rotate approximately 45 degrees in both directions through the lever (30). The structure of the fastener (37), the round insert (39), and the key (27) is further illustrated in detail in FIG. 7d.

[0046] In some embodiments, the lever (30) and the guide arm (12) may be formed as a single part. In other embodiments, as described above with reference to FIG. 4e, the lever (30) may be attached to the guide arm (12) by an adhesive or a suitable mechanical fastening means (e.g., a fastener (37)).

[0047] As previously described, and with further reference to FIG. 10, the handle (14) may be configured to be held by the user's hand (99). In some embodiments, the lever (30) may be configured to be rotated by the thumb (98) of the hand (99). In other words, the lever (30) may be actuated by the user's thumb (98) (e.g., by pressing, pushing). For example, as illustrated in detail in FIG. 6a through 6i, the lever (30) may have a contour that allows the lever (30) to be rotated by an angular rotation amount (21) by the user's thumb while the user's hand is holding the handle (14). In this sense, the lever (30) may be considered a thumb lever. Although the lever (30) is depicted as being actuated after the handle (14) has been extended away from the guide arm (12), it should be understood that the lever (30) may be actuated in a similar manner at any position relative to the guide arm (12) of the handle (14), including the positions depicted in FIGS. 2b and FIGS. 2f. It should be understood that the illustrated embodiment of the lever (30) is essentially exemplary and that a lever (30) having any configuration suitable for causing rotation of the guide arm (12) may be provided. For example, in other embodiments, the lever (30) may be provided in the form of a knob.

[0048] As described above, the lever (30) can be actuated to rotate the guide arm (12) attached to the lever within the sleeve portion (16), thereby rotating the guide arm (12) by an angle of rotation (21). Accordingly, the handle (14) can be rotated and translated relative to the guide arm (12) based on the operation of the lever (30) (depending on the distance the handle (14) extends from the guide arm (12) as described above with reference to FIGS. 3a to 3d). For example, as described below with reference to FIGS. 11a and 11b, when the tip (26) is positioned to contact the meniscus insertion portion of the tibial plateau (114), the handle (14) needs to be rotated relative to the knee (110) to properly position the sleeve (20) relative to the knee (110). In order to ensure that this rotation is made without the tip (26) being disengaged from the tibial plateau (114), the lever (30) can be operated to rotate the handle (14) in a controlled manner relative to the guide arm (12).

[0049] As described below, the device (10) may further include a detent mechanism (34) configured to provide resistance to rotation of the lever (30). In this sense, the detent mechanism (34) may be configured to provide resistance to rotation of the guide arm (12) relative to the sleeve (16).

[0050] Now, referring to FIGS. 6a through 6i, the sleeve (16) and lever (30) of various embodiments of the present invention are illustrated in more detail. In some embodiments, the sleeve (16) includes a detent mechanism (34). The detent mechanism (34) may be configured to provide resistance (e.g., by means of friction, deflection, lock-in-place, etc.) to the guide arm (12) rotating relative to the sleeve (16). In particular, the detent mechanism (34) may be configured to maintain the angular position of the guide arm (12) relative to the sleeve (16) (and accordingly the handle (14)) when the guide arm (12) is not rotating by the operation of the lever (30) as described above. Thus, the detent mechanism (34) may be configured to prevent the guide arm (12) from unintentionally rotating relative to the handle (14).

[0051] The detent mechanism (34) may include a plurality (e.g., a set) of ribs (38) (e.g., divots) and at least one detent arm (36), and the detent arm (36) is configured to mechanically engage with at least one of the plurality of ribs (38). The ribs (38) may be formed on the sleeve portion (16). For example, the ribs (38) may be distributed along the outer curved surface of the sleeve portion (16). In other words, the ribs (38) may be formed to form a recess in an elongated channel below the surface of the sleeve portion (16). Each detent arm (36)(s) may include a protrusion (e.g., a tooth) configured to fit within a segment of the ribs (38). To provide the aforementioned resistance to rotation of the guide arm (12) relative to the sleeve portion (16), detent arms (36)(s) may be formed on the lever (30). In this sense, the detent arms (36)(s) may be considered as parts of the lever (30). In another embodiment, the detent arms (36)(s) may be positioned on the lever (30) and extend from the lever (30).

[0052] After the protrusion(s) of the detent arm (36)(s) are positioned within the segment of the ribs (38), the detent arm (36)(s) can provide a deflection force to maintain the position of the protrusion(s) within the segment of the ribs (38), thereby maintaining the orientation of the guide arm (12) until a threshold force is applied to the lever (30) (and thus until the protrusion(s) of the detent arm (36)(s) move to an adjacent segment of the ribs (38). Of course, the ribs (38) (e.g., segments of the ribs) may be spaced apart at specific intervals to provide precise orientation of the guide arm (12).

