Multi-bore drill guide and multi-bore drill guide system

Abstract

A multi-bore drill guide and a multi-bore drill guide system are disclosed, the multi-bore drill guide comprising: an elongate body extending along a longitudinal axis and having a proximal end and a distal end; a shank extending from the elongate body; a first channel extending from the proximal end to the distal end; a second channel extending from the proximal end to the distal end at an angle relative to the first channel; and a convergence region at the distal end where the first channel and the second channel intersect.

Description

[0001] This application is a continuation of application number 201880051069.3 (international application number PCT / US2018 / 035260) filed May 31, 2018, having the title "Multi-Drill Guide".

[0002] Cross Reference to Related Applications

[0003] This application claims priority to and the benefit of U.S. Non-Provisional Application No. 15 / 679,641 filed August 17, 2017 and Provisional Patent Application No. 62 / 515,074 filed June 5, 2017. TECHNICAL FIELD

[0004] The present invention relates to drill guides for drilling a pilot hole at a surgical repair site and inserting a suture anchor into the pilot hole, and more particularly to a multi-drill guide for both drilling a pilot hole at a surgical repair site and inserting a suture anchor into the pilot hole while maintaining alignment of the drill guide with the pilot hole. BACKGROUND

[0005] Many orthopedic and medical procedures require the fixation of one body to another. Such bodies can include bone, soft tissue, and prosthetics. One body can be fixed in place relative to another using connector devices such as screws and suture anchors (e.g., cannulated, non-knot type suture anchors and soft, all-suture anchors). For example, various orthopedic surgeries require the insertion and fixation of suture anchors within bone. In such surgeries, a pilot hole is drilled in the bone prior to insertion of the suture anchor. Traditionally, a standard single-drill guide is placed on the bone at the desired pilot hole location, and then a drill is placed through the drill guide to form the pilot hole. The drill is then removed and replaced with a driver pre-loaded with a suture anchor. Thus, the surgeon must remove the drill entirely from the drill guide and insert the driver, all while maintaining alignment of the drill guide with the pilot hole. Changing tools within the drill guide after the pilot hole is formed increases the risk that the drill guide will lose alignment with the pilot hole. Losing alignment requires additional surgical time to correct the misalignment (if it is even possible), and can potentially result in tissue or bone damage around the pilot hole. Losing alignment can also result in the anchor inserter shaft bending or the anchor not being fully inserted into the pilot hole, which can increase costs as well as surgical time. To avoid misalignment with a standard single-drill guide, additional auxiliary devices can be required to help maintain alignment or attempt to realign.

[0006] DISCLAIMER FOR THE RELEVANT ART SECTION: To the extent that specific patents / publications / products are discussed above in this RELEVANT ART section or elsewhere in this disclosure, such discussion is not an admission that the patent / publication / product is prior art to this disclosure or to any aspect of this disclosure. For example, some or all of the patents / publications / products discussed above can not pertain to the technical field of the present disclosure or can not be considered prior art under 35 U.S.C. § 102 in light of the specific disclosure provided herein. To the extent that specific patents / publications / products are discussed above in this RELEVANT ART section and / or throughout this application, the description / disclosure thereof is incorporated by reference herein in its entirety. SUMMARY

[0007] Embodiments of the present disclosure recognize that conventional single- barrel drill guides present potential problems and / or disadvantages (as discussed herein and above). For example, removing the drill bit from the drill guide and replacing it with a driver to insert a suture anchor increases the risk of misalignment of the drill guide with the pilot hole, which requires additional surgical time and risks damage to surrounding tissue and bone. Accordingly, there is a need for a simple and easy-to-use multi-barrel drill guide configured to simultaneously accommodate a drill bit and a driver with a suture anchor. This structural configuration allows the suture anchor to be in place at the time the anchor driver is in separate but converging passageways / channels in the drill guide and ready to be inserted into the pilot hole immediately after the pilot hole is formed by the drill bit, without having to pull the drill bit out of the drill guide before the suture anchor driver can be inserted into the converging rear region of the drill guide. Various embodiments of the present disclosure can be advantageous in that they can address or reduce one or more of the potential problems and / or disadvantages discussed herein.

