Method for soft tissue reconstruction

• US 6,802,862 B1
• Filed: 09/08/2000
• Issued: 10/12/2004
• Est. Priority Date: 01/24/1995
• Status: Expired due to Fees

• Current Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Original Assignee: Smith & Nephew Incorporated (Smith & Nephew PLC)
• Inventors: Roger, Gregory James, Pinczewski, Leo Arieh
• Primary Examiner(s): Willse, David H.
• Application Number:
  US09/657,379
• Time in Patent Office: 1,495 Days
• Field of Search: 623/13.14, 623/13-1-, 623/FOR.13, 606/73, 606/104
• US Class Current: 623/13.14
• 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

Abstract

A method for the reconstruction of the anterior cruciate ligament of a patient is described. The process comprises the steps of:

1) harvesting from the patient semitendonosus and gracilis tendons, or other suitable tendons of adequate length, to form a tendon graft;

2) forming a hole through the patient'"'"'s femur from the intercondylar notch therein anteriorly and laterally;

3) enlarging the cross-sectional area of that femoral hole adjacent the notch sufficiently to receive one end of the tendon graft and a suitable screw;

4) forming a suitably positioned hole through the patient'"'"'s tibia opening at one end adjacent the medial tibial spine and having a cross-sectional area sufficient to receive the other end of the tendon graft and a suitable screw;

5) drawing the one end of the tendon graft through the tibial hole and the joint into the femoral hole while leaving the other end of the tendon graft in the tibial hole;

6) inserting a suitable screw into the femoral hole from its intercondylar notch end until the head of the screw is just within that end of the hole and the screw is pressing the tendon graft directly and firmly against a sidewall of the femoral hole; and

7) after tensioning the tendon graft, inserting a suitable screw into the hole in the tibia externally until the head of the screw is within the exterior end of the tibial hole and the screw is pressing the tendon graft directly and firmly against a sidewall of the tibial hole.

Claims

1. A method for the attachment of a graft of a natural tendon or ligament to a bone of a patient, comprising the steps of:

a) forming a hole in said bone;

b) disposing at least a portion of the graft in said hole;

c) providing a fixation screw device having an exterior threaded surface configured to directly engage the natural tendon or ligament of the graft during insertion of said fixation screw device into said hole; and

d) threadably inserting said fixation screw device into said hole so that as said fixation screw device advances into said hole the exterior threaded surface of the fixation screw device engages the natural tendon or ligament of the graft and presses the natural tendon or ligament of the graft directly and firmly against a sidewall of said hole in said bone sufficiently to firmly secure said graft in said hole.

2. The method set forth in claim 1, wherein a second bone is adjacent to said bone, and further including the steps of:

a) forming a second hole in said second bone;

b) disposing a second portion of the graft in said second hole;

c) providing a second fixation screw device having an exterior threaded surface configured to directly engage the natural tendon or ligament of the graft during insertion of said second fixation screw device into said second hole; and

d) threadably inserting said second fixation screw device into said second hole so that as said second fixation screw device advances into said second hole the exterior threaded surface of the second fixation screw device engages the natural tendon or ligament of the graft and presses the natural tendon or ligament of the graft directly and firmly against a sidewall of said second hole in said second bone sufficiently to firmly secure said graft in said second hole.

3. The method set forth in claim 1 wherein said method is used for the reconstruction of an anterior cruciate ligament of a patient and said bone is a femur in the patient, and further comprising forming said hole from a suitable point in an intercondylar notch in said femur anteriorly and laterally.

4. The method set forth in claim 2 wherein said method is used for the reconstruction of an anterior cruciate ligament of a patient and said bone is a femur in the patient, and said second bone is a tibia in the patient;

and

further comprising forming said hole from a suitable point in an intercondylar notch in said femur anteriorly and laterally, and forming said second hole through the tibia and open at one end adjacent a medial spine of the tibia.

5. The method set forth in claim 1, in which the fixation screw device is cannulated.

6. The method set forth in claim 1, in which the fixation screw device has a screw thread which is devoid of an outermost cutting line.

7. The method set forth in claim 1, in which the fixation screw device has a hemispherical head at the trailing end thereof.

8. The method set forth in claim 1, in which the fixation screw device has a screw thread which is substantially nontapered.

9. The method set forth in claim 2, in which the second fixation screw device is cannulated.

10. The method set forth in claim 2, in which the second fixation screw device has a screw thread which is devoid of an outermost cutting line.

11. The method set forth in claim 2, in which the second fixation screw device has a hemispherical head at the trailing end thereof.

12. The method set forth in claim 2, in which the second fixation screw device has a screw thread which is substantially nontapered.

13. The method of claim 1 for the reconstruction of an anterior cruciate ligament of the patient, wherein forming the hole includes

forming the hole in a femur from a suitable point in an intercondylar notch in said femur anteriorly and laterally;

and

the natural tendon or ligament of the graft is pressed directly and firmly against the sidewall of said hole in said femur, the fixation screw device being cannulated and having a screw thread which is devoid of an outermost cutting line and is substantially nontapered, the fixation screw device having a hemispherical head at an end thereof.

14. The method set forth in claim 13 further including the steps of:

a) forming a hole in a tibia through the tibia and open at one end adjacent a medial spine of the tibia;

b) disposing a second portion of the graft in said tibia hole;

c) providing a second fixation screw device having an exterior threaded surface configured to directly engage the natural tendon or ligament of the graft during insertion of said second fixation screw device into said tibia hole; and

d) threadably inserting said second fixation screw device into said tibia hole so that as said second fixation screw device advances into said tibia hole the exterior threaded surface of the second fixation screw device engages the natural tendon or ligament of the graft and presses the natural tendon or ligament of the graft directly and firmly against a sidewall of said tibia hole sufficiently to firmly secure said graft in said tibia hole, the second fixation screw device being cannulated and having a screw thread which is devoid of an outermost cutting line and is substantially nontapered, the second fixation screw device having a hemispherical head at an end thereof.