The anterior and posterior cruciate ligaments in the knee act in conjunction with the other ligaments and soft tissue to provide both static and dynamic stability to the function of the knee. Often for example, due to sports related injuries, the anterior cruciate ligament (ACL) becomes ruptured or torn. This requires replacement and reconstruction of the ligament in order to restore normal usage of the knee.
When the ACL is replaced, a substitute synthetic or harvested graft is typically utilized. The graft is anchored in place either inside or outside tunnels or passages formed in the tibia and femur. The operation and interdependency of the ACL with the other knee ligaments, bones and soft tissue is complex and for optimum reconstruction much precision is required in the formation and positioning of the passageways for the substitute graft, as well as in the methods and mechanisms used to anchor the graft. For best performance of the knee joint after surgery, it is necessary to locate and drill the tunnels at precise isometric locations so the graft will be implanted in the optimum position.
A drill guide for locating the precise tibial tunnel location and accurately aiming the tunnel forming drill is an important part of a successful ACL reconstruction procedure. The guide should have a probe or locator tip, as well as a drill jig or sleeve, at least one of which should be adjustable in order to accommodate differently sized and shaped human knees. The adjustable feature should also be quickly and accurately locked or otherwise held in position.
Once the guide device is properly positioned, a thin wire drill is first installed to mark and locate the passageway. After the guide device is removed, a cannulated surgical drill is used to form the complete passageway in the tibea. Thereafter, tibial tunnel or rear entry techniques are used to form the femoral tunnel and complete the ligament reconstruction procedure.
Other drill guide devices used in arthroscopic surgery are shown, for example, in U. S. Pat. No. 4,672,957 to Hourahane, No. 4,781,182 to Purnell et al., No. 4,920,958 to Walt et al. and No. 4,883,048 to Purnell et al. Additional surgical devices are shown in the two Sapega et al. U.S. Pat. Nos. 4,739,751 and 4,922,897. Another known device is the "Bow & Arrow" drill guide made by Instrument Makar in Okemos, Mich.
It is an object of the present invention to provide a method and apparatus for the proper and accurate location and placement of replacement graft passages in ACL reconstruction operations.
It is another object of the present invention to provide an improved tibial tunnel placement guide for use in knee surgery. It is still another object to provide a unique surgical tunnel placement guide which is easier to operate and more accurate and precise than guides known in the field.
It is a further object of the invention to provide a tibial drilling device with improved locking and securing mechanisms for positioning of the location probe and for holding of the wire drill guide sleeve.
Additional objects, advantages, and novel features of the invention are set forth in the description of the invention contained in this document which will be understood by persons skilled in the art upon examination of the following description and accompanying drawings or may be learned by practice of the invention. The objects and advantages of the invention may be realized and obtained by means of the instrumentalities and combinations particularly pointed out in the appended claims.