[0008] The present disclosure relates to the inventive configuration, structure and resulting functionality of a multi-barrel drill guide. The multi-barrel drill guide comprises an elongated body extending along a longitudinal axis, the elongated body having a proximal end and a distal end, a handle extending from the elongated body at an angle to the longitudinal axis (at an acute angle to the longitudinal axis or orthogonal to the longitudinal axis) at a location between the proximal end and the distal end. The drill guide further comprises an elongated distal guide tube attached to and extending from the distal end of the elongated body. According to one preferred embodiment, there are no movable parts on the exterior portion or surface of the elongated body. The drill guide has a first channel and a second channel, each of which extends from the proximal end to the distal end. The second channel extends at an angle relative to the first channel. The first channel and the second channel intersect at a convergence region at the distal end. The multi-barrel drill guide is configured to house a suture anchor and driver that is slidable within the first channel and a drill bit that is slidable within the second channel, or a drill bit that is slidable within the first channel and a suture anchor and driver that is slidable within the second channel. According to the preferred embodiment, the elongated body is completely enclosed except for the proximal entrance to the first and second channels, the distal single exit after the first and second channels converge, and an optional slot / slit for a suture line connected to the anchor, the optional slot / slit being positioned through the exterior surface of the elongated body (and preferably positioned into the channels with the driver and suture anchor) and extending from the proximal end of the elongated body (back to the proximal end of the anchor driver) to the distal end of the elongated body (and to the anchor).

[0009] According to another aspect, a method of drilling a guide hole and inserting a suture anchor into the guide hole includes, but is not limited to, the following steps: (i) providing a multi-cannula drill guide having: an elongated body extending along a longitudinal axis, the elongated body having a proximal end and a distal end; a handle extending at an angle from the elongated body to the longitudinal axis (at an acute angle to the longitudinal axis or orthogonal to the longitudinal axis) at a location between the proximal end and the distal end; an elongated distal guide tube attached to and extending from the distal end of the elongated body, wherein there are no movable parts on the exterior portion or surface of the elongated body; a first channel extending from the proximal end to the distal end; a second channel extending from the proximal end to the distal end at an angle relative to the first channel; and a convergence region at the distal end where the first channel and the second channel intersect; (ii) inserting a driver having a suture anchor into the first channel and a drill bit into the second channel; (iii) positioning the distal end of the drill guide against a bone; (iv) extending the drill bit through the convergence region; (v) drilling a guide hole in the bone with the drill bit; (vi) retracting the drill bit past the convergence region at the distal end of the elongated body of the drill guide; (vii) extending the driver having the suture anchor through the first channel and the convergence region; (viii) implanting the suture anchor into the guide hole; (ix) pulling a length of suture connected to the suture anchor through a slit and into the first channel, the slit being positioned through the exterior surface of the elongated body; and (x) removing the drill guide from the bone. The method mentioned above can be performed with the drill bit positioned within the first channel and the driver having the suture anchor positioned within the second channel.

[0010] Suture material or suture (as these terms are used and described herein) can include monofilament or multifilament suture and any other metallic or non-metallic filamentary or thread-like material suitable for performing the function of a suture. The material can include both bioabsorbable and non-absorbable materials.

[0011] Suture anchors (as used herein) can include both flexible and rigid suture anchors. Flexible suture anchors are formed from filaments of suture material that are retained within a pre-formed bone hole due to their deformability to increase their diameter to a size larger than the pre-formed bone hole, thus residing within the cancellous bone and beneath the cortical bone. One such suture anchor is disclosed in U.S. Patent Publication No. 2012 / 0290004, assigned to the assignee herein, and the entire contents are incorporated herein by reference. Because flexible anchors are often made entirely of suture material, they are sometimes referred to as “fully sutured” anchors and typically include a fiber-constructed anchor body (or a fiber, braided, or woven fabric-type structure, such as a flexible mesh, as described in U.S. Patent No. 9,173,652) and a suture or filament portion. Methods and apparatus for inserting / deploying such fully sutured anchors are known, examples of which are disclosed in U.S. Patent No. 9,173,652.

