Tendon Harvesting System

Abstract

A system for improving graft harvesting includes a blade guide (320) having a handle (370) and a guide portion with an elongated slot (330). The system may also include a first blade assembly (750) that slides along the elongated slot (330), the blade assembly (750) having a cutting blade (765) rotatably coupled to the handle (780). The cutting blade (765) may include a front cutting edge and a rear cutting edge. As the blade slides along the elongated slot (330), the blade assembly (350, 750) and the blade guide (320) may cooperate to control the depth of penetration of the blade into tissue. The blade guide (320) may include a means for stabilizing the guide to the tissue.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims priority to U.S. Provisional Application No. 62 / 862,407, filed on June 17, 2019, and U.S. Provisional Application No. 62 / 959,580, filed on January 10, 2020, both for "TENDON HARVESTING SYSTEM," the entire contents of which are incorporated herein by reference.

[0003] This application also claims priority to U.S. Provisional Application No. 63 / 036,567, filed on June 9, 2020, entitled “METHOD AND APPARATUS FOR GRAFT HARVESTING,” the entire contents of which are incorporated herein by reference. Technical Field

[0004] The present invention relates to the field of surgery, and more particularly to an instrument and method for harvesting quadriceps tendon. Background Art

[0005] The quadriceps tendon (QT or quad tendon) is commonly harvested as a graft for ligament surgery such as anterior cruciate ligament (ACL) revision / reconstruction. This tendon is located on the upper side of the patella on the anterior side of the thigh. Currently, harvesting a graft from the QT may require a large incision along the longitudinal axis of the femur to cut to the level of the tendon, resulting in a large postoperative scar. Alternatively, a dissector can be used, providing a smaller incision that can be blindly advanced from the knee in a proximal direction toward the quadriceps. Care must be taken during harvesting to avoid penetrating the waterproof capsule surrounding the knee joint, as this will allow saline to seep into the extracapsular area and potentially upward into the groin area. Joint pressure may also be lost, thereby swelling and visualization of the knee joint during ACL reconstruction. Since the preferred portion of the QT for harvesting is attached to the capsule without a natural separation plane, there is a need for a system and technique that safely harvests the graft in a reasonable time while protecting the capsule, providing a consistent, high-quality, uniformly sized graft with high cosmetic results, which is simple and easily reproducible. In addition, the consistency of the QT is dense and very fibrous, so the depth of the cut may be difficult to control. This is especially true if the cutting blade is at the end of an unsupported rod, such as one that may be pushed aside by a tendon. The tendon is often simply moved aside rather than cut. This tendon resistance requires the surgeon to use a jerky motion to cut the tendon. Therefore, there is a need for a blade guide assembly that can be placed directly on the tissue and held against the tendon to form a reliable axial incision with a consistent cutting depth. BRIEF DESCRIPTION OF THE DRAWINGS

[0006] For a detailed description of exemplary embodiments, reference will now be made to the accompanying drawings, in which:

[0007] Figure 1A schematically illustrates a perspective view of a tendon harvesting system according to at least some embodiments;

[0008] Figure 1B schematically illustrates a distal end of a tendon harvesting system according to at least some embodiments;

[0009] Figure 1C schematically illustrates a cross-section of a tendon harvesting system according to at least some embodiments;

[0010] Figure 1D schematically illustrates a cross-section of a tendon harvesting system according to at least some embodiments;

[0011] Figure 2A Schematically illustrates a method for advancing a Figures 1A-1D A view of a blade assembly of a tendon harvesting system with a blade in position as shown in FIG.

[0012] Figure 2B schematically illustrates a view of blade positions when retracting a blade assembly of a tendon harvesting system according to at least some embodiments;

[0013] Figures 3A-3C schematically illustrates a view of a tendon harvesting guide according to at least some embodiments;

[0014] Figure 4A schematically illustrates a tendon harvesting system with dual blades according to at least some embodiments;

[0015] Figure 4B Schematically illustrates a method according to at least some embodiments Figure 4A A cross section of the tendon harvesting system;

[0016] Figures 5A-5C schematically illustrates a view of another embodiment of a tendon harvesting assembly in accordance with at least some embodiments;

[0017] Fig. 6A and 6B schematically illustrates a perspective view of a tendon harvesting guide according to at least some embodiments;

[0018] Figures 7A-7D Various views of blade assemblies are shown according to at least some embodiments; and

[0019] Fig. 8A and 8B A tendon harvesting system is shown, according to at least some embodiments. Summary of the invention

[0020] Various terms are used to refer to specific system components. Different companies may refer to a component by different names - this document is not intended to distinguish between components that differ in name but function the same. In the following discussion and in the claims, the terms "include" and "comprising" are used in an open-ended manner and should be interpreted as "including but not limited to...". In addition, the terms "couple" or "coupled" are intended to mean either an indirect or direct connection. Thus, if a first device couples to a second device, that connection may be through a direct connection or through an indirect connection via other devices and connections.

[0021] The following discussion relates to various embodiments of the present invention. Although one or more of these embodiments may be preferred, the disclosed embodiments should not be interpreted or otherwise used to limit the scope of the present disclosure, including the claims. In addition, those skilled in the art will understand that the following description has broad application, and the discussion of any embodiment is intended only as an example of that embodiment and is not intended to imply that the scope of the present disclosure, including the claims, is limited to that embodiment.

[0022] Various embodiments relate to a quadriceps tendon (QT) harvesting system for procedures such as arthroscopic procedures. More specifically, some exemplary embodiments disclosed include a harvesting system for harvesting a target length of tendon tissue, comprising a guide. The guide has an elongated body defining a handle end and a free end and a longitudinal axis. The elongated body also includes an upper surface and a lower surface defining a thickness of the elongated body. The lower surface of the elongated body has a guide slot extending parallel to the longitudinal axis. The guide slot receives a blade therethrough and guides the blade to translate along the length of the guide slot and thereby along the tendon tissue. This maintains the blade along a preferred trajectory along the tendon tissue. The guide also limits the cutting depth of the blade into the tendon tissue as the blade translates along the trajectory. In some embodiments, the guide slot can extend upward from the lower surface to the upper surface and include the upper surface, so that the body thickness is configured to limit the extension of the blade through the slot and thereby limit the cutting depth of the blade into the tendon tissue as the blade translates along the length of the slot. In some embodiments, the free end of the elongated body is configured to anchor with the tendon tissue. In some embodiments, the elongated body may include a device for piercing tendon tissue and thereby anchoring to the tendon tissue. In some embodiments, the device for piercing tendon tissue may include at least two discrete elements extending perpendicularly from the longitudinal axis at the free end of the guide. In some embodiments, the free end may anchor the guide to the tendon tissue when the body is in a first orientation and a second orientation; the first orientation and the second orientation are flipped about 180 degrees relative to each other around the longitudinal axis. In some embodiments, the blade may include a surface that slides along the upper surface of the body when the blade is translated. In some embodiments, the blade may include a handle pivotally connected to the blade, and when the handle is pivoted, the handle keeps the blade slidingly engaged to the upper surface of the body. This allows the blade to be pushed along and under the patient's skin while the handle pivots to also slide under the skin.

