Joint fusion preparation assembly and related methods

Abstract

A joint fusion preparation assembly having a self-centering, non-rigid, "floating"cutting blade deployable to a target site in a minimally invasive procedure is disclosed herein. The joint fusion preparation assembly includes an outer cannula or access conduit, an inner sleeve, a cutter component, and a bone drill component. The outer cannula includes a distal abutment surface configured to register the distal end of the outer cannula against a bony surface and a spring-loaded locking element configured to securely engage with the inner sleeve to maintain the inner sleeve at a desired position. The inner sleeve is configured for insertion into the outer cannula and includes a spring-loaded locking element configured to securely engage with the cutter component and / or the bone drill component to maintain the cutter and / or bone drill in a desired position during use.

Description

JOINT FUSION PREPARATION ASSEMBLY AND RELATED METHODSCROSS-REFERENCES TO RELATED APPLICATIONS

[0001] The present application claims the benefit of priority from U.S. Provisional Application Serial No. 63 / 674,225, filed July 22, 2024 and entitled “Joint Fusion Preparation Assembly and Related Methods,” the entire contents of which are hereby incorporated by reference into this disclosure as if set forth fully herein.FIELD

[0002] The present disclosure relates generally to orthopedic surgery, and more particularly to instrumentation for use in preparing a joint for fusion.BACKGROUND

[0003] The sacroiliac joint (“SI joint”) is the joint where the sacrum (the triangular bone at the base of the spine) and the ilium (the broad, flat bone that forms the upper part of the hip bone) meet. The sacroiliac joint is a synovial joint cavity filled with synovial fluid, and it is supported by ligaments and muscles. The sacroiliac joint has a sacral component formed by the auricular surfaces of the sacrum, which are ear-shaped surfaces on the sides of the sacrum that articulate with the ilium. The sacral component of the joint is relatively immobile. The iliac component of the joint is formed by the iliac surface of the ilium, which articulates with the sacrum. Between the sacral and iliac components of the sacroiliac joint, there is a fibrous cartilage layer called the interosseous ligament. This ligament connects the two bones and helps to stabilize the joint. The joint is also supported by several other ligaments and muscles, including the sacroiliac ligaments, the iliolumbar ligaments, and the gluteal muscles.

[0004] Sacroiliac joint dysfunction is a condition that occurs when there is abnormal motion or alignment of the sacroiliac joint, which is the joint that connects the sacrum (the triangular bone at the bottom of the spine) to the pelvis. This can cause pain in the lower back, buttocks and legs, as well as stiffness and difficulty with mobility.

[0005] Sacroiliac joint fusion is a surgical procedure that aims to permanently join the sacrum and ilium bones of the pelvis at the sacroiliac joint. Sacroiliac joint fusion is typically done totreat chronic sacroiliac joint pain, which can result from various conditions, such as degenerative joint disease, traumatic injury, or pregnancy. The procedure involves decorticating or removing at least a portion of the interosseous ligament and / or the damaged joint surfaces and replacing them with bone grafts or other materials that promote the growth of new bone across the joint.

[0006] Some existing decorticators configured for use in the sacroiliac joint have retractable but rigid cutting elements. These rigid cutting elements can be problematic because a rigid cutting element does not always conform to patient anatomy, and the anatomical landscape can vary from patient to patient. As a result, the cutting element can cut into bone in an unintended manner.

[0007] The present disclosure is directed at overcoming the deficiencies of the prior art.SUMMARY

[0008] The present disclosure addresses the drawbacks of the prior art systems by providing a joint fusion preparation assembly having a self-centered, non-rigid, “floating” cutting blade deployable to a target site in a minimally invasive procedure. By way of example, the selfcentered, non-rigid, “floating” cutting blade may be configured to move (e.g., pivot) after deployment for example to enable the cutting blade to better conform to surrounding anatomy and remove only desired tissue from the target site.

[0009] In some embodiments, the joint fusion preparation assembly of the present example may include an outer cannula or access conduit (which for example may be a final dilator in a sequential dilation system), an inner sleeve, a cutter component, and a bone drill component. As will explained in further detail below, the outer cannula includes a distal abutment surface configured to register the distal end of the outer cannula against a bony surface, for example a surface of an iliac bone, and a spring-loaded locking element configured to securely engage with the inner sleeve to maintain the inner sleeve at a desired position. The inner sleeve is configured for insertion into the outer cannula and includes a spring-loaded locking element configured to securely engage with the cutter component and / or the bone drill component to maintain the cutter and / or bone drill in a desired position during use. In some embodiments, each of the cutter component and bone drill component are removable from the inner sleeve, which in turn isremovable from the outer cannula. By way of example, the outer cannula and / or inner sleeve may remain in place to provide for a safe access corridor for one or more of additional instrumentation, fusion implants, graft material, guide wires, and the like.

[0010] In some embodiments, the joint fusion preparation assembly of the present disclosure is adjustable and may be configured to enable a user to drill to the depth of the desired joint (e.g., a SI joint) or beyond the joint into the second (or distal) bone segment (e.g., a sacrum) if desired.

[0011] In some embodiments, the joint fusion preparation assembly of the present disclosure may be configured to create a safe operative corridor that protects surrounding tissue during the fusion procedure.

[0012] In some embodiments, the joint fusion preparation assembly of the present disclosure may be configured to ensure that the cutting flange is positioned within the target joint space (e.g., the SI joint) without extending into the distal bone segment (e.g., the sacrum).

[0013] In some embodiments, the joint fusion preparation assembly of the present disclosure may be configured to enable removal of decorticated joint material by suction through the outer cannula and / or inner sleeve.

[0014] In some embodiments, the joint fusion preparation assembly of the present disclosure may be configured to enable depositing of bone graft material within the decorticated joint space through the outer cannula and / or inner sleeve.

[0015] In some embodiments, the joint fusion preparation assembly of the present disclosure may be configured to enable re-insertion of the guide pin so that a fusion implant may be safely inserted once the assembly has been removed.

[0016] In some embodiments, the joint fusion preparation assembly of the present disclosure may be configured to establish an access corridor to the target joint space during an initial drilling step.