[0012] As described in U.S. Patent No. 8,409,252, for example, a “non-soft,” “hard,” or “rigid” suture anchor typically comprises a “hard” anchor body portion (which may or may not include internal and external components) and a suture / filament portion. The anchor body of such a suture anchor may be formed of a biocompatible and / or bioabsorbable material. These materials may have a composition such that they are reabsorbed by the body, for example, during the bone healing process. Exemplary materials suitable for use in the internal and external components include, but are not limited to, polyetheretherketone (“PEEK”), polylactic acid / β-tricalcium phosphate (“PLA / β-TCP”) composites, ultra-high molecular weight polyethylene (“UHMWPE”), and other metallic, non-metallic, and polymeric materials. Attached Figure Description

[0013] The invention will be more fully understood and appreciated by reading the following detailed description in conjunction with the accompanying drawings. The drawings illustrate only typical embodiments of the disclosed subject matter and are therefore not intended to limit its scope, as the disclosed subject matter may allow for other equivalent embodiments.

[0014] Now, please briefly refer to the attached diagram, in which:

[0015] Figure 1 This is a side view of the cross-section of a multi-cylinder drilling guide according to one implementation scheme.

[0016] Figure 2 This is a side view of the assembly of a multi-cylinder drilling guide according to one implementation scheme.

[0017] Figure 3 This is a side view of the cross-section of a multi-cylinder drilling guide according to one implementation scheme.

[0018] Figure 4AThis is a rear cross-sectional schematic diagram of a multi-cylinder drilling guide according to one implementation scheme.

[0019] Figure 4B This is a cross-sectional rear / near-side view schematic diagram of a multi-cylinder drilling guide according to one embodiment.

[0020] Figure 5 This is a front / far side view schematic diagram of a multi-cylinder drilling guide according to one implementation scheme.

[0021] Figure 6 This is a perspective view of a multi-cylinder drilling guide after assembly according to one implementation scheme.

[0022] Figure 7A This is a front / far side view of the cross-section of a multi-cylinder borehole guide according to one embodiment.

[0023] Figure 7B This is a side view of the cross-section of a multi-cylinder drilling guide according to one implementation scheme.

[0024] Figure 7C This is a front / far side view of the cross-section of a multi-cylinder borehole guide according to one embodiment.

[0025] Figure 8 This is a side view of the assembly of a multi-cylinder drilling guide according to one implementation scheme.

[0026] Figure 9 This is a side view of the assembly of a multi-cylinder drilling guide in use according to one implementation scheme.

[0027] Figure 10 This is a side view of the assembly of a multi-cylinder drilling guide in use according to one implementation scheme.

[0028] Figure 11 This is a side view of the assembly of a multi-cylinder drilling guide in use according to one implementation scheme.

[0029] Figure 12 This is a side view of the assembly of a multi-cylinder drilling guide in use according to one implementation scheme.

[0030] Figure 13 This is a side view schematic diagram of a deployment stitching anchor deployed by a multi-cylinder borehole guide according to one implementation scheme. Detailed Implementation

[0031] Now refer to the attached diagram, where similar reference numerals always refer to similar parts, in Figure 1A cross-sectional side view of a multi-tube drill guide 100 according to one embodiment is shown in the figure. In this depicted embodiment, the drill guide 100 includes: an elongated body 102 extending along a central longitudinal axis x-x, the elongated body having a proximal end 104 and a distal end 106; a shank 108 extending from the elongated body 102 between the proximal end 104 and the distal end 106; and a distal tube or guide end 128 extending from the distal end 106. The elongated body 102 has a fully enclosed exterior (as described above and as shown in the figures). The exterior portion of the elongated body 102 preferably does not include movable portions that complicate or hinder the ease of use of the drill guide 100.

[0032] like Figure 1 As shown, the handle 108 extends generally perpendicularly from the elongated body 102 between the proximal end 104 and the distal end 106 to increase balance and control of the drill guide 100. However, the handle 108 can extend at various angles to the central longitudinal axis x-x from any position along the elongated body 102 to provide stability when the user grips the handle 108 to position the drill guide 100 against the desired guide hole location on the bone.

