Method and Apparatus for Forming a Self-Locking Adjustable Loop

• US 20110208239A1
• Filed: 05/02/2011
• Published: 08/25/2011
• 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: Denham, Gregory J., Stone, Kevin T.
• Granted Patent: US 8,562,645 B2
• Time in Patent Office: Days
• US Class Current: 606/228
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• 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 17/06004 Means for attaching suture to needle tipping A61B17/06195; connecting wire to other metallic objects B21F15/00
• CPC Class Codes: A61B 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 2017/00858 high friction, non-slip on handles A61B2017/00429
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0477 with pre-tied sutures
• CPC Class Codes: A61B 2017/06019 by means of a suture-receiving lateral eyelet machined in the needle lateral opening for attaching suture to suture anchor A61B2017/0414

Abstract

A self-locking adjustable loop construction and a method of forming the construction are disclosed. The construction can include a flexible member having a first end, a second end and a first portion therebetween. The first end can be passed back through the first portion at a first point such that the first end passes through the first portion from a first side of the flexible member to a second opposite side of the flexible member. The first end can be passed through the first portion at a second point spaced apart from the first point such that the first end passes through the first portion from the second side to the first side so as to place the second end outside of the first portion.

Claims

1. A method of forming a self-locking adjustable loop, comprising:

providing a flexible member having a first end, a second end and a first portion therebetween;

passing the first end of the flexible member back through the first portion at a first point such that the first end passes through the first portion from a first side of the flexible member to a second opposite side of the flexible member; and

passing the first end through the first portion at a second point spaced apart from the first point such that the first end passes through the first portion from the second side to the first side so as to place the second end outside of the first portion.

2. The method according to claim 1, further comprising:

forming the first portion into an accordion configuration having a plurality of leg portions connected to each other;

wherein passing the first end of the flexible member through the first portion at a first point includes passing the first end though a first leg portion of the plurality of leg portions from the first side to the second side of the first portion in a direction other than parallel to a longitudinal axis of the first leg portion; and

wherein passing the first end through the first portion at a second point includes passing the first end through a second leg portion adjacent the first leg portion such that the first end passes through the second leg portion from the second side to the first side of the first portion in a direction other than parallel to a longitudinal axis of the second leg portion so as to place the second end outside of the accordion configuration.

3. The method according to claim 2, wherein forming the first portion into an accordion configuration includes forming the first portion into an accordion configuration having at least six leg portions.

4. The method according to claim 2, further comprising passing the first end through the first and second leg portions in a direction substantially perpendicular to the respective longitudinal axes of the first and second leg portions.

5. The method of claim 2, further comprising forming the first portion into the accordion configuration proximate the second end of the flexible member.

6. The method according to claim 2, further comprising passing the second end of the flexible member through the first and second leg portions in a direction opposite a direction the first end was passed through the first and second leg portions of the first portion to form two adjustable loops.

7. The method according to claim 6, wherein passing the second end of the flexible member through the first and second leg portions includes passing the second end through the second leg portion from the first side to the second side of the first portion and then passing the second end through the first leg portion from the second side to the first side of the first portion.

8. The method according to claim 6, further comprising passing the second end through the first and second leg portions such that a portion of the suture passed through the first and second leg portions by the second end is substantially parallel to a portion of the suture passed through the first and second leg portions by the first end.

9. The method according to claim 2, further comprising:

providing a portable flexible member forming device having first and second members each having a plurality of projections extending therefrom that are configured to intermesh with each other when the forming device is moved from an open position to a closed position;

positioning the first portion of the flexible member between the plurality of projections of the respective first and second members in the open position such that a longitudinal length of the flexible member is substantially perpendicular to a longitudinal length of each of the plurality of projections of the first and second portions;

forming the first portion into the accordion configuration intraoperatively by moving the first and second members to the closed position such the respective pluralities of projections intermesh with each other while the flexible member is positioned therebetween; and

passing the first end of the flexible member through an access port of the forming device in the closed position such that the first end passes through the first and second leg portions.

10. The method according to claim 1, wherein providing a flexible member includes providing a suture having a solid construction formed with a braided structure, a ribbon structure, or a monofilament structure, or combinations thereof.

11. The method according to claim 1, wherein providing a flexible member includes providing braided ribbon construction having a rectangular shape in cross-section.

12. The method according to claim 1, further comprising forming the flexible member into a pleated configuration having a plurality of interconnected layers extending along an entire length of the flexible member, the plurality of interconnected layers configured to be substantially parallel to each other in a compressed state of the flexible member.

13. The method according to claim 1, wherein passing the first end of the flexible member through the first portion at a first point includes passing the first end of the flexible member back through the first portion at a first point such that the first end passes through the first portion from a first side of the flexible member to a second opposite side of the flexible member in a direction other than parallel to a longitudinal axis of the first portion;

and

wherein passing the first end through the first portion at a second point includes passing the first end through the first portion at a second point spaced apart from the first point such that the first end passes through the first portion from the second side to the first side in a direction other than parallel to the longitudinal axis of the first portion.