[0017] In some embodiments, the joint fusion preparation assembly of the present disclosure may be configured to have an abutment surface / stop configured to rest on the proximal bone segment (e.g., the iliac) to provide a user with a reliable stop to prevent over-insertion of the drillcomponent and / or cutter component. For example, in a ST joint fusion procedure, the abutment surface / stop may be positioned against a proximal aspect of the iliac bone to prevent the drill component and / or cutter component from extending into the sacrum bone on the distal side of the SI joint space.

[0018] In some embodiments, the outer cannula may include indicia (e.g., depth markings) that would enable a user to determine the appropriate size of fusion implant to be used in the fusion procedure.

[0019] As additional description to the embodiments described below, the present disclosure includes the following embodiments.

[0020] Embodiment 1 is a joint fusion preparation assembly, comprising: a first cannula having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the elongated shaft having an inner lumen, the proximal end comprising a handle member including a first releasable locking element; a second cannula configured to be removably received within the inner lumen of the first cannula, the second cannula having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the elongated shaft having an inner lumen and an outer curved surface, the proximal end comprising a handle member including a second releasable locking element, the distal end comprising a deflector positioned within the inner lumen and an elongated slot extending through the outer curved surface to the inner lumen; and a cutter component configured to be removably received within the inner lumen of the second cannula, the cutter component having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the proximal end comprising a handle member including a rotatable knob, the distal end comprising a cutting flange pivotally connected to the distal end by a pivot pin; wherein upon distal advancement of the cutter component within the second cannula, the cutting flange is configured for deflection by the deflector such that the cutting flange protrudes through the elongated slot of the second cannula; and wherein the cutting flange is not rigidly held in place when the cutting flange protrudes through the elongated slot of the second cannula.

[0021] Embodiment 2 is the joint fusion preparation assembly of embodiment 1, wherein the cutting flange is curved.

[0022] Embodiment 3 is the joint fusion preparation assembly of embodiments 1 or 2, wherein the cutting flange has one or more cutting edges configured to cut through target tissue for removal.

[0023] Embodiment 4 is the joint fusion preparation assembly of any of embodiments 1 through 3, wherein the one or more cutting edges are positioned on only one side of the cutting flange.

[0024] Embodiment 5 is the joint fusion preparation assembly of any of embodiments 1 through 4, wherein the one or more cutting edges are positioned on both sides of the cutting flange.

[0025] Embodiment 6 is the joint fusion preparation assembly of any of embodiments 1 through 5, wherein the cutting flange is configured to pivot about the pivot pin after protrusion of the cutting flange through the elongated slot.

[0026] Embodiment 7 is the joint fusion preparation assembly of any of embodiments 1 through 6, wherein the elongated shaft of the cutting component has a pair of opposing flat surfaces.

[0027] Embodiment 8 is the joint fusion preparation assembly of any of embodiments 1 through 7, wherein the elongated shaft of the cutting component has a proximal end including a threaded portion configured to threadedly couple with the rotatable knob.

[0028] Embodiment 9 is the joint fusion preparation assembly of any of embodiments 1 through 8, wherein the proximal end of the elongated shaft of the cutter component has a pair of opposing flat surfaces extending into the threaded portion.

[0029] Embodiment 10 is the joint fusion preparation assembly of any of embodiments 1 through 9, wherein the opposing flat surfaces are configured to engage the second releasable locking element to prevent rotation of the cutter component during rotation of the rotatable knob.

[0030] Embodiment 11 is the joint fusion preparation assembly of any of embodiments 1 through 10, wherein the rotatable knob comprises a circumferential recess including a ratchetmechanism configured to engage the second locking element to facilitate a controlled advancement of the cutting flange through the elongated slot.

[0031] Embodiment 12 is the joint fusion preparation assembly of any of embodiments 1 through 11, wherein the handle member includes a spring loaded ratchet release button configured to release the engagement between the ratchet mechanism and the second locking element upon actuation of the release button.

[0032] Embodiment 13 is the joint fusion preparation assembly of any of embodiments 1 through 12, further comprising a drill component configured to be removably received within the inner lumen of the second cannula, the drill component being interchangeable with the cutter component.

[0033] Embodiment 14 is the joint fusion preparation assembly of any of embodiments 1 through 13, further comprising a suction component configured to employ suction to remove cut material through at least one if the inner lumen of the first cannula and the inner lumen of the second cannula.

[0034] Embodiment 15 is a joint fusion preparation assembly, comprising: a first cannula having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the elongated shaft having an inner lumen, the proximal end comprising a handle member including a first releasable locking element; a second cannula configured to be removably received within the inner lumen of the first cannula, the second cannula having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the elongated shaft having an inner lumen and an outer curved surface, the proximal end comprising a handle member including a second releasable locking element, the distal end comprising a deflector positioned within the inner lumen and an elongated slot extending through the outer curved surface to the inner lumen; a cutter component configured to be removably coupled with the second cannula, the cutter component having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the proximal end comprising a handle member including a rotatable knob, the distal end comprising a cutting flange pivotally connected to the distal end by a pivot pin; and a drill component configured to be removably coupled with the second cannula, the drill component being interchangeable withthe cutter component; wherein upon distal advancement of the cutter component within the second cannula, the cutting flange is configured for deflection by the deflector such that the cutting flange protrudes through the elongated slot of the second cannula; and wherein the second releasable locking element comprises an engagement feature configured to: (a) allow translation of the cutter component while preventing rotation of the cutter component upon rotation of the rotatable knob when the cutter component is coupled with the second cannula; and (b) allow rotation of the drill component while preventing translation of the drill component upon rotation of the driver engagement feature when the drill component is coupled with the second cannula.

[0035] Embodiment 16 is the joint fusion preparation assembly of embodiment 15, wherein the cutter component is removably coupled with the second cannula by inserting the cutter component into the inner lumen of the second cannula.

[0036] Embodiment 17 is the joint fusion preparation assembly of embodiments 15 or 16, wherein the drill component is removably coupled with the second cannula by inserting the drill component into the inner lumen of the second cannula.

[0037] Embodiment 18 is the joint fusion preparation assembly of any of embodiments 15 through 17, wherein the elongated shaft of the cutting component has a proximal end including a threaded portion configured to threadedly couple with the rotatable knob, the proximal end of the elongated shaft of the cutter component has a pair of opposing flat surfaces extending into the threaded portion, and the opposing flat surfaces are configured to engage the engagement feature of the second releasable locking element to prevent rotation of the cutter component during rotation of the rotatable knob.

