Anterior cruciate ligament tether

• US 20080097430A1
• Filed: 09/25/2006
• Published: 04/24/2008
• Est. Priority Date: 09/25/2006
• Status: Active Grant

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: James L. Carey, Joseph Bernstein
• Inventors: Bernstein, Joseph, Carey, James L.
• Granted Patent: US 7,776,039 B2
• Time in Patent Office: Days
• US Class Current: 606/60
• CPC Class Codes: A61B 17/1764 for the knee
• CPC Class Codes: A61B 17/1796 for holes for sutures or flexible wires
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61F 2/08 Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments

Abstract

A device and method to provide a surgically inserted internal tether between the femur and tibia is provided which will prevent distraction of the healing anterior cruciate ligament in all degrees of flexion and extension, at all times. The anterior cruciate ligament tether preserves the four-bar cruciate linkage, critical for normal knee mechanics. In addition, placement of the tether provides bleeding into the knee in the region of the anterior cruciate ligament attachment sites and the consequent inflow of pluripotential cells and healing mediators.

Claims

1. A surgical device for temporarily holding the tibia and femur of the knee together in the setting of a ruptured anterior cruciate ligament, comprising:

(a) a flexible, elongate material of sufficient strength and stiffness with a femoral portion and a tibial portion

(b) means for securing said femoral portion to the anatomic femoral attachment of said anterior cruciate ligament

(c) means for securing said tibial portion to the anatomic tibial attachment of said anterior cruciate ligament

whereby said device provides an internal tether preventing temporary distraction of said anterior cruciate ligament in all degrees of flexion and extension during the healing phase.

2. The device of claim 1 wherein said material is surgical suture.

3. The device of claim 1 wherein said material is a biocompatible, bioresorbable material.

4. The device of claim 1 wherein said means for securing said femoral portion of material comprises

(a) establishment of a bony tunnel which starts at the anatomic femoral attachment of said anterior cruciate ligament and finishes at the femoral cortex

(b) passage of said femoral portion through said bony tunnel

(c) securing said femoral portion to said cortex using a device selected from the group consisting of elongated buttons, staples, screws, and regular buttons.

5. The device of claim 1 wherein said means for securing said tibial portion of material comprises

(a) establishment of a bony tunnel which starts at the anatomic tibial attachment of said anterior cruciate ligament and finishes at the tibial cortex

(b) passage of said tibial portion through said bony tunnel

(c) securing said tibial portion to said cortex using a device selected from the group consisting of elongated buttons, staples, screws, and regular buttons.

6. The device of claim 1 wherein said means for securing said femoral or tibial portion of material comprises

(a) placement of a suture anchor at the anatomic attachment of the anterior cruciate ligament

(b) attachment of said material to the said suture anchor.

7. The device of claim 1 wherein said means for securing said femoral portion of material comprises

(a) establishment of multiple bony tunnels which start at said femoral attachment of said anterior cruciate ligament and finish at different points on the femoral cortex

(b) partial passage of a piece of said material through each bony tunnel

(c) tying said material together over cortical bony bridges between said tunnels

8. The device of claim 1 wherein said means for securing tibial portion of material comprises

(a) establishment of multiple bony tunnels which start at said tibial attachment of said anterior cruciate ligament and finish at different points on the tibial cortex

(b) partial passage of a piece of said material through each bony tunnel

(c) tying said material together over cortical bony bridges between said tunnels

9. The device of claim 1 wherein said means for securing femoral or tibial portion of material comprises chemical bonding.

10. The device of claim 1 wherein said means for securing femoral or tibial portion of material comprises interference fixation.

11. A method for temporarily holding the tibia and femur of the knee together in the setting of a ruptured anterior cruciate ligament, comprising steps of:

(a) inserting a flexible, elongate material of sufficient strength and stiffness into the knee

(b) securing one portion of said material to said femur at the anatomic attachment of the anterior cruciate ligament

(c) securing second portion of said material to said tibia at the anatomic attachment of the anterior cruciate ligament

whereby said material provides an internal tether preventing distraction of the healing anterior cruciate ligament in all degrees of flexion and extension.