[0023] In another embodiment, a harvesting system for harvesting a length of tissue is disclosed. The system includes a blade guide having a handle end and a guide end or portion extending therefrom. The guide end includes an elongated opening. The system also includes a blade assembly having a cutting blade. The blade assembly preferably slides along the elongated opening with the cutting blade extending through the elongated opening. As the blade assembly translates along the length of the elongated opening, the blade assembly and the guide end cooperate to control the extension of the cutting blade into the tissue. In some embodiments, the blade assembly may include a handle pivotally coupled to the cutting blade so that the handle can rotate relative to the cutting blade within a certain angular range when the cutting blade is translated along the elongated opening. In some embodiments, the blade assembly may include two cutting blades spaced laterally from each other. In some embodiments, the elongated opening may receive one of the two cutting blades therethrough, thereby placing the other of the two cutting blades along or adjacent to the most transverse outer surface of the blade guide. In some embodiments, the blade guide may include an element anchored to tendon tissue. In some embodiments, the blade guide may include at least one tooth extending perpendicularly from the longitudinal axis of the guide slot, the at least one tooth being configured to anchor to tendon tissue. In some embodiments, the blade assembly may include a surface that slidingly engages an upper surface of the leading end and controls extension of the cutting blade into tissue as the cutting blade is translated along the elongated opening.

[0024] An exemplary method for harvesting a graft is also disclosed, comprising inserting a guide portion of a blade guide through an incision and along the anterior surface of a quadriceps tendon (QT). A first cutting blade of a blade assembly is inserted into a first end of an elongated opening of the guide portion. When the first cutting blade is advanced along the elongated opening to a second opposite end of the elongated opening and thereby cutting a first length of the QT, a surface of the blade assembly is slidably engaged along the guide portion. Engaging the retaining surface along the guide portion controls the penetration depth of the first cutting blade into the QT. The first cutting blade may be pivotally coupled to a handle of the blade assembly such that when the first cutting blade is advanced, the handle may be rotated relative to the cutting blade within a certain angular range while the cutting blade maintains a constant penetration depth. The blade assembly may include a second cutting blade parallel to the first cutting blade and laterally offset therefrom, such that the second cutting blade is advanced while the first cutting blade is advanced and two parallel elongated incisions through the QT are formed. The exemplary method may also include anchoring a portion of the guide portion to the QT. The guide portion may be anchored prior to inserting the first cutting blade.

[0025] Another exemplary embodiment relates to a system for harvesting tendons, the system having a blade guide having a handle at a first end and a second end defining a guide portion, from which an elongated opening extends. The elongated opening or channel may have an open end adjacent to the handle. The system also includes a first blade assembly that can slide along the elongated opening. The elongated opening is configured to allow a cutting blade to pass therethrough to cut into the QT backward. The cutting blade may be rotatably coupled to the first blade assembly. The cutting blade may have a front cutting edge and a rear cutting edge. The cutting blade may rotate toward a first orientation when advancing in a first direction along the elongated channel to cut tissue at a first depth with the front cutting edge surface, and may also rotate to a different orientation when retracting the cutting blade along the elongated channel to cut tissue to a second greater depth with the rear edge surface. The blade guide may also include a second elongated channel or opening parallel to and laterally spaced from the first elongated channel. The first blade assembly may also slide along the second elongated channel to cut through the tendon. Alternatively, the system may include a second blade assembly that can slide along the second elongated channel, the second blade assembly may include a cutting blade that is rotatably connected to the second blade assembly, and the cutting blade has a front cutting edge surface and a rear cutting edge surface. The second blade assembly cutting blade can also rotate to a first orientation when advancing through the second elongated channel so as to cut tissue with a first depth with the front cutting edge surface, and is also configured to rotate to a different orientation when retracting the second blade assembly cutting blade so as to cut tissue with a second greater depth with the rear edge surface. The first blade assembly and the second blade assembly can both slide independently along the blade guide. Alternatively, the first blade assembly may include two blades that are laterally spaced from each other, each blade having a front cutting edge and a rear cutting edge. One of the two blades can extend through the elongated opening and the other of the two blades can extend along the most transverse outer surface of the blade guide. The front cutting edge and the rear cutting edge of each of the two blades can be continuous with each other and form an arc.

[0026] A method for harvesting a tendon is also disclosed, comprising inserting an elongated opening or passage of a blade guide through an incision and along the front surface of a quadriceps tendon. A first blade assembly may be inserted into and advanced along the elongated passage while the blade guide remains fixed. The first blade assembly may include a cutting blade pivotally coupled to a rod of the first blade assembly. The cutting blade may define a front cutting edge and a rear cutting edge, and upon advancing the first blade assembly, the front cutting edge may incise the quadriceps tendon and cut along the quadriceps tendon to form a first elongated incision having a first depth. The first blade assembly may then be retracted along the elongated passage to incise the first elongated incision with the rear cutting edge and cut along the first elongated incision to modify the first elongated incision to have a second depth. Upon advancing the first blade assembly, the cutting blade may be oriented at a first angle relative to the blade guide rod, thereby defining a first depth, and upon retracting the first blade assembly, the cutting blade may pivot to be oriented at a second angle relative to the blade guide rod, thereby defining a second depth. When retracted, the cutting blade may extend further into the quadriceps tendon. The step of inserting may also include inserting a second elongated channel of the blade guide through the incision and along the anterior surface of the quadriceps tendon; and inserting a second blade assembly into the second elongated channel and advancing the second blade assembly along the second channel, the second blade assembly having a pivoting cutting blade with a front cutting edge and a rear cutting edge, and when the second blade assembly is advanced, cutting into and along the quadriceps tendon with the front cutting edge to form a second elongated incision having a first depth, the second elongated incision being laterally spaced from and parallel to the first elongated incision. The method may also include retracting the second blade assembly along the second elongated channel to cut into and along the second elongated incision with the rear cutting edge to modify the second elongated incision to have a second depth.

