Combined flip cutter and drill
A flip cutter and drill instrument and method of antegrade drilling and retrograde cutting using such an instrument. The flip cutter and drill instrument is provided with a drill which has a multi-blade configuration and which engages an inner tube or inner member of the instrument to articulate between at least a first “straight” position (for example, about parallel to the longitudinal axis of the instrument) when the instrument is in the drilling mode, and at least a second “flip” position (for example, a non-parallel position relative to the longitudinal axis of the instrument) when the instrument is in the cutting mode.
1. A method of socket formation for ligament reconstruction, the method comprising:
inserting a retrograde flip cutter into an articular joint cavity formed of a first bone articulating with a second bone, the retrograde flip cutter comprising a cannulated shaft or outer tube having a distal end, a proximal end and a longitudinal axis, the cannulated shaft or outer tube housing an inner member; and a cutting member comprising a drill having a conical shape and provided with a plurality of cutting edges, the cutting member being disposed at the distalmost end of the cannulated shaft or outer tube and securely engaged to the inner member, the cutting member being capable of movement from a first position aligned with the longitudinal axis of the cannulated shaft or outer tube in a straight position to a second position which is not aligned with the longitudinal axis of the cannulated shaft or outer tube in a flip position, the retrograde flip cutter further comprising a locking tube provided over the cannulated shaft or outer tube at the proximal end, the cannulated shaft or outer tube having a slot at the distal end to securely lock the cutting member;
drilling a first tunnel or socket in an antegrade manner into the first bone with the cutting member in the first position, wherein the drill of the cutting member is aligned with the longitudinal axis of the cannulated shaft or outer tube in the straight position, by pushing the cutting member distally to allow drilling in the antegrade manner within the first bone to form the first tunnel or socket;
articulating the cutting member by retracting the locking tube and the cannulated shaft or the outer tube proximally to pivot the cutting member, while the cutting member is within the articular joint cavity, from the first position to the second position, wherein the drill of the cutting member is not aligned with the longitudinal axis of the cannulated shaft or outer tube when in the second position;
subsequently, locking the cutting member in the second position by tightening the locking tube and the cannulated shaft or the outer tube to securely lock the cutting member in the second position;
drilling a second tunnel or socket into the first bone in a retrograde manner with the cutting member in the second position, by pulling the cutting member proximally so that the cutting edges of the drill in the second position cut in the retrograde manner into the first bone, wherein the drill of the cutting member is not aligned with the longitudinal axis of the cannulated shaft or outer tube and is in the flip position to allow drilling in the retrograde manner within the first bone to form the second tunnel or socket, and wherein the drilling of the first tunnel or socket in the antegrade manner and the drilling of the second tunnel or socket takes place in the retrograde manner are performed sequentially without removing the cutting member from the articular joint cavity;
the second tunnel or socket exhibits a second diameter, and the first tunnel or socket exhibits a first diameter, and wherein the second diameter is greater than the first diameter; and
inserting and securing a graft within the first tunnel or socket and the second tunnel or socket.
2. The method of claim 1 , wherein the cutting member is articulated to an angle of about 10° to about 170° to the longitudinal axis of the shaft of the instrument when the cutting member is in the second position.