US20130261682A1 - Bone growth device and method - Google Patents
Bone growth device and method Download PDFInfo
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- US20130261682A1 US20130261682A1 US13/892,182 US201313892182A US2013261682A1 US 20130261682 A1 US20130261682 A1 US 20130261682A1 US 201313892182 A US201313892182 A US 201313892182A US 2013261682 A1 US2013261682 A1 US 2013261682A1
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- adjustment device
- external adjustment
- adjustable implant
- control module
- length
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/7258—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8866—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8875—Screwdrivers, spanners or wrenches
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8875—Screwdrivers, spanners or wrenches
- A61B17/8886—Screwdrivers, spanners or wrenches holding the screw head
- A61B17/8888—Screwdrivers, spanners or wrenches holding the screw head at its central region
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B2017/681—Alignment, compression, or distraction mechanisms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/02—Materials or treatment for tissue regeneration for reconstruction of bones; weight-bearing implants
Definitions
- the field of the invention generally relates to medical devices for treating conditions involving the skeletal system and in particular bone growth applications.
- Distraction osteogenesis also known as distraction callotasis and osteodistraction has been used successfully to lengthen long bones of the body.
- the bone if not already fractured, is purposely fractured by means of a corticotomy, and the two segments of bone are gradually distracted apart, which allows new bone to form in the gap. If the distraction rate is too high, there is a risk of nonunion, if the rate is too low, there is a risk that the two segments will completely fuse to each other before the distraction period is complete. When the desired length of the bone is achieved using this process, the bone is allowed to consolidate.
- Distraction osteogenesis applications are mainly focused on the growth of the femur or tibia, but may also include the humerus, the jaw bone (micrognathia), or other bones.
- the reasons for lengthening or growing bones are multifold, the applications including, but not limited to: post osteosarcoma bone cancer; cosmetic lengthening (both legs-femur and/or tibia) in short stature or dwarfism/achondroplasia; lengthening of one limb to match the other (congenital, post-trauma, post-skeletal disorder, prosthetic knee joint), non-unions.
- intramedullary distraction nails have been surgically implanted which are contained entirely within the bone. Some are automatically lengthened via repeated rotation of the patient's limb. This can sometimes be painful to the patient, and can often proceed in an uncontrolled fashion. This therefore makes it difficult to follow the strict daily or weekly lengthening regime that avoids nonunion (if too fast) or early consolidation (if too slow). Lower limb distraction rates are on the order of one millimeter per day.
- Other intramedullary nails have been developed which have an implanted motor and are remotely controlled. The motorized intramedullary nails have an antenna which needs to be implanted subcutaneously, thus complicating the surgical procedure, and making it more invasive.
- a lengthening device is configured for placement inside or across bone having first and second separate sections.
- the device includes a housing configured for attachment to one of the first and second separate bone sections and a distraction shaft having an internal cavity along a length thereof and configured for attachment to the other of the first and second separate bone sections.
- the device includes a permanent magnet configured for rotation relative to the housing and having at least two poles, the permanent magnet operatively coupled to a lead screw, the lead screw interfacing with a threaded portion of the internal cavity of the distraction shaft.
- a thrust bearing is disposed in the housing and interposed between the lead screw and the permanent magnet, the thrust bearing sandwiched between first and second abutments in the housing.
- a lengthening device is configured for placement inside an intramedullary canal of a bone having first and second separate sections.
- the device includes a housing configured for attachment to one of the first and second separate bone sections and a distraction shaft having an internal cavity along a length thereof and configured for attachment to the other of the first and second separate bone sections.
- a permanent magnet is disposed in the housing and configured for rotation and having at least two poles.
- a planetary gear set having a plurality of gears is provided, wherein one of the gears is operatively coupled to the permanent magnet and configured for transmitting torque, and wherein another gear of the plurality of gears terminates in an output shaft operatively coupled to a lead screw, the lead screw interfacing with a threaded portion of the internal cavity of the distraction shaft.
- a lengthening system is configured for placement inside an intramedullary canal of a bone.
- the system includes an actuator with a housing containing a rotatable permanent magnet and moveable distraction shaft telescopically mounted relative the housing, the moveable distraction shaft operatively coupled to the rotatable permanent magnet via a lead screw, wherein a distal end of the distraction shaft is configured for attachment to a first region of the bone and wherein a proximal end of the actuator has a geometrically shaped hub of a male type.
- the system further includes an extension rod having at one end thereof a geometrically shaped hub of a female type configured to secure to the geometrically shaped hub of the male type disposed on the actuator, wherein an opposing end of the extension rod is configured for attachment to a second region of the bone.
- a lengthening system is configured for placement inside an intramedullary canal of a bone.
- the system includes an actuator with a housing containing a rotatable permanent magnet and a moveable distraction shaft telescopically mounted relative the housing, the moveable distraction shaft operatively coupled to the rotatable permanent magnet via a lead screw, wherein a distal end of the distraction shaft is configured for attachment to a first region of the bone and wherein a proximal end of the actuator comprises a geometrically shaped hub of a female type.
- the system further includes an extension rod having at one end thereof a geometrically shaped hub of a male type configured to secure to the geometrically shaped hub of the female type disposed on the actuator, wherein an opposing end of the extension rod is configured for attachment to a second region of the bone.
- an external adjustment device for adjusting an adjustable implant includes a power supply, a control module, and a handheld device comprising at least one permanent magnet.
- the handheld device is configured to be placed on a first side of a patient's limb and the at least one permanent magnet is configured to turn a cylindrical magnet located inside an adjustable implant.
- the control module is configured to restrict the number of turns of the cylindrical magnet located inside the adjustable implant.
- FIG. 1 illustrates side view of an intramedullary lengthening device in place within a bone according to one embodiment.
- FIG. 2 illustrates a side view of the intramedullary lengthening device of FIG. 1 .
- FIG. 3A illustrates a cross-sectional view of the intramedullary lengthening device of FIGS. 1 and 2 taken along the line 3 A- 3 A of FIG. 2 .
- FIG. 3B illustrates a detailed view of the intramedullary lengthening device of FIG. 3A from the area of circle 3 B.
- FIG. 3C illustrates a cross-sectional view of the intramedullary lengthening device of FIGS. 1 and 2 taken along the line 3 C in FIG. 2 .
- FIG. 4A illustrates a view of several of the internal components of the intramedullary lengthening device of the prior FIGS.
- FIG. 4B illustrates a lip seal configured for use in the intramedullary lengthening device of the prior FIGS.
- FIG. 5 illustrates a detailed view of several internal components of the drive mechanism of the intramedullary lengthening device of the prior figures.
- FIG. 6 illustrates a perspective view of an external adjustment device.
- FIG. 7 illustrates an exploded view of the magnetic handpiece of the external adjustment device of FIG. 6 .
- FIG. 8 illustrates a cross-sectional representation of a prior art electromagnetic external device being positioned around a patient's lower thigh.
- FIG. 9 illustrates a cross-sectional representation of the external adjustment device handpiece of FIGS. 6 and 7 being positioned on a patient's lower thigh.
- FIG. 10 illustrates a sterilizable kit for use with a modular intramedullary lengthening device.
- FIG. 11 illustrates a modular intramedullary lengthening device according to one embodiment.
- FIG. 12 illustrates one end of the actuator of the intramedullary lengthening device of FIG. 11 .
- FIG. 13 illustrates an extension rod of the modular intramedullary lengthening device.
- FIG. 14 illustrates a second view of the extension rod of FIG. 13 .
- FIG. 15 illustrates a proximal drill guide for insertion and attachment of the modular intramedullary lengthening device.
- FIG. 16 illustrates a removal tool for removal of the modular intramedullary lengthening device.
- FIG. 17 illustrates a torque limiting driver for attaching the extension rod to the actuator of the modular intramedullary device.
- FIG. 18 illustrates a section of the actuator of the modular intramedullary lengthening device.
- FIG. 19 illustrates a gap (G) between a magnetic handpiece and an intramedullary lengthening device.
- FIG. 20 illustrates a locking screw driver for use with the intrameduallary lengthening device.
- FIG. 21A illustrates a locking screw for use with the intramedullary lengthening device.
- FIG. 21B illustrates the locking screw of FIG. 21A taken along line 21 B- 21 B of FIG. 21A .
- FIG. 1 illustrates the side view of an intramedullary lengthening device 110 which has been placed through a hole or bore 108 contained within a bone 100 .
- the hole or bore 108 may be made by drilling, reaming and the like and may extend through both cortical bone (at the end) and through cancellous (spongy) bone.
- the intramedullary lengthening device 110 illustrated in FIG. 1 includes a housing 112 and a distraction shaft 114 .
- the bone 100 In order to grow or lengthen the bone 100 , the bone 100 either has a pre-existing separation 106 or is purposely cut or broken to create this separation 106 , dividing the bone into a first section 102 and a second section 104 .
- the cut may be done prior to inserting and securing the intramedullary lengthening device 110 , or may be done after the device 110 is inserted, for example by use of a flexible Gigli saw.
- the distraction shaft 114 of the intramedullary lengthening device 110 is attached to the first section 102 using one or more attachment screws 118 .
- Fasteners other than screws 118 known to those skilled in the art may also be used to secure the distraction shaft 114 to the first section 102 of the bone 100 .
- the housing 112 of the intramedullary lengthening device 110 is secured to the second section 104 of bone 100 using one or more attachment screws 116 . Again, fasteners other than screws 116 may be used to secure the housing 112 to the second section 104 of bone 100 .
- Continually distracted is meant to indicate that distraction occurs on a regular basis which may be on the order of every day or every few days.
- An exemplary distraction rate is one millimeter per day although other distraction rates may be employed. That is to say, a typical distraction regimen may include a daily increase in the length of the intramedullary lengthening device 110 by about one millimeter. This may be done, for example, by four lengthening periods per day, each having 0.25 mm of lengthening.
- the intramedullary lengthening device 110 has a magnetic drive system, which allows the distraction shaft 114 to be telescopically extended from the housing 112 , thus forcing the first section 102 and the second section 104 of the bone 100 apart from one another. As the distraction is performed, a portion of the housing 112 is able to slide within the hole or bore 108 of the first section 102 if bone 100 within a displacement section 120 .
- the orientation of the intramedullary lengthening device 110 within the bone may be opposite of that shown in FIG. 1 .
- the distraction shaft 114 may be coupled to the second section 104 of the bone 100 and the housing 112 may be coupled to the first section 102 of the bone 100 .
- the intramedullary lengthening device 110 may be placed retrograde, from a hole or bore starting at the distal end of the bone 100 .
- the intramedullary lengthening device 110 has one or more distraction shaft screw holes 122 in the distraction shaft 114 through which the screws 118 ( FIG. 1 ) may be placed.
- the housing 112 is attached to an end cap 130 which has one or more housing screw holes 124 through which the screws 116 ( FIG. 1 ) may be placed.
- the housing 112 of the intramedullary lengthening device 110 includes a magnet housing 128 and a splined housing 126 . These housings 126 , 128 may be attached to each other by means of welding, adhesive bonding or other joining techniques.
- the magnet housing 128 is sealably closed at one end (the end opposite the interface with the splined housing 126 ) by the attachment of the end cap 130 .
- the end cap 130 may be attached to the magnet housing 128 by means of welding, adhesive bonding or other joining techniques.
- the distraction shaft 114 is driven from the housing 112 by means of a lead screw 136 which turns inside a nut 140 that is secured to an inner surface adjacent to a cavity 137 of the distraction shaft 114 .
- the lead screw 136 is mechanically coupled, in an indirect manner, to cylindrical permanent magnet 134 contained within the magnet housing 128 .
- rotation of the cylindrical permanent magnet 134 which is magnetically driven by an external adjustment device 180 ( FIG. 6 ), effectuates rotation of the lead screw 136 .
- Cylindrical magnet 134 is fixedly contained within a magnet casing 158 using, for example, an adhesive such as an epoxy.
- the magnet casing 158 rotates relative to the magnet housing 128 .
- the cylindrical magnet 134 may be a rare earth magnet such as Nd—Fe—B and may be coated with Parylene or other protective coatings in addition to being protected within the magnet casing 158 , for example hermetically potted with epoxy.
- the magnet casing 158 contains an axle 160 on one end which attaches to the interior of a radial bearing 132 .
- the outer diameter of the radial bearing 132 is secured to the interior of the end cap 130 . This arrangement allows the cylindrical magnet 134 to rotate with minimal torsional resistance.
- the magnet housing 158 includes an axle 161 , which is attached to a first planetary gear set 154 .
- the axle 161 includes the sun gear of the first planetary gear set 154 , the sun gear turning the planetary gears of the first planetary gear set 154 .
- the first planetary gear set 154 serves to reduce the rotational speed and increase the resultant torque delivery from the cylindrical magnet 134 to the lead screw 136 .
- a second planetary gear set 156 is also shown between the first planetary gear set 154 and the lead screw 136 , for further speed reduction and torque augmentation.
- the number of planetary gear sets and/or the number of teeth in the gears may be adjusted, in order to achieve the desired speed and torque delivery.
- a lead screw with eighty (80) threads per inch attached to two planetary gear sets of 4:1 gear ratio each inside a 9 mm device with magnet location in the distal femur can achieve at least 100 lb. of distraction force at a greater than average distance or gap from the external device ( FIG. 9 or FIG. 19 ).
- the planetary gear sets 154 , 156 output to a planetary gear output shaft 144 .
- the planetary gear output shaft 144 extends through a thrust bearing 138 and is secured (by welding and the like) to a lead screw coupling cap 146 .
- the lead screw 136 is secured to the lead screw coupling cap 146 by a locking pin 142 , which extends through a hole in the lead screw 136 and holes in the lead screw coupling cap 146 .
- a locking pin retainer 148 is a cylinder that surrounds the locking pin 142 , holding this assembly together. Attaching the lead screw 136 to the rest of the magnet/gear assembly in this manner, assures that the design is not over-constrained, and thus that the lead screw 136 does not gall with the nut 140 .
- a biocompatible grease for example KRYTOX, may be used on the moving parts (lead screw, nut, bearings, housing, and distraction shaft) in order to minimize frictional losses.
- the lead screw 136 is able to freely rotate within a cavity 137 of the distraction shaft 114 , and only need engage with the short length of the nut 140 , this feature also minimizing frictional losses.
- the thrust bearing 138 serves to protect the magnet/gear assembly of the drive from any significant compressive or tensile stresses.
- the thrust bearing 138 consists of two separate races with ball bearings between the two races. When there is a compressive force on the device, for example, when distracting a bone 100 , and thus resisting the tensile strength of the soft tissues, the thrust bearing 138 abuts against a magnet housing abutment or lip 150 located in the magnet housing 128 . Additionally, though the device is not typically intended for pulling bones together, there may be some applications where this is desired. For example, in certain compressive nail applications it is the goal to hold two fractured sections of a bone together.
- the bone 100 may have fractured in a non-uniform or shattered pattern, it may be difficult to determine the desired length of the nail until after it is implanted and fully attached. In these situations, it can be easy to misjudge the length, and so a gap may exist between the bones.
- the device 110 By placing a slightly extended intramedullary device 110 and securing it, the device 110 may be retracted magnetically, after it has been secured within the bone fragments, so that it applies the desired compression between the two fragments. In these compressive nail applications, there would be tensile force on the device 110 and the thrust bearing 138 would abut against a splined housing abutment or lip 152 .
- the thrust bearing 138 and a rigid portion of one of the housing sections take the large stresses, not the magnet/gear assembly of the drive system.
- the thrust bearing 138 is sandwiched between the abutment or lip 150 and the abutment or lip 152 .
- Distraction shaft 114 contains several axial grooves 166 .
- the grooves 166 have semi-circular indentation cross-sections which allow several balls 164 to roll within them.
- the balls 164 are trapped within a linear ball cage 162 .
- the splined housing 126 which fits over the balls 164 and linear ball cage 162 has axial grooves 163 ( FIG.
- a lip seal flange 168 contains a custom cross-section lip seal 169 (shown in FIG.
- the lip seal 169 includes a base portion 173 , which seals against the inner diameter of the lip seal flange 168 (and thus the splined housing 126 which is attached to the lip seal flange 168 ).
- the lip seal 169 also includes protrusions 171 which slidingly seal against the axial grooves 166 of the distraction shaft 114 .
- Inner surface 175 of the lip seal 169 slidingly seals against the overall outer diameter of the distraction shaft 114 .
- the lip seal 169 may be made from silicone, EPDM or other rubber materials, and may be coated with silicone oil, to aid in lubricity.
- the balls, grooves and ball cage may be coated with silicone oil or a liquid perfluorinated polyether such as KRYTOX to aid in lubricity.
- FIG. 5 shows a portion of the magnet casing 158 removed so that the South pole 170 and North pole 172 of the cylindrical magnet 134 may be illustrated.
- FIG. 6 illustrates an external adjustment device 180 which is used to non-invasively distract the intramedullary lengthening device 110 by means of a magnetic coupling which transmits torque.
- the external adjustment device 180 comprises a magnetic handpiece 178 , a control box 176 and a power supply 174 .
- the control box 176 includes a control panel 182 having one or more controls (buttons, switches or tactile, motion, audio or light sensors) and a display 184 .
- the display 184 may be visual, auditory, tactile, the like or some combination of the aforementioned features.
- the external adjustment device 180 may contain software which allows programming by the physician.
- the physician may desire that the patient take home the external adjustment device 180 in order that the patient or member of the patient's family or friends make daily distractions of the intramedullary lengthening device 110 implanted in the patient.
- the physician is able to keep the person operating the external adjustment device 180 from over distracting the patient by programming this into the control box 176 .
- the physician may pre-program the control 176 box so that only one (1) mm of distraction is allowed per day.
- the physician may additionally pre-program the control box 176 so that no more than 0.5 mm may be distracted during any two hour period, or that no more than 0.25 mm may be retracted during a five minute period. Settings such as these may serve to assure that the patient not be capable of causing severe damage to the bone or tissue, nor disrupt the lengthening process.
- such instructions or limits may be pre-programmed by the physician or even the manufacturer in a secure fashion such that user cannot alter the pre-programmed setting(s).
- a security code may be used to pre-program and change the daily distraction limit (or other parameters).
- the person operating the external adjustment device 180 will not be able to distract more than one (1) mm in a day (or more than two mm in a day), and will not have the security code to be able to change this function of the external adjustment device 180 . This serves as a useful lockout feature to prevent accidental over-extension of the intramedullary lengthening device 110 .
- the safety feature may monitor, for example, rotational movement of magnets 186 of the external adjustment device 180 , described in more detail below, or the safety feature may monitor rotation of the cylindrical magnet 134 in the intramedullary lengthening device 110 , via non-invasive sensing means.
- FIG. 7 shows the detail of the magnetic handpiece 178 of the external adjustment device 180 , in order to elucidate the manner that the magnets 186 of the external device serve to cause the cylindrical magnet 134 of the intramedullary lengthening device 110 to turn.
- the magnets 186 there are two (2) magnets 186 that have a cylindrical shape.
- the magnets 186 are made from rare earth magnets.
- the magnets 186 may have the same radial two pole configuration as the cylindrical magnet 134 seen in FIG. 5 .
- the magnets 186 are bonded or otherwise secured within magnetic cups 187 .
- the magnetic cups 187 include a shaft 198 which is attached to a first magnet gear 212 and a second magnet gear 214 , respectively.
- each the two magnets 186 are maintained in relation to each other by means of the gearing system (by use of center gear 210 , which meshes with both first magnet gear 212 and second magnet gear 214 ).
- center gear 210 which meshes with both first magnet gear 212 and second magnet gear 214 .
- the south pole of one of the magnets 186 is facing up whenever the south pole of the other magnet 186 is facing down. This arrangement, for example, maximizes the torque that can be placed on the cylindrical magnet 134 of the intramedullary lengthening device 110 .
- the components of the magnetic handpiece 178 are held together between a magnet plate 190 and a front plate 192 . Most of the components are protected by a cover 216 .
- the magnets 186 rotate within a static magnet cover 188 , so that the magnetic handpiece 178 may be rested directly on the patient, while not imparting any motion to the external surfaces of the patient.
- the operator Prior to distracting the intramedullary lengthening device 110 , the operator places the magnetic handpiece 178 over the patient near the location of the cylindrical magnet 134 as seen in FIG. 9 .
- a magnet standoff 194 that is interposed between the two magnets 186 contains a viewing window 196 , to aid in the placement.
- a mark made on the patient's skin at the appropriate location with an indelible marker may be viewed through the viewing window 196 .
- the operator holds the magnetic handpiece 178 by its handles 200 and depresses a distract switch 228 , causing motor 202 to drive in a first direction.
- the motor 202 has a gear box 206 which causes the rotational speed of an output gear 204 to be different from the rotational speed of the motor 202 (for example, a slower speed).
- the output gear 204 then turns a reduction gear 208 which meshes with center gear 210 , causing it to turn at a different rotational speed than the reduction gear 208 .
- the center gear 210 meshes with both the first magnet gear 212 and the second magnet gear 214 turning them at a rate which is identical to each other.
- this rate be controlled, to minimize the resulting induced current density imparted by magnet 186 and cylindrical magnet 134 though the tissues and fluids of the body.
- a magnet rotational speed of 60 RPM or less is contemplated although other speeds may be used such as 35 RPM or less.
- the distraction may be lessened by depressing the retract switch 230 . For example, if the patient feels significant pain, or numbness in the area being lengthened.
- FIGS. 8 and 9 A cross section of a patient's lower thigh 218 with the intramedullary lengthening device 110 implanted within the femur 220 is shown in FIGS. 8 and 9 .
- the magnetic handpiece 178 of the external adjustment device 180 of the invention is shown in position to adjust the cylindrical magnet 134 of the intramedullary lengthening device 110 .
- a scale depiction of a prior art magnetic stator “donut” 222 demonstrates the comparative efficiency of the two designs ( FIG. 8 illustrates an intramedullary lengthening device 110 of the type described herein placed in a “prior art” magnetic stator “donut” 222 ).
- the prior art magnetic stator “donut” 222 is large, expensive, and difficult to transport to a patient's home for daily adjustments.
- the use of a circular cross-section as a one-size-fits-all device is not very efficient because of several reasons: the cross section of most limbs is not circular, the bone is usually not centered within the limb and patients' limbs come in many different sizes.
- the thigh has been placed through the circular hole in the magnetic stator “donut” and the posterior portion 232 of the thigh rests at the lower portion 226 of the magnetic stator “donut” 222 .
- the strength of a magnetic field decreases in accordance with a power (such as the inverse square) of the distance, depending on the complexity of the specific field geometry. Therefore, in any magnetic design, making the distance between the driving magnetic field and the driven magnet as small as possible is desirable.
