A device for fusing the sacroiliac joint

Abstract

An apparatus for placing a fusion implant (5) in the sacroiliac joint (3) ("SI joint"). The apparatus includes a working channel (10), a joint locator (20), a polishing device (30), and an insertion device (60). The joint locator (20) is inserted into the working channel (10) and, guided by a K-wire (4), the combination is advanced into the SI joint (3). The joint locator (20) is removed, and the polishing device (30) is used to polish the sacrum (1) and ilium (2) inside the SI joint (3). The insertion device (60) then advances the implant (5) into the polished area of ​​the SI joint (3). The polished area heals over the implant (5), thereby fusing the sacrum (1) to the ilium (2) and fusing the SI joint (3).

Description

Technical Field

[0001] (1)(Field of Effort)

[0002] The present invention generally relates to the field of sacroiliac joint fusion surgery, and more particularly to a unique system and instrument for fusing the sacroiliac joint.

[0003] (2)(Description of Related Art)

[0004] The sacroiliac joint ("SI joint") is located at the interface between the sacrum and the ilium in the pelvic region of a human. The SI joint includes strong ligaments that allow only a small amount of movement between the sacrum and the ilium. The sacrum is connected to the bottom of the spine, and each ilium is connected to the upper part of the leg and the hip joint region. Thus, the SI joint connects the upper and lower bodies of a human.

[0005] Dysfunction of the SI joint is a common problem of low back pain. In fact, more than 25% of low back pain is caused by SI joint dysfunction. Even a normally functioning SI joint may become painful after certain types of spinal surgery. For example, SI joint pain occurs in more than 75% of lumbar fusion surgeries. In many cases, SI joint pain or dysfunction is addressed by fusing the SI joint, and there have been numerous surgeries for fusion to date. Past SI joint fusion surgeries have included the placement of complex implant devices such as bone anchors, fusion devices, multi-component implants, etc. These surgeries include complex devices such as drills and drill bits, and multi-component expanders, braces, and anchor placement devices. As a result, fusion surgeries using these devices are complex and time-consuming, and optimal results are often not obtained.

[0006] The set of instruments herein attempts to overcome these problems by providing a rationalized system and surgery for implanting an allograft implant in the SI joint without using a drill, drill bit, or other rotary cutting instrument.

[0007] Another complication of SI joint fusion is that promoting bone fusion often involves delamination of the cortical bone within the SI joint. This delamination is performed using a broach, rasp, or similar polishing device. These polishing devices can often get stuck inside the SI joint during the delamination process. When a polishing device gets stuck, it becomes impossible to apply counter-pressure to the patient to counteract the pull-out force needed to remove the polishing device. Such counter-pressure applied to the patient can cause injury to the patient or damage to surrounding tissues. Past solutions have been to attach a separate slap hammer or slide hammer to the polishing device so that the pull-out force can be applied to the polishing device without the need to apply counter-pressure to the patient or other objects. However, past slide hammer assemblies are cumbersome to operate, difficult to attach to the polishing device, and difficult to manipulate. They also complicate the instruments required to perform SI joint fusion surgery.

[0008] The set of tools described herein seeks to overcome these problems by providing a slide hammer integrated into a polishing device in a single tool. [Overview of the Initiative] [Means for solving the problem]

[0009] In a preferred embodiment, the system and instrument described herein comprises a working channel, a joint locator, a polishing device, and an implant inserter. The working channel has an insertion end and a working end, as well as a channel extending between them. The working channel provides a working passage for inserting other instruments of the system and for delivering implants to the SI joint. The insertion end has a pair of arms for engaging with the SI joint and for traction of the tissues surrounding the insertion end. The insertion end further has a first iliac contour and a first sacral contour, both of which are defined by the contour between the insertion arms and the body of the working channel. The inner surface of the working channel has alignment means including grooves, recesses, channels, indentations, etc., for receiving and engaging ridges, ribs, retainers, or other projections on mating instruments aligned with the alignment means. In one embodiment, the working channel further has a channel collar for receiving mating components of a joint locator, polishing device, or implant inserter to abut and engage.

[0010] The joint locator has an insertion end and a handle. The insertion end has a penetrating tip for penetrating the soft tissue near the SI joint. The leading edge of the penetrating tip may have a blade or chisel component, either entirely or partially, to facilitate this penetration. The insertion end of the joint locator has a second iliac contour and a second sacral contour. The outer surface of the joint locator has keying means for engaging with the alignment means of the working channel, the keying means having ridges, ribs, stoppers, or other projections on the outer surface of the joint locator that can engage with the alignment means.

