DOUBLE BUNDLE ACL REPAIR

• US 20100249930A1
• Filed: 03/31/2010
• Published: 09/30/2010
• Est. Priority Date: 03/31/2009
• Status: Active Grant

• Current Assignee: IMDS LLC, Thomas Myers
• Original Assignee: Medicinelodge, Inc (Nelso Antolotti)
• Inventors: Myers, Thomas
• Granted Patent: US 8,617,241 B2
• Time in Patent Office: Days
• US Class Current: 623/13.140
• 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 17/1604 Chisels; Rongeurs; Punches; Stamps
• 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 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 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• 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 2002/0829 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 2002/0858 Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• 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: A61F 2230/001 Figure-8-shaped, e.g. hourglass-shaped
• CPC Class Codes: A61F 2230/0013 Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0082 parallelepipedal
• CPC Class Codes: A61F 2240/008 : Means for testing implantable prostheses

Abstract

A system for single tunnel, double bundle anterior cruciate ligament reconstruction includes implant constructs and instruments. The implant constructs provide a combination of cortical fixation and bone tunnel aperture fixation. The implant constructs separate a graft into distinct bundles. The instruments are used to prepare shaped bone tunnels to receive the implant constructs and graft bundles. Methods for reconstructing the antero-medial and postero-lateral bundles of the anterior cruciate ligament may rely on single femoral and tibial tunnels and a single strand of graft.

Claims

1. An implant for anterior cruciate ligament reconstruction, comprising:

a body extending along a longitudinal axis from a leading end to a trailing end;

a groove extending across the leading end and extending generally parallel to the axis along a first pair of opposite sides of the body; and

a pair of indentations extending generally parallel to the axis along a second pair of opposite sides of the body, wherein the second pair of opposite sides is interposed with the first pair of opposite sides.

2. The implant of claim 1, wherein the body comprises a porous material.

3. The implant of claim 1, wherein the body comprises a therapeutic agent.

4. The implant of claim 1, further comprising an aperture through the body.

5. The implant of claim 1, wherein, when the body is inserted into a hole extending along the axis from a first end to a second end and having a FIG.-eight-shaped cross section comprising a pair of enlarged lobes separated by a constricted middle section, the pair of indentations congruently engage the constricted middle section.

6. The implant of claim 5, wherein a plurality of chambers are formed between the grooved first pair of opposite sides and the enlarged lobes.

7. The implant of claim 6, wherein, when the hole is formed in a bone so as to substantially occupy a natural attachment area of a natural anterior cruciate ligament to the bone, each chamber corresponds to a natural attachment area of a functional bundle of the anterior cruciate ligament to the bone.

8. An implant for anterior cruciate ligament reconstruction, comprising:

a body comprising a cross section projected along a longitudinal axis from a leading end to a trailing end, wherein the body cross section comprises a pair of open crescent-like portions formed in back-to-back relationship and having a common central portion;

wherein, when the leading end of the body is inserted into a hole comprising a cross section projected along the axis from a first end to a second end, wherein the hole cross section comprises a FIG.-eight shape having two enlarged portions arranged on opposite sides of a constricted middle portion, the body congruently engages the constricted middle portion and the crescent-like portions open toward the enlarged portions.

9. The implant of claim 8, wherein the body comprises a porous material.

10. The implant of claim 9, wherein the porous material comprises porous polyetheretherketone.

11. The implant of claim 8, wherein the body comprises a therapeutic agent.

12. The implant of claim 8, further comprising an aperture through the common central portion.

13. The implant of claim 8, wherein a pair of chambers are formed between the crescent-like portions and the enlarged portions.

14. The implant of claim 13, wherein, when the hole is formed in a bone so as to substantially occupy a natural attachment area of a natural anterior cruciate ligament to the bone, each chamber corresponds to a natural attachment area of a bundle of the anterior cruciate ligament to the bone.

