Abstract: A surgical instrument employs a mass-spring system to drive the periodic reversal of the rotational direction of a bone dissection head. The instrument comprises a housing, a harmonic oscillator contained in the housing, an output member at least partially received in the housing and configured to be driven by the harmonic oscillator to reversibly rotate about a longitudinal axis in alternating directions, a dissection head having an attachment portion configured to be selectively driven in alternating rotational directions by the output member to remove material from a target bone, and a controller operable to initiate and stop the harmonic oscillator.

Abstract: Cutting instruments and related methods are disclosed herein in which the diameter of the retrograde cutting blade can be adjusted to any of a plurality of diameter settings, allowing the same instrument to be used to form holes of different diameters. The limit diameter can be preset such that, during the cutting operation, the user need not be concerned with selecting the appropriate diameter, but rather can simply deploy the cutting blade until the preset limit is reached. Cutting instruments are also disclosed in which the retrograde cutting blade is distinct from the forward drilling tip and protected within a cavity formed in the body of the instrument when not in use, as are instruments in which the user is given visual and/or tactile feedback to confirm desired positioning of the cutting blade.

Abstract: Endodontic instruments are used to clean and enlarge the endodontic cavity space (ECS), also known as the root canal system, of a human tooth. This document describes novel endodontic instruments that are radially compressible, and methods for their use. Some embodiments include a shank and a body with a working surface. At least a portion of the working surface may define a center of mass path that spirals. The center of mass of a transverse cross-section of the working surface at the shank end can be offset from the axis of rotation of the instrument.

Abstract: Assemblies, systems, and methods are directed at a neuromonitoring bone drill bit. The assembly may include a surgical bone drill bit, a neuromonitoring connection in electrical communication with the drill bit, and a shield extending over a distal end of the drill bit. The shield may be configured to withdraw proximally as the drill bit is advanced into a subject's bone. The assembly may be connected to a surgical drill and used in a surgical spinal procedure. In operation, the assembly may be advanced to a subject's bone at a surgical site and the drill bit may rotate into the subject's bone. In response, the shield may engage the bone and the drill bit may be advanced with respect to the shield. The shield may electrically insulate tissue from electrical current passing through the drill bit as it is inserted at the surgical site.

Abstract: A tissue collection and processing system for collecting bone fragments and tissue aspirated from a bone. The tissue collection and processing system includes a collection vessel, a collection vessel cap, a processing piston, a first tubing and a fluid withdrawal mechanism. The collection vessel has an opening formed therein to receive bone fragments and tissue aspirated from the bone. The collection vessel cap is capable of engaging the collection vessel to substantially seal the opening. The collection vessel cap or the collection vessel has a first port. The processing piston has an upper surface and a lower surface. The processing piston has a connection port and a bore. The connection port is proximate the upper surface. The bore is fluidly connected to the connection port and extends toward the lower surface. The processing piston has a density that is less than a density of fluid in the aspirated bone fragments and tissue.

Abstract: A surgical power drill system includes a housing unit, a driving unit, a tool holder, and a screw member. The driving unit is movably mounted in the housing unit and includes a motor and a motor shaft coupled to the motor. The driving unit is movable relative to the housing unit between a distal position, where the driving unit is distal from a front end of the housing unit, and a proximate position, where the driving unit is proximate to the front end of the housing unit. The tool holder is coupled to a first end portion of the motor shaft. The screw member is coupled to a second end portion of the motor shaft.

Abstract: A surgical handpiece system for performing measurement functions and surgical operations. The system includes a handpiece assembly. The handpiece has a handpiece housing and a drive cannula rotatably coupled to the handpiece housing. The drive cannula extends along an axis and is configured to receive torque from a motor. A surgical attachment module has an attachment housing removably coupleable to the handpiece housing. The surgical attachment module has a drive shaft rotatably coupled to the surgical attachment housing and configured to receive torque from the drive cannula to operate an end effector. A measurement module has a measurement housing removably coupleable to the handpiece housing. The measurement module is configured to perform measurement functions associated with operation of the handpiece assembly.