[0011] The polishing device comprises a hammer sleeve at the proximal end, a polishing head at the distal end, and keying means similar to the articulated locator keying means of an articulated locator. In a preferred embodiment, the polishing device further comprises a slap hammer assembly or a slide hammer assembly. In one embodiment, the slide hammer assembly comprises a base connected to a shaft and a release means that releasably connects the hammer sleeve to the base. The released hammer sleeve is configured to slide engage along the shaft. To operate the slide hammer assembly, the hammer sleeve is disengaged from the base and the slide hammer assembly is placed in the open position. This open position allows the hammer sleeve to slide freely along the shaft. The hammer sleeve is pulled until the diaphragm inside the hammer sleeve engages with the stop end of the shaft, thereby generating an impact that delivers the force of the slide hammer.

[0012] The implant inserter has a handle and an implant insertion end. The implant insertion end has a pair of tines for holding the implant during the process of inserting the implant into the SI joint. The implant inserter further has inserter keying means similar to the keying means of a joint locator. [Brief explanation of the drawing]

[0013] [Figure 1] This shows a typical posterior view of the human pelvis.

[0014] [Figure 2] This is a perspective view of an embodiment of an allogeneic graft implant for insertion into the SI joint.

[0015] [Figure 3] An alternative diagram of one embodiment of an allograft implant is shown.

[0016] [Figure 4] This shows an embodiment of the device in a joint fusion apparatus.

[0017] [Figure 5] Shows embodiments of the working channel and embodiments of the joint locator.

[0018] [Figure 6] Shows an enlarged insertion end of one embodiment of the working channel.

[0019] [Figure 7] Shows an alternative view of the embodiment shown in FIG. 6.

[0020] [Figure 8] It is an enlarged view of the insertion end of an embodiment of the joint locator fully inserted into the working channel of FIG. 4.

[0021] [Figure 9] It is an enlarged view showing the reversed orientation of the device of FIG. 8.

[0022] [Figure 10] Shows an enlarged working end of one embodiment of the working channel.

[0023] [Figure 11] Shows the joint locator of FIG. 4 partially inserted into the working channel.

[0024] [Figure 12] Shows the joint locator of FIG. 4 fully inserted into the working channel.

[0025] [Figure 13] Shows embodiments of the working channel and the polishing device of FIG. 4.

[0026] [Figure 14] It is an enlarged view of an embodiment of the polishing head.

[0027] [Figure 15] Shows an enlarged view of one embodiment of the polishing head.

[0028] [Figure 16] Figure 13 shows a polishing device having an embodiment of a disassembled slide hammer.

[0029] [Figure 17] This is an enlarged view of an embodiment of the connection interface for a slide hammer.

[0030] [Figure 18] An enlarged view of one embodiment of the diaphragm and threaded connector of a slide hammer assembly is shown.

[0031] [Figure 19] Figure 4 shows the polishing device shown in Figure 13 partially inserted into the working channel.

[0032] [Figure 20] The polishing device shown in Figure 13 is fully inserted into the working channel in Figure 4 with the slide hammer in the closed position.

[0033] [Figure 21] Figure 13 shows the polishing device with the slide hammer in the extended position, fully inserted into the working channel of Figure 4.

[0034] [Figure 22] Figure 4 shows one embodiment of the work channel and insertion device.

[0035] [Figure 23] Figure 22 is a magnified view of the insertion end of the insertion device.

[0036] [Figure 24] Figure 22 shows an insertion device having an embodiment of an allograft implant loaded onto the tines of the insertion end.

[0037] [Figure 25]Figure 22 shows the insertion device and Figure 4 shows the allograft implant partially inserted into the working channel.

[0038] [Figure 26] Figure 22 shows the insertion device and Figure 4 shows the allograft implant fully inserted into the working channel. [Modes for carrying out the invention]

[0039] Referring to the drawings, systems and devices for fusing the sacroiliac joint ("SI joint") will now be described in terms of the best mode and preferred embodiments. The embodiments disclosed herein are illustrative of the invention and are not limiting. A typical practitioner will understand that it is possible to create many variations of the following embodiments without excessive experimentation.

