Bone graft delivery system

Abstract

Disclosed herein are components, systems, and methods delivery bone graft material to a treatment site. Specifically, embodiments of a bone graft delivery system are disclosed that include a cannula defining a lumen, and a sled defining a channel. A first portion of the sled forms a lateral opening extending into the channel perpendicular to a length of the sled, and a second portion of the sled includes an injector coupler. The sled is operably couplable to the cannula such that the first sled portion is positioned within the lumen and the second sled portion is positioned outside the lumen. Embodiments of the bone graft delivery system include a plunger sized to be insertable into the lumen through the channel, and a push step that slidably receives the plunger. Also disclosed are methods of use of the bone graft delivery system.

Description

BONE GRAFT DELIVERY SYSTEM, COMPONENTS, AND METHOD OF USE OF SAMECROSS-REFERENCE TO RELATED APPLICATION

[0001] This patent application claims priority of U.S. Patent Application No. 63 / 737,519, filed on December 20, 2024, the entire disclosure of which is hereby incorporated by reference herein for all purposes.BACKGROUND

[0002] This disclosure relates to systems and methods of bone graft delivery. Bone graft material is used in many procedures to repair damaged tissue and promote healing. There are many different types of bone graft material, each with their own characteristics. For example, different types of bone graft material may vary from highly flowable (e.g., with characteristics similar to a liquid) to not flowable at all (e.g., a solid “bead” form).

[0003] Known bone graft delivery systems deliver biologies, such as bone graft material, to target sites to facilitate the repair and regeneration of tissue at the affected site. However, these known systems have a limited capability to deliver a single type of biologic material. Thus, multiple different types of the known bone graft delivery systems may be needed to deliver the multiple types of bone graft material used during surgical procedures that involve the delivery of bone graft material to a treatment site.BRIEF SUMMARY

[0004] Some embodiments described herein provide a bone graft delivery system that is capable of receiving multiple types of bone graft material and delivering the received bone graft material to a treatment site. The system, in some cases, comprises a cannula and a sled, and at least a portion of the sled may be positioned within the cannula. The sled may be loaded with different types of bone graft material to be delivered through the cannula and to the treatment site. For example, a highly flowable type of bone graft material may be injected (e.g., via a syringe) into the sled when the sled is positioned within the cannula. In some cases, a less flowable type of bone graft material may be packed into the sled prior to insertion of the sled into the cannula.

[0005] Some embodiments described herein include components of the bone graft delivery system (e.g., the sled). Methods of using the bone graft delivery system are also described herein. Some embodiments of the method include methods of delivering bone graft material to a treatment site (e.g., loading one or more types of bone graft material into the sled) and methods of assembly of the bone graft delivery system).

[0006] As noted above, some embodiments described herein include a bone graft delivery system comprising a cannula and a sled. The cannula comprises proximal and distal ends with a body extending therebetween. The cannula body defines a lumen extending through a length of the cannula body from the proximal end to the distal end. The sled comprises proximal and distal ends and a body extending therebetween. The sled body defines a channel extending through a length of the sled body from the proximal end of the sled to the distal end of the sled. The sled body comprises first and second portions. The first portion extends from the distal end of the sled toward the proximal end of the sled, and the second portion extends from the proximal end of the sled toward the distal end of the sled. The first portion of the sled body forms a lateral opening extending into the channel perpendicular to the length of the sled body, and the second portion of the sled body includes a proximal opening. The sled is operably couplable to the cannula such that the first portion of the sled body is positioned within the lumen and the second portion of the sled body is positioned outside the lumen.

[0007] In some embodiments, the lateral opening may allow the channel of the sled to be packed with a first type of bone graft material. For example, a putty-like (e.g., malleable, but not free flowing) bone graft material may be loaded into the channel of the sled via the lateral opening when the sled is removed from the cannula. During a surgical procedure, harvested bone graft material may be mixed with one or more additives to form the putty-like bone graft material. The putty-like bone graft material may then be packed into the channel (e.g., through the lateral opening which may extend along at least a portion of and up to an entirety of the length of the channel). The packed sled may then be inserted into the lumen of the cannula.

[0008] In some embodiments, the proximal opening may allow the channel of the sled to be packed with a second type of bone graft material. For example, a flowable (e.g., more malleable than the putty-like material, liquid-like, free flowing) bone graft material may be loaded into the channel of the sled via the proximal opening when the sled is coupled to the cannula (e.g., such that the channel is within the lumen). During a surgical procedure, harvested bone graft material may be mixed with one or more additives to form the flowable bone graft material. The flowable bone graft material may then be injected into the channel (e.g., via a syringe through the proximal opening). With the sled positioned within the lumen of the cannula, the injected, most if not all of the flowable bone graft material is retained within the lumen and not lost during transition.

[0009] In some cases, the sled of the bone graft delivery system described above may advantageously be loaded with different types of bone graft material to be delivered through the cannula and to the treatment site. Additionally, the sled may be loaded in various ways (e.g., through the lateral opening by hand, through the proximal opening bysyringe, etc.), and at various times (e.g., prior to or subsequent to insertion into the lumen of the cannula). For example, a first (e.g., highly flowable) type of bone graft material may be injected (e.g., via a syringe) into the sled when the sled is positioned within the cannula. A second (e.g., less flowable) type of bone graft material may be packed into the sled prior to insertion of the sled into the cannula.

[0010] Some embodiments described herein include a method of using a bone graft delivery system. The method comprises loading a channel of a sled with a bone graft material through a lateral opening formed by a sled body of the sled. The sled body extends from a proximal end to a distal end, and the channel extends through a length of the sled body from the proximal end to the distal end. The lateral opening extends into the channel perpendicular to the length of the sled body. The method further includes moving the channel loaded with the bone graft material through a proximal opening of a cannula and into a lumen formed by a cannula body of the cannula. The cannula body extends from a proximal end of the cannula to a distal end of the cannula, and the lumen extends through a length of the cannula body from the proximal opening formed by the proximal end of the cannula to a distal opening formed by the distal end of the cannula. According to the method a tip of a plunger is inserted through the proximal opening and into the channel. The method further comprises advancing the tip of the plunger through the channel toward the distal end of the sled, and moving the bone graft material out of the channel while remaining in the lumen. The bone graft material may then be moved out of the lumen through the distal opening.

[0011] According to some embodiments, a method of using a bone graft delivery system comprises inserting a distal portion of a sled into a lumen of a cannula such that a channel formed by a sled body of the sled is within the lumen. When the distal portion of the sled is within the lumen, a flowable bone graft injector may be coupled to a proximal portion of the sled that is positioned outside the lumen of the cannula. The method comprises moving a volume of bone graft material from a chamber of the flowable bone graft injector through the proximal portion of the sled and into the channel and decoupling the flowable bone graft injector from the proximal portion of the sled. A tip of a plunger may then be inserted through a proximal sled opening formed by the proximal sled end, and the tip may be advanced through the channel toward a distal sled end of the sled that is opposite the proximal sled end along a length of the sled. According to the method the bone graft material may be moved out of the channel while remaining in the lumen, and the moved out of the lumen.