14. A method of forming a self-locking adjustable loop, comprising:

providing a flexible member having a first end, a second end, and a first portion therebetween;

forming the flexible member into a pleated configuration having a plurality of interconnected layers each extending a length of the flexible member and orientated in a stacked relationship relative to each other;

passing the first end of the flexible member flexible member back through the first portion at a first point such that the first end passes through the first portion from a first side of the flexible member to a second opposite side in a direction other than parallel to a longitudinal axis of the first portion; and

passing the first end through the first portion at a second point such that the first end passes through the first portion from the second side to the first side in a direction other than parallel to the longitudinal axis the of the first portion so as to place the second end outside of the first portion, the second point being spaced longitudinally from the first point.

15. The method according to claim 14, further comprising:

passing the first end through the first portion at a third point from the first side to the second side, and passing the first end through the first portion at a fourth point from the second side to the first side;

wherein the third and fourth points are spaced apart from each other and the first and second points.

16. The method according to claim 15, wherein passing the first end through the first portion at the first, second, third and fourth points includes passing the first end through the first portion at the first, second, third and fourth points in a direction substantially perpendicular to the longitudinal axis of the first portion and through each of the plurality of interconnected layers of the pleated configuration.

17. The method according to claim 15, wherein forming the flexible member into a pleated configuration having a plurality of interconnected layers includes forming the flexible member into a pleated configuration having a plurality of interconnected layers each orientated substantially parallel to each other in a stacked relationship.

18. The method according to claim 15, further comprising:

passing the second end of the flexible member through the first portion so as to follow an opposite direction of a path of a portion of the flexible member passed through the first portion by passing the first end through the first, second, third and fourth points.

19. The method according to claim 18, wherein passing the second end of the flexible member through the first portion includes passing the second end through the fourth point from the first side and following the path to the first point such that the portion of the flexible member passed through the first portion by the first end and a portion of the flexible member passed through the first portion by the second end are contiguous to each other between the first and fourth points.

20. The method according to claim 14, further comprising:

providing a portable flexible member forming arrangement having first and second members each having a plurality of projections extending therefrom that are configured to intermesh with each other when the forming device is moved from an open position to a closed position;

positioning the first portion of the flexible member between the plurality of projections of the respective first and second members in the open position such that a longitudinal length of the flexible member is substantially parallel to a longitudinal length of each of the plurality of projections of the first and second portions;

forming the first portion into the pleated configuration intraoperatively by moving the first and second members to the closed position such that the plurality of projections of the first and second members intermesh with each other while the flexible member is positioned therebetween; and

translating the flexible member relative to the forming arrangement in the closed position to form the pleated configuration along a length of the flexible member.

21. The method according to claim 14, wherein providing a flexible member includes providing a fascia lata allograft or autograft.

22. A self-locking adjustable loop construction, comprising:

a flexible member having a first end, a second end, and a first portion between the first and second ends, said first end being passed through said first portion at a first point from a first side to a second side in a direction other than parallel to a longitudinal axis of the first portion proximate the first point, said first end being passed through said first portion to form a self-locking adjustable loop.

23. The loop construction of claim 22, wherein said first end passes through said first portion at a second point spaced apart from said first point in a direction other than parallel to a longitudinal axis of the first portion proximate the second point.

24. The loop construction of claim 23, wherein the first end passes through the first portion at the second point from the first side to the second side of the first portion.

25. The loop construction of claim 23, wherein the first end passes through the first portion at the second point from the second side to the first side of the first portion.

26. The loop construction of claim 25, wherein the first portion is formed into an accordion configuration having a plurality of leg members interconnected to each other about respective opposite longitudinal ends of the leg members, said first end being passed through a first leg member of the plurality of leg members at the first point from the first side to the second side of the first portion and through a second leg portion of the plurality of leg portions at the second point from the second side to the first side of the first portion, said first end being passed through the first and second leg portions in a direction other than parallel to a longitudinal axis of each of the first and second leg portions.

27. The loop construction of claim 26, wherein each of said leg portions are orientated in the accordion configuration at an acute angle relative to each other.

28. The loop construction of claim 26, wherein the self-locking adjustable loop is formed by the flexible member on a first side of the accordion configuration and the first end passes through the first and second legs of the accordion configuration so as to exit the accordion configuration on a second side thereof opposite the first side of the accordion configuration.

29. The loop construction of claim 26, further comprising said second end being passed through said first and second leg members along a direction opposite of a direction of a portion of the flexible member passed through the first and second leg members by the first end to form two self-locking adjustable loops.

30. The loop construction of claim 29, further comprising said second end being passed through the second point of the second leg member and the first point of the first leg member such that a portion of the suture passed through the first and second leg members by the second end is parallel to the portion of the suture passed through the first and second leg members by the first end.

31. The loop construction of claim 22, wherein the flexible member further comprises a pleated configuration extending between the first and second ends thereof, the pleated configuration including a plurality of layers interconnected to each other and orientated in a stacked relationship relative to each other.

32. The loop construction of claim 22, wherein the flexible member includes a solid construction formed from a braided structure, a ribbon structure or monofilament structure, or combinations thereof.

33. The loop construction of claim 22, wherein said first end passes through said first portion at a first point more than one time.

34. A self-locking adjustable loop construction, comprising:

a flexible member having a first end, a second end, and first and second portions between the first and second ends, said second portion being passed through said first portion at a first point from a first side to a second side in a direction other than parallel to a longitudinal axis of the first portion to form a self-locking adjustable loop.