Adjustable device for identifying a target location for a tibial tunnel and related method thereof

Abstract

An adjustable device for identifying the target location for, and placement of, a bone tunnel wherein the device is capable of measuring a total distance across a region of an anatomic structure. The device may be further configured to engage the anatomic structure at a target distance across the anatomic structure to identify the location for bone tunnel placement. A method for identifying the target location for, and placement of, a bone tunnel such that the method is capable of measuring a total distance across a region of an anatomic structure and capable of engaging the anatomic structure at a target distance across the anatomic structure.

Claims

1. An adjustable device for identifying a target location for a bone tunnel of a subject, said device comprising: a first arm comprising an anterior portion and a posterior portion opposite said anterior portion, wherein said posterior portion is configured to engage a reference structure; a targeting arm movably disposed on said first arm; wherein said targeting arm is configured to extend toward and engage across a region of an anatomic structure; a second arm comprising a superior portion and an inferior portion opposite said superior portion, wherein said superior portion of said second arm is in communication with said anterior portion of said first arm; and a measurement member slidably disposed on said second arm, wherein said measurement member and said second arm are configured to move relative to each other, and wherein said measurement member is configured to extend toward and engage a surface of the anatomic structure.

2. The device in claim 1, further comprising a targeting arm adjustment means disposed on said device, wherein said targeting arm adjustment means is configured to move said targeting arm relative to said first arm.

3. The device in claim 1, wherein said targeting arm is further configured to slide along said first arm.

4. The device in claim 1, wherein said targeting arm is configured to pivot about a fixed point on said first arm.

5. The device in claim 1, wherein said targeting arm is further configured to withdraw and lay flush against a surface of said first arm.

6. The device in claim 1, further comprising a guiding device disposed on said inferior portion of said second arm, wherein said guiding device is configured to receive a guide pin.

7. The device in claim 6, wherein said guiding device further comprises a guiding device adjustment means disposed on said guiding device, wherein said guiding device adjustment means is configured to adjust the angle of said guiding device relative to said second arm.

8. The device in claim 7, wherein said guiding device is further configured to rotate about a fixed point on said inferior portion of said second arm.

9. The device in claim 6, wherein said guide pin has a diameter of 3/32 of an inch.

10. The device in claim 1, wherein said second arm is convexly curved.

11. The device in claim 1, wherein said inferior portion of said second arm is further configured to engage a surface of the anatomic structure.

12. The device in claim 1, wherein the bone tunnel is a tibial bone tunnel.

13. The device in claim 1, wherein said first arm further comprises a plurality of graduated markings indicating units of length.

14. The device in claim 1, wherein said measurement member further comprises a plurality of graduated markings indicating units of length.

15. The device in claim 1, wherein said posterior portion of said first arm terminates in a curved hook, wherein said curved hook is configured to engage said reference structure.

16. The device in claim 1, wherein the reference structure is a posterior cruciate ligament.

17. The device in claim 1, wherein the reference structure is a posterior end of a tibial plateau.

18. The device in claim 1, wherein the region of the anatomic structure is a tibial plateau.

19. The device in claim 1, wherein said targeting arm is further configured to engage the anatomic structure at a target distance across the anatomic structure, said target distance corresponding to a predetermined percentage across the total distance across the anatomic structure, wherein said target distance is calculated in reference to said predetermined percentage and said total distance across the anatomic structure.

20. The device in claim 1, wherein said second arm further comprises an outer portion of said second arm, an inner portion of said second arm in communication with at least one surface of said outer portion, and a second arm adjusting means disposed on said second arm, wherein said second arm adjusting means is configured to alter a length of said second arm by slidably moving said inner portion of said second arm and said outer portion of said second arm relative to each other.

21. The device in claim 20, further comprising a means to separate said outer portion of said second arm and said inner portion of said second arm, wherein said outer portion of said second arm is offset from said inner portion of said second arm, and wherein said means to separate said outer portion of said second arm and said inner portion of said second arm is configured to allow said outer portion of said second arm and said inner portion of said second arm to move relative to each other.

22. The device in claim 20, wherein said outer portion of said second arm completely envelops said inner portion of said second arm.

23. The device in claim 20, wherein said outer portion of said second arm is disposed superiorly to said inner portion of said second arm.

24. The device in claim 20, wherein said outer portion of said second arm is disposed inferiorly to said inner portion of said second arm.

25. The device in claim 1, wherein said second arm further comprises a slot, wherein said slot is configured to accommodate said measurement member.

26. The device in claim 25, wherein said measurement member is further configured to slidably move within said slot.

27. The device in claim 25, wherein said second arm further comprises a measurement member adjustment means disposed on said second arm, wherein said measurement member adjustment means is configured to slidably adjust said measurement member within said slot.

28. The device in claim 25, wherein said measurement member further comprises a measurement member adjustment means disposed on said measurement member, wherein said measurement member adjustment means is configured to slidably adjust said measurement member within said slot.

29. The device in claim 1, wherein said adjustable device is composed of a material selected from the group consisting of surgical-grade stainless steel, titanium, aluminum, or plastic.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The foregoing and other objects, features, and advantages of the present invention, as well as the invention itself, will be more fully understood from the following description of preferred embodiments, when read together with the accompanying drawings.

(2) The accompanying drawings, which are incorporated into and form a part of the instant specification, illustrate several aspects and embodiments of the present invention and, together with the description herein, serve to explain the principles of the invention. The drawings are provided only for the purpose of illustrating select embodiments of the invention and are not to be construed as limiting the invention.

(3) FIG. 1 is a schematic side view of a device in accordance with an embodiment.

