Minimally invasive orthopaedic apparatus and methods

Abstract

Apparatus and methods for use in the performance of minimally invasive orthopaedic procedures, including apparatus and methods for use in the performance of such procedures under the visualization of an endoscope, are herein disclosed. Such procedures include a minimally invasive intramedullary nailing procedure, a minimally invasive bone graft harvesting procedure, a minimally invasive pelvic osteotomy procedure, an orthopaedic implant revision procedure, and a minimally invasive percutaneous bone plating procedure.

1 . A method of performing an intramedullary nailing procedure on a fractured bone, the method comprising the steps of: 
 advancing a tip of a trocar through a skin incision and through subcutaneous tissue under visualization of an endoscope to a nail-entry location of the fractured bone,    advancing an instrument through a cannula of the trocar so as to prepare the nail-entry location of the fractured bone, and    implanting an intramedullary nail through the skin incision and into the fractured bone through the nail-entry location.    
     
     
         2 . The method of  claim 1 , wherein the step of advancing the instrument through the cannula of the trocar comprises advancing the instrument under visualization of an endoscope.  
     
     
         3 . The method of  claim 1 , further comprising the step of positioning an endoscope in the cannula of the trocar during the step of advancing the tip of the trocar.  
     
     
         4 . The method of  claim 1 , wherein the step of advancing the instrument through the cannula of the trocar so as to prepare the nail-entry location of the fractured bone comprises advancing an awl through the cannula of the trocar.  
     
     
         5 . The method of  claim 1 , wherein the step of advancing the instrument through the cannula of the trocar so as to prepare the nail-entry location of the fractured bone comprises advancing a bone drill through the cannula of the trocar.  
     
     
         6 . The method of  claim 1 , wherein the step of advancing the instrument through the cannula of the trocar so as to prepare the nail-entry location of the fractured bone comprises advancing a guide wire through the cannula of the trocar.  
     
     
         7 . The method of  claim 1 , wherein an endoscope is positioned in the cannula of the trocar during the step of advancing the instrument through the cannula of the trocar so as to prepare the nail-entry location of the fractured bone.  
     
     
         8 . A method of performing a bone harvesting procedure, the method comprising the steps of: 
 advancing a tip of a trocar through a skin incision and through subcutaneous tissue to a harvesting location of a donor bone, and    advancing an instrument through a cannula of the trocar so as to remove bone graft material from the donor bone.    
     
     
         9 . The method of  claim 8 , wherein the step of advancing the tip of the trocar comprises advancing the tip of the trocar under visualization of an endoscope.  
     
     
         10 . The method of  claim 8 , further comprising the step of positioning an endoscope in the cannula of the trocar during the step of advancing the tip of the trocar.  
     
     
         11 . The method of  claim 8 , wherein the step of advancing the instrument through the cannula of the trocar so as to remove bone graft material from the donor bone comprises advancing an osteotome through the cannula of the trocar.  
     
     
         12 . The method of  claim 8 , wherein the step of advancing the instrument through the cannula of the trocar so as to remove bone graft material from the donor bone comprises removing the bone graft material from the donor bone under visualization of an endoscope.  
     
     
         13 . The method of  claim 12 , further comprising the step of positioning the endoscope in the cannula of the trocar during the step of advancing the tip of the trocar.  
     
     
         14 . A method of performing a pelvic osteotomy, the method comprising the steps of: 
 advancing a tip of a trocar through a skin incision and through subcutaneous tissue to a location proximate a hip bone, and    advancing an instrument through a cannula of the trocar so as to cut a portion of the hip bone.    
     
     
         15 . The method of  claim 14 , wherein the step of advancing the tip of the trocar comprises advancing the tip of the trocar under visualization of an endoscope.  
     
     
         16 . The method of  claim 14 , further comprising the step of positioning an endoscope in the cannula of the trocar during the step of advancing the tip of the trocar.  
     
     
         17 . The method of  claim 14 , wherein the step of advancing the instrument through the cannula of the trocar so as to cut a portion of the hip bone comprises cutting the hip bone under visualization of an endoscope.  
     
     
         18 . The method of  claim 14 , further comprising the step of positioning an endoscope in the cannula of the trocar during cutting of the hip bone.  
     
     
         19 . A method of performing an orthopaedic revision procedure, the method comprising the steps of: 
 removing material from an intramedullary canal of a bone, and    positioning the endoscope in the intramedullary canal of a bone.    
     
     
         20 . The method of  claim 19 , wherein the removing step is performed while the endoscope is positioned in the intramedullary canal.  
     
     
         21 . The method of  claim 19 , wherein the removing step is performed under the visualization of the endoscope.  
     
     
         22 . The method of  claim 19 , wherein the removing step comprises removing bone cement material from the intramedullary canal of the bone.  
     
     
         23 . The method of  claim 19 , wherein the removing step and the positioning step are performed contemporaneously.  
     
     
         24 . The method of  claim 19 , further comprising the step of removing the endoscope from the intramedullary canal of the bone prior to the removing step.