Surgical access tools, guide instruments and accessories for subchondral treatment of bone

1. A guide system for guiding an access device into a bone, comprising:

a cartridge comprising a main body and a translatable arm receivable in the main body for translating relative to the main body, the translatable arm including a portal for receiving an access device in alignment with an opening in the main body;

a probe extending from the translatable arm and translating with the arm; and

an access device configured to extend through the portal and the opening in the main body;

wherein the translatable arm is translatable relative to the main body with a ratcheting mechanism, the ratcheting mechanism including a plurality of teeth extending from the translatable arm to allow incremental movement of the translatable arm relative to the main body.

2. The guide system of claim 1 further comprising a handle extending from the cartridge.

3. The guide system of claim 1 , wherein the access device includes a cannulated section.

4. A guide instrument for guiding an access device into a bone of a joint, comprising:

a cartridge comprising a main body and a translatable arm receivable in a passage in the main body for translating relative to the main body, the translatable arm including a portal for receiving an access device in alignment with an opening in the main body so that the access device can extend through the portal and the opening;

a probe extending from the translatable arm by a fixed distance, wherein translation of the translatable arm causes a corresponding translation of the probe relative to the main body; and

a handle extending from the cartridge.

5. The guide instrument of claim 4 , wherein the guide instrument s operable to guide the access device to a location spaced from the probe.

6. The guide instrument of claim 4 , wherein the probe further comprises a probe tip.

7. The guide instrument of claim 6 , wherein the probe tip is configured to rest against bone or cartilage.

8. The guide instrument of claim 4 , wherein the probe comprises a wire.

9. The guide instrument of claim 8 , wherein the wire is detachable.

10. The guide instrument of claim 4 , wherein the probe comprises a needle or trocar.

11. The guide instrument of claim 4 , wherein the translatable arm is translatable relative to the main body with a ratcheting system, a threaded system or a sliding cam system.

12. The guide instrument of claim 11 , wherein the translatable arm is lockable within the main body.

13. The guide instrument of claim 4 , wherein the handle is detachable from the cartridge.

14. The guide instrument of claim 4 , wherein the cartridge comprises visual markers for depth control.

15. The guide instrument of claim 4 , wherein the handle comprises a visual marker.

16. The guide instrument of claim 4 , wherein the guide instrument is sized and shaped for arthroscopic use.

17. The guide instrument of claim 4 , wherein the handle provides a passage for receiving a second access device.

18. A guide system for guiding an access device into a bone, comprising:

a cartridge comprising:

a main body;

a translatable arm receivable in the main body for translating relative to the main body, the translatable arm including a portal for receiving an access device in alignment with an opening in the main body, wherein the translatable arm is lockable within the main body, and wherein the cartridge comprises visual markers for depth control;

a ratcheting mechanism operable to control translation of the translatable arm relative to the main body; and

a probe extending from the translatable arm by a fixed distance and adapted to be positioned adjacent to a soft tissue or bone surface, wherein translation of the translatable arm causes a corresponding translation of the probe relative to the main body; and

an access device configured to extend through the portal and the opening in the main body such that, when the access device is fully seated within the portal, a tip of the access device is disposed at a known position relative to a tip of the probe.

19. The guide system of claim 18 , further comprising

a handle configured to extend from the cartridge.