Method and implant for surgical manipulation of bone

An implant for positioning in hard tissue cortex for surgical instrument access to a medullary compartment of bone or cartilage and for manipulation of bone or marrow, said implant comprising:

• a port having
• an outer surface and an inner surface, said inner surface formed by a longitudinally oriented port bore, said port bore having means of insert fixation,
• said port having a predetermined length terminating in a first end and a second end, the first end protruding from hard tissue cortex an amount that allows closure of overlying soft tissue during use, the second end partially reaching beyond the cortex during use,
• a plurality of longitudinally oriented flutes that form prongs, the flutes formed to allow bone ingrowth and to promote port torsional resistance during use, the prongs directing elastically generated force against walls of hard tissue cortex during use,
• the prongs having circumferential beading at the second end of the port, wherein the beading partially reaches beyond the cortex during use thereby exerting a force that pulls the implant toward the medullary compartment of bone during use;
• and
• an insert for insertion into said port bore and for use with a surgical instrument, said insert having
• means of insert fixation complementary to said means for fixation into the port bore,
• a length and a diameter to substantially fill the port bore thereby preventing blockage of the port during use,
• said insert selected from the group consisting of
• i. a penetrable, non-osseous-integrating plug,
• ii. a combination of
• a. an adapter having a bore for insertion of a surgical instrument, and
• b. a surgical instrument fittable into the adapter bore selected from the group consisting of a knife, curette, rotating cutter, flexible shaft cutter, clipper, laser scalpel, electrical coagulator, mechanical manipulator, chemical manipulator, and sonic manipulator,
• iii. an adapter having a bore, the bore fitted with a penetrable, non-osseous-integrating plug,
• iv. a combination of
• a. a penetrable. non-osseous-integrating plug, and
• b. a surgically-related instrument, the instrument positioned within the penetrable plug, and
• v. a combination of
• a. an adapter having a bore, the bore fitted with a penetrable, non-osseous-integrating plug, and
• b. a surgically-related instrument, the instrument positioned within the penetrable plug.