Drill guide for creating a tunnel in bone for fixating soft tissue to the bone and kit and method for fixating soft tissue to bone

• US 6,059,789 A
• Filed: 03/19/1999
• Issued: 05/09/2000
• Est. Priority Date: 06/22/1998
• Status: Expired due to Term

• Current Assignee: Integra Lifesciences Corporation (Integra LifeSciences Holdings Corporation)
• Original Assignee: Xomed Surgical Products, Inc. (Medtronic Plc)
• Inventors: Williamson, Guy K., Dinger, Fred B.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Shai, Daphna
• Application Number:
  US09/272,332
• Time in Patent Office: 417 Days
• Field of Search: 606/79, 606/80, 606/86, 606/96, 606/98
• US Class Current: 606/96
• 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 17/1796 for holes for sutures or flexible wires

Abstract

A drill guide for positioning on a surface of a bone includes a projection for penetrating the bone, an abutment for engaging the surface of the bone to ensure penetration of the bone by the projection to a predetermined depth, less than the length of the projection, and a pair of guide passages having central longitudinal axes, respectively, converging at a predetermined point in the bone when the projection penetrates the bone to the predetermined depth. A kit for fixating soft tissue to bone includes a drill guide, a drill bit, a suture and a suture passer. The drill bit is insertable in a pair of guide passages of the drill guide to cut first and second passages converging in the bone to define a continuous tunnel. The suture passer has a portion for being introduced in the tunnel to engage the suture externally of the bone such that the suture is drawn through the tunnel when the suture passer is withdrawn therefrom. A method of fixating soft tissue to bone includes the steps of penetrating a bone with a projection of a drill guide, engaging the bone with an abutment of the drill guide to ensure penetration of the bone by the projection to a predetermined depth, introducing a drill bit through a pair of guide passages of the drill guide and into the bone to form first and second passages converging in the bone to define a continuous tunnel, introducing a suture passer into the tunnel such that a suture engaging member of the suture passer protrudes externally of the bone, engaging a suture with the suture engaging member, withdrawing the suture passer from the tunnel to draw the suture through the tunnel and using the suture to fixate soft tissue to the bone.

Claims

1. A drill guide for use in forming converging passages in bone cooperating to form a continuous tunnel in the bone comprising

a guide member for positioning upon a surface of a bone and including a support plate, an abutment member protruding below said support plate and forming a contact point for abutment with the surface of the bone, a projection protruding below said support plate and terminating at a tip disposed a predetermined distance below said support plate for penetrating the bone, said contact point being disposed a predetermined distance below said support plate that is less than said predetermined distance that said tip is disposed below said support plate such that said projection penetrates the bone to a predetermined depth when said contact point is in abutment with the surface of the bone;

and

a pair of guide passages extending angularly, entirely through said guide member for receiving and guiding a drill bit, said guide passages having central longitudinal axes, respectively, converging at a predetermined point within the bone when said projection penetrates the bone to said predetermined depth such that a drill bit guided into the bone by said guide passage forms converging passages in the bone cooperating to form a continuous tunnel in the bone.

2. A drill guide as recited in claim 1 wherein said support plate includes a planar upper surface, a planar lower surface and a uniform thickness between said upper and lower surfaces, and said abutment member protrudes downwardly from said lower surface.

3. A drill guide as recited in claim 2 wherein said guide member includes a plurality of projections extending perpendicularly from said lower surface, each of said projections terminating at a tip disposed said predetermined distance below said lower surface for penetrating the bone.

4. A drill guide as recited in claim 3 wherein said abutment member forms a pair of contact points disposed said predetermined distance below said lower surface that is less than said predetermined distance that said tips are disposed below said lower surface, and said guide passages have exit openings, respectively, disposed on said abutment member adjacent said contact points, respectively.

5. A drill guide as recited in claim 4 wherein said central longitudinal axes of said guide passages are disposed at an angle of 40 to said upper surface.

6. A drill guide as recited in claim 5 wherein said support plate includes a central axis and said plurality of projections includes three projections arranged in a triangular pattern around said central axis of said support plate.

7. A drill guide as recited in claim 6 wherein said guide member further includes a ridge member protruding upwardly from said upper surface and said guide passages have entry openings, respectively, on said ridge member, said ridge member forming a stop ensuring insertion of a drill bit in said guide passages, via said entry openings, to a predetermined depth.

8. A drill guide as recited in claim 7 wherein said abutment member includes a bottom wall extending between said contact points and configured to define a space between said bottom wall and the surface of the bone when said contact points are in abutment with the surface of the bone.

9. A drill guide as recited in claim 8 and further including a handle extending upwardly from said ridge member in alignment with said central axis of said support plate.