[0033] See still Figure 1 The elongated body 102 includes a first channel 110 and a second channel 112 for receiving tools to drill a guide hole and insert a suture anchor. In the depicted embodiment, both the first channel 110 and the second channel 112 extend from the proximal end 104 of the elongated body 102 to the distal end 106. Figure 1 As shown, the first channel 110 and the second channel 112 have different inlet points along the proximal end 104 of the elongated body 102. The first channel 110 extends from inlet point (A) on the proximal end 104, and the second channel 112 extends from inlet point (B) on the proximal end 104. The two separate inlet points (A) and (B) accommodate two tools, one for drilling a pilot hole and the other for inserting a suture anchor into the drilled pilot hole.

[0034] exist Figure 1 In the embodiment shown, the first channel 110 extends substantially straight along a horizontal axis parallel to the central longitudinal axis x-x of the elongated body 102. The second channel 112 extends at an angle relative to the first channel 110 and the central longitudinal axis x-x, which allows the first channel 110 and the second channel 112 to have separate entry points (A) and (B) and a convergence region 114, at which the channels converge before a single exit point (C) (described below). The separation of channels 110 and 112 allows for the coexistence and storage of two tools within the drill guide 100.

[0035] Although the first channel 110 and the second channel 112 extend from different inlet points (A) and (B) along the proximal end 104 of the elongated body 102, the first channel 110 and the second channel 112 share a single outlet point (C) from the elongated body 102 at the distal end 106 of the elongated body 102. This outlet point (C) leads to a single distal tube or guide end 128. Figure 1 As further shown, the first channel 110 and the second channel 112 extend from the proximal end 104 and converge at a converging region 114 at the distal end 106 of the elongated body 102. In this depicted embodiment, the converging region 114 extends from the exit point (C) into the distal end 106. Thus, the first channel 110 is separate and distinct from the second channel 112 between the entry points (A), (B) and the converging region 114. Therefore, a user can employ a desired tool (one at a time) in either the first channel 110 or the second channel 112 by extending the tool into the converging region 114 and through the exit point (C) out of the drill guide 100, then into and out of the distal guide end 128, while another tool can be located (positioned but not moved within) in the opposing channel.

[0036] In an additional embodiment, the second channel 112 may include a curved portion 122 that extends at an angle increasing relative to the first channel 110. Thus, the curved portion 122 extends at an angle different from the rest of the second channel 112. The curved portion 122 ensures a sufficiently large distance between entry point (A) and entry point (B) such that inserting and removing a tool through entry point (A) does not impede the tool's positioning in entry point (B), and vice versa.

[0037] To drill the pilot hole and insert the stitching anchor, the separation of channels 110 and 112 allows both the drill bit 116 and the anchor driver 118 to be used in the drill guide 100 without the risk of movement that could lead to misalignment of the drill guide 100. In one embodiment, the drill bit 116 is placed through the second channel 112 until it is positioned at the exit point (C) and through the distal tube or guide end 128, while the stitching anchor is placed through the first channel 110. Figures 1 to 2 In the embodiment shown, a stitch anchor is preloaded onto the driver 118 and placed through the first channel 110 up to the convergence region 114, but does not extend into the convergence region 114. In an alternative embodiment, a drill bit 116 is placed in the first channel 110, while the driver 118 with the preloaded stitch anchor is placed within the second channel 112.

[0038] Next, the distal guide end 128 of the drill guide 100 (or the distal end 106 of the drill guide 100, if the distal end 128 is absent) is placed against the bone, and a guide hole is drilled using the drill bit 116 (a similar method of use of this drill guide is shown and described below with respect to the drill guide 200). The drill bit 116 is then removed, and the actuator 118 is extended through the first channel 110, the converging region 114, and the exit point (C) through the distal end 128 (if present) to insert the suture anchor into the guide hole. Because the first channel 110 and the second channel 112 share a common exit point (C) (and in some embodiments, a common distal end 128), the actuator 118 can be used to push the suture anchor directly into the guide hole. Therefore, after the guide hole is drilled (i.e., each tool (drill bit; actuator with anchor) is present and ready for use), the surgeon requires only minimal movement to insert the suture anchor. Therefore, the drill guide 100 will move with less risk of misalignment with the guide hole.

