Arthroscopic graft delivery system

Abstract

An arthroscopic graft delivery system and methods are provided for treating bone voids and cartilage type defects. The arthroscopic graft delivery system includes a cannula, a threaded extruder, and an obturator. The cannula is an elongated member having a proximal cannula and an extrusion tip. The proximal cannula receives a portion of graft to deliver to a treatment site. The threaded extruder enables pushing the graft from the proximal cannula into the cannula. The obturator enables pushing the graft through the cannula and out of the extrusion tip. The extrusion tip includes an extrusion hole surrounded by an extrusion surface. The extrusion surface is at an angle with respect to the cannula. A spatula surface opposite of the extrusion surface enables smoothing and contouring the graft at the treatment site. Laser marked indicators and labels indicate proper orientation of the arthroscopic graft delivery system both externally and arthroscopically.

Description

ARTHROSCOPIC GRAFT DELIVERY SYSTEMPRIORITY

[0001] This application claims the benefit of and priority to U.S. Provisional Application, entitled “Arthroscopic Graft Delivery System,” filed on January 17, 2024, and having application serial number 63 / 621,867, the entirety of said application being incorporated herein by reference.FIELD

[0002] Embodiments of the present disclosure generally relate to surgical implants. More specifically, embodiments of the disclosure relate to an arthroscopic graft delivery system and methods for treating bone voids and cartilage type defects.BACKGROUND

[0003] Arthroscopy is a surgical procedure whereby a joint is accessed and treated without making a large incision through the skin and other soft tissues. During joint arthroscopy, an arthroscope is inserted into the joint to diagnose joints defects and to guide miniature surgical instruments. Because the arthroscope and surgical instruments are thin, very small incisions can be used rather than the larger incisions associated with open surgery.

[0004] Grafting is a surgical procedure whereby a portion of living tissue is transplanted from one location on a patient to another operative location on the patient so as to assist with healing following surgery. For example, bone grafting is very common in orthopedic surgery, neuro / spine surgery, and plastic surgery. Bone generally has the ability to regenerate completely; but in many cases, some sort of scaffold is required to encourage bone adhesion and growth.

[0005] As such, there is a need for an arthroscopic graft delivery system for repairing bone voids and cartilage type defects that results in less pain and joint stiffness for patients, and thus shortens recovery time.SUMMARY

[0006] An arthroscopic graft delivery system and methods are provided for treating bone voids and cartilage type defects. The arthroscopic graft delivery system includes a cannula, a threaded extruder, and an obturator. The cannula is an elongated member having a proximal cannula andan extrusion tip. The proximal cannula receives a portion of graft to deliver to a treatment site. The threaded extruder enables pushing the graft from the proximal cannula into the cannula. The obturator enables pushing the graft through the cannula and out of the extrusion tip. The extrusion tip includes an extrusion hole surrounded by an extrusion surface. The extrusion surface is at an angle with respect to the cannula. A spatula surface opposite of the extrusion surface enables smoothing and contouring the graft at the treatment site. Laser marked indicators and labels indicate proper orientation of the arthroscopic graft delivery system both externally and arthroscopically.

[0007] In an exemplary embodiment, an arthroscopic graft delivery system for treating bone voids and cartilage type defects comprises: a cannula comprising an elongated member having a proximal cannula and an extrusion tip; a threaded extruder for pushing a portion of graft from the proximal cannula into the cannula; and an obturator for pushing the portion of graft through the cannula and out of the extrusion tip.

[0008] In another exemplary embodiment, the proximal cannula is adapted to receive the portion of graft to deliver to a treatment site by way of the extrusion tip. In another exemplary embodiment, a lumen is disposed between the proximal cannula and the extrusion tip.

[0009] In another exemplary embodiment, the threaded extruder includes exterior threads configured to engage with similar threads disposed within the proximal cannula. In another exemplary embodiment, turning the threaded extruder clockwise with respect to the cannula moves the threaded extruder in a distal direction. In another exemplary embodiment, turning the threaded extruder counterclockwise moves the threaded extruder in the distal direction. In another exemplary embodiment, the threaded extruder includes wings that are configured to enable turning the threaded extruder.