[0053] In some embodiments, due to the arrangement of the ribs (38), a resting angular position of the guide arm (12) with respect to the sleeve (16) is provided every 6 degrees. In other embodiments, due to the arrangement of the ribs (38), such a resting angular position is provided every 7 degrees. In yet another embodiment, due to the arrangement of the ribs (38), a different suitable distribution regarding the resting angular position of the guide arm (12) with respect to the sleeve (16) is provided.

[0054] In particular, in some embodiments illustrated in FIGS. 6a through 6e, the detent arms (36)(s) extend downward from the lever (30). Subsequently, ribs (38) may be formed on the curved outer profile of the sleeve portion (16), thereby allowing the protrusion(s) of the detent arms (36)(s) to extend inward (e.g., radially inward) from the detent arms (36)(s) and engage with the ribs (38). In particular, in other embodiments illustrated in FIGS. 6f through 6i, the detent arms (36)(s) are integrated with the flat profile of the lever (30). That is to say, the detent arms (36)(s) may be formed by at least one cut formed on the surface of the lever (30), and in some cases may be located coplanar with the upper surface of the lever (30). Subsequently, ribs (38) may be formed along a curved path on the upper surface of the sleeve (16), thereby allowing the protrusion(s) of the detent arms (36)(s) to extend downward from the detent arms (36) and engage with the ribs (38). Thus, in some embodiments, the engagement of the detent mechanism (34) is provided on the side of the sleeve (16) (particularly as shown in FIGS. 6a through 6e), and in other embodiments, the engagement of the detent mechanism (34) is provided on the upper side of the sleeve (16) (particularly as shown in FIGS. 6f through 6i) (see FIGS. 6F through 6I).

[0055] In particular, in some embodiments illustrated in FIGS. 6a, 6d, and 6e, the detent arm (36)(s) consists of a single member (e.g., detent arm (36)). In particular, in other embodiments illustrated in FIGS. 6b, 6c, 6f, and 6h, the detent arm (36)(s) may consist of a plurality of members. In particular, in the first example illustrated in FIGS. 6f and 6h, the detent arm (36)(s) may consist of two members, namely a first detent arm (36a) and a second detent arm (36b). In the second example illustrated in FIGS. 6b and 6c, the detent arm (36)(s) may consist of three members, namely a first detent arm (36a), a second detent arm (36b), and a third detent arm (36c). In additional embodiments, the detent arm (36)(s) may be composed of four or more members. Depending on the embodiment, more than one protrusion may be provided by a single detent arm (36). For example, referring particularly to FIGS. 6b through 6c, the first detent arm (36a) may have sufficient width to be configured so that a plurality of protrusions interact with the ribs (38).

[0056] In some embodiments, particularly when the detent arm (36)(s) is configured to have a plurality of protrusions as described above, only some of the protrusions (e.g., one of the protrusions, only one of the protrusions, etc.) may engage with the ribs (38) at a specific point in time (e.g., when the guide arm (12) is in a specific orientation), while other protrusions may be in a resting state on top of the ribs (38). Advantageously, this configuration makes it possible to form the segments of the ribs (38) more deeply (and the corresponding protrusions more distinctly), thereby further improving the ability to maintain the orientation of the guide arm (12) in a single desired position.

[0057] In some embodiments, the detent arm (36)(s) and the sleeve (16) are formed as a single part. In other embodiments, the detent arm (36)(s) are attached to the sleeve by adhesive or other suitable mechanical fastening means. Thus, the detent arm (36)(s) and the ribs (38) enhance the ability of the detent mechanism (34) to lock and fix the angular position of the guide arm (12) relative to the sleeve (16). However, the detent arm (36)(s) may be configured to have appropriate flexibility so that the protrusion(s) can be easily pushed from one segment of the ribs (38) to another segment of the ribs (38), thereby allowing the user to rotate the guide arm (12) via the lever (30).

[0058] In an additional embodiment, the detent mechanism (34) may be configured to have an orientation opposite to that of the configuration described above (e.g., configured so that a male projection extending from the detent arm (36)(s) is received within the female segment of the ribs (38). For example, the detent arm (36)(s) may provide a female component that receives a male component extending from the ribs (38).

[0059] In an additional embodiment, the detent mechanism (34) may include an additional lock feature configured to be fixed over the detent arm (36)(s), thereby preventing (or at least resisting) the ability of the detent arm (36)(s) to act as a spring as described above. In this sense, the protrusion extending from the detent arm (36)(s) may be prevented from being bent outward to remove the protrusion from the current segment of the ribs (38), thereby more firmly fixing the current orientation of the guide arm (12).