[0040] The systems and devices described herein are used to fuse the SI joint 3 in the human pelvis. Referring to Figures 1 to 3, the allograft implant 5 is placed in the soft tissue of the SI joint 3 between the sacrum 1 and ilium 2 of the pelvis. The implant 5 provides a matrix for bone healing of the entire SI joint, thereby fusing the sacrum 1 and ilium 2. In one embodiment, the implant 5 generally includes a nose 6 and at least one pair of opposing sides 7, each having a groove 8 positioned at least partially along the length of each such side 7.

[0041] Referring to Figure 4, in one embodiment, the system comprises a working channel 10, a joint locator 20, a polishing device 30, and an implant inserter 60. Each of these instruments has a longitudinal axis along its centerline. Referring to Figure 5, the working channel 10 is a tubular member that provides a working passage for inserting other instruments of the system and for delivering implants 5 to the SI joint 3. The working channel 10 is a cannula, lumen, sleeve, or other device suitable for providing working access for other instruments to the SI joint 3, as described below. The working channel 10 has an insertion end 11 and a working end 12, and a channel 13 extending between them. The channel 13 is a tube or hole having a straight or curved cross-section. The insertion end 11 has a pair of arms 14 for providing engagement with the SI joint 3 and traction of tissue around the insertion end 11. The arms 14 are probes, prongs, or other members protruding from the insertion end 11 of the working channel 10. When the arm 14 is inserted into the SI joint 3, the working channel 10 resists or prevents rotation of the SI joint 3 about its longitudinal axis, as described below. The longitudinal axis generally extends along the length of the working channel 10, close to the centerline of the channel 13.

[0042] The insertion end 11 of the working channel 10 is configured to seat within and against the SI joint 3, particularly against the sacrum 1 and ilium 2. The insertion end 11 has a first ilium contour 15 and a first sacrum contour 16, both of which are defined by the contour between the insertion arm 14 and the body of the working channel 10. Referring, for example, to Figures 6 to 9, as described below, one side of the insertion end 11 has an arm 14 connected to the working channel 10 via the first ilium contour 15, and the arm 14 is configured to abut against the ilium 2 when the arm 14 is inserted into the SI joint 3 and seated therein. The other side of the insertion end 11 has an arm 14 connected to the working channel 10 via the first sacrum contour 16, and the arm 14 is configured to abut against the sacrum 1 when the arm 14 is inserted into the SI joint 3 and seated therein.

[0043] Referring to Figures 5 and 10, the inner surface of the working channel 10 has means for aligning an instrument, and the aligning means 17 has grooves, recesses, channels, indentations, etc. for receiving and engaging ridges, ribs, stoppers, or other projections on a mating instrument aligned with the aligning means 17. In one embodiment, the working channel 10 further has a channel collar 18 for receiving a mating component of an articular locator 20, polishing device 30, or implant inserter 60 to abut and engage, as described below. In embodiments of the channel collar 18, the collar further has an aligning means 17.

[0044] Referring to Figure 5, the joint locator 20 has an insertion end 21 and a handle 22, or a working end. The insertion end 21 has a penetrating tip 23 for penetrating soft tissue near the SI joint 3. This soft tissue is soft tissue such as muscle tissue between the surface of the patient's skin and the SI joint 3, as well as soft tissue inside the SI joint 3, such as cartilage and ligaments. The penetrating tip 23 is configured to penetrate these types of soft tissue. For example, one embodiment of the penetrating tip 23 has a blade or chisel component for cutting soft tissue. The leading edge of the penetrating tip 23 may have such a blade or chisel component, either entirely or partially.

[0045] Referring again to Figures 8 and 9, the insertion end 21 of the joint locator 20 has a second iliac contour 24 and a second sacral contour 25. For example, one side of the insertion end 21 of the joint locator 20 has a second iliac contour 24 configured to abut against the ilium 2 when the through-tip 23 is inserted into the SI joint 3, as described below. The other side of the insertion end 21 of the joint locator 20 has a second sacral contour 25 configured to abut against the sacrum 1 when the through-tip 23 is inserted into the SI joint 3.

[0046] The outer surface of the articulated locator 20 has means for keying to the alignment means 17 of the work channel 10, and the keying means 27 has ridges, ribs, retainers, or other projections on the outer surface of the articulated locator 20 that can engage with the alignment means 17 to resist or prevent relative rotation between the articulated locator 20 and the work channel 10.

