Method and apparatus for coupling soft tissue to a bone

• US 10,595,851 B2
• Filed: 02/01/2018
• Issued: 03/24/2020
• Est. Priority Date: 02/03/2006
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Kaiser, Ryan A., Denham, Gregory J., Stone, Kevin T.
• Primary Examiner(s): Dang, Phong Son H
• Application Number:
  US15/886,712
• Publication Number:
  US 20180153538A1
• Time in Patent Office: 782 Days
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/1631 Special drive shafts, e.g. flexible shafts A61B17/1642, A61B17/164 take precedence
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/00858 high friction or non-slip
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0432 the separate member staying in the anchor after placement
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61F 2/0811 : Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0852 : Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0858 : Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/0882 : Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• CPC Class Codes: A61F 2002/0888 : Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel.

Claims

1. A method for securing soft tissue to bone, comprising:

locating an elongate bone engaging member in a longitudinal bore formed in a bone with an adjustable suture construct extending down into the elongate bone engaging member through an opening in a trailing end of the elongate bone engaging member to couple the adjustable suture construct to the elongate bone engaging member, the adjustable suture construct including a suture with a free end that extends through a longitudinal passage in the suture to form an adjustable loop, wherein at least a portion of the adjustable loop protrudes from the opening in the trailing end of the elongate bone engaging member and extends around a portion of soft tissue positioned over the bone; and

pulling on the free end of the suture from outside the bone so as to decrease a size of the adjustable loop for pulling the portion of soft tissue toward the bone.

2. The method of claim 1, wherein the suture comprises a braided body, the free end extending into the longitudinal passage through a first aperture in the braided body and out of the longitudinal passage through a second aperture in the braided body.

3. The method of claim 1, the elongate bone engaging member comprises a threaded member.

4. A method for securing soft tissue to bone, comprising:

locating an elongate bone engaging member in a longitudinal bore formed in a bone with a suture extending down into the elongate bone engaging member through an opening in a trailing end of the elongate bone engaging member to couple the suture to the elongate bone engaging member;

passing a free end of the suture that is coupled to the elongate bone engaging member up through a soft tissue positioned over the bone; and

pulling on the free end of the suture from outside the bone as the suture is extending through the soft tissue, wherein the free end has been made to extend through a longitudinal passage in the suture to form an adjustable loop, at least a portion of the adjustable loop protruding from the opening in the trailing end of the elongate bone engaging member and extending around a portion of the soft tissue, wherein said pulling decreases a size of the adjustable loop for pulling the portion of the soft tissue toward the bone.

5. The method of claim 4, wherein the elongate bone engaging member comprises a threaded member.

6. The method of claim 4, wherein the free end is a first free end, the longitudinal passage is a first longitudinal passage, and the adjustable loop is a first adjustable loop, the suture further including a second free end that extends through a second longitudinal passage in the suture to form a second adjustable loop.

7. The method of claim 6, wherein the first free end extends through the first longitudinal passage without extending through the second longitudinal passage, and wherein the second free end extends through the second longitudinal passage without extending through the first longitudinal passage.

8. The method of claim 6, wherein the first free end extends into the suture through a first aperture in the suture, longitudinally within the suture along the first longitudinal passage, and out of the suture through a fourth aperture in the suture to form the first adjustable loop, and wherein the second free end extends into the suture through a second aperture in the suture, longitudinally within the suture along the second longitudinal passage, and out of the suture through a third aperture in the suture to form the second adjustable loop, the first aperture, the second aperture, the third aperture, and the fourth aperture all being separate apertures in the suture.

9. The method of claim 4 further comprising coupling the adjustable suture construct to a second elongate bone engaging member that is located in a second longitudinal bore in the bone spaced from the first longitudinal bore.

