US-12622710-B2 - Center of rotation guide

Abstract

Surgical constructs, assemblies and methods of elbow repair and reconstruction. A center of rotation guide has specific dimensions configured to be secured on either the lateral or medial side of the elbow. At one end, the guide is provided with a plurality of full concentric through-holes (circles of different diameters) with bisecting lines every 90 degrees to identify the center of rotation on the lateral and medial epicondyle. At another end, the guide is provided with a linear pattern of through-holes or apertures located about the centerline of the guide. The linear pattern of through-holes identifies the attachment point on the ulnar tuberosity. The concentric and linear pattern through-holes of the guide are sized to receive instrumentation such as K-wire guides and/or drill guides. One or more spikes or tines are provided on the bottom of the guide for stabilization during use.

Inventors

• Stephan M. BOSCH
• Allen E. Holowecky
• Steven J. Lee
• Steven S. SHIN
• Michael J. Garcia
• Damon C. ADAMANY

Assignees

• ARTHREX, INC.

Dates

Publication Date

20260512

Application Date

20230721

Claims (18)

1. 1 . A center of rotation guide comprising: a cuboid body with a length, a width and a height; at least one protuberance adapted to engage a surface of a capitellum of an elbow; two or more concentric circular holes of different diameters, the two or more concentric circular holes being positioned at one end of the cuboid body; and a linear pattern of a plurality of through-holes extending from a first surface of the cuboid body to a second surface of the cuboid body, wherein the linear pattern of the plurality of through-holes is located at another end of the cuboid body.
2. 2 . The center of rotation guide of claim 1 , wherein the at least one protuberance consists of one or more spikes or tines.
3. 3 . The center of rotation guide of claim 2 , wherein the at least one protuberance consists of two spikes, and wherein one of the two spikes has a height of about 9 mm, and the other of the two spikes has a height of about 5 mm.
4. 4 . The center of rotation guide of claim 1 , wherein the two or more concentric circular holes are through-holes extending from the first surface of the cuboid body to the second surface of the cuboid body, and wherein the two or more concentric circular holes determine the center of rotation of a lateral or medial epicondyle of the elbow.
5. 5 . The center of rotation guide of claim 1 , wherein the linear pattern of the plurality of through-holes is positioned along a longitudinal axis of the cuboid body.
6. 6 . The center of rotation guide of claim 1 , wherein the linear pattern of the plurality of through-holes is configured to identify an attachment point on an ulnar tuberosity.
7. 7 . The center of rotation guide of claim 1 , wherein the length is about 1.9 to about 2.25 inches, the width is about 0.8 to about 1.2 inches, and the height is about 0.060 to 0.120 inches.
8. 8 . The center of rotation guide of claim 1 , wherein the length is about 1.98 inches and the width is about 0.9 inches.
9. 9 . The center of rotation guide of claim 1 , wherein the plurality of linear through-holes are symmetrically located relative to a longitudinal axis of the cuboid body.
10. 10 . The center of rotation guide of claim 1 , wherein the guide is configured to be employed in ulnar collateral ligament repair or reconstruction.
11. 11 . The center of rotation guide of claim 1 , wherein the guide is configured to be employed in lateral ulnar collateral ligament repair or reconstruction.
12. 12 . The center of rotation guide of claim 1 , wherein the two or more concentric circular holes include a plurality of bisecting lines.
13. 13 . A surgical kit, comprising: a center of rotation guide comprising a cuboid body; one or more spikes configured to attach to a surface of a capitellum to be drilled; two or more concentric circular holes of different diameters positioned at one end of the cuboid body for identifying a center of rotation of lateral or medial epicondyle, the two or more concentric circular holes including a plurality of bisecting lines; and a plurality of through-holes positioned at another end of the cuboid body for identifying an attachment point on ulnar tuberosity; and at least one surgical instrument.
14. 14 . The surgical kit of claim 13 , wherein the at least one surgical instrument is a pin, a guide, a k-wire, a drill, or a cutting instrument.
15. 15 . The surgical kit of claim 13 , further comprising at least one fixation device.
16. 16 . The surgical kit of claim 15 , wherein the at least one fixation device is a suture anchor.
17. 17 . The surgical kit of claim 13 , wherein the center of rotation guide is disposable.
18. 18 . The surgical kit of claim 13 , wherein the plurality of through-holes are symmetrically located relative to a longitudinal axis of the cuboid body.