[0047] In one embodiment, referring to Figures 5, 11, and 12, the articular locator 20 has a channel 26 for receiving the K-wire 4. The channel 26 is preferably a cannula, lumen, or other hole-like feature that can receive the K-wire 4 in a pass-through manner along the longitudinal axis or centerline of the articular locator 20. In one embodiment of the articular locator 20, the handle 22 further has a fastener 28 for contacting the channel collar 18 of the working channel 10.

[0048] Referring to Figure 13, the polishing device 30 has a hammer sleeve 31 at its proximal end and a polishing head 32 at its distal end. The polishing head 32 is a rasp, broach, or other polishing tool used to wear down, polish, or otherwise delaminate the cortical bone within the SI joint 3. In one embodiment shown in Figures 14 and 15, the polishing head 32 is a substantially rectangular member having polishing surfaces 33 on opposite sides of the head 32, an open tip 34 for insertion into the SI joint 3, and an open side 35 between the polishing surfaces 33. Each polishing surface 33 has one or more teeth, barbs, blades, ridges, slots, broaches, or other members or features that can polish the cortical bone of the SI joint 3. The open tip 34 has a cutting edge 36 around all or part of the open tip 34.

[0049] Referring again to Figure 19, the polishing device 30 further has keying means 37 similar to the keying means 27 of the articulated locator 20 described above. The keying means 37 engages with alignment means 17 in the work channel 10 to resist or prevent relative rotation between the polishing device 30 and the work channel 10 around the respective longitudinal axis of each member. The polishing device 30 further has polishing stoppers 38 for contacting the channel collar 18 of the work channel 10. In one embodiment, the polishing device 30 further has a K-wire channel for receiving a K-wire 4. This K-wire channel preferably has a cannula, lumen, or other hole-like feature that can receive the K-wire 4 in a pass-through manner along the longitudinal axis of the polishing device 30.

[0050] Referring to Figures 16, 17, and 18, the polishing device 30 further comprises a slap hammer assembly or a slide hammer assembly 40. In one embodiment, the slide hammer assembly 40 has a base 51 connected to a shaft 44, and a release means for releasably connecting a hammer sleeve 31 to the base 51. The released hammer sleeve 31 is configured to slide engage along the shaft 44. The release means is any means for releasably connecting the hammer sleeve 31 to the base 51. The release means may be a mating screw connection, a quick-disconnect attachment, a push-down tab, a latch, a clasp, a clip, a clamp, or other equivalent connection structure.

[0051] In one embodiment shown in Figures 16, 17, and 18, the release means is a mating screw connection. This embodiment includes a collar 41, a slide hammer shaft 44, and a hammer sleeve 31 on a polishing device 30. The collar 41 has female threads 42 and male threads 43. The shaft 44 has a threaded end 45 and a stop end 46. The hammer sleeve 31 has a threaded connector 48 and a hollow cylindrical hole having an internal diaphragm 47 with a diaphragm opening 49 (see Figure 18). The diaphragm opening 49 is sized to allow the sliding path of all parts of the shaft 44 except the stop end 46. The stop end 46 is too large to be mated through the diaphragm opening 49.

[0052] To assemble the slide hammer assembly 40 of this embodiment, the threaded end 45 of the shaft 44 is inserted into the hole in the hammer sleeve 31 through the diaphragm 47 inside the hammer sleeve 31, and the threaded end 45 is screwed into and mated with the female thread 42 of the collar 41. Then, the threaded connector 48 of the hammer sleeve 31 is mated with the male thread 43 of the collar 41 to facilitate a secure connection. The stop end 46 is positioned inside the hole in the hammer sleeve 31 on the side of the diaphragm 47 opposite to the position of the threaded connector 48. In this configuration shown in Figure 20, the slide hammer assembly 40 is in its closed position.

[0053] To operate the slide hammer assembly 40, the threaded connector 48 is disengaged from the male thread 43 of the collar 41, and the slide hammer assembly 40 is positioned in its open position as shown in Figure 21. This open position allows the hammer sleeve 31 to slide freely along the shaft 44. The hammer sleeve 31 is pulled until the diaphragm 47 inside the hammer sleeve 31 engages with the stop end 46 of the shaft 44, thereby generating the impact that delivers the force of the slide hammer.