- the size of the patient's lower thigh 218 and the decision to how it is placed within the magnetic stator “donut” 222 in FIG. 8 create a geometry so that the distance L 1 between the cylindrical magnet 134 and the upper portion 224 of the magnetic stator “donut” 222 is about the same as the distance L 2 between the cylindrical magnet 134 and the lower portion 226 of the magnetic stator “donut” 222 .
- the length L 1 would become less while the length L 2 would become greater.
- the magnetic stator “donut” 222 of FIG. 8 is almost impossible to optimize. Therefore, an extra large magnetic field needs to be generated as the standard magnetic field of the device, thus requiring more expense (for the hardware to power this larger field). This in turn means that each patient will be exposed to a larger magnetic field and larger tissue and fluid current density than is really required.
- the intramedullary lengthening device 110 may be secured to the bone 100 , unnecessarily large magnetic fields may cause unwanted motion of the bone 100 , for example in any of the radial directions of the cylindrical magnet 134 . If the magnetic field is too high, the patient's leg may be moved out of ideal position, and may even cause the patient some annoyance, including pain.
- the configuration of the magnetic handpiece 178 of the external adjustment device 180 as shown in FIG. 9 optimizes the ability of the magnets 186 to deliver torque to the cylindrical magnet 134 of the intramedullary lengthening device 110 , without exposing the patient to large magnetic fields. This also allows the cylindrical magnet 134 of the intramedullary lengthening device 110 to be designed as small as possible, lowering the implant profile so that it may fit into the humerus, or the tibia and femurs of small stature patients, such as those who might desire cosmetic limb lengthening. As mentioned, a 9 mm diameter intramedullary lengthening device can deliver 100 lb. distraction force, and even 8 mm and 7 mm devices are contemplated.
- the alternating orientation of the two magnets 186 creates an additive effect of torque delivery to cylindrical magnet 134 , and thus maximizes distraction force for any specific cylindrical magnet 134 size.
- the separation (S) between the centers of the two magnets 186 match with the curvature of the outer surfaces of the majority of limbs, thus making the distances L 3 and L 4 between each of the magnets 186 and the cylindrical magnet 134 as small as possible. This is especially aided by the concave contour 238 of the magnetic handpiece 178 .
- skin and fat may be compressed by the magnet covers 188 causing an indentation 236 on one or both sides which allows the distances L 3 and L 4 between each of the magnets 186 and the cylindrical magnet 134 to be yet smaller.
- FIG. 10 illustrates a sterilizable kit 400 containing a plurality of extension rods 406 which are configured to be attached to an actuator 412 ( FIG. 11 ) in order to construct a modular intramedullary lengthening device 410 ( FIG. 11 ).
- the actuator 412 is supplied sterile, and the extension rods 406 and the remainder of the contents of the sterilizable kit 400 are sterilizable by autoclave (e.g., steam), Ethylene Oxide or other methods known to those skilled in the art.
- the sterilizable kit 400 contents includes one or more of the extension rods 406 and accessories 408 for use in the insertion, attachment, adjustment and removal of the modular intramedullary lengthening device 410 .
- first sterilizable tray 402 The contents are located within a first sterilizable tray 402 and a second sterilizable tray 404 .
- Second sterilizable tray 404 and first sterilizable tray 402 have a plurality of holes 405 to allow gas to enter.
- Other items in the kit 400 will be described in several of the following figures.
- FIG. 11 the assembly of the modular intramedullary lengthening device 410 is shown.
- the actuator 412 is designed to be placed in the bone of the patient in the opposite orientation than that of the intramedullary lengthening device 110 of FIG. 1 . Therefore, the distraction shaft 413 is orientated towards the distal end of the bone (distal is the down direction of FIG. 11 ).
- Distal screw holes 415 in the distraction shaft 413 allow the placement of distal locking screws 420 .
- the distal locking screws 420 ( FIGS. 21A and 21B ) have proximal threads 417 for engaging the bone, while the remainder of the shaft 419 of the distal locking screws 420 is of a constant diameter for maximum strength and stability.
- the extension rod 406 ( FIGS. 13 and 14 ) has a corresponding hexagonal hole 428 or female end into which the hexagonal male hub 414 of the actuator 412 is placed.
- the transverse set screw 416 is nested within the threaded hole 429 of the hexagonal male hub 414 so that it does not interfere with the hexagonal hole 428 of the extension rod 406 , when they are placed together.
- the actuator 412 and extension rod 406 are placed together so that the set screw holes 422 extend coaxially with the set screw 416 .
- a male hex 490 of a set screw tightening driver such as the torque limiting driver 488 of FIGS. 10 and 17 , to be inserted into a hex hole of the set screw 416 .
- the torque limiting driver 488 is tightened and ratchets at its set control torque
- the other end of the set screw 416 which is either threaded or a non threaded peg, inserts into the opposite set screw hole 422 , thus tightly securing the actuator 412 to the extension rod 406 .
- the set screw holes 422 are sized to allow the male hex 490 to smoothly clear, but the non-threaded peg of the set screw 416 clear very slightly, making a static connection that cannot be easily loosened during implantation.
- bone cement may be placed in annulus of set screw hole 422 , to even further bond set screw 416 .
- a second screw may be screwed in behind the head of the set screw into the female thread that the set screw 416 was originally nested in. The head of this second screw will add additional resistance to shear failure of the set screw 416 .
- the second screw can be tightened so that it jams into the set screw 416 , thus making back-out of the set screw 416 unlikely.
- Any non-circular cross-section may be used in place of the hex cross-section, for example a square or oval cross-section.
- Proximal locking screws 418 insert through locking screw holes 430 in the extension rod 406 .
- the extension rod 406 may be straight, or may have a specific curve 432 , for example, for matching the proximal end of the femur or tibia. It can be appreciated that the modular arrangement allows the actuator 412 to be attached to one of numerous different models of extension rods 406 , having different lengths, curves (including straight), diameters, hole diameters, and angulations.
- the first sterilization tray 402 may include many of these different extension rods 406 , which may be selected as appropriate, and attached to the actuator 412 . Because the actuator 412 is supplied sterile, this arrangement is also desirable, as only a single model need be supplied.
- actuators may exist, for example, different diameters (10.5 mm, 12.0 mm, 9 mm, 7.5 mm) or with different distal screw hole diameters, configurations or angulations.
- the preferred configuration for a multitude of patients and different bone types and sizes can be available, with a minimum number of sterile actuator models.
- a proximal drill guide 434 is illustrated and is configured for attaching to the modular intramedullary lengthening device 410 to ease its insertion into the intramedullary canal, the drilling of holes in the bone and the attachment of the proximal locking screws 418 to the bone.
- the proximal drill guide 434 comprises an extension arm 436 attached to a connection tube 446 through which a locking rod 448 is inserted.
- the locking rod 448 has a locking knob 450 at the proximal end and a male thread 452 at the distal end.
- a locking tab 454 of the proximal drill guide 434 is inserted into a locking groove 424 of the extension rod 406 and the locking knob 450 is turned, threading the male thread 452 of the locking rod 448 into a female thread 426 of the extension rod 406 .
- a drill guide extension 438 is attached via a knob 440 to the extension arm 436 .
- the modular intramedullary lengthening device 410 After reaming the medullary canal of the bone to a diameter slightly larger than the outer diameter of the modular intramedullary lengthening device 410 (for example 11 mm), distal end of the modular intramedually lengthening device 410 is inserted into the medullary canal and the flat proximal surface of the locking knob 450 is hammered with a mallet, allowing the modular intramedullary lengthening device 410 to be inserted to the correct depth.
- Dimension X is sufficient to clear large thighs or hips (in the worst case femoral application). For example, 8 to 10 cm is appropriate.
- the proximal drill guide 434 is left attached and a guide sleeve 442 is placed through one of the holes 456 , 458 , 460 , 462 and slid so that the distal end 443 reaches the skin of the patient.
- the drill guide extension 438 , extension arm 436 and holes 456 , 458 , 460 , 462 are dimensioned and oriented so that the guide sleeve 442 is oriented at the exact angle to allow drilling and placement of screws through the locking screws holes 430 of the extension rod 406 and through the bone.
- a drill bushing 444 is placed through the incision, with the tapered tip 445 passing through tissue and reaching the bone to be drilled.
- drills and locking screws may be inserted down the drill bushing 444 , or alternatively, drills may be inserted down the drill bushing 444 and then, after the drilling is complete, the drill bushing 444 is removed and proximal locking screw 418 is inserted down the guide sleeve 442 .
- Alternative guide sleeves 464 and drill bushings 466 can be placed through holes 460 and 462 , as seen in FIG. 10 .
- a removal tool 468 is illustrated.
- the removal tool 468 is used after the distraction period and consolidation period are complete.
- the skin is incised and bone exposed at the locations of the proximal and distal locking screws 418 , 420 and at the proximal end of the modular intramedullary lengthening device 410 .
- a removal rod 470 is connected to the female thread 426 of the extension rod 406 of the modular intramedullary lengthening device 410 by inserting the engagement tip 476 and screwing the male thread 474 into the female thread 426 , holding onto the locking knob 472 .
- the locking knob 472 contains a female thread 478 which allows the attachment of a male thread 486 of a removal extension 480 , which has an impact knob 482 and removal hammer 484 .
- the male thread 486 is coupled to the removal extension 480 by a pivot 477 of a pivoting base 479 .
- the male thread 486 is secured to the female thread 478 by grasping and turning the impact knob 482 .
- the proximal and distal locking screws 418 , 420 Prior to removing the modular intramedullary lengthening device 410 , the proximal and distal locking screws 418 , 420 are removed. They may be removed with the use of the locking screw driver 498 ( FIGS.
- FIGS. 10 and 20 which has a male hex tip 497 to engage the proximal ends of the locking screws 418 , 420 .
- a screw capture rod 500 ( FIGS. 10 and 20 ) inserts down the center of the locking screw driver 498 and has a male threaded tip 501 .
- At a deeper portion past the female hex 513 in the locking screws 418 , 420 is a female thread 511 .
- the male threaded tip 501 of the screw capture rod 500 threads into the female thread 511 of the locking screws 418 , 420 , and tightened by using the tightening handle 503 of the screw capture rod 500 which sits at the handle end 509 of the locking screw driver 498 so that once the locking screws 418 , 420 are removed from the bone, they are still secured to the locking screw driver 498 , and will not become prematurely displaced. For example, the locking screws 418 , 420 will not be lost or dropped into the patient.
- the modular intramedullary lengthening device 410 may now be removed from the medullary canal by grasping the removal hammer 484 , and moving it quickly in the direction (D) so that hammer impact surface 485 strikes knob impact surface 483 . This is done until the modular intramedullary lengthening device 410 is completely removed. It should be noted that locking knob 450 of the proximal drill guide 434 of FIG.
- the 15 also has a female thread (not pictured) so that during the insertion of the modular intramedullary lengthening device 410 , if it is desired to remove the device for any reason, the male thread 486 of the removal tool 468 may be attached to the female thread of the locking knob 450 , and the removal hammer 484 can be used against the impact knob 482 to remove the modular intramedullary lengthening device 410 .
- the torque limiting driver 488 of FIG. 17 comprises a handle 496 and a shaft 492 having a torque-specific ratchet 494 connecting them.
- the male hex tip 490 fits into the hex hole of the set screw 416 , or even into the female hex 513 of the locking screws 418 , 420 .
- An exemplary ratcheting torque for the set screw 416 is 9 inch-pounds (1.0 Newton-meter), and an exemplary hex size is 1/16′′ (1.59 mm).
- FIG. 18 illustrates the actuator 412 of FIG. 11 in a sectional view.
- the distal screw holes 415 are visible in the distraction shaft 413 .
- the distraction shaft 413 is shown in a fully extended position in relation to the housing 312 .
- the cavity 337 has opened to its maximum length.
- the distraction shaft 413 has a purely cylindrical surface, and is dynamically sealed to the housing 312 by two o-ring seals 502 .
- the o-ring seals 502 may be made of silicone, EPDM, or other rubber materials, and may be coated with silicone oil, to aid in lubricity.
- Tabs 504 on the end of the distraction shaft 413 fit into these grooves 326 to keep the distraction shaft 413 from being able to rotate with respect to the housing 312 .
- the housing 312 is welded to a magnet housing 328 and the magnet housing 328 is welded to hexagonal male hub 414 .
- the set screw 416 on the hexagonal male hub 414 is used to attach the actuator 412 to the extension rod 406 .
- the cylindrical permanent magnet 334 is cased with epoxy inside magnet casing 358 having an end pin 360 .
- the end pin 360 inserts through radial bearing 332 , allowing it to rotate with low friction.
- first planetary gear set 354 As the magnet 334 is rotated by the external magnets, first planetary gear set 354 , second planetary gear set 356 and third planetary gear set 357 allow a total reduction of 64:1 (4 ⁇ 4 ⁇ 4). Each gear set allows a 4:1 reduction.
- Planetary gear output shaft 344 is attached to lead screw 336 by locking pin 342 , and locking pin 342 is held in place by cylindrical locking pin retainer 348 .
- Thrust bearing 338 abuts housing abutment or lip 352 and magnet housing abutment or lip 350 (thrust bearing 338 is sandwiched between housing abutment or lip 352 and magnet housing abutment or lip 350 ).
- thrust bearing 338 abuts housing abutment or lip 352 in tension and magnet housing abutment or lip 350 in compression. It should be noted that the sandwich arrangement allows for some slop or play between the thrust bearing 338 and the housing abutment or lip 352 and the magnet housing abutment or lip 350 .
- Lead screw 336 engages with nut 340 , which is secured within distraction shaft 413 .
- distraction forces of greater than 300 pounds (1334 Newtons) have been consistently achieved with a gap (G in FIG. 19 ) of 2 inches (5.08 cm) between the magnetic hand piece 178 and the intramedullary lengthening device 110 . This is sufficient for distracting a large range of typical patients.
- any of these embodiments may be used with the distraction shaft pointing distally or proximally.
- the invention may also be applied to distractable bone plates that are not located within the intramedullary canal, but are external to the bone.
- one alternative lengthening scheme includes the purposeful over-lengthening (to further stimulate growth) followed by some retraction (to minimize pain).
- each of four daily 0.25 mm lengthening periods may consist of 0.35 mm of lengthening, followed by 0.10 mm of retraction.
- the materials of the accessories 408 are medical grade stainless steel, though other materials of varying densities may be used depending on the desired weight and the required size.
- the majority of the components of the intramedullary lengthening devices are preferably Titanium or Titanium alloys although some of the internal components may be made from stainless steel.
Abstract
Description
- This application is a continuation of U.S. patent application Ser. No. 12/875,585, filed on Sep. 3, 2010 and incorporated in its entirety by reference herein, which claims the benefit of priority to U.S. Provisional Appl. Nos. 61/363,986 and 61,240,071, filed on Jul. 13, 2010 and Sep. 4, 2009 respectively, both of which are incorporated in their entirety by reference herein.
- The field of the invention generally relates to medical devices for treating conditions involving the skeletal system and in particular bone growth applications.
- Distraction osteogenesis, also known as distraction callotasis and osteodistraction has been used successfully to lengthen long bones of the body. Typically, the bone, if not already fractured, is purposely fractured by means of a corticotomy, and the two segments of bone are gradually distracted apart, which allows new bone to form in the gap. If the distraction rate is too high, there is a risk of nonunion, if the rate is too low, there is a risk that the two segments will completely fuse to each other before the distraction period is complete. When the desired length of the bone is achieved using this process, the bone is allowed to consolidate. Distraction osteogenesis applications are mainly focused on the growth of the femur or tibia, but may also include the humerus, the jaw bone (micrognathia), or other bones. The reasons for lengthening or growing bones are multifold, the applications including, but not limited to: post osteosarcoma bone cancer; cosmetic lengthening (both legs-femur and/or tibia) in short stature or dwarfism/achondroplasia; lengthening of one limb to match the other (congenital, post-trauma, post-skeletal disorder, prosthetic knee joint), non-unions.
- Distraction osteogenesis using external fixators has been done for many years, but the external fixator can be unwieldy for the patient. It can also be painful, and the patient is subject to the risk of pin track infections, joint stiffness, loss of appetite, depression, cartilage damage and other side effects. Having the external fixator in place also delays the beginning of rehabilitation.
- In response to the shortcomings of external fixator distraction, intramedullary distraction nails have been surgically implanted which are contained entirely within the bone. Some are automatically lengthened via repeated rotation of the patient's limb. This can sometimes be painful to the patient, and can often proceed in an uncontrolled fashion. This therefore makes it difficult to follow the strict daily or weekly lengthening regime that avoids nonunion (if too fast) or early consolidation (if too slow). Lower limb distraction rates are on the order of one millimeter per day. Other intramedullary nails have been developed which have an implanted motor and are remotely controlled. The motorized intramedullary nails have an antenna which needs to be implanted subcutaneously, thus complicating the surgical procedure, and making it more invasive. These devices are therefore designed to be lengthened in a controlled manner, but due to their complexity, may not be manufacturable as an affordable product. Others have proposed intramedullary distractors containing and implanted magnet, which allows the distraction to be driven electromagnetically by an external stator (i.e., a large electromagnet). Because of the complexity and size of the external stator, this technology has not been reduced to a simple and cost-effective device that can be taken home, to allow patients to do daily lenthenings.
- In a first embodiment, a lengthening device is configured for placement inside or across bone having first and second separate sections. The device includes a housing configured for attachment to one of the first and second separate bone sections and a distraction shaft having an internal cavity along a length thereof and configured for attachment to the other of the first and second separate bone sections. The device includes a permanent magnet configured for rotation relative to the housing and having at least two poles, the permanent magnet operatively coupled to a lead screw, the lead screw interfacing with a threaded portion of the internal cavity of the distraction shaft. A thrust bearing is disposed in the housing and interposed between the lead screw and the permanent magnet, the thrust bearing sandwiched between first and second abutments in the housing.
- In a second embodiment, a lengthening device is configured for placement inside an intramedullary canal of a bone having first and second separate sections. The device includes a housing configured for attachment to one of the first and second separate bone sections and a distraction shaft having an internal cavity along a length thereof and configured for attachment to the other of the first and second separate bone sections. A permanent magnet is disposed in the housing and configured for rotation and having at least two poles. A planetary gear set having a plurality of gears is provided, wherein one of the gears is operatively coupled to the permanent magnet and configured for transmitting torque, and wherein another gear of the plurality of gears terminates in an output shaft operatively coupled to a lead screw, the lead screw interfacing with a threaded portion of the internal cavity of the distraction shaft.
- In a third embodiment, a lengthening system is configured for placement inside an intramedullary canal of a bone. The system includes an actuator with a housing containing a rotatable permanent magnet and moveable distraction shaft telescopically mounted relative the housing, the moveable distraction shaft operatively coupled to the rotatable permanent magnet via a lead screw, wherein a distal end of the distraction shaft is configured for attachment to a first region of the bone and wherein a proximal end of the actuator has a geometrically shaped hub of a male type. The system further includes an extension rod having at one end thereof a geometrically shaped hub of a female type configured to secure to the geometrically shaped hub of the male type disposed on the actuator, wherein an opposing end of the extension rod is configured for attachment to a second region of the bone.
- In yet another embodiment, a lengthening system is configured for placement inside an intramedullary canal of a bone. The system includes an actuator with a housing containing a rotatable permanent magnet and a moveable distraction shaft telescopically mounted relative the housing, the moveable distraction shaft operatively coupled to the rotatable permanent magnet via a lead screw, wherein a distal end of the distraction shaft is configured for attachment to a first region of the bone and wherein a proximal end of the actuator comprises a geometrically shaped hub of a female type. The system further includes an extension rod having at one end thereof a geometrically shaped hub of a male type configured to secure to the geometrically shaped hub of the female type disposed on the actuator, wherein an opposing end of the extension rod is configured for attachment to a second region of the bone.
- In still another aspect of the invention, an external adjustment device for adjusting an adjustable implant includes a power supply, a control module, and a handheld device comprising at least one permanent magnet. The handheld device is configured to be placed on a first side of a patient's limb and the at least one permanent magnet is configured to turn a cylindrical magnet located inside an adjustable implant. The control module is configured to restrict the number of turns of the cylindrical magnet located inside the adjustable implant.