[0039] See now Figure 2 This illustrates an implementation scheme as follows: Figure 1 The diagram shows a side view of the fully assembled multi-barrel drill guide 100. In this depicted embodiment, the elongated body 102 includes a slot 120 extending from a proximal end 104 to a distal end 106. The slot 120 extends from the distal portion of a first channel through the elongated body 102 into the first channel 110 and then to the distal end 106 of the guide 106, and the proximal portion of the slot 120 does not extend into the first channel, so the suture 123 will not impede the movement of the actuator 118 in the first channel 110 (although in some embodiments, the suture extends into the first channel along the full length of the slot or a length between 50% of the slot's length and the full length). A length of the suture 123 extending from an anchor (not shown) can be pulled through the slot 120, so the drill guide 200 can be withdrawn from the guide hole without damaging the implanted suture anchor. Furthermore, the slot 120 facilitates the use of an anchor with a needle with the drill guide 200. The slot 120 allows the needle and suture 123 to be released from the anchor drive shank and pulled away from the guide 100 without the need for the bent suture needle to travel through the channel or slot.

[0040] Figures 3 to 13Alternative embodiments of the borehole guide 200 are described. The borehole guide 200 includes many of the same elements as the borehole guide 100 as described above. These alternative embodiments include optional and sometimes additional components; however, some of the alternative embodiments function in a similar manner. Therefore, much of the discussion above regarding the functionality of the previous embodiments, as well as the discussion above regarding some basic parts of the borehole guide, also applies to the alternative embodiments discussed below.

[0041] Go to Figure 3 A cross-sectional side view of a multi-tube drill guide 200 according to one embodiment is provided. Similar to drill guide 100, drill guide 200 includes: an elongated body 202 extending along a central longitudinal axis x-x, the elongated body having a proximal end 204 and a distal end 206; a shank 208 extending from the elongated body 202 between the proximal end 204 and the distal end 206; and a distal tube or guide end 228 extending distally from the distal end 206. The elongated body 202 has a fully enclosed exterior (as described above and as shown in the figures). The exterior portion of the elongated body 202 preferably does not include movable portions that complicate or hinder the ease of use of the drill guide 200.

[0042] See still Figure 3 The elongated body 202 includes a first channel 210 and a second channel 212 for receiving tools to drill a pilot hole and insert the suture anchor 10. In the depicted embodiment, both the first channel 210 and the second channel 212 extend from a proximal end 204 to a distal end 206 of the elongated body 202. The first channel 210 and the second channel 212 have different entry points along the proximal end 204. The first channel 210 extends from an entry point (A) on the proximal end 204, and the second channel 212 extends from an entry point (B) on the proximal end 204. The two separate entry points (A) and (B) receive two tools, one (e.g., a drill bit 216) for drilling the pilot hole and the other (e.g., an anchor actuator 218) for inserting the suture anchor 10 into the drilled pilot hole.

[0043] The first channel 210 extends along the elongated body 202 and has a constant slight curvature in the direction toward the handle 208 (see reference). Figure 7B(Further discussion). Alternatively, there may be a slight bend in the direction toward the shank, which is not a constant curve, starting at certain points between the proximal and distal ends of the elongated body. The second channel 212 extends at an angle relative to the central longitudinal axis x-x, which allows the first channel 210 and the second channel 212 to have separate entry points (A), (B) and a converging region 214, at which the channels converge before a single exit point (C) (described below). The separation of channels 210, 212 allows for the coexistence and storage of two tools within the drill guide 200.

