# US 2014/0155896 A1 · Instrument and Method to Enhance Articular Cartilage Regeneration > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0155896 A1 - Document ID: US20140155896A1 - Status: Published application - Kind: A1 - Application number: 13/705,472 - Filed: 2012-12-05 - Published: 2014-06-05 - Earliest claimed: 2012-12-05 - Assignees: DePuy Mitek, LLC - Applicants: Depuy Mitek, LLC - Inventors: John R. Cournoyer; Dina Belloli; Jonathan Correia; Scott Woodruff; Bethany F. Grant; Joseph Hernandez - Web page: https://patentgrep.com/patent/US20140155896A1 ## CPC - A61B 17/320016: {Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes (A61B10/0233, A61B17/29, A61B17/3207 take precedence)} - A61B 17/16: Instruments for performing osteoclasis; Drills or chisels for bones; Trepans {(arthroscopic bone cutters A61B17/320016)} - A61B 17/1617: {with mobile or detachable parts} - A61B 17/3472: {for bones, e.g. intraosseus injections} - A61B 17/3478: {Endoscopic needles, e.g. for infusion (biopsy needles A61B10/0233; catheters with injection needles A61M25/0067)} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A perforation instrument and method of using same, including a shaft capable of being inserted into a joint of a patient, having a longitudinal axis, and carrying at least one piercing member, each piercing member having a tip suitable to pierce sub-chondral bone. The instrument is capable of being altered between an exposed condition wherein the tip of the at least one piercing member is exposed and a safety condition wherein the tip of the at least one piercing member is not capable of piercing tissue. ## Claims ### Claim 1 A perforation instrument constructed of medical-grade materials, comprising: a shaft capable of being inserted into a joint of a patient, having a longitudinal axis, and carrying at least one piercing member, each piercing member having a tip suitable to pierce sub-chondral bone; and at least one actuation mechanism to alter the instrument between an exposed condition wherein the tip of the at least one piercing member is exposed and a safety condition wherein the tip of the at least one piercing member is not capable of piercing tissue. ### Claim 2 (depends on 1) The instrument of claim 1 wherein the actuation mechanism is capable of driving the tip of the at least one piercing member transverse to the longitudinal axis of the shaft. ### Claim 3 (depends on 1) The instrument of claim 1 wherein the actuation mechanism is capable of driving the tip of the at least one piercing member to extend radially outwardly. ### Claim 4 (depends on 1) The instrument of claim 1 wherein the at least one piercing member is curved along a plane substantially perpendicular to the longitudinal axis of the shaft. ### Claim 5 (depends on 1) The instrument of claim 1 further including a handle graspable by a hand of a user. ### Claim 6 (depends on 1) The instrument of claim 1 wherein the actuation member includes a movable cover element that substantially encloses the at least one piercing member in the safety condition and is capable of being moved in a manner which exposes the at least one piercing member in the exposed condition. ### Claim 7 (depends on 6) The instrument of claim 6 wherein the actuation member includes a plurality of articulated segments connected to the movable cover element. ### Claim 8 (depends on 1) The instrument of claim 1 wherein the shaft is generally cylindrical. ### Claim 9 (depends on 1) The instrument of claim 1 wherein the shaft is sized to fit within a hip joint. ### Claim 10 (depends on 1) The instrument of claim 1 wherein the shaft has a working length of at least three centimeters and has an outer diameter of less than ten millimeters. ### Claim 11 A perforation instrument constructed of medical-grade materials, comprising: a handle graspable by a hand of a user; a shaft capable of being inserted into a joint of a patient, having a proximal end connected to the handle, having a longitudinal axis, and carrying at least two piercing members at a distal end, each piercing member having a tip suitable to pierce sub-chondral bone to a depth sufficient to release marrow-derived cells; and at least one actuation mechanism to alter the instrument between an exposed condition wherein the tip of each of the at least two piercing members is exposed and a safety condition wherein the tip of the at least two piercing members is not capable of piercing tissue. ### Claim 12 (depends on 11) The instrument of claim 11 wherein at least one of the at least two piercing members is curved along a plane substantially perpendicular to the longitudinal axis of the shaft. ### Claim 13 (depends on 11) The instrument of claim 11 wherein the actuation member includes a movable cover element that substantially encloses each of the at least two piercing members in the safety condition and is capable of being moved in a manner which exposes each of the at least two piercing members in the exposed condition. ### Claim 14 (depends on 13) The instrument of claim 13 wherein the actuation member includes a plurality of articulated segments connected to the movable cover element. ### Claim 15 A method of performing microfracture of sub-chondral bone tissue, comprising: selecting a region within a joint of a patient having sub-chondral bone to be perforated; selecting a perforation instrument including a shaft having a longitudinal axis and carrying at least one piercing member, each piercing member having a tip suitable to pierce sub-chondral bone; placing the instrument into a safety condition wherein the tip of the at least one piercing member is not capable of piercing tissue; inserting the instrument, in the safety condition, into the joint of the patient in the vicinity of the selected region; altering the instrument into an exposed condition wherein the tip of the at least one piercing member is exposed; forming multiple perforations in the sub-chondral bone; returning the instrument to the safety condition; and removing the instrument from the patient. ### Claim 16 (depends on 15) The method of claim 15 wherein forming multiple perforations includes rotating the shaft at least during contact of the tip with bone tissue to be pierced. ### Claim 17 (depends on 16) The method of claim 16 wherein the shaft is rotated manually.