Adjustable knotless loops

• US 20080255613A1
• Filed: 04/10/2007
• Published: 10/16/2008
• Est. Priority Date: 04/10/2007
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Denham, Gregory J., Kaiser, Ryan A.
• Granted Patent: US 9,017,381 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/06185 hollow or tubular
• 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 2002/0888 Anchor in or on a blind hole or on the bone surface without formation of a tunnel

Abstract

Methods of attaching a soft tissue to an adjacent bone at a defect site are provided. An adjustable loop region of a flexible construct contained in a bore defined by a fastener is passed through a tissue. The adjustable loop is passed through the tissue. The fastener is passed back through the adjustable loop to fold the adjustable loop upon itself. The fastener is attached to the bone. An adjusting arm on the flexible construct is engaged to reduce the size of the adjustable loop and secure the soft tissue to the bone.

Claims

1. A method of attaching a soft tissue to an adjacent bone at a defect site comprising:

passing an adjustable loop of a flexible construct contained in a bore defined by a fastener through the soft tissue;

passing the fastener back through the adjustable loop to fold the adjustable loop upon itself;

attaching the fastener to the bone; and

engaging an adjusting arm on the flexible construct to reduce the size of the adjustable loop and secure the soft tissue to the bone.

2. The method of claim 1, further comprising preparing a hole in the bone to receive the fastener.

3. The method of claim 1, further comprising passing the adjustable loop of the flexible construct through the bore defined by the fastener by advancing the adjustable loop from within the bore of the fastener and through a suture-receiving port and down a suture-receiving channel on the fastener.

4. The method of claim 1, further comprising securing the adjustable loop to a proximal end of the fastener with a restriction element.

5. The method of claim 4, further comprising regulating movement of the adjusting arm through the bore of the fastener via the restriction element.

6. The method of claim 1, wherein the fastener is passed back through the adjustable loop away from the defect site.

7. The method of claim 1, wherein the fastener is passed back through the adjustable loop at the defect site.

8. The method of claim 1, further comprising engaging the adjusting arm at a proximal end of the fastener to cause reduction of the adjustable loop at the distal end of the fastener.

9. The method of claim 1, further comprising interlacing a plurality of adjustable loops from a plurality of fasteners to form a suture bridge.

10. The method of claim 1, further comprising mounting the adjustable loop to an adjustable loop mount on a driver and retaining the adjusting arm in an adjusting arm receptacle.

11. The method of claim 1, further comprising forming the adjustable loop by passing a first end of a hollow suture through a first opening on the hollow suture, advancing the first end through a passage formed in the hollow suture, and pulling the first end out of a second opening on the hollow suture.

12. A method of attaching a soft tissue to an adjacent bone at a defect site comprising:

offsetting an adjustable loop of a flexible construct through a bore defined by a fastener;

passing the adjustable loop through the soft tissue;

passing the fastener back through the adjustable loop to fold the adjustable loop upon itself;

fixing the fastener to an area adjacent the defect such that the adjustable loop and a proximal end of the fastener abut the defect;

engaging an adjusting arm on the flexible construct to reduce the size of the adjustable loop and to retain the fastener proximal end in abutment with the soft tissue.

13. The method of claim 12, wherein offsetting the adjustable loop comprises disposing a region of the adjustable loop in an interior bore in the fastener body that opens at a proximal end of the fastener body and disposing a region of the adjustable loop in an exterior channel connected to the interior bore.

14. The method of claim 12, wherein the defect is an articular cartilage defect.

15. The method of claim 12, wherein the defect is a labral tear.

16. A method of attaching a soft tissue to an adjacent bone at a defect site comprising:

passing a first adjustable loop of a first flexible construct contained in a bore defined by a first fastener through the soft tissue;

attaching the first fastener to the bone;

passing a second fastener having a second adjustable loop of a second flexible construct through a bore defined by the second fastener through the adjustable loop on the first fastener;

passing the second fastener back through the first adjustable loop to interlace the first adjustable loop and the second adjustable loop.

17. The method of claim 16, further comprising attaching the second fastener through the tissue and into the bone.

18. The method of claim 17, further comprising engaging a first adjusting arm on the first flexible construct to reduce the size of the first adjustable loop and engaging a second adjusting arm on the second flexible construct to reduce the size of the second adjustable loop and thereby forming a suture bridge to secure the soft tissue to the bone.

19. The method of claim 16, wherein passing the adjustable loop portion of the first or second flexible construct through the bore in the respective fastener further comprises advancing the respective adjustable loop from within the respective fastener bore and through a suture-receiving port and down a suture-receiving channel on the respective fastener.

20. The method of claim 18, further comprising engaging the first adjusting arm and the second adjusting arm at the proximal end of the respective fasteners to cause reduction of the respective adjustable loops.

21. The method of claim 16, further comprising interlacing a plurality of adjustable loops from a plurality of fasteners to form the suture bridge.