[0038] Embodiment 19 is the joint fusion preparation assembly of any of embodiments 15 through 18, wherein the drill component has a distal end including a rotatable drill bit, a proximal end comprising a depth control feature configured to engage with the engagement feature of the second releasable locking element, and an elongated shaft extending between the distal end and the proximal end.

[0039] Embodiment 20 is the joint fusion preparation assembly of any of embodiments 15 through 19, wherein the depth control feature comprises a plurality of notches formed in the elongated shaft of the drill component.

[0040] Embodiment 21 is the joint fusion preparation assembly of any of embodiments 15 through 20, wherein the notches in the plurality of notches are spaced evenly apart.

[0041] Embodiment 22 is the joint fusion preparation assembly of any of embodiments 15 through 21, wherein the engagement feature comprises one or more elongated ridges.

[0042] Embodiment 23 is the joint fusion preparation assembly of any of embodiments 15 through 22, wherein the engagement feature comprises a pair of elongated ridges separated by a space.BRIEF DESCRIPTION OF THE DRAWINGS

[0043] Many advantages of the present disclosure will be apparent to those skilled in the art with a reading of this specification in conjunction with the attached drawings, wherein like reference numerals are applied to like elements and wherein:

[0044] Fig. 1 is a perspective view of an example of a joint fusion preparation assembly with a tissue cutter component, according to some embodiments;

[0045] Fig. 2 is a perspective view of the joint fusion preparation assembly of Fig. 1 with a bone drill component in place of the tissue cutter component, according to some embodiments;

[0046] Figs. 3-4 are exploded perspective view of the joint fusion preparation assembly of Fig. 1, according to some embodiments;

[0047] Figs. 5-6 are exploded perspective view of the joint fusion preparation assembly of Fig. 2, according to some embodiments;

[0048] Figs. 7-8 are exploded perspective views of an outer cannula component forming part of the joint fusion preparation assembly of Fig. 1, according to some embodiments;

[0049] Figs. 9-10 are exploded perspective views of an inner cannula component forming part of the joint fusion preparation assembly of Fig. 1, according to some embodiments;

[0050] Figs. 11-12 are exploded perspective views of a tissue cutter component forming part of the joint fusion preparation assembly of Fig. 1, according to some embodiments;

[0051] Figs. 13-14 are exploded perspective views of a bone drill component forming part of the joint fusion preparation assembly of Fig. 1, according to some embodiments;

[0052] Figs. 15-16 are perspective views of the joint fusion preparation assembly of Fig. 1 illustrating an example of the tissue cutter component in an undeployed position, according to some embodiments;

[0053] Fig. 17 is a perspective view of the joint fusion preparation assembly of Fig. 1 illustrating an example of the tissue cutter component in a deployed position, according to some embodiments;

[0054] Fig. 18 is a side plan view of the joint fusion preparation assembly of Fig. 1 illustrating an example of the tissue cutter component in a deployed position, according to some embodiments;

[0055] Fig. 19 is a side plan view of the joint fusion preparation assembly of Fig. 1 illustrating an example of the tissue cutter component in a partially deployed position, according to some embodiments;

[0056] Fig. 20 is a sectional view of the joint fusion preparation assembly of Fig. 1 taken along line I — I in Fig. 18, according to some embodiments;

[0057] Fig. 21 is another perspective view of the joint fusion preparation assembly of Fig. 2, according to some embodiments;

[0058] Fig. 22 is a side plan view of the joint fusion preparation assembly of Fig. 2, illustrating an example of the bone drill component in a fully deployed position, according to some embodiments;

[0059] Fig. 23 is a side plan view of the joint fusion preparation assembly of Fig. 2, illustrating an example of the bone drill component in a partially deployed position, according to some embodiments;

[0060] Fig. 24 is a sectional view of the joint fusion preparation assembly of Fig. 2 taken along line II — II of Fig. 23, according to some embodiments;

[0061] Fig. 25 is an enlarged view of area III of Fig. 24, according to some embodiments; and

[0062] Figs. 26-31 are flowcharts depicting several steps of a method of fusing a joint using the joint fusion preparation assembly of Fig. 1, according to some embodiments.DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT

[0063] Illustrative embodiments of the disclosure are described below. In the interest of clarity, not all features of an actual implementation are described in this specification. It will of course be appreciated that in the development of any such actual embodiment, numerous implementation-specific decisions must be made to achieve the developers’ specific goals, such as compliance with system-related and business-related constraints, which will vary from one implementation to another. Moreover, it will be appreciated that such a development effort might be complex and time-consuming, but would nevertheless be a routine undertaking for those of ordinary skill in the art having the benefit of this disclosure. The joint fusion preparation assembly and related methods disclosed herein boasts a variety of inventive features and components that warrant patent protection, both individually and in combination.

[0064] Figs. 1-6 illustrate an example of a joint fusion preparation assembly 10 (also referred to herein as “assembly 10”) according to some embodiments of the disclosure. By way of example, the assembly 10 of the present example may include an outer cannula or access conduit 12 (which for example may be a final dilator in a sequential dilation system), an inner sleeve 14, a cutter component 16, and a bone drill component 18. As will explained in further detail below, the outer cannula 12 includes a distal abutment surface 32 configured to register the distal end 24 of the outer cannula 12 against a bony surface, for example a surface of an iliac bone, and a spring-loaded locking element 42 configured to securely engage with the inner sleeve 14 tomaintain the inner sleeve 14 at a desired position. The inner sleeve 14 is configured for insertion into the outer cannula 12 and includes a spring-loaded locking element 102 configured to securely engage with the cutter component 16 and / or the bone drill component 18 to maintain the cutter 16 and / or bone drill 18 in a desired position during use. In some embodiments, each of the cutter component 16 and bone drill component 18 are removable from the inner sleeve 14, which in turn is removable from the outer cannula 12. By way of example, the outer cannula 12 and / or inner sleeve 14 may remain in place to provide for a safe access corridor for one or more of additional instrumentation, fusion implants, graft material, guide wires, and the like.

