Apparatus and method for reconstructing a ligament

• US 20030065391A1
• Filed: 04/16/2002
• Published: 04/03/2003
• Est. Priority Date: 10/01/2001
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Scandius BioMedical Inc. (Medtronic Plc)
• Inventors: Marshall, Peter F., Re, Paul, Johanson, Mark A.
• Granted Patent: US 6,712,849 B2
• Time in Patent Office: Days
• US Class Current: 623/13.14
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1714 for applying tendons or ligaments implements for applying tendons or ligaments A61F2/0805
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 2090/062 penetration depth
• 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 2002/0882 Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• CPC Class Codes: Y10S 606/907 Composed of particular material or coated
• CPC Class Codes: Y10S 606/908 Bioabsorbable material
• CPC Class Codes: Y10S 606/909 Bone
• CPC Class Codes: Y10S 606/91 Polymer
• CPC Class Codes: Y10S 606/916 Tool for installing or removing orthopedic fastener

Abstract

A method and apparatus for reconstructing a ligament using a graft ligament support block which comprises a body, and a graft hole and a transverse fixation pin hole extending through the body, with both the graft hole and the fixation pin hole preferably extending substantially perpendicular to the longitudinal axis of the body. A graft ligament is looped through the graft hole, and the support block is advanced into the bone tunnel, with the two free ends of the looped graft ligament extending back out the bone tunnel. Next, a transverse tunnel is formed in the host bone, with the transverse tunnel being aligned with the fixation pin hole. Then the support block is secured in place by pinning the support block within the tunnel, i.e., by advancing a fixation pin along the transverse tunnel in the host bone and into the fixation pin hole in the support block.

Claims

1. Apparatus for use in reconstructing a ligament, said apparatus comprising:

a graft ligament support block for supporting a graft ligament in a bone tunnel, said graft ligament support block comprising;

a body having a distal end, a proximal end, and a longitudinal axis extending between said distal end and said proximal end;

a graft hole extending through said body transverse to said longitudinal axis and configured to receive a graft ligament therein; and

a transverse fixation pin hole extending through said body transverse to said longitudinal axis and configured to receive a transverse fixation pin therein.

2. Apparatus according to claim 1 wherein said graft hole resides closer to said proximal end of said body than said transverse fixation pin hole.

3. Apparatus according to claim 1 wherein at least a portion of an opening of said graft hole is tapered so as to provide a less traumatic bearing surface for a graft ligament looped through said graft hole.

4. Apparatus according to claim 1 wherein an opening of said transverse fixation pin hole is tapered so as to facilitate entry of a transverse fixation pin into said transverse fixation pin hole.

5. Apparatus according to claim 1 wherein at least a portion of said body between said graft hole and said transverse fixation pin hole has a substantially cylindrical cross-section.

6. Apparatus according to claim 1 wherein said distal end of said body is tapered so as to facilitate advancement of said graft ligament support block through a bone tunnel.

7. Apparatus according to claim 1 wherein said proximal end of said body is sculpted away so as to provide more room for a graft ligament looped through said graft hole and extending proximally therefrom.

8. Apparatus according to claim 7 wherein said proximal end of said body is sculpted away so as to form at least one substantially planar surface.

9. Apparatus according to claim 7 wherein said proximal end of said body is sculpted away so as to form at least one surface groove extending between said graft hole and said proximal end of said body.

10. Apparatus according to claim 1 wherein said body is formed out of a material selected from the group consisting of a polymer, a bioabsorbable material, a bioremodelable material, allograft bone, a metal, a ceramic, coral, a fiber composite, and a composite including at least one of the foregoing.

11. Apparatus according to claim 1 wherein said body further comprises at least one element for engagement by an installation tool.

12. Apparatus according to claim 11 wherein said at least one element comprises an opening formed in said proximal end of said body and adapted for engagement by a finger formed on the installation tool.

13. Apparatus according to claim 11 wherein said at least one element comprises a finger extending proximally from said proximal end of said body and adapted for engagement in an opening formed on the installation tool.

14. Apparatus according to claim 1 wherein said body further comprises a suture hole extending through said body transverse to said longitudinal axis and configured to receive a tow suture therein.

15. Apparatus according to claim 14 wherein said suture hole resides closer to said distal end of said body than said transverse fixation pin hole.

16. Apparatus according to claim 1 further comprising an installation tool, said installation tool comprising:

a holder, said holder comprising;

a shaft having a distal end, a proximal end and longitudinal axis extending between said distal end and said proximal end, said proximal end of said shaft comprising at least one finger for engagement in said opening; and

a handle mounted to said proximal end of said shaft.

17. Apparatus according to claim 16 further comprising at least one suture post formed on said proximal end of said shaft.

18. Apparatus according to claim 16 wherein said installation tool further comprises a drill guide adapted to be releasably secured to said holder.

19. Apparatus according to claim 18 wherein said drill guide comprises:

a n outrigger comprising a distal end and a proximal end, with said proximal end of said outrigger being configured to be releasably secured to said holder; and

a drill sleeve moveably attached to said distal end of said outrigger, said drill sleeve comprising a drilling lumen extending therethrough.

20. Apparatus according to claim 19 wherein said installation tool is configured so that when said graft ligament support block is attached to said distal end of said shaft, said drilling lumen in said drill guide is aligned with said transverse fixation pin hole in said body.

21. Apparatus according to claim 16 wherein said proximal end of said holder comprises an orientation marker for visually indicating the axial orientation of said distal end of said shaft.

22. A method for securing a graft ligament in a bone tunnel, comprising the steps of:

looping a graft ligament through a graft hole in a graft ligament support block;

advancing the graft ligament support block into the bone tunnel;

forming a transverse tunnel in the host bone, with a transverse tunnel being aligned with a transverse fixation pin hole in the graft ligament support block; and

pinning the graft ligament support block within the bone tunnel by advancing a transverse fixation pin along the transverse tunnel in the host bone and into the transverse fixation pin hole in the graft ligament support block.

23. A method according to claim 22 wherein an installation tool is used to advance the graft ligament support block into the bone tunnel.

24. A method according to claim 23 wherein the two free ends of the graft ligament are secured to the installation tool prior to advancing the graft ligament support block into the bone tunnel.

25. A method according to claim 23 wherein the installation tool is used to form the transverse tunnel in the host bone.

26. A method according to claim 22 wherein a tow suture is used to advance the graft ligament support block into the bone tunnel.

27. A method for securing a graft ligament in a bone tunnel, said method comprising the steps of:

forming a transverse tunnel in the host bone;

looping a graft ligament through a graft hole in a graft ligament support block;

advancing the graft ligament support block into the bone tunnel so that a transverse fixation pin hole in the graft ligament support block is aligned with the transverse tunnel; and

pinning the graft ligament support block within the bone tunnel by advancing a transverse fixation pin along the transverse tunnel in the host bone and into the transverse fixation pin hole in the graft ligament support block.

28. A method according to claim 27 wherein an installation tool is used to advance the graft ligament support block into the bone tunnel.

29. A method according to claim 28 wherein the two free ends of the graft ligament are secured to the installation tool prior to advancing the graft ligament support block into the bone tunnel.