Abstract: Methods of harvesting cancellous bone and bone marrow include extracting loosened cancellous bone and bone marrow—including a liquid component thereof—to a collection container that has a first cup and a suction port to which a suction source is connected. After extraction, the suction source is disconnected and a lid of the collection container is removed and replaced with a lid having a plunger with a press head that is configured to filter the extracted liquid by depressing the plunger toward a bottom of the first cup. The filtered liquid is poured through a suction port into a second cup while depressing the plunger, thereby separating the liquid from a semi-solid mass of cancellous bone that remains. The bone is extracted through a cortical opening in the femur, tibia, or calcaneus, or from an intermedullary canal that is preferably formed by reaming of the tibia using an orthopedic reamer.

Abstract: Apparatus for mounting in a bone of a patient, consisting of a rigid elongated member having an axis of symmetry and a distal section, a proximal section, and an intermediate section connecting the distal and proximal sections. The apparatus has n helical blades, formed in the distal section, distributed symmetrically about the axis, each of the blades having a helix angle greater than zero and less than 45°. A cross-section of the distal section, taken orthogonally to the axis of symmetry, includes n mirror planes containing the axis of symmetry, wherein n is a whole number greater than one, and wherein the blades are configured to penetrate into the bone and engage stably therein. Adapters coupling the apparatus to different types of markers are also described.

Abstract: The present invention relates to an articular joint replacement system. The system has first and second components. Each component has a tapered head piece for covering the end of a bone and for acting as an articular surface, an integrally formed screw stem having a length sufficient to extend into the medullary canal, and inwardly angled bone grips affixed to the underside of the head piece to allow solid fixation to the bone by compression press fit. The head piece of the first component is provided with a shaped exterior surface which complements the shaped exterior surface of the head piece of the second component and which allows motion in three planes.

Abstract: A system for decorticating at least one bone surface includes an elongated soft tissue protector, an elongated drive shaft and a cutter. The elongated soft tissue protector has a bore extending therethrough. The bore has a non-circular lateral cross-section, a maximum lateral extent and a minimum lateral extent. The cutter may be located on or near a distal end of the drive shaft. The cutter has a non-circular lateral cross-section, a maximum lateral extent and a minimum lateral extent. The maximum lateral extent of the cutter is greater than the minimum lateral extent of the bore but is no greater than the maximum lateral extent of the bore. The bore of the soft tissue protector is configured to slidably receive the cutter therethrough. Other systems and methods for decorticating at least one bone surface are also provided.

Abstract: An apparatus for verifying an osteotomy trajectory includes a straight rod portion extending along a first axis in a first direction, a sliding arm slidably coupled to the straight rod portion and configured to slide along a sliding direction on the straight rod portion along the first axis. The sliding arm may include a sliding portion slidably coupled to the straight rod portion to slide along the sliding direction, a pointing portion including a tip protruded along a second axis in a second direction, the second axis being at least substantially parallel to the first axis, and an extending portion having a first side attached to the sliding portion and a second side attached to the pointing portion. The apparatus further includes a fixed arm coupled to the straight rod portion and configured to mount a drill thereon to point the drill along the second axis toward the tip.

Abstract: A surgical instrument (25), in particular a surgical cutting or drilling instrument, the surgical instrument (25) comprising: a drive unit; a cutting tool or drill bit (5) engageable with the drive unit; a measuring device (1) which is configured to measure the distance [x(t)] covered by the cutting tool or drill bit (5) along a cutting or drilling path with respect to time and relative to a reference position; a processing un and a digital data storage, wherein in the digital data storage reference data are stored which include at least N one data set specifying a reference graph GRef within a time window (11) in the range of a transition and defining a reference point of a transition (21?), wherein the time window (11) includes a first time period before the reference point of a transition (21?) and a second time period after the reference point of a transition (21?) and wherein the processing unit (14) suitably programmed to compare the recorded graph G with the at least one reference graph GRef and to fin

Abstract: A robotic surgical system is provided that includes a robot connected to a computer system to help effect control of the robot. A tool is removably mounted to a distal end of a robot arm. The tool is adapted to selectively grip, move and drive an effector and a coupled fastener. The fastener is used in orthopedic surgery, and the effector is uncoupled from the fastener after it is inserted in a patient.

Abstract: A flexible tube insertion support apparatus includes a generation section configured to generate propriety information regarding a propriety of a twisting operation of a flexible tube in accordance with a force quantity of an external force applied to the flexible tube when the flexible tube is twisted in a counterclockwise direction or a clockwise direction around a central axis of the flexible tube. The external force is detected by at least one external force detector that is disposed on the flexible tube to be inserted into the subject and configured to detect the external force. The flexible tube insertion support apparatus also includes an output section configured to output the propriety information generated by the generation section.