[0065] By way of example only, Figs. 7-8 illustrate an outer cannula / access conduit 12 according to some embodiments of the present disclosure. In some embodiments, the outer cannula may include an elongated shaft 20 extending distally from a handle 22. By way of example, the elongated shaft 20 may have any cross-sectional shape that enables passage of additional instrumentation, implants, and / or graft material therethrough, including but not limited to circular, oval, elliptical, triangular, square, rectangular, pentagonal, and the like. In some embodiments, the elongated shaft 20 may be a linear in shape and may define a longitudinal axis extending therethrough. In some embodiments, the elongated shaft 20 may be may of rigid construction. In some embodiments, the elongated shaft 20 may be curved and / or made of elastic material. In some embodiments, the elongated shaft 20 may have a distal end 24, a proximal end 26, and an inner lumen 28 extending the length of the shaft 20. In some embodiments, the distal end 24 may include an abutment feature 30 having a width and / or circumference that is greater than the width and / or circumference of the shaft 20, and a distal- facing abutment surface 32 configured to interface with a bony structure, for example an iliac bone during a sacroiliac joint (or “SI joint”) fusion procedure. In some embodiments, the proximal end 26 of the elongated shaft 20 may include a threaded portion 34 configured to engage the threaded aperture 36 of the handle 22. In some embodiments, the proximal end 26 may further include a stop feature 38 such as a ledge, ridge, or raised member to prevent overinsertion of the elongated shaft into the handle 22.

[0066] In some embodiments, the handle 22 includes an inner lumen 40 extending therethrough, the inner lumen 40 being aligned with the inner lumen 28 of the elongated shaft 20 and a locking element 42 configured to releasably engage with the inner sleeve 14 to securelyhold the inner sleeve 14 in a desired position during use. By way of example only, the locking element 42 comprises a spring-loaded button 44 disposed within a recess 46 on the handle 22. In some embodiments, the button 44 may include an outer surface 48 having a friction element 50 configured to enable user manipulation of the button 44. In some embodiments, the locking element 42 further includes a medial flange 52 extending generally perpendicularly from the button 44, the medial flange 52 having central opening 54 configured to receive passage of the distal extension 98 of the inner sleeve 14 handle 72, one or more lateral slots 56 configured to receive a guide pin 58 therein to ensure that the button 44 remains properly aligned, and an engagement feature 60 configured to engage with a complimentary engagement feature 142 of the distal extension 98 of the inner sleeve 14 handle 72 to securely hold the inner sleeve 14 in a desired position relative to the outer cannula 12. By way of example, the complimentary engagement features 60, 142 may comprise any features that facilitate a secure yet releasable coupling between the outer cannula 12 and inner sleeve 14. For example, in some embodiments, the engagement feature 60 may comprise a ridge configured to engage with grooves 142 on the distal protrusion 98 of the inner sleeve 14 handle 72. In some embodiments, a spring 62 is provided to bias the button 44 away from the handle 22, which urges the engagement feature 60 into contact with the complimentary engagement feature 142, thereby “locking” the inner sleeve 14 in position relative to the outer cannula 12. To uncouple the outer cannula 12 and inner sleeve 14, a use may apply a compressive force to the button 44 sufficient to overcome the biasing force of the spring 62, which causes the medial flange 52 to translate such that the engagement feature 60 uncouples from the engagement feature 142 enabling removal or adjustment of the inner sleeve 14 relative to the outer cannula 12.

[0067] By way of example, Figs. 9-10 illustrate an inner sleeve 14 according to some embodiments of the present disclosure. In some embodiments, the inner sleeve 14 may include an elongated shaft 70 extending distally from a handle 72. By way of example, the elongated shaft 70 may have any cross-sectional shape that enables passage of the cutter component 16 and / or the bone drill component 18 therethrough, including but not limited to circular, oval, elliptical, triangular, square, rectangular, pentagonal, and the like. In some embodiments, the elongated shaft 70 may be a linear in shape and may define a longitudinal axis extending therethrough. In some embodiments, the elongated shaft 70 may be may of rigid construction. In some embodiments, the elongated shaft 70 may be curved and / or made of elastic material. Insome embodiments, the elongated shaft 70 may have a distal end 74, a proximal end 76, and an inner lumen 78 extending the length of the shaft 70. In some embodiments, the distal end 74 may include a tissue abrading feature 80 on a distal-facing surface 82 configured to abrade tissue such as cartilage and / or bone, for example an iliac bone and / or joint cartilage during a SI joint fusion procedure. In some embodiments, the distal end 74 may include a “top” elongated opening or slot 84 configured to enable passage and / or movement of the cutting flange 156 therethrough during use and one or more lateral elongated openings or slots 86. By way of example, the distal end 74 may further include an aperture 88 configured to receive a deflector 90 therein, which in some embodiments has a convex or spherical surface that extends into the inner lumen 78. The deflector 90 may be configured to obstruct the inner lumen 78 such that, as the cutting flange 156 is advanced distally through the inner lumen 78, the cutting flange 156 contacts the deflector 90 and then pivots into position through the top elongated opening 84. In some embodiments, upon deployment through the top elongated opening 84, the cutting flange 156 is not held rigidly in place, but instead is configured to freely pivot about pivot pin 212 limited only by the size and length of the top elongated opening 84. In some embodiments, the proximal end 76 is sized and configured to be received within the inner lumen 100 of the distal extension 98 of the handle 72 and may further include a proximal pin aperture 92 configured to receive coupling pin 94 to securely couple the elongated shaft 70 to the handle 72.

[0068] In some embodiments, the handle 72 includes a knob 96, a distal extension 98 extending distally from the knob 96, an inner lumen 100 extending through the knob 96 and distal extension 98, the inner lumen 100 being aligned with the inner lumen 78 of the elongated shaft 70, and a locking element 102 configured to releasably engage with the cutter component 16 and / or drill component 18 to securely hold the cutter component 16 and / or drill component 18 in a desired position during use. In some embodiments, the knob 96 includes an outer surface 104 having a plurality of gripping features 106 to enable user manipulation of the knob 96.

[0069] By way of example only, the locking element 102 comprises a spring-loaded button 108 disposed within a recess 110 on the knob 96. In some embodiments, the button 108 may include an engagement surface 112 configured to enable user manipulation of the button 108. In some embodiments, the locking element 102 includes a proximal medial flange 114 extending generally perpendicularly from a proximal aspect of the button 108, the proximal medial flange114 having central opening 116 configured to allow passage of the cutter component 16 and / or drill component 18 therethrough, and an engagement feature 118 configured to engage with ratchet feature 176 on the cutter component 16. By way of example only, the engagement feature 118 may be a ledge or other protrusion extending into the central opening configured to provide an abutment surface for the ratchet feature 176.

