Drill guide for cruciate ligament repair

Abstract

A guide that facilitates the creation of two bone tunnels for use during a “double bundle” cruciate ligament repair. In the case of an anterior cruciate ligament repair the guide facilitates the formation of two tibial tunnels extending between a single aperture on the anterior tibia and two distinct apertures on the tibial plateau. The guide has a single angled throughbore for guiding a drill bit on a predetermined angle relative to the anterior portion of the tibial tunnel. In an alternative embodiment the guide has two independent and non-intersecting bores which allow the simultaneous placement into the tibial tunnel of two separate guide pins to guide the formation of two tibial tunnels on the tibial plateau.

1 . A guide for guiding a drill bit into a preformed bone tunnel having a first diameter, said guide comprising:
 an elongated body having a proximal end, a distal end, a first axis and a cylindrical portion at said distal end, said cylindrical portion coaxial with said axis and having a predetermined outer diameter adapted to fit within said bone tunnel;   a bore extending through said cylindrical portion, said bore having a second axis, oriented at a predetermined angle relative to said first axis.   
     
     
         2 . A guide according to  claim 1  further comprising:
 a transverse, distally facing end surface coaxially situated on said cylindrical portion.   
     
     
         3 . A guide according to  claim 2  wherein at least a portion of said bore intersects said end surface. 
     
     
         4 . A guide according to  claim 1  further comprising a bore having a third axis oriented at a predetermined angle relative to said first and second axes. 
     
     
         5 . A guide according to  claim 1  wherein, when said guide is inserted into a bone tunnel, said bore is adapted to receive and guide an elongated drill bit into the bone around the bone tunnel at a predetermined angle relative to the tunnel axis. 
     
     
         6 . A tibial guide for guiding a plurality of guide pins into a preformed tibial bone tunnel comprising:
 a body having an axis and a distal portion thereof adapted to be received in the bone tunnel;   an axial bore extending through said body;   a first bore through said distal portion for receiving a first guide pin and directing it through said body toward a first point on the tibial plateau, said first bore inclined at a first predetermined angle relative to said axis; and   a second bore through said distal portion for receiving a second guide pin and directing it through said body to a second point on the tibial plateau, the second point being spaced a predetermined distance from said first point, said second bore inclined at a first predetermined angle relative to said axis.   
     
     
         7 . A tibial guide according to  claim 6  wherein said first and second bores are each inclined relative to said axis. 
     
     
         8 . A tibial guide according to  claim 6  wherein said second point is posterior to said first point. 
     
     
         9 . A tibial guide according to  claim 7  wherein said first and second bores do not intersect said axis. 
     
     
         10 . A tibial guide according to  claim 9  wherein said first and second bores are each inclined relative to said axis in two orthogonal views. 
     
     
         11 . A tibial guide according to  claim 10  wherein said orthogonal views are lateral and anterior-posterior. 
     
     
         12 . A method of creating a pair of tibial bone tunnels, each having a separate exit aperture on the tibial plateau, said method comprising the steps of:
 forming a first bone tunnel extending from the anterior tibia toward but not through the tibial plateau;   providing a guide for guiding a drill bit into a preformed bone tunnel having a first diameter, said guide comprising:   an elongated body having a proximal end, a distal end, a first axis and a cylindrical portion at said distal end, said cylindrical portion coaxial with said axis and having a predetermined outer diameter adapted to fit within said bone tunnel;   a bore extending through said cylindrical portion, said bore having a second axis, oriented at a predetermined angle relative to said first axis;   inserting the cylindrical distal portion of said guide into said bone tunnel;   drilling through said distal portion of bone in said first bone tunnel to form a second bone tunnel having a predetermined diameter smaller than the diameter of said first bone tunnel, thereby producing a shoulder between said first and second bone tunnels;   inserting said guide into said first bone tunnel;   advancing said guide until it abuts the shoulder at the junction of said first and second bone tunnels;   orienting said guide about its axis to align said bore with a selected point on the tibial plateau;   advancing a drill through said bore toward said selected point on the tibial plateau to form a third bone tunnel.   
     
     
         13 . A method of creating a pair of bone tunnels in a bone having an anterior surface and a posterior surface comprising the steps of:
 forming a first bone tunnel extending along a first axis from a first aperture in the anterior bone surface towards a first predetermined point on the posterior bone surface; and   forming a second bone tunnel extending along a second axis from said first aperture on the anterior bone surface towards a second predetermine point on the posterior bone surface.