Abstract: A disc preparation instrument for use in fusing spinal vertebrae comprises a modular scoring trial and a depth stop releasably attached to the scoring trial. The trial includes an elongate stem supporting a trial device at its distal tip. The trial device is insertable into a disc space and includes a rotatable rasp for scoring opposing vertebral endplates at a scored location. A stop, sized to engage an exterior surface of the vertebrae, is movable on the depth stop stem by rotation of an adjustment knob to a plurality of selectable distances between the proximal end of the trial device and the movable stop. An actuator releasably attached to the trial is operable to rotate the rasp. A plurality of modular trials, each having a trial device of different heights may be provided in a kit. Each scoring trial is selectively releasably attachable to a single depth stop.

Abstract: A system, method and/or reamer driver device provides a driver which has a mean for remotely connect or disconnect (release) the reamer without having to manipulate a release sleeve located close to the surgical tool connector. The surgical reamer driver has a transmission drive train, a housing assembly enclosing the transmission drive train and a locking surgical tool connector. The driver further includes a device for remotely inducing relative movement of the transmission drive assembly with respect to at least a portion of the housing assembly to activate locking and unlocking of the locking surgical tool connector.

Abstract: A handpiece for a handheld surgical instrument having a motor and a heatsink is provided. The motor is within a motor housing and the heat sink is disposed around and thermally coupled with the motor housing. The handpiece is formed from a material having a first thermal conductivity and the heat sink has a second thermal conductivity that is greater in value than the first thermal conductivity of the material of the handpiece. The heat sink is configured to dissipate heat from the motor during operation of the motor to the handpiece.

Abstract: This disclosure relates to assemblies and methods for repairing bone defects. The assemblies disclosed herein may be utilized for determining a dimension of a surgical site and removing bone prior to positioning a graft and/or implant at the surgical site.

Abstract: A surgical instrument system (1) for treatment of an anatomical structure (3, 5) comprises an instrument (8) and/or a patient specific instrument (2, 4) for performing the treatment on the anatomical structure. The instrument (8) and/or the patient specific instrument (2, 4) comprises an integrated measurement system (20, 40, 80) for tracking the instrument (8) and/or the patient specific instrument (2, 4) relative to the anatomical structure (3, 5), whereby the integrated measurement system comprises a tracking system (6, 10), which comprises a shadow imaging tracking system.

Abstract: Surgical constructs that at least one fixation device, at least one flexible strand the forms at least one adjustable loop, and a self-locking mechanism, and methods of tissue repair using the same.

Abstract: Apparatuses and methods for microfracture (e.g., forming a plurality of microfractures in a bone to encourage cartilage regeneration). Some of the present apparatuses and methods are configured to create microfractures with smaller transverse dimensions (e.g., diameters) and greater depths than previously known. Some of the present apparatuses and methods comprise a penetrator removal tab coupled to the penetrator and configured to retract the penetrator relative to the cannula.

Abstract: A surgical system for use in correcting hammer toe or otherwise straightening toes or fusing other bones to one another includes a male drill bit and a female drill bit, as well as an absorbable pin. The male and female drill bits are configured to define complementary features from opposed, or facing, ends of bones that are to be fused to one another. The male and female drill bits may also be configured to define channels through the lengths of the bones that are to be fused to one another, with the channels being configured to align and define a continuous channel through the bones when they are assembled. The absorbable pin, which may be absorbed by a subject's body over time, is configured to be positioned in the continuous channel, and may hold the bones in an assembled relationship before and while they fuse to one another.

Abstract: A surgical tool including a socket having a housing and an aperture within the housing, the socket configured to receive a ball and a pin at least partially in the aperture. The ball is positioned at least partially in the socket and configured to rotate within the socket, the ball comprising an elongated opening extending through the ball. The pin is coupled to the socket and disposed at least partially in the socket on opposite sides of the socket, the pin including a first longitudinal axis and extending through the elongated opening of the ball between opposite sides of the socket. The ball is configured to partially rotate about the first longitudinal axis of the pin, and partially rotate, about a second axis perpendicular to the first longitudinal axis of the pin, in a plane aligned with the elongated opening.

