Described herein are cannulated reamer designs and methods. In one embodiment, a reamer comprises a cannulated central body portion, a plurality of cutting legs and outer frame. The cannulated central body portion has an inner wall surface and an opposing outer wall surface defining a thickness and a bone contacting surface and an opposing distal end surface defining a length, the inner wall surface defining a bore about a central longitudinal axis of the cannulated central body portion. The plurality of cutting legs extends outwardly from the cannulated central body portion. The other defines a periphery of the reamer, the outer frame coupled to a lateral end of each of the plurality of cutting legs. The cannulated central body portion has a recess extending entirely through the thickness and only partially though the length.