[0070] In some embodiments, the locking element 102 includes a distal medial flange 120 extending generally perpendicularly from a distal aspect of the button 112, the distal medial flange 120 having a medial -facing U-shaped recess 122 configured to allow passage of the cutter component 16 and / or drill component 18 therethrough, and an engagement feature 124. In some embodiments, the engagement feature 124 may be configured to engage with the opposing flat surfaces 184 of the cutter component 16 to prevent rotation of the cutter component 16 during rotation of the knob 160 thereby ensuring translation-only movement of the cutter component 16 during deployment. In some embodiments, the engagement feature 124 may be configured to engage with the depth control feature 238 of the drill component 18 to maintain the drill component 18 in a desired translated position to control the depth at which the drill component 18 can penetrate the target tissue while allowing the drill component 18 to rotate during drilling. By way of example, in the instant embodiment the engagement feature 124 may comprise one or more elongated protrusions extending into the U-shaped recess 122, the elongated protrusions configured to engage with the depth control feature 238 (e.g., notches) on the drill component 18, for example as shown in Figs. 23-25. In some embodiments, the distal medial flange 120 may further include an elongated pin slot 126 configured to receive guide pin 128 (which also extends through guide pin aperture 130 on the knob 96) to ensure secure coupling of the button 108 to the knob 96 as well as a smooth and controlled translation of the button 108 during use.

[0071] In some embodiments, the recess 110 includes a spring recess 132 configured to receive the biasing spring 134 therein, a proximal opening 136 configure to receive the proximal medial flange 114 therein, and a distal opening 138 configured to receive the distal medial flange 120 therein. By way of example, the proximal opening 136 and distal opening 138 each extend into the knob 96 and intersect with the inner lumen 100 to enable engagement of the proximal medial flange 114 and distal medial flange 120 with the cutter component 16 and / or drill component 18.

[0072] In some embodiments, the distal extension 98 is sized and shaped for receipt within the inner lumen 40 of the outer cannula 12 handle 22 and may include a pin aperture 140 configured to receive the coupling pin 94 therethrough to ensure secure coupling of the elongated shaft 70 and the handle 72. In some embodiments, the distal extension 98 may include an engagement feature 142 configured to engage with complimentary engagement features 60 of the outer cannula 12 to securely hold the inner sleeve 14 in a desired position relative to the outer cannula 12, as described above.

[0073] By way of example, Figs. 11-12 illustrate a cutter component 16 according to some embodiments of the present disclosure. In some embodiments the cutter component 16 includes a handle 150, an elongated shaft 152, a shaft extension 154, and a cutting flange 156. In practice, the cutter component 16 is operable to extend the cutting flange 156 through the top elongated opening 84 of the inner sleeve 14 so that the cutting flange 156 pivots into position to cut tissue.

[0074] In some embodiments, the handle 150 comprises a knob 160 and a distal protrusion 162 extending distally from the knob 160. In some embodiments, the knob 160 includes an outer surface 164 including a gripping feature 166, a proximal facing recess 168, and an inner lumen 170 that extends through the knob 160 and the distal protrusion 162, which includes a threaded opening 172 to the inner lumen 170. In some embodiments, the distal protrusion 162 may include a circumferential recess 174 having a ratchet feature 176 disposed therein. By way of example, the ratchet feature 176 is configured to interact with the engagement feature 118 of the proximal medial flange 114 of the inner sleeve 14 described above. By way of example, the ratchet feature 176 functions to provide a controlled deployment of the cutting flange 156 upon rotation of the knob 160.

[0075] In some embodiments, the elongated shaft 152 comprises a main body portion 178, a proximal end 180, and a distal end 182. In some embodiments, the main body portion 178 may have opposing flat surfaces 184 extending substantially the length of the elongated shaft 152 and opposing curved surfaces 186 extending substantially the length of the elongated shaft 152. By way of example only, the proximal end 178 may include a threaded portion 188 configured to mate with the threaded opening 172 of the knob 160 and a proximal post 190 that threadedlymates with a retention cap 192. In some embodiments, the retention cap 192 includes a radial flange 194 configured to abut the proximal facing recess 168 to secure the elongated shaft 152 to the handle 150. In some embodiments, the opposing flat surfaces 184 extend into the threaded portion 188. In some embodiments, the opposing flat surfaces 184 (e.g., particularly the opposing flat surfaces extending into the treaded portion 188) are configured to interact with the engagement feature 124 of the locking element 102 to prevent rotation of the cutter component 16 during rotation of the knob 160 during deployment, thereby ensuring translation-only movement of the cutter component 16 upon knob rotation 160. In some embodiments, the opposing flat surfaces 184 also ensure proper alignment (or “self-centering”) of the cutter component 16 during assembly so that the cutting flange 156 is aligned with the top elongated opening 84.

[0076] In some embodiments, the distal end 182 includes a U-shaped distal recess 196 configured to receive the proximal pin 208 of the shaft extension 154 therein, a pair of guide slots 198 formed within the flat surfaces 184 and configured to receive proximal protrusions 204 of the shaft extension 154 to ensure stable translation of the shaft extension 154 relative to the shaft 152, and ridged regions 200 positioned on a distal aspect of the opposing flat surfaces 184 configured to assist in the controlled translation of the elongated shaft 152. In some embodiments, the U-shaped distal recess 196 may include one or more medial protrusions configured to assist in the controlled translation of the shaft extension 154.

[0077] In some embodiments, the shaft extension 154 is positioned distally of the distal end 182 of the elongated shaft 152 and may include a pair of proximal protrusions 204 configured to mate within the guide slots 198 of the shaft 152, one or more proximal pin apertures 206 configured to receive a proximal pin 208 therein, a pair of distal pin apertures 210 configured to receive a pivot pin 212 therein, and one or more ridged surfaces 214 configured to assist in the controlled translation of the shaft extension 154.

[0078] By way of example, the cutting flange 156 is a solid component secured to the shaft extension 154 by way of the pivot pin 212. In some embodiments, a pusher element 216 is operable to force the cutting flange 156 into a deployed position. In some embodiments, the cutting flange 156 may be curved. In some embodiments, the cutting flange may have one ormore cutting edges 218 provided thereon and configured to cut through target tissue for removal. In some embodiments, the one or more cutting edges 218 may be on only one side of the cutting flange. In some embodiments, cutting edges 218 may be on both sides of the cutting flange 218. In some embodiments, the cutting flange may be rasp-like with a roughened surface. In some embodiments, the cutting flange may be provided in varying shapes and sizes. In some embodiments, the cutting flange 156 may have a pin aperture 220 configured to receive the pivot pin 212 therein.

