Method and apparatus for coupling soft tissue to a bone

• US 10,695,052 B2
• Filed: 03/10/2017
• Issued: 06/30/2020
• 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: Denham, Gregory J., Stone, Kevin T.
• Primary Examiner(s): Hurley, Shaun R
• Application Number:
  US15/455,895
• Publication Number:
  US 20170181746A1
• Time in Patent Office: 1,208 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 2017/00526 Methods of manufacturing
• CPC Class Codes: A61B 2017/00845 of moving parts with respect to each other
• CPC Class Codes: A61B 2017/00858 high friction or non-slip
• CPC Class Codes: A61B 2017/0404 Buttons
• 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 2017/042 plastically deformed during insertion
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0475 : using sutures having a slip knot
• CPC Class Codes: A61B 2017/0477 : with pre-tied sutures
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/0618 : elastic, e.g. stretchable
• CPC Class Codes: A61B 2017/06185 : hollow or tubular
• CPC Class Codes: A61F 2/08 : Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0805 : Implements for inserting tendons or ligaments
• CPC Class Codes: A61F 2/0811 : Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0823 : Modular anchors comprising a plurality of separate parts
• 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 2002/0864 : Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
• CPC Class Codes: A61F 2002/087 : Anchor integrated into tendons, e.g. bone blocks, integrated rings
• 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
• CPC Class Codes: D04C 1/06 : Braid or lace serving particular purposes
• CPC Class Codes: D04C 1/12 : Cords, lines, or tows
• CPC Class Codes: D10B 2509/00 : Medical; Hygiene
• CPC Class Codes: D10B 2509/04 : Sutures

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. A collapsible tube is positioned about the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel and the collapse of the tube to form an anchor.

Claims

1. A method of constructing an adjustable suture construct, comprising:

passing a first free end of a suture;

(i) through a first aperture in the suture;

(ii) longitudinally within the suture along a first longitudinal passage; and

(iii) out of the suture through of a fourth aperture in the suture to form a first adjustable loop;

passing a second free end of the suture;

(i) through a second aperture in the suture;

(ii) longitudinally within the suture along a second longitudinal passage; and

(iii) out of the suture through a third aperture in the suture to form a second adjustable loop; and

coupling a bone fixation member to the suture,

wherein the first aperture, the second aperture;

the third aperture, and the fourth aperture are all separate apertures in the suture, and wherein, with the first adjustable loop and the second adjustable loop formed, the first free end can be pulled to decrease a size of the first adjustable loop without decreasing a size of the second adjustable loop and the second free end can be pulled to decrease a size of the second adjustable loop without decreasing a size of the first adjustable loop.

2. The method of claim 1, wherein said coupling leaves at least part of the first longitudinal passage and at least part of the second longitudinal passage within the bone fixation member.

3. The method of claim 1, wherein the bone fixation member is shaped so that the bone fixation member can obtain a first profile for passing through a bone tunnel and be converted to a second profile outside the bone tunnel for contacting bone around an opening to the bone tunnel for inhibiting passage of the bone fixation member back through the bone tunnel.

4. The method of claim 1, wherein the bone fixation member comprises a deformable tube, and wherein said coupling includes slidably receiving the deformable tube on the suture.

5. The method of claim 1, wherein the bone fixation member is an elongate threaded fastener.

6. The method of claim 5, wherein said coupling includes passing the suture down into the elongate threaded fastener through an opening in a trailing end of the elongate threaded fastener.

7. The method of claim 1, wherein the first adjustable loop is formed without the first free end passing through the second longitudinal passage, and wherein the second adjustable loop is formed without the second free end passing through the first longitudinal passage.

8. The method of claim 1, wherein the first longitudinal passage is separate from the second longitudinal passage in the suture.

9. The method of claim 1, wherein the first longitudinal passage and the second longitudinal passage are longitudinally spaced apart from one another along a length of the suture.

10. The method of claim 1 further comprising looping the first adjustable loop through the second adjustable loop.

23. The method of claim 1, wherein said coupling leaves at least part of the first longitudinal passage and at least part of the second longitudinal passage adjacent the bone fixation member.

11. A method of constructing an adjustable suture construct, comprising:

passing a first free end of a suture through a first longitudinal passage in the suture to form a first adjustable loop;

passing a second free end of the suture through a second longitudinal passage in the suture to form a second adjustable loop; and

coupling a bone fixation member to the suture,

wherein the first longitudinal passage is separate from the second longitudinal passage in the suture, and wherein, with the first adjustable loop and the second adjustable loop formed, the first free end can be pulled to decrease a size of the first adjustable loop and the second free end can be pulled to decrease a size of the second adjustable loop.

12. The method of claim 11, wherein, with the first adjustable loop and the second adjustable loop formed, the first free end can be pulled to decrease a size of the first adjustable loop without decreasing a size of the second adjustable loop and the second free end can be pulled to decrease a size of the second adjustable loop without decreasing a size of the first adjustable loop.

13. The method of claim 11, wherein the first adjustable loop is formed without the first free end passing through the second longitudinal passage, and wherein the second adjustable loop is formed without the second free end passing through the first longitudinal passage.

14. The method of claim 11, wherein the first longitudinal passage and the second longitudinal passage are longitudinally spaced apart from one another along a length of the suture.

15. The method of claim 11 further comprising looping the first adjustable loop through the second adjustable loop.

24. The method of claim 11, wherein said coupling leaves at least part of the first longitudinal passage and at least part of the second longitudinal passage adjacent the bone fixation member.

25. The method of claim 11, wherein said coupling leaves at least part of the first longitudinal passage and at least part of the second longitudinal passage within the bone fixation member.

16. A method of constructing an adjustable suture construct, comprising:

passing a first free end of a suture;

(i) into the suture through a first aperture in the suture;

(ii) longitudinally within the suture between the first aperture and a fourth aperture in the suture; and

(iii) out of the suture through the fourth aperture to form a first adjustable loop;

passing a second free end of the suture;

(i) into the suture through a second aperture in the suture;

(ii) longitudinally within the suture between the second aperture and a third aperture in the suture; and

(iii) out of the suture through the third aperture to form a second adjustable loop; and

coupling a bone fixation member to the suture,

wherein the first aperture, the second aperture, the third aperture, and the fourth aperture are all separate apertures in the suture, and wherein, with the first adjustable loop and the second adjustable loop formed, the first free end can be pulled to decrease a size of the first adjustable loop and the second free end can be pulled to decrease a size of the second adjustable loop.

17. The method of claim 16, wherein the first free end of the suture extends through the first aperture and the fourth aperture without extending through the second aperture or the third aperture, and wherein the second free end of the suture extends through the second aperture and the third aperture without extending through the first aperture or the fourth aperture.

18. The method of claim 16, wherein, with the first adjustable loop and the second adjustable loop formed, the first free end can be pulled to decrease a size of the first adjustable loop without decreasing a size of the second adjustable loop and the second free end can be pulled to decrease a size of the second adjustable loop without decreasing a size of the first adjustable loop.

19. The method of claim 16, wherein each of the first aperture, the second aperture, the third aperture, and the fourth aperture is longitudinally spaced apart from the others along a length of the suture.

20. The method of claim 16 further comprising looping the first adjustable loop through the second adjustable loop.

21. The method of claim 16, wherein said coupling leaves the third aperture and the fourth aperture adjacent the bone fixation member.

22. The method of claim 17, wherein said coupling leaves the third aperture and the fourth aperture within the bone fixation member.