[0060] Here, the detent mechanism (34) is illustrated as comprising ribs (38) and a detent arm (36)(s) having at least one tooth, but the detent mechanism (34) may include any suitable part necessary to fix the angular position of the guide arm (12) described herein. Thus, the detent mechanism (34) may include a ball-and-socket configuration, a friction fit configuration, a biased ball bearing on a spring configuration, etc. Thus, the detent mechanism (34) may be attached to or integrated with another part of the device (10) having any form suitable for providing the aforementioned function of fixing the angular position of the guide arm (12) relative to the sleeve (16).

[0061] As described in detail below, the device (10) may further include a neck locking mechanism (31) disposed on the handle (14). In some embodiments, the neck locking mechanism (31) is configured to hold the neck (24) in place relative to the handle (14) and to release the neck (24). For example, the neck locking mechanism (31) may include a hinge (32). The hinge (32) may move angularly in a rotational manner relative to the handle (14). For example, the hinge (32) may be movable between a first hinge position in which the neck locking mechanism (31) holds the neck (24) in place relative to the first handle passage (15) and a second hinge position in which the neck locking mechanism releases the neck (24). In some cases, the hinge (32) may be rotated by the user's index finger.

[0062] Now, referring to FIGS. 7a through 7f, a neck locking mechanism (31) according to various embodiments of the present invention is illustrated in more detail. As previously described, the neck locking mechanism (31) may be configured to selectively fix the position of the neck (24) relative to the handle (14). For example, the locking mechanism may be placed on the handle (14). The neck locking mechanism (31) may include a hinge (32), and the hinge (32) may move between a first hinge position (illustrated in FIGS. 7a to 7d) and a second hinge position (illustrated in FIGS. 2a to 2d) (see FIGS. 2A to 2D) (along the path (33)), at the first hinge position the neck locking mechanism (31) holds the neck (24) in place relative to the first handle passage (15), and at the second hinge position the neck locking mechanism releases the neck (24) (thereby enabling the neck (24) to move in an axial translational manner relative to the first handle passage (15)). In another embodiment, the first hinge position shown in FIGS. 2a through 2d is the position of the hinge (32) in which the neck locking mechanism (31) holds the neck (24) in place, and the second position shown in FIGS. 7a through 7d is the position of the hinge (32) in which the neck locking mechanism (31) releases the neck (24). Of course, it should be understood that the illustrated positions of the hinge (32) are essentially exemplary and that the first and second positions may be provided according to varying degrees of rotation of the hinge (32).

[0063] As described above, when the hinge (32) is rotated relative to the handle (14) and moves between the first hinge position and / or the second hinge position (e.g., along the path (33)), the hinge (32) can lock the axial position of the neck portion (24) relative to the first handle passage (15). After the tip (26) engages with the tibial plateau (114) of the knee (110), and before or after the guide arm (12) is rotated relative to the handle (14) as described above, the neck portion (24) can be translated axially relative to the first handle passage (15) (as described above), thereby allowing the second handle passage (18) to be properly positioned to guide the sleeve (20) toward the tibia (112) of the knee. Advantageously, once this positioning is achieved, the neck locking mechanism (31) can be used to fix this configuration of the device (10) in place, thereby enabling the user to advance the sleeve (20) through the second handle passage (18) to form a bone passage within the tibia (112).

[0064] In some embodiments illustrated in FIGS. 7d ​​through 7f, the neck locking mechanism (31) further comprises a cam (43) and a shim (45). The cam (43) can be rotated to move angularly with respect to the handle (14) in accordance with the rotation of the hinge (32). Subsequently, the shim (45) can be rotated to move angularly with respect to the handle (14) in accordance with the rotation of the cam (43). Thus, the cam (43) can be integrated with the hinge (32) so that when the hinge (32) is rotated as illustrated, the cam (43) can contact the neck (24) (or make contact easier as described in detail below) and hold the neck (24) in place with respect to the handle (14). Accordingly, the shim (45) is pivoted by the cam (43) and comes into contact with the neck portion (24), thereby engaging with the neck portion (24) and holding the neck portion (24) in place relative to the handle (14) (more specifically, the first handle passage (15)).

[0065] In particular, as illustrated in FIG. 7e and 7f, the cam (43) may include an elliptical track (47) on which the shim (45) is placed. Thus, when the cam (43) is rotated according to the angular movement of the hinge (32), the elliptical track (47) can gradually guide the shim (45) toward the neck (24), and this guidance is maintained until the shim (45) contacts the neck (24) and secures the neck (24) in place. Advantageously, the elliptical track (47) can enable full articulation of the hinge (32) (suitable for the user's tactile engagement), thereby reducing the amount of pivot required to bring the shim (45) into contact with the neck (24). Of course, it should be understood that the neck locking mechanism (31) may include any combination of parts suitable for enabling the user to lock the neck (24) to the position of the first handle passage (15) described herein.

