Braking tower with biasing member and medical injection device comprising same
By using protrusions of brake tower-shaped components or offset cylinders of nail-shaped components in medical injection devices, the problem of inaccurate drug delivery in existing devices is solved, and more accurate drug dosage control is achieved.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- BECTON DICKINSON & CO
- Filing Date
- 2021-09-23
- Publication Date
- 2026-06-16
AI Technical Summary
The lack of control and load recovery in the elastic components used in existing medical injection devices leads to inaccurate drug delivery.
A brake tower-shaped component is used as a spring replacement. The brake tower-shaped component has a distal side and sidewalls. The distal side is provided with protrusions or nail-like parts to bias the cylinder of the medical injection device and ensure that it does not move during injection.
The biasing effect of protrusions or nails ensures the accuracy and stability of drug delivery and avoids errors in drug dosage.
Smart Images

Figure CN116528930B_ABST
Abstract
Description
[0001] Cross-reference to related applications
[0002] This application claims priority to U.S. Provisional Application No. 63 / 083,617, filed on September 25, 2020, entitled “Brake Tower with Biasing Components and Medical Injection Device Including the Same”, the entire disclosure of which is incorporated herein by reference.
[0003] Background Art of the Invention
[0004] Field of the Invention
[0005] This disclosure generally relates to components used as alternatives to helical coil springs in medical devices, and in specific embodiments or aspects, to injection devices including a brake tower-shaped component with a biasing element.
[0006] Description of related technologies
[0007] Medical injection devices typically use resilient components (e.g., springs) placed between various parts to bias these parts and ensure more accurate drug delivery. However, the resilient components currently used in medical injection devices have drawbacks such as a lack of control and load recovery. Therefore, there is a need in the art for a more robust component that allows for greater load recovery. Summary of the Invention
[0008] This document provides a brake tower-shaped member for use in a medical injection device. The brake tower-shaped member has a proximal end, a distal end, and a sidewall. The distal end has a distal surface, and the sidewall defines a longitudinal axis between the proximal end and the distal end. The brake tower-shaped member also includes one or more protrusions disposed on the sidewall and / or the distal surface, and extending distally from the sidewall and / or the distal surface.
[0009] The one or more protrusions may be integral with the sidewall and / or the distal side. The one or more protrusions may include: a first portion extending distally from the distal side of the brake tower-like member along the longitudinal axis, wherein the first portion has a proximal end and a distal end; and a second portion extending from the distal end of the first portion, the second portion being arranged perpendicular to the first portion. The second portion may extend radially inward from the distal end of the first portion. The one or more protrusions may be configured to bend when a force is applied to the one or more protrusions along the longitudinal axis. The one or more protrusions may be formed of a polymer. The polymer may be a thermoplastic.
[0010] The one or more protrusions may be one or more nail-like elements. The one or more nail-like elements may include: a plurality of longitudinally extending portions, each having a proximal end and a distal end, the proximal end being embedded in the distal side of the brake tower-like element, the distal end being spaced apart from the embedded proximal end; and a vertically extending portion attached to the distal end of the longitudinally extending portions. The proximal end of the longitudinally extending portion may be configured to be embedded in the distal side of the brake tower-like element. The nail-like element may be formed of metal or a metal alloy. The proximal end, the distal end, and the sidewall of the brake tower-like element may define a defining cylinder.
[0011] The distal end of the brake tower may have a larger outer periphery than the proximal end and / or the sidewall of the brake tower. The sidewall may define at least a partially hollow interior. The distal side may include two to ten protrusions arranged on the distal side.
[0012] This document also provides a medical injection device comprising a brake tower having a proximal end, a distal end, and a sidewall, the distal end having a distal surface, the sidewall defining a longitudinal axis between the proximal end and the distal end; and one or more protrusions disposed on the sidewall and / or the distal surface and extending distally from the sidewall and / or the distal surface. Attached Figure Description
[0013] Figure 1 A perspective view of a brake tower-like member according to a non-limiting embodiment or aspect as described herein is shown;
[0014] Figure 2 A side view of a brake tower-like member according to a non-limiting embodiment or aspect as described herein is shown;
[0015] Figure 3 This is a partial cross-sectional view of a medical injection device including a brake tower-like member according to a non-limiting embodiment or aspect described herein, showing the position before engagement;
[0016] Figure 4This is a partial cross-sectional view of a medical injection device including a brake tower-like member according to a non-limiting embodiment or aspect described herein, showing the engagement position;
[0017] Figure 5 This is a side view of a brake tower-like member as described herein, according to a non-limiting embodiment or aspect.