[0012] Some embodiments provided herein include a bone graft delivery system comprising a cannula and a sled. The cannula comprises a proximal end, a distal end, and a cannula body extending therebetween. The cannula body defines a first lumenextending through a length of the cannula body from the proximal end to the distal end, and a second lumen extending from an injector coupler to the first lumen. The second lumen intersects the first lumen between the proximal end and the distal end. The sled comprises a proximal end, a distal end, and a sled body extending therebetween. The sled body defines a channel extending through a length of the sled body from the proximal end of the sled to the distal end of the sled. The sled body comprises first and second portions. The first portion extends from the distal end of the sled toward the proximal end of the sled, and the second portion extends from the proximal end of the sled toward the distal end of the sled. The first portion of the sled body forms a lateral opening extending into the channel perpendicular to the length of the sled body.BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

[0013] In the drawings, identical reference numbers identify similar elements or acts. The sizes and relative positions of elements in the drawings are not necessarily drawn to scale. For example, the shapes of various elements and angles are not necessarily drawn to scale, and some of these elements may be arbitrarily enlarged and positioned to improve drawing legibility. Further, the particular shapes of the elements as drawn, are not necessarily intended to convey any information regarding the actual shape of the particular elements, and may have been solely selected for ease of recognition in the drawings. The headings and Abstract of the Disclosure provided herein are for convenience only and do not interpret the scope or meaning of the embodiments.

[0014] Figure 1 is an isometric view of a bone graft delivery system.

[0015] Figure 2 is an exploded isometric view of the bone graft delivery system illustrated in Figure 1.

[0016] Figure 3 is an isometric cross-sectional view of a cannula of the bone graft delivery system illustrated in Figure 1, taken along line 3-3.

[0017] Figure 4 is a side elevation view of a sled of the bone graft delivery system illustrated in Figure 1.

[0018] Figure 5 is a front elevation view of the sled illustrated in Figure 4.

[0019] Figure 6 is a side cross-sectional view of the sled illustrated in Figure 4.

[0020] Figure 7 is a side elevation view of a plunger and push step of the bone graft delivery system illustrated in Figure 1.

[0021] Figure 8 is a cross-sectional view of the plunger and push step illustrated in Figure 1, taken along line 8-8.

[0022] Figure 9 is an isometric view of the sled illustrated in Figure 4, the sled loaded with bone graft material.

[0023] Figure 10 is an isometric cross-sectional view of the sled illustrated in Figure 10 coupled to the cannula illustrated in Figure 3.

[0024] Figure 11 is a cross-sectional view of the cannula illustrated in Figure 10, taken along line 10-10.

[0025] Figure 12 is a cross-sectional view of the cannula and sled illustrated in Figure 10, taken along line 11-11.

[0026] Figure 13 is an isometric cross-sectional view of the bone graft delivery system illustrated in Figure 1, loaded with bone graft material.

[0027] Figure 14 is an isometric view of the bone graft delivery system illustrated in Figure 13, during a first phase of delivery of the bone graft material.

[0028] Figure 15 is an isometric view of the bone graft delivery system illustrated in Figure 14, during a second phase of delivery of the bone graft material.

[0029] Figure 16 is an isometric view of the bone graft delivery system illustrated in Figure 15, during a third phase of delivery of the bone graft material.

[0030] Figure 17 is an isometric view of the bone graft delivery system illustrated in Figure 15, including a tip that prevents early release of the bone graft material prior to delivery.

[0031] Figure 18 is an isometric view of the bone graft delivery system illustrated in Figure 1, attached to a bone graft material injector.

[0032] Figure 19 is an isometric view of the bone graft delivery system illustrated in Figure 18, during injection of the bone graft material.

[0033] Figure 20 is an isometric view of a bone graft delivery system.

[0034] Figure 21 is an exploded isometric view of the bone graft delivery system illustrated in Figure 20.DETAILED DESCRIPTION

[0035] As noted above, conventional bone graft delivery systems are known and utilized to deliver bone graft material to a target location. Some known systems are configured to be loaded with and deliver flowable, liquid-like bone graft material, while other known systems are configured to be loaded with and delivery less flowable, puttylike bone graft material.

[0036] In contrast to conventional systems, some embodiments of the bone graft delivery system described herein comprise a sled configured to be loaded with and deliver multiple types of bone graft material. The sled may include a lateral opening that runs along at least a portion of a length of a channel of the sled, and a proximal opening formed in a proximal end of the sled. The lateral opening enables the length of the channel to be packed with bone graft material that is less flowable (e.g., putty-like) priorto insertion of the sled into a cannula that establishes a path for the bone graft material to the surgical site. The proximal opening enables the channel to be loaded with bone graft material that is more flowable (e.g., liquid-like) after insertion of the sled into the cannula.

[0037] Conventional bone graft delivery systems are loaded using a single mechanism and method that does not accommodate different types of bone graft material. In contrast, some of the bone graft delivery systems described herein comprise a sled that includes separate openings enabling the sled to be opened along various paths, at various times, and / or using various types of bone graft material. Compared to the conventional bone graft delivery systems, the sled and multiple loading options of the bone graft delivery systems described herein reduce the number of instruments needed for surgical procedures, and improve efficiency by avoiding the time needed to switch between different types of bone graft delivery systems.

[0038] Referring now to the drawings, and specifically to Figures 1 and 2, some embodiments of a bone graft delivery system 100 comprise a cannula 102 that establishes a path for bone graft material. The path established by the cannula 102 may provide access to a treatment site within a cavity (e.g., a body). The path may enable delivery of the bone graft material through a restricted or confined space (e.g., a minimally invasive incision).

[0039] The bone graft delivery system 100 may further comprise a sled 104 that is loaded with bone graft material prior to delivery of the bone graft material to the treatment site through the cannula 102. The sled 104 may be operably couplable to the cannula 102 such that the cannula 102 and the sled 104 cooperatively define the path for the bone graft material to be delivered to the treatment site.

[0040] The bone graft delivery system 100 may further comprise a plunger 106 that advances the bone graft material along the path to deliver the bone graft material to the treatment site. The plunger 106 may be operably couplable to the cannula 102 and the sled 104 such that the plunger 106 is slidingly receivable within the cannula 102 and the sled 104. The plunger 106 may be advanced along the path to push the bone graft material along the path and deliver the bone graft material to the treatment site.

