Tools for performing less invasive orthopedic joint procedures

Abstract

A tool set for preparing a joint, inserting an implant or removing an implant from a joint in an open or less invasive procedure generally comprises a set of nested tools, pin guides, jigs, and/or immobilization elements. The nested tool set comprises at least one pin and at least one cannulated tool. The cannula can comprise tangs that project from the distal end of the cannula. The tangs can be offset such that drilling removes different amounts of bone relative to drilling through a centered drill guide. The cannulated tool kit can comprise at least one tool guide/cannula, drill bits/reamer, syringe, and/or inserter. At least one cannula is positioned over and around the pin position into the joint. The channel of the cannula guides the other tools into the joint.

What is claimed is: 
     
         1 . A method for preparing an orthopedic joint for the placement of an implant into or extraction of an implant from the joint, the method comprising:
 cutting a passageway into the joint using a drill guide that is positioned asymmetrically relative to the center of the joint, wherein the joint is a sacroiliac joint with the procedure approaching the joint between the ilium and the sacrum through an extra-articular recess.   
     
     
         2 . The method of  claim 1  wherein the drill guide comprises projections asymmetrically positioned relative to a drill channel within the guide and wherein the projections are placed within the joint. 
     
     
         3 . The method of  claim 1  further comprising using a pin to position the drill guide wherein the position of the pin is checked using an imaging technique. 
     
     
         4 . The method of  claim 1  wherein the drilling is performed with a motorized reamer. 
     
     
         5 . A method of placing an implant from a joint, the method comprising:
 preparing the joint for the placement of the implant according to the method of  claim 1 ; and   inserting an implant into the drilled region.   
     
     
         6 . The method of  claim 5  further comprising placement of a biological agent to stimulate bone growth into the joint. 
     
     
         7 . The method of  claim 5  wherein the implant is inserted using a cannulated inserter guided over a pin and within a cannula. 
     
     
         8 . A method for preparing a joint for placement of an implant into or extraction of an implant from a joint, the method comprising:
 placing a set of nested cannulae into a patient, wherein the cannulae comprise projections from a tip of each cannula that are inserted into the joint, at least an inner cannulae further comprising a connection for a releasable handle near a proximal end of the inner cannula, with the inner cannulae sliding effectively freely within an outer cannula such that the inner cannula can be removed to provide the larger inner space of the outer cannula for the performance of a procedure at the joint.   
     
     
         9 . A method for preparing for the insertion of a plurality of implants into or extraction of a plurality of implants from a sacroiliac joint between an ilium and a sacrum through an extra-articular recess using a drill guide comprising a plurality of bores comprising:
 creating a plurality of passageways into the sacroiliac joint by inserting a cannula comprising a channel over pins in different bores of the positioned drill guide, wherein the plurality of bores are spaced in preselected amounts for spacing the implants in preselected amounts in the sacroiliac joint.