[0054] Referring to Figures 22 to 26, the implant inserter 60 has a handle 61 and an implant insertion end 62. The implant insertion end 62 has a pair of tines 63 for holding the implant 5 during the process of inserting the implant 5 into the SI joint 3. Each tine 63 is supported by a tine shaft 66 terminating at a shoulder 67. The tine shaft 66 provides flexibility so that the implant 5 is removably held between the tines 63 and the shoulder 67 abuts against the implant 5 (see Figure 24). For example, in one embodiment, the width of the implant 5 between opposing grooves 8 is slightly greater than the space between each tine 63 so that when the implant 5 seats in the implant insertion end 62, each tine 63 is slightly pushed apart by the groove 8. This creates a small amount of friction between the tines 63 and the grooves 8, thereby removably holding the implant 5 in the implant insertion end 62.

[0055] The implant inserter 60 further includes an inserter keying means 65 similar to the keying means 27 of the joint locator 20. The inserter keying means 65 engages with alignment means 17 in the working channel 10 to resist or prevent relative rotation between the implant inserter 60 and the working channel 10 around the longitudinal axis of each member. In one embodiment, the implant inserter 60 further includes a channel 64 for receiving the K-wire 4 (see Figure 23). This channel 64 has a cannula, lumen, or other hole-like feature that allows the K-wire 4 to be received in a pass-through manner. In one embodiment of the implant inserter 60, the handle 61 further includes an insertion stopper 68 for contacting the channel collar 18 of the working channel 10.

[0056] In one embodiment of the method for placing implant 5, the surgery to place implant 5 in the SI joint 3 is initiated by inserting a K-wire 4 into the SI joint 3 at the location where implant 5 will be placed. The K-wire 4 is preferably inserted from a posterior approach. It is preferable, but not essential, for implant 5 to be placed below the portion of the posterior superior iliac spine that protrudes into the SI joint 3. One or more alternative locations are also suitable for the fusion of the SI joint 3. The K-wire 4 is inserted into the SI joint 3 at each location where implant 5 will be inserted.

[0057] Next, the joint locator 20 is fully inserted into the working channel 10 (see Figure 12). When the joint locator 20 is fitted inside the working channel 10, the keying means 27 of the joint locator 20 is oriented to engage with the alignment means 17 of the working channel 10. This engagement allows the first iliac contour 15 of the working channel to be positioned in a fitted alignment with the second iliac contour 24 of the joint locator 20, and the first sacral contour 16 of the working channel 10 to be positioned in a fitted alignment with the second sacral contour 25 of the joint locator 20 (see Figures 8 and 9). The first and second iliac contours 15, 24 are configured to be positioned relative to the ilium 2 when the insertion end 11 is positioned inside the SI joint 3, and the first and second sacral contours 16, 25 are configured to be positioned corresponding to the sacrum 1 when the insertion end 11 is positioned inside the SI joint 3.

[0058] The free end of the K-wire is inserted into the K-wire channel 26 of the coupled joint locator 20 / working channel 10, and this coupled device advances toward the SI joint 3, guided by the K-wire 4. As the coupled joint locator 20 / working channel 10 advances, the penetrating tip 23 cuts through the upper and inner soft tissue of the SI joint 3. If necessary, the coupled joint locator 20 / working channel 10 is advanced by striking the handle 22 from a mallet. The impact force from the mallet is transmitted through the handle 22 to the stopper 28, where the force is applied to the channel collar 18 and the working channel 10. Thus, the impact force from the mallet is balanced between the working channel insertion end 11 and the joint locator insertion end 21.

[0059] The combined joint locator 20 / working channel 10 advances until its respective first and second iliac contours 15, 24 abut against the ilium 2 and its respective first and second sacral contours 16, 25 abut against the sacrum 1. In this position, the arm 14 of the working channel 10 is positioned inside the SI joint 3 to maintain proper alignment of the working channel 10 and therefore the alignment means 17, thereby ensuring proper alignment of the polishing device 30 and the implant inserter 60 later in the surgery. In some embodiments, insertion of the arm 14 into the SI joint 3 tractions the joint and thus separates the sacrum 1 and ilium 2. This traction establishes a uniform width of the distance between the SI joint 3 before the use of other instruments. Thus, the instruments described herein work in patients of any size, regardless of the size or scale of the sacrum 1 or ilium 2, because the arm 14 sets the width of the SI joint 3 to a constant distance.

[0060] In an alternative embodiment of the installation method, the K-wire 4 is omitted from the surgery. Instead, the coupled joint locator 20 / working channel 10 advances through the patient's incision, and this advancement continues as described above until the insertion ends 11, 21 are inserted into the SI joint 3 as described above.