[0027] Alternatively, the step of inserting may also include inserting a second elongated channel of the blade guide through the incision and along the front surface of the quadriceps tendon; and inserting the first blade assembly into the second elongated channel and advancing the first blade assembly along the second channel, and while advancing the first blade assembly, cutting into and along the quadriceps tendon with the front cutting edge to form a second elongated incision having a first depth, the second elongated incision being laterally spaced from and parallel to the first elongated incision. The method may also include retracting the first blade assembly along the second channel to cut into and along the second elongated incision with the rear cutting edge to modify the second elongated incision to have a second depth. While advancing the first blade assembly, tension from the quadriceps tendon causes the cutting blade to pivot toward a surface on the rod, the surface being configured to limit the first angle and thereby define the first target cutting depth. While retracting the first blade assembly, tension from the quadriceps tendon causes the cutting blade to pivot toward a second surface on the rod, the second surface being configured to limit the second angle and thereby define the second target cutting depth.

[0028] Also disclosed is a surgical system for harvesting a certain length of tendon tissue, the system includes a guide defining an elongated monomer, the guide having a distal portion configured to be anchored in the tendon tissue and a blade that slides along the elongated monomer. The blade selectively interacts with the guide and includes a distal cutting edge and a proximal cutting edge. The blade is slidably connected to the guide so that the blade can slide back and forth along the length of the guide. The blade can be selectively connected and arranged along the first most lateral edge of the guide and the second elongated edge of the guide groove. The blade can include two parallel distal cutting edges and two parallel proximal cutting edges that are both laterally spaced from each other, which can simultaneously form two parallel incisions along the tendon tissue. The guide can also include an elongated groove and the blade slides back and forth along the length of the groove. The proximal cutting edge and the distal cutting edge can be continuous to form a single curved cutting edge located on a plane parallel to the longitudinal axis of the guide.

[0029] Another exemplary embodiment relates to a surgical instrument for harvesting a target length of tendon tissue, comprising a ruler having a longitudinal axis, a width, a thickness, and a distal portion, the distal portion being configured to anchor a guide to the tendon tissue. A slot may extend through the thickness of the ruler, the slot extending parallel to the longitudinal axis, the slot being configured to receive a blade therethrough and guide the blade translation along the tendon. The slot length may be at least as long as the target length of the tendon tissue. The ruler thickness is configured to limit the extension of the blade through the slot and thereby limit the depth of cut as the blade translates along the length of the slot. In some embodiments, the slot may be offset from the longitudinal axis. In some embodiments, the distal portion may be configured to anchor the guide to the tendon tissue when the ruler is in a first orientation and a second orientation, the first orientation and the second orientation being flipped about 180 degrees relative to each other about the longitudinal axis.

[0030] Another exemplary embodiment disclosed is a surgical assembly for harvesting a length of tissue. The assembly includes a blade guide having a handle and a guide portion extending therefrom, the guide portion including an elongated opening extending therefrom. The assembly also includes a blade assembly, the blade assembly including a cutting blade, the blade assembly being configured to slide along the elongated opening when the cutting blade extends through the elongated opening. The blade assembly defines a first surface, the first surface being configured to slide along the top surface of the blade guide and limit the penetration of the cutting blade into the tissue. In some embodiments, the blade assembly can be pivotally coupled to the handle so that the handle can rotate relative to the cutting blade within a certain angular range when the cutting blade is translated along the opening. In some embodiments, the blade assembly can include two blades spaced laterally from each other. In this case, one of the two blades can extend through the elongated opening and the other of the two blades extends along the most lateral outer surface of the blade guide. In some embodiments, the first surface defines a flat surface that is offset and angled relative to the leading edge of the cutting blade.

[0031] Another exemplary method of harvesting a graft is also disclosed, comprising inserting a guide rail of a blade guide through an incision and along an anterior surface of a quadriceps tendon; inserting a blade assembly into and along the guide rail, the blade assembly having a cutting blade extending through an elongated opening extending along the length of the guide rail; and sliding a first surface of the blade assembly along a top surface of the guide rail as the blade assembly is advanced and cuts into and along the quadriceps tendon, the first surface being configured to limit the penetration depth of the cutting blade into the quadriceps tendon. In some methods, the cutting blade may be pivotally coupled to a handle of the first blade assembly such that the handle may rotate relative to the cutting blade within an angular range as the blade assembly is advanced. In some methods, the blade assembly may include two parallel cutting blades, one of the cutting blades extending through the elongated opening, and wherein during the step of advancing, two elongated incisions through the tissue may be simultaneously formed.

[0032] Disclosed is another embodiment of a surgical system for harvesting a length of tendon tissue, comprising a guide defining an elongated body, the guide having a distal portion configured to anchor with tendon tissue in a first orientation or a second orientation flipped relative to the first orientation, and a blade that selectively interacts with the guide, the blade having a first cutting edge surface for insertion through a slot of the guide and a second cutting edge surface parallel to the first cutting edge surface. In some embodiments, the first cutting edge surface and the second cutting edge surface are laterally spaced from each other to simultaneously form two parallel incisions along the tendon tissue when sliding along the guide. In some embodiments, the blade is pivotally coupled to a handle such that the handle pivots independently relative to the blade when the blade is translated along the guide slot. DETAILED DESCRIPTION

[0033] Various embodiments are directed to methods of using a QT recovery system. The description now turns to an exemplary system.

[0034] A first exemplary system may include a tendon harvesting system 100, which generally includes a blade guide 110 and at least one blade assembly 150. The blade guide 110 is configured to be placed in contact with the tendon and preferably placed along the anterior surface of the tendon extending proximally from the knee capsule. Thereafter, the blade guide 110 may remain fixed, and the sliding blade assembly 150 may slide along a portion of the guide 110 to cut into the tendon and cut along the tendon. The surgeon may make two parallel incisions in the tendon, spaced apart by a specific width. Preferably, each parallel incision also has a substantially similar final length and depth. The blade guide 110 may include a handle 112 and a guide rail 114. The handle 112 is generally configured to help place the guide rail 114 on the QT surface and may also help keep the guide rail 114 in contact or aligned with the QT. As shown, the handle 112 may be oriented at a non-zero angle relative to the longitudinal axis of the guide rail and may be substantially close to an orthogonal angle. In alternative embodiments, the inventors contemplate other handle embodiments that may be offset from the guide rail 114 and, for example, approximately parallel to the guide rail 114 .