[0066] In some embodiments, the shim (45) may maintain consistent contact with the neck (24) (over a range of orientation settings of the hinge (32) or over a potential angular orientation setting of the hinge (32)). In this regard, the shim (45) may provide friction that prevents the neck (24) from moving freely within the handle (14). In some embodiments, the shim (45) may be at least partially elastic to provide this friction.

[0067] In particular, in the additional embodiment illustrated in FIG. 7g, the neck locking mechanism (31) may include a screw lock (35). For example, the screw lock (35) may be rotated in any direction so that the screw member is rotated relative to the thread on the handle (14) to move the screw member toward or away from the neck (24). Thus, when the screw lock (35) is rotated so that the screw member engages with the neck (24), the screw lock (35) can secure the neck (24) in place relative to the handle (14).

[0068] Referring again to FIGS. 2b through 2d and FIGS. 2f through 2h, the device (10) may include a sleeve (20) according to various embodiments of the present invention. As previously described, the sleeve (20) may be received within a second handle passage (18) of the handle (14), and the drill (29) may be axially movable within the sleeve (20). Depending on the embodiment, the sleeve (20) may facilitate the use of a drill mechanism suitable for forming a bone passage during surgery, as well as a punch guide, a punch, or other suitable member for inserting such a drill mechanism into the bone passage. The second handle passage (18) may be formed at a second end of the handle (14) on the opposite side of the first end forming the handle opening (13). According to an embodiment, in order to position and guide the sleeve (20) to form a bone passage during a surgical procedure, the sleeve (20) may be inserted into the second handle passage (18) and the drill (29) may be inserted into the sleeve (20), which may be done before or after the various steps described herein.

[0069] Now, referring to FIGS. 8a through 8c, cross-sectional views of a device (10) according to various embodiments of the present invention are shown. As described above with reference to FIGS. 3a through 3d, the guide arm assembly (22) may include a neck portion (24), which is positioned within a first handle passage (15) of a handle (14) and is also movable in an axial translational manner with respect to the first handle passage (15), thereby enabling the device (10) to extend along a path (19). For example, the neck portion (24) and the handle (14) may come into contact in a sliding relationship along an arch-shaped path that follows an arcuate axis (17) of the first handle passage (15). In other words, the neck portion (24) and the handle (14) (more specifically, the first handle passage (15)) may have corresponding arch shapes. As described, the first handle passage (15) may start near the first end of the handle (14) forming the handle opening (13) and end near the second end of the handle (14) forming the second handle passage (18).

[0070] Although the neck portion (24) and the first handle passage (15) have generally been described as having a male-female configuration (e.g., a configuration in which the neck portion (24) passes into and through the first handle passage (15), in additional embodiments the neck portion (24) and the first handle passage (15) may have a female-male configuration (e.g., a configuration in which the neck portion (24) is configured to have a recess, and this recess is configured to accommodate the handle (14) inside and allow the handle to pass through). In this regard, the neck portion (24) may be configured to be a handle that is grasped by the user's hand (99), thereby allowing the handle grasped by the user to be positioned closer to the guide arm (12).

[0071] The arc axis (17) may have a constant radius, and accordingly, the device (10) may be adjusted between a first position (see FIG. 2a, 2d, and 2e) in which the first longitudinal axis (52) of the second handle passage (18) and the second longitudinal axis (54) of the guide arm (12) define a first angle (56) between them, and a second position (see FIG. 3a and 3c) in which the first longitudinal axis (52) and the second longitudinal axis (54) define a second angle (58) greater than the first angle (56) between them. Of course, the aforementioned first and second positions are essentially exemplary, and it should be understood that in order to provide the applications considered herein, the device (10) may be operated to take on a number of configurations depending on the movement of the neck portion (24) relative to the first handle passage (15).

[0072] As described above, the neck portion (24) and the first handle passage (15) may each have a corresponding arch shape (e.g., a curve defining part of the circumference of a circle). In this sense, the neck portion (24) may be inserted into the first handle passage (15) of the handle (14) (e.g., through the handle opening (13)) and may be translated axially along the axis (17) of the first handle passage (15). In another embodiment, the neck portion (24) may be coupled to the handle (14) by other suitable means for similar axial translation (e.g., when the neck portion (24) is slidably coupled to a track on one side of the handle (14) to maintain the aforementioned arch shape). Due to the arch shape of the neck portion (24) and the first handle passage (15), it can be ensured that the tip (26) of the guide arm (12) and the sleeve (20) have a common intersection point regardless of where the neck portion (24) is located along the axis (17) of the first handle passage (15).