[0010] In another exemplary embodiment, the threaded extruder includes a distal end adapted to push the portion of graft through the cannula when the threaded extruder advances in a distal direction. In another exemplary embodiment, the distal end includes a peripheral lip that is configured to decrease the amount of clearance between the threaded extruder and the inner wall of the proximal cannula. In another exemplary embodiment, the proximal cannula includes a distal taper to funnel the portion of graft through the cannula.

[0011] In another exemplary embodiment, the obturator is a generally smooth shaft disposed between a proximal handle and a distal end. In another exemplary embodiment, the proximal handle is adapted to be pressed by hand while the distal end is configured to push the portion of graft through the cannula. In another exemplary embodiment, the obturator is configured to be pressed into the cannula to dispense the portion of graft from the extrusion tip. In another exemplary embodiment, the obturator is configured to be pushed all the way through the cannula until the distal end protrudes beyond an extrusion surface of the extrusion tip. In another exemplary embodiment, the distal end is configured to be used to pack the portion of graft into a treatment site.

[0012] In another exemplary embodiment, the cannula includes finger ledges that facilitate providing a counterforce while pressing the proximal handle. In another exemplary embodiment, the obturator includes a narrow section configured to be gripped by retaining tabs comprising the threaded extruder, such that the distal end is aligned with the distal end of the threaded extruder. In another exemplary embodiment, the obturator is preassembled into the threaded extruder with the retaining tabs holding the obturator in a proximal disposition.

[0013] In another exemplary embodiment, the extrusion tip comprises an extrusion hole surrounded by an extrusion surface. In another exemplary embodiment, the extrusion surface is disposed at an angle with respect to the longitudinal dimension of the cannula. In another exemplary embodiment, the angle ranges between about 20 degrees and about 45 degrees. In another exemplary embodiment, a spatula surface is disposed opposite of the extrusion surface and is configured to enable smoothing and contouring the portion of graft that is applied to a treatment site.

[0014] In another exemplary embodiment, the extrusion tip includes a rounded configuration for ease of insertion through soft tissue. In another exemplary embodiment, the extrusion tip includes a squared configuration to create a spatula surface on an extrusion side of the extrusion tip. In another exemplary embodiment, the squared configuration includes a shaped extrusion hole. In another exemplary embodiment, the shaped extrusion hole includes an inner angle configured to control the trajectory of extruded graft in a direction that is more normal to the extrusion tip.

[0015] These and other features of the concepts provided herein may be better understood with reference to the drawings, description, and appended claims.BRIEF DESCRIPTION OF THE DRAWINGS

[0016] The drawings refer to embodiments of the present disclosure in which:

[0017] Figure 1 illustrates an exemplary embodiment of an arthroscopic graft delivery system, according to the present disclosure;

[0018] Figure 2 illustrates an exploded view of the arthroscopic graft delivery system of Fig. 1 in accordance with the present disclosure;

[0019] Figure 3 illustrates an exemplary embodiment of an arthroscopic graft delivery system in accordance with the present disclosure;

[0020] Figure 4 illustrates an exemplary embodiment of a cannula receiving a portion of graft to be delivered to a treatment site, according to the present disclosure;

[0021] Figure 5 illustrates a cross-sectional view of a threaded extruder engaging with threads disposed in a cannula in accordance with the present disclosure;

[0022] Figure 6 illustrates a cross-sectional view of an exemplary embodiment of a proximal cannula that includes a distal taper to funnel graft through a cannula, according to the present disclosure;

[0023] Figure 7 illustrates an exemplary embodiment of a threaded extruder that includes exterior threads configured to engage with similar threads disposed within a proximal cannula, according to the present disclosure;

[0024] Figure 8 illustrates a cross-sectional view of an exemplary embodiment of a narrow section of an obturator being gripped by way of retaining tabs comprising a threaded extruder in accordance with the present disclosure;

[0025] Figure 9 illustrates a cross-sectional view of an exemplary embodiment of a distal end of a threaded extruder aligned with a distal end of an obturator in accordance with the present disclosure;

[0026] Figure 10 illustrates an exemplary embodiment of an extrusion tip that includes an extrusion hole surrounded by an extrusion surface, according to the present disclosure;

[0027] Figure 11 illustrates an exemplary embodiment of an extrusion tip that includes a spatula surface disposed opposite of an extrusion surface, according to the present disclosure;

[0028] Figure 12 illustrates an exemplary embodiment of a squared extrusion tip that includes a shaped extrusion hole in accordance with the present disclosure;