[0035] The guide rail 114 defines a length L that is configured to guide the blade assembly 150 and produce a QT graft of a desired length. In some cases, the length L may be shorter than the desired length of the graft, and the blade assembly 150 may extend or slide beyond the end of the guide rail 114. In some cases, the length L may be longer than the desired graft length to accommodate different patients. The guide rail 114 also defines a width W that may at least partially define the width of the QT graft. The blade guide 110 may have a range of sizes having different lengths L and widths W to provide user selection of QT harvesting sizes. The guide rail 114 may include at least one elongated channel 116 that is configured to slidably receive the blade assembly 150. The channel 116 is Figure 1B , 1C 1D and is configured to allow the blade assembly 150 to slide proximally and distally along the channel 116 while maintaining a consistent track of the blade assembly 150. The channel 116 may include an open first end 118 for receiving the blade assembly 150 and may have a closed second end 120 to prevent the blade assembly 150 from extending beyond the guide rail. In an alternative embodiment, the channel 116 may have an open second end 120 to allow the blade assembly 150 to extend further. The channel 116 may define an elongated slot 122 along its length (at Figure 1B150 ), sufficient to allow the cutting blade 152 to extend therethrough while limiting lateral movement of the cutting blade 152 or rotation of the blade assembly 150 and thereby maintaining the cutting blade 152 along a controlled path of the tissue. The guide rail 114 includes two substantially equivalent channels 116 that may be parallel to each other on either side of the longitudinal axis of the guide rail 114. This may enable the surgeon to form two elongated parallel incisions through the tendon, either sequentially or simultaneously, of a specific width, length, and depth. The guide rail 114 may be located on the top or front surface of the QT and thereby cooperate with the cutting blade 152 to control or limit the depth of incision into the QT. The guide rail 114 may include teeth 156 configured to engage or anchor with the front side of the QT and limit accidental sliding.

[0036] Also like Figures 1A-1D As shown in , the blade assembly 150 may include at least one rod 154 to which the cutting blade 152 is rotatably coupled. If the surgeon prefers to make two incisions simultaneously or staggered with each other, two rods may be provided. Alternatively, one rod may be provided and placed sequentially with each channel 116. The rod 154 may include markings 157 (on Figure 1B The markings may be axially spaced apart and may or may not have a number indicated next to each marking to indicate the length value. The markings may be known unit distances, such as units of centimeters or inches, or simply reference marks that are consistently spaced apart axially. The cutting blade 152 may define a plane that is coaxial and parallel to the longitudinal axis of the rod and pivot along it. The rod 154 is shown as having a circular or oval cross-section, but may also be other cross-sections that slide fit within the corresponding channel cross-section. The rod 154 may have a first end adjacent to the handle 112, which may also include a handle or grip (not shown) to help advance and retract the blade assembly 150. In other embodiments, the rod 154 may include a key (not shown) along the outer surface of the rod 154 that engages a corresponding or mating keyway on the outer surface of the guide rail 114. The rod key may be inserted into and slide along the keyway, similar to a track or rail system.

[0037] Figure 1C and 1D A cross section of the assembly 100 is shown with two cutting blades 152 inserted equally from one another along the channel 116 on opposite sides of the longitudinal axis of the track. Figure 1C The blade is shown in a first orientation such that the blade extends rearwardly from the track 114 a first distance while the cutting blade 152 is advanced toward the distal end. Figure 1DThe blades are shown in a second different angular orientation such that the blades extend rearwardly from the track 114 a second increased distance while the cutting blades 152 are retracted away from the second distal end. The two cutting blades 152 can extend through the elongated slot 122 on the rear side of the guide rail 114 and thereby pierce the front surface of the QT and extend rearwardly. The front surface of the guide rail 114 can be smooth to easily slide under the skin and tissue to access the QT. It is noteworthy that, although shown as being axially opposed to each other, each blade assembly 150 can be operated independently, and further, only one blade assembly 150 can be provided and each incision made sequentially.

[0038] exist Figure 2A and 2B 1, the cutting blade 152 is movably and more preferably rotatably coupled to the rod 154. The rod 154 may include a first elongated opening 162 parallel to the longitudinal axis of the rod for receiving the cutting blade 152 therethrough. The rod 154 may include a plurality of through holes, the through holes being perpendicular to the first elongated opening to receive the pin 160. The pin 160 may also extend through a corresponding opening in the blade 152 and may be fixedly coupled to the rod 154, thereby allowing the cutting blade 152 to pivot around the axis of the through hole. The first elongated opening 162 may be defined in a recess terminating at a first surface 168 before the second end 170 of the rod 154, the recess being configured to limit the rotation of the cutting blade 152. In addition, the recess may define a second surface 169 configured to limit the rotation of the cutting blade 152 in a second direction. The cutting blade 152 defines a first or front cutting edge 153 along a first advancing edge of the cutting blade and a second or rear cutting edge 155 along a retracting edge of the cutting blade. The first cutting edge 153 and the second cutting edge 155 can extend toward each other and extend together at the tip of the blade 152. The two cutting edges allow the cutting blade 152 to cut through the tendon as it advances and retracts along the guide rail 114. Figure 2A As shown in FIG. 1 , the cutting blade 152 is configured to pivot to an advanced configuration in which the cutting blade 152 is oriented at a first angle relative to the longitudinal axis of the rod. The first angle is limited by the second recess surface 169 and defines a first target cutting depth by advancing the cutting edge 153 into the tendon tissue. The cutting blade 152 is also configured to pivot to Figure 2B , wherein the cutting blade 152 is oriented at a second angle relative to the longitudinal axis of the shaft 154. The second angle is limited by the first pocket surface 168 and defines a second target cutting depth into the tendon tissue, the second target cutting depth being greater than the first target cutting depth.

[0039] According to an exemplary method of the present invention, the graft may be harvested (sized and cut to a specific size) according to the following steps: First, a small incision may be made above the patella; then the guide rail 114 may be inserted through the incision, under the skin and along the anterior surface of the QT. The guide rail 114 may be advanced proximally along the QT using the handle 112. The guide rail 114 may be secured in place using a fixture. A first blade assembly 150 may be inserted into a first channel 116 of the guide rail 114 and advanced along the first channel, the first blade assembly 150 having a pivoting cutting blade 152 defining a first cutting edge along a first side of the blade and a second cutting edge along a second side of the blade. Upon advancing the rod 154, the cutting blade 152 may be pushed by the tendon toward a first angular orientation, and thereby an incision is formed posteriorly in the QT with the first cutting edge at a first depth. The first blade assembly may then be retracted along the first channel 116. Upon retraction, the cutting blade 152 may be pushed by the tendon toward a second angular orientation, and thereby an incision is formed posteriorly in the QT with the second cutting edge at a second depth. When in the second angular orientation, the cutting blade 152 extends further into the tissue. Therefore, the blade assembly 150 can be configured to cut when moving away from or toward the knee. The cavity or recess in the rod can define multiple surfaces on the rod 154 to limit the angular orientation of the cutting blade 152. The multiple surfaces can be the surfaces of the cavity in the rod 154 that partially nests the cutting blade 152. The first surface 169 defining the proximal end of the cavity 162 can limit the cutting blade to a first angular orientation relative to the longitudinal axis of the rod, and the second surface 168 can limit the cutting blade to a second angular orientation relative to the longitudinal axis of the rod. The second blade assembly 150 can be inserted into the second channel 116 of the guide rail 114, the second channel being parallel to the first channel and laterally spaced therefrom. Alternatively, the first blade 150 can be first removed from the first channel and then inserted into the second channel. The blade assembly 150 can also be advanced and retracted to partially cut into the QT to form two parallel incisions in the QT, the incisions defining the width and depth of the QT graft.