[0073] As described in detail below, the device (10) may further include a sleeve locking mechanism (40), the sleeve locking mechanism (40) is configured to allow the user to advance the sleeve (20) toward the guide arm (12), while preventing the sleeve (20) from retracting from the guide arm (12) after such advancement and while the drill in the sleeve (20) forms a bone passage (e.g., drilling a hole in the tibia (112)). The sleeve locking mechanism (40) may include a locking member (42) having a through hole (46) configured to receive the sleeve (20). The locking member (42) may move between a locking position in which the sleeve (20) is axially movable with respect to the through hole (46) and a locking position in which the sleeve (20) is prevented from moving away from the tip (26) due to the locking member (42). The locking member (42) can be biased toward the locked position by the biasing member (44).

[0074] Now, referring to FIGS. 9a through 9f, a sleeve locking mechanism (40) according to various embodiments of the present invention is illustrated in more detail. FIGS. 9a, 9c, and 9d illustrate a side cross-sectional view of the sleeve locking mechanism (40) with the sleeve (20) inserted into the second handle passage (18). The sleeve locking mechanism (40), together with the second handle passage (18), provides positioning and sliding control capabilities for the handle (14) of the sleeve (20). As described in detail below, the sleeve locking mechanism (40) may be a one-way locking mechanism comprising a locking member (42) having a through hole (46) configured to receive the sleeve (20). The sleeve locking mechanism (40) is movable between a first unlocked position and a second locked position. The sleeve locking mechanism (40) may further include a deflection member (44) configured to deflect the locking member (42) to the locked position. In the unlocked position, the sleeve (20) can be moved in both directions axially with respect to the second handle passage (18) (e.g., toward the tip (26) or toward the tip (26)). In the locked position, the sleeve (20) can be moved in only one direction axially, namely toward the tip (26).

[0075] The sleeve locking mechanism (40) may be located at the second end of the handle (14) on the opposite side of the first end forming the handle opening (13). As described above, the sleeve locking mechanism (40) may include a locking member (42) (e.g., a plate, a member, etc.) having a through hole (46) configured to accommodate the sleeve (20). For example, the locking member (42) may be made of a relatively thick plate-shaped material having a through hole (46) formed with a diameter slightly larger than that of the sleeve (20). The locking member (42) may be supported by the sleeve (20) by inserting the sleeve (20) into the through hole (46), thereby allowing the locking member (42) to slide axially with respect to the sleeve (20) and also to move with respect to the sleeve (20) with a slight clearance between the outer circumference of the sleeve (20) and the through hole (46). As described in detail below, the locking member (42) can move between an unlocked position in which the sleeve (20) is axially movable with respect to the through hole (46) (therefore, the sleeve (20) can move axially toward the tip (26) or away from the tip (26) through the second handle passage (18)) and a locked position in which the locking member (42) fixes the sleeve (20) in place with respect to the through hole (46) so that the drill sleeve (20) can move axially only in one direction, namely toward the tip (26).

[0076] As described above, the sleeve locking mechanism (40) may further include a deflection member (44) (e.g., a spring). The locking member (42) may be deflected toward the aforementioned locking position by the deflection member (44). For example, the deflection member (44) may be positioned on the handle (14) such that the deflection member (44) pushes the locking member (42) upward away from the guide arm (12). In this sense, the deflection member (44) may deflect the free end (48) of the locking member (42) upward so that the locking member (42) rotates around the pivot end (45) fixed to the handle (14).

[0077] As described above, the sleeve locking mechanism (40) of the handle (14) may be configured to allow the user to advance the sleeve (20) toward the guide arm (12), while preventing the sleeve (20) from retracting away from the guide arm (12) after such advancement. For example, when the sleeve (20) is properly positioned as described above and then advanced forward (e.g., toward the tibia (112) and guide arm (12), the locking member (42) moves together with the sleeve (20) while maintaining frictional engagement with the sleeve (20). When the sleeve (20) is pushed toward the guide arm (12) by the user, the deflection member (44) is compressed by the locking member (42) according to the movement of the sleeve (20), so that the angle of inclination of the locking member (42) relative to the sleeve (20) changes and the frictional engagement between the through hole (46) and the sleeve (20) is weakened. Accordingly, during such forward movement of the sleeve (20), the locking member (42) is maintained in a position that allows the sleeve (20) to move toward the tip (26). When the sleeve (20) is no longer pushed forward by the user, the angle of inclination of the locking member (42) increases due to the action of the deflection member (44), and the locking member (42) frictionally engages with the sleeve (20) again. This prevents the sleeve (20) from moving unintentionally away from the guide arm (12), such that the movement of the sleeve (20) away from the guide arm (12) is suppressed due to a kick-back force caused by, for example, a drill (29) drilling bone within the sleeve (20).