[0044] Although the first channel 210 and the second channel 212 extend from different inlet points (A) and (B) along the proximal end 204 of the elongated body 202, they share a single outlet point (C) from the elongated body 202 at the distal end 206. This outlet point (C) leads to a single distal tube or guide end 228. In the depicted embodiment, a converging region 214 extends from the outlet point (C) into the distal end 206. Thus, the first channel 210 is separate and distinct from the second channel 212 between the inlet points (A) and (B) and the converging region 214. Therefore, a user can employ a desired tool (one at a time) in either the first channel 210 or the second channel 212 by extending the tool into the converging region 214 and through the outlet point (C) out of the drill guide 200, then into and out of the distal guide end 228, while another tool can be located (positioned but not moved within) in the opposing channel. The second channel 212 may include a curved portion 222 that extends at an angle increasing relative to the first channel 210. Therefore, the curved portion 222 extends at an angle different from the rest of the second channel 212. The curved portion 222 ensures a sufficiently large distance between the entry point (A) and the entry point (B) such that inserting and removing a tool through the entry point (A) does not impede the tool's positioning in the entry point (B), and vice versa.

[0045] Go to Figures 4A to 4B A cross-sectional rear view schematic diagram of a multi-cylinder drill guide 200 according to one embodiment is provided. A locking mechanism 230 is shown, which includes a locking pin 230-1 having a stop 230-2 and a channel 230-3. The locking mechanism 230 is capable of... Figure 4A The locking position shown is the same as Figure 4BActuation is performed between the unlocked and locked positions shown. In the locked position, stop 230-2 contacts the shaft of anchor actuator 218 and secures anchor actuator 218 in place within the first channel 210. When the user is ready to use anchor actuator 218 after drill bit 216 has drilled out of the guide hole, the user can actuate locking mechanism 230 by pulling locking pin 230-3 (pulled from the other side of the drawing (not shown) into the page), causing stop 230-2 to no longer contact locking pin 230-1, and the shaft of anchor actuator 218 to move freely through channel 230-3 (as shown). Figure 4B (As shown in the diagram). Other locking mechanisms are envisioned, as long as the locking mechanism can be actuated from the locked position to the unlocked position (and vice versa) to allow locking and releasing of the anchor driver 218. These other locking mechanisms may be spring-loaded and push toward the locked or unlocked position (as those skilled in the art should understand in conjunction with viewing this disclosure).

[0046] like Figure 5 As shown, the distal guide tube 228 may also include a plurality of teeth 301 on its distal end 206. The teeth 301 protrude from the distal end of the distal guide tube 228 such that they grip the bone when the drill guide 200 is placed against the bone to form a guide hole. Therefore, the teeth serve to provide additional stability to the drill guide 200 and are structured to help maintain alignment of the drill guide 200 with the desired guide hole position on the bone. The number of teeth can vary from one to multiple and can have any shape and sharpness that contributes to the functions mentioned above.

[0047] Go to Figure 6 In an additional embodiment, the teeth 301 on the distal end of the distal guide tube 228 may be configured to receive additional force against bone around the desired location of the guide hole. In such an embodiment, the shank 208 of the drill guide 200 may also include a hammering section 303 that provides an additional surface area to the proximal end of the drill guide 200 for striking with a hammer or other similar device. As shown, the hammering section 303 protrudes proximally from the shank 108 near the location where the shank 208 extends from the elongated body 202 (however, the hammering section 303 may be positioned anywhere near the proximal end of the drill guide 200 and / or the shank 208). Because striking the hammering section 303 will apply a force toward the teeth 301 to the elongated body 202 to drive the teeth 301 into the bone around the desired location of the guide hole, the hammering section 303 is close to the elongated body 302. Applying force to the teeth 301 via the hammering section 303 increases the stability of the drill guide 200 against the bone and helps maintain alignment for drilling the guide hole and inserting the suture anchor.

[0048] Go to Figure 7AA cross-sectional side view of the distal end of a multi-cylinder drilling guide 200 according to one embodiment is provided. Figure 7A A portion of drill bit 216 is shown positioned within the second channel 212, passing through the distal end 206 of the elongated body 202, and within the distal guide tube 228. As shown, drill bit 216 bends at point 216-1 near the converging region 214 so that: (1) it can be manipulated straight through the distal guide tube 228, and (2) it drills a hole in the bone that is substantially parallel to the longitudinal axis x---x and preferably not at an angle to the longitudinal axis x---x. Drill bit 216 preferably has sufficient flexibility to bend appropriately as it is manipulated through the converging region and into the distal guide tube 228, and then withdraws again (similar properties are envisioned for anchor actuator 218 if it is positioned as an alternative to passing through the second channel 212). A cylindrical guide sleeve (not shown) can be positioned within the second channel 212, the converging region 214, and / or the distal guide tube 228, having an inner diameter slightly larger than the diameter of the drill bit 216 and an outer diameter slightly smaller than the diameters of the second channel 212, the converging region 214, and the distal guide tube 228. This guide sleeve can position the end of the drill bit 216 at the center of the distal guide tube 228 to further ensure a specific / predetermined trajectory for the pilot hole.

