GRAFT PULLEY AND METHODS OF USE

• US 20110118837A1
• Filed: 11/16/2009
• Published: 05/19/2011
• Est. Priority Date: 11/16/2009
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Wolf, Alan W., Delli-Santi, George
• Granted Patent: US 8,449,612 B2
• Time in Patent Office: Days
• US Class Current: 623/13.13
• 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 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• 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 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61F 2/0805 Implements for inserting tendons or ligaments
• 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 placement assembly used for positioning and holding a ligament graft within a selected bone tunnel. The assembly includes a graft pulley, a surgical suture, and a graft pulley placement instrument. The graft pulley includes a pulley portion and a bone anchoring portion. The pulley portion is adapted to receive the surgical suture and for surgical suture to be drawn through it, to act as a pulley. The bone anchoring portion comprises at least one flexible wing that is adapted to selectively fix the graft pulley within a bone tunnel. At least one wing is adapted to flex during insertion into a bone tunnel and then resist flex and thereby resist movement back out of the tunnel and hence wedge itself within the tunnel. The graft instrument may be selectively attached to the graft pulley and includes a handle and elongate body, adapted to insert the graft pulley into the selected bone tunnel. Once the graft pulley is in place, the placement instrument may then be detached and withdrawn leaving the graft pulley firmly fixed within the bone tunnel and can then be used to position a ligament graft.

Claims

1. A placement assembly for positioning a ligament graft within a selected bone tunnel comprising:

a graft pulley, having a pulley portion and a bone anchoring portion;

the pulley portion having an aperture sized to receive a surgical suture;

the bone anchoring portion having at least one flexible wing adapted to selectively fix the graft pulley within a bone tunnel; and

a graft pulley placement instrument having an elongate body and a handle;

the elongate body adapted to insert the graft pulley into the selected bone tunnel.

2. The placement assembly of claim 1 wherein at least one wing is adapted to flex in a second direction while inserting the graft pulley in a first direction, where the first direction is substantially opposite the second direction.

3. The placement assembly of claim 2 wherein at least one wing is adapted to resist flex when the graft pulley is pulled in the second direction via the surgical suture.

4. The placement assembly of claim 1 wherein the graft pulley is adapted to allow insertion in a first direction and resist movement along a second direction, where the first direction is substantially opposite the second direction.

5. The placement assembly of claim 1 wherein the graft pulley placement instrument handle comprises a suture securing portion, adapted to manage the surgical suture.

6. The placement assembly of claim 1 wherein the suture comprises a stop button adapted to prevent the suture from traveling through the anchor pulley aperture.

7. The placement assembly of claim 1 wherein a needle is removably attached to the suture for attaching the suture to a ligament graft.

9. The placement assembly of claim 1 wherein the graft pulley includes an attachment portion and the placement instrument includes a connecting portion, adapted to removably connect with the pulley attachment portion.

10. The graft pulley of claim 9 further comprising an attachment portion adapted to removably connect with a graft pulley placement instrument.

11. The graft pulley of claim 9 wherein at least one wing is adapted to flex in a second direction, while inserting the graft pulley in a first direction, and the first direction is substantially opposite the second direction.

12. The graft pulley of claim 11 wherein at least one wing is adapted to resist flex when the graft pulley is pulled in the second direction.

13. The graft pulley of claim 9 wherein the graft pulley is adapted to allow insertion in a first direction and resist movement along a second direction, and the first direction is substantially opposite the second direction.

14. The graft pulley of claim 9 wherein at least one wing is substantially circular in shape.

15. The graft pulley of claim 9 wherein the pulley has a longitudinal axis and wherein at least one wing is formed substantially perpendicular to said longitudinal axis.

16. The graft pulley of claim 9 wherein the pulley has a longitudinal axis and wherein at least one wing is formed at an angle to the longitudinal axis.

17. The graft pulley of claim 9 wherein the pulley has a longitudinal axis and wherein at least one wing comprises a hook radiating from said pulley longitudinal axis.

18. The graft pulley of claim 9 wherein the pulley has a longitudinal axis and wherein the anchoring portion comprises at least one flexible fin radiating from said pulley longitudinal axis.

19. The graft pulley of claim 9 wherein the at least one wing has a cross sectional dimension and wherein the bone tunnel has a diameter that is smaller than the wing cross sectional dimension.

20. The graft pulley of claim 9 wherein the graft pulley fixes within the bone tunnel without trauma to the bone tunnel.

21. The graft pulley of claim 9 wherein the pulley portion comprises a low friction material.

22. The graft pulley of claim 21 wherein the pulley portion comprises a polyolefin.

23. The graft pulley of claim 9 wherein a portion of the graft pulley comprises a radiopaque material.

24. The graft pulley of claim 9 wherein the at least one wing comprises a first wing having a first cross sectional dimension and a second wing with a second cross sectional dimension.

9-1. A graft pulley for positioning a ligament graft within a selected bone tunnel comprising:

a pulley portion having an aperture, sized to receive a surgical suture; and

a bone anchoring portion having at least one flexible wing adapted to selectively fix the graft pulley within a bone tunnel.

25. A method for placing a graft pulley in a bone tunnel comprising:

drilling a bone tunnel;

inserting a graft pulley into the bone tunnel in a first direction, the graft pulley comprising a pulley portion and a bone anchoring portion;

the pulley portion having an aperture adapted to receive a surgical suture;

the bone anchoring portion having at least one flexible wing adapted to fix the graft anchor within a bone tunnel;

wherein inserting the graft pulley into the bone tunnel in the first direction includes flexing the wings in a second direction; and

following the inserting step, pulling the graft pulley in the second direction to fix the graft pulley within the bone tunnel.

26. The method of claim 25 further comprising:

removing the placement instrument;

attaching a ligament graft to the surgical suture;

drawing the suture through the anchor pulley aperture to position the ligament graft to a desired position within the bone tunnel; and

affixing the ligament within the bone tunnel.

27. A method for placing a graft pulley in a bone tunnel comprising:

drilling a bone tunnel;

looping a surgical suture though a ligament;

inserting a graft pulley into the bone tunnel in a first direction using a pulley placement instrument, the graft pulley comprising a pulley portion and a bone anchoring portion;

the pulley portion having an aperture adapted to receive the surgical suture;

the bone anchoring portion having at least one flexible wing adapted to fix the graft anchor within a bone tunnel;

wherein inserting the graft pulley into the bone tunnel in the first direction includes flexing the wings in a second direction; and

following the inserting step, pulling the graft pulley in the second direction to fix the graft pulley within the bone tunnel.

28. The method of claim 27 further comprising:

removing the pulley placement instrument;

drawing the suture through the anchor pulley aperture to position the ligament graft to a desired position within the bone tunnel;

drawing one suture end to withdraw suture from bone tunnel; and

affixing ligament to bone tunnel.