[0079] In some embodiments, the pivot pin 212 is coupled to the shaft extension 154 by way of pivot pin apertures 210 described above and shown by way of example only in Figs 11-12. In such embodiments the pivot point of the cutting flange 156 is fixed. In some embodiments, the pivot pin 212 may be coupled to the shaft extension 154 by way of pivot pin slots formed in the shaft extension 154 in lieu of the pivot pin apertures 210 described above. In such embodiments, the pivot point of the cutting flange 156 may be variable.

[0080] By way of example, Figs. 13-14 illustrate a drill component 18 according to some embodiments of the disclosure. By way of example only, the drill component 18 may include an elongated shaft 230 and a driver engagement feature 232. The elongated shaft 230 includes a proximal end 234 and a distal end 236. In some embodiments, the proximal end 234 has a depth control feature 238. In some embodiments, the depth control feature 238 is configured to interact with the engagement feature 124 of the inner sleeve 14 described above (e.g., to enable rotation while preventing translation of the drill component 18). In some embodiments, the depth control feature 238 may comprise a series of notches spaced evenly apart, the notches configured to interact with an engagement feature 124 comprising one or more elongated ridges, for example as shown in Figs. 23-25. However, other mechanisms are possible without departing from the scope of the disclosure. In some embodiments, the proximal end 234 further includes a connector 240 configured to connect the elongated shaft 230 and the driver engagement feature 232. In some embodiments, the connector 240 may be a threaded post (e.g., as shown in Figs. 13-14). In some embodiments, the distal end 236 comprises a drill bit 242.

[0081] In some embodiments, the driver engagement feature 232 may include a tool engagement feature 244 and / or a drive feature 246. In some embodiments, the tool engagementfeature 244 is configured to securely engage a bit holder component of a driver instrument (not shown) and the drive feature 246 is configured to engage a rotational component of a driver instrument to facilitate rotation of the drill bit 242.

[0082] In some embodiments, the drill component 18 may be cannulated. In some embodiments, the drill component 18 may have an inner lumen 248 extending longitudinally through the elongated shaft 230 and driver engagement feature 232, as shown by way of example only in Figs. 24-25. In some embodiments, the inner lumen 248 may be sized and configured to receive a guide pin (e.g., K-wire or similar) therethrough.

[0083] By way of example only, Figs. 15-20 illustrate the joint fusion preparation assembly 10 with a cutter component 16 in an initial undeployed configuration (Figs. 15-16), a fully deployed position (Figs. 17-18), and a partially deployed position (Figs. 19-20) for example during a removal step. By way of example, while in an initial, undeployed position (see, e.g., Figs. 15-16), the cutting flange 156 extends distally from the shaft extension 154 and is fully housed within the inner lumen 100 of the inner sleeve 14, for example as shown in Figs. 15-16. Simultaneously, the ratchet feature 176 of the handle 150 of the cutter component 16 is engaged with the engagement feature 118 of the button 108 of the inner sleeve 14, as described above, and the opposing flat surfaces 184 are engaged with the engagement feature 124 of the button 108 of the inner sleeve 14, as described above. Rotation of the knob 160 causes the elongated shaft 152 and cutting flange 156 to advance distally (e.g., by translation motion without rotation) within the inner lumen 78 of the inner sleeve 14 in a controlled manner. As the cutting flange 156 contacts the deflector 90, the cutting flange 156 pivots about pivot pin 212 to extend through the top elongated opening 84. Continued rotation of the knob 160 causes further advancement of the cutting flange 156 until the cutting flange 156 is in a fully extended position, as shown by way of example in Figs. 17-18. In some embodiments, upon deployment through the top elongated opening 84, the cutting flange 156 is not held rigidly in place, but instead is configured to freely pivot about pivot pin 212 limited only by the size and length of the top elongated opening 84. Upon at least partial extension of the cutting flange 156 through the top elongated slot 84, the user may manually manipulate the assembly 10 to move the cutting flange 156 within the target tissue to dislodge the target tissue for removal from the target site (e.g., an SI joint). A user may decouple the cutter component 16 from the inner sleeve 14 by pressing on the button108 of the inner sleeve 14, which causes the engagement feature 118 to dissociate from the ratchet feature 176 (e.g., as shown in Fig. 20), enabling the user to translate the cutter component 16 proximally within the inner sleeve 14, eventually removing the cutter component 16 from the inner sleeve 14 altogether.

[0084] By way of example, Figs. 21-25 illustrate the joint fusion preparation assembly 10 with a drill component 18. Notably, Figs. 24-25 illustrate the interaction between the engagement feature 124 of the button 108 of the inner sleeve 14 and the depth control feature 238 of the drill component 18, as described above.

[0085] Referring to Figs. 26-31, a method 300 of fusing a joint between adjacent bone segments is described herein. In some embodiments, a first step 310 in of the method 300 is to access a target joint space, which for example may be a sacroiliac joint space between an ilium and sacrum of a human patient. In some embodiments, a second step 320 of the method 300 is to decorticate the target joint space. In some embodiments, a third step 330 of the method 300 is to remove the decorticated joint material from the target joint space. In some embodiments, a fourth step 340 of the method 300 is to insert bone graft material into the decorticated target joint space. In some embodiments, a fifth step of the method 300 is to place a joint fusion implant within and / or across the target joint space.