[0041] The bone graft delivery system 100 may further comprise a push step 108 that is operably couplable to the plunger 106 such that the plunger 106 may be advanced along the path with one hand. When coupled to the plunger 106, the push step 108 may be advanced toward the cannula 102 simultaneously advancing the plunger 106 along the path and moving the bone graft material along the path. Upon reaching a stop (e.g., the sled 104), further advancement of the push step 108 may be blocked. The plunger 106may then be advanced independently of the push step 108 to move the bone graft material further along the path and deliver the bone graft material to the treatment site.

[0042] Referring to Figure 3, the cannula 102 may comprise a proximal end 110 (also referred to herein as a proximal cannula end), a distal end 112 (also referred to herein as a distal cannula end), and a cannula body 114 extending therebetween. The cannula body 114 may define a lumen 116 (also referred to herein as a cannula lumen) extending through a length L1 of the cannula body 114 (e.g., from the proximal end 110 to the distal end 112). As shown, the lumen 116 may extend along an axis 117 parallel to a first direction D1, along which the length L1 is measured. The axis 117 may be a central axis for at least a portion of a length of the lumen 116.

[0043] The cannula 102 may comprise a proximal portion 118 and a distal portion 120. The proximal portion 118 may extend from the proximal end 110 toward the distal end 112, and the distal portion 120 may extend from the proximal portion 118 toward the distal end 112 (e.g., to the distal end 112). A cross-sectional shape of the lumen 116 may be defined within a plane that is normal to the axis 117. The cross-sectional shape of the lumen 116 in the proximal portion 118 may be different from the cross-sectional shape of the lumen 116 in the distal portion 120. For example, a maximum cross- sectional dimension of the lumen 116 in the proximal portion 118 may be greater than a maximum cross-sectional dimension of the lumen 116 in the distal portion 120.

[0044] A portion, up to an entirety, of the length of the lumen 116 may have a circular cross-sectional shape (such that the maximum cross-sectional dimension is a diameter). For example, the lumen 116 in the proximal portion 118, in the distal portion 120, or in both the proximal portion 118 and the distal portion 120 may have a circular cross- sectional shape. However, the cross-sectional shape of the lumen 116 is not limited to a circular (or any other particular) shape. Thus, some embodiments of the lumen 116 may include a cross-sectional shape that is polygonal or irregular.

[0045] The cannula 102 (e.g., the proximal portion 118) may include one or more engagement features 122 that operably couple the cannula 102 to the sled 104, as will be explained in greater detail below. According to some embodiments, the engagement feature 122 may include a recess 124 that extends from the proximal end 110 into the body 124 toward the distal end 112. The lumen 116 may extend from a proximal opening 126, formed in the proximal end 110 of the cannula 102, to a distal opening 128, formed in the distal end 112 of the cannula 102. As shown, the axis 117 may pass through both the proximal opening 126 and the distal opening 128.

[0046] Referring to Figures 4 to 6, the sled 104 may comprise a proximal end 130 (also referred to herein as a proximal sled end), a distal end 132 (also referred to herein as a distal sled end), and a sled body 134 extending therebetween. The sled body 134 maydefine a channel 136 (also referred to herein as a sled channel) extending along a length L2 of the sled body 134 (e.g., from the proximal end 130 to the distal end 132). As shown, the channel 136 may extend along an axis 137 parallel to the first direction D1 (e.g., when the sled 104 is operably coupled to the cannula 102 as shown in Figure 1) along which the length L2 is measured. The axis 137 may be a central axis for at least a portion of a length of the channel 136.

[0047] The sled 104 may comprise a first sled portion 138 and a second sled portion 140. The first sled portion 138 may extend from the proximal end 130 toward the distal end 132, and the second sled portion 140 may extend from the first sled portion 138 toward the distal end 132 (e.g., to the distal end 132). A cross-sectional shape of the channel 136 may be defined within a plane that is normal to the axis 137. The cross- sectional shape of the channel 136 in the first sled portion 138 may be different from the cross-sectional shape of the channel 136 in the second sled portion 140. For example, the cross-sectional shape of the channel 136 in the first sled portion 138 may have an open perimeter (e.g., a C-shape, a U-shape, etc.) and the cross-sectional shape of the channel 136 in the second sled portion 140 may have a closed perimeter (e.g., a circle, polygon, etc.). A maximum cross-sectional dimension of the channel 136 in the first sled portion 138 may be the same as the maximum cross-sectional dimension of the channel 136 in the second sled portion 140.

[0048] The sled 104 may include one or more engagement features 142 that operably couple the cannula 102 and the sled 104, as will be explained in greater detail below. According to some embodiments, the engagement feature 142 may include a projection 144 (e.g., a shoulder, a keel, etc.) that extends from the sled body 134, e.g., radially away from the channel 136.

[0049] The sled 104 may include a lateral opening 146 (e.g., defined by the open perimeter of the first sled portion 138) that extends into the channel 136. As shown, the lateral opening 146 may extend into the channel 136 in a second direction D2 that is perpendicular to the axis 137 and the length L2. According to some embodiments, the lateral opening 146 may extend along an entirety of the length of the first sled portion 138 (e.g., extending from the second sled portion 140 to the distal end 132).

[0050] Some embodiments of the sled 104 may include an injector coupler 148 that enables an injector (e.g., a device with a chamber that contains bone graft material and is capable of moving the bone graft material from the chamber to the sled 104) to move bone graft material into the channel 136 through the injector coupler 148. As shown in the illustrated embodiment, the injector coupler 148 may be included within the second sled portion 140. For example, the injector coupler 148 may comprise threads 150 formed on the closed outer perimeter. The threads 150 may extend from the proximalend 130 toward the distal end 132 (e.g., along at least a portion of a length of the second sled portion 140). The threads 150 may be external threads or internal threads, selected to correspond to threads on an injector / syringe to fluidly couple the sled 104 to an injector / syringe as described in further detail below.

[0051] Referring to Figures 7 and 8 the plunger 106 may comprise a proximal end 160 (also referred to herein as a proximal plunger end), a distal end 162 (also referred to herein as a distal plunger end), and a plunger body 164 extending therebetween (e.g., from the proximal end 160 to the distal end 162 along a length L3 of the plunger 106 measured parallel to an axis 167, which may be parallel to the first direction D1, when the plunger 106 is operably coupled to the cannula 102 (e.g., as shown in Figure 1).

[0052] The plunger 106 may comprise a proximal portion 168 and a distal portion 170. The proximal portion 168 may extend from the proximal end 160 toward the distal end 162, and the distal portion 170 may extend from the proximal portion 168 toward the distal end 162 (e.g., to the distal end 162). The proximal portion 168 may comprise a platform 172 that receives a force (e.g., via a thumb of a user holding the bone graft delivery system 100) to advance the plunger 106 in the first direction D1, as described in greater detail below). The platform 172 may be in the form of a flat flange with a circular perimeter, as shown in the illustrated embodiment. However, the platform 172 is not limited to that particular shape.