[0061] Once the combined joint locator 20 / work channel 10 device is properly seated in the SI joint 3, the joint locator 20 is removed from the work channel 10. The surrounding soft tissue remains pulled or expanded by the work channel 10 and its respective arms 14, thereby allowing direct access to the SI joint 3 area. The polishing device 30 is then inserted into the work channel 10, and the keying means 37 engages with the alignment means 17 to facilitate proper alignment of the polishing head 32 with respect to the SI joint 3. The polishing head 32 advances through the work channel 10 until it contacts the SI joint 3. The polishing head 32 is pushed into the SI joint 3 (using a mallet if necessary), and the cutting edge 36 cuts soft tissue such as ligaments or cartilage. The polishing stopper 38 abuts against the channel collar 18 of the work channel 10 to prevent excessive penetration of the polishing head 32 into the SI joint 3.

[0062] Next, the polishing device 30 operates inside and outside the working channel 10 so that the polishing surface 33 polishes or delaminates the respective surfaces of the sacrum 1 and ilium 2 on the inside of the SI joint 3. In this case as well, the polishing stopper 38 abuts against the channel collar 18 to prevent excessive intrusion of the polishing head 32. During this process, the polishing head 32 may get stuck inside the SI joint 3 and become difficult to remove. In these cases, the slide hammer assembly 40 is effective and, as described above, can remove the polishing head 32 by the impact force of the slide hammer assembly 40. The operation of the slide hammer assembly 40 offers many advantages over previous systems because, when the polishing head 32 gets stuck in the SI joint 3, it is not possible to apply back pressure to the patient to counteract the pull-out force required to remove the polishing head 32 from the SI joint 3. The slide hammer assembly 40 allows for the safe removal of the stuck polishing head 32 without applying back pressure to the patient.

[0063] As the polishing head 32 moves inside and outside the SI joint 3, the polishing surface 33 polishes the cortical bone of the sacrum 1 and ilium 2 inside the SI joint 3. The cortical bone is polished until bleeding begins, thereby promoting the healing process of the patient's cortical bone. This degree of polishing and the corresponding healing promote the fusion of the SI joint 3.

[0064] Once the SI joint 3 is properly polished, the polishing device 30 is removed from the working channel 10. At this point in the surgery, the K-wire 4 may be removed from the working channel 10 to allow for proper advancement of the implant 5 through the working channel 10 and proper placement of the implant 5 in the SI joint 5. Alternatively, the K-wire 4 may be removed from the working channel 10 at any time after the working channel 10 has properly seated in the SI joint 3, as described above.

[0065] The allogeneic graft implant 5 is positioned on the tines 63 of the implant inserter 60 such that each tine 63 seats in the mating groove 8 on the side surface 7 of the implant 5 and the shoulder 67 abuts against the implant 5. The implant inserter 60 is then inserted into the working channel 10 such that the keying means 65 engages with the alignment means 17 to ensure proper orientation of the implant inserter 60 and, therefore, the implant 5. The implant inserter 60 is used to deliver the implant 5 to the polishing area of ​​the SI joint 3 through the working channel 10. If necessary, the implant inserter 60 is struck with a mallet to push the implant 5 into the polishing area of ​​the SI joint 3, and the shoulder 67 transmits the impact force to the implant 5. In these cases, the insertion stopper 68 abuts against the channel collar 18 of the working channel 10 to prevent excessive intrusion of the implant 5 into the SI joint 3.

[0066] Once implant 5 is fully inserted into the SI joint 3, the implant inserter 60 is removed from the working channel 10, leaving implant 5 in place in the polished area of ​​the SI joint 3. In most cases, the frictional force between implant 5 and the inside of the SI joint 3 is greater than the frictional force between each tine 63 and groove 8. In these cases, removal of the implant inserter 60 is achieved by applying a removal force greater than the frictional force between the tine 63 and groove 8 to the implant inserter 60. In other cases, the frictional force between implant 5 and the inside of the SI joint 3 is less than the frictional force between each tine 63 and groove 8. In these cases, removal of the implant inserter 60 is achieved by inserting a K-wire 4 or similar device into the K-wire channel 64 and advancing the K-wire 4 until the distal end of the K-wire abuts against implant 5 between the tines 63. The K-wire 4 is used to hold implant 5 in place on the inside of the SI joint 3 when the removal force is applied to the implant inserter 60. Thereafter, the tines 63 are removed from groove 8 as the K-wire 4 holds implant 5 in place. When the tine 63 is withdrawn from the groove 8, the implant inserter 60 is disengaged from the implant 5, and the implant inserter 60 and K-wire 4 are removed from the working channel 10. The working channel 10 is then removed from the surgical site, the surgical site is sterilized and closed for healing.