[0078] When the user wishes to retract the sleeve (20), the user may press the free end (48) of the locking member (42) toward the guide arm (12), thereby moving the locking member (42) to an unlocked position, thereby removing the frictional engagement between the locking member (42) and the sleeve (20) and allowing the retraction of the sleeve (20). In this context, the sleeve (20) may also be moved toward the tip (26) in the unlocked position. In some embodiments, the sleeve locking mechanism (40) further includes an access hole (49), which facilitates the insertion of a member (e.g., a rod) so that the free end of the locking member (42) is pressed toward the guide arm (12) as described above.

[0079] In particular, in some embodiments illustrated in FIGS. 9d through 9f, the sleeve (20) may include a ring (25). The ring (25) may provide a mechanical stop for the surface of the handle (14) to limit the sleeve (20) from advancing toward the guide arm (12).

[0080] As described in detail below, the present invention provides a method for positioning and guiding a drill (29) to form a bone passage during surgery on a knee (110). The method may include the step of providing the aforementioned handle (14), neck portion (24) (including a sleeve portion (16) according to an embodiment), sleeve (20), and guide arm (12). The method may further include the step of advancing the guide arm (12) through an anterolateral insertion portion (134) of the knee (110) and positioning the tip (26) of the guide arm (12) on the tibial plateau (114) of the knee (110). The method may further include the step of translating the neck portion (24) relative to the handle (14) and translating the sleeve (20) relative to the handle (14) so ​​that the sleeve (20) is advanced toward the knee (110). Additionally, the method may include a further step of moving the lever (30) angularly in a rotational manner relative to the neck portion (24) so ​​that the guide arm (12) moves angularly in a rotational manner relative to the neck portion (24) according to the rotation of the lever (30). Additionally, the method may include a step of engaging the neck portion locking mechanism (31) so that the neck portion (24) is maintained in its proper position relative to the handle (14). In some embodiments, the method further includes a step of observing at least one image of the tibial plateau (114) through the anterior medial insertion portion (136) of the knee (110) via a camera (50). The method may further include a step of advancing the sleeve (20) toward the knee (110) through the second handle passage (18) of the handle (14).

[0081] Now, referring to FIGS. 11a and 11b, a device (10) according to various embodiments of the present invention is shown engaged with a knee (110). In particular, referring to FIG. 11a, a guide arm (12) (specifically, a tip (26)) is shown engaged with a tibial plateau (114) of the tibia (112) located below the femur, passing through an anterolateral insertion portion (138) of the knee (110). Accordingly, the tip (26) can grasp the tibial plateau (114), and the device (10) can be operated as described herein to guide the sleeve (20) to a position for forming a bone passage within the knee (110) (by means of a drill inserted into the sleeve (20)) during surgery. For example, the tip (26) can be manipulated through the anterolateral insertion (138) of the knee (110), thereby allowing the tip (26) to grasp the tibial plateau (114). From here, the handle (14) can be rotated relative to the guide arm (12) (e.g., by an angle rotation amount (21) shown in FIGS. 5a and 5b); and the handle (14) can be extended away from the guide arm (12) in an arc shape (e.g., along the path (19) shown in FIGS. 3a to 3d). Due to this movement, the sleeve (20) can be positioned at the depicted appropriate position, at which point the position of the handle (14) relative to the guide arm (12) (and the corresponding position of the sleeve (20)) can be locked in place by manipulating the hinge (32) (e.g., along the path (33) shown in FIGS. 7a to 7e).

[0082] By the above method, it becomes possible for the camera (50) to capture at least one image of the tibial plateau (114) through the anteromedial insertion part (136) of the knee (110). Advantageously, by configuring the guide arm (12) to advance to the anterolateral insertion part (138), the camera (50) can secure a path to clearly observe the tibial plateau (114) (through the anteromedial insertion part (136)) during the surgical procedure.

[0083] In an additional embodiment illustrated in FIG. 11b, the device (10) may be configured so that the guide arm (12) advances to the anteromedial insertion part (136), thereby allowing the camera (50) to secure a path to clearly view the tibial plateau through the anterolateral insertion part (138) during the surgical procedure.

[0084] To illustrate the advantages of the device and method described herein, FIG. 12 illustrates the view of the tibial plateau observed by the camera through the anterolateral insertion (138) of the knee (110) after the guide arm (12) has been introduced through the anteromedial insertion (136). In this case, the camera's field of view may be blocked because the tip (26) covers the meniscal root footprint. If the meniscal root footprint is covered by the guide arm (12), it may be difficult for the user to perform surgery on the knee (110). Conversely, FIG. 13 and 14 illustrate the field of view of the camera (50) when the guide arm (12) has been advanced to the anterolateral insertion (138) and the camera (50) uses the clear path secured through the anteromedial insertion (136) as described herein. Advantageously, the field of view of the camera (50) appears to be improved compared to the conventional method shown in FIG. 12. The tibial plateau (114) (particularly the meniscus) can be easily observed using the device and method described herein, and accordingly, the tip (26) can be properly positioned on the tibial plateau (114) (particularly the meniscus projection plane) while reducing the user's difficulty.