[0053] The distal portion 170 may comprise a shaft 174 that extends along the axis 167 (e.g., from the platform 172 to the distal end 162 or a distal tip 176 positioned at the distal end 162). The shaft 174 may include a first shaft portion 178 and a second shaft portion 180. The first shaft portion 178 may extend between the platform 172 and the second shaft portion 180, and the second shaft portion 180 may extend between the first shaft portion 178 and the distal end 162. As shown, the shaft 174 may define a cross- sectional shape within a plane that is normal to the axis 167. The cross-sectional shape of the first shaft portion 178 may be different from the cross-sectional shape of the second shaft portion 180. For example, a maximum cross-sectional dimension of the first shaft portion 178 may be less than a maximum cross-sectional dimension of the second shaft portion 180. A shoulder 182 may define a boundary / intersection of the first shaft portion 178 and the second shaft portion 180.

[0054] The push step 108 may comprise a proximal end 190 (also referred to herein as a proximal step end), a distal end 192 (also referred to herein as a distal step end), and a push step body 194 extending therebetween (e.g., from the proximal end 190 to the distal end 192 along a length L4 of the push step 108, which may be parallel to the axis 167, when the push step 108 is operably coupled to the plunger 106 (e.g., as shown in the illustrated embodiments). The push step 108 may define a push step channel 196extending through the push step body 194 (e.g., along the length L4 from the proximal end 190 to the distal end 192.

[0055] The push step channel 196 may be sized to correspond to the first shaft portion 178 (e.g., such that the first shaft portion 178 is receivable within the push step channel 196). The push step 108 may be operably couplable to the plunger 106 such that the push step 108 is slidable relative to the plunger 106 when the first shaft portion 178 is positioned within the push step channel 196. As shown, the push step 108 may be slidable distally (along the first direction D1) from a position between the platform 172 and the shoulder 182 (e.g., as shown in Figure 7) to a position in which the push step 108 (e.g., the distal end 192) abuts the shoulder 182 (e.g., as shown in Figure 8).

[0056] The push step channel 196 may have a cross-sectional shape with an open perimeter (e.g., a C-shape, a U-shape, etc.). The push step body 194 may be resilient enabling a “snap fit” with the first shaft portion 178, such that the cross-sectional shape of the push step channel 196 increases to permit entry of the first shaft portion 178 and the resiliently returns to its original (smaller) cross-sectional shape such that the first shaft portion 178 is retained within the push step channel 196.

[0057] The push step body 194 may comprise a push step platform 198. The push step platform 198 may receive a force (e.g., via a thumb of a user holding the bone graft delivery system 100) to advance the push step 108 in the first direction D1, as described in greater detail below). The push step platform 198 may be in the form of a flat flange with a circular perimeter, as shown in the illustrated embodiment. However, the push step platform 198 is not limited to that particular shape.

[0058] Referring to Figures 9 to 17, the bone graft delivery system 100 may be loaded with a bone graft material 200 to be delivered to a treatment site (e.g., within a body of a patient). The bone graft material 200 may be harvested from the patient (e.g., autograft) or from an outside source (allograft). The harvested bone graft material 200 may be modified (e.g., mixed with one or more additives) prior to delivery to the treatment site. Reference to “the bone graft material 200” herein includes bone graft material with and without such additives, and includes synthetic / artificial bone graft material in addition to natural / harvested bone graft material.

[0059] According to some embodiments, the bone graft delivery system 100 may be loaded by packing the channel 136 of the sled 104 with the bone graft material 200. The bone graft material 200 may be packed into the channel 136 via the lateral opening 146. The elongated opening into the channel 136 provided by the lateral opening 146 facilitates the length of the channel 136 being packed without the need to advance a plunger through the channel 136. Thus, the channel 136 may be loaded / packed with the bone graft material 200 prior to being operably coupled to the cannula 102, as shown inFigure 9. For procedures that are intended to deliver a higher volume of the bone graft material 200 to the treatment site, multiple sleds 104 may be pre-loaded with the bone graft material 200 as described above. The sleds 104 may then be sequentially coupled to the cannula 102, unloaded, removed, and replaced by another of the pre-loaded sleds 104.

[0060] The loaded sled 104 may be operably coupled to the cannula 102 prior to delivery of the bone graft material 200 to the treatment site. As shown in Figure 10, a portion of the sled 104 (e.g., the first sled portion 138) may be positioned within the lumen 116 of the cannula 102. For example, the distal end 132 of the sled 104 may pass through the proximal opening 126 (shown in Figure 3) and into the lumen 116 within the proximal portion 118. The sled 104 may then be advanced along the first direction D1 until a portion, up to an entirety of the first sled portion 138 and the bone graft material 200 packed therein, is positioned within the lumen 116.

[0061] The sled 104 may be secured relative to the cannula 102 such that rotation of the sled 104 relative to the cannula 102 (e.g., about an axis parallel to the first direction D1) is blocked by the engagement features 122 of the cannula 102 abutting the engagement features 142 of the sled 104. For example, the projection(s) 144 may be inserted into the corresponding recess(es) 124. One or more surfaces of the engagement features 122, 142 may block further movement of the sled 104 into the lumen 116 to establish the sled 104 being “fully inserted” into the cannula 102. As shown, when fully inserted the second sled portion 140 (e.g., the injector coupler 148) may be positioned outside the lumen 116 (e.g., proximally of the proximal end 110 of the cannula 102).

[0062] According to some embodiments, the bone graft delivery system 100 may comprise a passage 202 that extends through the cannula 102 and the sled 104 when the sled 104 is fully inserted into the cannula 102. The passage 202 may provide a “sealed” path for the bone graft material 200 devoid of openings / exits between the distal end 112 of the cannula 102 and the proximal end 130 of the sled 104 for the packed bone graft material 200.

[0063] As shown in Figures 11 and 12, the passage 202 may be cooperatively defined by the cannula 102 and the sled 104. For example, a distal portion 204 of the passage 202 may be defined by an inner wall 129 of the cannula 102 that forms a perimeter of the lumen 116. Thus, the distal portion 204 of the passage 202 may be formed by the lumen 116 in the distal portion 120 (as shown in Figure 11). A proximal portion 206 of the passage 202 may be cooperatively defined by the inner wall 129 of the cannula 102 and an inner wall 152 that forms a portion of a perimeter of the channel 136. Thus, theproximal portion 206 of the passage 202 may be formed by the lumen 116 and the channel 136 in the proximal portion 118 of the cannula 102 (as shown in Figure 12).