[0040] The second exemplary embodiment Figures 3A-3C and Figures 4A-4B. Similar to the previous embodiments, the system 300 generally includes a blade guide 320 and a blade assembly 350 selectively coupled to the guide 320. The guide 320 is generally an elongated slotted member having a first handle end 322 and a second end 324 that may include a handle 370. The handle 370 may be pivotally coupled to the second end 324. The guide 320 may include a means of engaging or anchoring with tissue disposed along its length that is configured to prevent the guide 320 from inadvertently sliding or moving on the tendon during use. As shown, the guide 320 includes at least one tooth 325 at the second end 324. It may be preferred to have teeth 325 at the ends of the guide 320 rather than along the length, thereby limiting any potential damage to the graft caused by the teeth 325 to areas that can be easily removed or do not form part of the graft itself, and thus maintaining good vitality of the resulting graft. The guide may also include at least one hole or opening 372. The (one or more) holes 372 are configured to receive a guide wire, needle or pin (not shown) therethrough and stabilize the guide 320. The needle or pin can extend through the patient's skin and then through the (one or more) holes 372. The second end 324 of the guide can be a single component including a distal vertically oriented tooth 325 for engaging with tissue. The tooth 325 can be configured to pierce the tendon and can have a length X extending from the rear surface 332 of the guide 320 that is approximately equal to or less than the target graft thickness. In some embodiments, this can alternatively be stated as at least one tooth length X can be approximately the same as the blade extension (Y) below the rear surface 332 of the guide 320. Alternative embodiments can include multiple teeth. In addition, in addition to or in place of the teeth, a high friction surface along a portion of the rear surface of the guide 320 can help maintain the position of the guide 320 on the smooth front surface of the QT.

[0041] The guide 320 may also include a series of markings 328 on the top surface 326, indicating inches or some equivalent unit of measurement, for visual feedback of the insertion depth of the guide 320 into the incision and along the tendon. The markings 328 may also be used to estimate the graft cut length and may therefore indicate a distance along the elongated slot or opening 330 rather than from the farthest end of the guide 320. As shown, the slot 330 does not necessarily originate from the farthest end of the guide 320; the end 331 is spaced apart from the end. For example, in use, during insertion of the guide 300 between tissues and above the QT, the markings 328 corresponding to the desired graft length may be aligned with the upper end of the patella, and at least one tooth 325 may then be anchored with an adjacent portion of the tendon tissue. A pin or needle may also be placed through the hole 372 to further anchor the guide 320.

[0042] The groove 330 can extend through the entire thickness T of the guide 320. The groove 330 can help maintain the direction and trajectory of the blade assembly 350. The groove 330 can be wide enough to receive a portion of the blade assembly 350 therethrough and allow the blade assembly 350 to move along it. However, the groove 330 can be narrow enough to limit the lateral movement of the blade when the blade 350 slides. As shown, the groove 330 can extend along a portion of the guide 320, similar to the guide rail portion described in the earlier embodiment. The groove 330 can be offset or set toward the half of the guide 320 spaced apart from the handle end 322, closer to the second end 324. The ends of the grooves 331 and 333 are configured to limit the movement of the blade along the tendon, and thereby limit the length of the graft formed. The groove ends 331 and 333 can act as hard stops to prevent the blade assembly 350 from extending beyond the guide 320 and inadvertently damaging the tissue. During use, the groove 330 can be placed on the target transplant portion, and then the blade assembly 350 can pierce the front surface of the tendon adjacent to the end 333, and then move between the two ends 331 and 333 to form the lateral side of the desired graft length. The groove 330 is shown as a single elongated opening. In an alternative embodiment (not shown), the guide groove 330 can define a circuitous path for the blade to follow. For example, the groove 330 may include a first longitudinal groove, a distal transverse groove adjacent to the end 324, and a second longitudinal groove that may be parallel to the first longitudinal groove. The groove may be an elongated "U" shape. A single blade along the path defined by the "U" shaped groove can therefore guide the blade to form the two lateral sides of the transplant strip and cut off the end of the strip.

[0043] Once the guide 320 has been placed, the cutting can be performed safely with minimal visualization. Therefore, the guide 320 can be provided as a series of guides with various sizes (e.g., corresponding guide thickness T and slot length). The guide 320 may include a lower or rear surface 332 that is atraumatically located on the anterior surface of the QT and easily slides on the anterior surface of the tendon. The top surface 334 may also be smooth to aid insertion between patient tissues. The guide thickness T may be sufficient to cooperate with the blade assembly 350 to limit the cutting depth into the tissue. When paired with the intended blade, this can limit the cutting depth to reduce the risk of penetrating the knee capsule.

[0044] like Figure 4A and 4BAs shown in , the blade assembly 350 is configured to selectively engage and remove from the guide 320. The blade 350 may include a flat top surface 355 that is smooth to easily slide between tissue layers, along the guide top surface 334 and along the slot 330. The blade 330 may be "U" shaped, defining two cutting edges 360a and 360b, so that movement of the blade assembly 350 along the slot 330 can simultaneously form two parallel incisions in the tendon, defining the graft width. Therefore, one of the blades 330 extends through the slot 330 that is open throughout the thickness of the guide 320. The blade assembly 350 may include a handle 360 ​​that can help slide the blade 350 along the slot 330. Each blade assembly 350 may define an arcuate or curved cutting edge 360a and 360b so that tissue can be cut when the blade assembly 350 moves back and forth. In other words, the arcuate blades 360a and 360b each define a distal cutting edge and a proximal cutting edge. As the blade assembly 350 is advanced toward at least one tooth 325, the distal cutting edge can cut through the tendon, and as the blade 350 is retracted, the proximal cutting edge can cut deeper into the tendon. As previously described, the tendon can be a fibrous tissue that is not easily cut, so several passes of the blade 350 are preferred. By controlling the blade movement with a guide 320, these passes can be made more reliable and consistent. In alternative embodiments, the blade assembly 350 can define an energy-based device, such as a razor device, an ultrasonic cutting tool, or an electrosurgical device. These devices can more easily transect tough QT tissue. The guide groove 330 can be wide enough to receive existing energy-based devices and can be up to 5 mm wide. Alternatively, a construction similar to the blade assembly 350 having a cutting edge or a "U" shaped cross-section can be configured to be operably connected to an energy-based power source and electrosurgically cut tissue.