10. A kit for fixating soft tissue to bone comprising

a drill guide including a guide member for positioning upon a surface of a bone and comprising a support plate, an abutment member terminating below said support plate at a contact point forming an abutment with the surface of the bone when said guide member is positioned thereupon, a projection terminating below said support plate at a tip disposed a predetermined distance below said support plate for penetrating the bone and a pair of guide passages extending angularly, entirely through said guide member, said contact point being disposed a predetermined distance below said support plate that is less than said predetermined distance that said tip is disposed below said support plate such that said projection penetrates the bone to a predetermined depth when said contact point is in abutment with the surface of the bone, said guide passages having central longitudinal axes, respectively, converging at a predetermined point within the bone when said projection penetrates the bone to said predetermined depth;

a drill bit including a cutting member for being introduced in said guide passages and for being moved forwardly in said guide passages into the bone to cut converging passages, respectively, in the bone forming a continuous tunnel in the bone having access openings, respectively, on the surface of the bone;

a suture for being passed through the tunnel and comprising a length of filamentous suture material terminating at opposing ends; and

a suture passer for passing said suture through the tunnel, said suture passer having a portion for being introduced in the tunnel through one of the access openings and a suture engaging member for protruding externally from the tunnel through the other of the access openings for engaging said suture externally of the bone such that said suture is passed through the tunnel when said suture passer is withdrawn from the tunnel through the one access opening whereby said suture extends entirely through the tunnel with said opposing ends extending through the access openings, respectively, for suturing soft tissue to the bone.

11. A kit for fixating soft tissue to bone as recited in claim 10 and further including a stop on said drill bit engageable with said guide member to ensure movement of said cutting member into the bone to a maximum predetermined depth.

12. A kit for fixating soft tissue to bone as recited in claim 11 wherein said guide member further includes a ridge member protruding above said support plate and said stop includes a shoulder on said drill bit for abutting said ridge member.

13. A kit for fixating soft tissue to bone as recited in claim 12 wherein said suture engaging member includes a loop circumscribing an opening for receiving said suture therethrough.

14. A method of fixating soft tissue to bone comprising the steps of

positioning a drill guide upon a surface of a bone to which soft tissue is to be fixated;

penetrating the bone with a projection of the drill guide;

engaging the surface of the bone with an abutment of the drill guide to ensure penetration of the bone by the projection to a predetermined depth, less than the length of the projection, such that central longitudinal axes of guide passages, respectively, of the drill guide converge at a predetermined point within the bone;

introducing a drill bit through one of the guide passages and into the bone to form a first passage in the bone;

withdrawing the drill bit from the one guide passage;

introducing the drill bit through the other guide passage and into the bone to form a second passage in the bone converging with the first passage to define a continuous tunnel in the bone having access openings, respectively, on the surface of the bone and a bone bridge between the access openings;

withdrawing the drill bit from the other guide passage;

introducing a portion of a suture passer into the tunnel through one of the access openings such that a suture engaging member of the suture passer protrudes externally from the tunnel through the other access opening;

engaging a filamentous suture with the suture engaging member externally of the bone;

withdrawing the suture passer from the tunnel through the one access opening to draw the suture through the tunnel such that the suture extends entirely through the tunnel with opposing ends of the suture extending externally of the bone through the access openings, respectively;

passing one of the ends of the suture through soft tissue; and

tying the ends of the suture to fixate the soft tissue to the bone bridge.

15. A method of fixating soft tissue to bone as recited in claim 14 wherein said step of penetrating includes penetrating the bone with sharp tips of three projections, respectively, of the drill guide.

16. A method of fixating soft tissue to bone as recited in claim 15 wherein said step of engaging the surface of the bone includes engaging the surface of the bone with a pair of contact points of the abutment member.

17. A method of fixating soft tissue to bone as recited in claim 16 wherein said steps of introducing a drill bit include engaging the drill guide with a stop on the drill bit to prevent movement of the drill bit into the bone beyond a maximum predetermined depth such that the first and second passages converge at a predetermined point in the bone.

18. A method of fixating soft tissue to bone as recited in claim 17 wherein said step of engaging the drill guide includes engaging a ridge member of the drill guide with a shoulder of the drill bit.

19. A method of fixating soft tissue to bone as recited in claim 18 wherein said steps of introducing a drill bit include forming the first and second passages to converge at a predetermined point located a depth of 4 mm in the bone.

20. A method of fixating soft tissue to bone as recited in claim 19 wherein said step of tying includes tensioning the suture to elevate the soft tissue relative to the bone and fixating the soft tissue in the elevated position.