(4) FIG. 2 is a schematic side view of an adjustable device in a protracted configuration in accordance with an embodiment.

(5) FIG. 3 is a schematic side view of an adjustable device in a contracted configuration in accordance with embodiment.

(6) FIG. 4 is a schematic side view of an adjustable device in operation with associated anatomy in accordance with an embodiment.

(7) FIG. 5 is a schematic side view of an adjustable device in operation with associated anatomy in accordance with an embodiment.

(8) FIG. 6 is a schematic side view of an adjustable device in accordance with an embodiment.

(9) FIG. 7 is a schematic side view of an adjustable device in a steep angle configuration in accordance with an embodiment.

(10) FIG. 8 is a schematic side view of an adjustable device in a shallow angle configuration in accordance with an embodiment.

DETAILED DESCRIPTION OF THE INVENTION

(11) Turning now to the drawings, the subject invention, as shown in FIGS. 1-8 includes an adjustable device 11 for identifying a target location for a bone tunnel 45 in an anatomic structure such as, for example, a tibia 51.

(12) An aspect of an embodiment of the present invention has a broad application in the field of orthopedic surgery. Exemplary applications of the technology herein disclosed include measuring a total distance across a region of an anatomic structure and identifying a target location for a bone tunnel based upon a predetermined target percentage across the anterior-posterior distance of the anatomic structure. Further applications of the technology herein disclosed may include placing a guide pin in accordance with the identified target location for a bone tunnel and drilling a bone tunnel. Additional non-limiting examples include measuring a total distance across a tibial plateau, engaging a region of the tibial plateau at a target distance, and drilling a tibial bone tunnel in accordance with the identified target distance across the tibial plateau during ACL reconstructive surgery.

(13) FIG. 1 illustrates an exemplary and non-limiting embodiment of the present invention. An adjustable device 11 comprises a first arm 13 and a second arm 19 in communication with the first arm 13.

(14) The first arm 13 further comprises a targeting arm 15 perpendicularly disposed on a surface of the first arm 13; or the targeting arm 15 may protrude from the first arm 13 at any alignment or angle to meet the operational or situational demands dictated by the use of the adjustable device 11. The first arm 13 further comprises a plurality of graduated markings indicating units of length. These units of length may be inches, centimeters, millimeters, or further divisions thereof. These markings may also or alternatively indicate graduated percentages across an anatomic structure.

(15) The targeting arm 15 may be movably disposed on the first arm 13. For example, and without limitation, the targeting arm 15 may be configured to slide or ratchet across a surface of the first arm 13, or it may pivot about a fixed point on a surface of the first arm 13. The adjustable device 11 may further comprise a targeting arm adjustment means 16 disposed on a surface of the adjustable device 11. The targeting arm adjustment means 16 may be configured to adjust the location and orientation of the targeting arm 15.

(16) Those skilled in the art will appreciate that the targeting arm adjustment means 16 may be in any form suitable to couple with, and adjust the location and orientation of, the targeting arm 15. For example, and without limitation, the targeting arm adjustment means 16 may be a dial, ratchet, button, switch, or suitable equivalents thereof. The targeting arm adjustment means 16 may be manually or electrically operated. For example, the targeting arm adjustment means 16 may be coupled to a motor or similar apparatus that is coupled to the targeting arm 15. This motor or similar apparatus may be powered using a battery, inductive power, or directly through a power cord. However, this is not required, and the targeting arm adjustment means 16 may be directly coupled to the targeting arm 15 such that the location and orientation of the targeting arm 15 may be manually adjusted without the use of electronic means.

(17) In FIG. 1, the targeting arm 15 is depicted as a rectangular member that tapers and terminates in a point. However, this is not required, and the targeting arm 15 may take on a variety of forms and shapes. For example, and without limitation, the targeting arm 15 may be substantially two-dimensional or it may be three-dimensional with a circular, square, rectangular, or other suitably shaped cross-section. The targeting arm 15 may terminate in a tapered point, may retain a uniform shape throughout, or take on a variety of other shapes and forms as operational or situational demands dictate.

(18) In FIG. 1, the posterior region of the first arm 15 terminates in a curved hook 17. However, this is meant to be exemplary and not limiting, and the posterior region of the targeting arm 15 may terminate in any form suitable to engage a reference structure 35, as depicted in FIGS. 4 and 5. For example, the posterior region of the first arm 15 may alternatively terminate in a point, clasp, tip, claw, or suitable equivalents thereof.

(19) Though not depicted in FIG. 1, the targeting arm 15 may be configured to withdraw so as to lay flush against the first arm 13 or substantially parallel with the first arm 13. This may be accomplished by, for example, rotating the targeting arm 15 about a fixed point on the first arm 13. Similarly, the targeting arm adjustment means 16 may be configured to perform such a withdrawal, or any other withdrawal such that the targeting arm 15 lays flush against the first arm 13, or substantially parallel with the first arm 13.

(20) The curved hook 17 terminates in a point that is aligned with a measurement member 29 that is disposed on the second arm 19 such that the curved hook 17 and measurement member 29 can simultaneously engage opposing ends of a region of an anatomic structure. For example, FIGS. 4 and 5 depict the curved hook 17 and measurement member 29 simultaneously engaging opposite ends of a tibial plateau.

(21) The measurement member 29 further comprises a plurality of graduated markings indicating units of length. These units of length may be inches, centimeters, millimeters, or further divisions thereof. These markings may also or alternatively indicate graduated percentages across an anatomic structure.

