Apparatus and methods for independently conditioning and pre-tensioning a plurality of ligament grafts during joint repair surgery
First Claim
1. A tensioning system for use in joint repair surgery comprising:
- a plurality of breakaway guide pins adapted for attachment to a patient'"'"'s bone and including one or more notches or grooves that facilitate preferential breakage of the guide pins at or near the notches or grooves; and
a tensioning device comprising;
an attachment portion comprising a plurality of attachment posts, each configured to slidably attach to one of said breakaway guide pins; and
a tensioning portion configured to independently apply a desired tensile load to at least two separate strands of a soft tissue graft, the tensioning portion comprising;
a first adjustable tensioning apparatus configured so as to selectively increase or decrease a first tensile load applied to a first strand of a soft tissue graft; and
a second adjustable tensioning apparatus configured so as selectively increase or decrease a second tensile load applied to a second strand of the soft tissue graft independently of the first tensile load applied by the first adjustable tensioning apparatus.
1 Assignment
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Accused Products
Abstract
Apparatus and methods for conditioning and pre-tensioning soft tissue grafts during joint repair surgery, such as during repair of the anterior cruciate ligament (ACL). The inventive apparatus is advantageously adapted and configured so as to enable a surgeon to independently apply a desired tensile load to individual graft strands or graft bundles of a multi-strand tissue graft. The inventive methods enable each graft strand or bundle to be properly tensioned so as to both “condition” the graft to prevent subsequent stretching, relaxation or elongation following surgery, which can destabilize the joint, and to pre-tension each graft strand or bundle to a predetermined amount so that each contributes to the strength and stability of the joint, thus resulting in a stronger and more durable joint. The tensioning device is advantageously equipped with structure for attachment to a patient'"'"'s limb during the conditioning and pre-tensioning procedure. It has multiple adjustable tension applicators that can be independently manipulated so as to apply a separate tensile load to one or more ends of a tissue graft strand attached to each adjustable tension applicator.
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Citations
24 Claims
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1. A tensioning system for use in joint repair surgery comprising:
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a plurality of breakaway guide pins adapted for attachment to a patient'"'"'s bone and including one or more notches or grooves that facilitate preferential breakage of the guide pins at or near the notches or grooves; and
a tensioning device comprising;
an attachment portion comprising a plurality of attachment posts, each configured to slidably attach to one of said breakaway guide pins; and
a tensioning portion configured to independently apply a desired tensile load to at least two separate strands of a soft tissue graft, the tensioning portion comprising;
a first adjustable tensioning apparatus configured so as to selectively increase or decrease a first tensile load applied to a first strand of a soft tissue graft; and
a second adjustable tensioning apparatus configured so as selectively increase or decrease a second tensile load applied to a second strand of the soft tissue graft independently of the first tensile load applied by the first adjustable tensioning apparatus. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A tensioning system for use in joint repair surgery comprising:
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a tensioning device comprising;
an attachment portion configured to removably attach the tensioning device to a person'"'"'s limb; and
a tensioning portion configured to independently apply a desired tensile load to at least two separate strands of a soft tissue graft, the tensioning portion comprising;
a first adjustable tensioning apparatus configured so as to selectively increase or decrease a first tensile load applied to a first strand of a soft tissue graft; and
a second adjustable tensioning apparatus configured so as selectively increase or decrease a second tensile load applied to a second strand of the soft tissue graft independently of the first tensile load applied by the first adjustable tensioning apparatus; and
at least one suture strand separator configured for removable attachment to the tensioning device and adapted to maintain at least two suture strands attached to different ends of a multi-strand tissue graft in a desired space-apart relationship. - View Dependent Claims (12, 13, 14, 15, 16, 17)
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18. A method for repairing a patient'"'"'s joint, comprising:
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removing at least two soft tissue strands from the patient'"'"'s body;
doubling over the soft tissue strands to form looped tissue graft bundles, each having a doubled-over end and two free ends opposite the doubled over end, the looped tissue graft bundles together comprising a composite tissue graft;
attaching the doubled-over end of each looped tissue graft bundle to a first bone of the patient'"'"'s joint while leaving the free ends of each looped tissue graft bundle initially unaffixed to a second bone of the patient'"'"'s joint;
applying a first tensile load to the free ends of a first looped graft bundle in manner so that the first tensile load is equalized between the free ends of the first graft bundle;
applying a second tensile load to the free ends of a second looped graft bundle independently from the first tensile load and in manner so that the second tensile load is equalized between the free ends of the second graft bundle;
affixing the composite tissue graft to the second bone of the patient'"'"'s joint after conditioning and pre-tensioning each looped graft bundle. - View Dependent Claims (19, 20, 21, 22, 23, 24)
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Specification