Coracoid Resection Guide for Latarjet Bone Graft Alignment
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Solution Overview
Problem
Current Latarjet procedures face challenges in achieving proper alignment and orientation of coracoid and glenoid holes, leading to potential misalignment and reduced bone fusion success due to the lack of efficient instrumentation for coracoid resection and glenoid hole drilling.
Innovation Solution
A coracoid resection guide with a gripping tool and alignment guide is introduced, featuring a pivotably actuatable jaw and rotatable, translatable alignment guide with locking mechanism, facilitating precise hole drilling perpendicular to the coracoid graft surface, and a glenoid drill guide with offset features to avoid glenoid cavity impingement, ensuring accurate placement and alignment of coracoid and glenoid holes.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If traditional Latarjet procedures are performed without specialized instrumentation, then the surgical procedure can be completed, but proper alignment and orientation of coracoid and glenoid holes cannot be achieved, leading to misalignment and reduced bone fusion success
Solution Approach 1:
The patent introduces specialized guide instruments (coracoid resection guide and glenoid drill guide) as intermediary tools that mediate between the surgeon and the bone structures. These guides provide mechanical constraints and reference surfaces that ensure precise alignment of holes without requiring complex surgical techniques, directly resolving the contradiction between alignment precision and instrumentation complexity.
Solution Approach 2:
The guides are designed to establish reference surfaces and alignment relationships before the actual hole drilling occurs. The coracoid resection guide pre-establishes the correct orientation for coracoid hole drilling, while the glenoid drill guide pre-establishes the correct positioning for glenoid hole drilling, ensuring proper alignment is achieved before the critical bone fusion procedure begins.
2Reliability
If efficient instrumentation is introduced to improve alignment precision, then bone fusion success increases, but device complexity and surgical time increase
Solution Approach 1:
The guide instruments are designed to be self-aligning and self-positioning through their mechanical structures. The coracoid resection guide uses the coracoid process itself as a reference for positioning, and the glenoid drill guide uses the glenoid cavity geometry for alignment. This self-service capability reduces the time required for complex alignment maneuvers while ensuring high reliability of hole placement for bone fusion.
3Ease of operation
If traditional drilling methods are used without alignment guides, then surgical procedure is simpler, but misalignment of holes occurs reducing bone fusion effectiveness
Solution Approach 1:
The guide instruments serve as intermediary tools that simplify the drilling operation while ensuring precision. Rather than requiring the surgeon to manually align and orient drill bits complexly, the guides provide pre-established reference surfaces and mechanical constraints that make the drilling operation straightforward and precise simultaneously.
Solution Approach 2:
The surgical procedure is segmented into distinct steps with dedicated guides for each step. The coracoid resection guide handles coracoid hole drilling separately from the glenoid drill guide that handles glenoid hole drilling. This segmentation allows each guide to be optimized for its specific function, maintaining surgical simplicity while ensuring precision for each critical alignment task.
4Object-affected harmful factors
If glenoid drill guide without offset features is used, then device structure is simpler, but glenoid cavity impingement occurs causing damage to articular cartilage
Solution Approach 1:
The glenoid drill guide incorporates offset features that preemptively counteract the tendency of drill bits to impinge on the glenoid cavity. By designing the guide with built-in offset distances from the glenoid cavity surface, the system prevents harmful contact before it can occur, protecting the articular cartilage while maintaining reasonable structural complexity.
Data Source
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AI summary
Embodiments of the present disclosure are directed to instrumentation that facilitate coracoid-glenoid fixation in Latarjet procedures. For example, a single instrument, a coracoid resection tool, may be provided/utilized to prepare a coracoid bone graft for size, flatness, and hole drilling. A glenoid drill guide may further be provided/utilized that uses sized offsets for placement of the coracoid graft flush with the glenoid. Further embodiments of the disclosure are directed to corresponding methods that employ this instrumentation. For example, a surgeon may employs the coracoid resection tool as a guide to plane the inferior coracoid surface that will serve as the coracoid graft surface. The coracoid resection tool may further guide the placement of coracoid holes along the length of the coracoid and orient the holes approximately perpendicular to the planed coracoid graft surface. For example a proximal coracoid hole may be positioned towards the proximal end (i.e., the cut end) of the resected coracoid while a distal coracoid hole may be positioned towards the distal end (i.e., the tip) of the resected coracoid.