(22) The measurement member 29 is accommodated within a slot 31 disposed on the second arm 19. The measurement member 29 is further configured to move within the slot 31 such that the measurement member 29 may move relative to the second arm 19. However, this is not required, and the measurement member 29 may alternatively be movably or statically disposed on a surface of the second arm 19, or the measurement member 29 may be statically disposed within the slot 31. Further, the measurement member 29 may be configured to move relative to the second arm 19 in any suitable manner such as, for example, by sliding or ratcheting. The slot 31 may be disposed within the second arm 19 or on an outer surface of the second arm 19.

(23) FIG. 1 further depicts a measurement member adjustment means 30 protruding from a surface of the second arm 19 and coupled with the measurement member 29. The measurement member adjustment means 30 is depicted as a rod coupled with the measurement member 29 that terminates in a small knob. However, it should be appreciated that the measurement member adjustment means 29 may take on a variety of other forms, such as, but not limited to, a dial, ratchet, button, switch, plunger or suitable equivalents thereof.

(24) As depicted in FIG. 1, the user may control the lateral displacement of the measurement member 29 within the slot 31 by pulling or pushing on the measurement member adjustment means 30. In an exemplary use of the present invention, a user would adjust the measurement member adjustment means 30 until the measurement member 29 lays flush against an anterior portion or edge of an anatomic surface, such as a tibial plateau, as illustrated in FIGS. 4 and 5.

(25) In FIG. 1, the second arm 19 is in communication with the anterior region of the first arm 13. The second arm 19 is depicted as being convexly curved in FIG.1. However, this is not required, and the second arm 19 may be substantially straight, slanted, or otherwise shaped if operational or situational demands should dictate it to be.

(26) FIG. 1 depicts the inferior portion of the second arm 19 terminating in a manner such that it may engage and rest against a surface of an anatomic surface. For example, in FIG. 5, the inferior portion of the second arm 19 rests against an anterior surface of a tibia 51. However, this is not required, and in other non-limiting exemplary embodiments the inferior portion of the second arm 19 may terminate such that it is not configured to rest against a surface of an anatomic structure. For example, the second arm 19 may alternatively terminate in a handle such that a user may grasp and control the adjustable device 11 during operation.

(27) FIGS. 2 and 3 illustrate additional exemplary embodiments of the adjustable device 11 of the present invention, with the addition of an outer portion of the second arm 21, inner portion of the second arm 23, second arm adjustment means 27, guiding device 33, and guide pin 43. The remaining elements illustrated in FIGS. 2 and 3 are substantially similar in form and function as those disclosed herein in FIG. 1.

(28) FIG. 2 illustrates an exemplary embodiment of the adjustable device 11 in a protracted position. The inner portion of the second arm 23 engages the outer portion of the second arm 21 on two surfaces. However, this is not required, and the inner portion of the second arm 23 may be completely enveloped by the outer portion of the second arm 21 or the inner portion 23 may engage the outer portion 21 on more or fewer than two surfaces. Additionally, though the inner portion of the second arm 23 is depicted in FIG. 2 as being disposed superiorly to the outer portion of the second arm 21, this is not required. For example, the outer portion of the second arm 21 may be disposed superiorly to the inner portion of the second arm 23 in alternative embodiments.

(29) The inner portion of the second arm 23 and outer portion of the second arm 21 are configured to move relative to each other. This may be accomplished in a variety of ways, such as, for example, by ratcheting or sliding. For example, in FIG. 2, the inner portion of the second arm 23 is configured to slide within the outer portion of the second arm 21 such that a length of second arm 25 is adjusted by changing the magnitude of overlap between the two portions of the second arm 19. That is, further sliding the inner portion of the second arm 23 within the outer portion of the second arm 21 will increase the amount that the two portions overlap and shorten the length of second arm 25.

(30) In FIGS. 2 and 3, the second arm 19 further comprises second arm adjustment means 27 that is configured to move the inner portion of the second arm 23 and the outer portion of the second arm 21 relative to each other. The second arm adjustment means 27 is depicted as a knob in FIGS. 2 and 3. Also, in FIGS. 2 and 3, the second arm adjustment means 27 is disposed on the inner portion of the second arm 23 such that a user can grab or otherwise engage the second arm adjustment means 27 and slide the inner portion of the second arm 23 within the outer portion of the second arm 21. It should be appreciated that this adjustment may be accomplished without any additional tools.

(31) Those skilled in the art will appreciate that the second arm adjustment means 27 may be in any form suitable to move the inner portion of the second arm 23 and the outer portion of the second arm 21 relative to each other. For example, the second arm adjustment means 27 may be a button, dial, ratchet, switch, notch, or suitable equivalents thereof. The second arm adjustment means 27 may be manually or electrically operated. For example, the second arm adjustment means 27 may be coupled to a motor that is coupled to the inner portion of the second arm 23, or the outer portion of the second arm 21, or another portion of the second arm 19. This motor may be powered using a battery, inductive power, or directly through a power cord. However, this is not required, and the second arm adjustment means 27 may be directly coupled to one or more portions of the second arm 19 such that the length of the second arm 25 may be manually adjusted without the use of electronic means.

(32) FIGS. 2 and 3 further depict a guiding device 33 disposed on an inferior portion of the second arm 19. The guiding device 33 is configured to engage and lay flush against a surface of an anatomic structure. For example, as depicted in FIG. 4, the guiding device 33 may engage and lay flush against an anterior surface of a tibia 51.

(33) The guiding device 33 may be further configured to receive a guide pin 43. The guide pin 43 may be 3/32 of an inch in diameter, but this is not required, and those skilled in the art will appreciate that a differently sized guide pin 43 may be required and utilized as operational or situational demands dictate.