[0067] As the polished cortical bone heals, it fuses with the allograft implant 5, ultimately causing the sacrum 1 and ilium 2 to grow together at the implant 5 site, thereby fusing the SI joint 3.

[0068] In any of the embodiments described above, one or more instruments may have disposable materials such as medical-grade plastic, certain metals, or other disposable materials.

[0069] The embodiments described above are merely representative of SI joint fusion devices and are not intended to limit the present invention. For example, those skilled in the art will readily understand that there are several embodiments and configurations of the polishing devices, slide hammer devices, and other devices described herein that do not substantially alter the properties of the SI joint fusion device. As another example, the alignment means 17 and the respective keying means 27, 37, and 67 can be reversed such that the working channel 10 has keying means, and the joint locator 20, rasp device 30, and implant inserter 60 each have mating alignment means. Thus, it will be understood that the equivalents and substitutions of the above-described elements and components are part of the present invention as described herein, and the true scope of the invention is described in the following claims.

Claims

1. A system of instruments for placing a fusion implant in the sacroiliac joint, wherein the system of instruments is A work channel (10) having an insertion end and a work end connected by a channel (13), wherein the work channel (10) further has alignment means, An articulated locator inserted into the channel of the work channel, wherein the articulated locator has a through-tip portion including a blade or chisel component provided at the insertion end, a handle at the proximal end, and a first keying means for mating engagement with the alignment means, A polishing device inserted into the channel of the work channel, wherein the polishing device comprises a polishing head including a polishing surface provided at the distal end and a slide hammer assembly at the proximal end, and the polishing device further comprises a second keying means for mating engagement with the alignment means, An implant inserter inserted into the channel of the work channel, wherein the implant inserter has an insertion end including a pair of tines for releasably receiving a joint fusion implant, and the implant inserter further has a third keying means for mating engagement with the alignment means, A system of instruments in which the insertion end of the working channel (10) further has a first iliac contour and a first sacral contour, and the through-tip of the articular locator further has a second iliac contour and a second sacral contour, and when the articular locator is fully inserted into the working channel (10), the first iliac contour and the second iliac contour and the first sacral contour and the second sacral contour are positioned in a fit alignment.

2. The system of the device according to claim 1, wherein the slide hammer assembly of the polishing device has a bottom connected to a shaft and a release means for releasably connecting a hammer sleeve to the bottom, and the released hammer sleeve is configured to slide engage along the shaft.

3. The apparatus system according to claim 1, wherein the working channel (10) further comprises a channel collar, the polishing device further comprises a polishing stopper, and the channel collar abuts against the polishing stopper to prevent excessive intrusion of the polishing head.

4. The apparatus system according to claim 2, wherein the working channel (10) further comprises a channel collar, the polishing device further comprises a polishing stopper, and the channel collar abuts against the polishing stopper to prevent excessive intrusion of the polishing head.

5. The apparatus system according to claim 1, wherein the polishing head further comprises an open tip portion having a cutting edge.

6. The apparatus system according to claim 2, wherein the polishing head further comprises an open tip portion having a cutting edge.

7. The apparatus system according to claim 3, wherein the polishing head further comprises an open tip portion having a cutting edge.

8. A system of instruments for placing a fusion implant in the sacroiliac joint, wherein the system of instruments is A work channel (10) having an insertion end and a work end connected by a channel (13), wherein the work channel (10) further has alignment means, An articulated locator having a through-tip, a handle, and a first keying means for fitting and engaging with the alignment means, A polishing device having a polishing head at a distal end and a slide hammer assembly at a proximal end, wherein the polishing device further has a second keying means for mating engagement with the alignment means, and the slide hammer assembly is A collar on the polishing device, wherein the collar has a female thread and a male thread, A slide hammer shaft having a threaded end for fitting with the female thread of the collar on the polishing device, and a sliding stop end, A hammer sleeve having a hollow cylindrical hole with an internal diaphragm and a threaded connector configured to engage with the male thread of the collar, wherein the internal diaphragm has a diaphragm opening sized to allow the sliding path of the slide hammer shaft and the blocking path of the sliding stop end, and a polishing device comprising a hammer sleeve, An implant inserter having an insertion end including a pair of tines for releasably receiving a joint fusion implant, wherein the implant inserter further has a third keying means for mating engagement with the alignment means, and A system of equipment that includes these features.