[0029] Figure 13 illustrates a cross-sectional view of an exemplary embodiment of a shaped extrusion hole that is angled with respect to a cannula in accordance with the present disclosure;

[0030] Figure 14 illustrates a cross-sectional view of an exemplary embodiment of an extrusion surface that is disposed at an angle with respect to the longitudinal dimension of a cannula in accordance with the present disclosure;

[0031] Figure 15 illustrates a side view of an exemplary embodiment of an extrusion surface that is disposed at an angle with respect to the longitudinal dimension of a cannula, according to the present disclosure;

[0032] Figure 16 illustrates a side view of an exemplary embodiment of a threaded extruder with a specialized connector end opposite of a threaded interface, according to the present disclosure;

[0033] Figure 17 illustrates a back view of the threaded extruder of Fig. 16 in accordance with the present disclosure;

[0034] Figure 18 illustrates an exemplary embodiment of an arthroscopic graft delivery system that includes the threaded extruder of Fig. 16 connecting to tubing / hosing for suctioning, according to the present disclosure;

[0035] Figure 19 illustrates an exemplary -use environment of a treatment site in accordance with the present disclosure;

[0036] Figure 20 illustrates an exemplary embodiment of an arthroscopic graft delivery system that is loaded with a portion of graft, according to the present disclosure;

[0037] Figure 21 illustrates graft being dispensed by way of the arthroscopic graft delivery system of Fig. 20, according to the present disclosure;

[0038] Figure 22 illustrates an exemplary embodiment of an obturator that is pushed all the way through a cannula such that a distal end of the obturator protrudes beyond a extrusion surface of the extrusion tip in accordance with the present disclosure; and

[0039] Figure 23 illustrates an exemplary-use environment wherein graft material has been dispensed and packed into a treatment site, according to the present disclosure.

[0040] While the present disclosure is subject to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and will herein be described in detail. The present disclosure should be understood to not be limited to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the present disclosure.DETAILED DESCRIPTION

[0041] In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present disclosure. It will be apparent, however, to one of ordinary skill in the art that the arthroscopic graft delivery system and methods disclosed herein may be practiced without these specific details. In other instances, specific numeric references such as “first screw,” may be made. However, the specific numeric reference should not be interpreted as a literal sequential order but rather interpreted that the “first screw” is different than a “second screw.” Thus, the specific details set forth are merely exemplary. The specific details may be varied from and still be contemplated to be within the spirit and scope of the present disclosure. The term “coupled” is defined as meaning connected either directly to the component or indirectly to the component through another component. Further, as used herein, the terms “about,”“approximately,” or “substantially” for any numerical values or ranges indicate a suitable dimensional tolerance that allows the part or collection of components to function for its intended purpose as described herein.

[0042] In general, the present disclosure describes an arthroscopic graft delivery system and methods for treating bone voids and cartilage type defects. The arthroscopic graft delivery system includes a cannula, a threaded extruder, and an obturator. The cannula is an elongated member having a proximal cannula and an extrusion tip. The proximal cannula receives a portion of graft to deliver to a treatment site. The threaded extruder enables pushing the graft from the proximal cannula into the cannula. The obturator enables pushing the graft through the cannula and out of the extrusion tip. The extrusion tip includes an extrusion hole surrounded by an extrusion surface. The extrusion surface is at an angle with respect to the cannula. A spatula surface opposite of the extrusion surface enables smoothing and contouring the graft at the treatment site. Laser marked indicators and labels indicate proper orientation of the arthroscopic graft delivery system both externally and arthroscopically.

[0043] Figure 1 illustrates an exemplary embodiment of an arthroscopic graft delivery system 100, according to the present disclosure. The arthroscopic graft delivery system 100 includes a cannula 104, a threaded extruder 108, and an obturator 112. The arthroscopic graft delivery system 100 is configured to deliver graft 116 or biomaterials by way of an extrusion tip 120 comprising the cannula 104.

[0044] The arthroscopic graft delivery system 100 is configured to deliver graft 116 and / or biomaterials arthroscopically to address bone voids or cartilage type defects. As such, the arthroscopic graft delivery system 100 can deliver the graft 116 through a small opening in the skin / soft tissue. After the graft 116 is delivered, the extrusion tip 120 can be used to smooth / shape / compact the graft 116 at the defect location, as described herein. It is contemplated that the arthroscopic graft delivery system 100 may be provided sterile in a kit along with some drying components, such as cotton swabs, if the defect site needs to be dried prior to delivery of the graft 116.

