ADJUSTABLE SUTURE BUTTON CONSTRUCT AND METHODS OF TISSUE RECONSTRUCTION

• US 20100268273A1
• Filed: 03/31/2010
• Published: 10/21/2010
• Est. Priority Date: 03/31/2009
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Jolly, Jacob A., Albertorio, Ricardo, Zajac, Eric S.
• Granted Patent: US 8,460,379 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 17/0487 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 17/8061 specially adapted for particular bones A61B17/70 and A61B17/74 take precedence
• CPC Class Codes: A61B 2017/0403 Dowels other bone dowels A61B17/68; dowels for connecting prosthetic parts A61F2002/30433
• CPC Class Codes: A61B 2017/0404 Buttons
• 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 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• 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

An adjustable construct for fixation of a tendon or ligament graft in a tunnel. The construct comprises a flexible, adjustable loop connected to tissue (for example, graft, ligament or tendon). The adjustable loop may be integrated with an additional tissue supporting device (for example, a wedge or a plug). The tissue is secured within a bone socket/tunnel by adjusting the length of the flexible adjustable loop.

Claims

1. A fixation system for tissue reconstruction, comprising an adjustable button/loop construct having a button and a flexible loop connected to the button, the flexible loop having an adjustable length and two adjustable eyesplices that are interconnected.

2. The fixation system of claim 1, further comprising tissue connected to the flexible loop.

3. The fixation system of claim 2, wherein the tissue is passed through and looped over the flexible loop.

4. The fixation system of claim 2, wherein the tissue is connected to the flexible loop by a tissue supporting device connected to the flexible loop.

5. The fixation system of claim 4, wherein the tissue supporting device is a wedge, a plug, an implant, an anchor or a screw.

6. The fixation system of claim 4, wherein the tissue supporting device is a wedge having at least two holes to allow at least two portions of the adjustable loop to pass thereto and to connect the tissue supporting device to the button.

7. The fixation system of claim 4, wherein the tissue supporting device is positioned over an eyesplice interconnection of the button/loop construct.

8. The fixation system of claim 4, wherein the tissue supporting device is about 180 degrees from an eyesplice interconnection of the button/loop construct.

9. The fixation system of claim 2, wherein the tissue comprises soft tissue.

10. The fixation system of claim 2, wherein the tissue is soft tissue, graft, tendon, ligament, synthetic material, biological material, bone, or a combination of such materials.

11. The fixation system of claim 2, wherein the tissue is an autograft or an allograft.

12. The fixation system of claim 1, wherein the adjustable loop is formed of a high strength suture.

13. The fixation system of claim 1, wherein the adjustable loop is formed of a braided material.

14. A fixation system for tissue reconstruction, comprising:

an adjustable button/loop construct having a button and a flexible loop connected to the button, the flexible loop having an adjustable length; and

tissue connected to the flexible loop.

15. The fixation system of claim 14, wherein the flexible loop has two adjustable eyesplices that are interconnected.

16. The fixation system of claim 14, wherein the tissue is passed through and looped over the flexible loop.

17. The fixation system of claim 14, wherein the tissue is connected to the flexible loop by a graft supporting device connected to the flexible loop.

18. The fixation system of claim 17, wherein the graft supporting device is a wedge, a plug, an implant, an anchor or a screw.

19. The fixation system of claim 17, wherein the graft supporting device is a wedge having at least two holes to allow at least two portions of the adjustable loop to pass thereto and to connect the fixation device to the button.

20. The fixation system of claim 17, wherein the graft supporting device is positioned over an eyesplice interconnection of the button/loop construct.

21. The fixation system of claim 17, wherein the graft supporting device is positioned adjacent an eyesplice interconnection of the button/loop construct.

22. The fixation system of claim 17 wherein the tissue is further secured to the graft supporting device through at least one flexible member.

23. The fixation system of claim 14, wherein the tissue is soft tissue, graft, tendon, ligament, synthetic material, biological material, bone, or a combination of such materials.

24. The fixation system of claim 14, wherein the tissue is a graft.

25. The fixation system of claim 14, wherein the adjustable loop is formed of a braided material.

26. The fixation system of claim 14, wherein the adjustable loop is formed by the steps of:

providing a flexible strand having two ends;

passing the flexible strand through holes of the button, so that each end passes through an original hole in the button; and

splicing each end through itself traveling in a direction back towards the original hole passed through in the button to form two interconnected eyesplices.

27. The fixation system of claim 26, further comprising the step of passing each end through a hole opposite the original hole and towards the two interconnected eyesplices subsequent to the step of splicing each end through itself.

28. An ACL construct for fixation within femoral and tibia tunnels or sockets, comprising:

a tissue construct extending between first and second fixation devices, the tissue construct being secured to each of the first and second fixation devices; and

a loop of flexible material attached to the first fixation device, wherein the loop has an adjustable length to allow positioning of the tissue construct within the femoral and tibia tunnels or sockets.

29. The ACL construct of claim 28, wherein the tissue construct is passed through the adjustable loop and looped over the loop to form a double bundle construct.

30. The ACL construct of claim 28, wherein the first fixation device is a button and the second fixation device is an interference device.

31. The ACL construct of claim 30, wherein the button is adapted for engagement on the femur and secures the tissue construct within the femoral socket, and wherein the interference device secures the tissue construct within the tibia socket.

32. The ACL construct of claim 28, wherein the construct has a length which is about equal to a length of the femoral tunnel, the tibia tunnel and of an intraarticular distance between the femoral tunnel and the tibia tunnel.

33. The AC L construct of claim 28, wherein the tissue construct is soft tissue, graft, tendon, ligament, synthetic material, biological material, bone, or a combination of such materials.

34. A method of tissue reconstruction, comprising:

providing a construct comprising an adjustable button/loop construct having a button and a flexible, adjustable loop connected to the button, the flexible loop having an adjustable length; and

a tissue connected to the flexible, adjustable loop;

inserting the construct within a first bone tunnel and a second bone tunnel; and

adjusting the length of the loop to secure the tissue within the first and second bone tunnels.

35. The method of claim 34, further comprising the steps of:

attaching the loop to the button by forming an eyesplice interconnection on the loop and positioning the button over the eyesplice interconnection;

passing the tissue through the loop and looping the tissue over the loop to form a double looped tissue;

advancing the construct through the first bone tunnel so as the button exits the first bone and pivots and engages a cortical surface of the first bone; and

adjusting the length of the loop to position the double looped tissue within the first bone tunnel.

36. The method of claim 35, further comprising the step of securing the double looped tissue within the second bone tunnel.

37. The method of claim 34, further comprising the steps of attaching a supporting device to the loop and looping the tissue over the supporting device.

38. The method of claim 37, wherein the supporting device is a wedge, a plug, an implant, an anchor or a screw.

39. The method of claim 34, wherein the tissue is soft tissue, graft, tendon, ligament, synthetic material, biological material, bone, or a combination of such materials.

40. The method of claim 34, wherein the construct is formed by the steps of:

providing a suture strand having two ends;

attaching one end to a suture passing device;

passing the suture passing device through the center of the suture strand to form a first eyesplice with one of the two ends;

sliding the button over a non-spliced strand so that the button rests over the spliced strand; and

passing the suture passing device through the center of the first eyesplice to form a second eyesplice with the other of the two ends, wherein the first eyesplice is interconnected to the second eyesplice.

41. The method of claim 40, wherein the suture passing device is a needle.