ACL reconstruction technique using retrodrill

• US 20040199166A1
• Filed: 03/18/2004
• Published: 10/07/2004
• Est. Priority Date: 03/18/2003
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Schmieding, Reinhold, Puddu, Giancarlo
• Granted Patent: US 7,238,189 B2
• Time in Patent Office: Days
• US Class Current: 606/79
• CPC Class Codes: A61B 17/1617 with mobile or detachable parts
• 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 2002/0852 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

Methods and apparatus for arthroscopic tenodesis using sockets in bone created by retrograde cutting. A cannulated pin is drilled through bone and into a joint space in the normal, antegrade direction, guided by a drill guide. A strand provided through the cannulated pin is used to draw a retrodrill cutter into the joint space. The retrodrill cutter is threaded onto the cannulated pin, which is turned for retrograde cutting of a socket into the bone. The method is used to form a pair of sockets in the joint, which accept the respective ends of a replacement graft. The graft is brought into position in the joint space using loops formed in the strands, in a manner similar to introduction of the retrodrill cutter. The reconstruction is completed by securing suture attached to the graft ends with a button implant installed at the bone surface.

Claims

1. A method of forming a socket in bone comprising:

introducing a guide pin through the bone antegrade to expose a distal end of the guide pin;

inserting the distal end of the guide pin through a cannulation in a cutter;

securing the cutter to the distal end of the guide pin; and

drilling into the bone to create the socket by rotating the cutter and moving the cutter in a retrograde manner using the guide pin.

2. A method according to claim 1, wherein the step of introducing the guide pin includes aligning the guide pin using a drill guide and a marking hook.

3. A method according to claim 2, wherein the marking hook includes a hook tip and a visible mark disposed 5 mm proximal to the hook tip.

4. A method of knee reconstruction comprising:

forming a socket in a femur in a retrograde manner;

forming a socket in a tibia in a retrograde manner; and

securing the ends of a graft respectively in the sockets of the femur and the tibia.

5. A method according to claim 4, wherein the step of forming a socket in the femur in a retrograde manner includes introducing a guide pin through the femur, attaching a retrograde cutter to the guide pin, and retrograde cutting into the femur by rotating and withdrawing the guide pin to form the socket in the femur.

6. A method according to claim 4, wherein the step of introducing a guide pin through the femur includes aligning the guide pin using a drill guide and an offset marking hook.

7. A method according to claim 6, wherein the step of aligning the pin includes using the offset marking hook to align the pin 5 mm proximate a distal tip of the marking hook.

8. A method according to claim 5, wherein the guide pin is cannulated, and the step of attaching a retrograde cutter to the pin includes pulling the retrograde cutter into the knee using a strand introduced through the cannulated guide pin.

9. A method according to claim 4, wherein the step of forming the socket in the tibia includes introducing a guide pin through the tibia, attaching a retrograde cutter to the guide pin, and retrograde cutting into the tibia to form the retrograde socket in the tibia.

10. A method according to claim 9, wherein the guide pin is cannulated, and the step of attaching a retrograde cutter to the pin includes pulling the retrograde cutter into the knee using a strand introduced through the cannulated guide pin.

11. A method according to claim 4, wherein the step of aligning the guide pin includes using a drill guide and an offset marking hook.

12. A marking hook comprising:

an elongate body having proximal and distal ends;

a hook tip formed at the distal end; and

a visible line 5 mm proximal the hook tip.

13. A drill guide comprising:

a C-ring;

a guide sleeve supported on the C-ring; and

a marking hook supported by the C-ring, the marking hook including an elongate body having proximal and distal ends, a hook tip formed at the distal end, and a visible line 5 mm proximal the hook tip, the marking hook being supported such that an extended axis of the marking hook intersects an extended axis of the guide sleeve.