[0045] Figure 2 illustrates an exploded view of the arthroscopic graft delivery system 100 in accordance with the present disclosure. As mentioned in connection with Fig. 1, the arthroscopicgraft delivery system 100 includes the cannula 104, the threaded extruder 108, and the obturator 112. In some embodiments, the arthroscopic graft delivery system 100 comprises a transparent material that provides visibility of advancement of the graft 116 through the arthroscopic graft delivery system 100. As shown in Fig. 4, the cannula 104 is a generally elongated member disposed between a proximal cannula 124 and the extrusion tip 120. The proximal cannula 124 is adapted to receive a portion of graft 116 to deliver to a treatment site by way of the extrusion tip 120. It should thus be understood that a lumen is disposed between the proximal cannula 124 and the extrusion tip 120.

[0046] The threaded extruder 108 is configured to push the portion of graft 116 from the proximal cannula 124, through the cannula 104 and out of the extrusion tip 120. As shown in Fig. 7, the threaded extruder 108 includes exterior threads 128 configured to engage with similar threads 132 (see Fig. 4) disposed within the proximal cannula 124. As shown in Fig. 5, turning the threaded extruder 108 clockwise with respect to the cannula 104 moves the threaded extruder 108 in a distal direction 140. In some embodiments, however, turning the threaded extruder 108 counterclockwise moves the threaded extruder 108 in the distal direction 140. Wings 144 are configured to enable turning the threaded extruder 108.

[0047] As shown in Fig. 7, the threaded extruder 108 includes a distal end 148 adapted to push the graft 1 16 through the cannula 104 when the threaded extruder 108 advances in the distal direction 140. The distal end 148 includes a peripheral lip 152 that is configured to decrease the amount of clearance between the threaded extruder 108 and the inner wall of the proximal cannula 124 to ensure a maximum material is retained. Further, as shown in Fig. 6, the proximal cannula 124 includes a distal taper 156 to funnel the graft 116 through the cannula 104.

[0048] Returning, again, to Fig. 2, obturator 112 is a generally elongated member disposed between a proximal handle 160 and a distal end 164. The proximal handle 160 is adapted to be pressed by hand while the distal end 164 is configured to push the graft 116 through the cannula 104, as described herein. The obturator 112 is a generally smooth shaft, with the exception of a narrow section 168. As shown in Figs. 7-8, the narrow section 168 is configured to be gripped by way of retaining tabs 172 comprising the threaded extruder 108, such that the distal end 164 is aligned with the distal end 148 of the threaded extruder 108 as shown in Fig. 9. It is contemplatedthat the obturator 112 may be preassembled into the threaded extruder 108 with the retaining tabs 172 holding the obturator 112 in a proximal disposition, as shown in Fig. 3, until the proximal handle 160 is used to advance the obturator 112 in a distal direction 174 through the cannula 104. As shown in Fig. 3, the cannula 104 includes finger ledges 178 that facilitate providing a counterforce 182 while pressing the proximal handle 160. Thus, a practitioner may use the finger ledges 178 to support the arthroscopic graft delivery system 176 while pressing the proximal handle 160 to deliver the graft 116 to the treatment site.

[0049] Turning, now, more particularly to Fig. 3, an exemplary embodiment of an arthroscopic graft delivery system 176 is shown in accordance with the present disclosure. The arthroscopic graft delivery system 176 shown in Fig. 3 is substantially similar to the arthroscopic graft delivery system 100 shown in Fig. 2, with the exception that the arthroscopic graft delivery system 176 includes a rounded extrusion tip 180 in lieu of the square extrusion tip 120 of Fig. 2. The rounded extrusion tip 180 is shown in greater detail in Figs. 10-11.

[0050] As shown in Figs. 10-11, the extrusion tip 180 comprises an extrusion hole 184 surrounded by an extrusion surface 188. As shown in Figs. 14-15, the extrusion surface 188 is disposed at an angle 192 with respect to the longitudinal dimension of the cannula 104. In some embodiments, the angle 192 ranges between about 1 degree and about 90 degrees, without limitation. More particularly, in some embodiments, the angle 192 ranges between about 20 degrees and about 45 degrees, without limitation. As best shown in Fig. 11, a spatula surface 196 may be disposed opposite of the extrusion surface 188. The spatula surface 196 is configured to enable smoothing and contouring the graft 116 or biomaterials that are applied to a treatment site by way of the extrusion hole 184.