Abstract: Methods of cutting bone using a robotic cutting system are provided. The robotic cutting system includes one or more controllers, a robotic manipulator, and one or more cutting tools, such as those including a bur or a saw blade, that can be coupled to the robotic manipulator. An initial cut, such as a notch, is made into the bone with the bur or the saw blade. This notch is then used to constrain the saw blade for limiting skiving of the saw blade during cutting along a cutting plane.

Abstract: A medical or dental device for determining a bone's quality by cutting a thread into the bone with a rotating threaded element comprises a control unit having a measurement circuit configured: (i) to determine values of the motor current via a first electrical contact device with which the motor drive is supplied for rotational drive of the threaded element that can be connected to the motor drive, the current values being a measure of the bone's quality; (ii) to monitor and/or to determine the penetration depth of the threaded element into the bone, and (iii) to generate measurement signals which show the relationship between the penetration depth and the determined current values or parameters derived therefrom, and to transmit these signals to a display unit, which displays the relationship between the determined current values or parameters derived therefrom, in particular the bone's quality, and the penetration depth.

Abstract: Minimally invasive percutaneous methods, devices, and systems for placing guide wires in bones in a desired position and orientation and for facilitating the treatment of fractures such as but not limited to intertrochanteric fractures or other applications such as osteotomies. The methods, devices, and systems may allow for rapid and reproducible placement of a guide wire in a bone. Each degree of freedom may be controlled independently.

Abstract: A handle for a surgical tool including a shaft having a proximal end and a distal end with a gripping handle affixed to the proximal end of the shaft. A bushing is attached to the distal end of the shaft, the bushing including a plurality of flexible members circumferentially spaced apart. The handle further includes a sleeve circumscribing the shaft and the bushing. The sleeve is moveable between a first position substantially covering an entirety of the bushing and a second position spaced from a most distal end of the bushing.

Abstract: An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Abstract: Described herein are examples of orthopedic reamer heads for preparing a bone to receive an implant, as well as methods of assembling reamer heads. An illustrative example of a modular reamer head can include a body and a cutting system. The body can include a generally dome shape having an outer surface extending from an apex region to a base. The outer surface can have a recess including one or more arcuate channels that extend from the apex region towards the base of the dome. The cutting system can have one or more arcuate elements having cutting elements. One or more arcuate elements can extend from first end portions in the apex region towards second end portions proximate the base. At least a portion of the one or more arcuate elements can be located in the one or more arcuate channels to extend outward beyond the outer surface.

Abstract: The present invention is directed to material removal instrument for forming cavities in interior body regions, particularly cavities in intervertebral discs and vertebrae. The instrument includes a cannula and a rotation mechanism disposed at least partially within the cannula. A cutting element extends from the rotation mechanism and impacts and dislocates tissue as the rotation mechanism is rotated within the body. Dislocated tissue with withdrawn from the body via the cannula.

Abstract: Measurement of a leading edge of an instrument passing from a first medium having a first density to a second medium having a second density using a displacement sensor alone. In particular, a displacement signal, a velocity signal, and an acceleration signal measured from or derived from a displacement sensor are analyzed to determine when the leading edge of the instrument passes from the first material to the second material as the leading edge of the instrument is advanced relative to the material. For instance, the measurement may be used to output an occurrence signal that indicates to a user that the instrument has passed from the first medium to the second medium. Additionally, a length measurement of the path of the instrument when passing from the first medium to the second medium may be recorded, and/or the instrument may be controlled (e.g., the instrument may be stopped).

Abstract: A handheld surgical instrument includes a motor that transmits rotational movement to a drill bit of the handheld surgical instrument. The drill bit extends through a depth measurement module with a depth measurement extension, and a cannula, which extends forward from the drill to measure bore depth. The depth measurement extension is moveably mounted to the drill so as to extend into the rotor bore of the motor. As the drill advances forward, the depth measurement extension remains static. As a result of the advancement of the drill, the rotor extends over the proximal end of the depth measurement extension. A controller is configured to determine a breakthrough time and a breakthrough displacement of the drill bit based on displacement data and derived signals. The controller is further configured to determine a proper length of a screw to be used in a fixation surgical procedure based on the displacement data.