[0045] According to an exemplary method of the present invention, a graft may be harvested (sized and cut to a specific size) by the following steps: A guide 320 may be inserted through a small incision above the kneecap, beneath the skin, and along the anterior surface of the QT. A marking 328 on the guide 320 corresponding to the desired graft length may be aligned with the upper end of the patella, and at least one tooth 325 of the guide 320 may then be anchored with an adjacent portion of the tendon tissue. The tooth 325 may be configured so that pressure from a user's hand may be sufficient to anchor the tooth 325 within the tissue. A needle or pin may then be pushed through the patient's skin and through the hole 372 and into the QT. A blade assembly 350 may be inserted into and advanced along the slot 330 of the guide 320, the blade assembly 350 having a first cutting edge along a first side of the blade and a second cutting edge along a second side of the blade; the first side and the second side being continuous with each other, forming an arcuate cutting edge. Alternatively, the blade assembly 350 may be an energy-based device, such as a razor blade or an electrosurgical device. The blade assembly 350 can slide along the elongated slot 330, which defines the trajectory of the blade assembly and thereby controls the cutting depth and trajectory into the QT. The blade assembly can then be retracted along the first opening 330 to further cut into the QT. The blade assembly 350 may include two laterally spaced blades that simultaneously produce two incisions parallel to each other, defining the width of the tendon graft. The first of the two laterally spaced blades can extend through the thickness of the guide through the slot 330. The other of the two laterally spaced blades can extend along or adjacent to the most lateral outer surface of the guide 320. The blade cooperates with the thickness of the guide 320 to define the cutting depth into the tendon. The method may include guiding the blade assembly using software guidance.

[0046] The guide 320 can also be used to guide the cutting of the bone block portion of the implant, where the QT is removed and a portion of the patella is still attached. The guide 320 can be placed so that the teeth 325 are turned up and passed through a hole 372 placed on the top of the patella. The guide longitudinal axis can be parallel and coaxial with the implant longitudinal axis. A needle or guide wire can then be placed through the hole 372 and into a portion of the patella to stabilize the guide 320 while the bone block is formed.

[0047] Figures 5A-5CAn alternative embodiment of a QT harvesting tool 500 is schematically shown, which includes a handle 505 or rod having a blade guide 530 and a blade 550 at a distal end. The handle 505 can be selectively removed from the blade guide 530 and can be a reusable handle, configured to be sterilized and having a universal attachment device for attaching to several tool working ends during surgery. The blade guide 530 defines a surface 535 that is configured to engage and slide along the top or front surface of the QT to limit the movement of the blade 550 into the QT. The blade 550 extends rearwardly from the surface 535 and can include two blade surfaces 555a and 555b that can extend perpendicularly from the surface 535, with a connecting blade surface 555c between them. The blade surface 555c can be parallel to the surface 535. At least one of the blade surfaces can be configured to cut. In some exemplary embodiments, all of the blade surfaces 555a, 555b, and 555c are configured to cooperate and cut a graft of a defined shape (in this case a rectangular shape). In alternative embodiments, blade surfaces 555a, 555b, and 555c can be oriented to cut different predetermined shapes, such as quadrilaterals, diamonds, trapezoids, or squares. Blade surfaces 555a, 555b, and 555c can also be curved blades and cut a more curved or rounded graft. In some alternative embodiments, the lateral side of the graft can be cut using a device such as the embodiment shown in the figures.

[0048] like Figure 5B As can be seen in the figure, blade 550 has a length "L" which can help stabilize the structure of the blade to resist deformation from tough QT tissue. The cross-section defined by 555a, 555b and 555c along the length "L" is shown as constant. However, in alternative embodiments, opening 540 can be graduated from the cutting edge to a gradually larger opening size, so that the transplant tissue can be cut at the cutting edges 555a, 555b and 555c and then extend through the opening 540 with minimal interference from the blade walls.

[0049] Surface 535 extends further laterally and axially than blade 550 to provide stability and maintain a desired path of blade 550 when sliding the blade along the anterior surface of the QT. In other words, blade cutting surfaces 555a and 555b are laterally spaced a first distance to define a width of the QT graft corresponding to the first distance, and wherein guide surface 535 has a width that extends further laterally than the lateral spacing of cutting surfaces 555a and 555b. Thus, the guide surface has a width greater than the first distance. Blade cutting edges 555a and 555b are disposed on opposite sides of the longitudinal axis of harvesting tool 500. A method of using a QT graft such as Figures 5A-5CThe method of harvesting QT in the device embodiment shown in the embodiment includes first cutting the fat tissue from the QT / surrounding muscle tissue and identifying the desired QT track. The QT is then isolated at the proximal end of the patella and a locking suture is placed through the QT, with the suture tail extending from the locking suture. The suture tail is then fed through an opening 540 in the blade, which is defined by the first, second and third cutting edges. The QT is pulled into the opening 540 using a combination of tension on the suture tail to prepare the graft while pushing and sliding / guiding the blade along the QT. The guide surface 535 can slide along the anterior surface of the QT and the blade 550 creates an incision.

