Prosthetic Ligament System for Knee Joint

• US 20100292792A1
• Filed: 05/27/2010
• Published: 11/18/2010
• Est. Priority Date: 09/29/2006
• Status: Active Grant

• Current Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Biomet Sports Medicine LLC (Zimmer Biomet Holdings, Inc.)
• Inventors: Metzger, Robert, Stone, Kevin T.
• Granted Patent: US 8,801,783 B2
• Time in Patent Office: Days
• US Class Current: 623/13.14
• 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 2017/00336 with a protective sleeve, e.g. retractable or slidable
• CPC Class Codes: A61B 2017/00858 high friction, non-slip on handles A61B2017/00429
• 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 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0435 the barbs being separate elements mechanically linked to the anchor, e.g. by pivots
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/06185 hollow or tubular hollow suture needles A61B2017/061
• 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 2002/0823 Modular anchors comprising a plurality of separate parts
• 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 2002/0835 with deformation of anchor parts, e.g. expansion of dowel by set screw
• 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 2002/0882 Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
• CPC Class Codes: A61F 2210/0004 bioabsorbable
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0095 : Saddle-shaped
• CPC Class Codes: A61F 2250/0007 : for adjusting length
• CPC Class Codes: A61F 2250/0012 : for adjusting elasticity, flexibility, spring rate or mechanical tension
• CPC Class Codes: A61F 2250/0018 : differing in elasticity, stiffness or compressibility
• CPC Class Codes: A61F 2250/0029 : differing in bending or flexure capacity
• CPC Class Codes: A61L 27/04 : Metals or alloys
• CPC Class Codes: A61L 27/10 : Ceramics or glasses
• CPC Class Codes: A61L 27/22 : Polypeptides or derivatives thereof , e.g. degradation products
• CPC Class Codes: D04C 1/06 : Braid or lace serving particular purposes

Abstract

A system for a knee joint includes a first fastener and a second fastener operable to be connected to the tibia and femur, respectively. Furthermore, the system includes a flexible prosthetic ligament member. The ligament member is operably coupled to the first and second fasteners to support the tibia and the femur for relative movement. The ligament member extends from a first end to a second end, and includes an outer wall that defines a hollow longitudinal passage portion. The first end extends into and out of the longitudinal passage portion through the outer wall to define a first adjustable loop, and the second end extends into and out of the longitudinal passage portion through the outer wall to define a second adjustable loop.

Claims

1. A system for a knee joint with a tibia and a femur, the system comprising:

a first fastener operable to be connected to the tibia;

a second fastener operable to be connected to the femur; and

a prosthetic ligament member that is flexible, the ligament member operably coupled to both the first and second fasteners to support the tibia and the femur for relative movement, the ligament member extending from a first end to a second end, the ligament member including an outer wall that defines a hollow longitudinal passage portion, the first end extending into the longitudinal passage portion through the outer wall and out of the longitudinal passage portion through the outer wall to define a first adjustable loop, the second end extending into the longitudinal passage portion through the outer wall and out of the longitudinal passage portion through the outer wall to define a second adjustable loop, at least one of the first and second adjustable loops receiving at least one of the first and second fasteners.

2. The system of claim 1, wherein both the first and second adjustable loops are selectively adjustable to adjust a tension in the ligament member.

3. The system of claim 1, wherein the first end also includes a first free end, wherein the second end also includes a second free end, the first free end pullable to reduce a size of the first adjustable loop, the second free end pullable to reduce a size of the second adjustable loop.

4. The system of claim 3, wherein the first and second free ends are cuttable.

5. The system of claim 1, wherein the ligament member includes a plurality of apertures extending through the outer wall, wherein the first end enters the longitudinal passage portion through the same aperture that the second end exits the longitudinal passage portion, and wherein the second end enters the longitudinal passage portion through the same aperture that the first end exits the longitudinal passage portion.

6. The system of claim 1, wherein the ligament member includes a plurality of apertures extending through the outer wall, wherein the first end enters the longitudinal passage portion through a different aperture from which the second end exits the longitudinal passage portion, and wherein the second end enters the longitudinal passage portion through a different aperture from which the first end exits the longitudinal passage portion.

7. The system of claim 1, wherein the ligament member includes at least one of polyethylene, polyester, polyetheretherketone (PEEK), poly-para-phenylene terephthalamide, collagen, polyglycolic acid (PGA), polylactic acid (PLA), polyurethane urea, and silk.

8. The system of claim 1, wherein the ligament member includes a plurality of braided fibers.

9. The system of claim 1, wherein at least a portion of the ligament member is resorbable.

10. The system of claim 1, wherein at least a portion of the ligament member is resilient.

11. The system of claim 1, wherein the first and second adjustable loops are limited from enlargement due substantially only to friction between an interior surface of the longitudinal passage portion, the first end of the ligament member, and the second end of the ligament member.

