Transverse fixation technique for ACL reconstruction using bone-tendon-bone graft with loop at end

• US 20030176919A1
• Filed: 02/24/2003
• Published: 09/18/2003
• Est. Priority Date: 02/12/1997
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Schmieding, Reinhold
• Granted Patent: US 7,077,863 B2
• Time in Patent Office: Days
• US Class Current: 623/13.12
• CPC Class Codes: A61B 17/0642 for bones, e.g. for osteosynthesis or connecting tendon to bone
• CPC Class Codes: A61B 17/076 for removing surgical staples or wound clamps
• 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 17/8625 Shanks, i.e. parts contacting bone tissue
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable or resorptive
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0648 threaded, e.g. tacks with a screw thread
• 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 2/38 for elbows or knees
• CPC Class Codes: A61F 2002/0852 Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/087 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

Abstract

A surgical method for transosseous fixation of a bone-tendon-bone (BTB) graft into a joint is disclosed. A longitudinal tunnel formed in a bone is intersected by a transverse pin. A flexible strand is drawn with the pin through the bone. A portion of the strand is diverted so as to protrude out of the entrance to the longitudinal tunnel. The strand portion is attached to a loop extending from the bone block of the BTB graft, preferably by forming the loop around the strand. The strand attached to the bone block loop is retracted into the tunnel, drawing the attached BTB graft into the tunnel. The BTB graft is fixed in the tunnel using a transverse implant passed through the loop.

Claims

1. A method of anterior cruciate ligament reconstruction, comprising the steps of:

forming a tibial tunnel between an anterior tibial surface and the tibial plateau;

forming a femoral tunnel having an opening and a sidewall;

introducing a strand into the femoral tunnel through said sidewall;

pulling said strand through said opening of said femoral tunnel and down through said tibial tunnel;

attaching said strand to a loop extending from a bone block of a bone-tendon-bone graft; and

pulling said strand attached to said bone block of said bone-tendon-bone graft into said femoral tunnel.

2. The method of claim 1 further comprising the step of supporting said bone-tendon-bone graft in said femoral tunnel.

3. The method of claim 2, wherein said step of supporting said bone-tendon-bone graft in said femoral tunnel is conducted using a transosseous implant passed through the loop formed on the bone block.

4. The method of claim 1 further comprising the step of forming the loop around said strand after said step of pulling said strand through said opening of said femoral tunnel and down through said tibial tunnel.

5. The method of claim 1, wherein said step of pulling said strand through said opening of said femoral tunnel and down through said tibial tunnel is performed by engaging said strand with a hook.

6. The method of claim 5 further comprising the step of inserting said hook into said femoral tunnel and retracting said hook and said strand engaged thereto from said femoral tunnel.

7. A method of anterior cruciate ligament reconstruction, the method comprising the steps of:

forming a tibial tunnel between an anterior tibial surface and the tibial plateau;

forming a femoral tunnel having an opening and a sidewall;

introducing a suture into the femoral tunnel through said sidewall;

pulling said suture through said opening of said femoral tunnel and down through said tibial tunnel;

attaching said suture to a loop extending from a bone block of a bone-tendon-bone graft;

lifting said bone block of said bone-tendon-bone graft into said femoral tunnel; and

supporting said bone-tendon-bone graft into said femoral tunnel by using a transosseous implant.

8. The method of claim 7 further comprising the step of introducing a nitinol wire through said hole of said bone block of said bone-tendon-bone graft after the bone block of the bone-tendon-bone graft has been lifted into the femoral tunnel, and advancing a cannulated along the wire and through the loop formed on bone block to support the graft in the femoral tunnel.