Anthroscopic tunnel guide for rotator cuff repair

Abstract

A drill guide assembly for drilling a tunnel having a fixed, non-zero radius of curvature, where the drill guide assembly includes a housing and a sleeve, or cutting tube, configured to reciprocate within the distal portion where the sleeve, or cutting tube, is configured to receive a bone cutting instrument.

1 - 20 . (canceled) 
     
     
         21 . A guide assembly for forming a tunnel within a bone, the guide assembly comprising:
 a housing having a proximal portion including an elongate handle and a distal portion including a distal opening;   a passage extending through the housing from the proximal portion to the distal portion and terminating at the distal opening;   a sleeve configured to be disposed in and move relative to the passage through the distal portion;   a flexible shaft having a distal end comprising a piercing member, the flexible shaft being configured to:
 be disposed within and move relative to the sleeve, 
 be disposed in and move relative to the passage, and 
 retractably extend from the distal opening of the housing; 
   where in a first position:
 at least a portion of the sleeve and the piercing member are disposed within the passage of the distal portion of the housing, and 
 the distal portion of the housing is configured to abut against an external surface of a bone at the distal opening of the housing; and 
   where in a second position:
 at least a portion of the piercing member is moved in a direction away from the proximal portion of the housing and extending from the distal opening of the housing into the bone, such that the piercing member forms a tunnel within the bone, and 
 the distal portion of the housing is configured to maintain the abutment of the distal portion against the external surface of the bone at the distal opening of the housing as established in the first position. 
   
     
     
         22 . The guide assembly of  claim 21 , wherein the flexible shaft further comprises a stop member configured to abut a limiting surface of the housing to limit a distance the flexible shaft travels along the passage within the housing in a proximal to distal direction. 
     
     
         23 . The guide assembly of  claim 21 , wherein the flexible shaft further comprises a stop member configured to abut a proximal end of the sleeve to limit a distance of travel of the flexible shaft within and relative to the sleeve in a proximal to distal direction. 
     
     
         24 . The guide assembly of  claim 21 , wherein the passage through the distal portion has a non-zero radius of curvature. 
     
     
         25 . The guide assembly of  claim 21 , wherein the passage through the distal portion includes a radius of curvature of less than or equal to 75 mm. 
     
     
         26 . The guide assembly of  claim 21 , wherein the passage through the distal portion includes a radius of curvature of between 15 mm and 50 mm. 
     
     
         27 . The guide assembly of  claim 21 , wherein the passage through the distal portion includes an arc-shape of less than or equal to 300 degrees. 
     
     
         28 . The guide assembly of  claim 21 , wherein the passage through the distal portion includes an arc-shape of between about 10 and 30 degrees. 
     
     
         29 . The guide assembly of  claim 21 , wherein the passage through the distal portion has a non-zero radius of curvature and the housing further comprises a distal curvature orientation indicator that indicates an orientation of the non-zero radius of curvature of the distal portion. 
     
     
         30 . The guide assembly of  claim 21 , wherein the sleeve has a diameter of up to approximately 2.2 mm. 
     
     
         31 . The guide assembly of  claim 21 , wherein the sleeve has a diameter of between approximately 2 mm and 4 mm, inclusive. 
     
     
         32 . The guide assembly of  claim 21 , wherein the piercing member has an outer diameter of between approximately 1 mm and 15 mm, inclusive. 
     
     
         33 . The guide assembly of  claim 21 , where in the second position, at least a portion of the sleeve is moved in a direction away from the proximal portion of the housing and extending from the distal opening of the housing into the tunnel within the bone formed by the piercing member. 
     
     
         34 . The guide assembly of  claim 21 , wherein the flexible shaft comprises a plurality of markings viewable external to the housing to indicate a distance the piercing member extends from the distal opening of the housing. 
     
     
         35 . A method for drilling a tunnel within a bone, the method comprising:
 inserting a flexible shaft having a distal end comprising a piercing member into a sleeve and a passage extending through a housing from a proximal portion including an elongate handle to a distal portion including a distal opening, such that at least a portion of the sleeve and the piercing member are disposed within the passage of the distal portion of the housing;   positioning the distal portion of the housing to abut against an external surface of a bone at the distal opening of the housing;   advancing the flexible shaft and the piercing member through the passage toward the distal opening of the housing;   rotationally moving the piercing member relative to the passage through the distal portion of the housing while further advancing the piercing member through the distal opening of the housing into the bone and while maintaining the abutment of the distal portion against the external surface of the bone at the distal opening of the housing; and   forming, by the piercing member, a tunnel within the bone while the piercing member is rotationally moving and further advancing into the bone.   
     
     
         36 . The method of  claim 35 , further comprising advancing the sleeve through the distal opening of the housing into the bone along with the piercing member. 
     
     
         37 . The method of  claim 35 , further comprising limiting a distance of travel of the flexible shaft within the passage of the housing in a proximal to distal direction by engaging a stop member that stops further advancement of the flexible shaft when the stop member abuts a limiting surface of the housing. 
     
     
         38 . The method of  claim 35 , further comprising limiting a distance of travel of the flexible shaft within the sleeve in a proximal to distal direction by engaging a stop member that stops further advancement of the flexible shaft when the stop member abuts a limiting surface of the sleeve. 
     
     
         39 . The method of  claim 35 , wherein advancing the flexible shaft and the piercing member through the passage toward the distal opening of the housing comprises advancing the flexible shaft and the piercing member through a curved portion of the passage having an arc-shape of between about 10 and 30 degrees. 
     
     
         40 . The method of  claim 35 , wherein positioning the distal portion of the housing to abut against an external surface of a bone comprises orienting a plane of a non-zero radius of curvature of the passage through the distal portion of the housing relative to the external surface of the bone according to a distal curvature orientation indicator that indicates an orientation of the non-zero radius of curvature of the distal portion.