Arthroscopic devices and methods

Abstract

An elongated shaft assembly includes a rotatable inner cutting sleeve and a non-rotating outer sleeve. A window of the inner cutting sleeve is selectively rotatable within an opening of the non-rotating outer sleeve to cut tissue with a sharpened cutting blade when rotated in a first rotational direction and to cut tissue with an electrode when rotated in a second rotational direction.

1 . A surgical system comprising:
 an outer sleeve having a longitudinal axis and an opening in a distal region thereof;   an inner sleeve rotationally disposed within said outer sleeve, said inner sleeve having a distal region, a proximal region, and an interior passageway disposed therebetween, wherein a cutting window is formed in a wall of the distal region of the inner sleeve;   a cutting edge on one side of the cutting window; and   an electrode on an opposite side of the cutting window;   wherein rotating the inner sleeve in a first rotational direction relative to the outer sleeve cuts tissue with the cutting edge and rotating the inner sleeve in a second rotational direction opposite to the first rotational direction cuts tissue with the electrode.   
     
     
         2 . The surgical system of  claim 1  further comprising:
 a motor configured to selectively rotate in the inner sleeve in first and second rotational directions; and 
 a radiofrequency (RF) current source configured to be coupled to the electrode 
 
     
     
         3 . The surgical system of  claim 2  further comprising a controller operatively coupled to the motor and to the RF source. 
     
     
         4 . The surgical system of  claim 3  wherein the controller is configured to selectively operate in a first mode in which the motor rotates the inner sleeve in the first rotational direction with the electrode not energized and in a second mode in which the motor rotates the inner sleeve in the second rotational direction with the RF source delivering a cutting current to the electrode to cut tissue. 
     
     
         5 . The surgical system of  claim 4  wherein the controller is further configured to selectively operate in a third mode in which the motor drive is stopped with the RF source delivering a cauterizing current to the electrode to coagulate to tissue. 
     
     
         6 . The surgical system of  claim 4  wherein the controller is further configured to selectively operate in a fourth mode in which the motor drive is stopped with the RF source delivering a cutting current to the electrode to cut or ablate tissue. 
     
     
         7 . The surgical system of  claim 4  wherein the controller is configured to selectively operate in a fifth mode in which the motor rotationally oscillates the inner sleeve relative to the outer sleeve in the first and second rotational directions. 
     
     
         8 . The surgical system of  claim 2  further comprising a hub at a proximal end of the shaft assembly, wherein the hub is detachably connected to the motor. 
     
     
         9 . The surgical system of  claim 1  wherein a proximal portion of the shaft assembly is configured to be connected to an external fluid source to deliver a fluid through a passageway in the shaft assembly and release the fluid from a distal region of the shaft assembly to a tissue interface. 
     
     
         10 . The surgical system of  claim 1  wherein a proximal portion of the shaft assembly is configured to be connected to an external vacuum source to draw a vacuum through a passageway in the shaft assembly to aspirate fluid from a tissue interface at a distal region of the shaft assembly. 
     
     
         11 . The surgical system of  claim 1  wherein at least the cutting edge of the inner sleeve comprises a ceramic. 
     
     
         12 . The surgical system of  claim 11  wherein the entire distal portion of the inner sleeve comprises the ceramic. 
     
     
         13 . The surgical system of  claim 3  wherein the controller is configured to stop rotation of the inner sleeve in a selected rotational position relative to the outer sleeve. 
     
     
         14 . The surgical system of  claim 13  wherein the opening in the outer sleeve and the window in the inner sleeve are rotationally aligned in the stopped position. 
     
     
         15 . The surgical system of  claim 13  wherein the opening in the outer sleeve and the window in the inner sleeve are out of rotational alignment in the stopped position.