[0051] Moreover, while the rounded extrusion tip 180 is well adapted for ease of insertion through soft tissue, the extrusion tip can be configured with shaped other than the rounded shape shown in Figs. 10-11, without limitation. For example, Figs. 12-13 illustrate an exemplary embodiment of a squared extrusion tip 200 that includes a shaped extrusion hole 204. The squared extrusion tip 200 is configured to create a spatula on both the extrusion side and the side opposite of extrusion. Further, the shaped extrusion hole 204 can be configured to a desired shaped including, but not limited to, square, rectangle, circle, oval, triangle, and other polygon typeshapes, without limitation. Further, in some embodiments, the shaped extrusion hole 204 may round off or include an inner angle 208, as shown in Fig. 13. It is contemplated that the inner angle 208 can control the trajectory of extruded graft 116 or biomaterial in a direction that is more normal to the angle of the squared extrusion tip 200.

[0052] As further shown in Figs. 10-15, laser marked indicators 208 may be applied to the extrusion tips 180, 200 to indicate the location of the extrusion holes 184, 204 on the cannula 104. The laser marked indicators 208 are configured to cooperate with laser marked labels 212 that are applied to the cannula 104 (see, for example, Figs. 3 and 18) so as to provide visibility of proper orientation of the arthroscopic graft delivery system 100 both externally and arthroscopically.

[0053] Turning, now, to Figs. 16-18, an exemplary embodiment of a threaded extruder 216 is shown in accordance with the present disclosure. The threaded extruder 216 shown in Figs. 16- 18 is substantially similar to the threaded extruder 108 shown in Fig. 7, with the exception that the threaded extruder 216 includes a tapered adapter 220 and lacks the retention tabs 172, shown in Fig. 7. As shown in Fig. 18, the tapered adapter 220 is configured to receive a flexible suction tube 224. As will be recognized, the tapered adapter 220 facilitates using the cannula 104 for suction of fluids and materials from the treatment site.

[0054] Figure 19 illustrates an exemplary -use environment wherein an incision has been performed on a patient’s foot 232 to gain access to a defect 236 to be treated by of an arthroscopic graft delivery system 100, as shown in Fig. 20. A cotton swab 228 or another similar drying component is first used to dry the defect 236. As discussed in connection with Fig. 4, the proximal cannula 124 is adapted to receive a portion of graft 116 or biomaterial to deliver to a treatment site, such as the defect 236 shown in Fig. 19, by way of the extrusion tip 120. Once the graft 116 is loaded into the proximal cannula 124, the threaded extruder 108 can be turned in an appropriate direction to push the graft 116 from the proximal cannula 124 into the cannula 104. Wings 144 are configured to enable turning the threaded extruder 108.

[0055] Next, as shown in Fig. 21, the obturator 112 can be pressed into the cannula 104 to dispense graft material 240 from the extrusion tip 120. As disclosed hereinabove, the obturator 112 may be preassembled into the threaded extruder 108 with the retaining tabs 172 (see Fig. 8) holding the obturator 112 in a proximal disposition, as shown in Fig. 20, until the proximal handle160 is used to advance the obturator 112 into the cannula 104. As shown in Fig. 3, the cannula 104 includes finger ledges 178 that facilitate providing a counterforce 182 while pressing the proximal handle 160. As such, the practitioner can use the finger ledges 178 to support the arthroscopic graft delivery system 100 while pressing the proximal handle 160 to deliver the graft material 240 to the defect 236 shown in Fig. 19.

[0056] As shown in Fig. 22, the obturator 112 can be pushed all the way through the cannula 104 until the distal end 164 of the obturator 112 protrudes beyond the extrusion surface 188 of the extrusion tip 120. It is contemplated that the distal end 164 can be used to pack the graft material 240 into the defect 236 site. Once the graft material 240 is dispensed and packed into the defect 236, the spatula surface 196 may be used to smooth and contour the graft material 240 to completely fill the defect 236, as shown in Fig. 23.

