Methods and Devices for Surgical Guide Pin Placement

Abstract

Methods and devices are provided for placing surgical guide pins, reamers, and ligament grafts into bone. In one exemplary embodiment, the method can include advancing a guide pin that includes a proximal rigid portion and a flexible distal portion. The rigid proximal portion can be advanced into a femoral tunnel such that the flexible distal portion extends across an intra-articular space. The flexible portion of the guide pin can be bent to adjust a distance between the guide pin and articular cartilage. A cannulated reamer can be advanced over the flexible portion of the guide pin and the reamer can be manipulated to avoid contact with the articular cartilage in the intra-articular space. A ligament graft can be secured in the femoral tunnel created by the guide pin and the reamer.

What is claimed is: 
     
         1 . A surgical kit, comprising:
 a guide pin having a rigid proximal portion and a flexible distal portion, the rigid proximal portion of the guide pin being configured to be advanced through a tissue opening adjacent to a femur, across an intra-articular space, and into a femoral tunnel such that the flexible distal portion of the guide pin extends across the intra-articular space and extends out of the tissue opening, the flexible distal portion of the guide pin being configured to be bent within the intra-articular space such that the rigid proximal portion of the guide pin extends at a non-zero angle relative to the flexible distal portion of the guide pin; and   a cannulated reamer, the cannulated reamer being configured to be advanced over the flexible distal portion of the guide pin and to extend across the intra-articular space to position a proximal tip of the reamer in contact with the femur.   
     
     
         2 . The kit of  claim 1 , wherein at least the flexible distal portion of the guide pin is formed of a selectively stiffenable material. 
     
     
         3 . The kit of  claim 2 , wherein the flexible distal portion of the guide pin and the proximal rigid portion of the guide pin are formed of the selectively stiffenable material. 
     
     
         4 . The kit of  claim 2 , wherein the flexible distal portion of the guide pin is formed of the selectively stiffenable material and the proximal rigid portion of the guide pin is not formed of the selectively stiffenable material. 
     
     
         5 . The kit of  claim 1 , wherein the rigid proximal portion and the flexible distal portion are integrally formed. 
     
     
         6 . The kit of  claim 1 , wherein the rigid proximal portion and the flexible distal portion are separate elements, a proximal end of the flexible distal portion being configured to attach to a distal end of the rigid proximal portion to form the guide pin. 
     
     
         7 . A surgical method, comprising:
 attaching a proximal end of a flexible distal portion to a distal end of a rigid proximal portion to form a guide pin;   advancing the rigid proximal portion of the guide pin through a tissue opening adjacent to a femur, across an intra-articular space, and into a femoral tunnel such that the flexible distal portion attached thereto extends across the intra-articular space and extends out of the tissue opening;   bending the flexible distal portion of the guide pin within the intra-articular space such that the rigid proximal portion of the guide pin extends at a non-zero angle relative to the flexible distal portion; and   advancing a cannulated reamer over the flexible distal portion of the guide pin to position a proximal tip of the reamer in contact with the femur, the cannulated reamer being manipulated to substantially avoid contact with articular cartilage within the intra-articular space.   
     
     
         8 . The method of  claim 7 , wherein bending the flexible distal portion of the guide pin comprises bending the flexible distal portion of the guide pin within the intra-articular space away from the articular cartilage. 
     
     
         9 . The method of  claim 7 , wherein advancing the rigid proximal portion of the guide pin through the femur comprises advancing the rigid proximal portion of the guide pin to protrude through a lateral side of the femur. 
     
     
         10 . The method of  claim 7 , further comprising, after advancing the cannulated reamer over the flexible distal portion of the guide pin, straightening the flexible distal portion of the guide pin and reaming the cannulated reamer into the femur over the rigid proximal portion of the guide pin. 
     
     
         11 . A surgical method, comprising:
 advancing a rigid proximal portion of a guide pin anteromedially through a femur to extend out a lateral side of the femur until a flexible distal portion of the guide pin attached to the proximal portion of the guide pin is positioned within the intra-articular space near the femur;   flexing the flexible distal portion of the guide pin within the intra-articular space to adjust a distance between the flexible distal portion of the guide pin and femoral articular cartilage; and   after flexing the flexible distal portion of the guide pin, advancing a reamer over the flexible distal portion of the guide pin to advance the reamer over the rigid proximal portion of the guide pin and into the femur.   
     
     
         12 . The method of  claim 11 , wherein adjusting the distance between the flexible distal portion of the guide pin and the femoral articular cartilage comprises increasing the distance. 
     
     
         13 . The method of  claim 11 , further comprising:
 removing the guide pin and the reamer from a tunnel formed in the femur by the reamer;   after removing the guide pin and the reamer, advancing a graft into the tunnel; and   securing the graft within the tunnel.