-
FIG. 1 illustrates side view of an intramedullary lengthening device in place within a bone according to one embodiment. -
FIG. 2 illustrates a side view of the intramedullary lengthening device ofFIG. 1 . -
FIG. 3A illustrates a cross-sectional view of the intramedullary lengthening device ofFIGS. 1 and 2 taken along theline 3A-3A ofFIG. 2 . -
FIG. 3B illustrates a detailed view of the intramedullary lengthening device ofFIG. 3A from the area ofcircle 3B. -
FIG. 3C illustrates a cross-sectional view of the intramedullary lengthening device ofFIGS. 1 and 2 taken along theline 3C inFIG. 2 . -
FIG. 4A illustrates a view of several of the internal components of the intramedullary lengthening device of the prior FIGS. -
FIG. 4B illustrates a lip seal configured for use in the intramedullary lengthening device of the prior FIGS. -
FIG. 5 illustrates a detailed view of several internal components of the drive mechanism of the intramedullary lengthening device of the prior figures. -
FIG. 6 illustrates a perspective view of an external adjustment device. -
FIG. 7 illustrates an exploded view of the magnetic handpiece of the external adjustment device ofFIG. 6 . -
FIG. 8 illustrates a cross-sectional representation of a prior art electromagnetic external device being positioned around a patient's lower thigh. -
FIG. 9 illustrates a cross-sectional representation of the external adjustment device handpiece ofFIGS. 6 and 7 being positioned on a patient's lower thigh. -
FIG. 10 illustrates a sterilizable kit for use with a modular intramedullary lengthening device. -
FIG. 11 illustrates a modular intramedullary lengthening device according to one embodiment. -
FIG. 12 illustrates one end of the actuator of the intramedullary lengthening device ofFIG. 11 . -
FIG. 13 illustrates an extension rod of the modular intramedullary lengthening device. -
FIG. 14 illustrates a second view of the extension rod ofFIG. 13 . -
FIG. 15 illustrates a proximal drill guide for insertion and attachment of the modular intramedullary lengthening device. -
FIG. 16 illustrates a removal tool for removal of the modular intramedullary lengthening device. -
FIG. 17 illustrates a torque limiting driver for attaching the extension rod to the actuator of the modular intramedullary device. -
FIG. 18 illustrates a section of the actuator of the modular intramedullary lengthening device. -
FIG. 19 illustrates a gap (G) between a magnetic handpiece and an intramedullary lengthening device. -
FIG. 20 illustrates a locking screw driver for use with the intrameduallary lengthening device. -
FIG. 21A illustrates a locking screw for use with the intramedullary lengthening device. -
FIG. 21B illustrates the locking screw ofFIG. 21A taken alongline 21B-21B ofFIG. 21A . -
FIG. 1 illustrates the side view of anintramedullary lengthening device 110 which has been placed through a hole or bore 108 contained within abone 100. The hole or bore 108 may be made by drilling, reaming and the like and may extend through both cortical bone (at the end) and through cancellous (spongy) bone. Theintramedullary lengthening device 110 illustrated inFIG. 1 includes ahousing 112 and adistraction shaft 114. In order to grow or lengthen thebone 100, thebone 100 either has apre-existing separation 106 or is purposely cut or broken to create thisseparation 106, dividing the bone into afirst section 102 and asecond section 104. The cut may be done prior to inserting and securing theintramedullary lengthening device 110, or may be done after thedevice 110 is inserted, for example by use of a flexible Gigli saw. Thedistraction shaft 114 of theintramedullary lengthening device 110 is attached to thefirst section 102 using one or more attachment screws 118. Fasteners other thanscrews 118 known to those skilled in the art may also be used to secure thedistraction shaft 114 to thefirst section 102 of thebone 100. Thehousing 112 of theintramedullary lengthening device 110 is secured to thesecond section 104 ofbone 100 using one or more attachment screws 116. Again, fasteners other thanscrews 116 may be used to secure thehousing 112 to thesecond section 104 ofbone 100. - Over the treatment period, the
bone 100 is continually distracted, creating anew separation 106, into which osteogenesis can occur. Continually distracted is meant to indicate that distraction occurs on a regular basis which may be on the order of every day or every few days. An exemplary distraction rate is one millimeter per day although other distraction rates may be employed. That is to say, a typical distraction regimen may include a daily increase in the length of theintramedullary lengthening device 110 by about one millimeter. This may be done, for example, by four lengthening periods per day, each having 0.25 mm of lengthening. Theintramedullary lengthening device 110, as will be shown in the following FIGS., has a magnetic drive system, which allows thedistraction shaft 114 to be telescopically extended from thehousing 112, thus forcing thefirst section 102 and thesecond section 104 of thebone 100 apart from one another. As the distraction is performed, a portion of thehousing 112 is able to slide within the hole or bore 108 of thefirst section 102 ifbone 100 within adisplacement section 120. The orientation of theintramedullary lengthening device 110 within the bone may be opposite of that shown inFIG. 1 . For example, thedistraction shaft 114 may be coupled to thesecond section 104 of thebone 100 and thehousing 112 may be coupled to thefirst section 102 of thebone 100. For example, theintramedullary lengthening device 110 may be placed retrograde, from a hole or bore starting at the distal end of thebone 100. - Turning to
FIGS. 2 through 5 , theintramedullary lengthening device 110 has one or more distraction shaft screw holes 122 in thedistraction shaft 114 through which the screws 118 (FIG. 1 ) may be placed. Likewise, thehousing 112 is attached to anend cap 130 which has one or more housing screw holes 124 through which the screws 116 (FIG. 1 ) may be placed. Thehousing 112 of theintramedullary lengthening device 110 includes amagnet housing 128 and asplined housing 126. Thesehousings magnet housing 128 is sealably closed at one end (the end opposite the interface with the splined housing 126) by the attachment of theend cap 130. Theend cap 130 may be attached to themagnet housing 128 by means of welding, adhesive bonding or other joining techniques. In use, thedistraction shaft 114 is driven from thehousing 112 by means of alead screw 136 which turns inside anut 140 that is secured to an inner surface adjacent to acavity 137 of thedistraction shaft 114. Thelead screw 136 is mechanically coupled, in an indirect manner, to cylindricalpermanent magnet 134 contained within themagnet housing 128. As explained in more detail below, rotation of the cylindricalpermanent magnet 134, which is magnetically driven by an external adjustment device 180 (FIG. 6 ), effectuates rotation of thelead screw 136. -
Cylindrical magnet 134 is fixedly contained within amagnet casing 158 using, for example, an adhesive such as an epoxy. Themagnet casing 158 rotates relative to themagnet housing 128. Thecylindrical magnet 134 may be a rare earth magnet such as Nd—Fe—B and may be coated with Parylene or other protective coatings in addition to being protected within themagnet casing 158, for example hermetically potted with epoxy. Themagnet casing 158 contains anaxle 160 on one end which attaches to the interior of aradial bearing 132. The outer diameter of theradial bearing 132 is secured to the interior of theend cap 130. This arrangement allows thecylindrical magnet 134 to rotate with minimal torsional resistance. At its other, opposing end, themagnet housing 158 includes anaxle 161, which is attached to a first planetary gear set 154. Theaxle 161 includes the sun gear of the first planetary gear set 154, the sun gear turning the planetary gears of the first planetary gear set 154. The first planetary gear set 154 serves to reduce the rotational speed and increase the resultant torque delivery from thecylindrical magnet 134 to thelead screw 136. A second planetary gear set 156 is also shown between the first planetary gear set 154 and thelead screw 136, for further speed reduction and torque augmentation. The number of planetary gear sets and/or the number of teeth in the gears may be adjusted, in order to achieve the desired speed and torque delivery. For example, a lead screw with eighty (80) threads per inch attached to two planetary gear sets of 4:1 gear ratio each inside a 9 mm device with magnet location in the distal femur can achieve at least 100 lb. of distraction force at a greater than average distance or gap from the external device (FIG. 9 orFIG. 19 ). The planetary gear sets 154, 156 output to a planetarygear output shaft 144. The planetarygear output shaft 144 extends through athrust bearing 138 and is secured (by welding and the like) to a leadscrew coupling cap 146. Thelead screw 136 is secured to the leadscrew coupling cap 146 by alocking pin 142, which extends through a hole in thelead screw 136 and holes in the leadscrew coupling cap 146. A lockingpin retainer 148 is a cylinder that surrounds thelocking pin 142, holding this assembly together. Attaching thelead screw 136 to the rest of the magnet/gear assembly in this manner, assures that the design is not over-constrained, and thus that thelead screw 136 does not gall with thenut 140. In addition, a biocompatible grease, for example KRYTOX, may be used on the moving parts (lead screw, nut, bearings, housing, and distraction shaft) in order to minimize frictional losses. Thelead screw 136 is able to freely rotate within acavity 137 of thedistraction shaft 114, and only need engage with the short length of thenut 140, this feature also minimizing frictional losses. - The
thrust bearing 138 serves to protect the magnet/gear assembly of the drive from any significant compressive or tensile stresses. Thethrust bearing 138 consists of two separate races with ball bearings between the two races. When there is a compressive force on the device, for example, when distracting abone 100, and thus resisting the tensile strength of the soft tissues, thethrust bearing 138 abuts against a magnet housing abutment orlip 150 located in themagnet housing 128. Additionally, though the device is not typically intended for pulling bones together, there may be some applications where this is desired. For example, in certain compressive nail applications it is the goal to hold two fractured sections of a bone together. Because thebone 100 may have fractured in a non-uniform or shattered pattern, it may be difficult to determine the desired length of the nail until after it is implanted and fully attached. In these situations, it can be easy to misjudge the length, and so a gap may exist between the bones. By placing a slightly extendedintramedullary device 110 and securing it, thedevice 110 may be retracted magnetically, after it has been secured within the bone fragments, so that it applies the desired compression between the two fragments. In these compressive nail applications, there would be tensile force on thedevice 110 and thethrust bearing 138 would abut against a splined housing abutment orlip 152. In both situations, thethrust bearing 138 and a rigid portion of one of the housing sections take the large stresses, not the magnet/gear assembly of the drive system. In particular, thethrust bearing 138 is sandwiched between the abutment orlip 150 and the abutment orlip 152. - Turning specifically to
FIGS. 4A and 5 , the housing components have been removed to reveal various internal features, including a collar that allows sliding of thedistraction shaft 114 within thehousing 112, and which also keeps thedistraction shaft 114 from being able to rotate within thehousing 112. This allows full stability of thebone 100.Distraction shaft 114 contains severalaxial grooves 166. Thegrooves 166 have semi-circular indentation cross-sections which allowseveral balls 164 to roll within them. Theballs 164 are trapped within alinear ball cage 162. Thesplined housing 126 which fits over theballs 164 andlinear ball cage 162 has axial grooves 163 (FIG. 3C ) along its inner diameter surface that are similar to theaxial grooves 166 of thedistraction shaft 114. In this regard, theballs 164 and theball cage 162 are interposed between thedistraction shaft 114 and thesplined housing 126. Therefore, theballs 164 are held in place by thelinear ball cage 162, and mechanically lock the respective grooves to each other, thus impeding rotation of thedistraction shaft 114 within thehousing 112. However, theballs 164 are able to roll within thelinear ball cage 162, thus allowing axial displacement of thedistraction shaft 114 in relation to thesplined housing 126 of thehousing 112 with very low friction. Alip seal flange 168 contains a custom cross-section lip seal 169 (shown inFIG. 4B ) which allows a sliding seal between thedistraction shaft 114 and thesplined housing 126, thus protecting the inner contents of the entire assembly from the body environment. Thelip seal 169 includes abase portion 173, which seals against the inner diameter of the lip seal flange 168 (and thus thesplined housing 126 which is attached to the lip seal flange 168). Thelip seal 169 also includesprotrusions 171 which slidingly seal against theaxial grooves 166 of thedistraction shaft 114.Inner surface 175 of thelip seal 169 slidingly seals against the overall outer diameter of thedistraction shaft 114. It should also be noted that thelip seal 169 may be made from silicone, EPDM or other rubber materials, and may be coated with silicone oil, to aid in lubricity. Also, the balls, grooves and ball cage may be coated with silicone oil or a liquid perfluorinated polyether such as KRYTOX to aid in lubricity.FIG. 5 shows a portion of themagnet casing 158 removed so that theSouth pole 170 andNorth pole 172 of thecylindrical magnet 134 may be illustrated. -
FIG. 6 illustrates anexternal adjustment device 180 which is used to non-invasively distract theintramedullary lengthening device 110 by means of a magnetic coupling which transmits torque. Theexternal adjustment device 180 comprises amagnetic handpiece 178, acontrol box 176 and apower supply 174. Thecontrol box 176 includes acontrol panel 182 having one or more controls (buttons, switches or tactile, motion, audio or light sensors) and adisplay 184. Thedisplay 184 may be visual, auditory, tactile, the like or some combination of the aforementioned features. Theexternal adjustment device 180 may contain software which allows programming by the physician. For example, the physician may desire that the patient take home theexternal adjustment device 180 in order that the patient or member of the patient's family or friends make daily distractions of theintramedullary lengthening device 110 implanted in the patient. However, the physician is able to keep the person operating theexternal adjustment device 180 from over distracting the patient by programming this into thecontrol box 176. For example, the physician may pre-program thecontrol 176 box so that only one (1) mm of distraction is allowed per day. The physician may additionally pre-program thecontrol box 176 so that no more than 0.5 mm may be distracted during any two hour period, or that no more than 0.25 mm may be retracted during a five minute period. Settings such as these may serve to assure that the patient not be capable of causing severe damage to the bone or tissue, nor disrupt the lengthening process. - Preferably, such instructions or limits may be pre-programmed by the physician or even the manufacturer in a secure fashion such that user cannot alter the pre-programmed setting(s). For example, a security code may be used to pre-program and change the daily distraction limit (or other parameters). In this example, the person operating the
external adjustment device 180 will not be able to distract more than one (1) mm in a day (or more than two mm in a day), and will not have the security code to be able to change this function of theexternal adjustment device 180. This serves as a useful lockout feature to prevent accidental over-extension of theintramedullary lengthening device 110. The safety feature may monitor, for example, rotational movement ofmagnets 186 of theexternal adjustment device 180, described in more detail below, or the safety feature may monitor rotation of thecylindrical magnet 134 in theintramedullary lengthening device 110, via non-invasive sensing means. -
FIG. 7 shows the detail of themagnetic handpiece 178 of theexternal adjustment device 180, in order to elucidate the manner that themagnets 186 of the external device serve to cause thecylindrical magnet 134 of theintramedullary lengthening device 110 to turn. As seen inFIG. 7 , there are two (2)magnets 186 that have a cylindrical shape. Themagnets 186 are made from rare earth magnets. Themagnets 186 may have the same radial two pole configuration as thecylindrical magnet 134 seen inFIG. 5 . Themagnets 186 are bonded or otherwise secured withinmagnetic cups 187. Themagnetic cups 187 include ashaft 198 which is attached to afirst magnet gear 212 and asecond magnet gear 214, respectively. The orientation of the poles of each the twomagnets 186 are maintained in relation to each other by means of the gearing system (by use ofcenter gear 210, which meshes with bothfirst magnet gear 212 and second magnet gear 214). For example, it may be desired that the south pole of one of themagnets 186 is facing up whenever the south pole of theother magnet 186 is facing down. This arrangement, for example, maximizes the torque that can be placed on thecylindrical magnet 134 of theintramedullary lengthening device 110. - The components of the
magnetic handpiece 178 are held together between amagnet plate 190 and afront plate 192. Most of the components are protected by acover 216. Themagnets 186 rotate within astatic magnet cover 188, so that themagnetic handpiece 178 may be rested directly on the patient, while not imparting any motion to the external surfaces of the patient. Prior to distracting theintramedullary lengthening device 110, the operator places themagnetic handpiece 178 over the patient near the location of thecylindrical magnet 134 as seen inFIG. 9 . Amagnet standoff 194 that is interposed between the twomagnets 186 contains aviewing window 196, to aid in the placement. For instance, a mark made on the patient's skin at the appropriate location with an indelible marker may be viewed through theviewing window 196. To perform a distraction, the operator holds themagnetic handpiece 178 by itshandles 200 and depresses a distractswitch 228, causingmotor 202 to drive in a first direction. Themotor 202 has agear box 206 which causes the rotational speed of anoutput gear 204 to be different from the rotational speed of the motor 202 (for example, a slower speed). Theoutput gear 204 then turns areduction gear 208 which meshes withcenter gear 210, causing it to turn at a different rotational speed than thereduction gear 208. Thecenter gear 210 meshes with both thefirst magnet gear 212 and thesecond magnet gear 214 turning them at a rate which is identical to each other. Depending on the portion of the body where themagnets 186 of theexternal adjustment device 180 are located, it is desired that this rate be controlled, to minimize the resulting induced current density imparted bymagnet 186 andcylindrical magnet 134 though the tissues and fluids of the body. For example a magnet rotational speed of 60 RPM or less is contemplated although other speeds may be used such as 35 RPM or less. At any time, the distraction may be lessened by depressing the retractswitch 230. For example, if the patient feels significant pain, or numbness in the area being lengthened. - A cross section of a patient's