(34) FIG. 3 further illustrates an exemplary embodiment of the adjustable device 11 in a contracted state. FIG. 3 is provided to illustrate the adjustability of the length of the second arm 25. Comparing FIG. 3 with FIG. 2, the inner portion of the second arm 23 has been slid within the outer portion of the second arm 21 so as to maximize the magnitude of overlap between the two portions of the second arm 19. Accordingly, FIG. 3 depicts the length of the second arm 25 in its shortest configuration.

(35) It should be appreciated that embodiments of the adjustable device 11, such as those depicted in FIGS. 2 and 3, can be easily adjusted. The second arm adjustment means 27 can be utilized to quickly and simply adjust the length of the second arm 25. In other words, the current invention allows a user to change between a protracted state (e.g., as depicted in FIG. 2) and a contracted state (e.g., as depicted in FIG. 3), and vice versa. Moreover, this adjustment may be accomplished without the use of additional tools.

(36) It should also be appreciated that FIGS. 2 and 3 show only exemplary configurations that are not limiting. That is, the adjustable device 11 may be configured such that the length of the second arm 25 may be any length in the range of those depicted in FIGS. 2 and 3.

(37) Moreover, though FIGS. 2 and 3 depict exemplary configurations of the inner portion of the second arm 23 and the outer portion of the second arm 21, these are not meant to limit the possible ranges of motion of the portions of the second arm 19 nor are they intended to limit the range of possible lengths of the second arm 25. Alternative embodiments of the present invention may allow for a length of the second arm 25 outside of the range depicted in FIGS. 2 and 3. Adjusting the adjustable device 11 to allow for a length of the second arm 25 outside of the range depicted in FIGS. 2 and 3 would be within the context of the embodiments disclosed herein to meet the operational or situational demands dictated by use of the adjustable device 11.

(38) FIG. 4 further illustrates an exemplary embodiment of the adjustable device 11 in a configuration that may be seen in an exemplary use of the present invention. A first arm 13 terminates in a curved hook 17 that engages a reference structure 35. In FIG. 4, the curved hook 17 engages a posterior region of a tibial plateau. The curved hook 17 is aligned with a measurement member 29 that rests against an anterior edge of a tibial plateau such that the curved hook 17 and measurement member 29 simultaneously engage opposing ends of the tibial plateau. With both ends of the tibial plateau engaged, a total distance across the anatomic structure 41 can be determined by, for example and without limitation, reading the measurement by aligning graduated markings on the measurement member 29 and first arm 13. The total distance across the anatomic structure 41 may also be read with the assistance of arthroscopic devices or techniques, though these are not required. It should be appreciated that neither fluoroscopy nor other imaging techniques are required to determine or read the total distance across the anatomic structure 41.

(39) In FIG. 4, the targeting arm 15 is depicted as having engaged the surface of the tibial plateau at a target distance across the anatomic structure 39. The target distance across the anatomic structure 39 may be calculated by referencing a target percentage across the anterior-posterior distance of the anatomic structure. For example, and without limitation, the target percentage across the anatomic structure may be 35%. In these non-limiting embodiments, the anterior edge of the anatomic structure may correspond to 0% and the posterior edge of the anatomic structure may correspond to 100%. In some embodiments, the target distance across the anatomic structure 39 may be calculated by multiplying the total distance across the anatomic structure 41 by the target percentage across the anterior-posterior distance of the anatomic structure.

(40) Though not depicted in FIG. 4, additional arthroscopic devices, apparatuses, and techniques may be utilized to aid in the adjustment of the target arm 15. However, these are not required, and it should be appreciated that the targeting arm 15 may be adjusted to engage the anatomic structure at the target distance across the anatomic structure 39 without the use of additional tools.

(41) Though not depicted in FIG. 4, the target location for the bone tunnel 45 may be marked using conventional devices and techniques. For example, and without limitation, an electrocautery device, surgical pen, or microfracture awl may be used to mark where the targeting arm 15 engages an anatomic structure at the target distance across the anatomic structure 39. Other techniques and devices may also be employed, and identification of equivalents would be within the skill of an ordinary practitioner. However, this step is not required, and in other embodiments of the present invention the target location for the bone tunnel 45 may not be marked.

(42) In FIG. 4, a guiding device 33 engages an anterior surface of a tibia 51 in accordance with the position of the targeting arm 15. The length of the second arm 25 may be adjusted in accordance with the position of the targeting arm 15 by utilizing the second arm adjustment means 27 to slide the inner portion of the second arm 23 within the outer portion of the second arm 21 such that the guiding device is aligned with the position of the targeting arm 15. Those skilled in the art will appreciate that this adjustment may be made with the assistance of arthroscopic tools, apparatuses, or techniques, but these are not required. Accurately adjusting the length of the second arm 25 in accordance with the position of the targeting arm 15 may be accomplished using available computations and adjustments to achieve a reliable and precise calibration.

(43) The guiding device 33 may be configured to receive a guide pin 43. This guide pin 43 may be inserted in to an anterior surface of the tibia 51 to mark the path of a bone tunnel 45 that may be drilled using a cannulated drill, reamer, or other conventional surgical tool, device, instrument, or technique. It should be appreciated that other complimentary tools, devices, instruments, and materials may be implemented and employed within the context of various embodiments other than the guiding device and guide pin.

(44) FIG. 5 further illustrates an exemplary embodiment of the adjustable device 11 in a configuration that may be seen in an exemplary use of the present invention. A first arm 13 passes under a femur 53 and terminates in a curved hook 17 that engages a reference structure 35. In FIG. 5, the reference structure 35 is a posterior edge of a tibial plateau.