Abstract: Disclosed screwdrivers may include a rotatable drive shaft having a drive portion disposed at a distal end thereof, and a drive end disposed at a proximal end thereof. Disclosed screwdrivers may include an angled tip portion that is angled with respect to the longitudinal direction, and a mechanism configured to transfer a rotational force applied to the drive portion of the drive shaft through the angled tip portion to the drive end of the drive shaft. Disclosed screwdrivers may include an elastic retaining clip configured to have a bone screw securely attached therein at a clipping force and progressively release the bone screw therein at an extraction force. Disclosed screwdrivers may include at least one spring contacting the elastic retaining clip and the angled tip portion that is configured to facilitate the progressive release of the bone screw.

Abstract: A surgical instrument includes a housing, an outer shaft, an inner shaft, a trial sizer, a rod, and a head. The outer shaft is operatively coupled with the housing such that rotation of the housing causes axial displacement of the outer shaft. The outer shaft includes a keel cutter configured to form a channel in a vertebral body. The inner shaft disposed within the outer shaft. The trial sizer is configured to be received in intervertebral space. The trial sizer includes a pair of wings transitionable between a retracted position and an extended position in which the pair of wings extends transversely outward. The head is connected to the rod, wherein the head is operatively coupled with the pair of wings such that axial displacement of the rod causes transition of the pair of wings between the retracted and extended positions.

Abstract: A drill assembly for creating a reverse counterbore bone tunnel while increasing bone preservation. The drill assembly including a housing having an actuation mechanism and a cannulated shaft connected to the actuation mechanism. The drill assembly also includes a rigid rod extending through the cannulated shaft. Engaging the actuation mechanism moves the cannulated shaft along the rigid rod. The drill assembly additionally includes a distal tip connected to the cannulated shaft and the rigid rod. Proximal movement of the cannulated shaft along the rigid rod causes the distal tip to rotate from a first configuration to a second configuration. In the second configuration, the distal tip extends at an angle relative to the cannulated shaft.

Abstract: A rotary surgical assembly is disclosed. The assembly has a plurality of cutting teeth (216), a hollow dome (200) and a spindle (10). The hollow dome has a pole having a pole axis X, and a cutting surface featuring some of the cutting teeth. The cutting surface includes a curved part (214) and a substantially flat part (212) proximal the pole with an aperture (210) extending therethrough. The spindle has a proximal end (12) and a distal end (14) including a spindle mounting element (16). The spindle mounting element is secured to the dome beneath the substantially flat part of the cutting surface. The spindle mounting element has a cutting tooth (22) that extends distally through the cutting surface's aperture to form one of the said plurality of cutting teeth. A kit, and methods of manufacturing the rotary surgical assembly are described also.

Abstract: A method where a propeller is set into locomotion relative to a medium at least partially surrounding the propeller. An actuator induces a rotation of the propeller relative to the medium and about a rotational axis of the propeller, and the propeller converts its rotational movement into locomotion relative to the medium. The aspect ratio of at least one cross-section of the propeller is three or more. Also a helical or modifiedly helical propeller for converting rotational movement of the propeller into locomotion of the propeller relative to a medium at least partially surrounding the propeller, where the aspect ratio of at least one cross section of the propeller is three or more. And a method of producing a propeller, including the step of providing a plate extending along the helical axis, where the aspect ratio of at least one cross section of the plate is three or more.

Abstract: The present invention relates to a device and a method for measuring osseous quality.

Abstract: In some examples, a fixation device includes a flexible band with a first base portion, a second base portion, and a connecting strap connecting the first base portion to the second base portion, the connecting strap configured to retain a medical device to an anatomical structure of a patient, wherein the flexible band is constructed of a first material. The fixation device may further include a plurality of inserts, each insert of the plurality of inserts defining an inner channel and constructed of a second material more rigid than the first material of the flexible band, wherein a first insert of the plurality of inserts is at least partially within the first base portion, and wherein a second insert of the plurality of inserts is at least partially within the second base portion.

Abstract: A bone material removal device, including a tubular element comprising a proximal end and a distal end, a shaft received within the tubular element and comprising a proximal end and a distal end, a cutting tooth movably coupled to the distal end of the shaft and a shaft displacement actuator at the proximal end of the tubular element rotatably coupled to the shaft, wherein at least partial rotation of the actuator in a first direction brings the cutting tooth to travel from a closed retracted position to an open extended position.