lower thigh 218 with theintramedullary lengthening device 110 implanted within thefemur 220 is shown inFIGS. 8 and 9 . InFIG. 9 , themagnetic handpiece 178 of theexternal adjustment device 180 of the invention is shown in position to adjust thecylindrical magnet 134 of theintramedullary lengthening device 110. InFIG. 8 , however, a scale depiction of a prior art magnetic stator “donut” 222 demonstrates the comparative efficiency of the two designs (FIG. 8 illustrates anintramedullary lengthening device 110 of the type described herein placed in a “prior art” magnetic stator “donut” 222). The prior art magnetic stator “donut” 222 is large, expensive, and difficult to transport to a patient's home for daily adjustments. In addition, the use of a circular cross-section as a one-size-fits-all device is not very efficient because of several reasons: the cross section of most limbs is not circular, the bone is usually not centered within the limb and patients' limbs come in many different sizes. InFIG. 8 , the thigh has been placed through the circular hole in the magnetic stator “donut” and theposterior portion 232 of the thigh rests at thelower portion 226 of the magnetic stator “donut” 222. The strength of a magnetic field decreases in accordance with a power (such as the inverse square) of the distance, depending on the complexity of the specific field geometry. Therefore, in any magnetic design, making the distance between the driving magnetic field and the driven magnet as small as possible is desirable. The size of the patient'slower thigh 218 and the decision to how it is placed within the magnetic stator “donut” 222 inFIG. 8 create a geometry so that the distance L1 between thecylindrical magnet 134 and theupper portion 224 of the magnetic stator “donut” 222 is about the same as the distance L2 between thecylindrical magnet 134 and thelower portion 226 of the magnetic stator “donut” 222. However, if theanterior portion 234 of the thigh were instead placed against theupper portion 224 of the magnetic stator “donut” 222, the length L1 would become less while the length L2 would become greater. Because each patient has a different sized limb, and because small limbs like the upper arm as well as large limbs such as the upper leg are desired for treatment, the magnetic stator “donut” 222 ofFIG. 8 is almost impossible to optimize. Therefore, an extra large magnetic field needs to be generated as the standard magnetic field of the device, thus requiring more expense (for the hardware to power this larger field). This in turn means that each patient will be exposed to a larger magnetic field and larger tissue and fluid current density than is really required. It may be desired, in some embodiments, to maintain patient exposure to magnetic fields of 2.0 Tesla or less during operation of the device. It may also be desired, according to another embodiment, to maintain patient exposure of the patient's tissues and fluids to current densities of no more than 0.04 Amperes/meters2 (rms). In addition, because theintramedullary lengthening device 110 is secured to thebone 100, unnecessarily large magnetic fields may cause unwanted motion of thebone 100, for example in any of the radial directions of thecylindrical magnet 134. If the magnetic field is too high, the patient's leg may be moved out of ideal position, and may even cause the patient some annoyance, including pain. - The configuration of the
magnetic handpiece 178 of theexternal adjustment device 180 as shown inFIG. 9 optimizes the ability of themagnets 186 to deliver torque to thecylindrical magnet 134 of theintramedullary lengthening device 110, without exposing the patient to large magnetic fields. This also allows thecylindrical magnet 134 of theintramedullary lengthening device 110 to be designed as small as possible, lowering the implant profile so that it may fit into the humerus, or the tibia and femurs of small stature patients, such as those who might desire cosmetic limb lengthening. As mentioned, a 9 mm diameter intramedullary lengthening device can deliver 100 lb. distraction force, and even 8 mm and 7 mm devices are contemplated. The alternating orientation of the two magnets 186 (i.e., north pole of onemagnet 186 corresponding with south pole of the other magnet 186) creates an additive effect of torque delivery tocylindrical magnet 134, and thus maximizes distraction force for any specificcylindrical magnet 134 size. Also, the separation (S) between the centers of the two magnets 186 (for example 70 mm), and the resulting concave contour 238 (FIGS. 6 and 7 ), match with the curvature of the outer surfaces of the majority of limbs, thus making the distances L3 and L4 between each of themagnets 186 and thecylindrical magnet 134 as small as possible. This is especially aided by theconcave contour 238 of themagnetic handpiece 178. Also, skin and fat may be compressed by the magnet covers 188 causing anindentation 236 on one or both sides which allows the distances L3 and L4 between each of themagnets 186 and thecylindrical magnet 134 to be yet smaller. -
FIG. 10 illustrates asterilizable kit 400 containing a plurality ofextension rods 406 which are configured to be attached to an actuator 412 (FIG. 11 ) in order to construct a modular intramedullary lengthening device 410 (FIG. 11 ). In a one embodiment, theactuator 412 is supplied sterile, and theextension rods 406 and the remainder of the contents of thesterilizable kit 400 are sterilizable by autoclave (e.g., steam), Ethylene Oxide or other methods known to those skilled in the art. Thesterilizable kit 400 contents includes one or more of theextension rods 406 andaccessories 408 for use in the insertion, attachment, adjustment and removal of the modularintramedullary lengthening device 410. The contents are located within a firststerilizable tray 402 and a secondsterilizable tray 404. Secondsterilizable tray 404 and firststerilizable tray 402 have a plurality ofholes 405 to allow gas to enter. Other items in thekit 400 will be described in several of the following figures. - Turning to
FIG. 11 the assembly of the modularintramedullary lengthening device 410 is shown. Theactuator 412 is designed to be placed in the bone of the patient in the opposite orientation than that of theintramedullary lengthening device 110 ofFIG. 1 . Therefore, thedistraction shaft 413 is orientated towards the distal end of the bone (distal is the down direction ofFIG. 11 ). Distal screw holes 415 in thedistraction shaft 413 allow the placement of distal locking screws 420. The distal locking screws 420 (FIGS. 21A and 21B ) haveproximal threads 417 for engaging the bone, while the remainder of theshaft 419 of the distal locking screws 420 is of a constant diameter for maximum strength and stability. At theproximal end 421 of theactuator 412 there is a hexagonally-shapedmale hub 414 containing atransverse set screw 416, within a threadedhole 429 of the hexagonal male hub 414 (FIG. 12 ). The extension rod 406 (FIGS. 13 and 14 ) has a correspondinghexagonal hole 428 or female end into which the hexagonalmale hub 414 of theactuator 412 is placed. Thetransverse set screw 416 is nested within the threadedhole 429 of the hexagonalmale hub 414 so that it does not interfere with thehexagonal hole 428 of theextension rod 406, when they are placed together. There are two set screw holes 422 in the wall of theextension rod 406 which are in line with each other. Theactuator 412 andextension rod 406 are placed together so that the set screw holes 422 extend coaxially with theset screw 416. This allows amale hex 490 of a set screw tightening driver, such as thetorque limiting driver 488 ofFIGS. 10 and 17 , to be inserted into a hex hole of theset screw 416. When thetorque limiting driver 488 is tightened and ratchets at its set control torque, the other end of theset screw 416, which is either threaded or a non threaded peg, inserts into the oppositeset screw hole 422, thus tightly securing theactuator 412 to theextension rod 406. The set screw holes 422 are sized to allow themale hex 490 to smoothly clear, but the non-threaded peg of theset screw 416 clear very slightly, making a static connection that cannot be easily loosened during implantation. If desired, bone cement may be placed in annulus ofset screw hole 422, to even further bond setscrew 416. Also, a second screw may be screwed in behind the head of the set screw into the female thread that theset screw 416 was originally nested in. The head of this second screw will add additional resistance to shear failure of theset screw 416. In addition, the second screw can be tightened so that it jams into theset screw 416, thus making back-out of theset screw 416 unlikely. Any non-circular cross-section may be used in place of the hex cross-section, for example a square or oval cross-section. - Proximal locking screws 418 insert through locking
screw holes 430 in theextension rod 406. Theextension rod 406 may be straight, or may have aspecific curve 432, for example, for matching the proximal end of the femur or tibia. It can be appreciated that the modular arrangement allows theactuator 412 to be attached to one of numerous different models ofextension rods 406, having different lengths, curves (including straight), diameters, hole diameters, and angulations. Thefirst sterilization tray 402 may include many of thesedifferent extension rods 406, which may be selected as appropriate, and attached to theactuator 412. Because theactuator 412 is supplied sterile, this arrangement is also desirable, as only a single model need be supplied. However, if desired, several models of actuator may exist, for example, different diameters (10.5 mm, 12.0 mm, 9 mm, 7.5 mm) or with different distal screw hole diameters, configurations or angulations. The preferred configuration for a multitude of patients and different bone types and sizes can be available, with a minimum number of sterile actuator models. - Turning to
FIG. 15 , aproximal drill guide 434 is illustrated and is configured for attaching to the modularintramedullary lengthening device 410 to ease its insertion into the intramedullary canal, the drilling of holes in the bone and the attachment of the proximal locking screws 418 to the bone. Theproximal drill guide 434 comprises anextension arm 436 attached to aconnection tube 446 through which alocking rod 448 is inserted. The lockingrod 448 has a lockingknob 450 at the proximal end and amale thread 452 at the distal end. In order to temporarily attach theproximal drill guide 434 to the modularintramedullary lengthening device 410, alocking tab 454 of theproximal drill guide 434 is inserted into a lockinggroove 424 of theextension rod 406 and the lockingknob 450 is turned, threading themale thread 452 of the lockingrod 448 into afemale thread 426 of theextension rod 406. Prior to the procedure adrill guide extension 438 is attached via aknob 440 to theextension arm 436. After reaming the medullary canal of the bone to a diameter slightly larger than the outer diameter of the modular intramedullary lengthening device 410 (for example 11 mm), distal end of the modularintramedually lengthening device 410 is inserted into the medullary canal and the flat proximal surface of the lockingknob 450 is hammered with a mallet, allowing the modularintramedullary lengthening device 410 to be inserted to the correct depth. Dimension X is sufficient to clear large thighs or hips (in the worst case femoral application). For example, 8 to 10 cm is appropriate. Once the modularintramedullary lengthening device 410 is in place in the medullary canal, theproximal drill guide 434 is left attached and aguide sleeve 442 is placed through one of theholes distal end 443 reaches the skin of the patient. Thedrill guide extension 438,extension arm 436 andholes guide sleeve 442 is oriented at the exact angle to allow drilling and placement of screws through the lockingscrews holes 430 of theextension rod 406 and through the bone. The skin of the patient is cut and adrill bushing 444 is placed through the incision, with the taperedtip 445 passing through tissue and reaching the bone to be drilled. For example, drills and locking screws may be inserted down thedrill bushing 444, or alternatively, drills may be inserted down thedrill bushing 444 and then, after the drilling is complete, thedrill bushing 444 is removed andproximal locking screw 418 is inserted down theguide sleeve 442. Alternative guide sleeves 464 anddrill bushings 466 can be placed throughholes FIG. 10 . - Turning to
FIG. 16 , aremoval tool 468 is illustrated. Theremoval tool 468 is used after the distraction period and consolidation period are complete. To remove the modularintramedullary lengthening device 410 from the medullary canal, the skin is incised and bone exposed at the locations of the proximal and distal locking screws 418, 420 and at the proximal end of the modularintramedullary lengthening device 410. Aremoval rod 470 is connected to thefemale thread 426 of theextension rod 406 of the modularintramedullary lengthening device 410 by inserting theengagement tip 476 and screwing themale thread 474 into thefemale thread 426, holding onto the lockingknob 472. The lockingknob 472 contains afemale thread 478 which allows the attachment of amale thread 486 of aremoval extension 480, which has animpact knob 482 andremoval hammer 484. Themale thread 486 is coupled to theremoval extension 480 by apivot 477 of apivoting base 479. Themale thread 486 is secured to thefemale thread 478 by grasping and turning theimpact knob 482. Prior to removing the modularintramedullary lengthening device 410, the proximal and distal locking screws 418, 420 are removed. They may be removed with the use of the locking screw driver 498 (FIGS. 10 and 20 ), which has amale hex tip 497 to engage the proximal ends of the locking screws 418, 420. A screw capture rod 500 (FIGS. 10 and 20 ) inserts down the center of the lockingscrew driver 498 and has a male threadedtip 501. At a deeper portion past thefemale hex 513 in the locking screws 418, 420 (FIGS. 21A and 21B ) is afemale thread 511. The male threadedtip 501 of thescrew capture rod 500 threads into thefemale thread 511 of the locking screws 418, 420, and tightened by using the tightening handle 503 of thescrew capture rod 500 which sits at thehandle end 509 of the lockingscrew driver 498 so that once the lockingscrews screw driver 498, and will not become prematurely displaced. For example, the locking screws 418, 420 will not be lost or dropped into the patient. The modularintramedullary lengthening device 410 may now be removed from the medullary canal by grasping theremoval hammer 484, and moving it quickly in the direction (D) so thathammer impact surface 485 strikesknob impact surface 483. This is done until the modularintramedullary lengthening device 410 is completely removed. It should be noted that lockingknob 450 of theproximal drill guide 434 ofFIG. 15 also has a female thread (not pictured) so that during the insertion of the modularintramedullary lengthening device 410, if it is desired to remove the device for any reason, themale thread 486 of theremoval tool 468 may be attached to the female thread of the lockingknob 450, and theremoval hammer 484 can be used against theimpact knob 482 to remove the modularintramedullary lengthening device 410. - The
torque limiting driver 488 ofFIG. 17 comprises ahandle 496 and ashaft 492 having a torque-specific ratchet 494 connecting them. Themale hex tip 490, fits into the hex hole of theset screw 416, or even into thefemale hex 513 of the locking screws 418, 420. An exemplary ratcheting torque for theset screw 416 is 9 inch-pounds (1.0 Newton-meter), and an exemplary hex size is 1/16″ (1.59 mm). -
FIG. 18 illustrates theactuator 412 ofFIG. 11 in a sectional view. The distal screw holes 415 are visible in thedistraction shaft 413. Thedistraction shaft 413 is shown in a fully extended position in relation to thehousing 312. Thecavity 337 has opened to its maximum length. In this embodiment, thedistraction shaft 413 has a purely cylindrical surface, and is dynamically sealed to thehousing 312 by two o-ring seals 502. The o-ring seals 502 may be made of silicone, EPDM, or other rubber materials, and may be coated with silicone oil, to aid in lubricity. There are four axially extendinggrooves 326 on the inner wall of thehousing 312.Tabs 504 on the end of thedistraction shaft 413 fit into thesegrooves 326 to keep thedistraction shaft 413 from being able to rotate with respect to thehousing 312. Thehousing 312 is welded to amagnet housing 328 and themagnet housing 328 is welded to hexagonalmale hub 414. Theset screw 416 on the hexagonalmale hub 414 is used to attach theactuator 412 to theextension rod 406. The cylindricalpermanent magnet 334 is cased with epoxy insidemagnet casing 358 having anend pin 360. Theend pin 360 inserts throughradial bearing 332, allowing it to rotate with low friction. As themagnet 334 is rotated by the external magnets, first planetary gear set 354, second planetary gear set 356 and third planetary gear set 357 allow a total reduction of 64:1 (4×4×4). Each gear set allows a 4:1 reduction. Planetarygear output shaft 344 is attached to leadscrew 336 by lockingpin 342, and lockingpin 342 is held in place by cylindricallocking pin retainer 348.Thrust bearing 338 abuts housing abutment orlip 352 and magnet housing abutment or lip 350 (thrustbearing 338 is sandwiched between housing abutment orlip 352 and magnet housing abutment or lip 350). Therefore, thrustbearing 338 abuts housing abutment orlip 352 in tension and magnet housing abutment orlip 350 in compression. It should be noted that the sandwich arrangement allows for some slop or play between thethrust bearing 338 and the housing abutment orlip 352 and the magnet housing abutment orlip 350.Lead screw 336 engages withnut 340, which is secured withindistraction shaft 413. With the 64:1 gear reduction of this embodiment, distraction forces of greater than 300 pounds (1334 Newtons) have been consistently achieved with a gap (G inFIG. 19 ) of 2 inches (5.08 cm) between themagnetic hand piece 178 and theintramedullary lengthening device 110. This is sufficient for distracting a large range of typical patients. - It should be noted that although the embodiments of the intramedullary lengthening devices presented are shown to be used in a preferred orientation (distal vs. proximal), any of these embodiments may be used with the distraction shaft pointing distally or proximally. In addition, the invention may also be applied to distractable bone plates that are not located within the intramedullary canal, but are external to the bone.
- An alternative lengthening scheme than those presented above may be also used. For example, one alternative includes the purposeful over-lengthening (to further stimulate growth) followed by some retraction (to minimize pain). For instance, each of four daily 0.25 mm lengthening periods may consist of 0.35 mm of lengthening, followed by 0.10 mm of retraction.
- The materials of the
accessories 408 are medical grade stainless steel, though other materials of varying densities may be used depending on the desired weight and the required size. The majority of the components of the intramedullary lengthening devices are preferably Titanium or Titanium alloys although some of the internal components may be made from stainless steel. - While embodiments of the present invention have been shown and described, various modifications may be made without departing from the scope of the present invention. As one example, the devices described herein may be used to lengthen or reform a number of other bones such as the mandible or the cranium. The invention, therefore, should not be limited, except to the following claims, and their equivalents.
Claims (25)
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Families Citing this family (80)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11241257B2 (en) | 2008-10-13 | 2022-02-08 | Nuvasive Specialized Orthopedics, Inc. | Spinal distraction system |
CN105943145B (en) * | 2008-10-31 | 2020-09-08 | 伊姆普兰蒂卡专利有限公司 | Device and method for bone adjustment using wireless energy transmission |
KR101710741B1 (en) | 2009-09-04 | 2017-02-27 | 누베이시브 스페셜라이즈드 오소페딕스, 인크. | Bone growth device and method |
FR2949662B1 (en) * | 2009-09-09 | 2011-09-30 | Arnaud Soubeiran | INTRA-BODY DEVICE FOR MOVING TISSUE |
US8858555B2 (en) | 2009-10-05 | 2014-10-14 | Stryker Trauma Sa | Dynamic external fixator and methods for use |
US8357162B2 (en) * | 2010-01-13 | 2013-01-22 | Paul Christopher Frake | Intramedullary mandibular condyle implants and method for application of the same |
US8777947B2 (en) * | 2010-03-19 | 2014-07-15 | Smith & Nephew, Inc. | Telescoping IM nail and actuating mechanism |
US9044256B2 (en) * | 2010-05-19 | 2015-06-02 | Board Of Regents, The University Of Texas System | Medical devices, apparatuses, systems, and methods |
US8945128B2 (en) | 2010-08-11 | 2015-02-03 | Stryker Trauma Sa | External fixator system |
US11141196B2 (en) | 2010-08-11 | 2021-10-12 | Stryker European Operations Holdings Llc | External fixator system |
EP2417924B1 (en) | 2010-08-11 | 2015-07-01 | Stryker Trauma SA | External fixator system |
US8961567B2 (en) | 2010-11-22 | 2015-02-24 | DePuy Synthes Products, LLC | Non-fusion scoliosis expandable spinal rod |
US8852187B2 (en) | 2011-02-14 | 2014-10-07 | Ellipse Technologies, Inc. | Variable length device and method |
US9387013B1 (en) | 2011-03-01 | 2016-07-12 | Nuvasive, Inc. | Posterior cervical fixation system |