[0050] exist Fig. 6A and 6B A fourth exemplary embodiment is shown in the embodiment described with reference to FIGS. 3 , 4A and 4B. This embodiment is configured to allow the guide to operate in two orientations, which are flipped relative to each other, depending on the surgeon's preference and which leg to select for the patient. They may be flipped for left or right adjustment. Similar to the previous embodiment, the ruler 600 generally includes a blade guide 620, which can cooperate with a blade assembly such as 350 or 750 selectively coupled to the guide 620. The blade guide 620 is generally an elongated slotted ruler having a first end 622 and a second end 624 that can include a handle. The guide 620 may include a device for engaging or anchoring with tissue arranged along its length, which is configured to prevent the guide 620 from accidentally sliding or moving on the tendon during use. As shown, the guide 620 includes at least one tooth 625 at the second end 624. The teeth may be similar to the embodiment shown in FIG. 3 . This embodiment can be flipped to operate on either side, so there may be teeth on both the top surface 620a and the bottom surface 620b. The bottom surface 620b is in some orientations, such as Fig. 6A The orientation can be in the rear surface of the bonded QT, or in the flipped orientation ( Figure 6B ) is the top surface. It may be preferred to have teeth 625 at the ends of the guide 620 rather than along the length, thereby limiting any potential damage to the graft caused by the teeth 625 to areas that can be easily removed or do not form part of the graft itself, and thereby maintaining good vitality of the resulting graft. The teeth 625 can be configured to pierce the tendon and can have an extended length that is approximately equal to or less than the target graft thickness. In some embodiments, similar to the embodiments disclosed in, for example, Figures 3 and 4A, the teeth 625 can alternatively be configured such that at least one tooth length can be approximately the same as the blade extension (Y) below the first surface 620a or the second surface 620b. Alternative embodiments may include multiple teeth. Additionally or alternatively, in addition to or in place of the teeth, a high friction surface along the first portion of the guide 620 can help maintain the position of the guide 620 on the smooth front surface of the QT.

[0051] The guide 620 may also include a series of markings 628 on at least one of the first and second surfaces 620a, 620b indicating inches or some equivalent unit of measurement for visual feedback of the insertion depth of the guide 620 into the incision and along the tendon. The markings 628 may also be used to estimate the graft cut length, and thus may indicate a distance along the slot or opening 660 rather than from the farthest end of the guide 620. As shown, the slot 660 does not necessarily originate from the farthest end of the guide 620; the end 661 is spaced from the end 624. For example, in use, during insertion of the guide 600 between tissues and over the QT, the markings 628 corresponding to the desired graft length may be aligned with the upper end of the patella, and the at least one tooth 625 may then be anchored with an adjacent portion of the tendon tissue.

[0052] Similar to Figures 3A-3C In the embodiment of the present invention, the groove 660 can extend through the entire thickness of the guide 620. The groove 660 can help maintain the direction and trajectory of the blade assembly such as the blade assembly 350. The groove 660 can be wide enough to receive a portion of a cutting tool, such as the blade assembly 350 or 750, and allow the blade assembly 350 or 750 to move along it. However, the groove 660 can be narrow enough to limit the lateral movement of the cutting blade when the blade slides. As shown, the groove 660 can extend along a portion of the guide 620, similar to the guide rail portion described in the previous embodiment, and the groove 660 is mainly offset or arranged toward the half of the guide 620 spaced apart from the handle end 622, closer to the second end 624. The ends of the grooves 661 and 666 are configured to limit the movement of the blade along the tendon, and thereby limit the length of the graft formed. The groove ends 661 and 66 can be used as hard stops to prevent the blade assembly 650 from extending beyond the guide 620 and inadvertently damaging the tissue. The slot 660 can be parallel to the longitudinal axis of the guide 600 and laterally offset from the longitudinal axis. Adjusting the slot 660 to one side can provide better visualization of the cutting mark 628 and the cutting blade.

[0053] During use, the slot 660 can be placed along the QT under the skin through a small incision near the patella. The blade assembly 350, 750 can then move between the two ends 661 and 666 to form the desired graft length. Once the guide 620 has been placed, cutting can be performed under minimal visualization because some of the guide 600 may be blocked by the patient's skin. Therefore, the guide 620 can be provided as a series of guides with various sizes (e.g., corresponding guide thickness and slot length). The guide thickness T can be sufficient to cooperate with the blade assembly 350 to limit the cutting depth into the tissue. When paired with the expected blade, this can limit the cutting depth to reduce the risk of penetrating the knee joint capsule. The guide 600 can be formed by injection molding and / or can be formed by a disposable single-use material that is generally plastic. The guide handle 622 can be hingedly attached to the ruler 620 and can be removably connected to the ruler 620. Having an articulated attachment can allow the handle to move away from the surgeon's field of vision.

[0054] According to an exemplary method of the present invention, a graft may be harvested (sized and cut to a specific size) by the following steps: The surgeon may choose to adjust the side of the flip ruler guide 620. In this selected adjustment, the guide 620 may be inserted through a small incision above the kneecap, under the skin, and along the anterior surface of the QT. A marking 628 on the guide 620 corresponding to the desired graft length may be aligned with the upper end of the patella, and at least one tooth 625 of the guide 620 may then be anchored with an adjacent portion of the tendon tissue. The tooth 625 may be configured so that pressure from the user's hand may be sufficient to anchor the tooth 625 within the tissue. A blade assembly such as the blade assembly 350 may be inserted into the opening or slot 660 of the guide 620 and advanced along the opening 660. The blade assembly 350 may slide along the elongated opening or slot 660, which defines the trajectory of the blade assembly and thereby controls the depth and trajectory of the cut into the QT. The blade assembly may then be retracted along the first opening 660 to further cut into the QT. The blade cooperates with the thickness of the guide 620 to define the depth of cut into the tendon. The offset slot 660 of the guide allows the surgeon to view the marking 628 and the blade assembly as the blade assembly translates along the guide 620.

[0055] Embodiments of the pivoting blade assembly are Figures 7A-7D As shown in Figures 3A-3Cor the ruler guide shown in 6A and 6B. The pivoting blade assembly 750 provides a means to produce an incision of consistent depth in the QT regardless of the angle at which the user orients the handle. The blade assembly 750 allows the handle 780 to rotate independently while the blade orientation remains constant. For example, when using an off-the-shelf scalpel, where the handle is fixedly coupled to the blade in a fixed orientation, the cutting depth is determined by the angle at which the surgeon introduces and holds the blade to the surface of the soft tissue. If access to the soft tissue is limited by the surrounding skin / fat, such as in minimally invasive quadriceps tendon soft tissue harvesting, the limited access to the tendon portion in the case of a fixed handle such as an off-the-shelf scalpel may result in inconsistent overall tendon thickness.