12. The system of claim 1, wherein at least one of the first and second fasteners includes a base with a hollow interior space, the at least one of the first and second fasteners also including an attachment portion that is disposed within the hollow interior space, the ligament member received in the hollow interior space and extending about the attachment portion to operably couple to the attachment portion.

13. The system of claim 12, wherein the base includes an open end that receives the ligament member, and wherein the open end includes a fillet.

14. The system of claim 12, wherein the base includes a thread on an outer surface thereof.

15. The system of claim 14, wherein the thread helically winds about a longitudinal axis, wherein the attachment portion is removably attached to the base, and wherein the attachment portion is keyed to the base against rotation about the longitudinal axis.

16. The system of claim 1, wherein at least one of the first and second fasteners includes a base and an attachment portion, and wherein the ligament member is operable to be received in a tunnel formed in one of the tibia and the femur, the ligament member extending about the attachment portion to operably couple to the attachment portion.

17. The system of claim 16, wherein the attachment portion extends continuously about the ligament member to thereby encircle the ligament member and inhibit movement of the ligament member outside the attachment portion.

18. The system of claim 16, wherein the attachment portion includes an opening allowing the ligament member to selectively move in and out of the attachment portion.

19. The system of claim 1, wherein at least one of the first and second fasteners is chosen from a group consisting of:

a pin operable to be embedded within and attached to one of the femur and the tibia to extend transversely across a tunnel formed within the one of the femur and the tibia, wherein the ligament member is operable to be received in the tunnel and extend about the pin to operably couple to the pin;

a first base and a first attachment portion, wherein the first base has a first position in which the first base is operable to move within a tunnel formed in one of the femur and the tibia, wherein the first base has a second position in which the first base is operable to seat against the one of the femur and the tibia outside the tunnel, and wherein the ligament member is operable to be received in the tunnel and extend about the first attachment portion to operably couple to the first attachment portion, wherein the first base is rigid, wherein, in the first position, an axis of the first base is substantially aligned with a longitudinal axis of the tunnel, and wherein, in the second position, the axis of the first base is transverse to the longitudinal axis of the tunnel; and

a second base and a second attachment portion, wherein the second base has a second position in which the second base is operable to move within a tunnel formed in one of the femur and the tibia, wherein the second base has a second position in which the second base is operable to seat against the one of the femur and the tibia outside the tunnel, and wherein the ligament member is operable to be received in the tunnel and extend about the second attachment portion to operably couple to the second attachment portion, wherein the second base is moveably attached to the second attachment portion such that the one of the first and second fastener is selectively collapsible and expandable, wherein, in the first position, the one of the first and second fastener is collapsed to allow the second base and the second attachment portion to move within the tunnel, and wherein, in the second position, the one of the first and second fastener is extended to seat outside the tunnel.

20. The system of claim 1, further comprising a biasing member that applies a biasing force to the ligament member to tension the ligament member.

21. A method of repairing a knee joint comprising:

operably coupling a first fastener to a tibia of a patient;

operably coupling a second fastener to a femur of the patient; and

intraoperatively adjusting a tension of a prosthetic ligament member that is flexible and that is operatively coupled to both the first and second fasteners, the ligament member having a first end, a second end, and an outer wall that defines a hollow longitudinal passage portion, the first end extending into the longitudinal passage portion through the outer wall and out of the longitudinal passage portion through the outer wall to define a first adjustable loop and a first free end, the second end extending into the longitudinal passage portion through the outer wall and out of the longitudinal passage portion through the outer wall to define a second adjustable loop and a second free end.

22. The method of claim 21, wherein adjusting the tension includes pulling on at least one of the first and second free ends to increase the tension in the ligament member.

23. A system for a knee joint with a tibia and a femur, the system comprising:

a first fastener connected to the tibia;

a second fastener connected to the femur; and

a prosthetic ligament member that is flexible and that is operably coupled to both the first and second fasteners to support the tibia and the femur for relative movement, the ligament member extending from a first end to a second end, the ligament member including an outer wall that defines a hollow longitudinal passage portion, the ligament member also including at least one first aperture extending through the outer wall and disposed between the first and second ends, the ligament member further including at least one second aperture extending through the outer wall and disposed between the first and second ends, the first end extending through the at least one first aperture and the at least one second aperture and the longitudinal passage portion to define a first adjustable loop and a first free end, the second end extending through the at least one first aperture and the at least one second aperture and the longitudinal passage portion to define a second adjustable loop and a second free end, at least one of the first and second adjustable loops receiving at least one of the first and second fasteners, the first and second free ends pullable to increase a tension in the ligament member, the ligament member including a plurality of braided fibers made from at least one of polyethylene, polyester, polyetheretherketone (PEEK), poly-para-phenylene terephthalamide, collagen, polyglycolic acid (PGA), polylactic acid (PLA), polyurethane urea, and silk.