[0085] Accordingly, an exemplary method of using the device (10) described herein may include the step of advancing the guide arm (12) through the anterolateral insertion (138) of the knee (110) and positioning the tip (26) on the tibial plateau (114) of the knee (110). The method may further include the step of capturing at least one image of the tibial plateau (114) through the anteromedial insertion (136) of the knee (110) by means of a camera (50).

[0086] Referring again to FIGS. 3a through 3d, an extended device (10) as described above is illustrated therein. Accordingly, as described above with reference to FIG. 11, after the tip (26) engages with the tibial plateau (114) of the knee (110), and before or after the guide arm (12) is rotated relative to the handle (14), the neck portion (24) can be translated axially relative to the first handle passage (15), thereby allowing the second handle passage (18) to be appropriately positioned to guide the sleeve (20) toward the tibia (112) of the knee. Accordingly, the aforementioned method using the device (10) may further include the step of withdrawing the handle (14) from the guide arm (12) so that the neck portion (24) is translated arcwise relative to the first handle passage (15) (e.g., axially moved considering the corresponding arch configuration).

[0087] Referring again to FIGS. 5a and 5b, a device (10) having a guide arm (12) that rotates about a handle (14) is illustrated herein. As described and illustrated above, the handle (14) can be rotated about the guide arm (12) (via the lever (30) and controlled by the detent mechanism (34)), and this rotation is appropriately made to position a second handle passage (18) (and accordingly sleeve (20)) about the tibia (112) to form a bone passage within the tibia (112) during surgery. Accordingly, the aforementioned method using the device (10) may further include the step of rotating the lever (30) so that the guide arm (12) moves angularly in a rotational manner about the sleeve portion (16).

[0088] Referring again to FIGS. 7a through 7g, a device (10) is illustrated therein having a locking mechanism that fixes the neck portion (24) in place relative to the handle (14). As previously described, after the second handle passage (18) is properly positioned, the hinge (32) may further include a step of rotating between a first hinge position in which the neck locking mechanism (31) maintains the neck portion (24) in place relative to the first handle passage (15) and a second hinge position in which the neck locking mechanism (31) releases the neck portion (24). Thus, the second handle passage (18) may be fixed in a position for the sleeve (20) to advance toward the tibia (112). Thus, the method of using the device (10) may further include a step of rotating the hinge (32) so that the neck locking mechanism (31) fixes the neck portion (24) in place relative to the first handle passage (15).

[0089] Referring again to FIG. 11, a device (10) is illustrated having a sleeve (20) that advances into the tibia (112) to form a bone passage during surgery on the knee (110). As previously described, the use of a sleeve locking mechanism (40) may be further included, thereby preventing the sleeve (20) from unintentionally retracting from the tibia (112) due to a repulsive force that may occur during the drilling process. In this sense, when the sleeve (20) advances through the second handle passage (18), the locking member (42) may be moved from a second driving member position, where the locking member (42) fixes the sleeve (20) in place with respect to the through hole (46), to a first driving member position, where the sleeve (20) is movable by axial translation with respect to the through hole (46). The locking member (42) may be deflected toward the second driving member position by a deflection member (44). Accordingly, the aforementioned method using the above device (10) may further include the step of advancing the sleeve (20) toward the knee (110) through the second handle passage (18) to provide a bone passage through the tibia (112).

[0090] Although specific embodiments of the new and useful surgical drill guide device and method of the present invention have been described hereby, the description of these specific embodiments is not intended to limit the scope of protection of the present invention.

