Anterior cruciate ligament reconstruction hamstring tendon fixation system

• US 20020007182A1
• Filed: 09/21/2001
• Published: 01/17/2002
• Est. Priority Date: 08/19/1998
• Status: Active Grant

• Current Assignee: Andrew C. Kim
• Original Assignee: Andrew C. Kim
• Inventors: Kim, Andrew C.
• Granted Patent: US 6,632,245 B2
• Time in Patent Office: Days
• US Class Current: 606/53
• 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 2002/0829 without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
• 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

Abstract

A system for securing a tendon to a bore hole surface in a femur and a tibia, the system including a bone anchor having a flexible body with a distal end having an aperture to receive the tendon, and two legs forming a concave relief extending from the aperture to a split end, with the concave relief forcing the tendon into direct contact with the femur bore hole surface. An anchor insertion instrument is used to insert the anchor into the femur bore hole, the instrument having a pair of spaced apart pins to hold the bone anchor. A tibia fixation device joins the tendon to the tibia bore hole and has a generally cylindrical body with an open proximal end and at least two rounded legs formed by at least two slits extending from a distal end. At least one opening is located adjacent to the open proximal end for receiving the tendon. A clamping screw and spiked washer are used to lock the tibia fixation device and tendons into the tibia bore hole.

Claims

1. A apparatus for securing a tendon or ligament to a bore hole surface in a bone, comprising:

an elongated body having a longitudinal axis, a distal end, and a proximal end;

an aperture transverse to the longitudinal axis, located in the distal end; and

where the proximal end is formed by a pair of elongated legs extending from the distal end with each leg biased away from the longitudinal axis, the legs shaped to form a concave recess that extends from the aperture to the proximal end.

2. The apparatus of claim 1, wherein the elongated legs each have a substantially triangular cross-section, comprising a base, two sides, and an apex, with the base forming an outer convex surface, and the sides of the triangle forming at least two concave recesses, whereby the substantially triangular shape facilitates the legs bending outward against the bore hole surface.

3. The apparatus of claim 2, wherein the outer convex surface of the elongated legs have burrs or anchoring ridges located thereon to engage the bore hole surface.

4. The apparatus of claim 2, wherein each substantially triangular leg has a plurality of notches located on the apex.

5. The apparatus of claim 4, further comprising a wedge member, to engage at least two notches on the apex of the legs, whereby the wedges force the legs against the bore hole surface.

6. The apparatus of claim 1, wherein the proximal end of each leg has at least one indentation to receive a tip of an insertion tool.

7. The apparatus of claim 1, further comprising a needle having an eye for receiving a suture threaded through the aperture, the needle and suture pulling the apparatus into the bore hole.

8. The apparatus of claim 1, wherein:

the aperture receives the tendon or ligament, and the tendon or ligament is then positioned against each side of the legs, so that the legs force the tendon or ligament into direct contact with the bore hole surface.

9. An apparatus for securing a tendon or ligament against a bore hole surface in a bone, comprising:

an elongated rail for extending into the bore hole, the rail having an threaded surface and a bore hole engaging surface; and

a ring connected to the elongated rail, for securing the elongated rail in the bore hole with the ring positioned at an opening of the bore hole for receiving a portion of ligament.

10. The apparatus of claim 9, further comprising:

a second elongated rail for extending into the bore hole, connected to the ring, and having a threaded surface and a bore hole engaging surface; and

located substantially opposite the first elongated rail.

11. The apparatus of claim 9, wherein the elongated rail:

increases in thickness from the ring connection point to an end of the elongated rail;

tapers from a widest dimension at the ring connection point to a narrowest dimension at the end of the elongated rail; and

bends relative to the ring.

12. The apparatus of claim 10, wherein the second rail:

increases in thickness from the ring connection point to an end of the second rail;

tapers from a widest dimension at the ring connection point to a narrowest dimension at the end of the second rail; and

bends relative to the ring.

13. The apparatus of claim 9, further comprising anchoring means on the bore hole engaging surface of the elongated rail, the anchoring means selected from the group consisting of burrs, anchoring ridges, and barbs.

14. The apparatus of claim 10, further comprising anchoring means on the bore hole engaging surface of the second elongated rail, the anchoring means selected from the group consisting of burrs, anchoring ridges, and barbs.

15. The apparatus of claim 9, further comprising a screw for inserting into the ring and engaging the rail to anchor the apparatus into the bore hole and to force the tendon portion against the bore hole surface.

16. The apparatus of claim 9, further comprising:

a washer having an aperture and a plurality of spikes located about a perimeter, so that when the washer is placed over the ring and the bore hole the spikes clamp the tendon against a bone surface.

17. An apparatus for inserting a tendon or ligament anchoring device in a bore hole in a bone, comprising:

a shaft;

a handle at a first end of the shaft;

a pair of spaced apart pins at a second end of the shaft; and

a plunger slidably mounted within the shaft, the plunger having a forked end that protrudes from the second end of the shaft;

an actuator that protrudes from the first end of the shaft; and

wherein the forked end and the pair of spaced apart pins are disposed at about ninety degrees relative to each other.