(45) As in FIG. 4, FIG. 5 depicts a targeting arm 15 engaging a tibial plateau at a target distance across the anatomic structure 39. The adjustment of the targeting arm 15 may be accomplished using the targeting arm adjustment means 16.

(46) Though not depicted in FIG. 5, additional arthroscopic devices, apparatuses, and techniques may be utilized to aid in the adjustment of the target arm 15. However, it should be appreciated that the targeting arm 15 may be adjusted to engage the anatomic structure at the target distance across the anatomic structure 39 without the use of additional tools.

(47) In FIG. 5, a second arm 19 terminates in a curved and planar configuration that is configured to engage and rest against a surface of an anatomic structure. For example, as depicted in FIG. 5, the second arm 19 may rest against an anterior surface of a tibia 51. However, this is not required. The second arm 19 may alternatively terminate in a manner such that it does not rest against a surface of an anatomic structure. For example, the second arm 19 may terminate in a handle that allows a user to grasp and control the adjustable device 11 during operation.

(48) FIG. 5 additionally depicts an operational or strategic location for a bone tunnel 45 based upon the target distance across the anatomic structure 39 as engaged by the targeting arm 15. Though not depicted in FIG. 5, the operational or strategic exit point of the bone tunnel 45 (as engaged by the targeting arm 15 in FIG. 5) may be marked using conventional surgical techniques and devices. For example, an electrocautery device, surgical pen, or microfracture awl may be utilized for this purpose. Once the target distance across the anatomic structure 39 is identified in accordance to the aspects of various embodiments of the present invention disclosed herein, placing a bone tunnel 45 directed to the target distance across the anatomic structure 39 would be well within the skill of an ordinary artisan. Available tibial tunnel placement guides, such as the Acufex Director, may be utilized to drill a bone tunnel 45 to the target location engaged by the targeting arm 15. However, this is not required, and additional embodiments of the present invention (such as those depicted in FIG. 4) provide for a device that can both identify the target location for a bone tunnel and provide a guiding device 33 for placing a guide pin 43 that can then identify the path of a bone tunnel 45.

(49) FIG. 6 depicts an additional embodiment of the adjustable device 11 of the present invention. In FIG. 6, the inner portion of the second arm 23 and the outer portion of the second arm 21 are separated by a means to separate the second arm 47. The means to separate the second arm 47 is configured to allow the inner portion of the second arm 23 and outer portion of the second arm 21 to move relative to each other so as to adjust a length of the second arm 25.

(50) Those skilled in the art will appreciate that the means to separate the second arm 47 may be of any form suitable to separate the inner portion of the second arm 23 and the outer portion of the second arm 21. For example, in some non-limiting embodiments, the means to separate the second arm 47 may be, but is not limited to, a bracket, clamp, guide, bridge, or suitable equivalents thereof. FIG. 6 depicts the means to separate the second arm 47 as a bracket with ends that completely envelop respective regions of the portions of the second arm 19. However, this is not required. For example, the means to separate the second arm 47 may engage a portion of one or both of the portions of the second arm 19 on one or more of their respective surfaces, or the means to separate the second arm 47 may envelop a smaller portion of the respective portions of the second arm 19. In some embodiments, the means to separate the second arm 47 may remain in a fixed position, and in other embodiments the means to separate the second arm 47 may move relative to one or both of the inner portion of the second arm 23 and the outer portion of the second arm 21.

(51) FIG. 6 further depicts a second arm adjustment means 27 disposed on an inferior portion of the second arm. However, this is not required, and the second arm adjustment means 27 may be disposed on any surface of the adjustable device 11, such as, for example, on a superior region on the second arm 19. Alternatively, the second arm adjustment means 27 may be disposed on the inner portion of the second arm 23, the outer portion of the second arm 21, or the means to separate the second arm 47.

(52) The additional elements of the adjustable device 11 as depicted in FIG. 6 are substantially similar in form and function as those disclosed and depicted in FIGS. 2, 3, and 4.

(53) FIGS. 7 and 8 illustrate additional exemplary embodiments of the adjustable device 11 of the present invention. An adjustable guiding device 33 is disposed on an inferior portion of the second arm 19.

(54) In FIG. 7, the adjustable guiding device 33 is configured to pivot about a guiding device adjustment means 49 disposed on an inferior portion of the second arm 19. The guiding device adjustment means 49 is configured to allow the guiding device 33 to pivot, rotate, translate, or otherwise move about a point on the second arm 19 so as to adjust the angle of the guiding device 33 with respect to the second arm 19.

(55) It should be appreciated that the guiding device adjustment means 49 may be of any form suitable to allow the guiding device 33 to move relative to the second arm 19. For example, the guiding device adjustment means 49 may be, but is not limited to, a knob, dial, button, switch, ratchet, nut, bolt, hinge, ball and socket joint, or suitable equivalents thereof.

(56) FIG. 7 depicts the adjustable device 11 in a configuration where the guiding device 33 is oriented at a steep angle with respect to the second arm 19. Such a configuration may be advantageous in situations where the target location for bone tunnel placement is located on a substantially anterior region of the target anatomy.

(57) FIG. 8 depicts the adjustable device 11 in a configuration where the guiding device 33 is oriented at a shallow angle with respect to the second arm 19. As compared to the configuration depicted in FIG. 7, this adjustment is possible by, for example, rotating the guiding device 33 about the guiding device adjustment means 49. Such a configuration may be advantageous in situations where the target location for bone tunnel placement is located on a more posterior region of the target anatomy, as compared with the configuration depicted in FIG. 7.