Description

BACKGROUND The disclosure relates to the field of surgery and, more particularly, to guides for determining a center of rotation of an elbow joint and associated methods of surgical repairs. SUMMARY A center of rotation guide is in the form of a cuboid with specific dimensions configured to be secured on either the lateral or medial side of the elbow. At one end, the guide is provided with a plurality of full concentric through-holes (circles of different diameters) with bisecting lines about every 90 degrees to identify the center of rotation on the lateral or medial epicondyle. At another end, the guide is provided with a linear pattern of through-holes or apertures located about the centerline of the guide. The linear pattern of through-holes identifies the attachment point on ulna. The concentric and linear pattern through-holes of the guide are sized to receive instrumentation such as K-wires, guides and/or drills. One or more bone engaging structures (spikes or tines) can be provided on one of the surfaces of the guide for stabilization during use. Methods of surgeries are also disclosed. In an embodiment, collateral ligament repair or reconstruction is conducted with a guide configured to accurately identify the center of rotation of the lateral and/or medial epicondyle for medial/lateral collateral ligament repair/reconstruction around the elbow. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 illustrates a perspective view of a center of rotation guide. FIG. 2 is a top view of the guide of FIG. 1. FIG. 3 is a lateral side view of the guide of FIG. 1. FIG. 4 is a front view of the guide of FIG. 1. FIG. 5 illustrates a perspective view of another center of rotation guide. FIG. 6 is a top view of the guide of FIG. 5. FIG. 7 is a lateral side view of the guide of FIG. 5. FIG. 8 is a front view of the guide of FIG. 5. FIG. 9 illustrates a top view of another center of rotation guide. FIGS. 10-12 illustrate subsequent steps of reconstructive surgery with a center of rotation guide. DETAILED DESCRIPTION The disclosure provides surgical constructs, assemblies, kits, and methods for locating, determining, and marking the center of rotation of the elbow joint (i.e., center of rotation of the lateral and/or medial epicondyle) for repairs and reconstructions of the elbow, for example, ulnar collateral ligament (UCL) repair or lateral ulnar collateral ligament (LUCL) repair. The surgical guide of the present disclosure allows finding the center of rotation in a quick, easy, and efficient manner. The surgical guide eliminates the need for the current use of radiographic or fluoroscopic images, or the use of 3-dimensional computed tomography (CT), that currently aid surgeons in finding the center of rotation. Radiography, fluorography, and CT are time consuming, difficult, and expose both the providers and patients to radiation, while still averaging about 1.1 mm of elongation throughout the elbow's range of motion. Fluoroscopy is also associated with substantial rotational errors and large inconsistencies among surgeons. As detailed below, the surgical guide of the disclosure assists surgeons in locating the center of rotation via three checks: 1. using the outer edge of the capitellum articular surface and the equidistant central point from the edge (for the lateral collateral ligament);2. using the convergent point of the bisecting lines of the radial head measured at various degrees such as 0, 45 and 90 degrees; and3. using the drill hole pattern that, when combined with k-wire(s), can determine if the isometric location has been found when the elbow is put through the range of motion. The use of the guide eliminates the need for fluoroscopy, radiography, and CT; speeds up the procedure time; eliminates exposure to radiation; improves surgeons' accuracy; and improves the elbow isometry in collateral ligament repair/reconstruction. The use of the guide also eliminates the need for finding the true axis of rotation (and the use of a corresponding axis guide and subsequent second surgery for removal) as commonly used in current elbow stabilization systems. As detailed below, a center of rotation guide can include a solid metal body in the shape of a general cuboid having a length of about 1.9 to about 2.25 inches, a width of about 0.8 to about 1.2 inches, and a height of about 0.06 to 0.12 inches. One end of the guide has a semi-circular configuration and is provided with two or more concentric through-holes or circles, which pinpoint the center of rotation. The other end of the guide has a generally rectangular shape and is provided with a plurality of through-holes or apertures. The plurality of through-holes or apertures can form a linear pattern located about the centerline of the guide. The linear pattern of through-holes or apertures helps in identifying the attachment point on the ulnar tuberosity. One or more bone engaging structures (spikes or tines) can be provided on one of the surfaces of the guide (on the