# US 2014/0155946 A1 · Adjustable devices for treating arthritis of the knee

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- Number: US 2014/0155946 A1
- Document ID: US20140155946A1
- Status: Published application
- Kind: A1
- Application number: 14/065,342
- Filed: 2013-10-28
- Published: 2014-06-05
- Earliest claimed: 2012-10-29
- Assignees: Ellipse Technologies, Inc.
- Applicants: Ellipse Technologies, Inc.
- Inventors: David Skinlo; Thomas B. Buford; Ephraim Akyuz; Thomas Weisel; Roger Pisarnwongs; Adam G. Beckett; Jeffrey Lee Gilbert; Frank Yan Liu; Urs Weber; Edmund J. Roschak; Blair Walker; Scott Pool
- Web page: https://patentgrep.com/patent/US20140155946A1

## CPC

- A61B 17/8095: {Wedge osteotomy devices}
- A61B 6/12: Arrangements for detecting or locating foreign bodies
- A61B 17/1675: {for the knee}
- A61B 17/7216: {for bone lengthening or compression (A61B17/7258 takes precedence)}
- A61B 17/8004: {with means for distracting or compressing the bone or bones}
- A61B 17/8023: {Variable length plates adjustable in both directions}
- A61B 17/8061: {specially adapted for particular bones (A61B17/70 and A61B17/74 take precedence)}
- A61B 17/8852: {capable of being assembled or enlarged, or changing shape, inside the bone or disc}
- A61B 17/8872: {Instruments for putting said fixation devices against or away from the bone (A61B17/7074, A61B17/808 take precedence)}
- A61B 17/7016: {electric or electromagnetic means}
- A61B 17/7017: {pneumatic or hydraulic means}
- A61B 2017/00212: {using remote controls}
- A61B 2017/00402: {Piezo electric actuators}
- A61B 2017/00411: {actuated by application of energy from an energy source outside the body}
- A61B 2017/00539: {hydraulically}
- A61B 2017/00544: {pneumatically}
- A61B 2017/00734: {battery operated}
- A61B 2017/00867: {shape memory effect}
- A61B 2017/00876: {magnetic}
- A61B 2017/00991: {Telescopic means}
- A61B 2017/564: {Methods for bone or joint treatment}
- A61B 2017/681: {Alignment, compression, or distraction mechanisms}
- A61F 2/389: {Tibial components (A61F2/3868 takes precedence)}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)

## Abstract

A method of changing a bone angle includes creating an osteotomy between a first portion and a second portion of a tibia of a patient; creating a cavity in the tibia by removing bone material along an axis extending in a substantially longitudinal direction from a first point at the tibial plateau to a second point; placing a non-invasively adjustable implant into the cavity, the non-invasively adjustable implant comprising an adjustable actuator having an outer housing and an inner shaft, telescopically disposed in the outer housing, and a driving element configured to be remotely operable to telescopically displace the inner shaft in relation to the outer housing; coupling one of the outer housing or the inner shaft to the first portion of the tibia; coupling the other of the outer housing or the inner shaft to the second portion of the tibia; and remotely operating the driving element to telescopically displace the inner shaft in relation to the outer housing, thus changing an angle between the first portion and second portion of the tibia.

## Claims

### Claim 1

A method of changing a bone angle, the method comprising:
creating an osteotomy between a first portion and a second portion of a tibia of a patient;
creating a cavity in the tibia by removing bone material along an axis extending in a substantially longitudinal direction from a first point at the tibial plateau to a second point;
placing a non-invasively adjustable implant into the cavity, the non-invasively adjustable implant comprising an adjustable actuator having an outer housing and an inner shaft telescopically disposed in the outer housing, and a driving element configured to be remotely operable to telescopically displace the inner shaft in relation to the outer housing;
coupling one of the outer housing or the inner shaft to the first portion of the tibia;
coupling the other of the outer housing or the inner shaft to the second portion of the tibia; and
remotely operating the driving element to telescopically displace the inner shaft in relation to the outer housing, thus changing an angle between the first portion and second portion of the tibia.

### Claim 2 (depends on 1)

The method of claim 1, wherein the remotely operating step increases the angle between the first portion and second portion of the tibia.

### Claim 3 (depends on 1)

The method of claim 1, wherein the remotely operating step decreases the angle between the first portion and second portion of the tibia.

### Claim 4 (depends on 1)

The method of claim 1, wherein the remotely operating step is performed a plurality of times.

### Claim 5 (depends on 4)

The method of claim 4, wherein the remotely operating step is performed a plurality of times over of period of between one day and one month.

### Claim 6 (depends on 4)

The method of claim 4, wherein a gap (G) measured at a medial edge of the osteotomy is increased a total of between 1 mm and 20 mm during the plurality of times.

### Claim 7 (depends on 6)

The method of claim 6, wherein the gap (G) is increased at an average gap increase rate (GIR) of less than or equal to two millimeters per day during the plurality of times.

### Claim 8 (depends on 1)

The method of claim 1, wherein a gap (G) measured at a medial edge of the osteotomy is increased at a positive distance less than or equal to two millimeters during a twenty-four hour period.

### Claim 9 (depends on 1)

The method of claim 1, further comprising the step of monitoring the growth of bone.

### Claim 10 (depends on 9)

The method of claim 9, wherein the monitoring step is performed via radiography.

### Claim 11 (depends on 1)

The method of claim 1, further comprising the step of allowing bone material to consolidate between the first portion and first portion of the tibia.

### Claim 12 (depends on 1)

The method of claim 1, further comprising the step of surgically removing the non-invasively adjustable implant from the tibia.

### Claim 13 (depends on 1)

The method of claim 1, further comprising the step of removing at least the radially-poled permanent magnet from the patient.

### Claim 14 (depends on 1)

The method of claim 1, wherein the remotely operating step is performed with the patient awake.

### Claim 15 (depends on 14)

The method of claim 14, wherein the amount chosen to telescopically displace the inner shaft is at least partially determined by interpreting feedback from the awake patient.

### Claim 16 (depends on 1)

The method of claim 1, wherein the driving element is selected from the group comprising: a permanent magnet, an inductively coupled motor, an ultrasonically actuated motor, a subcutaneous hydraulic pump, a subcutaneous pneumatic pump, and a shape-memory driven actuator.

### Claim 17 (depends on 16)

The method of claim 16, wherein the driving element comprises a permanent magnet.

### Claim 18 (depends on 17)

The method of claim 17, wherein the permanent magnet is a radially poled rare earth magnet.

### Claim 19 (depends on 17)

The method of claim 17, wherein the remotely operating step further comprises placing an external adjustment device capable of causing a moving magnetic field in the proximity of the patient and causing the permanent magnet to rotate.