[0018] Figure 6 This is a partial cross-sectional view of a medical injection device including a brake tower-like member according to a non-limiting embodiment or aspect described herein, showing the position before engagement;
[0019] Figure 7 This is a partial cross-sectional view of a medical injection device including a brake tower-like member according to a non-limiting embodiment or aspect described herein, showing the engagement position;
[0020] Figure 8 This is an exploded view of a medical injection device including a brake tower-shaped member with a biasing component, according to a non-limiting embodiment or aspect described herein; and
[0021] Figure 9 This is a cross-sectional view of a medical injection device including a brake tower-shaped member with a biasing component, according to a non-limiting embodiment or aspect described herein.
[0022] Specific embodiments of the present invention
[0023] Unless otherwise expressly stated, the use of numerical values within the various ranges specified in this application is to describe approximate values, as the minimum and maximum values within the described ranges are preceded by the word "approximately". As used herein, the term "approximately" means ±10% of the described value. In this way, substantially the same result as the value within the described range can be achieved using small variations above and below the described range. Furthermore, unless otherwise stated, the disclosure of these ranges is intended as a continuous range including each value between the minimum and maximum values. For the definitions provided herein, these definitions refer to the morphological, cognate, and grammatical variations of those words or phrases.
[0024] Unless otherwise stated, the accompanying drawings are representative in nature and should not be construed as implying any particular scale or orientation. In the following, for descriptive purposes, the terms “upper,” “lower,” “right,” “left,” “vertical,” “horizontal,” “top,” “bottom,” “lateral,” “longitudinal,” and their derivatives will be used in relation to the invention as oriented in the drawings. However, it should be understood that the invention may take various alternative variations and sequences of steps unless explicitly stated to the contrary. Therefore, specific dimensions and other physical characteristics relating to the embodiments disclosed herein should not be considered limiting.
[0025] This article provides a brake tower-shaped component with a biasing element for use as a replacement for springs in medical devices.
[0026] Go to Figures 1 to 4 , Figures 1 to 4 A non-limiting embodiment or aspect of a brake tower member 5 for a medical injection device is shown. The brake tower member can adopt any useful configuration for a medical injection device. In a non-limiting embodiment or aspect, the brake tower member 5 is cylindrical and has a proximal end, a distal end, and sidewalls defining a longitudinal axis between the proximal and distal ends. In a non-limiting embodiment or aspect, the brake tower member 5 is at least partially hollow, and the proximal end, distal end, and sidewalls define at least partially open interiors that can accommodate one or more other components of the medical injection device, as will be described below. In a non-limiting embodiment or aspect, the interior of the brake tower member 5 includes one or more features for interacting with components housed within the interior of the brake tower member, for example, by reversible or irreversible locking. Such features may include, for example, slots, lugs, recesses, and / or openings, but are not limited thereto. Such features can, for example, prevent relative rotation between the brake tower member 5 and components housed within the brake tower member, such as brake tower cores, lead screws, and / or piston rods.
[0027] In a non-limiting embodiment or aspect, the sidewall of the brake tower 5 may include one or more splines or teeth configured to allow the brake tower 5 to rotate when engaged with another component (e.g., a rear component) within a medical injection device. In a non-limiting embodiment or aspect, one or more splines or teeth are configured to allow the brake tower 5 to rotate only in a single direction.
[0028] In a non-limiting embodiment or aspect, the distal end of the brake tower 5 is enlarged, for example, by having a larger outer periphery than the proximal end. In a non-limiting embodiment or aspect, the distal end of the brake tower 5 includes one or more features for interacting with another component (e.g., a housing) of a medical injection device, for example, through reversible or irreversible locking. Such features may include, but are not limited to, one or more slots, lugs, recesses, and / or openings, and may prevent relative rotation between the brake tower and the component.
[0029] The brake tower 5 can be formed of any suitable material. In a non-limiting embodiment or aspect, the brake tower 5 is formed of a polymer material (e.g., plastic). In a non-limiting embodiment or aspect, the brake tower 5 is formed of a thermoplastic. In a non-limiting embodiment or aspect, the brake tower 5 is formed of a metal or metal alloy.