(58) It should be appreciated that embodiments of the adjustable device 11, such as those depicted in FIGS. 7 and 8, can be easily adjusted. The guiding device adjustment means 49 can be utilized to quickly and simply adjust the angle of guiding device 33 with respect to the second arm 19. In other words, an aspect of an embodiment of the invention allows a user to change between a steep angle configuration (e.g., as depicted in FIG. 7) and a shallow angle configuration (e.g., as depicted in FIG. 8), and vice versa. Moreover, this adjustment may be accomplished without the use of additional tools.

(59) It should also be appreciated that FIGS. 7 and 8 show only exemplary configurations that are not limiting. That is, the angle of the guiding device 33 with respect to the second arm 19 may be any angle in the range of those depicted in FIGS. 7 and 8. The guiding device 33 may be configured to pivot, rotate, translate or otherwise move in any continuous or iterative manner about the guiding device adjustment means 49. For example, and without limitation, the guiding device 33 may slide, rotate continuously, or ratchet.

(60) Moreover, though FIGS. 7 and 8 depict exemplary angles at the limits of the depicted range of motion, these are not meant to be limiting. Alternative embodiments of the present invention may allow for angles of the guiding device 33 with respect to the second arm 19 outside of the range depicted in FIGS. 7 and 8. Adjusting the adjustable device 11 to allow for more extreme angles would be within the context of the embodiments disclosed herein to meet the operational or situational demands dictated by use of the adjustable device 11.

(61) The additional elements of the adjustable device 11 as depicted in FIGS. 7 and 8 are substantially similar in form and function as those disclosed and depicted in FIGS. 1 and 5.

(62) The adjustable device 11 as shown and depicted in FIGS. 1-8 may be constructed of a number of suitable materials. Such materials may include, for example, surgical-grade stainless steel, titanium, aluminum, or plastic polymers. Other materials would also be suitable. Identification of equivalents is well within the skill of the ordinary practitioner and would require no more than routine experimentation. It should be appreciated that the adjustable device 11 may be composed of such materials in part or in whole.

(63) Further, it should be appreciated that an embodiment may have additional uses in addition to those heretofore disclosed and discussed. For example, the present invention may be used to identify a target location for one or more bone tunnels during reconstructive procedures involving other structures of the knee, such as the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), or the lateral collateral ligament (LCL). It should also be appreciated that embodiments may be implemented and directed at other target areas or intended areas of the subject in addition to those disclosed and discussed. The present invention has a broad application in the field of orthopedic surgery and may be utilized in any setting wherein a target location for a bone tunnel is identified. For example, embodiments of the present invention may be utilized during reconstructive procedures of the shoulder, ankle, or elbow.

(64) Of course, it should be understood that a wide range of changes and modifications may be made to the preferred embodiment described above. It is therefore intended that the foregoing detailed description be regarded as illustrative rather than limiting, and that it be understood that it is the following claims, including all equivalents, which are intended to define the scope of this invention.

EXAMPLES

(65) Practice of an aspect of an embodiment (or embodiments) of the invention will be still more fully understood from the following examples and experimental results, which are presented herein for illustration only and should not be construed as limiting the invention in any way.

Example 1

(66) An adjustable device for identifying a target location for a bone tunnel of a subject. The device may comprise: a first arm comprising an anterior portion and a posterior portion opposite said anterior portion, wherein said posterior portion is configured to engage a reference structure; a targeting arm movably disposed on said first arm; wherein said targeting arm is configured to extend toward and engage across a region of an anatomic structure; a second arm comprising a superior portion and an inferior portion opposite said superior portion, wherein said superior portion of said second arm is in communication with said anterior portion of said first arm; and a measurement member slidably disposed on said second arm, wherein said measurement member and said second arm are configured to move relative to each other, and wherein said measurement member is configured to extend toward and engage a surface of the anatomic structure.

Example 2

(67) The device in example 1, further comprising a targeting arm adjustment means disposed on said device, wherein said targeting arm adjustment means is configured to move said targeting arm relative to said first arm.

Example 3

(68) The device in example 1 (as well as subject matter in whole or in part of example 2), wherein said targeting arm is further configured to slide along said first arm.

Example 4

(69) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-3, in whole or in part), wherein said targeting arm is configured to pivot about a fixed point on said first arm.

Example 5

(70) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-4, in whole or in part), wherein said targeting arm is further configured to withdraw and lay flush against a surface of said first arm.

Example 6

(71) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-5, in whole or in part), further comprising a guiding device disposed on said inferior portion of said second arm, wherein said guiding device is configured to receive a guide pin.

Example 7

(72) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-6, in whole or in part), wherein said second arm is convexly curved.

Example 8

(73) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-7, in whole or in part), wherein said inferior portion of said second arm is further configured to engage a surface of the anatomic structure.

Example 9

(74) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-8, in whole or in part), wherein the bone tunnel is a tibial bone tunnel.

Example 10

(75) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-9, in whole or in part), wherein said first arm further comprises a plurality of graduated markings indicating units of length.

Example 11

(76) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-10, in whole or in part), wherein said measurement member further comprises a plurality of graduated markings indicating units of length.

Example 12

(77) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-11, in whole or in part), wherein said posterior portion of said first arm terminates in a curved hook, wherein said curved hook is configured to engage said reference structure.

Example 13

(78) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-12, in whole or in part), wherein the reference structure is a posterior cruciate ligament.

Example 14

(79) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-13, in whole or in part), wherein the reference structure is a posterior end of a tibial plateau.

Example 15

(80) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-14, in whole or in part), wherein the region of the anatomic structure is a tibial plateau.