10. A method for securing soft tissue to bone, comprising:

passing suture of an adjustable suture construct through soft tissue positioned over a bone, wherein during said passing the suture is anchored inside the bone to an elongate bone engaging member located in a longitudinal bore formed in the bone, the anchored suture extending down into the elongate bone engaging member through an opening in a trailing end of the elongate bone engaging member, around an interior portion of the elongate bone engaging member, and back out of the elongate bone engaging member through the opening in the trailing end of the elongate bone engaging member, the adjustable suture construct including a suture with a free end that extends through a longitudinal passage in the suture to form an adjustable loop, wherein at least part of the adjustable loop extends around a portion of the soft tissue following said passing; and

pulling on the free end of the suture from outside the bone so as to decrease a size of the adjustable loop for pulling the portion of the soft tissue toward the bone.

11. The method of claim 10, wherein the elongate bone engaging member comprises a threaded member.

12. The method of claim 10, wherein the free end is a first free end, the longitudinal passage is a first longitudinal passage, and the adjustable loop is a first adjustable loop, the suture further including a second free end that extends through a second longitudinal passage in the suture to form a second adjustable loop.

13. The method of claim 12, wherein the first free end extends through the first longitudinal passage without extending through the second longitudinal passage, and wherein the second free end extends through the second longitudinal passage without extending through the first longitudinal passage.

14. The method of claim 12, wherein the first free end extends into the suture through a first aperture in the suture, longitudinally within the suture along the first longitudinal passage, and out of the suture through a fourth aperture in the suture to form the first adjustable loop, and wherein the second free end extends into the suture through a second aperture in the suture, longitudinally within the suture along the second longitudinal passage, and out of the suture through a third aperture in the suture to form the second adjustable loop, the first aperture, the second aperture, the third aperture, and the fourth aperture all being separate apertures in the suture.

15. The method of claim 10 further comprising coupling the adjustable suture construct to a second elongate bone engaging member that is located in a second longitudinal bore in the bone spaced from the first longitudinal bore.

16. A method for securing soft tissue to bone, comprising:

locating an adjustable suture construct adjacent a bone with a first portion of the adjustable suture construct positioned inside the bone where the adjustable suture construct is coupled to an elongate bone engaging member located in a longitudinal bore in the bone and with a second portion of the adjustable suture construct located outside the bone and extending around a portion of soft tissue positioned over the bone, wherein the adjustable suture construct being coupled to the elongate bone engaging member includes the adjustable suture construct extending down into the elongate bone engaging member through an opening in a trailing end of the elongate bone engaging member, around an interior portion of the elongate bone engaging member, and back out of the elongate bone engaging member through the opening in the trailing end of the elongate bone engaging member, the adjustable suture construct including a suture with a free end that extends through a longitudinal passage in the suture to form an adjustable loop, the adjustable loop forming at least part of the first portion of the adjustable suture construct positioned inside the bone and at least part of the second portion of the adjustable suture construct positioned outside the bone; and

pulling on the free end of the suture from outside the bone so as to decrease a size of the adjustable loop for pulling the portion of soft tissue toward the bone.

17. The method of claim 16, wherein the elongate bone engaging member comprises a threaded member.

18. The method of claim 16, wherein the free end is a first free end, the longitudinal passage is a first longitudinal passage, and the adjustable loop is a first adjustable loop, the suture further including a second free end that extends through a second longitudinal passage in the suture to form a second adjustable loop.

19. The method of claim 18, wherein the first free end extends through the first longitudinal passage without extending through the second longitudinal passage, and wherein the second free end extends through the second longitudinal passage without extending through the first longitudinal passage.

20. The method of claim 18, wherein the first free end extends into the suture through a first aperture in the suture, longitudinally within the suture along the first longitudinal passage, and out of the suture through a fourth aperture in the suture to form the first adjustable loop, and wherein the second free end extends into the suture through a second aperture in the suture, longitudinally within the suture along the second longitudinal passage, and out of the suture through a third aperture in the suture to form the second adjustable loop, the first aperture, the second aperture, the third aperture, and the fourth aperture all being separate apertures in the suture.

21. The method of claim 16 further comprising coupling the adjustable suture construct to a second elongate bone engaging member that is located in a second longitudinal bore in the bone spaced from the first longitudinal bore.