Arthroscopic bone transplanting procedure, and medical instruments useful therein

Abstract

Described is an arthroscopic bone transplanting procedure for transplanting a section of a first bone to a second bone. The described procedure is particularly useful for the treatment an anterior shoulder instability, where the first bone is the coracoid and the second bone is the glenoid. Also described is a kit of medical instruments particularly useful in such a procedure.

What is claimed is: 
     
         1 . An arthroscopic drill guide for drilling a second bore in a bone section intended for transplanting over to a second bone, said second bore drilled a predetermined distance from a first bore formed in said bone section, comprising:
 a handle;   an elongated shaft comprising a proximal end and a distal end, said proximal end coupled to said handle, said shaft configured to receive a bone drill;   a drill nut extending distally from said distal end of said shaft and configured to allow a bone drill received within said shaft to pass through;   an arm extending from said distal end of said shaft and at an angle with respect to a longitudinal axis of said shaft, said arm comprising a guide pin mounted on a distal end of said arm and extending parallel to said drill nut, said guide pin positioned a fixed predetermined distance from said drill nut; said guide pin configured to fit within said first bore formed in said bone section.   
     
     
         2 . The drill guide according to  claim 1 , wherein said predetermined distance is 9 mm. 
     
     
         3 . The drill guide according to  claim 1 , wherein said handle is a T-handle. 
     
     
         4 . The drill guide according to  claim 1 , wherein said shaft is cylindrical. 
     
     
         5 . The drill guide according to  claim 1 , wherein said shaft is configured to receive a bone drill of 3 mm in diameter. 
     
     
         6 . The drill guide according to  claim 1 , wherein said drill guide is configured for insertion through an incision formed in an arthroscopic anterior shoulder instability procedure. 
     
     
         7 . A method for drilling a bore in a bone at a predetermined distance from a first bore formed in said bone using a drill guide comprising a handle;
 an elongated shaft comprising a proximal end and a distal end, said proximal end coupled to said handle, said shaft configured to receive a bone drill;   a drill nut extending distally from said distal end of said shaft and configured to allow a bone drill received within said shaft to pass through;   an arm extending from said distal end of said shaft and at an angle with respect to a longitudinal axis of said shaft, said arm comprising a guide pin mounted on a distal end of said arm and extending parallel to said drill nut, said guide pin positioned a fixed predetermined distance from said drill nut; said guide pin configured to fit within said first bore formed in said bone section;   said method comprising
 drilling a first bore in said bone; 
 positioning said guide pin in said first bore; 
 passing a bone drill via said drill nut, and drilling a second bore in said 
 bone at a fixed, predetermined distance from said first bore. 
   
     
     
         8 . The method according to  claim 7 , wherein said method is performed in the treatment of anterior shoulder instability, and wherein said bone is the coracoid. 
     
     
         9 . The method according to  claim 7 , further comprising implanting inserts in said bores. 
     
     
         10 . The method according to  claim 7 , further comprising tapping a thread in said bores. 
     
     
         11 . The method according to  claim 10 , further comprising attaching suture strands or flexible wires to said bores by threading said suture strands or flexible wires into said bores. 
     
     
         12 . The method according to  claim 11 , further comprising attaching said bone to a double cannula via said suture strands or flexible wires. 
     
     
         13 . The method according to  claim 12 , further comprising separating a section of said bone in which said bores were formed to transfer said section using said double cannula. 
     
     
         14 . A kit comprising:
 a drill guide for drilling a second bore in a bone at a predetermined distance from a first bore formed in said bone, said drill guide comprising:
 an elongated shaft; 
 a drill nut extending distally from a distal end of said shaft; 
 an arm extending from said distal end of said shaft and at an angle to a longitudinal axis of said shaft, said arm comprising a guide pin mounted on a distal end of said arm and extending parallel to said drill nut, said guide pin positioned a fixed predetermined distance from said drill nut; 
   a bone drill configured to be inserted through said elongated shaft of said drill guide; and   an elongated tap configured to thread one or more bores formed in a bone by said drill.   
     
     
         15 . A kit according to  claim 14 , further comprising one or more inserts for implanting in said one or more bores. 
     
     
         16 . A kit according to  claim 14 , further comprising suture strands or flexible wires threadable into said bores. 
     
     
         17 . A kit according to  claim 14 , further comprising an osteotome for separating a section of said bone in which said one or more bores are formed. 
     
     
         18 . A kit according to  claim 17 , further comprising a double cannula configured to attach to said bone section via said suture strands or flexible wires.