Example 16

(81) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-15, in whole or in part), wherein said targeting arm may be further configured to engage the anatomic structure at a target distance across the anatomic structure. Further, said target distance corresponds to a predetermined percentage across the total distance across the anatomic structure, wherein said target distance is calculated in reference to said predetermined percentage and said total distance across the anatomic structure.

Example 17

(82) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-16, in whole or in part), wherein said second arm may further comprise an outer portion of said second arm, an inner portion of said second arm in communication with at least one surface of said outer portion, and a second arm adjusting means disposed on said second arm. Further, wherein said second arm adjusting means is configured to alter a length of said second arm by slidably moving said inner portion of said second arm and said outer portion of said second arm relative to each other.

Example 18

(83) The device in example 17 (as well as subject matter of one or more of any combination of examples 2-16, in whole or in part), further comprising a means to separate said outer portion of said second arm and said inner portion of said second arm, wherein said outer portion of said second arm is offset from said inner portion of said second arm, and wherein said means to separate said outer portion of said second arm and said inner portion of said second arm is configured to allow said outer portion of said second arm and said inner portion of said second arm to move relative to each other.

Example 19

(84) The device in example 17 (as well as subject matter of one or more of any combination of examples 2-16 and 18, in whole or in part), wherein said outer portion of said second arm completely envelops said inner portion of said second arm.

Example 20

(85) The device in example 17 (as well as subject matter of one or more of any combination of examples 2-16 and 18-19, in whole or in part), wherein said outer portion of said second arm is disposed superiorly to said inner portion of said second arm.

Example 21

(86) The device in example 17 (as well as subject matter of one or more of any combination of examples 2-16 and 18-20, in whole or in part), wherein said outer portion of said second arm is disposed inferiorly to said inner portion of said second arm.

Example 22

(87) The device in example 6 (as well as subject matter of one or more of any combination of examples 1-5 and 7-21, in whole or in part), wherein said guiding device further comprises a guiding device adjustment means disposed on said guiding device, wherein said guiding device adjustment means is configured to adjust the angle of said guiding device relative to said second arm.

Example 23

(88) The device in example 22 (as well as subject matter of one or more of any combination of examples 2-21, in whole or in part), wherein said guiding device is further configured to rotate about a fixed point on said inferior portion of said second arm.

Example 24

(89) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-23, in whole or in part), wherein said second arm further comprises a slot, wherein said slot is configured to accommodate said measurement member.

Example 25

(90) The device in example 24 (as well as subject matter of one or more of any combination of examples 2-23, in whole or in part), wherein said measurement member is further configured to slidably move within said slot.

Example 26

(91) The device in example 24 (as well as subject matter of one or more of any combination of examples 2-23 and 25, in whole or in part), wherein said second arm further comprises a measurement member adjustment means disposed on said second arm, wherein said measurement member adjustment means is configured to slidably adjust said measurement member within said slot.

Example 27

(92) The device in example 24 (as well as subject matter of one or more of any combination of examples 2-23 and 25-26, in whole or in part), wherein said measurement member further comprises a measurement member adjustment means disposed on said measurement member, wherein said measurement member adjustment means is configured to slidably adjust said measurement member within said slot.

Example 28

(93) The device in example 6 (as well as subject matter of one or more of any combination of examples 1-5 and 7-27, in whole or in part), wherein said guide pin has a diameter of 3/32 of an inch. It should be noted that the diameter of the guide pin (or other tool or device) may be larger or smaller as desired.

Example 29

(94) The device in example 1 (as well as subject matter of one or more of any combination of examples 2-28, in whole or in part), wherein said adjustable device is composed of a material selected from the group consisting of surgical-grade stainless steel, titanium, aluminum, or plastic. It should be noted that other materials may be appropriate, and the device may be constructed of such materials in whole or in part.

Example 30

(95) A method for identifying a target location for a bone tunnel in a subject. The method may comprise utilizing an adjustable device to engage a reference structure of said subject; utilizing a measurement member of said adjustable device to measure a total distance across a region of an anatomic structure of said subject; calculating a target distance across the region of the anatomic structure of said subject based upon a predetermined target percentage across said total distance; and engaging the anatomic structure at said target distance across the region of the anatomic structure by adjusting a targeting arm that is movably disposed on a first arm of said adjustable device.

Example 31

(96) The method of example 30, further comprising the step of marking said target distance across the region of the anatomic structure.

Example 32

(97) The method of example 30 (as well as subject matter in whole or in part of example 31), further comprising the step of moving said measurement member such that said measurement member is advanced toward a surface of the anatomic structure.

Example 33

(98) The method of example 30 (as well as subject matter of one or more of any combination of examples 31-32, in whole or in part), further comprising the step of moving said measurement member such that said measurement member engages a surface of the anatomic structure.

Example 34

(99) The method of example 30 (as well as subject matter of one or more of any combination of examples 31-33, in whole or in part), further comprising the step of adjusting a second arm of said adjustable device in accordance with the position of said targeting arm.

Example 35

(100) The method of example 34 (as well as subject matter of one or more of any combination of examples 31-33, in whole or in part), wherein said adjusting includes altering the length of said second arm.

Example 36

(101) The method of example 34 (as well as subject matter of one or more of any combination of examples 31-33 and 35, in whole or in part), further comprising the step of adjusting a guiding device disposed on an inferior portion of said second arm in accordance with the position of said targeting arm; wherein said guiding device is configured to rotate about a fixed point on an inferior portion of said second arm.

Example 37

(102) The method of example 34 (as well as subject matter of one or more of any combination of examples 31-33 and 35-36, in whole or in part), further comprising adjusting an angle of a guiding device that is disposed on an inferior portion of said second arm wherein said guiding device is angled to correspond with the position of said targeting arm.

