Retro guidewire reamer

Patent metadata

Field	Value
Publication number	US-10105150-B2
Application number	US-201414198900-A
Country	US
Kind code	B2
Filing date	Mar 6, 2014
Priority date	Mar 12, 2013
Publication date	Oct 23, 2018
Grant date	Oct 23, 2018

Abstract

A retro guidewire reamer includes a cutting member, and a mechanism for moving the cutting member from a closed position to a deployed position in a single manual motion. Once a desired size of a bone tunnel is established, a surgeon uses the reamer to create a primary bone tunnel over a guidewire from the outside in. The surgeon retracts the guidewire, and activates the mechanism to deploy the cutting member within the bone joint to conform to the size of a tendon graft. The surgeon uses the deployed cutting member to create a counter bore through the bone in a retrograde manner. Once the counter bore is drilled, the surgeon activates the mechanism to close the cutting member, allowing the reamer to be withdrawn through the primary tunnel. The retro guidewire reamer can be used to provide more accurate bone tunnel placement during ligament reconstruction surgery.

First claim

What is claimed is:

1. A surgical instrument for use in creating tunnels through bone, comprising:
a first tubular shaft having an open distal end and a proximal end, the first tubular shaft being configured to be disposable over a guidewire;
at least one cutting member movably disposed adjacent the distal end of the first tubular shaft and
a first mechanism disposed adjacent the proximal end of the first tubular shaft, the first mechanism operative in a single manual motion to move the at least one cutting member between a closed position, wherein the at least one cutting member is covered by the first tubular shaft, and a deployed position, wherein the at least one cutting member extends from the open distal end of the first tubular shaft, the single manual motion constituting an axial movement of the first tubular shaft toward the first mechanism;
wherein the first mechanism includes a drive bushing configured for axial movement along an outer surface of the first tubular shaft;
wherein the at least one cutting member defines a hole through the cutting member adapted to accommodate the guidewire at least while in the deployed position, thereby preventing movement of the at least one cutting member from the deployed position during use; and
wherein the hole is configured to be engageable with a structural feature of the guidewire while in the deployed position.

2. The surgical instrument of claim 1 wherein the at least one cutting member is further configured to be engageable with the guidewire while in the closed position, thereby preventing further movement of the at least one cutting member from the closed position during use.

3. The surgical instrument of claim 1 , wherein the cutting member includes at least one first structural feature configured to be engageable with the structural feature of the guidewire while in the deployed position, thereby preventing the movement of the cutting member from the deployed position during use, wherein the at least one first structural feature is a tab and the structural feature of the guidewire is one of a helix spline, a flute, a slot, and a thread.

4. The surgical instrument of claim 1 further comprising:
a second mechanism operative to secure the guidewire within the first tubular shaft while the at least one cutting member is at least in the deployed position.

5. The surgical instrument of claim 4 wherein the second mechanism includes a lock knob disposed adjacent the proximal end of the first tubular shaft, the lock knob having a pin or projection configured to engage a hole in the tubular shaft.

6. The surgical instrument of claim 5 wherein the second mechanism further includes a lock bushing ring, and wherein the pin or projection of the lock knob is configured to pass through the lock bushing ring, and to engage the hole in the tubular shaft, thereby allowing the pin or projection to make contact with the guidewire disposed in the first tubular shaft.

7. The surgical instrument of claim 1 wherein the surgical instrument further comprises:
a second tubular shaft having a distal end and a proximal end, the second tubular shaft being disposed at least partially within the first tubular shaft, the at least one cutting member being movably coupled to the second tubular shaft adjacent the distal end of the second tubular shaft; and
an actuator coupled between the first mechanism and the at least one cutting member.

8. The surgical instrument of claim 7 wherein the axial movement of the first tubular shaft toward the first mechanism causes the first mechanism to move the actuator toward the at least one cutting member for moving the at least one cutting member from the closed position to the deployed position.

9. The surgical instrument of claim 7 further comprising:
a drill bit disposed at the distal end of the second tubular shaft for over-drilling the guidewire.

10. The surgical instrument of claim 1 further comprising:
a second tubular shaft having a distal end and a proximal end, the second tubular shaft being disposed at least partially within the first tubular shaft,
wherein the first mechanism is disposed adjacent the distal end of the second tubular shaft and includes at least one stop, and
wherein the at least one cutting member is movably coupled to the first tubular shaft adjacent the distal end of the first tubular shaft.

11. The surgical instrument of claim 10 wherein the axial movement of the first tubular shaft toward the first mechanism causes the at least one cutting member to contact the at least one stop, and, in response to contacting the at least one stop, to move from the closed position to the deployed position.

12. The surgical instrument of claim 1 further comprising an elongated actuator operatively connected between the drive bushing and the at least one cutting member.

13. The surgical instrument of claim 1 wherein the at least one cutting member is configured as a hollow segment with a central axis, and wherein the at least one cutting member has a cannulated sidewall with first sharpened edges at a forward circumferential end thereof, and second sharpened edges on an outside surface thereof.

14. The surgical instrument of claim 13 wherein the first tubular shaft has a longitudinal axis, wherein the at least one cutting member is rotatably coupled at the distal end of the first tubular shaft such that it can rotate between the closed position where its central axis is coincident with the longitudinal axis of the first tubular shaft, and the deployed position where its central axis is disposed at an angle to the longitudinal axis of the first tubular shaft, and wherein the at least one cutting member is operative, while in the closed position, to drill a tunnel through the bone over the guidewire in an antegrade manner, and, while in the deployed position, to drill a counter bore through the bone over the guidewire in a retrograde manner.

15. The surgical instrument of claim 1 wherein the at least one cutting member is configured as a hollow segment with a central axis, and wherein the at least one cutting member has a cannulated sidewall with first sharpened edges on an outside surface thereof.

16. The surgical instrument of claim 15 wherein the first tubular shaft has a longitudinal axis, and wherein the at least one cutting member is rotatably coupled at the distal end of the first tubular shaft such that it can rotate between the closed position where its central axis is coincident with the longitudinal axis of the first tubular shaft, and the deployed position where its central axis is disposed at an angle to the longitudinal axis of the first tubular shaft.

17. The surgical instrument of claim 16 wherein the first tubular shaft has second sharpened edges at a forward circumferential end thereof, wherein the first tubular shaft is operative, while the at least one cutting member is in the closed position, to drill a tunnel through the bone over the guidewire in an antegrade manner, and wherein the at least one cutting member is operative, while in the deployed position, to drill a counter bore through the bone over the guidewire in a retrograde manner.

Assignees

• Smith & Nephew Inc
• Smith & Newphew Inc

Inventors

• Bourque Bernard J
• Callaghan David J
• Ferragamo Michael C

Classifications

• A61B17/1624

  Drive mechanisms therefor · CPC title

• A61B17/1675

  for the knee · CPC title

• A61B17/1697

  specially adapted for wire insertion · CPC title

• A61B2090/036

  abutting on tissue or skin · CPC title

• A61B17/1622

  Drill handpieces (A61B17/1626, A61B17/1628 take precedence) · CPC title