[0030] Continue to refer to Figures 1 to 4The distal end of the brake tower 5 includes a distal side. The brake tower 5 also includes one or more projections 11 extending distally. In a non-limiting embodiment or aspect, one or more projections 11 are arranged on a sidewall and extend distally from the sidewall at the distal end of the brake tower 5. In a non-limiting embodiment or aspect, one or more projections 11 are arranged on the distal side of the brake tower and extend distally from the distal side of the brake tower. The one or more projections 11 are used to bias a cartridge housed within a medical injection device including a brake tower as described herein, minimizing movement of the component and thereby ensuring more accurate delivery of the composition from the cartridge. In a non-limiting embodiment or aspect, the distal side of the brake tower 5 includes 2, 3, 4, 5, 6, 7, 8, 9, 10 or more projections 11. In one non-limiting embodiment or aspect, the distal side of the brake tower 5 includes two to four projections.
[0031] One or more protrusions 11 may take any suitable form to provide a biasing force on other components (e.g., the barrel or barrel housing) within the medical injection device. In non-limiting embodiments or aspects, for example, as... Figure 1 and Figure 2 As shown, one or more protrusions 11 may be molded plastic lugs. In a non-limiting embodiment or aspect, one or more protrusions 11 are co-molded with the brake tower 5 (e.g., by injection molding, compression molding, or any other suitable process), thereby being integrally formed with the brake tower 5 and made of the same material. In a non-limiting embodiment or aspect, one or more protrusions 11 are added after the brake tower 5 is molded, for example with a suitable adhesive (e.g., hot melt adhesive), and the protrusion may have the same or different material as the brake tower 5. In such an embodiment or aspect, one or more protrusions 11 may be formed of any suitable material, as long as the material provides the desired compressibility / expansion.
[0032] Continue to refer to Figures 1 to 4 One or more protrusions 11 may take any useful shape, configuration, and / or orientation on the sidewalls and / or distal surfaces of the brake tower 5. In a non-limiting embodiment or aspect, one or more resilient protrusions have a circular or polygonal shape (e.g., triangular, quadrilateral, etc.). One or more resilient protrusions 11 may also have a first height and a second height, the first height being when the brake tower 5 is pressed against another component (e.g., cylinder 15). Figure 3 Before the second height is measured distally from the distal side of the brake tower 5 along the longitudinal axis defined by the sidewall of the brake tower 5; this second height is measured distally when the brake tower 5 is pressed against another component (e.g., cylinder 15). Figure 4Then, measurements are taken distally from the distal side of the brake tower 5 along the longitudinal axis defined by the sidewall of the brake tower. (e.g.) Figure 3 and Figure 4 As shown, one or more protrusions 11 deflect to bias the cylinder 15 such that a first height is greater than a second deflection height. The one or more protrusions 11 may be randomly oriented on the sidewalls and / or distal surfaces of the brake tower 5, or oriented in a specific pattern.
[0033] In non-limiting embodiments or aspects, for example, such as Figure 1 and Figure 2 As shown, one or more protrusions 11 are configured substantially in an "L" shape, the "L" shape having a first portion and a second portion. The first portion extends distally from the distal end of the brake tower member 5 (e.g., from a sidewall or distal side) along a longitudinal axis defined by the sidewall. The second portion is disposed at the distal end of the first portion and extends substantially perpendicular to the first portion. In a non-limiting embodiment or aspect, the second portion extends radially inward from the distal end of the first portion. In a non-limiting embodiment or aspect, for example, as... Figure 1 As shown, one or more protrusions 11 include relatively weak areas (e.g., seams) to allow one or more protrusions 11 to bend or deflect when pressed against another component (e.g., cylinder 15). The biasing nature of the one or more protrusions 11 is at least in part based on the material used to form the one or more protrusions 11, which allows the one or more protrusions 11 to bend while still exerting a biasing force on the other component (e.g., cylinder).