Example 38

(103) The method of example 34 (as well as subject matter of one or more of any combination of examples 31-33 and 35-37, in whole or in part), further comprising the step of inserting a guide pin through a guiding device disposed on an inferior portion of said second arm.

Example 39

(104) The method of example 38 (as well as subject matter of one or more of any combination of examples 31-37, in whole or in part), further comprising the step of drilling a bone tunnel at the location of the guide pin insertion.

Example 40

(105) The method of example 30 (as well as subject matter of one or more of any combination of examples 31-39, in whole or in part), further comprising the steps of removing the adjustable device and utilizing a tibial tunnel guide device to engage said region of the anatomic structure at said target distance.

Example 41

(106) The method of example 40 (as well as subject matter of one or more of any combination of examples 31-39, in whole or in part), further comprising the steps of inserting a guide pin in said anatomic structure using said tibial tunnel guide device and drilling a bone tunnel.

Example 42

(107) The method of example 30 (as well as subject matter of one or more of any combination of examples 31-41, in whole or in part), wherein the bone tunnel is a tibial tunnel.

Example 43

(108) The method of example 30 (as well as subject matter of one or more of any combination of examples 31-42, in whole or in part), wherein the reference structure is a posterior cruciate ligament.

Example 44

(109) The method of example 30 (as well as subject matter of one or more of any combination of examples 31-43, in whole or in part), wherein the reference structure is a posterior end of a tibial plateau.

Example 45

(110) The method of example 30 (as well as subject matter of one or more of any combination of examples 31-44, in whole or in part), wherein the region of the anatomic structure is a tibial plateau.

Example 46

(111) The method of example 30 (as well as subject matter of one or more of any combination of examples 31-45, in whole or in part), wherein the predetermined target percentage is 35% and wherein said anterior end of the region of the anatomic structure corresponds to 0% and said posterior end of the region of the anatomic structure corresponds to 100%.

Example 47

(112) The method of manufacturing any of the devices (or their components and subcomponents) provided in any one or more of examples 1-29.

Example 48

(113) The method of using any of the devices (or their components and subcomponents) provided in any one or more of examples 1-29.

Example 49

(114) A system including any of the devices (or their components and subcomponents) provided in any one or more of examples 1-29.

Example 50

(115) A kit including any of the devices (or their components and subcomponents) provided in any one or more of examples 1-29.

REFERENCES

(116) The devices, systems, apparatuses, compositions, materials, machine readable media, computer program products, and methods of various embodiments of the invention disclosed herein may utilize aspects disclosed in the following references, applications, publications and patents and which are hereby incorporated by reference herein in their entirety, and which are not admitted to be prior art with respect to the present invention by inclusion in this section:

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(163) 47. http://www.smith-nephew.com/professional/products/all-products/acufex-director/.

(164) 48. http://www.boviemedical.com/cauteries.

(165) Unless clearly specified to the contrary, there is no requirement for any particular described or illustrated activity or element, any particular sequence or such activities, any particular size, speed, material, duration, contour, dimension or frequency, or any particularly interrelationship of such elements. Moreover, any activity can be repeated, any activity can be performed by multiple entities, and/or any element can be duplicated. Further, any activity or element can be excluded, the sequence of activities can vary, and/or the interrelationship of elements can vary. It should be appreciated that aspects of the present invention may have a variety of sizes, contours, shapes, compositions and materials as desired or required.

(166) In summary, while the present invention has been described with respect to specific embodiments, many modifications, variations, alterations, substitutions, and equivalents will be apparent to those skilled in the art. The present invention is not to be limited in scope by the specific embodiment described herein. Indeed, various modifications of the present invention, in addition to those described herein, will be apparent to those of skill in the art from the foregoing description and accompanying drawings. Accordingly, the invention is to be considered as limited only by the spirit and scope of the following claims, including all modifications and equivalents.

(167) Still other embodiments will become readily apparent to those skilled in this art from reading the above-recited detailed description and drawings of certain exemplary embodiments. It should be understood that numerous variations, modifications, and additional embodiments are possible, and accordingly, all such variations, modifications, and embodiments are to be regarded as being within the spirit and scope of this application. For example, regardless of the content of any portion (e.g., title, field, background, summary, abstract, drawing figure, etc.) of this application, unless clearly specified to the contrary, there is no requirement for the inclusion in any claim herein or of any application claiming priority hereto of any particular described or illustrated activity or element, any particular sequence of such activities, or any particular interrelationship of such elements. Moreover, any activity can be repeated, any activity can be performed by multiple entities, and/or any element can be duplicated. Further, any activity or element can be excluded, the sequence of activities can vary, and/or the interrelationship of elements can vary. Unless clearly specified to the contrary, there is no requirement for any particular described or illustrated activity or element, any particular sequence or such activities, any particular size, speed, material, dimension or frequency, or any particularly interrelationship of such elements. Accordingly, the descriptions and drawings are to be regarded as illustrative in nature, and not as restrictive. Moreover, when any number or range is described herein, unless clearly stated otherwise, that number or range is approximate. When any range is described herein, unless clearly stated otherwise, that range includes all values therein and all sub ranges therein. Any information in any material (e.g., a United States/foreign patent, United States/foreign patent application, book, article, etc.) that has been incorporated by reference herein, is only incorporated by reference to the extent that no conflict exists between such information and the other statements and drawings set forth herein. In the event of such conflict, including a conflict that would render invalid any claim herein or seeking priority hereto, then any such conflicting information in such incorporated by reference material is specifically not incorporated by reference herein.