[0064] According to some embodiments, the passage 202 of the bone graft delivery system 100 may have a constant cross-sectional shape (e.g., normal to the length L1) along its length (e.g., from the proximal end 130 of the sled 104 to the distal end 112 of the cannula 102. The constant cross-sectional shape advantageously enables the distal tip 176 (shown in Figure 7) to have a shape that corresponds to the passage 202 so as to move the bone graft material 200 through the passage 202 with minimal loss of the bone graft material 200.

[0065] The cross-sectional shape of the passage 202 may be a circle, as shown in the illustrated embodiment, but is not limited to any particular shape. For example, the distal portion 120 of the cannula 102 may have a circular cross-sectional shape with a diameter J1. The cross-sectional shape of the proximal portion 118 of the cannula 102 may include a portion with a circular cross-sectional diameter J2 that matches the diameter J1. The cross-sectional shape of the proximal portion 118 of the cannula 102 may include a recess 208 that receives the sled 104. The cross-sectional shape of the sled 104 may include a cross-sectional shape that forms a portion of a circle with a diameter J3 that matches J1. Thus, when the sled 104 is operably coupled to the cannula 102, such that the sled is positioned within the recess 208, the inner wall 129 and the inner wall 152 may collectively define a cross-sectional shape that matches that of the distal portion 120 of the cannula 102 (e.g., a circle with a diameter that matches J1).

[0066] As shown in Figure 13, with the sled 104 fully inserted into the cannula 102 as described above, the plunger 106 may be inserted into the passage 202 to advance the bone graft material 200 packed in the channel 136 of the sled 104. The distal tip 176 may enter the passage 202 through the proximal end 130. The distal tip 176 may be a resilient material (e.g., such that upon entry into the passage 202 the distal tip 176 compresses to closely correspond to the cross-sectional shape of the passage 202 thereby preventing the bone graft material 200 from getting “behind” the distal tip 176 as the distal tip 176 advances in the first direction D1). The distal tip 176 may first advance through the injector coupler 148, which may be devoid of the bone graft material 200, before entering the channel 136.

[0067] As shown in Figure 14, when the distal tip 176 is positioned within the passage 202 (e.g., within the proximal portion 206), the bone graft delivery system 100 may be actuated to advance the bone graft material 200 along the first direction D1 , toward the distal end 112 of the cannula 102. According to some embodiments, the bone graft delivery system 100 may be actuated with one hand. For example, fingers of a handmay brace against a handle 210 of the cannula 102 while a thumb of the hand braces against the platform 172 of the plunger 106. If the plunger 106 is a certain length, the platform 172 of the plunger 106 may not be reachable by the thumb. Thus, the thumb may instead brace against the push step platform 198 (e.g., as shown in the illustrated embodiment).

[0068] A force F may be applied (e.g., by squeezing the thumb of the hand toward the fingers of the hand) to the push step platform 198 thereby advancing the push step 108 toward the proximal end 130 of the sled 104. When the push step 108 abuts the shoulder 182, movement of the push step 108 in the first direction D1 also advances the plunger 106 in the first direction D1. Thus, applying the force F to the push step platform 198 may advance the distal tip 176 within the passage 202 thereby moving the bone graft material 200 therewithin toward the distal end 112. While moving push step 108, some of the bone graft material 200 may be moved from the proximal portion 206 of the passage 202 to the distal portion 204 of the passage 202.

[0069] As shown in Figure 15, the force F may be applied to the push step 108 until the distal end 192 of the push step 108 abuts the proximal end 130 of the sled 104. The force F may then be withdrawn from the push step 108 and applied to the plunger 106. For example, the thumb may be moved from the push step platform 198 to the platform 172 of the plunger 106. Whereas the length of the plunger 106 may have prevented this before, the movement of the push step 108 when coupled to the plunger 106 may shorten a distance between the handle 210 and the platform 172. Thus, the bone graft delivery system 100 may be operable to deliver the bone graft material 200 through the passage 202 to a treatment site with one hand.

[0070] The plunger 106 may be slidable relative to the push step 108. According to some embodiments, the shoulder 182 may only block movement of the push step 108 relative to the plunger 106 in the first direction D1 , and not vice versa. Thus, the force F applied to the platform 172 may advance the plunger 106 in the first direction D1 , moving distally through the push step channel 196. As the plunger 106 moves, the distal tip 176 continues to advance distally within the passage 202 thereby moving the bone graft material 200 toward (and eventually through) the distal end 112 of the cannula 102 thereby exiting the passage 202, as shown in Figure 16. Movement of the plunger 106 may be prevented by a stop that prevents the distal tip 176 from exiting the passage 202. Some embodiments of the bone graft delivery system 100 may be devoid of the push step 108.

[0071] Referring to Figure 17, the bone graft delivery system 100 may include a cap 216 that blocks the exit of the passage 202 at the distal end 112 of the cannula 102. As shown, the cap 216 may have a flap 218 or membrane that prevents the bone graftmaterial 200 from exiting the passage 200 prior to the bone graft material 200 being advanced trough the passage 202 by the plunger 106. For example, the bone graft material 200 may be solid-like spheres, which may move / roll within the passage 202 without being pushed by the plunger 106. The cap 216 may retain the bone graft material 200 within the passage 202 until the plunger advances the bone graft material 200 with a sufficient force to open the flap 218 and deliver the bone graft material 200 to the treatment site.

[0072] Referring to Figures 18 and 19, the bone graft delivery system 100 may include an injector 220. The injector 220 may be used to load the bone graft material 200 into the passage 202 as described below. The injector 220 may comprise a chamber 222 that defines an interior volume. The chamber 222 may contain the bone graft material 200. The injector 220 may have a sled coupler 224 that corresponds to the injector coupler 148. For example, the sled coupler 224 may comprise threads 226 that correspond to the threads 150 of the sled 104.

[0073] The injector 220 may be coupled to the sled 104 (e.g., via threaded engagement of the threads 150 and the threads 226). When coupled, the interior volume of the chamber 222 may be connected (e.g., fluidly) to the passage 202 such that the bone graft material 200 within the chamber 222 is transferable to the passage 202 (e.g., through the sled coupler 224 and the injector coupler 148). The injector 220 may include a plunger 228 that advances through the chamber 222 to push the bone graft material 200 (e.g., along the first direction D1) out of the chamber 222, through the injector coupler 148 and the sled coupler 224, and into the passage 202. After the bone graft material 200 is transferred out of the chamber 222 and into the passage 202, the injector 220 may be removed from the sled 104 (e.g., by disengaging the injector coupler 148 and the sled coupler 224).

[0074] With the injector 220 decoupled from the sled 104, the plunger 106 (and optionally the push step 108) may be used as described above to advance the bone graft material 200 along the passage 202, out of the bone graft delivery system 100, and to the treatment site.