WO2012134308A1 (en) * | 2011-03-25 | 2012-10-04 | Orthopaedic International, Inc. | Instrument for locating distal screw holes in intramedullary nails |
KR101221220B1 (en) | 2011-04-26 | 2013-01-11 | 연세대학교 산학협력단 | Cylinder for continuous bone distraction and continuous bone distraction apparatus using the same |
EP2712304A4 (en) | 2011-05-16 | 2015-06-17 | Smith & Nephew Inc | Measuring skeletal distraction |
JP5927297B2 (en) * | 2011-08-18 | 2016-06-01 | ミリッツ マティーアス | Medical device for bone expansion |
DE102011053638A1 (en) * | 2011-09-15 | 2013-03-21 | Wittenstein Ag | Mark Nagel |
US10016226B2 (en) | 2011-12-12 | 2018-07-10 | Children's Hospital Medical Center Of Akron | Noninvasive device for adjusting fastener |
EP2790600B1 (en) | 2011-12-12 | 2017-04-26 | Austen Bioinnovation Institute in Akron | Noninvasive device for adjusting fastener |
TR201202105A2 (en) * | 2012-02-24 | 2012-12-21 | İstemi̇ Alp Yücel İrşadi̇ | Magnetically extending nail. |
US20130338714A1 (en) | 2012-06-15 | 2013-12-19 | Arvin Chang | Magnetic implants with improved anatomical compatibility |
US9101398B2 (en) | 2012-08-23 | 2015-08-11 | Stryker Trauma Sa | Bone transport external fixation frame |
US9044281B2 (en) | 2012-10-18 | 2015-06-02 | Ellipse Technologies, Inc. | Intramedullary implants for replacing lost bone |
US20140155946A1 (en) | 2012-10-29 | 2014-06-05 | Ellipse Technologies, Inc. | Adjustable devices for treating arthritis of the knee |
WO2014124328A1 (en) | 2013-02-08 | 2014-08-14 | Gorsline Robert | Systems, methods, apparatuses for fusion, stabilization, or fixation of bones |
US9855063B2 (en) | 2013-02-28 | 2018-01-02 | Jonathan Feibel | Systems, methods, and apparatuses for reaming bone elements |
WO2014137909A1 (en) | 2013-03-04 | 2014-09-12 | Mechano-Transduction, Llc | Dynamic force generation for bone repair |
US9179938B2 (en) | 2013-03-08 | 2015-11-10 | Ellipse Technologies, Inc. | Distraction devices and method of assembling the same |
TWI516696B (en) * | 2013-05-03 | 2016-01-11 | Timotion Technology Co Ltd | Electric cylinder with cushioning structure |
US10226242B2 (en) | 2013-07-31 | 2019-03-12 | Nuvasive Specialized Orthopedics, Inc. | Noninvasively adjustable suture anchors |
US20150105834A1 (en) * | 2013-10-11 | 2015-04-16 | Ellipse Technologies, Inc. | Methods and apparatus for bone reshaping |
EP3125792B1 (en) * | 2014-03-28 | 2019-01-02 | DePuy Synthes Products, Inc. | Bone distraction system |
WO2015184397A1 (en) | 2014-05-30 | 2015-12-03 | Texas Tech University System | Internal bone lengthener device and method of use thereof |
JP6271363B2 (en) * | 2014-07-23 | 2018-01-31 | 帝人メディカルテクノロジー株式会社 | Medical screwdriver |
DE102014112573A1 (en) * | 2014-09-01 | 2016-03-03 | Wittenstein Ag | Mark Nagel |
US9931138B2 (en) * | 2014-10-15 | 2018-04-03 | Globus Medical, Inc. | Orthopedic extendable rods |
KR20230116081A (en) | 2014-12-26 | 2023-08-03 | 누베이시브 스페셜라이즈드 오소페딕스, 인크. | Systems and methods for distraction |
US10357314B2 (en) | 2015-07-08 | 2019-07-23 | Stryker European Holdings I, Llc | Instrumentation and method for repair of a bone fracture |
FR3044888A1 (en) * | 2015-12-09 | 2017-06-16 | Ecole Nat Superieure De Techniques Avancees | PLATE DISTRACTOR AND ASSEMBLY OF SUCH A PLATE DISTRACTOR AND AN ACTIVATION TOOL |
WO2017100774A1 (en) | 2015-12-10 | 2017-06-15 | Nuvasive Specialized Orthopedics, Inc. | External adjustment device for distraction device |
US10327789B2 (en) | 2015-12-29 | 2019-06-25 | Medos International Sarl | Methods and systems for preparing bone for a surgical procedure |
EP3656323B1 (en) * | 2016-01-28 | 2021-06-23 | NuVasive Specialized Orthopedics, Inc. | Systems for bone transport |
WO2017139785A1 (en) | 2016-02-12 | 2017-08-17 | Nuvasive, Inc. | Post-operatively adjustable spinal fixation devices |
WO2017139782A1 (en) | 2016-02-12 | 2017-08-17 | Nuvasive, Inc. | Post-operatively adjustable angled rod |
US11446063B2 (en) | 2016-02-12 | 2022-09-20 | Nuvasive, Inc. | Post-operatively adjustable angled rod |
US10456172B2 (en) | 2016-02-12 | 2019-10-29 | Nuvasive, Inc. | Magnetically actuateable rod insertion for minimally invasive surgery |
CN105686872B (en) * | 2016-03-10 | 2019-02-05 | 成都新澳冠医疗器械有限公司 | A kind of bridge joint combination internal fixation system for Limb lengthening |
US11065037B2 (en) | 2016-05-19 | 2021-07-20 | Auctus Surgical, Inc. | Spinal curvature modulation systems and methods |
US10010350B2 (en) | 2016-06-14 | 2018-07-03 | Stryker European Holdings I, Llc | Gear mechanisms for fixation frame struts |
WO2018081831A1 (en) * | 2016-10-31 | 2018-05-03 | Epix Orthopaedics, Inc. | Sterilization tray for facilitating attachment of implant insertion device to implantable device |
WO2018102101A2 (en) * | 2016-11-09 | 2018-06-07 | Children's Hospital Medical Center Of Akron | Distraction osteogenesis system |
KR101750913B1 (en) * | 2017-01-09 | 2017-06-26 | 원유건 | Device for fixing spine |
US10874433B2 (en) | 2017-01-30 | 2020-12-29 | Stryker European Holdings I, Llc | Strut attachments for external fixation frame |
WO2018144386A1 (en) * | 2017-02-02 | 2018-08-09 | Smith & Nephew, Inc. | Implantable bone adjustment devices |
DE102017107259A1 (en) * | 2017-04-04 | 2018-10-04 | Karl Leibinger Medizintechnik Gmbh & Co. Kg | Skull bone segment positioning device, positioning device manufacturing method and positioning device system with attachment devices |
IT201700048446A1 (en) * | 2017-05-04 | 2018-11-04 | Orthofix Srl | Improved bone screw for the treatment of sagging or bone deformation, such as in the case of the Charcot foot, and insertion instruments in the bone screw of anti-migration elements |
CN107280747B (en) * | 2017-07-25 | 2024-04-02 | 魏巍 | Intramedullary pin |
US10667850B2 (en) * | 2017-08-17 | 2020-06-02 | Spinal Generations, Llc | Modular femoral nail and method of use thereof |
PL3491998T3 (en) | 2017-11-30 | 2021-11-15 | Endotact | Implantable distraction device |
CN109276300B (en) * | 2018-08-09 | 2020-12-18 | 盐城日升月恒智能科技有限公司 | Intramedullary and extramedullary combined bevel gear bone lengthening device |
CN108904026A (en) * | 2018-08-13 | 2018-11-30 | 北京大学人民医院 | It can be used for the electromagnetic drive intramedullary needle of bone carrying |
US10653469B2 (en) | 2018-09-04 | 2020-05-19 | Biosense Webster (Israel) Ltd. | Orthopedic implant installation using magnetically driven screws |
WO2020131292A1 (en) * | 2018-12-19 | 2020-06-25 | Dadourian Gregory Haig | Compressive intramedullary rod |
US11589901B2 (en) | 2019-02-08 | 2023-02-28 | Nuvasive Specialized Orthopedics, Inc. | External adjustment device |
DE102019122354A1 (en) * | 2019-08-20 | 2021-02-25 | Orthofix Srl | Intramedullary nail for distraction of a long bone |
US11523854B2 (en) * | 2019-09-12 | 2022-12-13 | DePuy Synthes Products, Inc. | Driver and system for threaded intramedullary nail retaining endcaps |
CN110584841B (en) * | 2019-09-30 | 2024-04-12 | 北京爱康宜诚医疗器材有限公司 | Extensible prosthesis |
WO2022015898A1 (en) | 2020-07-17 | 2022-01-20 | Nuvasive Specialized Orthopedics, Inc. | Extramedullary device and system |
CN112915389A (en) * | 2021-01-20 | 2021-06-08 | 清华大学 | Bone growth assisting system and flexible magnetic field generator |
JP2024508252A (en) | 2021-02-16 | 2024-02-26 | テトラビジョン,エルエルシー | Spinal alignment system with thermally actuated components |
US20220265327A1 (en) | 2021-02-23 | 2022-08-25 | Nuvasive Specialized Orthopedics, Inc. | Adjustable implant, system and methods |
US11737787B1 (en) | 2021-05-27 | 2023-08-29 | Nuvasive, Inc. | Bone elongating devices and methods of use |
EP4153077A1 (en) | 2021-06-04 | 2023-03-29 | NuVasive Specialized Orthopedics, Inc. | Adjustable implant with advanced sealing and retention |
WO2022271550A1 (en) | 2021-06-25 | 2022-12-29 | Nuvasive Specialized Orthopedics, Inc. | Adjustable implant, system and methods |
AU2022325024A1 (en) | 2021-08-03 | 2024-02-22 | Nuvasive Specialized Orthopedics, Inc. | Adjustable implant |
CN113558740B (en) * | 2021-08-04 | 2023-07-14 | 西安市红会医院 | Bone cement self-stirring pusher for vertebroplasty |
WO2023107823A1 (en) | 2021-12-07 | 2023-06-15 | Nuvasive Specialized Orthopedics, Inc. | Adjustable implant with cycloid gears |
CN116919556A (en) * | 2023-08-03 | 2023-10-24 | 上海康定医疗器械有限公司 | Bone extension intramedullary nail device and electromagnetic intramedullary limb reconstruction system |
Citations (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3915151A (en) * | 1973-03-23 | 1975-10-28 | Werner Kraus | Apparatus for promoting healing processes |
US4731051A (en) * | 1979-04-27 | 1988-03-15 | The Johns Hopkins University | Programmable control means for providing safe and controlled medication infusion |
US5142407A (en) * | 1989-12-22 | 1992-08-25 | Donnelly Corporation | Method of reducing leakage current in electrochemichromic solutions and solutions based thereon |
US20030204274A1 (en) * | 2002-04-26 | 2003-10-30 | Medtronic, Inc. | Patient controlled activation with implantable drug delivery devices |
US20060006944A1 (en) * | 2001-06-29 | 2006-01-12 | Renesas Technology Corp. | High frequency power amplifier circuit |
US20070027080A1 (en) * | 2005-07-29 | 2007-02-01 | Abburi Ramaiah | Method for treatment of vitiligo |
US20080003343A1 (en) * | 2006-06-29 | 2008-01-03 | Patriek Destrooper | Dissolving element |
US20090112262A1 (en) * | 2007-10-30 | 2009-04-30 | Scott Pool | Skeletal manipulation system |
US20090125062A1 (en) * | 2007-11-08 | 2009-05-14 | Uri Arnin | Spinal implant having a post-operative adjustable dimension |
US20100094302A1 (en) * | 2008-10-13 | 2010-04-15 | Scott Pool | Spinal distraction system |
US20100121323A1 (en) * | 2008-11-10 | 2010-05-13 | Ellipse Technologies, Inc. | External adjustment device for distraction device |
US7753915B1 (en) * | 2007-06-14 | 2010-07-13 | August Eksler | Bi-directional bone length adjustment system |
Family Cites Families (582)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2702031A (en) | 1953-09-25 | 1955-02-15 | Wenger Herman Leslie | Method and apparatus for treatment of scoliosis |
US3111945A (en) | 1961-01-05 | 1963-11-26 | Solbrig Charles R Von | Bone band and process of applying the same |
US3333333A (en) | 1963-08-14 | 1967-08-01 | Rca Corp | Method of making magnetic material with pattern of embedded non-magnetic material |
US3377576A (en) | 1965-05-03 | 1968-04-09 | Metcom Inc | Gallium-wetted movable electrode switch |
US3372476A (en) | 1967-04-05 | 1968-03-12 | Amp Inc | Method of making permanent connections between interfitting parts |
USRE28907E (en) | 1967-06-05 | 1976-07-20 | Self-tapping threaded bushings | |
FR1556730A (en) | 1967-06-05 | 1969-02-07 | ||
US3512901A (en) | 1967-07-28 | 1970-05-19 | Carrier Corp | Magnetically coupled pump with slip detection means |
US3810259A (en) | 1971-01-25 | 1974-05-14 | Fairchild Industries | Implantable urinary control apparatus |
US3817237A (en) | 1972-08-24 | 1974-06-18 | Medtronic Inc | Regulatory apparatus |
GB1467248A (en) | 1973-07-30 | 1977-03-16 | Horstmann Magnetics Ltd | Electric motors |
US3892182A (en) | 1973-12-10 | 1975-07-01 | Cbf Systems Inc | Squib control circuit |
CH581988A5 (en) | 1974-04-09 | 1976-11-30 | Messerschmitt Boelkow Blohm | |
US3900025A (en) | 1974-04-24 | 1975-08-19 | Jr Walter P Barnes | Apparatus for distracting or compressing longitudinal bone segments |
FI53062C (en) | 1975-05-30 | 1978-02-10 | Erkki Einari Nissinen | |
US4010758A (en) | 1975-09-03 | 1977-03-08 | Medtronic, Inc. | Bipolar body tissue electrode |
US4068821A (en) | 1976-09-13 | 1978-01-17 | Acf Industries, Incorporated | Valve seat ring having a corner groove to receive an elastic seal ring |
SU715082A1 (en) | 1977-01-24 | 1980-02-15 | Всесоюзный научно-исследовательский и испытательный институт медицинской техники | Surgical suturing apparatus |
DE2705154C2 (en) | 1977-02-08 | 1986-02-20 | Friedrich Prof. Dr.Med. 8858 Neuburg Baumann | Bone marrow nail and aiming device for this bone marrow nail |
US4357946A (en) | 1980-03-24 | 1982-11-09 | Medtronic, Inc. | Epicardial pacing lead with stylet controlled helical fixation screw |
US4386603A (en) | 1981-03-23 | 1983-06-07 | Mayfield Jack K | Distraction device for spinal distraction systems |
US4448191A (en) | 1981-07-07 | 1984-05-15 | Rodnyansky Lazar I | Implantable correctant of a spinal curvature and a method for treatment of a spinal curvature |
FR2514250A1 (en) | 1981-10-08 | 1983-04-15 | Artus | HANDPIECE WITH INTEGRATED MOTOR |
FR2523232B1 (en) | 1982-03-09 | 1985-09-20 | Thomson Csf | TELESCOPIC COLUMN WITH CYLINDRICAL TUBES |
CH648723GA3 (en) | 1982-09-10 | 1985-04-15 | ||
DE3340596A1 (en) | 1982-11-16 | 1984-05-24 | Tokyo Electric Co., Ltd., Tokyo | MATRIX PRINTER |
IL67773A (en) | 1983-01-28 | 1985-02-28 | Antebi E | Tie for tying live tissue and an instrument for performing said tying operation |
DE3306657C2 (en) | 1983-02-25 | 1986-12-11 | Fa. Heinrich C. Ulrich, 7900 Ulm | Spine correction implant with a distraction rod |
US4501266A (en) | 1983-03-04 | 1985-02-26 | Biomet, Inc. | Knee distraction device |
US4595007A (en) | 1983-03-14 | 1986-06-17 | Ethicon, Inc. | Split ring type tissue fastener |
FR2551350B1 (en) | 1983-09-02 | 1985-10-25 | Buffet Jacques | FLUID INJECTION DEVICE, SUITABLE FOR IMPLANTATION |
US4522501A (en) | 1984-04-06 | 1985-06-11 | Northern Telecom Limited | Monitoring magnetically permeable particles in admixture with a fluid carrier |
US4573454A (en) | 1984-05-17 | 1986-03-04 | Hoffman Gregory A | Spinal fixation apparatus |
SE450153B (en) * | 1985-01-22 | 1987-06-09 | Ffv Affersverket | TELESCOPE CONTROL, SPECIAL FOR TRANSMISSION OF TORQUE |
US4570944A (en) * | 1985-05-15 | 1986-02-18 | W. S. Shamban & Company | Seal assembly with reduced wear low pressure sealing ring |
DE8515687U1 (en) | 1985-05-29 | 1985-10-24 | Aesculap-Werke Ag Vormals Jetter & Scheerer, 7200 Tuttlingen | Distraction device for extension osteotomy |
US4642257A (en) | 1985-06-13 | 1987-02-10 | Michael Chase | Magnetic occluding device |
US4931055A (en) | 1986-05-30 | 1990-06-05 | John Bumpus | Distraction rods |
US4776330A (en) | 1986-06-23 | 1988-10-11 | Pfizer Hospital Products Group, Inc. | Modular femoral fixation system |
US4700091A (en) | 1986-08-22 | 1987-10-13 | Timex Corporation | Bipolar stepping motor rotor with drive pinion and method of manufacture |
SE460301B (en) | 1986-10-15 | 1989-09-25 | Sandvik Ab | CUTTING ROD FOR STOCKING DRILLING MACHINE |
DE8704134U1 (en) | 1987-03-19 | 1987-07-16 | Zielke, Klaus, Dr.Med., 3590 Bad Wildungen, De | |
DE8704901U1 (en) | 1987-04-02 | 1987-07-23 | Kluger, Patrick, Dr.Med., 3590 Bad Wildungen, De | |
SU1528471A1 (en) | 1987-06-19 | 1989-12-15 | Московский медицинский стоматологический институт им.Н.А.Семашко | Arrangement for intramedullar osteosynthesis |
DE3728686A1 (en) | 1987-08-27 | 1989-03-09 | Draenert Klaus | PREDICTABLE SURGICAL NETWORK |
US4940467A (en) | 1988-02-03 | 1990-07-10 | Tronzo Raymond G | Variable length fixation device |
FR2632514B1 (en) | 1988-06-09 | 1990-10-12 | Medinov Sarl | PROGRESSIVE CENTRO-MEDULAR NAIL |
US4904861A (en) | 1988-12-27 | 1990-02-27 | Hewlett-Packard Company | Optical encoder using sufficient inactive photodetectors to make leakage current equal throughout |
US4973331A (en) | 1989-03-08 | 1990-11-27 | Autogenesis Corporation | Automatic compression-distraction-torsion method and apparatus |
JPH0620466B2 (en) | 1989-03-31 | 1994-03-23 | 有限会社田中医科器械製作所 | Spinal column correction device |
US5092889A (en) | 1989-04-14 | 1992-03-03 | Campbell Robert M Jr | Expandable vertical prosthetic rib |
US5053047A (en) | 1989-05-16 | 1991-10-01 | Inbae Yoon | Suture devices particularly useful in endoscopic surgery and methods of suturing |
DE3921972C2 (en) | 1989-07-04 | 1994-06-09 | Rainer Dr Med Baumgart | Intramedullary nail |
IT1236172B (en) | 1989-11-30 | 1993-01-11 | Franco Mingozzi | EXTERNAL FIXER FOR THE TREATMENT OF LONG BONE FRACTURES OF THE LIMBS. |
US5116378A (en) | 1990-01-23 | 1992-05-26 | Orthovations, Inc. | Method and apparatus for expanding a shaft for use in prosthesis |
US5030235A (en) | 1990-04-20 | 1991-07-09 | Campbell Robert M Jr | Prosthetic first rib |
US5290289A (en) | 1990-05-22 | 1994-03-01 | Sanders Albert E | Nitinol spinal instrumentation and method for surgically treating scoliosis |
RU1782564C (en) | 1990-05-23 | 1992-12-23 | Кооперативное Объединение "Ялос" | Appliance for bone stretching |
US5156605A (en) | 1990-07-06 | 1992-10-20 | Autogenesis Corporation | Automatic internal compression-distraction-method and apparatus |
US5122141A (en) | 1990-08-30 | 1992-06-16 | Zimmer, Inc. | Modular intramedullary nail |
US5133716A (en) | 1990-11-07 | 1992-07-28 | Codespi Corporation | Device for correction of spinal deformities |
US5098435A (en) | 1990-11-21 | 1992-03-24 | Alphatec Manufacturing Inc. | Cannula |
DE9115200U1 (en) | 1991-12-07 | 1992-02-13 | Howmedica Gmbh, 2314 Schoenkirchen, De | |
DE9115810U1 (en) | 1991-12-20 | 1992-02-20 | Howmedica Gmbh, 2314 Schoenkirchen, De | |
CA2137660C (en) | 1992-06-08 | 2004-02-03 | Robert M. Campbell Jr. | Segmental rib carriage instrumentation and associated methods |
US5437266A (en) | 1992-07-02 | 1995-08-01 | Mcpherson; William | Coil screw surgical retractor |
US5676651A (en) | 1992-08-06 | 1997-10-14 | Electric Boat Corporation | Surgically implantable pump arrangement and method for pumping body fluids |
US5466261A (en) | 1992-11-19 | 1995-11-14 | Wright Medical Technology, Inc. | Non-invasive expandable prosthesis for growing children |
US5306275A (en) | 1992-12-31 | 1994-04-26 | Bryan Donald W | Lumbar spine fixation apparatus and method |
US5458640A (en) * | 1993-01-29 | 1995-10-17 | Gerrone; Carmen J. | Cannula valve and seal system |
US5336223A (en) | 1993-02-04 | 1994-08-09 | Rogers Charles L | Telescoping spinal fixator |
US5356424A (en) | 1993-02-05 | 1994-10-18 | American Cyanamid Co. | Laparoscopic suturing device |
US5429638A (en) | 1993-02-12 | 1995-07-04 | The Cleveland Clinic Foundation | Bone transport and lengthening system |
US5626579A (en) | 1993-02-12 | 1997-05-06 | The Cleveland Clinic Foundation | Bone transport and lengthening system |
US5536269A (en) | 1993-02-18 | 1996-07-16 | Genesis Orthopedics | Bone and tissue lengthening device |
US5356411A (en) | 1993-02-18 | 1994-10-18 | Spievack Alan R | Bone transporter |
US5516335A (en) * | 1993-03-24 | 1996-05-14 | Hospital For Joint Diseases Orthopaedic Institute | Intramedullary nail for femoral lengthening |
US5364396A (en) | 1993-03-29 | 1994-11-15 | Robinson Randolph C | Distraction method and apparatus |
US5334202A (en) | 1993-04-06 | 1994-08-02 | Carter Michael A | Portable bone distraction apparatus |
US5527309A (en) | 1993-04-21 | 1996-06-18 | The Trustees Of Columbia University In The City Of New York | Pelvo-femoral fixator |
US5403322A (en) | 1993-07-08 | 1995-04-04 | Smith & Nephew Richards Inc. | Drill guide and method for avoiding intramedullary nails in the placement of bone pins |
FR2709246B1 (en) | 1993-08-27 | 1995-09-29 | Martin Jean Raymond | Dynamic implanted spinal orthosis. |
US5505733A (en) | 1993-10-22 | 1996-04-09 | Justin; Daniel F. | Intramedullary skeletal distractor and method |
US5468030A (en) | 1994-01-04 | 1995-11-21 | Caterpillar Inc. | Tube clamp and coupling |
AU1011595A (en) | 1994-01-13 | 1995-07-20 | Ethicon Inc. | Spiral surgical tack |
US5762599A (en) | 1994-05-02 | 1998-06-09 | Influence Medical Technologies, Ltd. | Magnetically-coupled implantable medical devices |
US6649143B1 (en) | 1994-07-01 | 2003-11-18 | The Board Of Trustees Of The Leland Stanford Junior University | Non-invasive localization of a light-emitting conjugate in a mammal |
US5489284A (en) | 1994-07-15 | 1996-02-06 | Smith & Nephew Richards Inc. | Cannulated modular intramedullary nail |
US5620445A (en) | 1994-07-15 | 1997-04-15 | Brosnahan; Robert | Modular intramedullary nail |
US5509888A (en) | 1994-07-26 | 1996-04-23 | Conceptek Corporation | Controller valve device and method |
IT1268313B1 (en) | 1994-07-28 | 1997-02-27 | Orthofix Srl | MECHANICAL EQUIPMENT FOR CENTERING BLIND HOLES FOR BONE SCREWS OF INTRAMIDOLLAR NAILS |
US5582616A (en) | 1994-08-05 | 1996-12-10 | Origin Medsystems, Inc. | Surgical helical fastener with applicator |
US5573012A (en) | 1994-08-09 | 1996-11-12 | The Regents Of The University Of California | Body monitoring and imaging apparatus and method |
JP2998575B2 (en) | 1994-10-20 | 2000-01-11 | 日産自動車株式会社 | Catalyst deterioration diagnosis device for internal combustion engine |
US5549610A (en) | 1994-10-31 | 1996-08-27 | Smith & Nephew Richards Inc. | Femoral intramedullary nail |
CN1045531C (en) | 1994-11-16 | 1999-10-13 | 安德烈·阿尔诺·苏贝朗 | Device for mutually moving two bodies |
US5659217A (en) | 1995-02-10 | 1997-08-19 | Petersen; Christian C. | Permanent magnet d.c. motor having a radially-disposed working flux gap |