[0034] Go to Figures 5 to 7 In a non-limiting embodiment or aspect, one or more protrusions 11 may be one or more stapes extending distally from the distal side of the brake tower 5. The stapes may be formed of any suitable material, but in a preferred non-limiting embodiment or aspect, the stapes are metal or metal alloys. After the brake tower 5 is formed, the stapes may be attached to the brake tower 5. The stapes may be configured to take any suitable shape. In a non-limiting embodiment or aspect, the stapes include two longitudinally extending portions, each having a proximal end and a distal end, the proximal end being configured to embed in the distal side of the brake tower 5, the distal end being spaced apart from the proximal end. The stapes may also include a vertical portion attached to the distal end of the longitudinally extending portions, such as... Figure 5 As shown. When the distal side of the brake tower 5 is pressed against another component of the medical injection device (e.g., cylinder 15), the proximal end of the stud can be configured to reduce the force required to embed the stud into the distal side of the brake tower 5. For example, each proximal end of the stud can form a point, but is not limited thereto. The stud can be attached to the distal side of the brake tower 5 at any suitable penetration depth. Figure 6As shown, before one or more protrusions 11 engage with the cylinder 15, one or more protrusions 11 extend a first distance from the brake tower 5. Figure 7 As shown, when one or more protrusions 11 engage with the cylinder 15, the one or more protrusions 11 are further pushed into the brake tower 5, such that the one or more protrusions 11 extend from the brake tower 5 by a second distance, which is less than the first distance.
[0035] This document also provides a medical injection device comprising a brake tower-like member having one or more protrusions as described above. Such a device (e.g., an injection pen) is described in U.S. Patent No. 9,421,334, the entire contents of which are incorporated herein by reference. References Figure 8 and Figure 9 , Figure 8 and Figure 9 An exploded view of the injection pen 51 for delivering the composition to the user is shown. Figure 8 ) and cross-sectional view ( Figure 9 As shown, the injection pen 51 includes an upper pen body or housing 1 that houses multiple dose setting and injection components. The upper pen body 1 is connected to a cartridge housing 14 that houses a cartridge 15. The injection pen 51 may also include a lower pen cap 12 to cover the cartridge 15 and cartridge housing 14 when the injection pen 51 is not in use. As shown, the injection pen 51 may include a dose setting knob 2, which includes a knob-like portion that the user rotates to set the desired dose. The dose setting knob 2 may also include multiple numbers corresponding to multiple dose units visible through a window 13 on the upper pen body 1. The user rotates the dose setting knob 2 until the desired dose is visible in the window 13. The upper pen body 1 may include an arrow or other indicator 53 to precisely indicate the set dose. Once the desired dose is set, the user presses a button 3 until the set dose is fully injected. The outer shield 69 can cover the needle 56 to prevent accidental needle pricks when removing the lower pen cap 12.
[0036] The injection pen 51 may include a push button 3 located at the proximal end of the upper pen body 1, closest to the user and furthest from the needle 56. The push button 3 may include an annular flange or edge 57 that engages with a corresponding annular groove (not shown) on the inner surface of the dose setting knob 2. The connection between the annular edge and the groove may be a friction fit, which, under the force of the push button spring 10, holds the push button 3 in a biased position on the dose setting knob 2, but allows the push button 3 to be pushed into the dose setting knob 2 to inject the set dose. The interior of the push button 3 may accommodate a setback bearing insert 8, which rests on the inner surface of the proximal end of a rear member or driver 9. The push button 3 may be designed to rotate freely on the setback bearing insert 8.
[0037] The rear member or drive member 9 may be a cylindrical member, coaxial with and surrounded by the dose setting knob 2. As described above, the rear member 9 may surround and be coaxial with the brake tower member 5. The brake tower member 5 may be axially and rotatably fixed to the upper pen body 1. In a non-limiting embodiment or aspect, the brake tower member 5 surrounds and is coaxial with the piston rod 6. The piston rod 6 may include a set of keys (not shown) that engage slots (not shown) inside the brake tower member 5 (as described above) to rotatably lock the piston rod 6 to the brake tower member 5. The piston rod 6 may include a plurality of threads (not shown) disposed on the inner surface of the piston rod. The piston rod 6 may surround and be coaxial with the lead screw 4, which includes a series of threads 42 at least at its distal end. The threads 42 of the lead screw may be configured to engage with internal threads (not shown) disposed inside the piston rod 6. Because the piston rod is threadedly engaged with the lead screw 4, during the injection process, the piston rod 6 can move into the cylinder 15 to press against the stopper 16 located inside the cylinder 15, thereby discharging a dose of drug.
