Graft fixation using a plug against suture

• US 20040093031A1
• Filed: 04/03/2003
• Published: 05/13/2004
• Est. Priority Date: 06/22/2000
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Dreyfuss, Peter J., Burkhart, Stephen S., ElAttrache, Neal S.
• Granted Patent: US 7,329,272 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• 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 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/8645 Headless screws, e.g. ligament interference screws
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• 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 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• 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 2002/0841 Longitudinal channel for insertion tool running through the whole tendon anchor, e.g. for accommodating bone drill, guidewire
• CPC Class Codes: A61F 2002/0858 Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• CPC Class Codes: A61F 2002/0888 Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

A method for securing soft tissue to bone which does not require the surgeon to tie suture knots to secure the tissue to the bone. A pilot hole or socket is created in the bone at the location that the graft is to be secured. Suture is passed through the graft at desired points. A cannulated plug or screw is pre-loaded onto the distal end of a driver provided with an eyelet implant at its distal end. Suture attached to the graft is passed through the eyelet of the implant located at the distal end of the driver. The distal end of the driver together with the eyelet implant is inserted into the bottom of the hole, with the screw or plug disposed just outside the hole. Tension is applied to the suture to position the graft at the desired location relative to the bone hole. The screw or plug is then frilly advanced into the pilot hole by turning the interference screw or tapping the plug until the cannulated screw or plug securely engages and locks in the eyelet implant, so that the cannulated plug or screw with the engaged eyelet implant is flush with the bone. Once the screw or plug is fully inserted and the suture is impacted into the pilot hole, the driver is removed and any loose ends of the sutures protruding from the anchor site are then clipped short.

Claims

1. A driver for securing an interference device against a suture, the driver comprising:

a shaft having a proximal end and a distal end;

an interference device preloaded on the driver and disposed coaxially with the shaft; and

an aperture provided at the distal end of the driver.

2. The driver of claim 1, wherein the interference device is a screw.

3. The driver of claim 1, wherein the interference device is a plug.

4. The driver of claim 1, wherein the aperture is contained in an implant which is separable from the driver and matingly insertable into a cannula of the interference device.

5. The driver of claim 1, wherein the aperture is provided in the shape of a horseshoe.

6. The driver of claim 4, wherein the aperture of the implant has an eyelet configuration.

7. The driver of claim 6, wherein the implant is detachable from the driver.

8. The driver of claim 5, wherein the horseshoe-shaped aperture is contained in an implant which is separable from the driver and matingly insertable in a cannula of the interference device.

9. The driver of claim 8, wherein the implant is detachable from the driver.

10. The driver of claim 8, wherein the implant is affixed to the driver.

11. The driver of claim 1, wherein the aperture is provided within a tubing integral to the distal end of the driver.

12. A method of soft tissue repair, comprising the steps of:

providing a hole in a bone at a location at which a soft tissue graft is to be affixed;

attaching at least one suture to the soft tissue graft to be affixed;

preloading an interference device on a driver;

capturing the suture attached to the graft with an aperture provided at a distal end of the driver;

inserting the suture into the hole using the driver; and

inserting the interference device into the hole to secure the suture in the hole.

13. The method of soft tissue repair according to claim 12, wherein the interference device is a screw.

14. The method of soft tissue repair according to claim 12, wherein the interference device is a plug.

15. The method of soft tissue repair according to claim 12, wherein the aperture is contained in an implant, and the step of capturing the suture attached to the graft comprises the step of passing the suture through the aperture of the implant.

16. The method of soft tissue repair according to claim 15, wherein the aperture has an eyelet configuration.

17. The method of soft tissue repair according to claim 16, wherein the implant is detachable from the distal end of the driver.

18. The method of soft tissue repair according to claim 15, wherein the aperture has a horseshoe-shaped configuration.

19. The method of soft tissue repair according to claim 18, wherein the implant is detachable from the distal end of the driver.

20. The method of soft tissue repair according to claim 15, wherein the aperture is provided with at least one protuberance at its distal end.

21. The method of soft tissue repair according to claim 12, wherein the aperture is contained in an implant and the steps of capturing and inserting the suture attached to the graft includes:

inserting the suture attached to the graft into the aperture of the implant provided at the distal end of the driver;

feeding the suture through the aperture of the implant;

drawing the graft towards the distal end of the driver by pulling on the suture inserted through the aperture of the implant; and

inserting the distal end of the driver into the hole.

22. The method of soft tissue repair according to claim 21, wherein the driver includes an outer shaft disposed around an inner shaft and movable between a proximal position and a distal position along the inner shaft, and wherein the interference device is loaded onto the inner shaft by inserting the inner shaft through a cannula of the interference device with the outer shaft retracted to the proximal position so that the proximal end of the loaded interference device abuts the distal end of the outer shaft.

23. The method of soft tissue repair according to claim 22, wherein the interference device is a screw having a hex-shaped cannula and at least a portion of the implant at the distal end of the driver is hex-shaped to be matingly insertable into the hex-shaped interference screw cannula.

24. The method of soft tissue repair according to claim 22, wherein the interference device is a plug having a cannula and at least a portion of the implant at the distal end of the driver is matingly insertable into the cannula of the plug.

25. A method of graft repair, comprising the steps of:

forming a socket in a bone at a location at which a soft tissue graft is to be affixed;

providing a driver having a proximal end and a distal end;

preloading a cannulated plug on the driver;

providing an implant at the distal end of the driver;

feeding a suture attached to the soft tissue graft through an aperture of the implant;

tightening the suture from the distal end of the driver;

inserting the implant into the hole to secure the suture in the hole;

using the driver to matingly engage the implant with the cannulated plug; and

installing the plug into the hole.

26. The method of graft repair according to claim 25, wherein the implant is detachable from the distal end of the driver.

27. The method of graft repair according to claim 25, wherein the aperture of the implant has an eyelet configuration.

28. The method of graft repair according to claim 25, wherein the aperture of the implant has a horseshoe-shaped configuration.