[0049] Go to Figure 7B A cross-sectional side view schematic diagram of a multi-cylinder drilling guide 200 according to one embodiment is provided. Figure 7B A bend 210-1 in the first channel 210 is shown, which bends in the direction toward the shank 208. As shown, the first channel 210 bends in the direction toward the shank 208 from a point between the proximal and distal ends of the elongated body 202 to the converging region 214 (conceptually, this bend could begin at any point between the proximal and distal ends of the elongated body 202 and extend to the converging region, either just before or just after the converging region). This bend is structured and configured to position / guide the anchor driver along the same path as the drill bit (which is substantially straight along the bottom of the distal drill guide 228), making it easier for the anchor to be inserted into the previously drilled bone hole. In other words, with the bend 210-1 in place, the anchor is less likely to miss the previously drilled hole and is more likely to be inserted into the guide hole without adjusting the distal end of the distal guide tube 228 to adequately align the hole for anchor deployment. Figure 7C This is a schematic side view of the cross-section of the distal end of a multi-cylinder drilling guide 200 according to one embodiment. Figure 7CAn anchor actuator 218 is shown, positioned through the distal guide tube 228 and moving along the same path as the drill bit (which is substantially straight along the bottom of the distal guide tube 228). Therefore, if the position of the multi-tube drill guide 200 relative to the bone is maintained after the guide hole has been drilled, the anchor 10 with a suture 223 of a certain length should be easily delivered into the previously formed guide hole without having to move or change the angle of the distal guide tube 228 to position the guide hole.

[0050] Go to Figure 8 A fully assembled side view of a multi-barrel drilling guide 200 according to one embodiment is provided. From the proximal end to the distal end of the multi-barrel drilling guide 200, Figure 8 An anchor actuator 218, drill bit 216, elongated body 202, hammer section 303, shank 208, distal end 206 of elongated body 202, distal guide tube 228, and teeth 301 are shown. In this embodiment, the drill bit 216 has its distal end pre-loaded at the distal end of the distal guide tube 228.

[0051] Figures 9 to 13 A method of using the multi-barrel drill guide 200 according to one embodiment is illustrated. Each of these figures shows a fully assembled side view of the multi-barrel drill guide 200 according to one embodiment.

[0052] Go to Figure 9 In the first step, while holding the handle 208, the user / practicing physician positions the tooth 301 against the bone 400 to securely clamp the tooth 301 against the bone 400. (Continue to...) Figure 10 In the second step, the user advances drill bit 216 distally to form pilot hole 402, as shown. Figure 11 As shown in the diagram. After forming the pilot hole 402, in the third step, the drill bit 216 is removed from the multi-cylinder drill guide 200. (Go to...) Figure 12 In the fourth step, the anchor driver 218 is advanced distally to deploy the anchor 10 into the guide hole 402.

[0053] After the anchor has been inserted, the suture 223 is pulled out from the slot / slit 224 (which is positioned through the outer surface of the elongated body 202). Before deployment, the suture 223 is positioned partially through the slot / slit 224 on the side of the body 202 and is positioned in the channel at the distal end of the first channel 210 using the actuator 218 and connected to the suture anchor 10. The slot 120 extends through the elongated body 202 into the first channel 210, from the distal portion of the first channel to the distal end of the guide 206, and the proximal portion of the slot does not extend into the first channel, so the suture 223 does not obstruct the movement of the actuator 218 in the first channel 210. After the suture 223 has been pulled out and removed from the slot / slit 224, the multi-barrel drill guide 200 can be removed from the drill / deployment site (e.g., Figure 13 As shown in the figure, and the practicing physician can perform the insertion / deployment of the suture anchor 10 (as should be understood by those skilled in the art in conjunction with viewing this disclosure).