[0038] Referring to this disclosure, the injection pen 51 includes a brake tower 5 as described above. The brake tower 5 includes a distal side having one or more protrusions as described above, which are positioned between the brake tower 5 and the cartridge 15 to offset the cartridge 15 in a distal direction, thereby preventing any movement of the cartridge 15 during injection and thus ensuring an accurate dosage.
[0039] about Figures 1 to 4 In the embodiment shown, when assembling the injection pen 51 including the brake tower 5 as shown, the distal side of the brake tower 5 is pressed against the cylinder 15. As a result, one or more protrusions deform by bending, for example, as... Figure 4As shown. By means of one or more protrusions formed of elastic material, the protrusions remain in contact with the cylinder 15 and maintain a biasing force on the cylinder 15, preventing the cylinder from moving during injection and ensuring accurate dosage.
[0040] about Figures 5 to 7 In the embodiment shown, when assembling the injection pen 51 including the brake tower 5 as shown, the distal side of the brake tower 5 is pressed against the cylinder 15. As a result, one or more spikes are further embedded in the distal side of the brake tower 5. However, the embedding degree of the one or more spikes does not exceed the degree required to allow the brake tower 5 and the cylinder 15 to abut each other within the upper body 1 of the injection pen 51. The vertical portions of the one or more spikes abut the proximal end of the cylinder 15 to prevent the cylinder from moving during injection and to ensure an accurate dosage.
[0041] After assembly, and when ready to use the injection pen 51, the dosage for drug delivery can be set. To set the dosage using the injection pen 51 as described herein, the user rotates the knob portion of the dosage setting knob 2 relative to the upper pen body 1. Figure 8 and Figure 9 As shown, the outer surface of the dosage setting knob 2 may include a thread 23, which threadedly engages with a plurality of threads 17 provided on the inner surface of the upper pen body 1. Therefore, as... Figure 9 As shown, as the dosage setting knob 2 rotates relative to the upper pen body 1, the dosage setting knob 2 rotates out or moves forward a certain distance from the upper pen body 1. Figure 9 As shown, the dose setting knob 2 may include an annular shoulder or edge 21 located on the inner surface near the proximal end of the dose setting knob. Figure 9 As shown, the annular shoulder 21 can engage with the enlarged portion or head 91 of the rear member 9. The annular shoulder 21 of the dose setting knob 2 may include a series of teeth or ridges that engage with a plurality of similarly shaped teeth or ridges (not shown) disposed on the enlarged head 91 of the rear member 9. The teeth of the dose setting knob and the teeth of the rear member may extend in opposite axial directions. During dose setting, the dose setting knob 2 can rotate freely relative to the rear member 9 in both clockwise and counterclockwise directions. When this occurs, the plurality of teeth or ridges on the dose setting knob 2 may slide over the teeth disposed on the head 91 of the rear member 9, thereby providing a tactile signal or click to indicate the dose setting.
[0042] Regarding the injection mechanism, as described above, the lead screw 4 may include a plurality of threads 42 at its distal end, which threadly engage with a plurality of threads 64 that may be arranged along the entire length of the hollow piston rod 6, such as... Figure 9As shown. Due to its non-rotatable coupling with the brake tower 5, which can be axially and rotatably fixed relative to the upper pen body 1, the piston rod 6 can remain non-rotatable relative to the upper pen body 1. The piston rod 6 may include a key or set of keys 62 at its distal end, which engages with a slot (not shown) provided on the inner surface of the brake tower 5 to prevent relative rotation between the piston rod and the brake tower 5 while allowing axial movement of the piston rod 6 relative to the brake tower 5. The thread 42 of the lead screw 4 may include a flat portion (not shown) corresponding to the flat portion 65 of the piston rod 6, such that axial movement of the lead screw during dose setting does not cause axial movement of the piston rod 6. Therefore, rotation of the lead screw 4 during injection dose can cause the thread 42 of the lead screw 4 to engage with the thread 64 of the piston rod 6, thereby allowing axial movement of the piston rod 6. Because the piston rod 6 can be non-rotatable relative to the upper pen body 1, as the lead screw 4 is driven to rotate during injection due to its rotational coupling with the rear member 9 as described above, the piston rod 6 can be driven to move in the distal direction through its threaded engagement with the lead screw 4 to press against the stop member 16 provided in the cylinder 15, thereby discharging the liquid drug from the cylinder.
