# US 10,765,453 B2 · Device and method for treating osteonecrosis

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- Number: US 10,765,453 B2
- Document ID: US10765453B2
- Status: Granted
- Kind: B2
- Application number: 15/956,245
- Filed: 2018-04-18
- Published: 2018-10-18
- Granted: 2020-09-08
- Earliest claimed: 2017-04-18
- Assignees: Texas Scottish Rite Hospital for Children
- Applicants: Texas Scottish Rite Hospital for Children
- Inventors: Harry K. W. Kim
- Web page: https://patentgrep.com/patent/US10765453B2

## CPC

- A61B 17/3472: {for bones, e.g. intraosseus injections}
- A61B 17/1622: {Drill handpieces (A61B17/1626, A61B17/1628 take precedence)}
- A61B 17/1664: {for the hip}
- A61B 17/1668: {for the upper femur (A61B17/164 takes precedence)}
- A61B 17/1697: {specially adapted for wire insertion}
- A61B 17/17: Guides {or aligning means} for drills {, mills, pins or wires}
- A61B 17/1714: {for applying tendons or ligaments (implements for applying tendons or ligaments A61F2/0805)}
- A61B 17/1721: {for applying pins along or parallel to the axis of the femoral neck}
- A61B 17/1725: {for applying transverse screws or pins through intramedullary nails or pins}
- A61B 17/1764: {for the knee}
- A61M 3/0204: {Physical characteristics of the irrigation fluid, e.g. conductivity or turbidity}
- A61M 3/0212: {after use}
- A61M 3/022: {Volume; Flow rate}
- A61B 17/1628: {Motors; Power supplies}
- A61B 17/1739: {specially adapted for particular parts of the body}
- A61B 17/3403: {Needle locating or guiding means}
- A61B 90/50: Supports for surgical instruments, e.g. articulated arms
- A61B 90/57: Accessory clamps
- A61B 2017/00477: {Coupling (A61B2017/0046 takes precedence)}
- A61B 2017/00893: {pharmaceutically effective}
- A61B 2017/3405: {using mechanical guide means}
- A61B 2017/347: {Locking means, e.g. for locking instrument in cannula}
- A61B 2090/062: {penetration depth}
- A61B 2217/007: with irrigation system
- A61M 3/00: Medical syringes, e.g. enemata; Irrigators (A61M5/00 takes precedence; pistons A61M5/315)
- A61M 2210/02: Bones
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

The present invention includes a method and devices for treating osteonecrosis in, e.g., children, adolescents, and adults comprising: identifying a subject in need of treatment for osteonecrosis; drilling two or more holes into a bone in need of treatment for osteonecrosis; inserting two or more needles or cannulas into the holes in the bone; washing an interior of the bone with a washing fluid introduced through one or more of the needles or cannulas inserted into the bone; and after washing the interior of the bone introducing one or more bone growth promoting materials or cells into the bone.

## Claims

### Claim 1

A surgical instrument for washing a bone marrow comprising:
a handle;
a central stationary assembly coupled to the handle, comprising a first guide cannula, a clamping mechanism, a first depth adjustment, and a first protractor arm component;
a first needle assembly disposed to be inserted into, and end in the bone marrow at a first location, and wherein the first needle assembly is inserted into the first guide cannula and comprising a first needle assembly cannula, a first drilling assembly disposed to be inserted in the first needle assembly cannula, and a first locking mechanism disposed to engage the first drill assembly;
an adjustable subassembly disposed to be rotatably coupled to the central stationary assembly and comprising a second guide cannula disposed to engage the clamping mechanism, a second depth adjustment, and a second protractor arm component disposed to slidably engage the first protractor arm component; and
a second needle assembly disposed to be inserted into, and end in the bone marrow at a second location, wherein the first and second locations are separated by the bone marrow to be washed, and the second needle assembly is inserted into the second guide cannula and comprising a second needle assembly cannula, a second drilling assembly disposed to be inserted in the second needle assembly cannula, and a second locking mechanism disposed to engage the second drilling assembly, wherein the first needle assembly and the second needle assembly do not intersect and wherein the first needle assembly cannula is adapted to injected a fluid into the bone marrow that washes the bone marrow to remove dead cell debris, necrotic marrow fat, necrotic extracellular matrix and inflammatory factors from the bone marrow through the second needle assembly cannula.

### Claim 2 (depends on 1)

The surgical instrument of claim 1, wherein the first locking mechanism comprises a first luer lock and a first luer lock collar disposed to engage the first luer lock.

### Claim 3 (depends on 1)

The surgical instrument of claim 1, wherein the second locking mechanism comprises a second luer lock and a second luer lock collar disposed to engage the second luer lock.

### Claim 4 (depends on 1)

The surgical instrument of claim 1, wherein the first locking mechanism comprises a first luer lock and a first drill interface disposed to rotatably engage the first luer lock.

### Claim 5 (depends on 1)

The surgical instrument of claim 1, wherein the second locking mechanism comprises a second luer lock and a second drill interface disposed to rotatably engage the second luer lock.

### Claim 6 (depends on 1)

The surgical instrument of claim 1, wherein the clamping mechanism comprises a guide clamp disposed to engage the second guide cannula, a tension clamp, and a tension clamp lever.

### Claim 7 (depends on 1)

The surgical instrument of claim 1, wherein the first protractor arm component is disposed to slide on or within the second protractor arm component to position a first tip of the first needle assembly relative to a second tip of the second needle assembly when the first needle assembly is inserted into the first guide cannula and the second needle assembly is inserted into the second guide cannula.

### Claim 8

A surgical instrument for washing bone marrow comprising:
a frame with one or more locking pins disposed within the frame, wherein the frame is configured to receive a first guide cannula and a second guide cannula;
the first guide cannula and the second guide cannula, wherein the first guide cannula and the second guide cannula are disposed to be inserted into the frame and locked into place with the one or more locking pins;
a first needle assembly disposed to be inserted into, and end in the bone marrow at a first location, and wherein the first needle assembly is inserted into the first guide cannula and comprising a first needle assembly cannula, a first drilling assembly disposed to be inserted in the first needle cannula assembly, and a first locking mechanism disposed to engage the first drill assembly; and
a second needle assembly disposed to be inserted into, and end in the bone marrow at a second location, wherein the first and second locations are separated by the bone marrow to be washed, and the second needle assemble is inserted into the second guide cannula and comprising a second needle assembly cannula, a second drilling assembly disposed to be inserted in the second needle assembly cannula, and a second locking mechanism disposed to engage the second drilling assembly, wherein the first needle assembly and the second needle assembly do not intersect and wherein the first needle assembly cannula is adapted to injected a fluid into the bone marrow that washes the bone marrow to remove at least one of dead cell debris, necrotic marrow fat, necrotic extracellular matrix or inflammatory factors from the bone marrow through the second needle assembly cannula.

### Claim 9 (depends on 8)

The surgical instrument of claim 8, wherein the first locking mechanism comprises a first luer lock and a first luer lock collar disposed to engage the first luer lock.

### Claim 10 (depends on 8)

The surgical instrument of claim 8, wherein the second locking mechanism comprises a second luer lock and a second luer lock collar disposed to engage the second luer lock.

### Claim 11 (depends on 8)

The surgical instrument of claim 8, wherein the first locking mechanism comprises a first luer lock and a first drill interface disposed to rotatably engage the first luer lock.

### Claim 12 (depends on 8)

The surgical instrument of claim 8, wherein the second locking mechanism comprises a second luer lock and a second drill interface disposed to rotatably engage the second luer lock.