A medical device comprises a sheath element suitable of being brought intocontactwith live hard tissue and/or hard tissue replacement material. The sheathelement hasa generally elongate shape and a longitudinal bore defining a longitudinalopeningreaching from a proximal end of the sheath element into a distal direction,and aplurality of holes in a wall of the opening. The device comprises aliquefiableelement that is insertable or inserted in the longitudinal opening and atleast partlyliquefiable by the impact of energy impinging from the proximal side so thatliquefied material flows through the holes in the wall and out of thelongitudinalopening into structures of the hard tissue and/or hard tissue replacementmaterial. Adirecting structure is provided comprising walls that extend radially towardan innersurface of the sheath element for directing different portions of theliquefiablematerial to different holes.
