System And Technique For Accessing Extra Articular Lesions Or Abnormalities Or Intra Osseous Lesions Or Bone Marrow Lesions

Abstract

A technique for accessing extra articular lesions or abnormalities or intra osseous lesions or abnormalities or bone marrow lesions or all has the step of utilizing an intra articular localizing pinning member to determine a location of the lesion or abnormality wherein the utilization of the localizing pinning member includes the step of inserting the localizing pinning member through cartilage or subchondral bone into the lesion or abnormality to locate or stabilize or both creating a first entry access. The localizing pinning member enters the bony lesion or abnormality penetrating at least into or through the lesion or abnormality to set the localizing pinning member to the desired depth.

What is claimed is: 
     
         1 . A system for accessing extra articular lesions or abnormalities or intra osseous lesions or abnormalities or bone marrow lesions or all comprising an intra articular localizing pinning member to determine a location of the lesion or abnormality 
     
     
         2 . The system of  claim 1  wherein the utilization of the localizing pinning member includes inserting the localizing pinning member through cartilage or subchondral bone into the lesion or abnormality to locate or stabilize or both creating a first entry access. 
     
     
         3 . The system of  claim 1  wherein the localizing pinning member is a graduated or calibrated depth scale. 
     
     
         4 . The system of  claim 1  wherein the localizing pinning member enters the bony lesion or abnormality penetrating at least into or through the lesion or abnormality to set the localizing pinning member to the desired depth. 
     
     
         5 . The system of  claim 3  further comprises a guide component attachable to an exposed portion of the localizing pinning member at a predetermined position on a shank of the localizing pinning member wherein manipulating the guide component about the localizing pinning member establishes a desired location for the creation of a second entry access based on the relevant anatomy. 
     
     
         6 . The system of  claim 5  wherein the guide component is set or fixed at the desired second entry access point. 
     
     
         7 . The system of  claim 6  further comprises the fixed or set guide component having an opening for passing a drill, a pin or a punch through the guide component to form the second entry access to a desired depth within or in the proximity of the lesion or abnormality. 
     
     
         8 . The system of  claim 7  wherein the second entry access alignment is directed by the position of the localizing pinning member and the guide component, the first and second entry access being oriented in the same plane. 
     
     
         9 . The system of  claim 8  wherein straight lines, one line extending along a track of the localizing pinning member and one line extending along a track of the drill, pin or punch forming the second entry access intersect. 
     
     
         10 . The system of  claim 9  wherein the first entry access has an end in or through the lesion or abnormality and the second entry access has an end at least in proximity to, in or through the lesion or abnormality wherein the first access end is located short of the one line extending from the track of the second access entry, beyond or an intersection. 
     
     
         11 . The system of  claim 5  wherein the guide component has a first arm portion for attachment to the localizing pinning member and a second arm portion for guiding a drill, a punch or a pin. 
     
     
         12 . The system of  claim 11  wherein the first portion is a straight bar having an attachment feature for securing to the localizing pinning member at or near an end and the second arm portion extends arcuately from an end of the first arm portion to an end of the second arm portion, the second arm portion having a moveable guide with an opening for passing the drill, punch or pin. 
     
     
         13 . The system of  claim 12  wherein the moveable guide can be configured along the arcuate second arm portion at any angle between 0° up to 90° relative to the localizing pinning member. 
     
     
         14 . The system of  claim 13  wherein the movable guide is a tubular sleeve and the tubular sleeve is linearly moveable relative to the second arm portion to set the guide component when an end of the sleeve abuts tissue at the desired second access entry location. 
     
     
         15 . The system of  claim 14  wherein the guide component has a clamping attachment to fix the tubular sleeve to the second arm portion. 
     
     
         16 . The system of  claim 15  wherein the second arm portion has a curved slotted opening between ends allowing the guide component to be positioned along the slotted opening prior to being fixed and wherein the first arm portion has a locking nut at an end that when tightened fixes the pinning member depth.