[0056] The blade assembly 750 generally includes a handle 780 pivotally coupled to the blade portion 760. The handle 780 may be selectively removable from the blade portion 760. For example, the handle 780 may be pivotally coupled via a pin joint. The handle 780 may be independently rotated relative to the blade end 760 while still translating the blade end along the QT. The blade portion 760 may include at least one surface 762 for translating along a surface such as Figure 3A The ruler surface in 326 or Fig. 6A 762 can slide against the surface of 620a or 620b in the ruler guide 620, thereby limiting the cutting depth into the QT. Surface 762 can define a planar flat surface that is configured to maintain a constant penetration depth of the blade front edge 766 into the QT. Therefore, surface 762 can be offset ("O") and / or angled α relative to the blade front cutting edge. The offset "O" is at least as thick as the ruler guide 620 so as to extend through the slot of the ruler guide 620 and penetrate the QT. The blade portion 760 may include a device that is connected to a standard off-the-shelf blade 765. Fig. 7A The handle 780 is shown in a more horizontal orientation relative to the blade portion 760, which may be the preferred orientation at the cranial end of the QT when the system 750 is at least partially penetrated beneath the patient's skin. Figure 7B The handle 780 is shown in a more vertical orientation relative to the blade portion 760, which may be the preferred orientation at the patella end of the QT when the system is closest to the incision and initially penetrates the QT. Due to the pivot or hinge connection 770, the surface 762 can remain in contact with a ruler guide such as the ruler guide 620 for a range of handle orientations. In some alternative embodiments, there may be only one blade, as opposed to the double blade design disclosed herein. In some alternative embodiments, the rotation of the blade portion may be actively controlled. For example, a freely pivoting blade may be considered a risk and therefore has some control features, such as a spring that can be overcome with low force to pivot, or a lock. The spring may be coupled between the handle 780 and the blade portion 760. An alternative embodiment may be a rotationally controlled pivot that changes the depth of cut as the angle increases. In other alternative embodiments, a locking feature may be provided to lock the distal tip in a certain orientation.

[0057] according to Fig. 8A and 8B In the exemplary method of the present invention shown in , a graft can be harvested (sized and cut to a specific size) by the following steps: the guide 600 or 320 can be inserted through a small incision above the kneecap, under the skin and along the anterior surface of the QT. The marking 328 or 628 on the guide 320 or 600 corresponding to the desired graft length can be aligned with the upper end of the patella, and at least one tooth, such as the tooth 325 of the guide 320, can then be anchored with an adjacent portion of the tendon tissue. The tooth 325 can be configured so that pressure from the user's hand can be sufficient to anchor the tooth 325 within the tissue. According to the surgeon's preferred adjustment, the guide 600 with the offset slot 660 can be flipped to better visualize the marking 628 and the slot 660. A blade assembly such as the blade assembly 750 can include two blades 765, one of which can be inserted into the opening or slot 330 of the guide 320 (or 660 of the guide 600) and advanced along the slot 330. Surface 762, which may define a flat planar surface, may engage the top surface of guide 320 or 600. Blade assembly 750 may slide along elongated slot 330, which defines a trajectory of the blade assembly. Surface 762 may slide along the top surface of the guide and thereby control the depth and trajectory of the cut into the QT. Blade assembly 750 may slide along elongated slot 330 from a first position adjacent to the incision and patella with handle 780 in a first orientation, and then handle 780 moves blade portion 760 along guide 320 or 600, and the handle orientation changes from the first orientation to a different orientation ( Figure 8B ) while maintaining a constant orientation of the blade and thereby maintaining the QT cutting depth. The first orientation may be more vertical and a different orientation may be arranged more horizontally. The handle may pivot relative to the blade portion while moving along the guide 320 or 600 while the retaining surface 762 engages with the guide top surface. The blade assembly 750 may then be retracted along the first opening 330 or 660 to further cut into the QT.

[0058] The above discussion is intended to illustrate the principles and various embodiments of the present invention. Once the above disclosure is fully understood, many changes and modifications will become apparent to those skilled in the art. It is intended that the following claims be interpreted as including all such changes and modifications.

Claims

1. A tendon harvesting system for harvesting a target length of tendon tissue, comprising: a guide having an elongated body defining a shank end and a free end and a longitudinal axis, the elongated body further comprising an upper surface and a lower surface defining a thickness of the elongated body; wherein the lower surface of the elongated body includes a guide slot having a length extending parallel to the longitudinal axis, the guide slot being configured to receive a blade therethrough and guide the blade to translate along the length of the guide slot and thereby along the tendon tissue, and wherein the guide is configured to limit a cutting depth of the blade into the tendon tissue as the blade translates along the tendon tissue; wherein the guide slot extends upwardly from the lower surface to and includes the upper surface, and wherein the body thickness is configured to cooperate with the blade to limit the cutting depth of the blade into the tendon tissue as the blade translates along the slot length.

2. The harvesting system of claim 1, wherein the free end of the elongated body is configured to anchor with the tendon tissue.

3. The harvesting system of claim 1, wherein the elongated body includes means for piercing the tendon tissue and thereby anchoring to the tendon tissue.

4. The harvesting system of claim 3, wherein the means for piercing the tendon tissue comprises at least two discrete elements extending perpendicularly from the longitudinal axis at the free end of the guide.

5. The harvesting system of claim 1 , wherein the free end is configured to anchor the guide to the tendon tissue when the body is in a first orientation and a second orientation, the first orientation and the second orientation flipped about 180 degrees relative to each other about the longitudinal axis.

6. The harvesting system of claim 1, wherein the blade is operably coupled to a housing having a surface configured to engageably slide along the body upper surface upon translation of the blade and thereby limit extension of the blade into the tendon tissue.

7. The harvesting system of claim 6, wherein the blade is pivotally coupled to a handle, the handle being configured such that the housing surface remains in contact with and slides along the body upper surface when the handle is pivoted.

8. A harvesting system for harvesting a certain length of tissue, comprising: a blade guide having a shank end and a guide end extending therefrom, the guide end including an elongated opening; as well as a blade assembly including a cutting blade, the blade assembly being configured to slide along the elongated opening with the cutting blade extending from the elongated opening and into the tissue, the blade assembly and the leading end being configured to cooperate and control extension of the cutting blade into the tissue; Wherein, the elongated opening extends through the entire thickness of the blade guide.

9. The harvesting system of claim 8, wherein the blade assembly includes a handle pivotally coupled to the cutting blade such that the handle can rotate relative to the cutting blade through an angular range when the cutting blade is translated along the elongated opening.

10. The harvesting system of claim 8, wherein the blade assembly comprises two cutting blades laterally spaced from each other.

11. The harvesting system of claim 10, wherein the elongated opening is configured to receive one of the two cutting blades therethrough such that the other of the two cutting blades is positioned adjacent a laterally outermost surface of the blade guide.

12. The harvesting system of claim 8, wherein the blade guide is configured to anchor with the tissue.

13. The harvesting system of claim 12, wherein the blade guide comprises at least one tooth extending perpendicularly from the longitudinal axis of the elongated opening, the at least one tooth being configured to anchor with the tissue.

14. The harvesting system of claim 8, wherein the blade assembly includes a surface configured to slidingly engage an upper surface of the leading end and control extension of the cutting blade into the tissue as the cutting blade is translated along the elongated opening.

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