[0057] While the arthroscopic graft delivery system and methods have been described in terms of particular variations and illustrative figures, those of ordinary skill in the art will recognize that the arthroscopic graft delivery system is not limited to the variations or figures described. In addition, where methods and steps described above indicate certain events occurring in certain order, those of ordinary skill in the art will recognize that the ordering of certain steps may be modified and that such modifications are in accordance with the variations of the arthroscopic graft delivery system. Additionally, certain of the steps may be performed concurrently in a parallel process, when possible, as well as performed sequentially as described above. To the extent there are variations of the arthroscopic graft delivery system, which are within the spirit of the disclosure or equivalent to the arthroscopic graft delivery system found in the claims, it is the intent that this patent will cover those variations as well. Therefore, the present disclosure is to be understood as not limited by the specific embodiments described herein, but only by scope of the appended claims.

Claims

CLAIMSWhat is claimed is:

1. An arthroscopic graft delivery system for treating bone voids and cartilage type defects, the system comprising: a cannula comprising an elongated member having a proximal cannula and an extrusion tip; a threaded extruder for pushing a portion of graft from the proximal cannula into the cannula; and an obturator for pushing the portion of graft through the cannula and out of the extrusion tip.

2. The system of claim 1, wherein the proximal cannula is adapted to receive the portion of graft to deliver to a treatment site by way of the extrusion tip.

3. The system of claim 1, wherein a lumen is disposed between the proximal cannula and the extrusion tip.

4. The system of claim 1, wherein the threaded extruder includes exterior threads configured to engage with similar threads disposed within the proximal cannula.

5. The system of claim 1, wherein turning the threaded extruder clockwise with respect to the cannula moves the threaded extruder in a distal direction.

6. The system of claim 1, wherein turning the threaded extruder counterclockwise moves the threaded extruder in the distal direction.

7. The system of claim 1, wherein the threaded extruder includes wings that are configured to enable turning the threaded extruder.

8. The system of claim 1, wherein the threaded extruder includes one or more gripping features configured to enable turning the threaded extruder.

9. The system of claim 1 , wherein the threaded extruder includes a distal end adapted to push the portion of graft through the cannula when the threaded extruder advances in a distal direction.

10. The system of claim 9, wherein the distal end includes a peripheral lip that is configured to decrease the amount of clearance between the threaded extruder and the inner wall of the proximal cannula.

11. The system of claim 1, wherein the proximal cannula includes a distal taper to funnel the portion of graft through the cannula.

12. The system of claim 1, wherein the obturator is a generally smooth shaft disposed between a proximal handle and a distal end.

13. The system of claim 12, wherein the proximal handle is adapted to be pressed by hand while the distal end is configured to push the portion of graft through the cannula.

14. The system of claim 13, wherein the obturator is configured to be pressed into the cannula to dispense the portion of graft from the extrusion tip.

15. The system of claim 13, wherein the obturator is configured to be pushed all the way through the cannula until the distal end protrudes beyond an extrusion surface of the extrusion tip.

16. The system of claim 15, wherein the distal end is configured to be used to pack the portion of graft into a treatment site.

17. The system of claim 13, wherein the cannula includes finger ledges that facilitate providing a counterforce while pressing the proximal handle.

18. The system of claim 13, wherein the obturator includes a narrow section configured to be gripped by retaining tabs comprising the threaded extruder, such that the distal end is aligned with the distal end of the threaded extruder.

19. The system of claim 18, wherein the obturator is preassembled into the threaded extruder with the retaining tabs holding the obturator in a proximal disposition.

20. The system of claim 1, wherein the extrusion tip comprises an extrusion hole surrounded by an extrusion surface.

21. The system of claim 20, wherein the extrusion surface is disposed at an angle with respect to the longitudinal dimension of the cannula.

22. The system of claim 21, wherein the angle ranges between about 20 degrees and about 45 degrees.

23. The system of claim 21, wherein a spatula surface is disposed opposite of the extrusion surface and is configured to enable smoothing and contouring the portion of graft that is applied to a treatment site.

24. The system of claim 1, wherein the extrusion tip includes a rounded configuration for ease of insertion through soft tissue.

25. The system of claim 1, wherein the extrusion tip includes a squared configuration to create a spatula surface on an extrusion side of the extrusion tip.

26. The system of claim 25, wherein the squared configuration includes a shaped extrusion hole.

27. The system of claim 26, wherein the shaped extrusion hole includes an inner angle configured to control the trajectory of extruded graft in a direction that is more normal to the extrusion tip.

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