METHOD AND APPARATUS FOR COUPLING ANATOMICAL FEATURES

• US 20090054928A1
• Filed: 08/22/2008
• Published: 02/26/2009
• Est. Priority Date: 11/05/2004
• 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., Stone, Kevin T.
• Granted Patent: US 8,137,382 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 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 lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• 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 2017/0448 Additional elements on or within the anchor
• 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: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0475 using sutures having a slip knot
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/0641 : having at least three legs as part of one single body
• CPC Class Codes: A61F 2/08 : Muscles; Tendons; Ligaments sutures A61B17/04
• CPC Class Codes: A61F 2/0811 : Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0829 : without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
• CPC Class Codes: A61F 2002/0852 : Fixation of a loop or U-turn, e.g. eyelets, anchor having multiple holes
• CPC Class Codes: A61F 2002/0864 : Fixation of tendon or ligament between anchor elements, e.g. by additional screws in the anchor, anchor crimped around tendon
• 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
• CPC Class Codes: A61F 2002/0888 : Anchor in or on a blind hole or on the bone surface without formation of a tunnel
• CPC Class Codes: Y10T 29/49826 : Assembling or joining

Abstract

A method and apparatus for coupling a soft tissue implant into a locking cavity formed within a bone is disclosed. The apparatus includes a member to pull the soft tissue implant into a femoral tunnel. The member includes a suture having first and second ends which are passed through first and second openings associated with the longitudinal passage to form a pair of loops. Portions of the suture lay parallel to each other within the suture. Application of tension onto the suture construction causes retraction of the soft tissue implant into the femoral tunnel.

Claims

1. A method of coupling a first portion of an anatomy to a second portion of the anatomy comprising:

passing the suture through a first fastener;

coupling a second fastener to the suture;

passing a first end of the suture through a first aperture defined by the suture into a passage portion defined by the suture and out a second aperture defined by the suture so as to place the first end outside of the passage portion and form a first loop; and

coupling the first fastener to the first portion of the anatomy;

coupling the second fastener to the second portion of the anatomy; and

applying tension onto at least one of the first and second ends to constrict the first loop.

2. The method according to claim 1 further comprising:

forming a first tunnel in a bone;

threading the first loop through the tunnel;

applying tension onto at least one of the first and second ends to constrict the first loop; and

wherein coupling the second fastener to the second portion of the anatomy is coupling the second fastener to tissue.

3. The method according to claim 1 wherein the first portion of the anatomy is selected from the group consisting of bone, tissue, a prosthetic;

and wherein the second portion of the anatomy is selected from the group consisting of bone, tissue, and a prosthetic.

4. The method according to claim 2 wherein applying tension onto at least one of the first and second ends includes drawing the soft tissue into the first tunnel.

5. The method according to claim 2 further comprising forming a second tunnel perpendicular to the first tunnel in the bone.

6. The method according to claim 1 wherein the first fastener is selected from the group consisting of a screw, a cylindrical member, an anchor, and a collapsible tube.

7. The method according to claim 1 wherein the first portion of the anatomy comprises a bone-tendon-bone prosthetic.

8. A method of coupling a first portion of the anatomy to a second portion of the anatomy comprising:

passing the suture through an aperture defined by a first bone engaging member;

passing a first end of the suture through a first aperture defined by the suture into a passage portion defined by the suture and out a second aperture defined by the suture so as to place the first end outside of the passage portion and form a first loop;

coupling a second fastener to the suture;

coupling the first bone engaging member to a patient;

coupling the second fastener to the patient; and

applying tension to the at least one end of the suture to constrict the first loop, thereby pulling two anatomical portions together.

9. The method according to claim 8 further comprising coupling the second fastener to a bone.

10. The method according to claim 9 wherein the bone is selected from the group consisting of a coracoid process, a spine of scapula, a lunate, and a scaphoid.

11. The method according to claim 8 further comprising coupling the second fastener to a soft tissue replacement.

12. The method according to claim 11 wherein the soft tissue replacement is selected from the group selected from an ACL replacement, a bone-tendon-bone construction, a flexor tendon replacement, a bicep brachii tendon replacement.

13. A method of coupling a first portion of the anatomy to a second portion of the anatomy with a suture comprising:

forming a first tunnel in a first bone;

forming a second tunnel in a second bone;

providing a first locking member having a first profile which allows insertion of the first locking member through the first tunnel and a second profile which allows engagement with a first positive locking surface;

providing a second locking member having a third profile which allows engagement with a second positive locking surface;

passing the suture through a first bore defined in the first locking member and a second bore defined in a second locking member;

passing a first end of the suture through a first aperture into a passage portion defined by the suture and out a second aperture defined by the suture so as to place the first end outside of the passage portion and define a first loop;

threading the first end and a portion of the suture through the first tunnel; and

applying tension to at least one end of the suture.

14. The method according to claim 13 further including rotating the first locking member.

15. The method according to claim 14 further comprising applying tension onto at least one end to constrict the first loop and apply tension to the second bone.

16. The method according to claim 13 wherein applying tension onto the at least one end includes drawing the first loop into the first tunnel.

17. The method according to claim 15 further including forming a second tunnel in the first bone;

and

threading the first and second ends and the first and second loops through the second tunnel.

18. The method according to claim 17 wherein the second tunnel is generally perpendicular to the first tunnel.

19. The method according to claim 13 wherein the first anatomical member is one of a bicep brachii tendon, a bone-tendon-bone construction, a humerus, an ulna, a coracoid process, or a spine of scapula.