FR2730406B1 (en) | 1995-02-13 | 1997-08-14 | Medinov Sa | IMPROVED LENGTHENING DEVICE FOR LONG BONES |
US5575790A (en) | 1995-03-28 | 1996-11-19 | Rensselaer Polytechnic Institute | Shape memory alloy internal linear actuator for use in orthopedic correction |
US5536296A (en) | 1995-05-03 | 1996-07-16 | Alumax Inc. | Process for treating molten aluminum with chlorine gas and sulfur hexafluoride to remove impurities |
US5626613A (en) | 1995-05-04 | 1997-05-06 | Arthrex, Inc. | Corkscrew suture anchor and driver |
US5662683A (en) | 1995-08-22 | 1997-09-02 | Ortho Helix Limited | Open helical organic tissue anchor and method of facilitating healing |
JP3338944B2 (en) | 1995-08-25 | 2002-10-28 | 有限会社田中医科器械製作所 | Spinal deformity correction device |
US5771903A (en) | 1995-09-22 | 1998-06-30 | Kirk Promotions Limited | Surgical method for reducing the food intake of a patient |
US6102922A (en) | 1995-09-22 | 2000-08-15 | Kirk Promotions Limited | Surgical method and device for reducing the food intake of patient |
AU715921B2 (en) | 1995-12-01 | 2000-02-10 | Gurkan Altuna | Telescopic bone plate for use in bone lengthening by distraction osteogenesis |
US5672177A (en) | 1996-01-31 | 1997-09-30 | The General Hospital Corporation | Implantable bone distraction device |
US5704938A (en) | 1996-03-27 | 1998-01-06 | Volunteers For Medical Engineering | Implantable bone lengthening apparatus using a drive gear mechanism |
US5704939A (en) | 1996-04-09 | 1998-01-06 | Justin; Daniel F. | Intramedullary skeletal distractor and method |
US5979456A (en) | 1996-04-22 | 1999-11-09 | Magovern; George J. | Apparatus and method for reversibly reshaping a body part |
NZ333251A (en) | 1996-06-17 | 2000-08-25 | Lucent Medical Systems Inc | Medical tube and associated magnet for insertion and detection within the body of a patient |
US5700263A (en) | 1996-06-17 | 1997-12-23 | Schendel; Stephen A. | Bone distraction apparatus |
DE19626230A1 (en) | 1996-06-29 | 1998-01-02 | Inst Physikalische Hochtech Ev | Device for determining the position of magnetic marker through Magen-Darm tract |
US6835207B2 (en) | 1996-07-22 | 2004-12-28 | Fred Zacouto | Skeletal implant |
US6500110B1 (en) | 1996-08-15 | 2002-12-31 | Neotonus, Inc. | Magnetic nerve stimulation seat device |
US5810815A (en) | 1996-09-20 | 1998-09-22 | Morales; Jose A. | Surgical apparatus for use in the treatment of spinal deformities |
US5830221A (en) | 1996-09-20 | 1998-11-03 | United States Surgical Corporation | Coil fastener applier |
US6058323A (en) | 1996-11-05 | 2000-05-02 | Lemelson; Jerome | System and method for treating select tissue in a living being |
US5743910A (en) | 1996-11-14 | 1998-04-28 | Xomed Surgical Products, Inc. | Orthopedic prosthesis removal instrument |
DE19652608C1 (en) | 1996-12-18 | 1998-08-27 | Eska Implants Gmbh & Co | Prophylaxis implant against fractures of osteoporotically affected bone segments |
NL1004873C2 (en) | 1996-12-23 | 1998-06-24 | Univ Twente | Device for moving two objects together. |
DE19700225A1 (en) | 1997-01-07 | 1998-07-09 | Augustin Prof Dr Betz | Distraction device for moving two parts of a bone apart |
IT1293934B1 (en) | 1997-01-21 | 1999-03-11 | Orthofix Srl | ENDOMIDOLLAR NAIL FOR THE TREATMENT OF HIP FRACTURES |
US5997490A (en) | 1997-02-12 | 1999-12-07 | Exogen, Inc. | Method and system for therapeutically treating bone fractures and osteoporosis |
US5827286A (en) | 1997-02-14 | 1998-10-27 | Incavo; Stephen J. | Incrementally adjustable tibial osteotomy fixation device and method |
DE19708279C2 (en) | 1997-02-28 | 1999-10-14 | Rainer Baumgart | Distraction system for a long bone |
US6034296A (en) | 1997-03-11 | 2000-03-07 | Elvin; Niell | Implantable bone strain telemetry sensing system and method |
US6033412A (en) | 1997-04-03 | 2000-03-07 | Losken; H. Wolfgang | Automated implantable bone distractor for incremental bone adjustment |
FR2761876B1 (en) | 1997-04-09 | 1999-08-06 | Materiel Orthopedique En Abreg | INSTRUMENTATION OF LUMBAR OSTEOSYNTHESIS FOR CORRECTION OF SPONDYLOLISTHESIS BY POSTERIOR PATHWAY |
GB9713018D0 (en) | 1997-06-20 | 1997-08-27 | Secr Defence | Optical fibre bend sensor |
DE19741757A1 (en) | 1997-09-22 | 1999-03-25 | Sachse Hans E | Implantable hydraulic bone expansion device |
US6138681A (en) | 1997-10-13 | 2000-10-31 | Light Sciences Limited Partnership | Alignment of external medical device relative to implanted medical device |
DE19745654A1 (en) | 1997-10-16 | 1999-04-22 | Hans Peter Prof Dr Med Zenner | Port for subcutaneous infusion |
FR2771280B1 (en) | 1997-11-26 | 2001-01-26 | Albert P Alby | RESILIENT VERTEBRAL CONNECTION DEVICE |
US5935127A (en) | 1997-12-17 | 1999-08-10 | Biomet, Inc. | Apparatus and method for treatment of a fracture in a long bone |
US6336929B1 (en) | 1998-01-05 | 2002-01-08 | Orthodyne, Inc. | Intramedullary skeletal distractor and method |
JP2002500063A (en) * | 1998-01-05 | 2002-01-08 | オーソダイン・インコーポレーテッド | Intramedullary skeletal distractor and distraction method |
US6331744B1 (en) | 1998-02-10 | 2001-12-18 | Light Sciences Corporation | Contactless energy transfer apparatus |
US5945762A (en) | 1998-02-10 | 1999-08-31 | Light Sciences Limited Partnership | Movable magnet transmitter for inducing electrical current in an implanted coil |
DE19807663A1 (en) | 1998-02-24 | 1999-09-09 | Baur | Connection means for releasably connecting a first component and a second component and method for releasing a connection of a first component and a second component |
US6343568B1 (en) | 1998-03-25 | 2002-02-05 | Mcclasky David R. | Non-rotating telescoping pole |
GB9806999D0 (en) | 1998-04-02 | 1998-06-03 | Univ Birmingham | Distraction device |
US6363940B1 (en) | 1998-05-14 | 2002-04-02 | Calypso Medical Technologies, Inc. | System and method for bracketing and removing tissue |
DE29811479U1 (en) | 1998-06-26 | 1998-09-03 | Orto Maquet Gmbh & Co Kg | Plate arrangement for osteosynthesis |
DE19829523A1 (en) | 1998-07-02 | 2000-01-05 | Michael Butsch | Distraction device for moving apart a one- or two-part, possibly separate bone |
US6126660A (en) | 1998-07-29 | 2000-10-03 | Sofamor Danek Holdings, Inc. | Spinal compression and distraction devices and surgical methods |
JP2000120678A (en) * | 1998-10-16 | 2000-04-25 | Koyo Seiko Co Ltd | Linear type guide device |
DE19856062A1 (en) | 1998-12-04 | 2000-06-15 | Wittenstein Gmbh & Co Kg | Distraction device |
US6139316A (en) | 1999-01-26 | 2000-10-31 | Sachdeva; Rohit C. L. | Device for bone distraction and tooth movement |
US6315784B1 (en) | 1999-02-03 | 2001-11-13 | Zarija Djurovic | Surgical suturing unit |
DE19906423A1 (en) | 1999-02-16 | 2000-08-17 | Wittenstein Gmbh & Co Kg | Active marrow spike for drawing out sections of bone consists of two elements moving against each other and electrically operated driving element to supply spike with electrical energy via detachable plug-in element. |
US6162223A (en) | 1999-04-09 | 2000-12-19 | Smith & Nephew, Inc. | Dynamic wrist fixation apparatus for early joint motion in distal radius fractures |
US6299613B1 (en) | 1999-04-23 | 2001-10-09 | Sdgi Holdings, Inc. | Method for the correction of spinal deformities through vertebral body tethering without fusion |
US7008425B2 (en) | 1999-05-27 | 2006-03-07 | Jonathan Phillips | Pediatric intramedullary nail and method |
FR2794357B1 (en) | 1999-06-01 | 2001-09-14 | Frederic Fortin | DISTRACTION DEVICE FOR BONES OF CHILDREN HAVING HANGING AND ADJUSTMENT MEANS FOR TRACKING GROWTH |
US6221074B1 (en) | 1999-06-10 | 2001-04-24 | Orthodyne, Inc. | Femoral intramedullary rod system |
US6358283B1 (en) | 1999-06-21 | 2002-03-19 | Hoegfors Christian | Implantable device for lengthening and correcting malpositions of skeletal bones |
CA2374351A1 (en) | 1999-06-21 | 2000-12-28 | Fisher & Paykel Limited | Linear motor |
US7160312B2 (en) | 1999-06-25 | 2007-01-09 | Usgi Medical, Inc. | Implantable artificial partition and methods of use |
US6409175B1 (en) | 1999-07-13 | 2002-06-25 | Grant Prideco, Inc. | Expandable joint connector |
US6234956B1 (en) | 1999-08-11 | 2001-05-22 | Hongping He | Magnetic actuation urethral valve |
US6673079B1 (en) | 1999-08-16 | 2004-01-06 | Washington University | Device for lengthening and reshaping bone by distraction osteogenesis |
US6566676B1 (en) * | 1999-09-21 | 2003-05-20 | Fuji Photo Film Co., Ltd. | Image detector |
AU1963101A (en) | 1999-10-06 | 2001-05-10 | Orthodyne, Inc. | Device and method for measuring skeletal distraction |
US6926719B2 (en) | 1999-10-21 | 2005-08-09 | Gary W. Sohngen | Modular intramedullary nail |
AU1233301A (en) | 1999-10-26 | 2001-05-08 | H. Randall Craig | Helical suture instrument |
US6583630B2 (en) | 1999-11-18 | 2003-06-24 | Intellijoint Systems Ltd. | Systems and methods for monitoring wear and/or displacement of artificial joint members, vertebrae, segments of fractured bones and dental implants |
JP2003524493A (en) | 2000-02-03 | 2003-08-19 | アルファテック マニュファクチャリング, インコーポレイテッド | Intramedullary coupling screw |
BRPI0108178B8 (en) | 2000-02-10 | 2021-06-22 | Abdomica Ag | apparatus for the treatment of anal incontinence with wireless power supply. |
ATE410982T1 (en) | 2000-02-10 | 2008-10-15 | Obtech Medical Ag | REGULATED DEVICE FOR THE TREATMENT OF HEARTBURN AND ACID REGULS |
US7776068B2 (en) | 2003-10-23 | 2010-08-17 | Trans1 Inc. | Spinal motion preservation assemblies |
JP3464460B2 (en) * | 2000-02-24 | 2003-11-10 | ジー・ケー・エヌ・レブロ・ゲゼルシャフト・ミット・ベシュレンクテル・ハフツング | Drive shaft |
FR2805451B1 (en) | 2000-02-29 | 2002-04-19 | Arnaud Andre Soubeiran | IMPROVED DEVICE FOR MOVING TWO BODIES IN RELATION TO ONE ANOTHER, PARTICULARLY FOR REALIZING IMPLANTABLE SYSTEMS IN THE HUMAN BODY |
US20030220644A1 (en) | 2002-05-23 | 2003-11-27 | Thelen Sarah L. | Method and apparatus for reducing femoral fractures |
US6423061B1 (en) | 2000-03-14 | 2002-07-23 | Amei Technologies Inc. | High tibial osteotomy method and apparatus |
US6309391B1 (en) | 2000-03-15 | 2001-10-30 | Sdgi Holding, Inc. | Multidirectional pivoting bone screw and fixation system |
GB0009107D0 (en) * | 2000-04-13 | 2000-05-31 | Univ London | Surgical distraction device |
US6237956B1 (en) | 2000-04-17 | 2001-05-29 | Lear Corporation | Steering column support bracket |
US6510345B1 (en) | 2000-04-24 | 2003-01-21 | Medtronic, Inc. | System and method of bridging a transreceiver coil of an implantable medical device during non-communication periods |
US7241300B2 (en) | 2000-04-29 | 2007-07-10 | Medtronic, Inc, | Components, systems and methods for forming anastomoses using magnetism or other coupling means |
US7232449B2 (en) | 2000-04-29 | 2007-06-19 | Medtronic, Inc. | Components, systems and methods for forming anastomoses using magnetism or other coupling means |
US20020072758A1 (en) | 2000-12-13 | 2002-06-13 | Reo Michael L. | Processes for producing anastomotic components having magnetic properties |
US8518062B2 (en) | 2000-04-29 | 2013-08-27 | Medtronic, Inc. | Devices and methods for forming magnetic anastomoses between vessels |
US6656135B2 (en) | 2000-05-01 | 2003-12-02 | Southwest Research Institute | Passive and wireless displacement measuring device |
US7114501B2 (en) | 2000-08-14 | 2006-10-03 | Spine Wave, Inc. | Transverse cavity device and method |
US6554831B1 (en) | 2000-09-01 | 2003-04-29 | Hopital Sainte-Justine | Mobile dynamic system for treating spinal disorder |
FR2813786B1 (en) | 2000-09-11 | 2003-03-14 | Medical Innovation Dev | METHOD AND DEVICE FOR CONTROLLING THE INFLATION OF AN INFLATABLE PROSTHETIC BODY AND PROSTHESIS USING THE SAME |
DE10142544B4 (en) | 2000-09-15 | 2010-05-27 | Heidelberger Druckmaschinen Ag | Gear transmission stage with tensioning moment |
US6537196B1 (en) | 2000-10-24 | 2003-03-25 | Stereotaxis, Inc. | Magnet assembly with variable field directions and methods of magnetically navigating medical objects |
DE10054236A1 (en) | 2000-11-02 | 2002-07-25 | Okin Ges Fuer Antriebstechnik | telescopic arm |
DE10055519A1 (en) | 2000-11-09 | 2002-06-06 | Wittenstein Gmbh & Co Kg | distraction |
US6582313B2 (en) | 2000-12-22 | 2003-06-24 | Delphi Technologies, Inc. | Constant velocity stroking joint having recirculating spline balls |
GB0106588D0 (en) | 2001-03-16 | 2001-05-09 | Finsbury Dev Ltd | Tissue distracter |
US6802844B2 (en) | 2001-03-26 | 2004-10-12 | Nuvasive, Inc | Spinal alignment apparatus and methods |
US7787958B2 (en) | 2001-04-13 | 2010-08-31 | Greatbatch Ltd. | RFID detection and identification system for implantable medical lead systems |
US6565573B1 (en) | 2001-04-16 | 2003-05-20 | Smith & Nephew, Inc. | Orthopedic screw and method of use |
CA2447155C (en) | 2001-05-23 | 2010-11-16 | Orthogon Technologies 2003 Ltd. | Magnetically-actuable intramedullary device |
EP1260188B1 (en) | 2001-05-25 | 2014-09-17 | Zimmer GmbH | Femoral bone nail for implantation in the knee |
US8439926B2 (en) | 2001-05-25 | 2013-05-14 | Conformis, Inc. | Patient selectable joint arthroplasty devices and surgical tools |
US7041105B2 (en) | 2001-06-06 | 2006-05-09 | Sdgi Holdings, Inc. | Dynamic, modular, multilock anterior cervical plate system having detachably fastened assembleable and moveable segments |
CA2494237C (en) | 2001-06-28 | 2008-03-25 | Halliburton Energy Services, Inc. | Drill tool shaft-to-housing locking device |
US6375682B1 (en) | 2001-08-06 | 2002-04-23 | Lewis W. Fleischmann | Collapsible, rotatable and expandable spinal hydraulic prosthetic device |
JP2003059558A (en) | 2001-08-09 | 2003-02-28 | Tokai Rika Co Ltd | Connector for printed circuit board |
US20030069581A1 (en) | 2001-10-04 | 2003-04-10 | Stinson David T. | Universal intramedullary nails, systems and methods of use thereof |
EP1435857B1 (en) | 2001-10-19 | 2015-04-08 | Baylor College Of Medicine | Bone compression devices and systems and methods of contouring and using same |
US7001346B2 (en) | 2001-11-14 | 2006-02-21 | Michael R. White | Apparatus and methods for making intraoperative orthopedic measurements |
DE10156316A1 (en) | 2001-11-19 | 2003-06-05 | Wittenstein Ag | distraction |
DE10158545B4 (en) * | 2001-11-29 | 2004-05-19 | Gkn Driveline Deutschland Gmbh | Longitudinal displacement unit with hollow profile pin |
JP2003159258A (en) | 2001-11-29 | 2003-06-03 | Ichiro Okutsu | Bone fracture treatment instrument for injecting fluid |
US7601156B2 (en) | 2001-12-05 | 2009-10-13 | Randolph C. Robinson | Limb lengthener |
US6852113B2 (en) | 2001-12-14 | 2005-02-08 | Orthopaedic Designs, Llc | Internal osteotomy fixation device |
US20040019353A1 (en) | 2002-02-01 | 2004-01-29 | Freid James M. | Spinal plate system for stabilizing a portion of a spine |
US9101422B2 (en) | 2002-02-01 | 2015-08-11 | Zimmer Spine, Inc. | Spinal plate system for stabilizing a portion of a spine |
US7105029B2 (en) | 2002-02-04 | 2006-09-12 | Zimmer Spine, Inc. | Skeletal fixation device with linear connection |
US7678136B2 (en) | 2002-02-04 | 2010-03-16 | Spinal, Llc | Spinal fixation assembly |
FR2835734B1 (en) | 2002-02-11 | 2004-10-29 | Scient X | CONNECTION SYSTEM BETWEEN A SPINAL ROD AND A CROSS BAR |
US7163538B2 (en) | 2002-02-13 | 2007-01-16 | Cross Medical Products, Inc. | Posterior rod system |
UA75048C2 (en) | 2002-02-18 | 2006-03-15 | Товариство З Обмеженою Відповідальністю "Кримський Центр Травматології І Ортопедії Імені О.І. Блискунова-"Абас" | Blyskunov's device for extending long bones |
US6607363B1 (en) | 2002-02-20 | 2003-08-19 | Terumo Cardiovascular Systems Corporation | Magnetic detent for rotatable knob |
US7011658B2 (en) | 2002-03-04 | 2006-03-14 | Sdgi Holdings, Inc. | Devices and methods for spinal compression and distraction |
EP1343112A1 (en) | 2002-03-08 | 2003-09-10 | EndoArt S.A. | Implantable device |
US20100168751A1 (en) | 2002-03-19 | 2010-07-01 | Anderson D Greg | Method, Implant & Instruments for Percutaneous Expansion of the Spinal Canal |
US6774624B2 (en) | 2002-03-27 | 2004-08-10 | Ge Medical Systems Global Technology Company, Llc | Magnetic tracking system |
AU2003228391A1 (en) | 2002-03-30 | 2003-10-20 | Cool Brace | Intervertebral device and method of use |
US6761503B2 (en) | 2002-04-24 | 2004-07-13 | Torque-Traction Technologies, Inc. | Splined member for use in a slip joint and method of manufacturing the same |
US7445010B2 (en) | 2003-01-29 | 2008-11-04 | Torax Medical, Inc. | Use of magnetic implants to treat issue structures |
US20030220643A1 (en) | 2002-05-24 | 2003-11-27 | Ferree Bret A. | Devices to prevent spinal extension |
US7357037B2 (en) | 2002-07-10 | 2008-04-15 | Orthodata Technologies Llc | Strain sensing system |
US20040011137A1 (en) | 2002-07-10 | 2004-01-22 | Hnat William P. | Strain sensing system |
US7060075B2 (en) | 2002-07-18 | 2006-06-13 | Biosense, Inc. | Distal targeting of locking screws in intramedullary nails |
US20040133219A1 (en) | 2002-07-29 | 2004-07-08 | Peter Forsell | Multi-material constriction device for forming stoma opening |
FR2843538B1 (en) | 2002-08-13 | 2005-08-12 | Frederic Fortin | DEVICE FOR DISTRACTING AND DAMPING ADJUSTABLE TO THE GROWTH OF THE RACHIS |
US6667725B1 (en) | 2002-08-20 | 2003-12-23 | The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration | Radio frequency telemetry system for sensors and actuators |
AU2003264232A1 (en) | 2002-08-25 | 2004-03-11 | City University Of Hong Knong | Device for correcting spinal deformities |
FR2843875B1 (en) | 2002-08-30 | 2004-10-08 | Arnaud Andre Soubeiran | IMPLANTABLE DEVICE FOR TRANSFORMING ON DEMAND ALTERNATE COUPLES APPLIED BY MUSCLE FORCE BETWEEN TWO WORKPIECES IN A MOVEMENT OF TWO BODIES RELATIVELY TO ONE ANOTHER |
ES2295272T3 (en) | 2002-09-04 | 2008-04-16 | Endoart S.A. | CLOSURE SYSTEM FOR SURGICAL RING. |
EP1396243B1 (en) | 2002-09-04 | 2007-08-15 | Endoart S.A. | Surgical ring with remote control system for reversible variation of diameter |
US7441559B2 (en) | 2002-09-06 | 2008-10-28 | Koninklijke Philips Electronics N.V. | Devices, systems, and methods to fixate tissue within the regions of body, such as the pharyngeal conduit |
US7360542B2 (en) | 2002-09-06 | 2008-04-22 | Apneon, Inc. | Devices, systems, and methods to fixate tissue within the regions of body, such as the pharyngeal conduit |
US7216648B2 (en) | 2002-09-06 | 2007-05-15 | Apneon, Inc. | Systems and methods for moving and/or restraining tissue in the upper respiratory system |
ATE385831T1 (en) | 2002-09-20 | 2008-03-15 | Potencia Medical Ag | HARMLESS WIRELESS ENERGY TRANSFER TO AN IMPLANT |
US20040055610A1 (en) | 2002-09-25 | 2004-03-25 | Peter Forsell | Detection of implanted wireless energy receiving device |
EP1545343A2 (en) | 2002-10-03 | 2005-06-29 | Virginia Tech Intellectual Properties, Inc. | Magnetic targeting device |
US20100249782A1 (en) | 2002-10-03 | 2010-09-30 | Durham Alfred A | Intramedullary nail targeting device |
US6656194B1 (en) | 2002-11-05 | 2003-12-02 | Satiety, Inc. | Magnetic anchoring devices |
US6918910B2 (en) | 2002-12-16 | 2005-07-19 | John T. Smith | Implantable distraction device |
KR100498951B1 (en) | 2003-01-02 | 2005-07-04 | 삼성전자주식회사 | Method of Motion Estimation for Video Coding in MPEG-4/H.263 Standards |
US7364589B2 (en) | 2003-02-12 | 2008-04-29 | Warsaw Orthopedic, Inc. | Mobile bearing articulating disc |
US20070043376A1 (en) | 2003-02-21 | 2007-02-22 | Osteobiologics, Inc. | Bone and cartilage implant delivery device |
US7618435B2 (en) | 2003-03-04 | 2009-11-17 | Nmt Medical, Inc. | Magnetic attachment systems |
US20040193266A1 (en) | 2003-03-31 | 2004-09-30 | Meyer Rudolf Xaver | Expansible prosthesis and magnetic apparatus |
IL155222A0 (en) | 2003-04-03 | 2003-11-23 | Hadasit Med Res Service | An implant for treating idiopathic scoliosis and a method for using the same |
DE10317776A1 (en) | 2003-04-16 | 2004-11-04 | Wittenstein Ag | Device for lengthening bones or parts of bones |
BRPI0410697A (en) | 2003-05-02 | 2006-06-20 | Univ Yale | dynamic spine stabilizer and method |
JP4391762B2 (en) | 2003-05-08 | 2009-12-24 | オリンパス株式会社 | Surgical instrument |
US7553298B2 (en) | 2003-12-19 | 2009-06-30 | Ethicon Endo-Surgery, Inc. | Implantable medical device with cover and method |
US7862546B2 (en) | 2003-06-16 | 2011-01-04 | Ethicon Endo-Surgery, Inc. | Subcutaneous self attaching injection port with integral moveable retention members |
US7561916B2 (en) | 2005-06-24 | 2009-07-14 | Ethicon Endo-Surgery, Inc. | Implantable medical device with indicator |
US7218232B2 (en) | 2003-07-11 | 2007-05-15 | Depuy Products, Inc. | Orthopaedic components with data storage element |
US7794476B2 (en) | 2003-08-08 | 2010-09-14 | Warsaw Orthopedic, Inc. | Implants formed of shape memory polymeric material for spinal fixation |
US8037871B2 (en) | 2003-08-12 | 2011-10-18 | Cameron International Corporation | Seal assembly for a pressurized fuel feed system for an internal combustion engine |
US7371244B2 (en) | 2003-08-25 | 2008-05-13 | Ethicon, Inc. | Deployment apparatus for suture anchoring device |