[0086] Referring now to Fig. 27, in some embodiments the step 310 of accessing the target joint space may include one or more of the following sub-steps. In some embodiments, a first sub-step 312 of the step 310 of accessing the target joint space may be to register a guide pin (e g., K-wire or similar) to at least the first bone segment (e.g., ilium) to define an access trajectory to the target joint site. This may be accomplished by methods commonly known in the art. In some embodiments, a second sub-step 314 of the step 310 of accessing the target joint space may be to perform sequential dilation to place an access cannula along the defined access trajectory to the first bone segment. By way of example, sequential dilation may be accomplished by advancing a first dilator having a first diameter along the guide pin, advancing a second dilator having a second diameter that is larger than the first diameter along the guide pin, and so on, until a dilator having a diameter sufficient to provide access to the target site is inserted. In some embodiments, a third sub-step 315 of the step 310 of accessing the target jointspace may be to remove all dilators except for the largest-diameter dilator. In some embodiments, a fourth sub-step 316 of the step 310 of accessing the target j oint space may be to advance the joint fusion preparation assembly 10 with drill component 18 to the first bone segment using the guide pin, for example by inserting the guide pin into the inner lumen 248 of the cannulated drill component 18. In some embodiments, a fifth sub-step 317 of the step 310 of accessing the target joint space may be to activate the drill component 18 to drill a hole or bone tunnel through the first bone segment to the target joint space. In some embodiments, a sixth sub-step 318 of the step 310 of accessing the target joint space may be to remove the drill component 18 and guide pin from the inner sleeve 14.

[0087] Referring to Fig. 28, in some embodiments the step 320 of decorticating the target joint space may include one or more of the following sub-steps. In some embodiments, a first sub-step 322 of the step 320 of decorticating the target joint space may be to advance the cutter component 16 distally through the inner sleeve 14 to the target joint space. In some embodiments, a second sub-step 324 of the step 320 of decorticating the target joint space may be to partially deploy the cutting flange 156 (e.g., as described above) and rotate the assembly 10 to move the partially deployed cutting flange 156 through the target joint space and decorticate joint tissue. In some embodiments, a third sub-step 325 of the step 320 of decorticating the target joint space may be to further deploy the cutting flange 156 (e.g., as described above) and rotate the assembly 10 to move the further deployed cutting flange 156 through the target joint space and decorticate joint tissue. In some embodiments, a fourth sub-step 326 of the step 320 of decorticating the target joint space may be to continue decortication of the target joint space until satisfied that all desired joint material has been removed. In some embodiments, a fifth sub-step 328 of the step 320 of decorticating the target joint space may be to remove the cutting component 16 from the inner sleeve 14.

[0088] Referring to Fig. 29, in some embodiments the step 330 of removing decorticated j oint material from the target joint space may include one or more of the following sub-steps. In some embodiments, a first sub-step 332 of the step 330 of removing decorticated joint material from the target joint space may be to advance a suction instrument distally through the inner sleeve 14 to the target decorticated joint space. In some embodiments, a second sub-step 334 of the step 330 of removing decorticated joint material from the target joint space may be to activate thesuction instrument to remove decorticated joint material from the target joint space through the suction instrument. In some embodiments, a third sub-step 336 of the step 330 of removing decorticated joint material from the target joint space may be to remove the suction instrument from the inner sleeve 14 once the decorticated joint material has been removed.

[0089] Referring to Fig. 30, in some embodiments the step 340 of inserting bone graft material into the decorticated target joint space may include one or more of the following substeps. In some embodiments, a first sub-step 342 of the step 340 of inserting bone graft material into the decorticated target joint space may be to advance a bone graft tube distally through the inner sleeve 14 to the target decorticated joint space. In some embodiments, a second sub-step 344 of the step 340 of inserting bone graft material into the decorticated target joint space may be to deposit bone graft material into the decorticated target joint space through the inserted bone graft tube. In some embodiments, a third sub-step 346 of the step 340 of inserting bone graft material into the decorticated target joint space may be to remove the bone graft tube from the inner sleeve 14 once a desired amount of bone graft material has been deposited in the target decorticated joint space.

[0090] Referring to Fig. 31, in some embodiments the step 350 of inserting a fusion implant into (and / or across) the target decorticated joint space may include one or more of the following sub-steps. In some embodiments, a first sub-step 352 of the step 350 of inserting a fusion implant into (and / or across) the target decorticated joint space may be to advance the cannulated drill component 18 distally through the inner sleeve 14 to the target joint space. In some embodiments, a second sub-step 354 of the step 350 of inserting a fusion implant into (and / or across) the target decorticated joint space may be to insert the guide pin into the inner lumen 248 of the inserted cannulated drill component 18 and advance the guide pin distally to the target joint space. In some embodiments, a third sub-step 356 of the step 350 of inserting a fusion implant into (and / or across) the target decorticated joint space may be to remove all instrumentation except the placed guide pin from the operative corridor. In some embodiments, a fourth sub-step 358 of the step 350 of inserting a fusion implant into (and / or across) the target decorticated joint space may be to place the fusion implant in a desired location within (or across) the target joint space using the placed guide pin.

[0091] The term "coupled" is defined as connected, although not necessarily directly, and not necessarily mechanically. The use of the word "a" or "an" when used in conjunction with the term "comprising" in the claims and / or the specification may mean "one," but it is also consistent with the meaning of "one or more" or "at least one." The term "about" means, in general, the stated value plus or minus 5%. The use of the term "or" in the claims is used to mean "and / or" unless explicitly indicated to refer to alternatives only or the alternative are mutually exclusive, although the disclosure supports a definition that refers to only alternatives and "and / or."

[0092] The terms "comprise" (and any form of comprise, such as "comprises" and "comprising"), "have" (and any form of have, such as "has" and "having"), "include" (and any form of include, such as "includes" and "including") and "contain" (and any form of contain, such as "contains" and "containing") are open-ended linking verbs. As a result, a method or device that "comprises," "has," "includes" or "contains" one or more steps or elements, possesses those one or more steps or elements, but is not limited to possessing only those one or more elements. Likewise, a step of a method or an element of a device that "comprises," "has," "includes" or "contains" one or more features, possesses those one or more features, but is not limited to possessing only those one or more features. Furthermore, a device or structure that is configured in a certain way is configured in at least that way but may also be configured in ways that are not listed.

[0093] Any patents and publications mentioned in this specification are indicative of the levels of those skilled in the art to which the disclosure pertains. It is to be understood that while a certain form of the disclosure is illustrated, it is not to be limited to the specific form or arrangement herein described and shown. It will be apparent to those skilled in the art that various changes may be made without departing from the scope of the disclosure and the disclosure is not to be considered limited to what is shown and described in the specification and any drawings / figures included herein.

