Anterior cruciate ligament repair method

• US 5,702,422 A
• Filed: 12/06/1995
• Issued: 12/30/1997
• Est. Priority Date: 12/06/1995
• Status: Expired due to Fees

• Current Assignee: Kevin R. Stone
• Original Assignee: Kevin R. Stone
• Inventors: Stone, Kevin R.
• Primary Examiner(s): LEWIS, WILLIAM W
• Application Number:
  US08/567,895
• Time in Patent Office: 755 Days
• Field of Search: 606/1, 606/72, 606/73, 606/75, 606/76, 606/232, 606/80, 606/86, 606/88, 606/102, 606/96, 606/66, 128/897, 128/898, 623/13
• US Class Current: 606/232
• 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 17/1146 of tendons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2002/0888 Anchor in or on a blind hole or on the bone surface without formation of a tunnel
• CPC Class Codes: Y10S 606/916 Tool for installing or removing orthopedic fastener

Abstract

The invention provides a method of repairing tears or ruptures in an anterior cruciate ligament of the human knee, by reattaching the ligament to its anatomic insertion site on the intercondylar notch of the femur using a suture anchor, with healing at the insertion site being enhanced by formation of a cancellous bleeding bed.

Claims

1. A method of repairing a rupture in an anterior cruciate ligament of a knee, said ruptured ligament having a tibial portion extending from an insertion site on the tibia of said knee to a tibial distal tip, and said ligament further having a femoral portion extending from an insertion site on the femoral intercondylar notch of said knee to a femoral distal tip, comprising steps of:

A. establishing an access portal in said knee to expose said ligament and said notch,

B. creating a bleeding bed within cancellous bone located in a portion of said notch corresponding substantially to said insertion site thereon,

C. passing one or more sutures through a region of said tibial portion near said tibial distal tip,

D. affixing a suture anchor to said notch at said bleeding bed, and

E. attaching said sutures to said suture anchor, wherein said tibial distal tip is operatively coupled to said insertion site of said notch.

2. The method according to claim 1 including the further step of:

prior to step B, performing anterior notchplasty at said notch to establish increased access to said insertion site on said notch.

3. The method according to claim 1 including the further step of:

prior to step C, establishing one or more holes in said tibial portion near said tibial distal tip to permit passage of one or more sutures therethrough.

4. The method according to claim 1, wherein said steps C, D, and E are performed in the sequential order E, D, C.

5. The method according to claim 4 wherein said suture anchor affixing step D includes the substeps of:

i. drilling a hole in said bleeding bed,

ii. providing said anchor and an associated cannulated driver, said anchor having a self-tapping leading end and having a trailing end, said anchor being removably coupled to said driver,

iii. inserting said leading end of said anchor in said hole,

iv. rotating said driver and coupled anchor, whereby said leading end is driven into said hole, thereby affixing said anchor to said notch, and

v. decoupling said driver from said anchor and removing said driver.

6. The method according to claim 4 wherein said suture anchor attaching step D includes the substeps of:

i. providing said anchor and an associated cannulated driver, said anchor having a self-drilling, self-tapping leading end and having a trailing end, said anchor further being removably coupled to said driver,

ii. biasing said leading end against a point on said notch substantially at said insertion site,

iii. rotating said driver and coupled anchor, whereby said leading end drills into said notch, thereby affixing said anchor to said notch, and

iv. decoupling said driver from said anchor and removing said driver.

7. The method according to claim 1, wherein said steps C, D, and E are performed in the sequential order D, E, C.

8. The method according to claim 7 wherein said suture anchor affixing step D includes the substeps of:

i. drilling a hole in said bleeding bed,

ii. providing said anchor and an associated cannulated driver, said anchor having a self-tapping leading end and having a trailing end, said anchor being removably coupled to said driver,

iii. inserting said leading end of said anchor in said hole,

iv. rotating said driver and coupled anchor, whereby said leading end is driven into said hole, thereby affixing said anchor to said notch, and

v. decoupling said driver from said anchor and removing said driver.

9. The method according to claim 7 wherein said suture anchor attaching step D includes the substeps of:

i. providing said anchor and an associated cannulated driver, said anchor having a self-drilling, self-tapping leading end and having a trailing end, said anchor further being removably coupled to said driver,

ii. biasing said leading end against a point on said notch substantially at said insertion site,

iii. rotating said driver and coupled anchor, whereby said leading end drills into said notch, thereby affixing said anchor to said notch, and

iv. decoupling said driver from said anchor and removing said driver.

10. The method according to claim 1, wherein said steps C, D, and E are performed in the sequential order C, D, E.

11. The method according to claim 10 wherein said suture anchor affixing step D includes the substeps of:

i. drilling a hole in said bleeding bed,

ii. providing said anchor and an associated cannulated driver, said anchor having a self-tapping leading end and having a trailing end, said anchor being removably coupled to said driver,

iii. inserting said leading end of said anchor in said hole,

iv. rotating said driver and coupled anchor, whereby said leading end is driven into said hole, thereby affixing said anchor to said notch, and

v. decoupling said driver from said anchor and removing said driver.

12. The method according to claim 10 wherein said suture anchor attaching step D includes the substeps of:

i. providing said anchor and an associated cannulated driver, said anchor having a self-drilling, self-tapping leading end and having a trailing end, said anchor further being removably coupled to said driver,

ii. biasing said leading end against a point on said notch substantially at said insertion site,

iii. rotating said driver and coupled anchor, whereby said leading end drills into said notch, thereby affixing said anchor to said notch, and

iv. decoupling said driver from said anchor and removing said driver.

13. The method according to claim 1, wherein said steps C, D, and E are performed in the sequential order C, E, D.

14. The method according to claim 13 wherein said suture anchor affixing step D includes the substeps of:

i. drilling a hole in said bleeding bed,

ii. providing said anchor and an associated cannulated driver, said anchor having a self-tapping leading end and having a trailing end, said anchor being removably coupled to said driver,

iii. inserting said leading end of said anchor in said hole,

iv. rotating said driver and coupled anchor, whereby said leading end is driven into said hole, thereby affixing said anchor to said notch, and

v. decoupling said driver from said anchor and removing said driver.

15. The method according to claim 14 wherein said suture anchor attaching step D includes the substeps of:

i. providing said anchor and an associated cannulated driver, said anchor having a self-drilling, self-tapping leading end and having a trailing end, said anchor further being removably coupled to said driver,

ii. biasing said leading end against a point on said notch substantially at said insertion site,

iii. rotating said driver and coupled anchor, whereby said leading end drills into said notch, thereby affixing said anchor to said notch, and

iv. decoupling said driver from said anchor and removing said driver.