18. The apparatus of claim 17, wherein the tendon or ligament anchoring device attaches to the pair of spaced apart pins, for holding the tendon or ligament anchoring device in a compressed condition to facilitate insertion into the bore hole.

19. The apparatus of claim 17, further including a wedge coupled to the forked end, for insertion into the bore hole, and engaged with the tendon or ligament anchoring device in the bore hole, thereby securing the tendon or ligament anchoring device in the bore hole.

20. A kit for securing a tendon into a femur bore hole and a tibia bore hole, the kit comprising:

a) a femoral bone anchor comprising;

flexible body having a distal end with an aperture therein to receive the tendon, the body tapering in the direction of the distal tip from a split end; and

two legs forming a concave relief extending from the aperture to the split end; and

2) a tibia fixation apparatus comprising;

a generally cylindrical body having an open proximal end and at least two legs formed by at least two slits extending from a distal end; and

at least one opening adjacent to the open proximal end for inserting the tendon therein.

21. The kit of claim 20, further including an anchor insertion instrument for inserting the femoral bone anchor into the femur bone hole, the anchor insertion instrument comprising:

a shaft;

a handle at a first end of the shaft;

a pair of spaced apart pins at a second end of the shaft; and

a plunger slidably mounted within the shaft, the plunger having a forked end that protrudes from the second end of the shaft, and an actuator that protrudes from the first end of the shaft, wherein the forked end and the pair of spaced apart pins are disposed at about ninety degrees relative to each other.

22. The kit of claim 21, further comprising at least one indentation on each of the femoral anchor legs at the split end, for cooperating with the pair of spaced apart pins of the anchor insertion instrument

23. The kit of claim 20, further comprising:

a substantially circular washer having a central aperture and a plurality of spikes positioned about a periphery;

wherein the washer is placed over the tibia fixation apparatus for clamping the tendon against a bone surface.

24. The kit of claim 20, further including a screw for securing the tibia fixation apparatus into the tibia bore hole.

25. The kit of claim 20, further comprising anchoring means on an outer surface of the legs of the femoral anchor and on an outer surface of the legs of the tibia fixation apparatus, the anchoring means selected from the group consisting of burrs, anchoring ridges, and barbs.

26. The kit of claim 20, further comprising a wedge member, for engaging the femoral bone anchor legs, the wedge forcing the legs against an inner surface of the femur bore hole.

27. The wedge member of claim 26, wherein the wedge member is inserted in the bone anchor legs by an anchor insertion instrument.

28. A method for securing a tendon between a femur bone and a tibia bone, the method comprising the steps of:

drilling a bore hole in at least one of the tibia or the femur bones;

selecting an femur anchor comprising a body having an aperture located in a distal end, with a pair of flexible wings extending from the distal end, the wings forming a splayed end, shaped to form at least two concave recesses extending from the aperture to the splayed end;

threading a tendon through the transverse aperture in the femur anchor and along the concave recesses;

inserting the femur anchor, with the tendon threaded through the aperture, into the femur, a portion of the tendon extending from the femur;

threading the tendon portion through an open proximal end of a tibia fixation device comprising a generally cylindrical body having an open proximal end and at least two rounded legs formed by at least two slits extending from a distal end, and having at least one opening adjacent to the open proximal end for receiving the tendon threaded through the open proximal end;

inserting the tibia fixation device into the tibia bore hole; and

a screw into the tibia fixation device for fixing the anchor and the tendon into the tibia bone.

29. The method of claim 28, further comprising the step of inserting the femur anchor into the femur bone with an insertion tool.

30. The method of claim 28, further comprising the step of placing a washer around the screw for clamping the tendon to the tibia bone.

31. A bone anchor for securing a tendon or ligament in a bore hole in a bone, comprising:

a generally cylindrical body having an open proximal end and at least two rounded legs formed by at least two slits extending from a distal end; and

at least one opening adjacent to the open proximal end for inserting the tendon or ligament therein.

32. The apparatus of claim 31, wherein the open proximal end has a diameter that is greater than the generally cylindrical body, so that the open proximal end lodges in an opening of the bore hole.

33. The apparatus of claim 31, wherein the rounded legs increase in thickness from the open proximal end to the distal end.

34. The apparatus of claim 31, wherein the rounded legs are radially expandable and have an inner surface with threads thereon for engaging with a screw.

35. The apparatus of claim 31, further comprising anchoring means on an outer surface of the rounded legs, the anchoring means selected from the group consisting of burrs, anchoring ridges, and barbs.

36. The apparatus of claim 31, further comprising a screw for inserting into the open proximal end for forcing the tendon or ligament against the bore hole surface, and for locking the apparatus into the bore hole.

37. The apparatus of claim 31, further comprising:

a washer having an aperture and a plurality of spikes located about a perimeter, so that when the washer is placed over the open proximal end the spikes clamp the tendon or ligament against a bone surface.