Abstract: A surgical tool adaptor includes a distal interface member and a proximal holder. The surgical tool adaptor is formed with a lumen through the distal interface member and the proximal holder for passing a guiding element (e.g., K-wire) distally through the distal interface member. The proximal holder includes a locking element for locking the guiding element in the lumen and the distal interface member includes a connecting element for connecting to a surgical tool. The proximal holder is movable relative to the distal interface member so that the proximal holder is movable to a position wherein the guiding element does not protrude proximally out of the proximal holder.

Abstract: An ultrasonic tip and methods of operating the same. The ultrasonic tip comprises a shaft including a base and a flexible body. The body comprises a first portion and a second portion. The body is coupled to the base at the first portion and extends from the first portion to the second portion along a longitudinal axis. The second portion includes a cutting portion comprising a neck, and a head extending radially from the longitudinal axis. The head is coupled to the neck. A circular aperture is disposed between the head and the neck to define an inner circumferential surface. The head and the neck form an outer circumferential surface comprising a plurality of cutting teeth, the outer circumferential surface having a first thickness at the head that is greater than a second thickness at the neck.

Abstract: Embodiments of bone and tissue resection devices are disclosed herein. In one embodiment, a device can include a blade having a distal cutting edge configured to perform a cutting action that produces a plug or core from a media being cut by the cutting edge, a drive mechanism arranged to transfer an oscillating force to the cutting edge for oscillating the cutting edge, a shield positioned to block contact with a portion of the cutting edge, and a depth adjustment mechanism configured to translate the cutting edge along a proximal-distal axis of the shield to adjust an axial position of the cutting edge relative to the shield.

Abstract: A method of diagnosing, minimizing symptoms and/or treating the pathology of intervertebral disc degeneration includes introducing a first cannula through a vertebra along an axis of at least one pedicle of the vertebra from a generally posterior to a generally anterior direction and inserting a second cannula within a lumen of the first cannula, the second cannula constrained to a relatively straight configuration within at least a portion of the first cannula and assumes a nonlinear or curvilinear geometry external to the first cannula within at least a portion of a vertebral body of the vertebra and away from a longitudinal axis of the first cannula. The method includes forming a channel with the second cannula, the channel extending to or adjacent to a vertebral endplate of the vertebral body in order to create a defect through the vertebral endplate of the vertebra. Related systems, devices, and methods are described.

Abstract: A surgical tool that has a pair of transmissions coupled to one another to effect driving of a cutting tool in both an oscillating manner and a reciprocating manner. The transmissions are driven by a motor coupled to one of the transmissions.

Abstract: A sacroiliac joint fusion screw and associated delivery tools and method. Embodiments of the sacroiliac joint fusion screw comprise a shaft having proximal and distal end portions and a head on the proximal end of the shaft. A threaded portion on a distal portion of the shaft is configured to engage a sacrum. A glide zone portion on the shaft between the threaded portion and the proximal end portion is configured to extend through an ilium. The screw can provide stability and compression to the joint.

Abstract: A drill device including a shaft having a proximal end and a distal end, one or more first reaming heads configured to be positioned along the shaft adjacent the distal end and one or more second reaming heads configured to be positioned along the shaft at a location axially proximally spaced from the first reaming head.

Abstract: A surgical fastener applier including a housing containing a compartment, an elongated member extending distally from the housing, first and second jaws and a firing mechanism. The firing mechanism is movable between a first position and a second position to effect firing of fasteners into the tissue clamped between the first and second jaws. A power pack is removably loadable into the compartment, the power pack having a motor and an engagement member removably engageable with the firing mechanism within the compartment when the power pack is loaded into the compartment to effect movement of the firing mechanism. An interchangeable battery pack is removably loadable into the power pack for powering the motor. Bearings restrict axial and radial movement of the firing and articulation assembly in the power pack.

Abstract: A bone reamer is provided and may include a shaft and a cutting element. The shaft may include a proximal end, a distal end, and a flexible portion. The flexible portion may be disposed between the proximal and distal ends. The cutting element may be carried by the shaft and may include a cutting surface facing the distal end of the shaft. The distal end of the shaft may be offset from the cutting surface.