WO2005027763A1 (en) | 2003-08-28 | 2005-03-31 | Wittenstein Ag | Planetary roll system, in particular for a device for extending bones |
DE10340025A1 (en) | 2003-08-28 | 2005-03-24 | Wittenstein Ag | Surgical device for bone extension, comprising planetary gear acting on outer sleeve serving as ring gear |
JP4731482B2 (en) | 2003-09-04 | 2011-07-27 | ウォーソー・オーソペディック・インコーポレーテッド | Anterior spinal instrument |
EP1514518A1 (en) * | 2003-09-11 | 2005-03-16 | SDGI Holdings, Inc. | Impulsive percussion instruments for endplate preparation |
DK1662971T3 (en) | 2003-09-15 | 2011-08-29 | Allergan Inc | Fastening system for an implantable device |
US7255714B2 (en) | 2003-09-30 | 2007-08-14 | Michel H. Malek | Vertically adjustable intervertebral disc prosthesis |
US7485149B1 (en) | 2003-10-06 | 2009-02-03 | Biomet Manufacturing Corporation | Method and apparatus for use of a non-invasive expandable implant |
US20050090823A1 (en) | 2003-10-28 | 2005-04-28 | Bartimus Christopher S. | Posterior fixation system |
US20050261779A1 (en) | 2003-11-17 | 2005-11-24 | Meyer Rudolf X | Expansible rod-type prosthesis and external magnetic apparatus |
US7775099B2 (en) | 2003-11-20 | 2010-08-17 | Schlumberger Technology Corporation | Downhole tool sensor system and method |
US7862586B2 (en) | 2003-11-25 | 2011-01-04 | Life Spine, Inc. | Spinal stabilization systems |
US7429259B2 (en) | 2003-12-02 | 2008-09-30 | Cadeddu Jeffrey A | Surgical anchor and system |
US8162897B2 (en) | 2003-12-19 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Audible and tactile feedback |
JP3826134B2 (en) * | 2003-12-26 | 2006-09-27 | キヤノン株式会社 | Recording device |
US7833228B1 (en) | 2004-01-05 | 2010-11-16 | Biomet Manufacturing Corp. | Method and instrumentation for performing minimally invasive hip arthroplasty |
US7789912B2 (en) | 2004-01-08 | 2010-09-07 | Spine Wave, Inc. | Apparatus and method for injecting fluent material at a distracted tissue site |
US20050159754A1 (en) | 2004-01-21 | 2005-07-21 | Odrich Ronald B. | Periosteal distraction bone growth |
ATE537762T1 (en) | 2004-01-23 | 2012-01-15 | Allergan Inc | IMPLANTABLE DEVICE FASTENING SYSTEM |
US8758355B2 (en) | 2004-02-06 | 2014-06-24 | Synvasive Technology, Inc. | Dynamic knee balancer with pressure sensing |
US7442196B2 (en) | 2004-02-06 | 2008-10-28 | Synvasive Technology, Inc. | Dynamic knee balancer |
US8002809B2 (en) | 2004-02-10 | 2011-08-23 | Atlas Spine, Inc. | Dynamic cervical plate |
US8636802B2 (en) | 2004-03-06 | 2014-01-28 | DePuy Synthes Products, LLC | Dynamized interspinal implant |
US7458981B2 (en) | 2004-03-09 | 2008-12-02 | The Board Of Trustees Of The Leland Stanford Junior University | Spinal implant and method for restricting spinal flexion |
US20050272976A1 (en) | 2004-03-15 | 2005-12-08 | Olympus Corporation | Endoscope insertion aiding device |
US20050234448A1 (en) | 2004-03-19 | 2005-10-20 | Mccarthy James | Implantable bone-lengthening device |
WO2005092219A1 (en) | 2004-03-26 | 2005-10-06 | Hirotaka Shimizu | Bone connecting tool |
DE502005002795D1 (en) | 2004-03-27 | 2008-03-27 | Christoph Miethke Gmbh & Co Kg | ADJUSTABLE HYDROCEPHALUS VALVE |
US7909852B2 (en) | 2004-03-31 | 2011-03-22 | Depuy Spine Sarl | Adjustable-angle spinal fixation element |
US7489495B2 (en) | 2004-04-15 | 2009-02-10 | Greatbatch-Sierra, Inc. | Apparatus and process for reducing the susceptibility of active implantable medical devices to medical procedures such as magnetic resonance imaging |
US7531002B2 (en) | 2004-04-16 | 2009-05-12 | Depuy Spine, Inc. | Intervertebral disc with monitoring and adjusting capabilities |
WO2005102195A1 (en) | 2004-04-20 | 2005-11-03 | Allez Spine, Llc | Pedicle screw assembly |
US7763080B2 (en) | 2004-04-30 | 2010-07-27 | Depuy Products, Inc. | Implant system with migration measurement capacity |
US7333013B2 (en) | 2004-05-07 | 2008-02-19 | Berger J Lee | Medical implant device with RFID tag and method of identification of device |
US7314372B2 (en) | 2004-05-19 | 2008-01-01 | Orthovisage, Inc. | System and method to bioengineer facial form in adults |
US7390294B2 (en) | 2004-05-28 | 2008-06-24 | Ethicon Endo-Surgery, Inc. | Piezo electrically driven bellows infuser for hydraulically controlling an adjustable gastric band |
US7243719B2 (en) | 2004-06-07 | 2007-07-17 | Pathfinder Energy Services, Inc. | Control method for downhole steering tool |
JP4874970B2 (en) | 2004-06-07 | 2012-02-15 | ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング | Orthopedic implant with sensor |
US7191007B2 (en) | 2004-06-24 | 2007-03-13 | Ethicon Endo-Surgery, Inc | Spatially decoupled twin secondary coils for optimizing transcutaneous energy transfer (TET) power transfer characteristics |
US7776091B2 (en) | 2004-06-30 | 2010-08-17 | Depuy Spine, Inc. | Adjustable posterior spinal column positioner |
US7481841B2 (en) | 2004-06-30 | 2009-01-27 | Depuy Products, Inc. | Adjustable orthopaedic prosthesis and associated method |
US7955357B2 (en) | 2004-07-02 | 2011-06-07 | Ellipse Technologies, Inc. | Expandable rod system to treat scoliosis and method of using the same |
WO2006010037A2 (en) | 2004-07-08 | 2006-01-26 | Deborah Schenberger | Strain monitoring system and apparatus |
US7402134B2 (en) | 2004-07-15 | 2008-07-22 | Micardia Corporation | Magnetic devices and methods for reshaping heart anatomy |
US7285087B2 (en) | 2004-07-15 | 2007-10-23 | Micardia Corporation | Shape memory devices and methods for reshaping heart anatomy |
US7875033B2 (en) | 2004-07-19 | 2011-01-25 | Synthes Usa, Llc | Bone distraction apparatus |
GB0417005D0 (en) | 2004-07-29 | 2004-09-01 | Finsbury Dev Ltd | Auto-extensible device |
US7708765B2 (en) | 2004-08-03 | 2010-05-04 | K Spine, Inc. | Spine stabilization device and method |
WO2006017641A2 (en) | 2004-08-03 | 2006-02-16 | Vertech Innovations, L.L.C. | Spinous process reinforcement device and method |
US20060036259A1 (en) | 2004-08-03 | 2006-02-16 | Carl Allen L | Spine treatment devices and methods |
US8114158B2 (en) | 2004-08-03 | 2012-02-14 | Kspine, Inc. | Facet device and method |
US20060036323A1 (en) | 2004-08-03 | 2006-02-16 | Carl Alan L | Facet device and method |
US20060036251A1 (en) | 2004-08-09 | 2006-02-16 | Reiley Mark A | Systems and methods for the fixation or fusion of bone |
US8444693B2 (en) | 2004-08-09 | 2013-05-21 | Si-Bone Inc. | Apparatus, systems, and methods for achieving lumbar facet fusion |
US8470004B2 (en) | 2004-08-09 | 2013-06-25 | Si-Bone Inc. | Apparatus, systems, and methods for stabilizing a spondylolisthesis |
US7763053B2 (en) | 2004-08-30 | 2010-07-27 | Gordon Jeffrey D | Implant for correction of spinal deformity |
US9717537B2 (en) | 2004-08-30 | 2017-08-01 | Globus Medical, Inc. | Device and method for treatment of spinal deformity |
US7255682B1 (en) | 2004-09-09 | 2007-08-14 | Bartol Jr Robert J | Spot locator device |
US7887566B2 (en) | 2004-09-16 | 2011-02-15 | Hynes Richard A | Intervertebral support device with bias adjustment and related methods |
US7302858B2 (en) | 2004-09-24 | 2007-12-04 | Kevin Walsh | MEMS capacitive cantilever strain sensor, devices, and formation methods |
US8623036B2 (en) | 2004-09-29 | 2014-01-07 | The Regents Of The University Of California | Magnamosis |
US20060079897A1 (en) | 2004-09-29 | 2006-04-13 | Harrison Michael R | Apparatus and methods for magnetic alteration of anatomical features |
US8043290B2 (en) | 2004-09-29 | 2011-10-25 | The Regents Of The University Of California, San Francisco | Apparatus and methods for magnetic alteration of deformities |
US8915915B2 (en) | 2004-09-29 | 2014-12-23 | The Regents Of The University Of California | Apparatus and methods for magnetic alteration of anatomical features |
US8439915B2 (en) | 2004-09-29 | 2013-05-14 | The Regents Of The University Of California | Apparatus and methods for magnetic alteration of anatomical features |
US20060271107A1 (en) | 2004-09-29 | 2006-11-30 | Harrison Michael R | Apparatus and methods for magnetic alteration of anatomical features |
US7559951B2 (en) | 2004-09-30 | 2009-07-14 | Depuy Products, Inc. | Adjustable, remote-controllable orthopaedic prosthesis and associated method |
US20100004654A1 (en) | 2008-07-01 | 2010-01-07 | Schmitz Gregory P | Access and tissue modification systems and methods |
US20100331883A1 (en) | 2004-10-15 | 2010-12-30 | Schmitz Gregory P | Access and tissue modification systems and methods |
US8226690B2 (en) | 2005-07-22 | 2012-07-24 | The Board Of Trustees Of The Leland Stanford Junior University | Systems and methods for stabilization of bone structures |
US20070239159A1 (en) | 2005-07-22 | 2007-10-11 | Vertiflex, Inc. | Systems and methods for stabilization of bone structures |
US8267969B2 (en) | 2004-10-20 | 2012-09-18 | Exactech, Inc. | Screw systems and methods for use in stabilization of bone structures |
AU2005302633A1 (en) | 2004-10-28 | 2006-05-11 | Axial Biotech, Inc. | Apparatus and method for concave scoliosis expansion |
US7105968B2 (en) | 2004-12-03 | 2006-09-12 | Edward William Nissen | Magnetic transmission |
US20060136062A1 (en) | 2004-12-17 | 2006-06-22 | Dinello Alexandre | Height-and angle-adjustable motion disc implant |
US20060142767A1 (en) | 2004-12-27 | 2006-06-29 | Green Daniel W | Orthopedic device and method for correcting angular bone deformity |
US8496662B2 (en) | 2005-01-31 | 2013-07-30 | Arthrex, Inc. | Method and apparatus for forming a wedge-like opening in a bone for an open wedge osteotomy |
US7927357B2 (en) | 2005-02-02 | 2011-04-19 | Depuy Spine, Inc. | Adjustable length implant |
US7942908B2 (en) | 2005-02-02 | 2011-05-17 | Depuy Spine, Inc. | Adjustable length implant |
US8057513B2 (en) | 2005-02-17 | 2011-11-15 | Kyphon Sarl | Percutaneous spinal implants and methods |
US7988709B2 (en) | 2005-02-17 | 2011-08-02 | Kyphon Sarl | Percutaneous spinal implants and methods |
US20070276373A1 (en) | 2005-02-17 | 2007-11-29 | Malandain Hugues F | Percutaneous Spinal Implants and Methods |
US20060184248A1 (en) | 2005-02-17 | 2006-08-17 | Edidin Avram A | Percutaneous spinal implants and methods |
US20070276493A1 (en) | 2005-02-17 | 2007-11-29 | Malandain Hugues F | Percutaneous spinal implants and methods |
US8034080B2 (en) | 2005-02-17 | 2011-10-11 | Kyphon Sarl | Percutaneous spinal implants and methods |
WO2006090380A2 (en) | 2005-02-22 | 2006-08-31 | Orthogon Technologies 2003 Ltd. | Device and method for vertebral column distraction and oscillation |
WO2008024937A2 (en) | 2006-08-23 | 2008-02-28 | Pioneer Surgical Technology, Inc. | Minimally invasive surgical system |
US7775215B2 (en) | 2005-02-24 | 2010-08-17 | Ethicon Endo-Surgery, Inc. | System and method for determining implanted device positioning and obtaining pressure data |
JP2008536537A (en) | 2005-03-02 | 2008-09-11 | オステオメトリックス・エルエルシー | Non-invasive methods, devices, kits and systems for intraoperative position and length determination |
JP2006250178A (en) | 2005-03-08 | 2006-09-21 | Nsk Ltd | Bearing unit for supporting wheel and method for manufacturing the same |
US7189005B2 (en) | 2005-03-14 | 2007-03-13 | Borgwarner Inc. | Bearing system for a turbocharger |
CN101170966A (en) | 2005-04-01 | 2008-04-30 | 科罗拉多州立大学董事会 | A graft fixation device and method |
US20060235424A1 (en) | 2005-04-01 | 2006-10-19 | Foster-Miller, Inc. | Implantable bone distraction device and method |
US7708762B2 (en) | 2005-04-08 | 2010-05-04 | Warsaw Orthopedic, Inc. | Systems, devices and methods for stabilization of the spinal column |
US7846188B2 (en) | 2005-04-12 | 2010-12-07 | Moskowitz Nathan C | Bi-directional fixating transvertebral body screws, zero-profile horizontal intervertebral miniplates, total intervertebral body fusion devices, and posterior motion-calibrating interarticulating joint stapling device for spinal fusion |
US20060235299A1 (en) | 2005-04-13 | 2006-10-19 | Martinelli Michael A | Apparatus and method for intravascular imaging |
US20060241746A1 (en) | 2005-04-21 | 2006-10-26 | Emanuel Shaoulian | Magnetic implants and methods for reshaping tissue |
US7361192B2 (en) | 2005-04-22 | 2008-04-22 | Doty Keith L | Spinal disc prosthesis and methods of use |
US7811328B2 (en) | 2005-04-29 | 2010-10-12 | Warsaw Orthopedic, Inc. | System, device and methods for replacing the intervertebral disc with a magnetic or electromagnetic prosthesis |
US20060249914A1 (en) | 2005-05-06 | 2006-11-09 | Dulin Robert D | Enhanced reliability sealing system |
US20070264605A1 (en) | 2005-05-19 | 2007-11-15 | Theodore Belfor | System and method to bioengineer facial form in adults |
US7390007B2 (en) | 2005-06-06 | 2008-06-24 | Ibis Tek, Llc | Towbar system |
WO2006138439A2 (en) | 2005-06-14 | 2006-12-28 | Fell Barry M | System and method for joint restoration by extracapsular means |
US7918844B2 (en) | 2005-06-24 | 2011-04-05 | Ethicon Endo-Surgery, Inc. | Applier for implantable medical device |
IL176810A (en) | 2005-07-12 | 2011-02-28 | Intramed Systems Ltd | Intramedullar distraction device with user actuated distraction |
WO2007013059A2 (en) | 2005-07-26 | 2007-02-01 | Ram Weiss | Extending intrabody capsule |
AU2006274537A1 (en) | 2005-08-01 | 2007-02-08 | Orthogon Technologies 2003 Ltd. | An implantable magnetically activated actuator |
US20070031131A1 (en) | 2005-08-04 | 2007-02-08 | Mountain Engineering Ii, Inc. | System for measuring the position of an electric motor |
WO2007024990A2 (en) | 2005-08-23 | 2007-03-01 | Kim Richard C | Expandable implant device with interchangeable spacer |
CA2620247C (en) | 2005-08-23 | 2014-04-29 | Smith & Nephew, Inc. | Telemetric orthopaedic implant |
DE102005045070A1 (en) | 2005-09-21 | 2007-04-05 | Siemens Ag | Femur implant, comprises magnetically operated mechanism for moving holding elements |
US7985256B2 (en) | 2005-09-26 | 2011-07-26 | Coalign Innovations, Inc. | Selectively expanding spine cage, hydraulically controllable in three dimensions for enhanced spinal fusion |
US8070813B2 (en) | 2005-09-26 | 2011-12-06 | Coalign Innovations, Inc. | Selectively expanding spine cage, hydraulically controllable in three dimensions for vertebral body replacement |
FR2892617B1 (en) | 2005-11-02 | 2008-09-26 | Frederic Fortin | DAMPING DISPLACEMENT DEVICE AND CORRECTION ADJUSTABLE TO THE GROWTH OF THE RACHIS |
DE602006006394D1 (en) | 2005-11-16 | 2009-06-04 | Micardia Corp | Magnetic attachment of a catheter to an implant |
US20090216113A1 (en) | 2005-11-17 | 2009-08-27 | Eric Meier | Apparatus and Methods for Using an Electromagnetic Transponder in Orthopedic Procedures |
US20070173837A1 (en) | 2005-11-18 | 2007-07-26 | William Marsh Rice University | Bone fixation and dynamization devices and methods |
US8494805B2 (en) | 2005-11-28 | 2013-07-23 | Orthosensor | Method and system for assessing orthopedic alignment using tracking sensors |
US7749224B2 (en) | 2005-12-08 | 2010-07-06 | Ebi, Llc | Foot plate fixation |
US8663287B2 (en) | 2006-01-10 | 2014-03-04 | Life Spine, Inc. | Pedicle screw constructs and spinal rod attachment assemblies |
WO2007084416A2 (en) | 2006-01-13 | 2007-07-26 | Kim Richard C | Magnetic spinal implant device |
US20070185374A1 (en) | 2006-01-17 | 2007-08-09 | Ellipse Technologies, Inc. | Two-way adjustable implant |
US9301792B2 (en) | 2006-01-27 | 2016-04-05 | Stryker Corporation | Low pressure delivery system and method for delivering a solid and liquid mixture into a target site for medical treatment |
US7776075B2 (en) | 2006-01-31 | 2010-08-17 | Warsaw Orthopedic, Inc. | Expandable spinal rods and methods of use |
US8241293B2 (en) | 2006-02-27 | 2012-08-14 | Biomet Manufacturing Corp. | Patient specific high tibia osteotomy |
US8323290B2 (en) | 2006-03-03 | 2012-12-04 | Biomet Manufacturing Corp. | Tensor for use in surgical navigation |
KR101331604B1 (en) | 2006-04-06 | 2013-11-22 | 신세스 게엠바하 | remotely adjustable tissue displacement device |
WO2007118179A2 (en) | 2006-04-06 | 2007-10-18 | Synthes (U.S.A.) | Remotely adjustable tissue displacement device |
US20070255088A1 (en) | 2006-04-11 | 2007-11-01 | Jacobson Andrew D | Implantable, magnetic actuator |
CA2649107A1 (en) | 2006-04-12 | 2007-10-25 | Spinal Motion, Inc. | Posterior spinal device and method |
DE102006032957B4 (en) | 2006-05-01 | 2008-08-07 | Neue Magnetodyn Gmbh | Stimulation device for osteosynthesis and arthroplasty |
US7708779B2 (en) | 2006-05-01 | 2010-05-04 | Warsaw Orthopedic, Inc. | Expandable intervertebral spacers and methods of use |
FR2900563B1 (en) | 2006-05-05 | 2008-08-08 | Frederic Fortin | ADJUSTABLE SCOLIOSIS RECTIFIER DEVICE |
US8147517B2 (en) | 2006-05-23 | 2012-04-03 | Warsaw Orthopedic, Inc. | Systems and methods for adjusting properties of a spinal implant |
US20070276369A1 (en) | 2006-05-26 | 2007-11-29 | Sdgi Holdings, Inc. | In vivo-customizable implant |
US7727143B2 (en) | 2006-05-31 | 2010-06-01 | Allergan, Inc. | Locator system for implanted access port with RFID tag |
US20070288024A1 (en) | 2006-06-06 | 2007-12-13 | Sohrab Gollogly | Bone fixation |
WO2007146075A2 (en) | 2006-06-07 | 2007-12-21 | Cherik Bulkes | Analog signal transition detector |
FR2901991B1 (en) * | 2006-06-13 | 2021-07-09 | Arnaud Andre Soubeiran | INTRACORPAL EXTENSION DEVICE MOUNTED IN TENSILE SCREW |
US20080033431A1 (en) | 2006-06-29 | 2008-02-07 | Searete Llc, A Limited Liability Corporation Of The State Of Delaware | Position augmenting mechanism |
US8372078B2 (en) | 2006-06-30 | 2013-02-12 | Howmedica Osteonics Corp. | Method for performing a high tibial osteotomy |
GB0613240D0 (en) * | 2006-07-04 | 2006-08-09 | Univ Birmingham | Distraction device |
US20080015577A1 (en) | 2006-07-11 | 2008-01-17 | Alexander Loeb | Spinal Correction Device |
US8475499B2 (en) | 2006-07-14 | 2013-07-02 | DePuy Synthes Products, LLC. | Rod to rod connectors and methods of adjusting the length of a spinal rod construct |
US20080021456A1 (en) | 2006-07-21 | 2008-01-24 | Depuy Spine, Inc. | Sacral or iliac cross connector |
US20080021454A1 (en) | 2006-07-21 | 2008-01-24 | Depuy Spine, Inc. | Sacral or iliac connector |
US20080021455A1 (en) | 2006-07-21 | 2008-01-24 | Depuy Spine, Inc. | Articulating Sacral or Iliac Connector |
US20080051784A1 (en) | 2006-08-03 | 2008-02-28 | Sohrab Gollogly | Bone repositioning apparatus and methodology |
US8403958B2 (en) | 2006-08-21 | 2013-03-26 | Warsaw Orthopedic, Inc. | System and method for correcting spinal deformity |
US20080086128A1 (en) | 2006-09-07 | 2008-04-10 | David Warren Lewis | Method and apparatus for treatment of scoliosis |
US8685091B2 (en) | 2006-09-29 | 2014-04-01 | DePuy Synthes Products, LLC | System, method, and device for monitoring orthopaedic implant data over a cellular network |
FR2906453B1 (en) * | 2006-10-03 | 2009-03-06 | Arnaud Andre Soubeiran | INTRA-BODY LIFTING DEVICE WITH PERMANENT MAGNET. |
US7862502B2 (en) | 2006-10-20 | 2011-01-04 | Ellipse Technologies, Inc. | Method and apparatus for adjusting a gastrointestinal restriction device |
US8246533B2 (en) | 2006-10-20 | 2012-08-21 | Ellipse Technologies, Inc. | Implant system with resonant-driven actuator |
US20100145462A1 (en) | 2006-10-24 | 2010-06-10 | Trans1 Inc. | Preformed membranes for use in intervertebral disc spaces |
GB2443457B (en) | 2006-10-31 | 2011-11-02 | Hewlett Packard Development Co | Image processing system and method |
US8043299B2 (en) | 2006-11-06 | 2011-10-25 | Janet Conway | Internal bone transport |
US20080108995A1 (en) | 2006-11-06 | 2008-05-08 | Janet Conway | Internal bone transport |
CA2568078C (en) * | 2006-11-14 | 2014-03-18 | Unifor S.P.A. | Telescopic table support |
US20140163664A1 (en) | 2006-11-21 | 2014-06-12 | David S. Goldsmith | Integrated system for the ballistic and nonballistic infixion and retrieval of implants with or without drug targeting |
US7793583B2 (en) | 2006-12-06 | 2010-09-14 | Schaeffler Kg | Mechanical tappet in particular for a fuel pump of an internal combustion engine |
US20080177319A1 (en) | 2006-12-09 | 2008-07-24 | Helmut Schwab | Expansion Rod, Self-Adjusting |
DE102006059225A1 (en) | 2006-12-13 | 2008-06-26 | Wittenstein Ag | Medical device for determining the position of intracorporeal implants |
US20080167685A1 (en) | 2007-01-05 | 2008-07-10 | Warsaw Orthopedic, Inc. | System and Method For Percutanously Curing An Implantable Device |
US20080177326A1 (en) | 2007-01-19 | 2008-07-24 | Matthew Thompson | Orthosis to correct spinal deformities |
US8435268B2 (en) | 2007-01-19 | 2013-05-07 | Reduction Technologies, Inc. | Systems, devices and methods for the correction of spinal deformities |
US8523866B2 (en) | 2007-02-09 | 2013-09-03 | Christopher G. Sidebotham | Modular tapered hollow reamer for medical applications |
US20080255615A1 (en) | 2007-03-27 | 2008-10-16 | Warsaw Orthopedic, Inc. | Treatments for Correcting Spinal Deformities |
US8469908B2 (en) | 2007-04-06 | 2013-06-25 | Wilson T. Asfora | Analgesic implant device and system |
US8100967B2 (en) | 2007-05-01 | 2012-01-24 | Moximed, Inc. | Adjustable absorber designs for implantable device |