Claims

Claim 1 A drill positioning and guiding device for positioning and guiding a drill to form a bone passage during surgery, wherein the drill positioning and guiding device comprises: a handle; a sleeve disposed on the handle and configured to receive the drill; a neck disposed on the handle and movable in a translational manner relative to the handle; a lever disposed on the neck and movable in a rotational manner relative to the neck; a guide arm disposed on the lever; and a neck locking mechanism disposed on the handle and configured to maintain the neck in a position relative to the handle and release the neck. Claim 2 A drill positioning and guiding device according to claim 1, wherein the handle includes a first handle passage formed internally and a second handle passage formed internally, the neck portion is positioned in the first handle passage, and the sleeve is positioned in the second handle passage. Claim 3 In paragraph 2, the drill positioning and guiding device further comprises a detent mechanism configured to provide resistance to rotation of the lever. Claim 4 A drill positioning and guiding device according to paragraph 3, wherein the neck portion comprises a first end portion free from the first handle passage and a second end portion disposed in the first handle passage, the neck portion comprises a cuff portion formed on the first end portion, the guide arm is disposed in the cuff portion, and the guide arm is configured to be angularly movable in a rotational manner relative to the cuff portion as the lever rotates. Claim 5 In paragraph 4, the drill positioning and guiding device comprises a detent mechanism including a plurality of ribs and a detent arm configured to mechanically engage with at least one of the plurality of ribs. Claim 6 A drill positioning and guiding device according to claim 5, wherein the plurality of ribs are formed on the sleeve portion and the detent arm is formed on the lever. Claim 7 A drill positioning and guiding device according to claim 1, wherein the neck locking mechanism comprises a hinge, a cam, and a shim, wherein the hinge is angularly movable in a rotational manner with respect to the handle, the cam is angularly movable in a rotational manner with respect to the handle as the hinge rotates, the shim is angularly movable in a rotational manner with respect to the handle as the cam rotates, the cam is angularly movable in a rotational manner with respect to the handle, and the rotation of the shim causes the shim to engage with the neck and also causes the neck to be maintained in its proper position with respect to the handle. Claim 8 In claim 7, the drill positioning and guiding device, wherein the hinge is configured to be rotated by the user's index finger. Claim 9 A drill positioning and guiding device according to claim 1, wherein the guide arm is configured to engage with the tibial plateau of the knee through the anteromedial portal of the knee. Claim 10 A drill positioning and guiding device according to claim 1, wherein the guide arm is configured to engage with the tibial plateau of the knee by passing through the anterolateral portal of the knee. Claim 11 A drill positioning and guiding device according to claim 1, wherein the neck and handle have a corresponding arcuate shape. Claim 12 A drill positioning and guidance device according to claim 1, wherein the handle is configured to be held by the user's hand and the lever is configured to be rotated by the user's thumb. Claim 13 A method for positioning and guiding a drill to form a bone passage during surgery on a knee, wherein the drill positioning and guiding method comprises: providing a handle, a sleeve disposed on the handle, a neck disposed on the handle, a lever disposed on the neck, a guide arm disposed on the lever, and a neck locking mechanism disposed on the handle; advancing the guide arm through an anterolateral insertion portion of the knee and positioning the tip of the guide arm on the tibial plateau of the knee; moving the neck in a translational manner relative to the handle; moving the lever in a rotational manner relative to the neck so that the guide arm moves in a rotational manner relative to the neck as the lever rotates; moving the sleeve in a translational manner relative to the handle so that the sleeve advances toward the knee; and engaging the neck locking mechanism so that the neck is maintained in its proper position relative to the handle; comprising a drill positioning and guiding method. Claim 14 In claim 13, the drill positioning and guiding method further comprises: the step of observing at least one image of the tibial plateau through the anteromedial insertion part of the knee with a camera; a drill positioning and guiding method. Claim 15 A drill positioning and guiding method according to claim 13, wherein the handle comprises a first handle passage formed internally and a second handle passage formed internally, the neck portion is positioned in the first handle passage, and the sleeve is positioned in the second handle passage. Claim 16 A drill positioning and guiding method according to claim 15, wherein the first handle passage and the neck portion have corresponding arch shapes. Claim 17 In claim 15, the drill positioning and guiding method further comprises: the step of providing a detent mechanism; wherein the neck portion comprises a first end portion free from the first handle passage and a second end portion disposed in the first handle passage, the neck portion comprises a sleeve portion formed on the first end portion, the guide arm disposed on the sleeve portion, the detent mechanism comprises a plurality of ribs formed on the sleeve portion, the detent mechanism further comprises a detent arm formed on the lever, and the detent arm is configured to mechanically engage with at least one of the plurality of ribs. Claim 18 In claim 13, the neck locking mechanism comprises a hinge, a cam, and a shim, and the engagement of the neck locking mechanism includes an angular rotational movement of the hinge relative to the handle, the cam is angularly movable in a rotational manner relative to the handle as the hinge rotates, the shim is angularly movable in a rotational manner relative to the handle as the cam rotates, and the rotation of the shim causes the shim to engage with the neck and also causes the neck to be maintained in its proper position relative to the handle, a drill positioning and guiding method. Claim 19 In claim 18, the above hinge is configured to be rotated by the user's index finger, a drill positioning and guiding method. Claim 20 In claim 13, the drill positioning and guiding method further comprises: the step of the handle being grasped by the user's hand; and the step of the lever being rotated by the user's thumb.

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