15. A system for anterior cruciate ligament reconstruction, comprising:

a first apparatus for securing a first end of a soft tissue graft to a first bone of a joint, the first apparatus comprising;

body means for separating the graft into a plurality of bundles and for urging the bundles against a side wall of a first bone tunnel at a first end of the first tunnel, wherein the first tunnel is formed in the first bone, wherein the first end of the first tunnel is proximate an articular surface of the first bone, wherein the first tunnel comprises a noncircular cross section projected along a longitudinal axis from the first end of the first tunnel to a second end of the first tunnel, wherein the second end of the first tunnel is remote from the articular surface of the first bone;

fixation means separate from the body means for securing the first end of the graft to the first bone; and

connection means for securing the body means to the fixation means.

16. The system of claim 15, wherein the body means comprises a porous material.

17. The system of claim 15, wherein the soft tissue graft comprises two bundles, wherein the tunnel cross section is elongated so as to comprise a width and a height, wherein the width is greater than the height, wherein the body means urges the bundles against opposite portions of the first tunnel wall across the width.

18. The system of claim 15, wherein the cross section mimics an attachment area of a natural anterior cruciate ligament to the first bone, wherein the first end of the first tunnel is positioned to substantially overlap the attachment area.

19. The system of claim 15, wherein the fixation means engages a cortical portion of the first bone contralateral to the first end of the first tunnel.

20. The system of claim 15, further comprising:

a second apparatus for securing a second end of the graft to a second bone of the joint, the second apparatus comprising;

second body means for separating the bundles and for urging the bundles against a side wall of a second bone tunnel at a first end of the second tunnel, wherein the second tunnel is formed in the second bone, wherein the first end of the second tunnel is proximate an articular surface of the second bone, wherein the second tunnel comprises a noncircular cross section projected along a longitudinal axis from the first end of the second tunnel to a second end of the second tunnel, wherein the second end of the second tunnel is remote from the articular surface of the second bone;

second fixation means separate from the second body means for securing the second end of the graft to the second bone; and

second connection means for securing the second body means to the second fixation means.

21. The system of claim 20, wherein, when the first end of the graft is secured to the first bone by the first apparatus and the second end of the graft is secured to the second bone by the second apparatus, the graft is separated into a first bundle that mimics an anteromedial bundle of a natural anterior cruciate ligament and a second bundle that mimics a posterolateral bundle of the natural anterior cruciate ligament.

22. A system for anterior cruciate ligament reconstruction, comprising:

a first fixation device comprising a plug for insertion into a first end of a noncircular bone tunnel in a femur, wherein the first end of the femoral tunnel intersects a distal articular condyle of the femur, wherein, when the plug is operatively positioned in the femoral tunnel, a plurality of spaced-apart chambers are formed between the plug and a side wall of the femoral tunnel; and

a second fixation device for implantation proximate a second end of the femoral tunnel, wherein the first fixation device is connected to the second fixation device, wherein the second fixation device secures the first fixation device to the femur.

23. The system of claim 22, wherein the first fixation device comprises a porous material.

24. The system of claim 22, wherein the first fixation device comprises a therapeutic agent.

25. The system of claim 22, wherein first and second chambers are formed, wherein the first chamber is positioned to substantially overlap an attachment area of an anteromedial bundle of a natural anterior cruciate ligament to the femur and the second chamber is positioned to substantially overlap an attachment area of a posterolateral bundle of the natural anterior cruciate ligament to the femur.

26. The system of claim 22, wherein the second fixation device engages a cortical portion of the bone contralateral to the first end of the femoral tunnel.

27. The system of claim 22, further comprising:

a third fixation device similar to the first fixation device and comprising a second plug for insertion into a first end of a noncircular bone tunnel in a tibia, wherein the first end of the tibial tunnel intersects a proximal articular condyle of the tibia, wherein, when the second plug is operatively positioned in the tibial tunnel, a plurality of spaced-apart chambers are formed between the second plug and a side wall of the tibial tunnel; and

a fourth fixation device similar to the second fixation device for implantation proximate a second end of the tibial tunnel, wherein the third fixation device is connected to the fourth fixation device, wherein the fourth fixation device secures the third fixation device to the tibia.

28. The system of claim 27, wherein third and fourth chambers are formed between the second plug and the side wall of the tibial tunnel, wherein the third chamber is positioned to substantially overlap an attachment area of an anteromedial bundle of a natural anterior cruciate ligament to the tibia and the fourth chamber is positioned to substantially overlap an attachment area of a posterolateral bundle of the natural anterior cruciate ligament to the tibia.