[0075] Referring to Figures 9 to 19, the bone graft delivery system 100 may be loaded / packed with the bone graft material 200 using a variety of methods. For example, the sled 104 may be packed with the bone graft material 200 prior to the sled 104 being operably coupled (e.g., fully inserted) into the lumen 116 of the cannula 102. With the bone graft material 200 packed in the channel 136 and the sled 104 operably coupled to the cannula 102, the bone graft material 200 may be advanced within the passage 202 by the plunger 106 and / or the push step 108.

[0076] According to some embodiments, with the bone graft material 200 packed in the channel 136 and the sled 104 operably coupled to the cannula 102, the injector 220 may be coupled to the sled 104 and the bone graft material 200 may be transferred to the passage 202. Thus, the bone graft delivery system 100 may be loaded with two types of the bone graft material 200, which may be mixed within the passage 202.

[0077] According to some embodiments, with the channel 136 empty and the sled 104 operably coupled to the cannula 102, the injector 220 may be coupled to the sled 104 and the bone graft material 200 may be transferred to the passage 202. The sled 104 may be pre-loaded with the bone graft material 200 when the bone graft material 200 has a lower flowability (e.g., putty-like, solid beads, etc.). The injector 220 may be used to inject types of the bone graft material 200 with a higher flowability (e.g., liquid-like).

[0078] Some methods of using the bone graft delivery system 100 comprise loading the channel 136 of the sled 104 with the bone graft material 200 (e.g., through the lateral opening 146. The method may further comprise moving the channel 136 loaded with the bone graft material 200 through the proximal opening 126 of the cannula 102 and into the lumen 116. The method may further comprise inserting the distal tip 176 of the plunger 106 through the injector coupler 148 , and advancing the distal tip 176 through the channel 136 toward the distal sled end 132. According to the method, the bone graft material 200 may be moved out of the channel 136 while remaining in the lumen 116, and then moved out of the lumen 116 through the distal opening 128.

[0079] Some methods of using the bone graft delivery system 100 may comprise forming the passage 202 through the cannula 102, the passage comprising the proximal portion 206 and the distal portion 204. The method may further comprise, prior to inserting the distal tip 176 through the injector coupler 148, coupling the sled coupler 224 to the injector coupler 148 to operably (e.g., fluidly) connect the chamber 222 of the injector 220 to the channel 136 of the sled 104. A volume of the bone graft material 200 may be moved from the chamber 222 through the proximal sled end 130 and into the channel 136.

[0080] The method of using the bone graft delivery system 100 may comprise coupling the push step 108 to the first shaft portion 178, and applying the force F to the push step platform 198. The second shaft portion 180 may be moved through the proximal opening 126 and into the lumen 116. The method may further comprise abutting the push step 108 with the proximal sled end 130, applying the force F to the platform 172, and translating the first shaft portion 178 through the push step channel 196.

[0081] Some embodiments of methods of using the bone graft delivery system 100 comprise inserting a distal portion (e.g., the first sled portion 138) of the sled 104 into the lumen 116 of the cannula 102 such that the channel 136 is within the lumen 116. Whenthe distal portion of the sled 104 is within the lumen 116, the injector 220 (e.g., a syringe) may be coupled to a proximal portion (e.g., the second sled portion 140) of the sled 104 that is positioned outside the lumen 116 of the cannula 102. The method may comprise moving a volume of the bone graft material 200 from the chamber 222 of the injector 220 through the proximal portion of the sled 104 and into the channel 136.

[0082] The method may further comprise decoupling the injector 220 from the sled 104, and then inserting the distal tip 176 of the plunger 106 through the proximal end 130 of the sled 104. The distal tip 176 may be advanced through the channel 136 toward the distal end 132 of the sled 104, according to the method. The bone graft material 200 may be moved out of the channel 136 while remaining in the lumen 116, and then moved out of the lumen 116 (e.g., to a treatment site). The method may further comprise forming the passage 2020 through the cannula 102.

[0083] The method may further comprise coupling the push step 108 to the plunger 106, applying the force F to the push step 108, and moving the second shaft portion 180 through into the lumen 116. The method may comprise abutting the push step 108 with the sled 104, applying the force F to the plunger 106, and translating the first shaft portion 178 through the push step channel 196.

[0084] Referring to Figures 20 and 21, the bone graft delivery system 100 may include a non-linear (e.g., curved) passage 202. The non-linear passage 202 may be defined by a curved cannula body 114. The curved cannula body 114 may include a linear portion (e.g., the proximal portion 118) and a non-linear portion (e.g., the distal portion 120). The non-linear passage 202 may improve line-of-site to the treatment site by offsetting the proximal end 110 of the cannula 102 from a visual path to the treatment site. The bone graft delivery system 100 of any of the embodiments described herein may include either the linear cannula body 114 (as shown in Figures 1 to 3), or the curved cannula body 114 (as shown in Figures 20 and 21).

[0085] In some embodiments of the bone graft delivery system 100, the injector coupler 148 may be offset from the axis 117 of the cannula 102. As shown in the illustrated embodiment, the cannula body 114 may define a secondary lumen 212 branching off from the lumen 116 at a location between the proximal end 110 and the distal end 112. An injector (e.g., the injector 220) may be operably (e.g., fluidly) connected to the secondary lumen 212, for example similarly to how the injector 220 is operably couplable to the sled 104 as described above. However, other types of connections (e.g., push fit, friction fit, twist and lock, etc.) are also included within this disclosure. The bone graft delivery system 100 may include a cap 214 attachable to the cannula 102 to close access to the secondary lumen 212 when the injector is not operably connected to the secondary lumen 212.

[0086] As shown, the lumen 116 may extend along an axis 117 parallel to a first direction D1, along which the length L1 is measured. The axis 117 may be a central axis for at least a portion of a length of the lumen 116. The secondary lumen 212 may be used to load the bone graft delivery system 100 with the bone graft material 200 similarly to the injector 220 as described in detail above, just along a path that is offset from the passage 202 along which the plunger 106 travels.

[0087] The above description of illustrated embodiments, including what is described in the Abstract, is not intended to be exhaustive or to limit the embodiments to the precise forms disclosed. Although specific embodiments of and examples are described herein for illustrative purposes, various equivalent modifications can be made without departing from the spirit and scope of the disclosure, as will be recognized by those skilled in the relevant art. The various embodiments described above can be combined to provide further embodiments.

[0088] Many of the methods described herein can be performed with variations. For example, many of the methods may include additional acts, omit some acts, and / or perform acts in a different order than as illustrated or described.