US8123805B2 (en) | 2007-05-01 | 2012-02-28 | Moximed, Inc. | Adjustable absorber designs for implantable device |
US9907645B2 (en) | 2007-05-01 | 2018-03-06 | Moximed, Inc. | Adjustable absorber designs for implantable device |
US8709090B2 (en) | 2007-05-01 | 2014-04-29 | Moximed, Inc. | Adjustable absorber designs for implantable device |
US20080275567A1 (en) | 2007-05-01 | 2008-11-06 | Exploramed Nc4, Inc. | Extra-Articular Implantable Mechanical Energy Absorbing Systems |
US7611540B2 (en) | 2007-05-01 | 2009-11-03 | Moximed, Inc. | Extra-articular implantable mechanical energy absorbing systems and implantation method |
US20080272928A1 (en) | 2007-05-03 | 2008-11-06 | Shuster Gary S | Signaling light with motion-sensing light control circuit |
FR2916622B1 (en) | 2007-05-28 | 2009-09-04 | Arnaud Andre Soubeiran | IMPLANTABLE DISTRACTOR WITH MODIFIABLE LENGTH WITHOUT REOPERATION IN J-SHAPE |
WO2008154313A1 (en) | 2007-06-06 | 2008-12-18 | Vertech, Inc. | Medical device and method to correct deformity |
US8366628B2 (en) | 2007-06-07 | 2013-02-05 | Kenergy, Inc. | Signal sensing in an implanted apparatus with an internal reference |
CA2694437C (en) | 2007-07-26 | 2016-09-06 | Glenn R. Buttermann | Segmental orthopedic device for spinal elongation and for treatment of scoliosis |
US20090076597A1 (en) | 2007-09-19 | 2009-03-19 | Jonathan Micheal Dahlgren | System for mechanical adjustment of medical implants |
US20090082815A1 (en) | 2007-09-20 | 2009-03-26 | Zimmer Gmbh | Spinal stabilization system with transition member |
NO2197534T3 (en) | 2007-09-25 | 2018-08-04 | ||
US20090088803A1 (en) | 2007-10-01 | 2009-04-02 | Warsaw Orthopedic, Inc. | Flexible members for correcting spinal deformities |
WO2009046024A1 (en) | 2007-10-01 | 2009-04-09 | Physical Sciences, Inc. | Distraction osteogenesis methods and devices |
US20090093890A1 (en) * | 2007-10-04 | 2009-04-09 | Daniel Gelbart | Precise control of orthopedic actuators |
US20090093820A1 (en) | 2007-10-09 | 2009-04-09 | Warsaw Orthopedic, Inc. | Adjustable spinal stabilization systems |
US20090192514A1 (en) * | 2007-10-09 | 2009-07-30 | Feinberg Stephen E | Implantable distraction osteogenesis device and methods of using same |
EP2214602B1 (en) | 2007-10-31 | 2016-12-28 | Wright Medical Technology, Inc. | Orthopedic device |
AU2008340276B2 (en) | 2007-12-21 | 2014-08-07 | Microvention, Inc. | System and method for locating detachment zone of a detachable implant |
US20090171356A1 (en) | 2008-01-02 | 2009-07-02 | International Business Machines Corporation | Bone Repositioning Apparatus and System |
US20090177203A1 (en) | 2008-01-04 | 2009-07-09 | Inbone Technologies, Inc. | Devices, systems and methods for re-alignment of bone |
US8092499B1 (en) | 2008-01-11 | 2012-01-10 | Roth Herbert J | Skeletal flexible/rigid rod for treating skeletal curvature |
US8425608B2 (en) | 2008-01-18 | 2013-04-23 | Warsaw Orthopedic, Inc. | Lordotic expanding vertebral body spacer |
WO2009097485A1 (en) | 2008-02-01 | 2009-08-06 | Smith & Nephew, Inc. | System and method for communicating with an implant |
JP2011511676A (en) | 2008-02-07 | 2011-04-14 | ケー2エム, インコーポレイテッド | Automatic expansion bone fixation device |
CN101532646B (en) | 2008-03-14 | 2012-06-13 | 富准精密工业(深圳)有限公司 | Illuminating apparatus |
FI123247B (en) | 2008-03-19 | 2013-01-15 | Aalto Korkeakoulusaeaetioe | Intracorporeal bone distribution device |
EP2265164A4 (en) | 2008-04-01 | 2013-10-02 | Cardiomems Inc | Strain monitoring system and apparatus |
KR101045933B1 (en) | 2008-05-02 | 2011-07-01 | 김가브리엘민 | Calibration device |
US8211149B2 (en) | 2008-05-12 | 2012-07-03 | Warsaw Orthopedic | Elongated members with expansion chambers for treating bony members |
WO2009146377A1 (en) | 2008-05-28 | 2009-12-03 | Kerflin Orthopedic Innovations, Llc | Fluid-powered elongation instrumentation for correcting orthopedic deformities |
WO2009146457A1 (en) | 2008-05-30 | 2009-12-03 | Expanding Orthopedics, Inc. | Bone fracture treatment devices and methods of their use |
US8414584B2 (en) | 2008-07-09 | 2013-04-09 | Icon Orthopaedic Concepts, Llc | Ankle arthrodesis nail and outrigger assembly |
US20100057127A1 (en) | 2008-08-26 | 2010-03-04 | Mcguire Brian | Expandable Laminoplasty Fixation System |
WO2010028077A1 (en) | 2008-09-02 | 2010-03-11 | Christian M. Puttlitz Consulting, Llc | Biomems sensor and apparatuses and methods thereof |
DE102008050233A1 (en) | 2008-10-02 | 2010-04-08 | Copf jun., Franz, Dr. | Instrument for measuring the distraction pressure between vertebral bodies |
WO2010042767A1 (en) | 2008-10-11 | 2010-04-15 | Anthem Orthopaedics Van, Llc | Intramedullary rod with pivotable and fixed fasteners and method for using same |
US8095317B2 (en) | 2008-10-22 | 2012-01-10 | Gyrodata, Incorporated | Downhole surveying utilizing multiple measurements |
US20100100185A1 (en) | 2008-10-22 | 2010-04-22 | Warsaw Orthopedic, Inc. | Intervertebral Disc Prosthesis Having Viscoelastic Properties |
US8623056B2 (en) | 2008-10-23 | 2014-01-07 | Linares Medical Devices, Llc | Support insert associated with spinal vertebrae |
US20100106192A1 (en) | 2008-10-27 | 2010-04-29 | Barry Mark A | System and method for aligning vertebrae in the amelioration of aberrant spinal column deviation condition in patients requiring the accomodation of spinal column growth or elongation |
CN105943145B (en) | 2008-10-31 | 2020-09-08 | 伊姆普兰蒂卡专利有限公司 | Device and method for bone adjustment using wireless energy transmission |
US8828058B2 (en) | 2008-11-11 | 2014-09-09 | Kspine, Inc. | Growth directed vertebral fixation system with distractible connector(s) and apical control |
US8147549B2 (en) | 2008-11-24 | 2012-04-03 | Warsaw Orthopedic, Inc. | Orthopedic implant with sensor communications antenna and associated diagnostics measuring, monitoring, and response system |
US8043338B2 (en) | 2008-12-03 | 2011-10-25 | Zimmer Spine, Inc. | Adjustable assembly for correcting spinal abnormalities |
US20100137872A1 (en) | 2008-12-03 | 2010-06-03 | Linvatec Corporation | Drill guide for cruciate ligament repair |
US8133280B2 (en) | 2008-12-19 | 2012-03-13 | Depuy Spine, Inc. | Methods and devices for expanding a spinal canal |
US20100160924A1 (en) | 2008-12-23 | 2010-06-24 | Howmedica Osteonics Corp. | Drill guide with angle verification |
US8556911B2 (en) | 2009-01-27 | 2013-10-15 | Vishal M. Mehta | Arthroscopic tunnel guide for rotator cuff repair |
WO2010088621A1 (en) | 2009-02-02 | 2010-08-05 | Simpirica Spine, Inc. | Sacral tether anchor and methods of use |
US8221420B2 (en) | 2009-02-16 | 2012-07-17 | Aoi Medical, Inc. | Trauma nail accumulator |
US8197490B2 (en) | 2009-02-23 | 2012-06-12 | Ellipse Technologies, Inc. | Non-invasive adjustable distraction system |
DE102009011661A1 (en) | 2009-03-04 | 2010-09-09 | Wittenstein Ag | growing prosthesis |
WO2010104975A1 (en) | 2009-03-10 | 2010-09-16 | Simpirica Spine, Inc. | Surgical tether apparatus and methods of use |
JP2012520131A (en) | 2009-03-10 | 2012-09-06 | シンピライカ スパイン, インコーポレイテッド | Surgical tether device and method of use |
US8357183B2 (en) | 2009-03-26 | 2013-01-22 | Kspine, Inc. | Semi-constrained anchoring system |
US8668719B2 (en) | 2009-03-30 | 2014-03-11 | Simpirica Spine, Inc. | Methods and apparatus for improving shear loading capacity of a spinal segment |
JP2012522602A (en) | 2009-04-02 | 2012-09-27 | アヴェドロ・インコーポレーテッド | Eye treatment system |
US9095436B2 (en) | 2009-04-14 | 2015-08-04 | The Invention Science Fund I, Llc | Adjustable orthopedic implant and method for treating an orthopedic condition in a subject |
US20100318129A1 (en) | 2009-06-16 | 2010-12-16 | Kspine, Inc. | Deformity alignment system with reactive force balancing |
US8394124B2 (en) | 2009-06-18 | 2013-03-12 | The University Of Toledo | Unidirectional rotatory pedicle screw and spinal deformity correction device for correction of spinal deformity in growing children |
FR2947170B1 (en) | 2009-06-24 | 2011-07-22 | Jean Marc Guichet | ELONGATION NUTS FOR LONG OR SIMILAR BONES |
US8105360B1 (en) | 2009-07-16 | 2012-01-31 | Orthonex LLC | Device for dynamic stabilization of the spine |
EP2464300B1 (en) | 2009-08-13 | 2014-08-27 | Cork Institute Of Technology | Intramedullary nails for long bone fracture setting |
US9278004B2 (en) | 2009-08-27 | 2016-03-08 | Cotera, Inc. | Method and apparatus for altering biomechanics of the articular joints |
CN116570353A (en) | 2009-08-27 | 2023-08-11 | 铸造有限责任公司 | Device for changing the load between the patella and the femur in a knee joint and for treating hip joint diseases |
WO2014040013A1 (en) | 2012-09-10 | 2014-03-13 | Cotera, Inc. | Method and apparatus for treating canine cruciate ligament disease |
US8657856B2 (en) | 2009-08-28 | 2014-02-25 | Pioneer Surgical Technology, Inc. | Size transition spinal rod |
GB0915382D0 (en) | 2009-09-03 | 2009-10-07 | Dalmatic As | Expansion devices |
KR101710741B1 (en) | 2009-09-04 | 2017-02-27 | 누베이시브 스페셜라이즈드 오소페딕스, 인크. | Bone growth device and method |
US20110057756A1 (en) | 2009-09-04 | 2011-03-10 | Electron Energy Corporation | Rare Earth Composite Magnets with Increased Resistivity |
FR2949662B1 (en) | 2009-09-09 | 2011-09-30 | Arnaud Soubeiran | INTRA-BODY DEVICE FOR MOVING TISSUE |
US9168071B2 (en) | 2009-09-15 | 2015-10-27 | K2M, Inc. | Growth modulation system |
PL215752B1 (en) | 2009-09-28 | 2014-01-31 | Lfc Spolka Z Ograniczona Odpowiedzialnoscia | Equipment for surgical vertebra movement |
MX2009010782A (en) | 2009-10-05 | 2010-05-03 | Ruben Fernando Sayago | Remote control hydraulic internal distractor for correcting backbone deformities or for lengthening of long human bones. |
US20110098748A1 (en) | 2009-10-26 | 2011-04-28 | Warsaw Orthopedic, Inc. | Adjustable vertebral rod system and methods of use |
US8211151B2 (en) | 2009-10-30 | 2012-07-03 | Warsaw Orthopedic | Devices and methods for dynamic spinal stabilization and correction of spinal deformities |
WO2011066077A2 (en) | 2009-11-24 | 2011-06-03 | Spine21 Ltd. | Spinal fusion cage having post-operative adjustable dimensions |
EP2503947B1 (en) | 2009-11-25 | 2016-10-26 | Spine21 Ltd. | Spinal rod having a post-operative adjustable dimension |
CN102858262B (en) | 2009-12-01 | 2015-05-13 | 新特斯有限责任公司 | Non-fusion scoliosis expandable spinal rod |
US8556901B2 (en) | 2009-12-31 | 2013-10-15 | DePuy Synthes Products, LLC | Reciprocating rasps for use in an orthopaedic surgical procedure |
US8506569B2 (en) | 2009-12-31 | 2013-08-13 | DePuy Synthes Products, LLC | Reciprocating rasps for use in an orthopaedic surgical procedure |
US8585740B1 (en) | 2010-01-12 | 2013-11-19 | AMB Surgical, LLC | Automated growing rod device |
US8777947B2 (en) | 2010-03-19 | 2014-07-15 | Smith & Nephew, Inc. | Telescoping IM nail and actuating mechanism |
US8758347B2 (en) | 2010-03-19 | 2014-06-24 | Nextremity Solutions, Inc. | Dynamic bone plate |
CN102917659B (en) | 2010-03-19 | 2016-04-20 | 史密夫和内修有限公司 | Telescopic intramedullary pin and actuating mechanism |
FR2957776B1 (en) | 2010-03-23 | 2013-02-15 | Arnaud Andre Soubeiran | DEVICE FOR MOVING TISSUES INSIDE THE ORGANISM, ESPECIALLY BONE TISSUES, WITH FIXED TRACTION SCREWS AND ROTATING NUT |
WO2011119873A2 (en) | 2010-03-24 | 2011-09-29 | Board Of Regents Of The University Of Texas System | Ultrasound guided automated wireless distraction osteogenesis |
GB201006173D0 (en) | 2010-04-14 | 2010-06-02 | Depuy Ireland | A distractor |
US20110284014A1 (en) | 2010-05-19 | 2011-11-24 | The Board Of Regents Of The University Of Texas System | Medical Devices That Include Removable Magnet Units and Related Methods |
FI123991B (en) | 2010-05-24 | 2014-01-31 | Synoste Oy | Intrinsic treatment device |
US8641723B2 (en) | 2010-06-03 | 2014-02-04 | Orthonex LLC | Skeletal adjustment device |
EP2575656B1 (en) | 2010-06-07 | 2019-04-10 | Carbofix Orthopedics Ltd. | Composite material bone implant |
FR2960766B1 (en) | 2010-06-07 | 2012-06-15 | Tornier Sa | MODULAR PROSTHESIS AND SURGICAL KIT COMPRISING AT LEAST ONE SUCH MODULAR PROSTHESIS |
US8771272B2 (en) | 2010-06-18 | 2014-07-08 | Kettering University | Easily implantable and stable nail-fastener for skeletal fixation and method |
FR2961386B1 (en) | 2010-06-21 | 2012-07-27 | Arnaud Soubeiran | INTRA-MEDALLIC DEVICE FOR THE RELATIVE MOVEMENT OF TWO LOCKED BONE PORTIONS BY THE MEDULLARY CHANNEL. |
US20120019341A1 (en) | 2010-07-21 | 2012-01-26 | Alexandr Gabay | Composite permanent magnets made from nanoflakes and powders |
US20120019342A1 (en) | 2010-07-21 | 2012-01-26 | Alexander Gabay | Magnets made from nanoflake precursors |
US20120271353A1 (en) | 2010-08-16 | 2012-10-25 | Mark Barry | System and method for aligning vertebrae in the amelioration of aberrant spinal column deviation conditions in patients requiring the accomodation of spinal column growth or elongation |
DE102010047738A1 (en) | 2010-08-26 | 2012-03-01 | Wittenstein Ag | Actuator for scoliosis correction |
US20120088953A1 (en) | 2010-10-08 | 2012-04-12 | Jerry King | Fractured Bone Treatment Methods And Fractured Bone Treatment Assemblies |
US8282671B2 (en) | 2010-10-25 | 2012-10-09 | Orthonex | Smart device for non-invasive skeletal adjustment |
US20120109207A1 (en) | 2010-10-29 | 2012-05-03 | Warsaw Orthopedic, Inc. | Enhanced Interfacial Conformance for a Composite Rod for Spinal Implant Systems with Higher Modulus Core and Lower Modulus Polymeric Sleeve |
US8961567B2 (en) | 2010-11-22 | 2015-02-24 | DePuy Synthes Products, LLC | Non-fusion scoliosis expandable spinal rod |
US8636771B2 (en) | 2010-11-29 | 2014-01-28 | Life Spine, Inc. | Spinal implants for lumbar vertebra to sacrum fixation |
DE202010018144U1 (en) | 2010-12-10 | 2014-05-06 | Celgen Ag | Universal Disarctor for Bone Regeneration |
US9724135B2 (en) | 2010-12-17 | 2017-08-08 | DePuy Synthes Products, Inc. | Methods and systems for minimally invasive posterior arch expansion |
US9168076B2 (en) | 2011-01-25 | 2015-10-27 | Bridging Medical, Llc | Bone compression screw |
US8585595B2 (en) | 2011-01-27 | 2013-11-19 | Biomet Manufacturing, Llc | Method and apparatus for aligning bone screw holes |
US8486076B2 (en) | 2011-01-28 | 2013-07-16 | DePuy Synthes Products, LLC | Oscillating rasp for use in an orthopaedic surgical procedure |
WO2012107056A1 (en) | 2011-02-08 | 2012-08-16 | Stryker Trauma Gmbh | Implant system for bone fixation |
US8852187B2 (en) | 2011-02-14 | 2014-10-07 | Ellipse Technologies, Inc. | Variable length device and method |
US8591549B2 (en) | 2011-04-08 | 2013-11-26 | Warsaw Orthopedic, Inc. | Variable durometer lumbar-sacral implant |
PL218347B1 (en) | 2011-05-12 | 2014-11-28 | Lfc Spółka Z Ograniczoną Odpowiedzialnością | Intervertebral implant for positioning of adjacent vertebrae |
EP2712304A4 (en) | 2011-05-16 | 2015-06-17 | Smith & Nephew Inc | Measuring skeletal distraction |
US9572910B2 (en) | 2011-05-19 | 2017-02-21 | Northwestern University | pH responsive self-healing hydrogels formed by boronate-catechol complexation |
AU2012261983B2 (en) | 2011-06-03 | 2015-10-08 | K2M, Inc. | Spinal correction system actuators |
EP2723262B1 (en) | 2011-06-22 | 2017-05-17 | Synthes GmbH | Assembly for manipulating a bone comprising a position tracking system |
WO2013001463A1 (en) | 2011-06-27 | 2013-01-03 | University Of Cape Town | An endoprosthesis |
US20130013066A1 (en) | 2011-07-06 | 2013-01-10 | Moximed, Inc. | Methods and Devices for Joint Load Control During Healing of Joint Tissue |
WO2013006830A1 (en) | 2011-07-07 | 2013-01-10 | Samy Abdou | Devices and methods to prevent or limit spondlylolisthesis and other aberrant movements of the vertebral bones |
US8636770B2 (en) | 2011-08-08 | 2014-01-28 | Zimmer Spine, Inc. | Bone anchoring device |
DE102011053638A1 (en) | 2011-09-15 | 2013-03-21 | Wittenstein Ag | Mark Nagel |
US8920422B2 (en) | 2011-09-16 | 2014-12-30 | Stryker Trauma Gmbh | Method for tibial nail insertion |
US8968402B2 (en) | 2011-10-18 | 2015-03-03 | Arthrocare Corporation | ACL implants, instruments, and methods |
EP2768436B1 (en) | 2011-10-21 | 2018-04-11 | Innovative Surgical Designs Inc. | Surgical implants for percutaneous lengthening of spinal pedicles to correct spinal stenosis |
US9022917B2 (en) | 2012-07-16 | 2015-05-05 | Sophono, Inc. | Magnetic spacer systems, devices, components and methods for bone conduction hearing aids |
EP2790600B1 (en) | 2011-12-12 | 2017-04-26 | Austen Bioinnovation Institute in Akron | Noninvasive device for adjusting fastener |
US10016226B2 (en) | 2011-12-12 | 2018-07-10 | Children's Hospital Medical Center Of Akron | Noninvasive device for adjusting fastener |
US8617220B2 (en) | 2012-01-04 | 2013-12-31 | Warsaw Orthopedic, Inc. | System and method for correction of a spinal disorder |
US9848894B2 (en) | 2012-01-05 | 2017-12-26 | Pivot Medical, Inc. | Flexible drill bit and angled drill guide for use with the same |
WO2013119528A1 (en) | 2012-02-07 | 2013-08-15 | Io Surgical, Llc | Sensor system, implantable sensor and method for remote sensing of a stimulus in vivo |
US20140052134A1 (en) | 2012-02-08 | 2014-02-20 | Bruce Orisek | Limb lengthening apparatus and methods |
US9561062B2 (en) | 2012-03-19 | 2017-02-07 | Alphatec Spine, Inc. | Spondylolisthesis reduction system |
US20130253587A1 (en) | 2012-03-20 | 2013-09-26 | Warsaw Orthopedic, Inc. | Spinal systems and methods for correction of spinal disorders |
US9339197B2 (en) | 2012-03-26 | 2016-05-17 | Medtronic, Inc. | Intravascular implantable medical device introduction |
US8870881B2 (en) | 2012-04-06 | 2014-10-28 | Warsaw Orthopedic, Inc. | Spinal correction system and method |
US8945188B2 (en) | 2012-04-06 | 2015-02-03 | William Alan Rezach | Spinal correction system and method |
AU2013249305B2 (en) | 2012-04-17 | 2017-05-11 | Aurora Spine, Llc | A dynamic and non-dynamic interspinous fusion implant and bone growth stimulation system |
US20130325071A1 (en) | 2012-05-30 | 2013-12-05 | Marcin Niemiec | Aligning Vertebral Bodies |
WO2013181358A1 (en) | 2012-05-30 | 2013-12-05 | Acumed Llc | Articulated intramedullary nail |
US9393123B2 (en) | 2012-07-17 | 2016-07-19 | Clemson University Research Foundation | Lockable implants |
US20140058450A1 (en) | 2012-08-22 | 2014-02-27 | Warsaw Orthopedic, Inc. | Spinal correction system and method |
US9339300B2 (en) | 2012-11-05 | 2016-05-17 | University of Medical Center of Johannes Guten University Mainz | Dynamic stabilizing device for bones |
US8790409B2 (en) | 2012-12-07 | 2014-07-29 | Cochlear Limited | Securable implantable component |
US9532804B2 (en) | 2013-03-15 | 2017-01-03 | Moximed, Inc. | Implantation approach and instrumentality for an energy absorbing system |
US10420666B2 (en) | 2013-04-08 | 2019-09-24 | Elwha Llc | Apparatus, system, and method for controlling movement of an orthopedic joint prosthesis in a mammalian subject |
US9439797B2 (en) | 2013-04-08 | 2016-09-13 | Elwha Llc | Apparatus, system, and method for controlling movement of an orthopedic joint prosthesis in a mammalian subject |
US20140358150A1 (en) | 2013-05-29 | 2014-12-04 | Children's National Medical Center | Surgical distraction device with external activation |
KR102357811B1 (en) | 2013-10-15 | 2022-02-03 | 스팬도르소, 인코퍼레이티드 | Actuated positioning device for arthroplasty and methods of use |
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Patent Citations (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3915151A (en) * | 1973-03-23 | 1975-10-28 | Werner Kraus | Apparatus for promoting healing processes |
US4731051A (en) * | 1979-04-27 | 1988-03-15 | The Johns Hopkins University | Programmable control means for providing safe and controlled medication infusion |
US5142407A (en) * | 1989-12-22 | 1992-08-25 | Donnelly Corporation | Method of reducing leakage current in electrochemichromic solutions and solutions based thereon |
US20060006944A1 (en) * | 2001-06-29 | 2006-01-12 | Renesas Technology Corp. | High frequency power amplifier circuit |
US20030204274A1 (en) * | 2002-04-26 | 2003-10-30 | Medtronic, Inc. | Patient controlled activation with implantable drug delivery devices |
US20070027080A1 (en) * | 2005-07-29 | 2007-02-01 | Abburi Ramaiah | Method for treatment of vitiligo |
US20080003343A1 (en) * | 2006-06-29 | 2008-01-03 | Patriek Destrooper | Dissolving element |
US7753915B1 (en) * | 2007-06-14 | 2010-07-13 | August Eksler | Bi-directional bone length adjustment system |
US20090112262A1 (en) * | 2007-10-30 | 2009-04-30 | Scott Pool | Skeletal manipulation system |
US20090125062A1 (en) * | 2007-11-08 | 2009-05-14 | Uri Arnin | Spinal implant having a post-operative adjustable dimension |
US20100094302A1 (en) * | 2008-10-13 | 2010-04-15 | Scott Pool | Spinal distraction system |
US20100121323A1 (en) * | 2008-11-10 | 2010-05-13 | Ellipse Technologies, Inc. | External adjustment device for distraction device |
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