# US 11,439,425 B2 · Surgical procedure of knee joint > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,439,425 B2 - Document ID: US11439425B2 - Status: Granted - Kind: B2 - Application number: 16/686,664 - Filed: 2019-11-18 - Published: 2020-03-12 - Granted: 2022-09-13 - Earliest claimed: 2016-10-28 - Assignees: Olympus Corporation - Applicants: Olympus Corporation - Inventors: Michio Takayama; Takamitsu Sakamoto; Ken Fujisaki - Web page: https://patentgrep.com/patent/US11439425B2 ## CPC - A61B 17/320068: {using mechanical vibrations, e.g. ultrasonic (A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745)} - A61B 17/1675: {for the knee} - A61B 2017/320004: {abrasive} - A61B 2017/32007: {with suction or vacuum means} - A61B 2017/320072: {Working tips with special features, e.g. extending parts} - A61B 2017/320073: {probe} - A61B 2017/564: {Methods for bone or joint treatment} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A surgical procedure of preparing bone holes to dispose an implanted tendon to a femur when performing reconstruction of a ligament in a knee joint, includes: forming a first bone hole in the femur; and applying ultrasonic vibration from a treatment portion of an ultrasonic treatment instrument to the femur, thereby cutting and expanding the first bone hole from the inside of the knee joint to the first bone hole of the femur along a predetermined depth, and forming a second bone hole having a polygonal shape, an approximately polygonal shape, an elliptical shape or an approximately elliptical shape to receive the implanted tendon. ## Claims ### Claim 1 A surgical procedure of preparing bone holes to attach an implanted tendon to a target bone when performing reconstruction of a ligament, comprising: forming a first bone hole in the target bone with a drill that digs the first bone hole in the target bone by rotation; and forming a second bone hole in the target bone with an ultrasonic treatment instrument that shatters the bone by ultrasonic vibration, the second bone hole being configured for insertion of the implanted tendon, wherein: the second bone hole is formed by laterally repositioning the ultrasonic treatment instrument to form a plurality of adjoining bone holes with the ultrasonic treatment instrument in the bone; and the second bone hole, when formed, has a bottom surface including the first bone hole. ### Claim 2 (depends on 1) The surgical procedure according to claim 1, wherein the forming the first bone hole includes inserting the drill into a knee joint through a portal of a knee, the forming the second bone hole includes inserting the ultrasonic treatment instrument into the knee joint through the portal of the knee, and the target bone is a femur. ### Claim 3 (depends on 2) The surgical procedure according to claim 2, wherein the forming the first bone hole includes forming by driving the drill to abut on the femur from an inside to an outside of the knee joint. ### Claim 4 (depends on 2) The surgical procedure according to claim 2, wherein the forming the second bone hole includes forming by driving the ultrasonic treatment instrument to abut on the femur from an inside to an outside of the knee joint. ### Claim 5 (depends on 1) The surgical procedure according to claim 1, wherein the first bone hole is a through hole. ### Claim 6 (depends on 1) The surgical procedure according to claim 1, wherein the forming the second bone hole includes forming the second bone hole to have a polygonal shape or an elliptical shape suitable for the implanted tendon. ### Claim 7 (depends on 1) The surgical procedure according to claim 1, wherein the forming the first bone hole includes forming the first bone hole to have a cylindrical shape. ### Claim 8 (depends on 1) The surgical procedure according to claim 1, wherein the forming the second bone hole includes: forming a first-second bone hole; and forming a second-second bone hole. ### Claim 9 (depends on 8) The surgical procedure according to claim 8, wherein the forming the second-second bone hole includes abutting the ultrasonic treatment instrument on a position adjacent to first-second bone hole, and shattering the bone by the ultrasonic vibration. ### Claim 10 (depends on 8) The surgical procedure according to claim 8, wherein the forming the first-second bone hole includes shallowing the first-second bone hole with respect to the first bone hole. ### Claim 11 (depends on 9) The surgical procedure according to claim 9, wherein the forming the second-second bone hole includes shallowing the second-second bone hole with respect to the first bone hole. ### Claim 12 (depends on 8) The surgical procedure according to claim 8, wherein the forming the first-second bone hole includes abutting the ultrasonic treatment instrument so that a center of the first-second bone hole differs from a center of the first bone hole, and shattering the bone by the ultrasonic vibration. ### Claim 13 (depends on 12) The surgical procedure according to claim 12, wherein the forming the second-second bone hole includes abutting the ultrasonic treatment instrument so that a center of the second-second bone hole differs from a center of the first bone hole, and shattering the bone by the ultrasonic vibration. ### Claim 14 (depends on 8) The surgical procedure according to claim 8, wherein the forming the first-second bone hole includes abutting the ultrasonic treatment instrument to include at least a part of the first bone hole, and shattering the bone by the ultrasonic vibration. ### Claim 15 (depends on 14) The surgical procedure according to claim 14, wherein the forming the second-second bone hole includes abutting the ultrasonic treatment instrument to include at least a part of the first bone hole, and shattering the bone by the ultrasonic vibration. ### Claim 16 (depends on 1) The surgical procedure according to claim 1, wherein the plurality of adjoining bone holes are formed by withdrawing the ultrasonic treatment instrument from the second bone hole after a previous one of the adjoining holes is formed and cutting an additional one of the plurality of adjoining bone holes by commencing the cutting at an exterior surface of the target bone.