[0089] In some embodiments, any or some of the components or steps disclosed herein may be considered optional. In some cases, the disclosed embodiments may expressly exclude any or some of the aforementioned elements or steps in this description, e.g., via claim language. For example, claim language may be modified to recite that the disclosed bone graft delivery system 100 and / or methods, etc., do not utilize or comprise a push step and / or an injector. Such negative limitations are contemplated, and this text serves as support for negative limitations for components, steps, and / or features.

[0090] These and other changes can be made to the embodiments in light of the above-detailed description. In general, in the following claims, the terms used should not be construed to limit the claims to the specific embodiments disclosed in the specification and the claims but should be construed to include all possible embodiments along with the full scope of equivalents to which such claims are entitled. Accordingly, the claims are not limited by the disclosure.

Claims

CLAIMS1. A bone graft delivery system comprising: a cannula comprising a proximal cannula end, a distal cannula end, and a cannula body extending therebetween, the cannula body defining a lumen extending through a length of the cannula body from the proximal cannula end to the distal cannula end; and a sled comprising a proximal sled end, a distal sled end, and a sled body extending therebetween, the sled body defining a channel extending through a length of the sled body from the proximal sled end to the distal sled end, the sled body having a first sled portion extending from the distal sled end toward the proximal sled end, and a second sled portion extending from the proximal sled end toward the distal sled end, wherein the first sled portion of the sled body forms a lateral opening extending into the channel perpendicular to the length of the sled body, and the second sled portion includes an injector coupler, wherein the sled is operably couplable to the cannula such that the first sled portion is positioned within the lumen and the second sled portion is positioned outside the lumen.

2. The bone graft delivery system of claim 1 wherein the sled is operably couplable to a syringe via the injector coupler such that a chamber of the syringe is fluidly connected to the channel.

3. The bone graft delivery system of claim 1 wherein when the first sled portion is positioned inside the lumen the sled is operably couplable to a syringe via the injector coupler such that a chamber of the syringe is fluidly connected to the channel.

4. The bone graft delivery system of any one of claims 2 and 3, further comprising: the syringe comprising a sled coupler that engages the injector coupler to fluidly connect the chamber of the syringe to the channel.

5. The bone graft delivery system of any one of claims 1 to 4 wherein the injector coupler includes external threads.

6. The bone graft delivery system of any one of claims 1 to 5 wherein the sled body defines a cross-sectional shape normal to the length, and a portion of the cross- sectional shape within the first sled portion has an open perimeter.

7. The bone graft delivery system of claim 6 wherein a portion of the cross- sectional shape within the second sled portion has a closed perimeter.

8. The bone graft delivery system of any one of claims 1 to 7 wherein the cannula and the sled each comprise corresponding anti-rotation surfaces that prevent rotation of the sled relative to the cannula about an axis parallel to the length of the sled body when the first sled portion is positioned within the lumen.

9. The bone graft delivery system of any one of claims 1 to 8 wherein the lumen comprises a proximal portion extending from the proximal end toward the distal end, and the lumen comprises a distal portion extending from the proximal portion toward the distal end.

10. The bone graft delivery system of claim 9 wherein the lumen defines a cross- sectional shape normal to the length of the cannula body, and the cross-sectional shape of the lumen within the proximal portion is different than the cross-sectional shape of the lumen within the distal portion.

11. The bone graft delivery system of claim 10 wherein when the first sled portion is positioned within the proximal portion of the lumen, the cannula and the sled cooperatively define a cross-sectional shape of a passage through the cannula, and the cross-sectional shape of the passage is the same as the cross-sectional shape of the lumen within the distal portion.

12. The bone graft delivery system of any one of claims 1 to 11 , further comprising: a plunger sized to be insertable into the lumen through an opening defined by the proximal cannula end, when the first sled portion is positioned within the lumen, through the channel along a direction parallel to the length of the channel.

13. The bone graft delivery system of claim 12 wherein the plunger has a distal tip with a cross-sectional shape that corresponds to the lumen, such that the distal tipadvances bone graft material within the lumen toward the distal cannula end as the plunger advances through the lumen toward the distal cannula end.

14. The bone graft delivery system of claim 13, further comprising: a push step comprising a proximal step end, a distal step end, and a step body extending therebetween, the step body defining a step channel extending through a length of the step body from the proximal step end to the distal step end, wherein the plunger comprises a proximal plunger platform and a shaft extending distally from the proximal plunger platform to the distal tip, and the shaft includes a proximal portion and a distal portion, the distal portion positioned between the proximal portion and the distal tip, and wherein the proximal portion of the shaft is slidably receivable within the step channel, and the distal portion of the shaft is larger than the step channel.

15. The bone graft delivery system of claim 14 wherein the shaft comprises a shoulder between the proximal portion of the shaft and the distal portion of the shaft, and the push step is slidable along the proximal portion of the shaft between the proximal plunger platform and the shoulder.

16. The bone graft delivery system of any one of claims 14 and 15 wherein the push step comprises a proximal step platform with a cross-sectional dimension that is larger than a cross-sectional dimension of the distal portion of the shaft.

17. The bone graft delivery system of any one of claims 1 to 16 wherein the lumen extends through the length of the cannula body along a linear axis that passes through both the distal cannula end and the proximal cannula end.

18. The bone graft delivery system of any one of claims 1 to 16 wherein the lumen extends through the length of the cannula body along an axis with a linear portion that passes through the proximal cannula end and a curved portion that passes through the distal cannula end.

19. A method of use of a bone graft delivery system, the method comprising: loading a channel of a sled with a bone graft material through a lateral opening formed by a sled body of the sled, the sled body extending from a proximal sled end to a distal sled end, wherein the channel extends through a length of the sled body from theproximal sled end to the distal sled end, and the lateral opening extends into the channel perpendicular to the length of the sled body; moving the channel loaded with the bone graft material through a proximal opening of a cannula and into a lumen formed by a cannula body of the cannula, the cannula body extending from a proximal cannula end to a distal cannula end, wherein the lumen extends through a length of the cannula body from the proximal opening formed by the proximal cannula end to a distal opening formed by the distal cannula end; inserting a tip of a plunger through an injector coupler formed by the proximal sled end and into the channel; advancing the tip of the plunger through the channel toward the distal sled end; moving the bone graft material out of the channel while remaining in the lumen; and moving the bone graft material out of the lumen through the distal opening.

20. The method of claim 19, further comprising: forming a passage through the cannula, the passage comprising a proximal passage portion extending from the proximal cannula end toward the distal cannula end and a distal passage portion extending from the proximal passage portion toward the distal cannula end, wherein the proximal passage portion has a first cross-sectional shape defined cooperatively by the sled body and the cannula body, the distal passage portion has a cross-sectional shape defined by the cannula body, and the first cross-sectional shape is substantially the same as the second cross-sectional shape.