[0043] Although these apparatuses have been described in detail based on embodiments currently considered most practical and preferred for illustrative purposes, it should be understood that such detail is for that purpose only, and the systems and methods are not limited to the disclosed embodiments, but rather are intended to cover modifications and equivalent arrangements within the spirit and scope of the appended claims. For example, it should be understood that the systems and methods are contemplated that, to the extent possible, one or more features of any embodiment can be combined with one or more features of any other embodiment.
Claims
1. A braking tower-shaped component, the braking tower-shaped component being used in a medical injection device, the braking tower-shaped component comprising: A proximal end, a distal end, and a sidewall, the distal end having a distal surface, and the sidewall defining a longitudinal axis between the proximal end and the distal end; as well as One or more protrusions are disposed on the sidewall and / or the distal sidewall and extend distally from the sidewall and / or the distal sidewall. Wherein, the one or more protrusions are configured to apply a biasing force to other components, and The one or more protrusions are configured to bend when a force is applied to the one or more protrusions along the longitudinal axis, while still applying the biasing force to the other components.
2. The brake tower-shaped member according to claim 1, wherein, The one or more protrusions are integral with the sidewall and / or the distal surface.
3. The brake tower-shaped member according to claim 1, wherein, The one or more protrusions include: A first portion, extending distally from the distal side of the brake tower-like member along the longitudinal axis, the first portion having a proximal end and a distal end; and The second part extends from the distal end of the first part and is arranged perpendicular to the first part.
4. The brake tower-shaped member according to claim 3, wherein, The second portion extends radially inward from the distal end of the first portion.
5. The brake tower-shaped member according to any one of claims 1 to 4, wherein, The one or more protrusions comprise two first parts and one second part. Wherein, the proximal ends of the two first portions are embedded in the distal side of the brake tower-shaped member, and The second portion extends between the distal ends of the two first portions.
6. The brake tower-shaped member according to any one of claims 1 to 4, wherein, The one or more protrusions comprise a polymer.
7. The brake tower-shaped member according to claim 6, wherein, The polymer includes thermoplastics.
8. The brake tower-shaped member according to claim 1, wherein, The one or more protrusions include one or more nail-like elements.
9. The brake tower-shaped member according to claim 8, wherein, The one or more nail-like elements include: Multiple longitudinally extending portions, each longitudinally extending portion having a proximal end embedded in the distal side of the brake tower-like member and a distal end spaced apart from the embedded proximal end; and A vertically extending portion, which is attached to the distal end of the longitudinally extending portion.
10. The brake tower-shaped member according to claim 9, wherein, The proximal end of the longitudinally extending portion is configured to be embedded in the distal side of the brake tower-like member.
11. The brake tower-shaped member according to any one of claims 8 to 10, wherein, The one or more nails comprise metal or metal alloy.
12. The brake tower-shaped member according to any one of claims 1 to 4, wherein, The proximal end, the distal end, and the sidewall of the brake tower define a cylinder.
13. The brake tower-shaped member according to any one of claims 1 to 4, wherein, The distal end of the brake tower has a larger periphery than the proximal end and / or the sidewall of the brake tower.
14. The brake tower-shaped member according to any one of claims 1 to 4, wherein, The sidewall defines an interior that is at least partially hollow.
15. The brake tower-shaped member according to any one of claims 1 to 4, wherein, The distal side includes two to ten protrusions arranged on the distal side.
16. A medical injection device, comprising: A housing having a distal end and a proximal end; Brake tower-shaped member according to any one of claims 1 to 15; A cylinder, which is housed within the housing on the distal side of the brake tower and holds the composition within the cylinder; A cylindrical housing, which is received within the housing on the distal side of the brake tower-like member and configured to retain the cylinder within the cylindrical housing; An injection needle is located at the distal end of the housing and is in fluid communication with the cylindrical body; as well as An actuating member, located at the proximal end of the housing, is configured to actuate the medical injection device to deliver the composition via the injection needle. The one or more protrusions arranged on the sidewall and / or the distal side of the brake tower-like member and extending distally from the sidewall and / or the distal side cause the cylinder to be biased distally.