BONE-TENDON-BONE SUTURE BUTTON CONSTRUCTS AND METHODS OF TISSUE FIXATION

• US 20100324676A1
• Filed: 06/10/2010
• Published: 12/23/2010
• Est. Priority Date: 06/19/2009
• Status: Active Grant

• Current Assignee: Arthrex Incorporated
• Original Assignee: Arthrex Incorporated
• Inventors: Jolly, Jacob A., Albertorio, Ricardo
• Granted Patent: US 8,231,674 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 17/06 Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials puncturing needles A61B17/34; hypodermic needles A61M5/32 ; sewing needles D05B85/00
• 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 2017/0417 T-fasteners
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• 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

A continuous loop and button construct and technique for ligament repair and fixation, including bone to bone, or soft tissue to bone. The continuous loop, which is attached to the button, is formed of a flexible material and is provided with at least one joined region (a bridged, stitched, bonded or knotted region) to form a closed loop figure-8 construct with proximal and distal openings with respect to the fixation device. The figure-8 construct (either bridged, stitched, bonded or knotted) is adapted for attachment to a bone block of a BTB graft, for example, and used for ligament reconstruction.

Claims

1. A bone-tendon-bone graft comprising:

a graft attached to a first bone block and a second bone block; and

a button/loop construct attached to one of the first and second bone blocks, the button/loop construct comprising a button and a continuous flexible loop attached to the button, the flexible loop having a joined region between opposite ends of the loop.

2. The bone-tendon-bone graft of claim 1, wherein the joined region is one of a bridged, stitched, bonded or knotted region.

3. The bone-tendon-bone graft of claim 1, wherein the joined region is a knot.

4. The bone-tendon-bone graft of claim 1, wherein the joined region of the continuous flexible loop forms a closed loop figure-8 configuration with a proximal loop and a distal loop relative to the button.

5. The bone-tendon-bone graft of claim 1, wherein the joined region is a knot, and wherein the button/loop construct forms another knot when attached to one of the first and second bone blocks.

6. The bone-tendon-bone graft of claim 1, further comprising a needle attached to the button/loop construct and passing suture attached to the button.

7. The bone-tendon-bone graft of claim 1, wherein the continuous flexible loop of the button/loop construct is passed through a hole in one of the first and second bone blocks.

8. The bone-tendon-bone graft of claim 1, wherein the flexible loop is one of a suture loop, a nitinol loop, a suture tape loop or a collagen tape loop.

9. An assembled bone-tendon-bone graft for use in surgical procedures, comprising:

a graft attached to a first bone block and a second bone block;

a button/loop construct attached to one of the first and second bone blocks, the button/loop construct comprising a button and a continuous flexible loop attached to the button, the flexible loop having a knotted region that divides the flexible loop into a proximal loop and a distal loop relative to the button;

a needle attached to the distal loop; and

at least one passing suture attached to the button.

10. The assembled bone-tendon-bone graft of claim 9, wherein the flexible loop is formed of a high strength suture material.

11. The assembled bone-tendon-bone graft of claim 9, wherein the button/loop construct is attached to one of the first and second bone blocks by passing the needle and the loop through a hole in one of the first and second bone blocks, and then passing the loop in between loop strands and under the button, and placing the loop over the button and cinching down to form another knot.

12. The assembled bone-tendon-bone graft of claim 9, wherein the needle is a nitinol needle.

13. The assembled bone-tendon-bone graft of claim 9, wherein the needle and the at least one passing suture are pre-assembled to the graft and the button/loop construct prior to surgery.

14. The assembled bone-tendon-bone graft of claim 9, wherein the needle and the at least one passing suture are assembled to the graft and the button/loop construct by medical personnel, during surgery.

15. A method of ACL reconstruction, the method comprising the steps of:

providing a bone-tendon-bone graft comprising a first bone block and a second bone block attached to a graft;

providing a button/loop construct comprising a button;

a continuous flexible loop attached to the button, the flexible loop having a first joined region;

a needle attached to the button; and

a passing suture attached to the flexible loop;

attaching the button/loop construct to one of the first and second bone blocks; and

fixating the bone-tendon-bone graft with the button/loop construct within femur and tibia.

16. The method of claim 15, wherein the step of attaching the button/loop construct to one of the first and second bone blocks further comprises the steps of:

passing the needle with the attached loop through a hole formed within one of the first and second bone blocks;

removing the needle off the loop and passing the loop, between loop strands, and under the button;

placing the loop over the button; and

cinching down to secure the loop to the bone block.

17. The method of claim 15, wherein the step of fixating the bone-tendon-bone graft with the button/loop construct within the femur and the tibia further comprises the steps of:

forming a femoral socket and a tibial socket;

advancing the button with one of the first and second bone blocks through the femoral socket, so that the button exits the femur and pivots and engages a cortical surface of the femur; and

fixating the other of the first and second bone blocks within the tibial socket.