Method of securing a tendon graft with an interference fixation screw

• US 5,282,802 A
• Filed: 08/19/1991
• Issued: 02/01/1994
• Est. Priority Date: 02/07/1990
• Status: Expired due to Fees

• Current Assignee: Thomas H. Mahony III
• Original Assignee: Thomas H. Mahony III
• Inventors: Mahony, Thomas H. III
• Primary Examiner(s): Hafer, Robert A.
• Assistant Examiner(s): RIMELL, SAMUEL G
• Application Number:
  US07/746,965
• Time in Patent Office: 897 Days
• Field of Search: 606/60, 606/61, 606/62, 606/65, 606/72, 606/73, 606/76, 606/77, 606/104, 623/13, 623/16
• US Class Current: 606/309
• CPC Class Codes: A61B 17/8625 Shanks, i.e. parts contacting bone tissue
• CPC Class Codes: A61B 2017/00004 (bio)absorbable, (bio)resorbable, resorptive for implantable prostheses A61F2210/0004
• 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 2002/0858 Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
• 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
• CPC Class Codes: A61F 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: F16B 23/00 Specially shaped nuts or heads of bolts or screws for rotations by a tool detachable ornamental heads for screws A47G3/00; screwdrivers, wrenches B25B
• CPC Class Codes: F16B 33/006 Non-metallic fasteners using screw-thread
• CPC Class Codes: Y10S 606/908 Bioabsorbable material

Abstract

A method of securing a tendon graft in a ligament tunnel is described. The tendon graft is used to replace a ligament and has a length of tendon section with bone grafts attached to the tendon at each end. The method includes the step of providing an interference fixation screws made of material that is soft compared to bone. The fixation screws are cooled to a temperature to make them sufficiently rigid to track in a straight line when they are tightened in the ligament tunnel. Each bone graft is then secured in place in the ligament tunnel by inserting a fixation screw between each bone graft and the bone surrounding the ligament tunnel and tightening it therebetween. After each fixation screw is tightened, it has a portion extending beyond a respective entrance to the ligament tunnel which is then trimmed.

Claims

1. A method of affixing in place in a ligament tunnel a tendon graft used to replace a ligament, the tendon graft comprising a section of tendon having a bone graft at each end, comprising the steps of:

(a) providing an interference fixation screw made of material that is soft compared to bone;

(b) securing each bone graft in the ligament tunnel by tightening one of the fixation screws between each bone graft and the bone surrounding the ligament tunnel wherein the fixation screw has a portion extending beyond an entrance to the ligament tunnel after it has been tightened; and

(c) trimming the portion of the fixation screw that extends beyond the entrance to the ligament tunnel.

2. The method of claim 1 and further including the step of cooling each fixation screw before it is inserted in the ligament tunnel to a temperature to make it sufficiently rigid so that it tracks in a straight line as it is tightened in place.

3. The method of claim 2 wherein the fixation screw is made from ultra-high molecular weight polyethylene and the step of cooling it comprises cooling it to approximately forty degrees Fahrenheit.

4. A method of implanting an interference fixation screw made of ultra high molecular weight polyethylene in a ligament tunnel in bone comprising the steps of:

(a) cooling the fixation screw to about forty degrees Fahrenheit to make it sufficiently rigid so that is will track in a straight line as it is tightened; and

(b) inserting the fixation into the ligament tunnel and tightening it.

5. A method of implanting an interference fixation screw made of material that is soft compared to bone in a ligament tunnel in bone comprising the steps of:

(a) cooling the fixation screw to a temperature that makes it sufficiently rigid so that it will track in a straight line as it is tightened;

(b) inserting the fixation screw into the ligament tunnel and tightening it to where it is tight and so that it has a portion extending beyond an entrance to the ligament tunnel; and

(c) trimming the portion of the fixation screw that extends beyond the entrance of the ligament tunnel.

6. A method of affixing in place in a ligament tunnel a tendon graft used to replace a ligament, the tendon graft comprising a section of tendon having a bone graft at each end, comprising the steps of:

(a) providing an interference fixation screw made of material that is soft compared to bone;

(b) cooling each fixation screw before it is inserted into the ligament tunnel to a temperature that makes it sufficiently rigid to track in a straight line as it is tightened in the ligament tunnel;

(c) securing each bone graft in the ligament tunnel by tightening one of the fixation screws between each bone graft and the bone surrounding the ligament tunnel wherein the fixation screw has a portion extending beyond an entrance to the ligament tunnel after it has been tightened; and

(d) trimming the portion of the fixation screw that extends beyond the entrance to the ligament tunnel.

7. The method of claim 6 wherein the fixation screw is made from ultra-high molecular weight polyethylene and the step of cooling it comprises cooling it to approximately forty degrees Fahrenheit.

8. A method of affixing a tendon graft used to replace a ligament in place in tunnels formed in bones of a joint, the tendon graft comprising a length of tendon having bone grafts at each end, each bone of the joint having a ligament tunnel formed therein, comprising the steps of:

(a) providing an interference fixation screw made of material that is soft compared to bone for each bone graft of the tendon graft to be secured in one of the ligament tunnels;

(b) placing the tendon graft in the ligament tunnels with one of the bone grafts in each of the ligament tunnels;

(c) securing each of the bone grafts in their respective ligament tunnels with one of the fixation screws by tightening each fixation screw between the bone graft it is securing in place and the bone surrounding the ligament tunnel in which the bone graft was placed wherein each fixation screw has a portion extending beyond an entrance of its respective ligament tunnel after it has been tightened; and

(d) trimming the portion of each fixation screw that extends beyond the entrance to its respective ligament tunnel.

9. The method of claim 8 and further including the step of cooling each fixation screw prior to inserting it into a ligament tunnel to a temperature where it is sufficiently rigid so that it will track in a straight line when it is tightened.

10. The method of claim 9 wherein the step of providing the fixation screws comprises providing fixation screws made of ultra-high molecular weight polyethylene and the step of cooling the fixation screws comprises cooling them to approximately forty degrees Fahrenheit.

11. A method of affixing a tendon graft used to replace the anterior cruciate ligament in a knee in place in tunnels formed in the femur and the tibia of the knee, the tendon graft comprising a length of tendon having bone grafts at each end, comprising the steps of:

(a) providing an interference fixation screw made of material that is soft compared to bone for each bone graft of the tendon graft to be secured the ligament tunnels in the femur and the tibia;

(b) placing the tendon graft in the ligament tunnels with one of the bone grafts in each of the ligament tunnels in the femur and the tibia;

(c) securing each of the bone grafts in their respective ligament tunnels with one of the fixation screws by tightening each fixation screw between the bone graft it is securing in place and the bone surrounding the ligament tunnel in which the bone graft was placed wherein each fixation screw has a portion extending beyond an entrance of its respective ligament tunnel after it has been tightened; and

(d) trimming the portion of each fixation screw that extends beyond the entrance to its respective ligament tunnel.

12. The method of claim 11 and further including the step of cooling each fixation screw prior to inserting it into a ligament tunnel to a temperature where it is sufficiently rigid so that it will track in a straight line when it is tightened.

13. The method of claim 12 wherein the step of providing the fixation screws comprises providing fixation screws made of ultra-high molecular weight polyethylene and the step of cooling the fixation screws comprises cooling them to approximately forty degrees Fahrenheit.