[0094] One skilled in the art will readily appreciate that the present disclosure is well adapted to carry out the objectives and obtain the ends and advantages mentioned, as well as those inherent therein. The embodiments, methods, procedures and techniques described herein are presently representative of the preferred embodiments, are intended to be exemplary and are notintended as limitations on the scope. Changes therein and other uses will occur to those skilled in the art which are encompassed within the spirit of the disclosure and are defined by the scope of the appended claims. Although the disclosure has been described in connection with specific preferred embodiments, it should be understood that the disclosure as claimed should not be unduly limited to such specific embodiments. Indeed, various modifications of the described modes for carrying out the disclosure which are obvious to those skilled in the art are intended to be within the scope of the following claims.

Claims

1. CLAIMSWhat is claimed is:

1. A joint fusion preparation assembly, comprising: a first cannula having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the elongated shaft having an inner lumen, the proximal end comprising a handle member including a first releasable locking element; a second cannula configured to be removably received within the inner lumen of the first cannula, the second cannula having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the elongated shaft having an inner lumen and an outer curved surface, the proximal end comprising a handle member including a second releasable locking element, the distal end comprising a deflector positioned within the inner lumen and an elongated slot extending through the outer curved surface to the inner lumen; and a cutter component configured to be removably received within the inner lumen of the second cannula, the cutter component having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the proximal end comprising a handle member including a rotatable knob, the distal end comprising a cutting flange pivotally connected to the distal end by a pivot pin; wherein upon distal advancement of the cutter component within the second cannula, the cutting flange is configured for deflection by the deflector such that the cutting flange protrudes through the elongated slot of the second cannula; and wherein the cutting flange is not rigidly held in place when the cutting flange protrudes through the elongated slot of the second cannula.

2. The joint fusion preparation assembly of claim 1, wherein the cutting flange is curved.

3. The joint fusion preparation assembly of claim 1, wherein the cutting flange has one or more cutting edges configured to cut through target tissue for removal.

4. The joint fusion preparation assembly of claim 3, wherein the one or more cutting edges are positioned on only one side of the cutting flange.

5. The joint fusion preparation assembly of claim 3, wherein the one or more cutting edges are positioned on both sides of the cutting flange.

6. The joint fusion preparation assembly of claim 1, wherein the cutting flange is configured to pivot about the pivot pin after protrusion of the cutting flange through the elongated slot.

7. The joint fusion preparation assembly of claim 1, wherein the elongated shaft of the cutting component has a pair of opposing flat surfaces.

8. The joint fusion preparation assembly of claim 1, wherein the elongated shaft of the cutting component has a proximal end including a threaded portion configured to threadedly couple with the rotatable knob.

9. The joint fusion preparation assembly of claim 8, wherein the proximal end of the elongated shaft of the cutter component has a pair of opposing flat surfaces extending into the threaded portion.

10. The joint fusion preparation assembly of claim 9, wherein the opposing flat surfaces are configured to engage the second releasable locking element to prevent rotation of the cutter component during rotation of the rotatable knob.

11. The joint fusion preparation assembly of claim 1, wherein the rotatable knob comprises a circumferential recess including a ratchet mechanism configured to engage the second locking element to facilitate a controlled advancement of the cutting flange through the elongated slot.

12. The joint fusion preparation assembly of claim 11, wherein the handle member includes a spring-loaded ratchet release button configured to release the engagement between the ratchet mechanism and the second locking element upon actuation of the release button.

13. The joint fusion preparation assembly of claim 1, further comprising a drill componentconfigured to be removably received within the inner lumen of the second cannula, the drill component being interchangeable with the cutter component.

14. The joint fusion preparation assembly of claim 1, further comprising a suction component configured to employ suction to remove cut material through at least one if the inner lumen of the first cannula and the inner lumen of the second cannula.

15. A joint fusion preparation assembly, comprising: a first cannula having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the elongated shaft having an inner lumen, the proximal end comprising a handle member including a first releasable locking element; a second cannula configured to be removably received within the inner lumen of the first cannula, the second cannula having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the elongated shaft having an inner lumen and an outer curved surface, the proximal end comprising a handle member including a second releasable locking element, the distal end comprising a deflector positioned within the inner lumen and an elongated slot extending through the outer curved surface to the inner lumen; a cutter component configured to be removably coupled with the second cannula, the cutter component having a proximal end, a distal end, and an elongated shaft extending between the proximal and distal ends, the proximal end comprising a handle member including a rotatable knob, the distal end comprising a cutting flange pivotally connected to the distal end by a pivot pin; and a drill component configured to be removably coupled with the second cannula, the drill component being interchangeable with the cutter component; wherein upon distal advancement of the cutter component within the second cannula, the cutting flange is configured for deflection by the deflector such that the cutting flange protrudes through the elongated slot of the second cannula; andwherein the second releasable locking element comprises an engagement feature configured to:(a) allow translation of the cutter component while preventing rotation of the cutter component upon rotation of the rotatable knob when the cutter component is coupled with the second cannula; and(b) allow rotation of the drill component while preventing translation of the drill component upon rotation of the driver engagement feature when the drill component is coupled with the second cannula.

16. The joint fusion preparation assembly of claim 15, wherein the cutter component is removably coupled with the second cannula by inserting the cutter component into the inner lumen of the second cannula.

17. The joint fusion preparation assembly of claim 15, wherein the drill component is removably coupled with the second cannula by inserting the drill component into the inner lumen of the second cannula.

18. The joint fusion preparation assembly of claim 15, wherein the elongated shaft of the cutting component has a proximal end including a threaded portion configured to threadedly couple with the rotatable knob, the proximal end of the elongated shaft of the cutter component has a pair of opposing flat surfaces extending into the threaded portion, and the opposing flat surfaces are configured to engage the engagement feature of the second releasable locking element to prevent rotation of the cutter component during rotation of the rotatable knob.

19. The joint fusion preparation assembly of claim 15, wherein the drill component has a distal end including a rotatable drill bit, a proximal end comprising a depth control feature configured to engage with the engagement feature of the second releasable locking element, and an elongated shaft extending between the distal end and the proximal end.

20. The joint fusion preparation assembly of claim 19, wherein the depth control feature comprises a plurality of notches formed in the elongated shaft of the drill component.21 . The joint fusion preparation assembly of claim 20, wherein the notches in the plurality of notches are spaced evenly apart.

22. The joint fusion preparation assembly of claim 15, wherein the engagement feature comprises one or more elongated ridges.

23. The joint fusion preparation assembly of claim 15, wherein the engagement feature comprises a pair of elongated ridges separated by a space.

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