[0054] Although embodiments of the invention have been specifically shown and described with reference to certain exemplary embodiments, those skilled in the art will understand that various changes in detail may be made therein without departing from the spirit and scope of the invention as defined by the claims and supported by the written description and drawings. Furthermore, while exemplary embodiments have been described with reference to a specific number of elements, it should be understood that exemplary embodiments may be practiced using fewer or more elements.

Claims

1. A multi-cylinder drilling guide, comprising: An elongated body extending along a longitudinal axis and having a proximal end and a distal end; A handle that extends from the elongated body; A first channel extends from the proximal end to the distal end; A second channel extends from the proximal end to the distal end at an angle relative to the first channel; as well as A convergence region is located at the distal end, where the first channel and the second channel intersect. The first channel and the second channel converge before a single exit point of the elongated body and share that single exit point.

2. The multi-cylinder drilling guide according to claim 1, further comprising a hammering section extending proximally from the shank.

3. The multi-tube drilling guide according to claim 1, further comprising an elongated distal guide tube attached to and extending distally from the distal end of the elongated body.

4. The multi-tube drilling guide according to claim 3, further comprising a plurality of teeth on the distal end of the distal guide tube.

5. The multi-cylinder drilling guide according to claim 1, wherein, The convergence area extends to the single exit point.

6. The borehole guide according to claim 1, wherein, The second channel has a portion that extends relative to the longitudinal axis at an angle different from the rest of the second channel.

7. The multi-cylinder drilling guide according to claim 1, wherein, The first channel is curved in the direction toward the handle.

8. The multi-cylinder drilling guide according to claim 1, further comprising a slit extending into the first channel from the outside of the elongated body.

9. The multi-cylinder drilling guide according to claim 1, wherein, The handle extends at an angle relative to the longitudinal axis between the proximal end and the distal end of the elongated body.

10. The multi-cylinder drilling guide according to any one of claims 1 to 9, wherein, There are no movable parts on the outer portion of the elongated body.

11. A multi-cylinder borehole guide system, comprising: An elongated body extending along a longitudinal axis, having a proximal end and a distal end, wherein a handle extends from the elongated body; A first channel extends from the proximal end to the distal end; A second channel extends from the proximal end to the distal end at an angle relative to the first channel; A convergence region, wherein the first channel and the second channel intersect at the distal end; A suture anchor, which is slidably movable within the first channel; as well as A drill bit that can be slidably moved within the second channel. The first channel and the second channel converge before a single exit point of the elongated body and share that single exit point.

12. The multi-cylinder drilling guide system according to claim 11, wherein, The stitching anchor is mounted on a driver that is capable of being inserted into the first channel and moved slidably within the first channel.

13. The multi-barrel borehole guide system of claim 12, further comprising a locking mechanism configured to selectively lock the actuator in place relative to the first channel.

14. The multi-barrel drilling guide system of claim 11, further comprising a hammering section extending proximally from the shank.

15. The multi-tube borehole guide system of claim 11, further comprising an elongated distal guide tube attached to and extending from the distal end of the elongated body.

16. The multi-cylinder drilling guide system according to claim 15, wherein, The distal end of the distal guide tube has multiple teeth.

17. The multi-tube borehole guide system according to claim 11, wherein, There are no movable parts on the outer portion of the elongated body.

18. The multi-tube borehole guide system of claim 11, further comprising a curved portion of the second channel, the curved portion extending relative to the longitudinal axis at an angle different from the remainder of the second channel.

19. The multi-cylinder drilling guide system according to claim 11, wherein, The first channel is curved in the direction toward the handle.

20. The multi-barrel drilling guide system of claim 11, further comprising a slit extending into the first channel from the exterior of the elongated body.

21. The multi-cylinder drilling guide system according to claim 11, wherein, The handle extends at an angle relative to the longitudinal axis between the proximal end and the distal end of the elongated body.

22. The multi-tube borehole guide system according to any one of claims 11 to 21, wherein, The suture anchor is fully positioned within the first channel and is capable of sliding within the first channel.

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