9. The apparatus system according to claim 8, wherein the working channel (10) further comprises a channel collar, the polishing device further comprises a polishing stopper, and the channel collar abuts against the polishing stopper to prevent excessive intrusion of the polishing head.

10. The apparatus system according to claim 8, wherein the polishing head further comprises an open tip portion having a cutting edge.

11. The apparatus system according to claim 9, wherein the polishing head further comprises an open tip portion having a cutting edge.

12. The system of the instrument according to claim 8, wherein the insertion end of the working channel (10) further has a first iliac contour and a first sacral contour, and the through-tip of the articular locator further has a second iliac contour and a second sacral contour, and when the articular locator is fully inserted into the working channel (10), the first iliac contour and the second iliac contour and the first sacral contour and the second sacral contour are positioned in a fit alignment.

13. The system of the instrument according to claim 9, wherein the insertion end of the working channel (10) further has a first iliac contour and a first sacral contour, and the through-tip of the articular locator further has a second iliac contour and a second sacral contour, and when the articular locator is fully inserted into the working channel (10), the first iliac contour and the second iliac contour and the first sacral contour and the second sacral contour are positioned in a fit alignment.

14. The system of the instrument according to claim 10, wherein the insertion end of the working channel (10) further has a first iliac contour and a first sacral contour, and the through-tip of the articular locator further has a second iliac contour and a second sacral contour, and when the articular locator is fully inserted into the working channel (10), the first iliac contour and the second iliac contour and the first sacral contour and the second sacral contour are positioned in a fit alignment.

15. The system of the instrument according to claim 11, wherein the insertion end of the working channel (10) further has a first iliac contour and a first sacral contour, and the through-tip of the articular locator further has a second iliac contour and a second sacral contour, and when the articular locator is fully inserted into the working channel (10), the first iliac contour and the second iliac contour and the first sacral contour and the second sacral contour are positioned in a fit alignment.

16. The apparatus system according to claim 15, wherein the articulated locator has an elongated body between the through-tip and the handle, and a K-wire channel extending from the handle through the elongated body to the through-tip of the articulated locator.

17. A set of instruments for placing a fusion implant in the sacroiliac joint, wherein the set of instruments is A work channel having an insertion end and a work end, wherein the work channel further has alignment means extending along the longitudinal axis of the work channel, An articulated locator having a through-tip portion including a blade or chisel component provided at the insertion end, a handle at the proximal end, and a first keying means for mating engagement with the alignment means, wherein the first keying means extends along the longitudinal axis of the articulated locator, A polishing device having a polishing head including a polishing surface provided at the distal end, wherein the polishing device further has a second keying means for mating and engaging with the alignment means, the second keying means extending along the longitudinal axis of the polishing device, An implant inserter having an insertion end including a pair of tines for releasably receiving a joint fusion implant, wherein the implant inserter further has a third keying means for mating engagement with the alignment means, the third keying means extending along the longitudinal axis of the implant inserter, A set of instruments for setting a fusion implant in the sacroiliac joint, wherein the insertion end of the working channel further has a first iliac contour and a first sacral contour, and the through-tip of the joint locator further has a second iliac contour and a second sacral contour, and when the joint locator is fully inserted into the working channel, the first iliac contour and the second iliac contour and the first sacral contour and the second sacral contour are positioned in a mating alignment.

18. The set of instruments according to claim 17, wherein the polishing head further comprises an open tip portion having a cutting edge.

19. A set of instruments for placing a fusion implant in the sacroiliac joint, wherein the set of instruments is A work channel having an insertion end including a first iliac contour and a first sacral contour, and a work end having a collar and alignment means, The articular locator comprises an insertion end having a through-tip portion including a second iliac contour and a second sacral contour, a proximal end having a handle with a fastener for contacting the collar on the work channel, and a first keying means for engaging with the alignment means when the articular locator is inserted into the work channel, A set of instruments for setting a fusion implant in the sacroiliac joint, wherein when the joint locator is fully inserted into the working channel, the first iliac contour and the second iliac contour, as well as the first sacral contour and the second sacral contour, are positioned in a mating alignment.

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