21. The method of any one of claims 19 and 20, further comprising: prior to inserting a tip of the plunger through the injector coupler, coupling a sled coupler of a syringe to the injector coupler of the sled to fluidly connect a chamber of the syringe to the channel of the sled; and moving a volume of material from the chamber of the syringe through the proximal sled end and into the channel.

22. The method of any one of claims 19 to 21, further comprising: coupling a push step to a proximal portion of a shaft of the plunger; applying a force to a platform of the push step; and moving a distal portion of the shaft of the plunger through the proximal opening and into the lumen,wherein the distal portion of the shaft is between the proximal portion of the shaft and the distal tip, and the distal portion of the shaft has a cross-sectional dimension that is greater than a cross-sectional dimension of the proximal portion of the shaft.

23. The method of claim 22, further comprising: abutting the push step with the proximal sled end; applying a force to a platform of the shaft, wherein the platform of the shaft is proximal of the platform of the push step; and translating the proximal portion of the shaft through a channel of the push step such that the platform of the shaft approaches the platform of the push step.

24. A method of use of a bone graft delivery system, the method comprising: inserting a distal portion of a sled into a lumen of a cannula such that a channel formed by a sled body of the sled is within the lumen; when the distal portion of the sled is within the lumen, coupling a syringe to a proximal portion of the sled that is positioned outside the lumen of the cannula; moving a volume of bone graft material from a chamber of the syringe through the proximal portion of the sled and into the channel; decoupling the syringe from the proximal portion of the sled; inserting a tip of a plunger through a proximal sled opening formed by the proximal sled end; advancing the tip of the plunger through the channel toward a distal sled end of the sled that is opposite the proximal sled end along a length of the sled; moving the bone graft material out of the channel while remaining in the lumen; and moving the bone graft material out of the lumen.

25. The method of claim 24, further comprising: forming a passage through the cannula, the passage comprising a proximal passage portion extending from the proximal cannula end toward the distal cannula end and a distal passage portion extending from the proximal passage portion toward the distal cannula end, wherein the proximal passage portion has a first cross-sectional shape defined cooperatively by the sled body and the cannula body, the distal passage portion has a cross-sectional shape defined by the cannula body, and the first cross-sectional shape is substantially the same as the second cross-sectional shape.

26. The method of any one of claims 24 and 25, further comprising: coupling a push step to a proximal portion of a shaft of the plunger; applying a force to a platform of the push step; and moving a distal portion of the shaft of the plunger through the proximal opening and into the lumen, wherein the distal portion of the shaft is between the proximal portion of the shaft and the distal tip, and the distal portion of the shaft has a cross-sectional dimension that is greater than a cross-sectional dimension of the proximal portion of the shaft.

27. The method of claim 26, further comprising: abutting the push step with the proximal sled end; applying a force to a platform of the shaft, wherein the platform of the shaft is proximal of the platform of the push step; and translating the proximal portion of the shaft through a channel of the push step such that the platform of the shaft approaches the platform of the push step.

28. A bone graft delivery system comprising: a cannula comprising a proximal cannula end, a distal cannula end, and a cannula body extending therebetween, the cannula body defining: a first lumen extending through a length of the cannula body from the proximal cannula end to the distal cannula end; and a second lumen extending from an injector coupler to the first lumen, wherein the second lumen intersects the first lumen between the proximal cannula end and the distal cannula end; a sled comprising a proximal sled end, a distal sled end, and a sled body extending therebetween, the sled body defining a channel extending through a length of the sled body from the proximal sled end to the distal sled end, the sled body having a first sled portion extending from the distal sled end toward the proximal sled end, and a second sled portion extending from the proximal sled end toward the distal sled end, wherein the first sled portion of the sled body forms a lateral opening extending into the channel perpendicular to the length of the sled body.

29. The bone graft delivery system of claim 28 wherein the sled is operably couplable to the cannula such that the first sled portion is positioned within the lumen and the second sled portion is positioned outside the lumen.

30. The bone graft delivery system of any one of claims 28 and 29 wherein the cannula and the sled each comprise corresponding anti-rotation surfaces that prevent rotation of the sled relative to the cannula about an axis parallel to the length of the sled body when the first sled portion is positioned within the lumen.

31. The bone graft delivery system of any one of claims 28 to 30 wherein the lumen comprises a proximal portion extending from the proximal end toward the distal end, and the lumen comprises a distal portion extending from the proximal portion toward the distal end.

32. The bone graft delivery system of claim 31 wherein the lumen defines a cross-sectional shape normal to the length of the cannula body, and the cross-sectional shape of the lumen within the proximal portion is different than the cross-sectional shape of the lumen within the distal portion.

33. The bone graft delivery system of claim 32 wherein when the first sled portion is positioned within the proximal portion of the lumen, the cannula and the sled cooperatively define a cross-sectional shape of a passage through the cannula, and the cross-sectional shape of the passage is the same as the cross-sectional shape of the lumen within the distal portion.

34. The bone graft delivery system of any one of claims 28 to 33, further comprising: a plunger sized to be insertable into the lumen through an opening defined by the proximal cannula end, when the first sled portion is positioned within the lumen, through the channel along a direction parallel to the length of the channel.

35. The bone graft delivery system of claim 34 wherein the plunger has a distal tip with a cross-sectional shape that corresponds to the lumen, such that the distal tip advances bone graft material within the lumen toward the distal cannula end as the plunger advances through the lumen toward the distal cannula end.

36. The bone graft delivery system of claim 35, further comprising: a push step comprising a proximal step end, a distal step end, and a step body extending therebetween, the step body defining a step channel extending through a length of the step body from the proximal step end to the distal step end,wherein the plunger comprises a proximal plunger platform and a shaft extending distally from the proximal plunger platform to the distal tip, and the shaft includes a proximal portion and a distal portion, the distal portion positioned between the proximal portion and the distal tip, and wherein the proximal portion of the shaft is slidably receivable within the step channel, and the distal portion of the shaft is larger than the step channel.

37. The bone graft delivery system of claim 36 wherein the shaft comprises a shoulder between the proximal portion of the shaft and the distal portion of the shaft, and the push step is slidable along the proximal portion of the shaft between the proximal plunger platform and the shoulder.

38. The bone graft delivery system of any one of claims 36 and 37 wherein the push step comprises a proximal step platform with a cross-sectional dimension that is larger than a cross-sectional dimension of the distal portion of the shaft.

39. The bone graft delivery system of any one of claims 28 to 38 wherein the lumen extends through the length of the cannula body along a linear axis that passes through both the distal cannula end and the proximal cannula end.

40. The bone graft delivery system of any one of claims 28 to 38 wherein the lumen extends through the length of the cannula body along an axis with a linear portion that passes through the proximal cannula end and a curved portion that passes through the distal cannula end.

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